State court to hear case on whether nurse anesthetists need supervision

The Colorado Supreme Court announced Monday that it will hear a case that could decide whether nurse anesthetists can operate without the supervision of a physician.

The case, Colorado Medical Society v. Hickenlooper, centers on a federal Medicare regulation that allows nurse anesthetists to operate without direct supervision of a doctor.

That used to be a requirement until 2001, when then-President Bill Clinton eliminated it. His successor, President George W. Bush, immediately reversed it, but gave state governors the authority to opt out.

Then Gov. Bill Ritter did just that, but the medical society sued, saying only physicians can know when a patient is in danger while under anesthesia.

In 2011, a district court ruled against the medical society, and that decision was upheld by the Colorado Court of Appeals last year.

“Anesthesia care, while seemingly routine, is an extremely complex and potentially hazardous medical service,” said Dr. Paul Mongan, president of the Colorado Society of Anesthesiologists, which joined the medical society in the suit. “Had the Supreme Court allowed the lower court ruling to stand without review, it would have abandoned physician supervision of this vital component of medical care in Colorado.”

The Colorado Association of Nurse Anesthetists supports the rule, saying the physicians’ real problem with it is more about who gets paid rather than patient safety.

While Colorado is one of 17 states that have adopted the rule, it did so only for rural parts of the state.

That’s partly because smaller, rural hospitals can’t afford to hire anesthesiologists, who are trained physicians, officials at Rangely District Hospital and Delta County Memorial Hospital have said.

Larger hospitals in the Grand Valley don’t use nurse anesthetists.

It is unknown whether the court will hear oral arguments on the case or when it will rule on the matter.


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