Temporary nationwide suspension of CRNA physician supervision requirement effective immediately

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Status
Not open for further replies.
2.0%

2.0%

Full Member
5+ Year Member
Joined
Mar 3, 2019
Messages
39
Reaction score
31
"The Centers for Medicare and Medicaid Services is temporarily removing regulatory requirements to give hospitals a greater ability to treat an influx of patients with COVID-19 while also treating those needing other care. The changes apply immediately for the duration of the emergency declaration.
...
CMS is waiving the requirements that a certified registered nurse anesthetist is under the supervision of a physician. This will allow CRNAs to function to the fullest extent allowed by the state, and free up physicians from the supervisory requirement"

www.healthcarefinancenews.com

Hospitals can bill for treatment outside their four walls in new regulatory flexibility

CMS is also allowing ERs to use drive-through testing and telehealth, and for tests to be done at home for stay-at-home residents.
www.healthcarefinancenews.com www.healthcarefinancenews.com
Members don't see this ad.
 
Does that make sense!?! I see you guys are getting laid off or down to reduced hours and now crnas are getting incr hours? What? Are these guys going to swan into icu and save dying patients with their icu knowledge of ards, vent, fluid balance, pocus etc?

Hiw do crnas know and can do that if ye guys aren't doing it?

I'm guessing they want them as mobile tube squads for Emerg and some kind of PA in ICU that can't do much but easier to redeploy and cheaper than you
 
Members don't see this ad :)
I'm thinking this is due to the critical shortage of ICU personnel, considering CRNA's are former critical care nurses. Otherwise, it doesn't make sense. I mean, there's hardly any OR volume at all.
 
Ezekiel2517 said:
I'm thinking this is due to the critical shortage of ICU personnel, considering CRNA's are former critical care nurses. Otherwise, it doesn't make sense. I mean, there's hardly any OR volume at all.
Click to expand...

Along those lines I'm guessing it's so that they can intubate or do other ICU midlevel stuff without needing a physician to supervise or cosign their notes.

However, even given this emergency I think it sets a terrible precedent, and they shouldn't have done it unless anesthesia departments in the hot zones under the current supervisory model aren't meeting the needs of the ICU (which I cant imagine is the case given the low OR volume)
 
Last edited:
Physician Services. CMS is waiving requirements under 42 CFR §482.12(c)(1)–(2) and
§482.12(c)(4), which requires that Medicare patients be under the care of a physician.
This waiver may be implemented so long as it is not inconsistent with a state’s emergency
preparedness or pandemic plan. This allows hospitals to use other practitioners to the
fullest extent possible.


• Anesthesia Services. CMS is waiving requirements under 42 CFR §482.52(a)(5), §485.639(c)
(2), and §416.42 (b)(2) that a certified registered nurse anesthetist (CRNA) is under the
supervision of a physician in paragraphs §482.52(a)(5) and §485.639(c)(2). CRNA supervision
will be at the discretion of the hospital and state law. This waiver applies to hospitals,
CAHs, and Ambulatory Surgical Centers (ASCs). These waivers will allow CRNAs to function
to the fullest extent of their licensure, and may be implemented so long as they are not
inconsistent with a state’s emergency preparedness or pandemic plan.

This country is soooooo stupid beyond comprehension. Midlevels going to use this to finally get independence.
 
  • Like
Reactions: 1 users
I file this under the administration relaxing/suspending almost every rule they can find.

But it still does not remove state laws that are applicable or (what is usually more relevant) hospital policies/bylaws that require physician supervision.
 
  • Like
Reactions: 1 users
Word to the wise....new and graduating residents - you're phucked.
 
  • Like
  • Hmm
  • Wow
Reactions: 7 users
Startingover123 said:
Just a temporary change. Things will go back to normal once all this calms down?
Click to expand...

LOL CRNAs are not going to let this one go, this is what they've been fighting for all along and now handed to them on a golden platter. Death of medicine, death of Anesthesia. Same way like EPA's regulatory capacity is now "temporarily" suspended with no timeline, ain't coming back if big corporate can help it.
 
