Certified registered nurse anesthetists (CRNAs) in Washington, DC can now practice without a collaborating physician following the DC legislature’s recent passing of Bill B25-0545, also known as the Health Occupations Revision General Amendment Act of 2024, which amended the Health Occupations Revision Act of 1985 (HORA). The relevant revisions remove collaboration requirements for CRNAs when planning and delivering anesthesia, pain management, and other related patient care, allowing CRNAs to practice independently when delivering such services. HORA had previously been amended to allow advanced practice nurses (APRNs) to practice independently without a collaboration agreement, and this more recent amendment extends that independent practice to CRNAs. The full text of the Bill may be accessed here.
Various states have also lifted similar restrictions on CRNAs. According to the American Association of Nurse Anesthesiology, states that allow CRNAs to practice independently include Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Idaho, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington State, West Virginia, Wisconsin, and Wyoming.
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