On Monday, Colorado joined 15 other states in opting out of a Medicare rule that requires certified registered-nurse anesthetists to be supervised by a physician. Groups representing anesthesiologists and doctors have sued to block the policy change. "I have concluded it is in the interests of those relying on critical-access hospitals and the rural residents of Colorado to opt out of this requirement," Colorado Go. Bill Ritter said in a letter to Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, Tom McGhee of The Denver Post reports.
The new policy would allow advanced-practice nurses to administer anesthesia without a physician's supervision in rural hospitals. Urban hospitals would not be affected. "Supporters of the change say few rural hospitals have anesthesiologists on staff and they struggle to find other types of physicians willing to assume the liability of anesthesia," McGhee writes. Lou Ann Wilroy, chief executive of the state Rural Health Center, told McGhee, "This has been a regulatory burden on rural hospitals for years."
"We are incredibly disappointed in the governor's action and feel it is an unnecessary lowering of the standard of care in the hospitals he has now exempted," Dr. Randall Clark, head of anesthesiology at Children's Hospital in Aurora and a spokesman for the Colorado Society of Anesthesiologists, told McGhee. Colorado law makes the physician performing a procedure liable for the actions of anyone in the operating room, so CSA argues the policy change could add confusion about the physician's responsibility. Ritter spokesman Evan Dreyer told McGhee the Colorado Medical Board and Board of Nursing concluded that the move is consistent with state law, and, "The top priority will always be patient safety." (Read more)
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