PHOENIX – The Arizona Association of Nurse Anesthetists applauds Gov. Doug Ducey for standing with patients and health care professionals by signing into law HB 2845 (outpatient facilities; discharge; standards) – legislation that will expand access to care by clarifying what type of anesthesia professionals are authorized for discharging patients from Arizona’s outpatient surgery centers.
Previously the Arizona Department of Health (DHS) did not address both a “procedural” and “anesthesia” discharge - two separate duties from two separate professionals, and did not reflect current practice or policies from the Center for Medicaid and Medicare Services. CMS specifically requires a discharge from the operating practitioner (i.e. surgeon, gasteroenterologist) and also from the practitioner providing anesthesiology care i.e. a CRNA (Certified Registered Nurse Anesthetist or Nurse Anesthesiologist) or a Physician Anesthesiologist (MD/DO). DHS previously had only required a physician on premises until discharge, which only addressed the first of these two duties.
HB 2845 authorizes DHS to allow both types of anesthesiology professionals to be present until patients are physically discharged, which now aligns with the CMS requirement for “anesthesia” discharge.
Surgery Centers were previously at risk for citation if health surveyors required surgeons to be present until patients were discharged from anesthesia care, which was potential interpretation of the previous DHS rule. This risk is not eliminated.
Arizona’s surgery centers play an increasingly important role in Arizona’s health care delivery, and CRNAs in Arizona and across the country are frequently taking leadership roles in these facilities and using a CRNA-only model of anesthesia delivery.
HB 2845 passed through the Arizona Senate unanimously and through the Arizona House 45-15. Much discussion was had by proponents and opponents during hearings. Trade groups opposed to HB 2845 did not cite specific safety concerns, or specific situations that could not be handled by any type of anesthesiology professional. During the health committee hearings, it was widely agreed upon that both anesthesiology professionals are educated and trained to respond to anesthetic emergencies, and both consult with surgeons or other professionals as needed to handle procedural emergencies.
Henry Sargent, CRNA, President of the Arizona Association of Nurse Anesthetists, said HB 2845 is critical for surgery centers and the patients they serve.
Said Henry –“On behalf of the more than 1000 CRNAs currently practicing in Arizona and the patients who will benefit from expanded access to quality, affordable care: Thank you, Gov. Ducey.”