Governors in Iowa and Nebraska have decided to allow hospitals to employ unsupervised nurse anesthetists under a new Medicare rule unveiled in November.
More governors may drop supervision, and in states like Minnesota, such an action would override the state's own supervision requirements for anesthetists, according to James Sieben, an attorney for the Metropolitan Anesthesia Network in Minneapolis.
Sieben, who is opposed to the new federal rule, says "a safety net would be removed" without such requirements.
Meanwhile, 31 states have already loosened supervision of nurse anesthetists.
However, Sieben says many of them call for "collaboration" with doctors, a step short of independent practice that has not been tested in the courts.