ALEC Action Letter to TX Gov. Abbott on Certified Registered Nurse Anesthetists Rule

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December 22, 2023 7:58 pm

To: Texas Governor Greg Abbott
From: ALEC Action
Re: Certified Registered Nurse Anesthetists Rule

Dear Governor Abbott,

As you know, ALEC Action is an organization dedicated to limited government, free markets, and federalism. The issue we write about today involves all of those principles. Under federal law, states can opt-out of a rule from the Center for Medicaid and Medicare Services (CMS) which requires Certified Registered Nurse Anesthetists (CRNAs) to report directly to a physician.

Occupational licensing restrictions are often burdensome and counterproductive. This rule forces physicians to spend time supervising CRNAs doing what they are trained to do. Opting out of this rule will allow CRNAs to work directly with patients and allow doctors to better utilize their time. There is no medical justification for the rule and no impact on patient safety. In fact, the rule was suspended by CMS during the pandemic’s emergency declaration, and it was done successfully with no negative effects.

We encourage you to join the 24 other states that have chosen to opt out of the federal rule, allowing CRNAs to practice to the full extent of their training. This would save Texas physicians valuable time and patients money.


Lisa B. Nelson
CEO, ALEC Action