HR6545119th CongressWALLET

Anesthesia for All Act

Sponsored By: Representative Torres (NY)

Introduced

Summary

Protecting medically necessary anesthesia from arbitrary time caps. This bill would bar group health plans, private insurers, and Medicaid from using preset duration limits to deny or cut reimbursement for anesthesia. Payment must be based on medical necessity as determined by the attending anesthesiologist, certified registered nurse anesthetist, or other licensed anesthesia provider.

Show full summary
  • Patients and families: Prevents payment denials or reduced coverage when anesthesia lasts longer than a preset time, supporting access and safety during medically necessary procedures.
  • Anesthesia providers: Gives attending anesthesiologists, CRNAs, and other anesthesia clinicians the authority to determine medical necessity for reimbursement decisions.
  • Medicaid enrollees: Amends Section 1902(a) of the Social Security Act to apply the same prohibition on arbitrary time caps to Medicaid, including services delivered through Medicaid managed care organizations.
  • Oversight and enforcement: Directs the Department of Health and Human Services Office of Inspector General to monitor insurers, perform audits, investigate complaints, and report to Congress within 1 year and then every 3 years with findings and recommendations.

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

Insured patients protected from anesthesia time caps

If enacted, health plans could not deny or limit payment for anesthesia just because it ran past a preset time cap. Payment decisions would be based on medical necessity as judged by your anesthesiologist, nurse anesthetist, or other licensed anesthesia provider. This would apply to group and individual coverage and would start upon enactment.

No Medicaid time caps on anesthesia

If enacted, state Medicaid programs, including managed care plans, could not deny or cap payment for anesthesia just because it lasted beyond a preset time. Medical necessity would be decided by the attending anesthesiologist, nurse anesthetist, or other anesthesia provider. This would start upon enactment.

HHS watchdog would audit insurers

If enacted, the HHS Office of Inspector General would audit insurers and investigate complaints about noncompliance with these anesthesia protections. The office would report to Congress within one year of enactment and then every three years. Reports would include audit findings, violations sent to HHS, and recommendations to improve compliance.

Sponsors & CoSponsors

Sponsor

Torres (NY)

NY • D

Cosponsors

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 12/18/2025

Roll Call Votes

No roll call votes available for this bill.

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