Across the country, states are rewriting the rules for certified registered nurse anesthetists, shifting away from physician supervision requirements and toward greater CRNA autonomy.
Here are the five most recent states to update their laws.
Ohio
In March, Ohio became the 45th state to modernize its CRNA laws, replacing a physician supervision requirement with a collaborative practice framework.
West Virginia
In April 2025, West Virginia passed a law allowing CRNAs to administer anesthesia in cooperation with — rather than under the supervision of — a physician. Under the new practice agreement, “cooperation” is defined as a CRNA and a physician, dentist, or podiatrist working together as a team, each contributing their respective expertise.
Kansas
In April 2025, Kansas passed legislation allowing CRNAs to prescribe, procure, and administer drugs consistent with their education and qualifications. Previously, CRNAs could perform those functions only upon the order of a physician or dentist.
Massachusetts
In June 2024, Massachusetts passed a law to opt out of federal regulations requiring physician supervision of CRNAs.
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