Anesthesiologists Urge CMS to Keep Supervision Rule
The American Society of Anesthesiologists asks Medicare to preserve its physician supervision standard for anesthesia care amid a CMS request for input.
Updated on Nov. 10, 2026 in Nursing Jobs
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The American Society of Anesthesiologists urged the Centers for Medicare & Medicaid Services to preserve Medicare's physician supervision standard for anesthesia care. CMS issued its CARE proposed rule and requested input on whether the current supervision requirement for CRNAs should be retained, revised, or modified.
Why it matters
The supervision requirement governs who may oversee anesthesia care delivered to Medicare patients, affecting staffing models for nurse anesthetists and physicians. The ASA argues that removing the standard would eliminate an important patient-safety safeguard.
Studies of Medicare's opt-out policy found no meaningful improvement in access to anesthesia care, and eliminating the supervision requirement would produce no direct Medicare budget savings. CMS has not yet decided whether the requirement will be retained, revised, or removed.
The players
Centers for Medicare & Medicaid Services
The federal agency that administers Medicare and Medicaid and issued the CARE proposed rule seeking input on the supervision requirement.
American Society of Anesthesiologists
A professional medical society representing anesthesiologists that urged CMS to preserve the physician supervision standard for anesthesia care.
The details
CMS is seeking public comment through a Request for Information within its CARE proposed rule, which is part of a broader effort to reduce administrative requirements in Medicare and Medicaid. The ASA cited 2024 California Department of Public Health reports documenting a CRNA-only anesthesia model in Modesto, California, which reported serious actual harm, serious potential harm, and risk of harm, injury and possibly death.
Timeline
2024: California Department of Public Health reports documented the CRNA-only model in Modesto.
Week of November 2, 2026: CMS issued the CARE proposed rule with the supervision RFI.
November 9, 2026: The ASA urged CMS to preserve the physician supervision standard.
Roadmap
The supervision RFI is one component of CMS's CARE proposed rule, which seeks to reduce administrative requirements across Medicare and Medicaid. The outcome could signal whether the federal government moves to loosen physician oversight rules for anesthesia care nationwide.
If CMS retains the physician supervision requirement, CRNAs will continue to practice under current oversight rules for Medicare patients. If the requirement is removed, hospitals and surgery centers could change how they staff anesthesia services.
The takeaway
Readers in nursing and anesthesia should watch the CARE rule comment process, since the supervision outcome will shape CRNA roles and workplace oversight.
Further reading
For more on staffing roles in this field, explore Nursing Jobs.
Source note: This article includes information reported by News-Medical.
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Should Medicare keep requiring physician supervision of nurse anesthetists during surgery?
