H.R. 6545 — Anesthesia for All Act

This section states congressional findings that (1) anesthesia care is essential and must be determined by medical necessity, not arbitrary limits; (2) time caps on reimbursement jeopardize patient safety, impose financial burdens, and interfere with informed medical decisions; and (3) prohibiting such practices protects patients, promotes fairness, and ensures equitable access to essential healthcare services.

This section adds a new section 2730 to the Public Health Service Act prohibiting group health plans and health insurance issuers offering group or individual coverage from imposing arbitrary time caps on reimbursement for anesthesia services provided during medically necessary procedures or denying payment solely because the duration exceeded a pre-set time limit. The section also amends Medicaid state plan requirements (42 U.S.C. 1396a(a)) by adding paragraph (88) to similarly prohibit arbitrary time caps and payment denials for anesthesia services, including those furnished through managed care organizations, with medical necessity determined by the attending anesthesiologist, certified registered nurse anesthetist, or other provider.

This section directs the Office of the Inspector General of the Department of Health and Human Services (HHS OIG) to (1) conduct periodic audits of health insurers to assess compliance with this Act and (2) investigate allegations of noncompliance submitted by patients, providers, or other stakeholders. The HHS OIG must submit a report to Congress not later than one year after enactment and every three years thereafter that includes audit findings, the number and nature of violations referred to the HHS Secretary, and recommendations for improving compliance.