Mississippi anesthesiologist says safety, not speed is important in delivering anesthesia services

• Dr. Tyler Stout is asking legislators to consider preventing insurance companies from setting time limits on anesthesiologists when providing services to patients.

A Jackson anesthesiologist is urging lawmakers to be proactive in addressing a recent medical trend that could harm surgical patients, not just in Mississippi, but nationwide.

During a recent hearing of the state Senate Insurance Study Committee, Dr. Tyler Stout said Anthem Blue Cross Blue Shield advanced a policy proposal last year that set a time limit on anesthesiologists, known as counting down the clock. The insurer was to use Physician Work Time values to “target the number of minutes reported for anesthesia services.”

The outcry from providers and policyholders was loud, and the insurer backed away from the policy proposal.

“To be clear, it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services,” the company said in December 2024. “The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.”

However, similar proposals are again being considered within the industry.

If the surgery went beyond the time Anthem Blue Cross Blue Shield estimated, the anesthesiologists would not have been paid, Dr. Stout said. He told lawmakers that traditionally, anesthesiologists are paid a set time, then an additional fee for every 15 minutes.

“Safety, not speed, should determine how long a person is in the operating room,” he told the Senate committee.

Dr. Stout said each patient is different, and operating time is determined by their health, past operations, and other factors.

“This is not an issue where we are trying to push back on the insurance companies for doing something wrong,” he said. “It’s more of an issue that we are trying to right for the patients.”

There has been some talk that Medicare uses the same practices that the insurance companies want to institute but Dr. Stout said that is not true. Medicaid does use time data for analysis purposes, but not to limit coverage.

The impact, he said, would be wide-ranging, from teaching and community hospitals to “really sick” patients.

The doctor said several states are in the midst of writing legislation to address the issue, including Maryland, Illinois, Connecticut, Oklahoma, and New York. He suggested that the Legislature study the bills being written in those states as guidelines for bills in the Magnolia State.

Additionally, when legislation is proposed, Dr. Stout asked legislators to consider preventing insurance companies from setting limits on anesthesiologists providing services to patients. He also encouraged the Senators to standardize how anesthesia care is defined in the state’s insurance code.

Finally, Stout voiced that he would like to see lawmakers maintain strict fraud guidelines while keeping medical decisions in the hands of doctors and patients.