Legislation expands nurse anesthetist's scope under physician supervision

On April 7, 2025, the Ohio Legislature introduced House Bill 224, a significant piece of legislation aimed at expanding the scope of practice for certified registered nurse anesthetists (CRNAs) in the state. The bill seeks to clarify and enhance the roles of CRNAs, particularly in the administration of anesthesia, while ensuring that these practices occur under appropriate supervision.

The primary provisions of House Bill 224 allow CRNAs to administer anesthesia and perform related procedures, such as anesthesia induction, maintenance, and emergence, under the supervision of a physician, podiatrist, or dentist. This supervision must occur in the immediate presence of the supervising professional, ensuring a collaborative approach to patient care. Additionally, CRNAs would be permitted to obtain informed consent for anesthesia care and conduct both preanesthetic and postanesthetic evaluations, thereby streamlining the anesthesia process and potentially improving patient outcomes.

However, the bill also imposes specific limitations on CRNAs based on the supervising professional's scope of practice. For instance, when supervised by a podiatrist, CRNAs are restricted to anesthesia procedures that the podiatrist is authorized to perform, and they are explicitly prohibited from administering general anesthesia in a podiatrist's office. Similar restrictions apply when CRNAs are supervised by dentists.

The introduction of House Bill 224 has sparked notable discussions among healthcare professionals and legislators. Proponents argue that the bill will enhance access to anesthesia services, particularly in rural areas where there may be a shortage of anesthesiologists. They contend that CRNAs are highly trained and capable of providing safe anesthesia care, thus alleviating some of the burdens on physicians.

Conversely, opponents express concerns regarding patient safety and the adequacy of CRNAs' training compared to anesthesiologists. Some fear that expanding CRNAs' roles without sufficient oversight could lead to complications in anesthesia administration.

The economic implications of House Bill 224 are also significant. By potentially increasing the availability of anesthesia services, the bill could lead to reduced healthcare costs and improved efficiency in surgical settings. This could be particularly beneficial in underserved areas, where access to specialized medical care is often limited.

As the bill progresses through the legislative process, it will likely undergo further scrutiny and debate. Stakeholders from various sectors, including nursing, medicine, and patient advocacy groups, are expected to weigh in on the proposed changes. The outcome of House Bill 224 could reshape the landscape of anesthesia care in Ohio, influencing both the practice of nursing and the delivery of healthcare services statewide.