Healthcare News & Insights

Court ruling: CRNAs don’t need physician supervision

Chalk one up for certified registered nurse anesthetists (CRNAs). They won their legal battle in California over the state’s opt-out rule!

Now CRNAs are free to deliver anesthesia in California without the supervision of a physician.

Last year, the California Society of Anesthesiologists (CSA) and California Medical Association (CMA) filed a petition with the state court of appeals to overturn former Gov. Arnold Schwarzenegger’s 2009 decision to opt out from Medicare’s facility reimbursement rule that required nurse anesthetists to deliver anesthesia under physician supervision. The CSA said the opt-out rule violated state law.

CSA and CMA hold fast to the belief that CRNAs don’t have enough training to adequately deal with anesthesia-related complications. Nurse anesthetists, however, feel they’re highly capable of administering anesthesia without the supervision of a physician, because they learn about the same drugs, equipment and standards of care as physicians do.

The state Supreme Court ended the feud when it ruled not to review California’s 2009 opt-out of the federal supervision requirement, thereby, allowing CRNAs to work without physician supervision.

According to, the California Association of Nurse Anesthetists (CANA) stood behind the skills and expertise of its members by pointing to a 2010 study that used data collected from opt-out states and showed anesthesia care was just as safe, despite whether or not a physician was present to supervise a CRNA.

So far, 17 states have opted out of the federal supervision requirement for CRNAs and not one of them has placed limitations on the kinds of procedures CRNAs can deliver anesthesia for.

The reason these states have opted to allow CRNAs to work without physician supervision is they believe it’s a needed change in today’s day and age. It gives increased access to healthcare for people in rural areas who have to travel outside their local community to find a facility that has an anesthesiologist.

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