UPDATE on CSA and CMA v. Arnold Schwarzenegger
San Francisco Superior Court, October 8, 2010-The motion filed by CSA/CMA to require California Governor Arnold Schwarzenegger withdraw his June 10, 2009 letter to the Centers for Medicare and Medicaid Services that exercised the option to exempt the State of California from the requirement that certified registered nurse anesthetists (CRNAs) be supervised by a physician has been denied.

The ruling was based on the presiding judge's conclusion that given the absence of a State statute that specifically stipulates physician supervision of nurse anesthetists who administer anesthesia, federal regulations allow the Governor discretion to conclude that opting out of the Medicare supervision requirement is consistent with State law.

The judge furthermore concluded that with respect to the physician supervision issue, current California State law does not refer to supervision and judicially interjecting a supervision requirement into the law would create ambiguity. The judge went on to state that the Legislature has the ability to impose a supervision requirement into State law should it wish. CSA notes that the Legislative Counsel, Attorney General Opinions, and prior court opinions came to a different conclusion.

In light of this ruling, the CSA and CMA are reviewing options for further action, including appealing the ruling.