New House “Independent” Practice Legislation for VA Nurse Anesthetists Coincides with AANA Mid-Year Assembly

Legislation that would allow the “independent” practice of certain Advanced Practice Registered Nurses (APRNs) including nurse anesthetists within the U.S. Department of Veterans Affairs (VA) has been introduced in the U.S. House of Representatives.  This legislation, the Improving Veterans Access to Quality Care Act, was introduced in conjunction with the American Association of Nurse Anesthetist (AANA) Washington, DC Mid-Year Assembly and Capitol Hill visits this week.

H.R. 1783, introduced by Congressman Sam Graves (R-MO-06), Congresswoman Jan Schakowsky (D-IL-09) and Congresswoman Lucille Roybal-Allard (D-CA-40), is principally designed to “revive and expand the Intermediate Care Technician Pilot Program of the Department of Veterans Affairs,” but also includes the troubling “independent” practice provision. The bill is similar to legislation introduced by the nursing community in the 2015-2016 legislative session that did not advance. 

ASA strongly opposes the APRN provisions of this legislation and is disappointed that this legislation is not in line with the Department of Veterans Affairs’ recent “Advanced Practice Registered Nurses” Final Rule.  The rule specifically excluded nurse anesthetists due to patient safety concerns and the lack of evidence of an access issue for anesthesia services.  This bill is also not aligned with growing bipartisan, bicameral Congressional consensus that the surgical/anesthesia setting is a high-risk health care environment requiring physician involvement in care.  Several Veterans organizations and medical organizations agree that Veterans should have access to physician-led surgical anesthesia care.  ASA applauds VA for recognizing in the final rule that Veterans have earned and deserve the highest quality health care.

More information about the Improving Veterans Access to Quality Care Act is available here.  H.R. 1783 has been referred to the House Committee on Veterans’ Affairs and the House Committee on Armed Services. ASA will continue to monitor this legislation but recognizes that VA and Congress are not expected to further address this issue now that VA has completed the comment period and issued a Final Rule.