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Only a few session days remain—six in the Senate, three in the House of Representatives—before Pennsylvania’s 2021-22 legislative session ends.


Any bill that hasn’t made it entirely through both chambers of the state General Assembly to get to the governor’s desk for his signature and enactment must be reintroduced and work itself through the whole legislative process again when the new two-year session starts in January 2023.


The end of session is good news when it comes to bad policy like House Bill 1956 and Senate Bill 1258, two companion measures that would license anesthesiologist assistants (AAs) for the first time in Pennsylvania.


Neither bill received consideration and no votes are pending in these waning days of session. But that doesn’t mean the issue is finished—far from it.


The Pennsylvania Association of Nurse Anesthetists (PANA) successfully pushed back against the legislation this year, but we fully expect the measures to be reintroduced in the 2023-24 session.


We’ll be ready, too. We have to be, because we’ve already seen some of tactics proponents will use to advance their bills. Consider the lengths they’ll go:


  • Certified Registered Nurse Anesthetists (CRNAs) and SRNAs heard rumors that the legislation passed. Nope. Never happened. In fact, on April 25, PANA testified against the legislation during a House Professional Licensure Committee hearing. The measure never received a vote.

  • In an unprecedented attempt to circumvent the legislative process, AAs began reaching out directly to both physician-owned and CRNA-owned anesthesia companies with notice that they are authorized to work in Pennsylvania under delegatory authority. The Pennsylvania Department of Health has made clear that anesthesiologist assistants are not recognized as an anesthesia provider in the state and therefore cannot operate as such in the commonwealth.

  • Working with their state and national organizations, anesthesiology assistants also have been claiming publicly that AAs and CRNAs can be used interchangeably, alleging an anesthesia shortage, as part of an attempt to move AAs into facilities where CRNAs are already working. Nonsense. AAs are limited by their training to only provide support as a technical assistant to a physician anesthesiologist and cannot provide anesthesia care apart from their direct supervision. Any scenario that has an AA working apart from a physician anesthesiologist is in direct violation of federal law.

So, while this legislative session is ending, it’s really just the beginning of the fight against a misguided policy that will NOT improve patient safety or enhance care; will NOT reduce health-care costs, but instead contribute to costlier care models; and will NOT improve access to anesthesia services.


Department of State opposes licensing CAAs in Pa.

Members of the Pennsylvania Association of Nurse Anesthetists (PANA) testified today before the House Professional Licensure Committee to oppose legislation (H.B. 1956) that would license Certified Anesthesiologist Assistants (CAAs) for the first time in Pennsylvania.

Testifying were Jessica Poole DNAP, CRNA, director of State Government Affairs for PANA and lead Certified Registered Nurse Anesthetist (CRNA) at BPW Medical Associates, P.C.; Matthew McCoy DNP, CRNA, past president of PANA and assistant director of the Crozer Chester Medical Center/Villanova University Nurse Anesthesia Program; and Christopher A. Heiss, MSN, CRNA, a PANA trustee and a CRNA practicing everywhere from large tertiary care facilities to rural critical access hospitals throughout Pennsylvania.

Testifying were Jessica Poole DNAP, CRNA, director of State Government Affairs for PANA and lead Certified Registered Nurse Anesthetist (CRNA) at BPW Medical Associates, P.C.; Matthew McCoy DNP, CRNA, past president of PANA and assistant director of the Crozer Chester Medical Center/Villanova University Nurse Anesthesia Program; and Christopher A. Heiss, MSN, CRNA, a PANA trustee and a CRNA practicing everywhere from large tertiary care facilities to rural critical access hospitals throughout Pennsylvania.


VIEWING OPTIONS:


VIEW THE HEARING IN ITS ENTIRETY:


VIEW ON PA HOUSE GOP'S LIVESTREAM SITE:


PANA’s testifiers urged the committee to oppose the legislation. House Bill 1956 will not improve patient safety or enhance care. It will not reduce health-care costs, but instead, contribute to costlier care models. And it will not improve access to anesthesia services or address critical care shortages in underserved areas.

There is no meaningful research data concerning CAA anesthesia safety. Because CAAs must be directly supervised by an anesthesiologist, the provider redundancy of the CAA/anesthesiologist team is one of the costliest anesthesia delivery models. That also greatly limits their utilization in rural and underserved communities where anesthesiologists don’t practice.


The Pennsylvania Department of State also testified and opposed the licensing standards, noting that the agency “views creating another licensure class for professionals who are already nationally credentialed as repetitive and unnecessary.” The department also made clear that “CAAs would appear to fall within the definition of technician. While the practice acts and board regulations do not prohibit CAAs from practicing in the Commonwealth, the Department of State and the State Board of Medicine do not have the authority to regulate hospitals and other health care facilities. That authority falls under the Department of Health, in the Health Care Facilities Act.


A representative from the Hospital and Health System Association of Pennsylvania (HAP) also testified. Although HAP did not oppose the legislation, the organization did call for allowing CRNAs to practice to the fullest extent of their education and training to increase the number of qualified anesthesia providers in Pennsylvania.

Out-of-state CAAs also testified with Pennsylvania-based anesthesiologists.

VIEW ALL TESTIMONY

JESS POOLE



MATT MCCOY



CHRISTOPHER HEISS



PA DEPARTMENT OF STATE




This is only the first step in a long legislative process. The hearing was informational only and the committee did not vote on the measure, which means under consideration. (Legislation must be approved by the committee before it goes to the full House for consideration.) No legislation has been introduced in the state Senate.

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Copyright © 2025 Pennsylvania Association of Nurse Anesthetists

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