12th State Opts Out

MONTANA

(from OGP)

Subject: Montana Governor Martz Removes Physician Supervision for Nurse Anesthetists

Montana Governor Martz Removes Physician Supervision for Nurse Anesthetists

Havre, Montana (January 24) – Governor Judy Martz informed on January 22nd the
Centers for Medicare and Medicare Services (CMS) that Montana has opted out of
the Federal physician requirements of Certified Registered Nurse Anesthetists
(CRNAs) that apply to reimbursement for anesthesia services.
Montana makes the 12th state to opt out, following Washington, Alaska, Kansas,
Nebraska, Idaho, Minnesota, New Hampshire, New Mexico, North Dakota, Oregon,
and Iowa. Many other states are currently investigating whether opting out is
in the best interest of their citizens, particularly their rural citizens.
Roughly one-quarter of the states have opted out of this financially oriented
Federal requirement to date.
Montana has approximately 40 anesthetizing locations that use CRNAs and/or
physician anesthetists. Currently, 31 of these areas are exclusively served by
CRNAs.
“Opting out of the supervision requirement is excellent and long-awaited news
for the hospitals and communities of Montana,” said Michael Barts, CRNA, APRN,
AAAPM, President of the Montana Association of Nurse Anesthetists (MTANA).
After two years of exhaustive investigation, Governor Martz made the decision
that this opt out was clearly in the best interests of her state. The
investigation included consultation with the Board of Medical Examiners and the
Board of Nursing of Montana, consulting with other governors, observing the
decision of the Montana House Committee On Human Services during the last
legislative session, and, recently, the verdict of a recent court decision
concerning the Montana Board of Nursing’s authority.
Across the states that have already opted out, no changes have been observed
in CRNAs’ excellent safety and service record over the past two years. Montana
CRNAs’ independent and/or collaborative practice relationship with Montana
physicians will continue unchanged. CRNAs have provided anesthesia service to
Montana patients since the earliest days of surgery in this state.
According to an Institute of Medicine report published in October 1999,
anesthesia care is nearly fifty times safer than it was twenty years ago. CRNAs
administer 65 percent of the anesthetics given each year in the U.S., and are
the predominant anesthesia providers in rural and other medically underserved
areas. Without these Advanced Practice Nurse Practitioners (APRNs), many
facilities serving these areas would be unable to maintain surgical,
obstetrical, trauma stabilization, and pain management services.