No doc supervision for nurse anesthetists

The "turf war" between nurses and physicians is heating up, with a California court allowing certified registered nurse anesthetists (CRNA) to work without physician supervision, according to Outpatient Surgery.net.

That's because the state Supreme Court ruled not to review California's 2009 opt-out of the federal supervision requirement.

"The courts' affirmation of the opt-out is worthy of celebration because it allows healthcare facilities to participate in Medicare and Medi-Cal without the unnecessary restriction of CRNA supervision," California Association of Nurse Anesthetists (CANA) President Joseph Janakes said Friday in a statement. "This facilitates access to safe, cost-effective anesthesia care for all Californians, especially in rural and other medically underserved communities," he added.

However, the California Society of Anesthesiologists and California Medical Association have long voiced their opposition to letting nurse anesthetists practice without physician supervision, claiming nurses don't have the necessary training to handle anesthesia-related complications, noted Outpatient Surgery.net. Last year, both physician groups appealed the opt-out, in which they said the move violated state law.

California's decision reaffirms its spot as the 16th state to opt out of the federal supervision requirement for CRNAs. In April, Kentucky became the 17th state to embrace the opt-out, aiming to improve access to critical services and operating room efficiency without compromising care quality, according to a statement from Gov. Steve Beshear's office.

In another heated debate over nonphysician providers, the Centers for Medicare & Medicaid Services last month released the final rule to the Conditions of Participation that gave nonphysician practitioners, such as advanced practice nurses, physician assistants and pharmacists, more authority to perform duties that they are trained for and allowed to do within their scope of practice and state law. CMS noted that if hospitals so choose, nonphysician practitioners could free up physicians to work on more medically complex patients, FierceHealthcare previously reported.

To learn more:
- read the Outpatient Surgery.net article
- here's the ruling
- read the CANA statement
- check out Gov. Beshear's statement

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