Nurse anesthesiologists challenge UnitedHealthcare’s 15% pay cut

 The American Association of Nurse Anesthesiology is contesting a new reimbursement policy from UnitedHealthcare that will cut payments by 15% for some certified registered nurse anesthetists.

Effective Oct. 1, the payer will reduce reimbursements by 15% for services provided by a CRNA without a physician’s medical direction, according to a policy update published July 1. The seven states excluded from this reduction are Arkansas, California, Colorado, Hawaii, Massachusetts, New Hampshire and Wyoming. 

In a July 2 statement, the AANA criticized the upcoming policy change, saying the 15% cut violates the ACA’s federal provider non-discrimination provision. The organization said it has asked a federal court to compel HHS Secretary Robert F. Kennedy Jr. to enforce the ACA provision. 

A spokesperson for UnitedHealthcare said the policy change aligns with how other insurers reimburse advanced practice providers. Several other insurers have cut or attempted to reduce CRNA reimbursements by 15%. 

“Healthcare affordability is one of the most pressing challenges Americans are facing today. We are committed to being a responsible steward of our customers’ and members’ healthcare dollars,” the spokesperson said. “We are updating our reimbursement approach for CRNAs to better align with their licensure. These changes are designed to help ensure claims are paid accurately and fairly, helping to control rising healthcare costs without affecting the quality of anesthesia services our members receive. In many cases, members may even see a reduction in their out-of-pocket expenses.”

https://www.beckershospitalreview.com/legal-regulatory-issues/aana-challenges-unitedhealthcares-15-pay-cut/