Governor Ritter needs to hear from you about opting-out of the certified registered nurse anesthetist (CRNA) Medicare supervision requirement. As you know, CRHC has long supported the opt-out of the Medicare requirement for CRNAs to be directly supervised by the attending physician, dentist or podiatrist, which adds another barrier for rural residents in accessing quality healthcare services. A recent study published in Health Affaris showed that there was no diminished quality of care or threat to patient safety in the 14 states (2005) that had opted-out of the supervision requirement. In fact, the study recommends that CRNA’s in every state be allowed to work without the supervision requirement. As of July 2009, 15 states had chosen to opt-out of the supervision requirement.

Recently, both the state Board of Nursing and the Colorado Medical Board voted on and supported the CRNA opt-out. Both respective entities stated that opting-out is consistent with the Nurse Practice Act and the Medical Practice Act. It is now up to Governor Ritter to submit a letter to the Center for Medicare & Medicaid Services (CMS) requesting Colorado be exempted from the supervision requirement.

If you have minute, please call the Governor at (303) 866-2471 and urge him to opt-out of the CRNA supervision requirement.

There are 42 rural hospitals in Colorado. Of those 4 do not provide anesthesia services at all. Of the remaining 38 that provide anesthesia services:
• 5 provide anesthesia services using physician anesthesiologists ONLY
• 9 provide anesthesia services using a combination of part time anesthesiologists and part time CRNAs
• 24 provide anesthesia services using CRNA’s ONLY and do not have anesthesiologists on staff.

Opting-out of CRNA supervision will not harm patient safety. It will not diminish the need for physicians and anesthesiologists in the healthcare arena. It WILL help increase access to care for the 700,000 plus residents of our state that call rural Colorado home. Tell Governor Ritter to increase healthcare access for rural residents by opting-out of the CRNA supervision requirement!