Anesthesia and Medicare Interpretive Guidelines

Centers for Medicare and Medicaid Services (CMS) issued a statement that it no longer requires physician supervision of CRNA’s providing labor analgesia or moderate sedation in hospitals participating in Medicare.  Along with this announcement was an additional statement that Medicare  requires, during deep sedation with propofol, the involvement of an anesthesia provider such as a CRNA.

This revision was to “ensure high quality, safe, and effective care provided by CRNA’s throughout the United States” as stated by James Walker president of AANA. In the article from the January AANA Journal, specific reference is made to the example of “deep sedation” for colonoscopy screening. It goes on to state most propofol use in this area is used to decrease patient movement and improve visualization in this invasive procedure. It continues, the reason that anesthesia personnel are needed is the potential for inadvertent progression to general anesthesia. Thus, the need for a highly qualified  individual trained in anesthesia is a must.

You can read more through the AANA website here, but you must register first.

Additional resources on this topic can be found below: