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Medicare Payments to CRNAs Irk Anesthesiologists, Again

Alexandra Wilson Pecci, for HealthLeaders Media, November 6, 2012

Another battle in the war between anesthesiologists and advanced practice nurses is under way.

The final rule on physician fees for 2013 allows Medicare to pay Certified Registered Nurse Anesthetists for services to the full extent of their state scope of practice.

Specifically, CMS says this applies to "anesthesia and related care [which] includes medical and surgical services that are related to anesthesia and that a CRNA is legally authorized to perform by the state in which the services are furnished."

According to the American Association of Nurse Anesthetists (AANA), nurse anesthetists have been getting paid by Medicare for their services for more than 20 years. But a challenge came in early 2011 when Medicare contractor Noridian decided to stop reimbursing CRNAs.

"This policy really restores reimbursement," Christine Zambricki, DNAP, CRNA, FAAN, senior director of federal affairs strategies at AANA, tells HealthLeaders Media. "It was necessary for the Medicare agency to make a strong policy."

Zambricki describes Noridian's quick decision to stop reimbursing CRNAs as "going rogue," since CRNAs had been being reimbursed by Medicare for years.

"It's very disappointing that something like this could take place when the goal in our healthcare system is to...really remove burdens to healthcare providers," she says. "This is a case study in the opposite."

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