Governor Removes Physician Supervision for South Dakota CRNAs

Gov. M. Michael Rounds has informed the Centers for Medicare & Medicaid Services (CMS) in Washington, D.C., that South Dakota is opting out of the federal physician supervision requirement for nurse anesthetists because it “is in the best interests of South Dakota’s citizens, rural communities and hospitals.” The opt-out, which was supported by the South Dakota Board of Nursing, is effective immediately.

“We are very pleased that Governor Rounds has decided to exercise the opt-out,” said Paul Beninga, CRNA, MS, president of the South Dakota Association of Nurse Anesthetists. “Certified registered nurse anesthetists (CRNAs) are an integral part of South Dakota’s healthcare delivery system. This decision will ensure that patients across the state continue to have access to high-quality anesthesia services for surgical, obstetrical and trauma stabilization procedures.”

South Dakota becomes the 13th state to take advantage of an anesthesia care rule published by CMS in the Federal Register [66 FR 56762-56769] on Nov. 13, 2001, following Iowa, Nebraska, Idaho, Minnesota, New Hampshire, New Mexico, Kansas, North Dakota, Washington, Alaska, Oregon, and Montana. The rule allows a governor to notify CMS in writing of the state’s desire to opt out of (be exempt from) the supervision requirement for CRNAs after the governor meets the following prerequisites: consults with the state’s boards of medicine and nursing, determines that opting out of the requirement is consistent with state law, and decides that it is in the best interests of the state’s citizens.

In the three years that states have been opting out of the supervision requirement, there have not been any reports of anesthesia patient deaths or injuries related to the removal of physician supervision of CRNAs.

In his letter to CMS, Gov. Rounds stated that, “I have consulted with the South Dakota Board of Medicine and Osteopathic Examiners, the South Dakota Board of Nursing, and other interested parties regarding this matter. Based upon their input, I have concluded that this exemption is consistent with South Dakota law and is in the best interests of South Dakota’s citizens, rural communities and hospitals.”

Source: American Association of Nurse Anesthetists