Montana Gov. Judy Martz, a former hospital board member, informed the CMS last month that her state would opt out of the federal requirement that physicians supervise certified registered nurse anesthetists, allowing the nurses to receive payments for their anesthesia services under Medicare and Medicaid.
Montana becomes the 12th state to avail itself of a 2001 CMS rule that allows governors to opt out if they first consult with the medical and nursing boards and determine that it is consistent with state law and is in the best interest of the state's residents. The other states are Alaska, Idaho, Iowa, Kansas, Minnesota, Nebraska, New Hampshire, New Mexico, North Dakota, Oregon and Washington, the American Association of Nurse Anesthetists said.
The governor's decision had the support of Montana's hospital association and the medical examiners and nursing boards.
It sparked a lawsuit by the Montana Society of Anesthesiologists, which earlier had offered legislation to amend the state's Nurse Practice Act to require physician supervision of nurse anesthetists. That legislation did not pass.
Martz, a Republican, is the former vice chairwoman of the board of St. James Healthcare, a 59-bed hospital in Butte.
The CMS confirmed receiving Martz's letter on Jan. 23, the date the policy became effective, according to a representative for the AANA.
In December 2003, the MSA filed a lawsuit against the Board of Nursing related to its actions in amending the nursing regulations last year to allow nurse anesthetists to practice independently.
The lawsuit alleges the board failed to allow public comment during the meeting when those rule changes were made and that the changes violate the Montana Medical Practices Act by authorizing nurse anesthetists to practice medicine without a license. The lawsuit is pending.