CMS could permanently waive CRNA supervision rules — 4 insights

As CMS considers allowing certified registered nurse anesthetists to continue practicing without physician supervision after the pandemic ends — an idea that CRNAs have long supported — anesthesiologists are voicing their opposition, Medscape reported Dec. 8.

What you should know:

1. A request for information was posted to the Federal Register on Nov. 25, seeking comments on whether CMS' temporary waiver of supervision requirements for CRNAs should be made permanent once the public health emergency ends. The temporary waiver was adopted in March as hospitals braced for potential anesthesiologist shortages due to COVID-19 surges.

2. The American Society of Anesthesiologists is strongly opposed to making the waiver permanent. Saying the waiver threatens care quality and increases risk for vulnerable patients, ASA has urged the public to post comments asking CMS to rescind the policy. ASA's position centers on the argument that physician anesthesiologists — who complete up to 14 years of education — are best equipped to handle any complications that arise. A survey conducted by the industry group found that 9 in 10 surgeons prefer that physician anesthesiologists be involved in patient care, rather than nurses alone.

3. The American Association of Nurse Anesthetists is strongly in favor of making the waiver permanent. The industry group's CEO Randal Moore, DNP, CRNA, told Medscape there isn't evidence that anesthesiologists have better outcomes than nurse anesthetists practicing without physician supervision. Dr. Moore also noted that nurse anesthetists provide care without an anesthesiologist's presence in "the vast majority" of rural, underserved areas, and that 18 states have opted out of physician supervision requirements for CRNAs.

4. Comments on waiving physician supervision requirements must be submitted to the Federal Register by the end of December. Comments can be submitted here.

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