Medicare Agency Rules in Favor of Patient Access to CRNA Care

​The Medicare agency issued its final ruling on Medicare coverage of chronic pain management services by CRNAs on Nov. 1, and it’s a victory for our patients and our profession.
 
The AANA applauds the Centers for Medicare & Medicaid Services and the Administration for ruling to preserve patient access to chronic pain management services administered by CRNAs – in fact, access to all services within the full scope of CRNA practice. The official language from the ruling can be found here.
 
Going into effect on January 1, 2013, the highlights of the agency ruling include:
 
  • Expanding Medicare coverage of services within CRNA scope of practice by stating that “Anesthesia and related care means those services that a certified registered nurse anesthetist is legally authorized to perform in that state in which the services are furnished”;
  • Agreeing with the AANA and those who submitted comments through the Protect My Pain Care Campaign, whose overarching message was that  the primary responsibility for establishing the scope of services CRNAs are trained for and authorized to furnish resides with the states; and
  • Defining the Medicare benefit category for CRNAs as including any services CRNAs are permitted to furnish under their state scope of practice. 
 
What does this mean?  It means that under Medicare, Americans suffering from chronic pain will continue to receive the pain care they need from CRNAs they know and trust.
 
This ruling is an important development both for patients and for the nation’s 45,000 nurse anesthetists who deliver more than 33 million anesthetics every year and have gone through nationally accredited educational programs at the masters’ or doctoral level. It is consistent with the Institute of Medicine’s recommendation that Medicare cover services provided by advanced practice nurses to the full extent of their state scope of practice. It is especially meaningful for patients in rural and other medically underserved communities. Without local access to pain treatment from CRNAs, many seniors would have to travel long distances to receive care, move into a nursing home, or forego treatment altogether. This federal ruling also respects state scope of practice rules and regulations.
 
This hard fought victory would not be possible without the hard work put forth by thousands of AANA members and allies of our Protect My Pain Care campaign, including patients, CRNAs, nurses, physicians and other healthcare providers, hospital administrators, and legislators. You have all worked tirelessly behind the scenes to ensure that access to quality care continues.
 
Important as this is, our work is not yet done.  We will have to work to protect this rule from attack on Capitol Hill during the post-election “lame duck” session of Congress, and we will have to continue working in the states to protect our practice and patient access to our services, as we have always had to do.
 
The AANA and our Protect My Pain Care campaign will keep you updated on developments leading up to the January 1 implementation date, and we look forward to helping ensure that the CMS ruling is applied so that all Americans can continue to receive the top-quality, necessary pain management care they need and deserve.