Affordable Care Act Implementation – No Charge for Anesthesia…

On May 11, CMS released FAQ’s about the Affordable Care Act Implementation.  Several items were addressed in the FAQ’s including anesthesia provided during a screening colonoscopy.  According to the FAQ’s, the plan or issuer may not impose cost sharing with respect to anesthesia services performed in connection with the preventive colonoscopy if the attending provider determines that anesthesia would be medically appropriate for the individual.  CMS did not provide guidance as to whether patient’s could appeal to their insurer for repayment of the cost sharing that they have made to their providers but now are outside the appeal timeframe allowed by their plan.   CMS also did not provide guidance to providers whose patients’ have outstanding balances related to the cost sharing as to how far back they can request payment from the insurer.

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