  • Like
Reactions: 2 users
I wouldn’t worry about this in the immediate period. There is minimal cases going on right now we have plenty of physicians to cover them and no reason to let anesthetists step out of their lane. If we were at war and our hospitals were packed with injured soldiers maybe it would be different. Even when it gets horrendous, the same will be true. I expect anesthetists will get drafted into ICU nursing or something similar to ICU NPs if places are desperate enough. I don’t see anywhere allowing them to be a makeshift “intensivist”

The KEY to all of this will be to ensure this is reversed going forward. I think it will be along with everything else - you can’t have hospitals going rampant and operating without much oversight during good times. It’ll create ridiculous monopolistic markets if they aren’t there already.

This is truly a red herring. Focus on the problem at hand. Or say the sky is falling, but I’ll note it’s the same ol’ crew saying the same crap.
 
Members don't see this ad :)
Since a picture is worth a thousand words, here you go....
head_up_your_ass2.jpg
 
  • Like
Reactions: 1 users
Consigliere said:
Word to the wise....new and graduating residents - you're phucked.
Click to expand...

AMC CEO- “Should we lay off the $400k a year Anesthesiologist or the $200k a year Anesthetist??? Oooh, I know!!!.....”
 
  • Like
Reactions: 1 users
AdmiralChz said:
I wouldn’t worry about this in the immediate period. There is minimal cases going on right now we have plenty of physicians to cover them and no reason to let anesthetists step out of their lane. If we were at war and our hospitals were packed with injured soldiers maybe it would be different. Even when it gets horrendous, the same will be true. I expect anesthetists will get drafted into ICU nursing or something similar to ICU NPs if places are desperate enough. I don’t see anywhere allowing them to be a makeshift “intensivist”

The KEY to all of this will be to ensure this is reversed going forward. I think it will be along with everything else - you can’t have hospitals going rampant and operating without much oversight during good times. It’ll create ridiculous monopolistic markets if they aren’t there already.

This is truly a red herring. Focus on the problem at hand. Or say the sky is falling, but I’ll note it’s the same ol’ crew saying the same crap.
Click to expand...

Eyes Wide Shut!!


Sent from my iPhone using Tapatalk
 
OneFellSwoop said:
That honestly makes the most sense, they’re highly experienced in intubation and do fine with the straightforward surgeries these patients are going to need (appys, etc) while you are a highly trained physician with skills that transcend the OR. This minimizes your exposure to the higher risk procedures and potential transmission and maximizes physician level care to those that need it. I’d rather see a CRNA knocked out of commission due to transmission than an anesthesiologist.


Sent from my iPhone using SDN
Click to expand...


You sound like him.



Sent from my iPhone using SDN mobile
 
dr doze said:

You sound like him.



Sent from my iPhone using SDN mobile
Click to expand...

Ha, death isn’t what I meant, I mean ‘out of commission’ as in can’t work for a period of time. Of course I don’t want anyone to get sick, particularly my coworkers. I was looking at it as a systems approach to a limited resource problem in a threat-level-midnight scenario that is being rapidly approached in many areas.


Sent from my iPhone using SDN
 
  • Like
Reactions: 1 users
OneFellSwoop said:
That honestly makes the most sense, they’re highly experienced in intubation and do fine with the straightforward surgeries these patients are going to need (appys, etc) while you are a highly trained physician with skills that transcend the OR. This minimizes your exposure to the higher risk procedures and potential transmission and maximizes physician level care to those that need it. I’d rather see a CRNA knocked out of commission due to transmission than an anesthesiologist.


Sent from my iPhone using SDN
Click to expand...
Let’s be honest. As we are learning In my practice very quickly, most anesthesiologists (myself included)are nowhere near ICU docs in terms of skill and knowledge. I’m not seeing anybody swoop in and save the day with our “highly trained physician skill”. Just vent management, lines, and drips.
 
  • Like
Reactions: 1 user
dannyboy1 said:
Let’s be honest. As we are learning In my practice very quickly, most anesthesiologists (myself included)are nowhere near ICU docs in terms of skill and knowledge. I’m not seeing anybody swoop in and save the day with our “highly trained physician skill”. Just vent management, lines, and drips.
Click to expand...
Let's be honest. There is no "swoop in and save the day" with this disease.
 
