Colorado Appellate Court Upholds Opt Out from Federal Anesthesia Rule

For Immediate Release:
July 19, 2012​
Contact: Scott Shaffer
Phone: (719)207-0912

New state policy upheld despite opposition from physicians groups to block governor’s actions

Park Ridge, Ill.— Today the Colorado Court of Appeals has upheld the previous ruling in favor of the Colorado governor and the Colorado Association of Nurse Anesthetists (CoANA). The Colorado Court of Appeals has affirmed that Colorado state law does not require Certified Registered Nurse Anesthetists (CRNAs) to be supervised by a physician. The court also ruled that former Gov. Bill Ritter acted within his rights by opting out of the federal physician supervision requirement for these advanced practice registered nurses in September 2010.
“We are pleased that the Appellate Court has upheld the lower court’s decision to continue to allow CRNAs to administer anesthesia without the supervision of a physician, which has always been the scope of practice the Colorado nurse anesthetists,” said Scott Shaffer, CRNA, president of CoANA.
On March 31, 2011, a district court granted summary judgment in favor of former Gov. Ritter and CoANA, the Colorado Nurses Association and the Colorado Hospital Association affirming Colorado’s opt-out of the federal supervision requirement. The district court judge stated that in the state of Colorado that the administration of anesthesia by CRNAs is an independent nursing function and does not require physician supervision, an important requirement for seeking an opt out from the Centers for Medicare & Medicaid Services (CMS).
Nurse anesthetists provide anesthesia services to 99 percent of the communities with surgical services throughout the state. This ruling is particularly important for rural communities, as CRNAs are the sole provider of anesthesia services in over 70 percent of hospitals. The court’s ruling dismisses the lawsuit filed in September 2010 by the Colorado Society of Anesthesiologists (CSA) and the Colorado Medical Society (CMS).
Certified Registered Nurse Anesthetists (CRNAs) are advanced practice registered nurses who personally administer approximately 32 million anesthetics to patients across the United States each year. Two recent national anesthesia studies confirmed the safety and cost-effectiveness of CRNAs, who practice in every type of setting in which anesthesia is delivered and are the sole anesthesia providers in most rural hospitals.
The federal supervision rule, however, is not a regulatory measure designed to ensure patient safety; in reality it is a requirement that hospitals must meet in order to receive Medicare reimbursement for anesthesia services, unless a state chooses to opt out of the rule as Colorado has done.
Colorado is the 16th of the 17 states to opt out of the federal rule, following Iowa, Nebraska, Idaho, Minnesota, New Hampshire, New Mexico, Kansas, North Dakota, Washington, Alaska, Oregon, Montana, South Dakota, Wisconsin, California, and Kentucky.
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