,i  #aahth ,,congress  #b;d ,session    
,h4 ,r4 #ajcca  ,,in ,,the ,,house ,,of 
,,representatives  ,december #i1        
#bjbd,mr4 ,torres of ,new ,york         
introduced the following bill2 which was
 referred to the ,committee on ,energy  
and ,commerce  ,a ,,bill  ,to prohibit  
health insurers1 including ,medicaid    
managed care organizations and other    
private health plans1 from imposing     
arbitrary time caps on reimbursement for
 anesthesia services and for other      
purposes4  #a4 ,short title ,this ,act  
may be cited as the ,anesthesia for ,all
 ,act4  #b4 ,findings ,congress finds   
the following3 7#a7 ,anesthesia care is 
essential and must be determined by     
medical necessity1 not arbitrary limits4
  7#b7 ,time caps on reimbursement      
jeopardize patient safety1 impose       
financial burdens1 and interfere with   
informed medical decisions4  7#c7       
,prohibiting such practices protects    
patients1 promotes fairness1 and ensures
 equitable access to essential          

healthcare services4  #c4 ,prohibition  
on arbitrary time caps for anesthesia   
services  7a7 ,in general ,part ,a of   
title ,,xxvii of the ,public ,health    
,service ,act 7#db ,u4,s4,c4 #cjj;gg et 
seq47 is amended by adding at the end   
the following new section3  #bgcj4      
,prohibition on arbitrary time caps for 
anesthesia services  7a7 ,prohibition on
 time limits ,a group health plan1 and a
 health insurance issuer offering group 
or individual health insurance coverage1
 may not impose arbitrary time caps on  
reimbursement for anesthesia services   
provided during medically necessary     
procedures4  7b7 ,requirement for       
reimbursement based on medical necessity
 ,reimbursement for anesthesia services 
shall be determined based on medical    
necessity as assessed by the attending  
anesthesiologist or licensed anesthesia 
provider4  7c7 ,denial of payment ,a    
group health plan1 and a health         
insurance issuer offering group or      
individual health insurance coverage1   

are prohibited from denying payment for 
anesthesia services solely because the  
duration of care exceeded a pre-set time
 limit4  4  7b7 ,medicaid ,section      
#aijb7;a7 of the ,social ,security ,act 
7#db ,u4,s4,c4 #acif;a7a77 is amended-- 
7#a7 in paragraph 7#hf71 by striking and
 at the end2  7#b7 in paragraph 7#hg71  
by striking the period and inserting 2  
and2 and  7#c7 by inserting after       
paragraph 7#hg7 the following new       
paragraph3  7#hh7 provide that medical  
assistance consisting of anesthesia1    
including such assistance furnished     
through a managed care organization1 is 
not subject to arbitrary time caps on   
reimbursement when furnished during     
medically necessary procedures 7as      
determined by the attending             
anesthesiologist or other provider of   
such anesthesia7 and that payment is not
 denied for such assistance solely      
because the duration of such assistance 
exceeded a pre-set time limit4  4  #d4  
,oversight by inspector general  7a7    

,monitoring and audits ,the ,office of  
the ,inspector ,general of the          
,department of ,health and ,human       
,services shall-- 7#a7 conduct periodic 
audits of health insurers to assess     
compliance with the provisions of this  
,act2 and  7#b7 investigate allegations 
of noncompliance submitted by patients1 
providers1 or other stakeholders4  7b7  
,reporting to congress ,not later than  
one year after the date of enactment of 
this ,act1 and every #c years           
thereafter1 the ,inspector ,general     
described in subsection 7a7 shall submit
 a report to ,congress that includes--  
7#a7 the findings of audits conducted   
under subsection 7a72  7#b7 the number  
and nature of violations referred to the
 ,secretary of ,health and ,human       
,services2 and  7#c7 recommendations1 if
 any1 for improving compliance with the 
provisions of this ,act4