Across the country, states are rewriting the rules for certified registered nurse anesthetists, shifting away from physician supervision requirements and toward greater CRNA autonomy.
Here are the five most recent states to update their laws.
1. Ohio became the 27th state to opt out of Medicare’s physician supervision requirement for CRNAs July 10. The opt-out follows Ohio House Bill 52, which took effect June 8 and replaced the state’s CRNA “supervision” standard with a collaboration model involving a physician, dentist or podiatrist. Mr. DeWine cited the law and consultations with the Ohio Board of Nursing and the State Medical Board of Ohio as the basis for the opt-out.
2. Just days before, Vermont opted out of federal regulations requiring physician supervision of CRNAs, following Gov. Phil Scott’s letter to CMS on July 2.
3. In April 2025, West Virginia passed a law allowing CRNAs to administer anesthesia in cooperation with — rather than under the supervision of — a physician. Under the new practice agreement, “cooperation” is defined as a CRNA and a physician, dentist, or podiatrist working together as a team, each contributing their respective expertise.
4. In April 2025, Kansas passed legislation allowing CRNAs to prescribe, procure, and administer drugs consistent with their education and qualifications. Previously, CRNAs could perform those functions only upon the order of a physician or dentist.
5. In June 2024, Massachusetts passed a law to opt out of federal regulations requiring physician supervision of CRNAs.