CMS is seeking public input on Medicare’s requirement that physicians supervise CRNA’s, according to a Nov. 10 news release from the American Association of Nurse Anesthesiology.
The request for information is part of CMS’ proposed rule on Cutting Administrative Requirements for Excellence in Patient Care. The agency is asking whether to keep, revise or otherwise change the requirement.
The AANA said 29 states and territories have opted out of the federal rule. Several have done so this year. Vermont and Ohio both opted out in July, becoming the 26th and 27th states. Washington, D.C., became the 28th U.S. jurisdiction in September after Mayor Muriel Bowser approved the change.
AANA President Tracy Young, CRNA, said the Trump administration took an important step by waiving the requirement during the public health emergency and that the RFI builds on that effort.
“At a time when anesthesia workforce shortages are straining access, healthcare facilities need the flexibility to determine how best to use their anesthesia professionals based on patient needs and available resources,” Ms. Young said in a statement shared with Becker’s. “The evidence is unequivocally clear that CRNA practice is safe, and we look forward to sharing evidence and real-world experience as part of the public comment process.”
Physician anesthesiologists are pushing back. In a Nov. 9 news release, the American Society of Anesthesiologists urged CMS to keep the requirement. The ASA said studies of opt-out states show no meaningful improvement in access and that eliminating the rule would produce no direct Medicare savings.
The ASA has said opting out of the federal supervision requirement does not change anesthesia care unless state law is also amended to remove physician oversight requirements for nurse anesthetists. According to the association, states that use terms such as collaboration, coordination, delegation or direction still expect physician involvement, and very few states permit a nurse-only model of anesthesia care.
“‘Opt-out’ does not mean physician supervision has been removed and a nurse-only model of anesthesia care has been adopted,” ASA President Patrick Giam, MD, wrote in a piece shared with Becker’s.
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