AANA Condemns UnitedHealthcare's Unlawful, Discriminatory Anesthesia Reimbursement Changes

ROSEMONT, Ill., July 9, 2025 /PRNewswire/ -- The American Association of Nurse Anesthesiology (AANA) strongly condemns UnitedHealthcare's announced changes to their anesthesia calculations, including a 15% cut in reimbursement for claims submitted for services rendered by a Certified Registered Nurse Anesthetist (CRNA) independently.

"This is yet another attempt to discriminate against CRNAs by offering less compensation for their skills, expertise, and time," said AANA President Jan Setnor, MSN, CRNA, Col. (Ret), USAFR, NC. "All anesthesia providers are trained in and use the exact same techniques to administer anesthesia, yet no other providers face the same cut – UnitedHealthcare is blatantly targeting CRNAs, based on their licensure alone. This action is unlawful, unacceptable, and unconscionable, particularly as our nation continues to face a shortage of anesthesia providers."

The policy is targeted specifically at anesthesia services appended with the QZ modifier, meaning CRNAs working independently and legally working to the top of their license. This is in direct conflict with the federal provider non-discrimination provision of the Affordable Care Act (ACA). AANA filed a petition for a writ of mandamus in the United States District Court for the Northern District of Ohio asking the court to compel the Department of Health and Human Services (HHS) Secretary to enforce the provision against insurance companies and health plans. This is a duty that the secretary is legally obligated to perform, and which would prevent bad actors from taking advantage of CRNA knowledge, skill and labor. UnitedHealthcare's discriminatory policies are a direct result of the Secretary's inaction.

"At a time when the country is acutely aware of healthcare costs and accessibility, United is choosing to pursue a reimbursement policy that will devastate healthcare delivery by further impeding patient access, particularly in rural and underserved areas. Make no mistake, this change only serves UnitedHealthcare's profits by shifting costs to hospitals and ambulatory surgery centers under the guise of a discriminatory attack on CRNA provided care. Further, this policy directly conflicts with the federal provider nondiscrimination law for commercial health plans. United needs to put patients above profits," Setnor continued.

The provider nondiscrimination provision in the ACA was passed in 2010 to prohibit health plans/health insurance companies (commercial payors) from discriminating against providers based on licensure, including setting up different reimbursement policies for those providers delivering the same high-quality healthcare services. In 2020, the No Surprises Act required the HHS, the Department of Labor, and the Department of Treasury to issue rules and enforcement policies within one year. However, there is still no level of enforcement in place. Until this is completed, commercial payors like United can continue to jeopardize patients' access to care through discriminatory policies.

AANA calls on UnitedHealthcare to follow the course of its peers in the insurance industry and reverse course on this discriminatory policy immediately. We also call on HHS to enforce the provider nondiscrimination provision of the ACA to protect patients' access to care.

UnitedHealthcare's anesthesia reimbursement change is effective October 1, 2025 and will affect all providers except those in Arkansas, California, Colorado, Hawaii, Massachusetts, New Hampshire, and Wyoming.

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SOURCE American Association of Nurse Anesthesiology