Bush Administration Suspends Another Last-Minute Clinton Rule

By Christine Hall | July 7, 2008 | 8:27 PM EDT

(CNSNews.com) - The Bush administration has suspended for six months another last-minute regulation issued by the Clinton administration, this one dealing with who is authorized to administer anesthesia to Medicare patients.

The Clinton rule would have allowed nurse anesthetists to administer anesthesia without supervision by a doctor.

A seniors group speculated that the Clinton rule was a "thank you" gesture to the American Association of Nurse Anesthetists for throwing political support behind Clinton-Gore re-election campaigns.

Health and Human Services Secretary Tommy Thompson explained the administration's decision as one that would "ensure that all Medicare beneficiaries receive the safe, high quality anesthesia services they need."

Thompson said the administration will propose a new rule that would allow state governors, in consultation with state boards of medicine and nursing, to request HHS to grant a waiver of the supervision requirement.

The proposal would reportedly only affect 10 states, however, because 40 states have regulations of their own requiring doctor supervision.

The Seniors Coalition, a national senior citizen advocacy group, praised the Bush administration's decision to look at safety issues associated with giving nurses sole responsibility for administering anesthesia.

The coalition delivered more than 30,000 petitions from senior citizens to HHS this week demanding repeal of the Clinton rule.

"The real issue is not who can or can't deliver anesthesia but what happens if there's an adverse outcome," said John Powell, senior vice president for the Seniors Coalition.

"Anesthesia is the most dicey part of any operation. It ought to be required that a doctor that has full medical training is there to diagnose and respond, rather than a nurse who may or may not have graduated from college, but has a couple of years of training in delivering anesthesia," he said.

The American Association of Nurse Anesthetists (AANA) criticized the Bush administration's decision, calling it a blow to the thousands of hospitals and patients who have been "anxiously waiting" for the rule to take effect.

"The AANA has said all along that individual states should be allowed to decide whether to require physician supervision of certified registered nurse anesthetists, based on each state's particular needs," said Larry Hornsby, president of the 28,000 member AANA.

Hornsby cited the need for greater staffing flexibility for hospitals, especially in rural and medically underserved areas.

"The proposed changes by HHS are consistent with this position," Hornsby continued. "However, it should be completely unacceptable to the American public that another delay has occurred thanks to the nurse-bashing tactics of physician anesthesiologists."

The AANA has long been feuding over this issue with the American Society of Anesthesiologists, which praised the Bush administration's decision.

"This is a great day for seniors everywhere," said ASA president Neil Swissman, M.D. "For more than three years, ASA has been arguing that patient safety was at stake, and now someone has listened."

"I cannot imagine that the governors will not adhere to [existing state law] in the case of the most vulnerable class of patients, our senior citizens," Swissman said.