Ohio has become the 27th state to opt out of Medicare’s physician supervision requirement for certified registered nurse anesthetists.
Gov. Mike DeWine notified CMS of the decision in a letter dated July 10, according to a July 13 news release by the AmericanAssociation of Nurse Anesthesiology. The opt-out follows Ohio House Bill 52, which took effect June 8 and replaced the state’s CRNA “supervision” standard with a collaboration model involving a physician, dentist or podiatrist. Mr. DeWine cited the law and consultations with the Ohio Board of Nursing and the State Medical Board of Ohio as the basis for the opt-out.
“AANA applauds Gov. DeWine for prioritizing patient access and recognizing the important role CRNAs have in the delivery of safe anesthesia care in Ohio,” AANA President Jeff Molter, MBA, MSN, CRNA, said in the release.
Ohio State Association of Nurse Anesthetists President Kim Riviello, DNP, MBA, CRNA, called the move “a significant win for Ohio patients,” saying it will let facilities more fully deploy CRNAs to meet community needs.
CRNAs administer more than 58 million anesthetics annually in the U.S. and are often the sole anesthesia providers in rural hospitals, supporting obstetric, surgical, pain management and trauma stabilization services. Ohio joins Vermont, which opted out July 9, as the most recent states to drop the federal supervision requirement, reflecting a broader national trend toward expanded CRNA practice authority.
The American Society of Anesthesiologists 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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