Massachusetts Association of Nurse Anesthetists

The Massachusetts Association of Nurse Anesthetists (MANA) is the state association of Certified Registered Nurse Anesthetists (CRNAs), advanced practice nurses. We are dedicated to the professional interests of nurse anesthetists in the Commonwealth of Massachusetts. Our main objectives are: patient safety through the advancement of the science and art of anesthesia, as well as the promotion of cooperation between nurse anesthetists, all medical professionals, hospitals and other agencies interested in anesthesia. MANA is an affiliate of the American Association of Nurse Anesthetists (AANA). Membership in the AANA automatically entitles any CRNA (or SRNA) who chooses Massachusetts for their state affiliation to be member of MANA. MANA has over 820 members who practice in a variety of settings including being the primary anesthesia providers in most rural areas. Nurse anesthetists have been providing anesthesia care to patients in the United States for nearly 150 years. Our association is involved in a variety of activities that advance the practice of anesthesia. The credential CRNA (Certified Registered Nurse Anesthetist) came into existence in 1956. CRNAs are anesthesia professionals who safely administer more than 32 million anesthetics to patients each year in the United States, according to the American Association of Nurse Anesthetists (AANA) 2010 Practice Profile Survey. CRNAs are the primary providers of anesthesia care in rural America, enabling healthcare facilities in these medically underserved areas to offer obstetrical, surgical, and trauma stabilization services. In some states, CRNAs are the sole providers in nearly 100 percent of the rural hospitals. Managed care plans recognize CRNAs for providing high-quality anesthesia care with reduced expense to patients and insurance companies. The cost-efficiency of CRNAs helps control escalating healthcare costs. In 2001, the Centers for Medicare & Medicaid Services (CMS) changed the federal physician supervision rule for nurse anesthetists to allow state governors to opt out of this facility reimbursement requirement (which applies to hospitals and ambulatory surgical centers) by meeting three criteria: consult the state boards of medicine and nursing about issues related to access to and the quality of anesthesia services in the state determine that opting out is consistent with state law, and determine that opting out is in the best interests of the state's citizens. To date, 18 states have opted out of the federal supervision requirement. Additional states do not have supervision requirements in state law and are eligible to opt out should the governors elect to do so. Nationally, the average 2009 malpractice premium for self-employed CRNAs was 33 percent lower than in 1988 (62 percent lower when adjusted for inflation). Legislation passed by Congress in 1986 made nurse anesthetists the first nursing specialty to be accorded direct reimbursement rights under the Medicare program. Legislation passed in 2010 gave CRNAs prescriptive authority within a 24-hour window. Legislation currently pending would advance CRNA practice in MA to the full scope of education and training as recommended by the IOM and FTC.