HCFA May Soon End Anesthesia Supervision Rule for Nurses
HCFA may soon lift a federal rule that requires nurse anesthetists to be under physician supervision when treating Medicare patients, the Wall Street Journal reports. The move -- the "latest development in a "nasty turf battle" between anesthesiologists and nurse anesthetists -- would give jurisdiction over the issue to the states, which have "widely varying laws" on the issue. Hospitals are also free to impose their own, stricter rules. Represented by the American Society of Anesthesiologists, the physician anesthesiologists have "staunchly opposed" eliminating the federal requirement, arguing that it would "hurt patient safety." The nurses, backed by the American Association of Nurse Anesthetists, have attempted to kill the supervision rule, contending that physicians only want to "protect their turf -- and incomes." They also argue that Medicare has lifted the federal supervision requirement for other health professionals, including nurse practitioners. If the Clinton administration ends the requirement, the physicians will likely "press" Congress, which remains "split" on the issue," and President-elect Bush's incoming administration to block the move, the Journal reports. To "sway" lawmakers, the two opposing groups have hired "high-profile" strategists and lobbyists. Former Sen. Bob Dole (R-Kansas) and former Rep. Tom Downey (D-N.Y.) are backing the anesthesiologists, while former Rep. Bob Livingston (R-La.) has supported the nurse anesthetists. HCFA proposed lifting the supervision requirement in 1997, and in May the agency sent the final rule the Office of Management and Budget, where it awaits approval (McGinley, Wall Street Journal, 1/17).