Masschusetts Nurse | April 2000

HCFA announces removal of supervision requirement for nurse anesthetists

After deliberating for more than two years, the Health Care Financing Administration (HCFA) has announced that it will remove the federal requirement that nurse anesthetists must be supervised by physicians when administering anesthesia to Medicare patients. The final rule is expected to be published in the Federal Register in June.

Until now, in anesthesia cases involving Medicare patients, the federal rule required physician supervision of nurse anesthetists in order for hospitals and ambulatory surgical centers to be reimbursed for the non-anesthesia portion of a patient's care. However, for the nurse anesthetists themselves to be reimbursed, Medicare did not require supervision.

HCFA first proposed changing this rule in December 1997, with the federal agency electing to defer to the states on the supervision issue. Presently, the nursing statutes and board of nursing rules in 29 states do not require physician supervision of nurse anesthetists. 

The rule change is good news for the American public because it ensures access to safe, high-quality anesthesia care, especially in rural areas and inner city hospitals where Certified Registered Nurse Anesthetists (CRNAs) are often the sole anesthesia providers. 
 

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