AANA stresses need for policies to improve competition in healthcare in letter to Biden administration


Posted: October 12, 2021 at 9:32 p.m. EDT|Update: 8 hours ago

RIDGE PARK, Ill., 12 October 2021 / PRNewswire / – In a October 5 letter to President Biden, President of the American Association of Nurse Anesthesiology (AANA) Dina velocci, DNP, CRNA, APRN, drew attention to the benefits that the health sector could derive from the removal of anti-competitive policies.

American Association of Anesthesiology Nurses (PRNewsfoto / American Association of Nurses A)

Velocci called on the White House Competition Council to develop strong rules for non-discrimination of providers, removing unnecessary regulatory hurdles such as the Medicare physician oversight requirement for the services of certified nurse anesthetists ( CRNA) and to implement full practice authority for CRNAs working in the Veterans Health Administration (VHA).

CRNAs play a critical role in ensuring that patients have access to essential anesthesia services, especially in rural and other underserved populations. Policies that increase competition between health care facilities will reduce health care costs and increase access to care for patients, allowing them to receive the care they need for surgery, labor and delivery, trauma stabilization and chronic pain management.

“A significant implementation of [the Consolidated Appropriations Act of 2021] It is important to protect patient access to essential services provided by CRNAs and other advanced practice providers (APPs) against discriminatory practices in the private insurance market, ”Velocci wrote. “CRNAs and other APPs, acting under their license or certification under state law or regulation, have experienced discrimination with respect to participation and coverage of proceedings that are clearly included in the scope of practice of their State. Such discrimination undermines access to necessary health services, consumer choice and competition, and undermines efforts to control rising health care costs. In addition, this discrimination violates the federal provision of non-discrimination of suppliers. “

The AANA also urged the White House to make Medicare’s exemption from the physician supervision requirement for CRNAs permanent. “The [waiver] showed the important need for healthcare professionals to work to the maximum of their ability to care for patients and highlights the important role that CRNAs play in our healthcare system…. During this pandemic, we have seen barriers to the practice of CRNAs removed at state and federal levels, enabling CRNAs to provide essential and life-saving patient care. CRNAs practice independently during this crisis, working under stressful conditions at facilities across America, providing invaluable support using their expertise in rapid systems assessment, airway management, ventilator management , resuscitation of vascular volume, establishment of invasive lines and monitors, supervision of complex hemodynamic monitoring, emergency preparedness and resource management. The data shows that physician supervision does not affect the quality of care and can increase costs.

In addition, AANA drew attention to a recommendation from the United States Federal Trade Commission in 2016 to allow ACCs working in all VHA facilities to practice to their fullest scope without barriers. However, today, CRNAs are not allowed to work independently throughout the VHA. “Allowing CRNAs to operate at their maximum range also provides inherent cost savings,” Velocci wrote. To help ensure that veterans receive the high-quality care they deserve, AANA calls for the development of national standards of practice that allow CRNAs and other providers to practice without barriers of supervision.

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SOURCE American Association of Nurses in Anesthesiology

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