Anthem's Cataract Anesthesia Guidance

Posted 4/30/18 (Mon)

Thanks for your partnership on our challenges with Anthem. For those of you who did not attend the State Society Executive Directors’ Forum during Mid-Year Forum 2018, I wanted to let you know that we have sent another letter to Anthem. This new letter is in response to their notification to us that they put language on their website clarifying that the cataract anesthesia guidance is not in effect.

We continue to insist that the language be removed as it is confusing and threatens access should there be any misunderstanding. Anthem continues to complain to us about the bad press they have received despite the fact that the policy is not in effect. Again, if you become aware of any denials, please immediately alert Cherie McNett, the Academy’s Health Policy Director (

Although we were successful in getting Anthem to drop their wrong headed payment changes related to modifier 25, some other plans have initiated similar policies. Please alert us as you see this occur.

I am also sharing our October 2017 letter on this issue again, which may be helpful.

Best wishes,

Cathy Grealy Cohen, MHSA, CAE
Vice President, Governmental Affairs