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End of session is just the beginning of AA legislative fight

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.


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