  • Like
Reactions: 3 users
I would love to go back and do a critical care fellowship but my income is my prison. The future of this specialty seems bleak without some refinement.
 
Why can a law get passed letting CRNAs get free practice, but we can’t get a law protecting physicians from lawsuits when they can’t take care of the COVID pts due to shortages (of icu nurses, PPE, vents) and when they start triaging care and pulling plugs from grannie so grandson can get a vent?
 
  • Like
Reactions: 1 user
MoMoGesiologist said:
Why can a law get passed letting CRNAs get free practice, but we can’t get a law protecting physicians from lawsuits when they can’t take care of the COVID pts due to shortages (of icu nurses, PPE, vents) and when they start triaging care and pulling plugs from grannie so grandson can get a vent?
Click to expand...
Because there are more lawyers than doctors in Congress?
 
  • Like
Reactions: 3 users
  • Like
Reactions: 1 users
And I thought having Jerome Adams in a high position would be of some benefit. I guess not
 
At least it's temporary and goes back to what it was once the "crisis" is over. Except for Arizona - their governor totally caved.
 
Why isn't this getting more attention besides this one website? Seems like a big enough deal that more people should be talking about this.
 
  • Like
Reactions: 1 user
GoPelicans said:
Why isn't this getting more attention besides this one website? Seems like a big enough deal that more people should be talking about this.
Click to expand...

Because you aren’t writing your politicians or the asa. Devise a letter a post it on here and we will sign it and send it off. Include addresses with your post


Sent from my iPhone using Tapatalk
 
  • Like
Reactions: 1 users
jwk said:
At least it's temporary and goes back to what it was once the "crisis" is over. Except for Arizona - their governor totally caved.
Click to expand...

does it have a specific end date?
 
OneFellSwoop said:
That honestly makes the most sense, they’re highly experienced in intubation and do fine with the straightforward surgeries these patients are going to need (appys, etc) while you are a highly trained physician with skills that transcend the OR. This minimizes your exposure to the higher risk procedures and potential transmission and maximizes physician level care to those that need it. I’d rather see a CRNA knocked out of commission due to transmission than an anesthesiologist.


Sent from my iPhone using SDN
Click to expand...

Knocked out of commission? You are a disgusting human being.
 
Gill23 said:
Knocked out of commission? You are a disgusting human being.
Click to expand...
What’s disgusting are the midlevels/ their organizational representatives who used a pandemic/ people dying to expand their scope and to personally profit off of it. Absolutely repulsive.
 
ChiTownBHawks said:
What’s disgusting are the midlevels/ their organizational representatives who used a pandemic/ people dying to expand their scope and to personally profit off of it. Absolutely repulsive.
Click to expand...

Ambulance chasers in their finest moment, these are the people clamoring to be psuedo docs, wonder how eager they are to manage Covid and critically ill patients without recourse. But hey, when there's a crisis, some see opportunity, like bears to honey
 
ChiTownBHawks said:
What’s disgusting are the midlevels/ their organizational representatives who used a pandemic/ people dying to expand their scope and to personally profit off of it. Absolutely repulsive.
Click to expand...
Putting politics aside for one moment...wishing harm on another is still f_cked up.
 
  • Like
Reactions: 1 user
Furthermore, the "let the nurse go intubate the super infectious critically ill hypoxic pt if they want to play doctor so bad" approach isn't good from a medical, ethical, or frankly even a PR standpoint.
 
  • Hmm
  • Like
Reactions: 1 users
Status
Not open for further replies.
Next unread thread

Similar threads

coffeebythelake
Supervising physician fined because DNP called herself Doctor.
Replies
14
Views
2K
anbuitachi
A
TheLoneWolf
Michigan scraps physician supervision requirement for CRNAs
Replies
37
Views
4K
Gern Blansten
Gern Blansten
bedrock
CRNA
Replies
22
Views
3K
buddababa
B
BLADEMDA
CRNA murders his wife
Replies
23
Views
3K
GaseousClay
GaseousClay
N
Crna delegation thread
Replies
0
Views
783
neutro
N
Top