On June 7, 2016, a bill expanding the scope of practice for certified nurse anesthetists (“NAs”) was introduced to the Michigan Senate by Sen. Mike Kowall (R-White Lake). Senate Bill 1019 would amend sections 17210 & 17708 of the Public Health Code (the “Code”). Specifically, the bill would:

Include certain anesthesia and analgesia services in 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”);

  • Authorize an NA to provide the Services as the sole and independent anesthesia provider if he or she is part of a patient-centered care team;
  • Allow an NA to perform the Services for operative, obstetrical, interventional or diagnostic purposes during the preoperative, intraoperative and postoperative service period or the obstetrical service period, as applicable;
  • Exclude from the scope of practice chronic pain management services but allow an NA to perform such services under delegation prescribed in the Code;
  • Include in the definition of “prescriber” an NA engaging in the practice of nursing and providing the Services proposed in the bill; and
  • Not require new or additional third-party reimbursement or mandated worker’s compensation benefits for anesthesia and analgesia services provided by an NA.

After being introduced on the Senate floor, the bill was approved on a 4-1 vote by the Michigan Competitiveness Committee. The bill was then referred to the Committee of the Whole.

Those who support SB 1019 say that the bill will enable Michigan hospitals to have the autonomy to choose which anesthesia delivery model best meets the needs of their patients and communities. Accordingly, proponents argue that the bill will improve access to care for Michigan patients, especially those in medically underserved areas.

In contrast, those who opposed SB 1019 find issue with removing the physician supervision requirement. Opponents argue that removing this requirement threatens patient health and safety because a physician’s enhanced training and expertise enables them to ensure the safest administration of life threatening anesthetics to patients.

Although SB 1019 was referred to the Committee of the Whole, no date has been set for its reading on the Senate floor. Hall Render will continue to provide timely updates on this matter.