Scope of Practice

The licensed CRNA is authorized to deliver comprehensive anesthesia care in Missouri under laws of the state. Their anesthesia practice consists of all accepted anesthetic techniques including general, epidural, spinal, sedation, or local.  The Scope of Practice describes the procedures, actions, and processes that a CRNA is permitted to undertake in keeping with the terms of their professional license. The scope of practice is limited to that which the law allows for specific education and experience, and specific demonstrated competency.

CRNA / AA Reimbursement Ratios (CMS)
This document highlights the difference between the Anesthesia Services Conditions of Participation and the applicability of medical direction modifiers versus a non-medically directed CRNA case.

Medical Direction vs. Supervision
This presentation discusses issues around medical direction and supervision and its influence on the CRNA practice.

MO History of CRNA Law & Order
This presentation discusses the evolution of state regulation of nursing practice, explains how nurse anesthesia practice recognized and regulated in the state of Missouri, describes the extent of federal regulation of nurse anesthesia practice, and discusse current Medicare reimbursement policies for CRNAs.

OPT-OUT – What does it mean to Missouri CRNAs?
This document discusses the historical background of the nurse anesthetist supervision opt-out legislation as well as its impact on CRNA practice within Missouri.

Remodeling Anesthesia Delivery
As CMS is considering measures of efficiency, Excel Anesthesia LLC offers insight, along with cost-effective recommendations, for remodeling the anesthesia care delivery practice model. These suggestions take a closer look at the various existing anesthesia practice models, especially those requiring subsidies.

[Medicare – Supervision] History in Brief – Information on Opt-Out
Discussion of the current state and anticipated future state of AANA’s push for full federal repeal of nurse anesthetist supervision.

The Legislative Process
Important overview of the legislative process, government leadership, important dates, and other concepts for nurse anesthetists in the state of Missouri.

The Nature of Supervision
Discussion of supervision, including ASA’s position. standards adopted by JCAHO, and key legislation