On September 8, 2016, the Michigan Senate passed a bill on a 22-15 vote, which expands the scope of practice for certified nurse anesthetists ("NAs"). Senate Bill 1019 amends Sections 17210 and 17708 of the Michigan Public Health Code (the "Code"). Specifically, the bill adds certain anesthesia and analgesia services to an NA's scope of practice, including: the development of a plan of care; implementation of the plan of care and addressing patient emergencies that arose during implementation; and prescription and administration of pharmacological agents to be received by a patient in the facility in which the services were performed (the "Services").
On June 7, 2016, the Michigan Competitiveness Committee approved a draft of the bill that would allow an NA to perform Services without physician supervision if the NA was a member of a "patient-centered care team." This version of the bill did not require a physician to be a member of the patient-centered care team but rather only referred to the patient and an interdisciplinary group of health care professionals, which could include a physician. However, opponents of the bill argued that the lack of a physician supervision requirement would threaten patient health and safety due to the inherent danger in administering anesthetics to patients.
Prior to approval by the Senate, revisions were made to the bill that require the Services performed by an NA to be supervised by a physician who is also a member of the patient-centered care team. Further, a patient-centered care team now must include at least one physician. The bill now authorizes NAs to perform Services if: (i) the NA is a member of a patient-centered care team; and (ii) he or she provides the Services under the supervision of a physician who is a member of that patient-centered care team.
On September 8, 2016, SB 1019 was referred to the House Committee on Health Policy. Hall Render will continue to provide timely updates on this matter.