New Mexico Governor Signs Patient Focused Certified Anesthesiologist Assistant Legislation

New Mexico Governor Michelle Lujan Grisham (D) signed into law Senate Bill 35 (effective June 2023) which increases the number of certified anesthesiologist assistants (CAAs) that an anesthesiologist can supervise and maintains state law authorizing CAAs to practice in counties with a population of over 100,000 (Class A counties). 

The New Mexico Legislature first authorized CAAs to practice at the University of New Mexico in 2001 and in Class A counties in 2015. Anesthesiologists could supervise up to four CAAs at the University of New Mexico and up to three CAAs in Class A counties. The language authorizing CAA practice in Class A counties was scheduled to sunset in 2025. This would have resulted in the needless elimination of the full anesthesia care team relied on by health systems in the state of New Mexico in these particular counties.  

This new law increases the CAA supervision ratio to four to one in all settings and removes the 2025 sunset language from existing law, ensuring continued access to safe anesthesia delivery through the anesthesia care team. 

CAAs work exclusively within the anesthesia care team environment, which consists of a supervising anesthesiologist and from one to four non-physician anesthesia providers (i.e., CAAs and nurse anesthetists). All CAAs possess a pre-medical undergraduate background and complete a comprehensive didactic and clinical graduate school program. They are trained extensively in the delivery and maintenance of quality anesthesia care as well as advanced patient monitoring techniques. CMS authorizes payment through Part A and Part B for both nurse anesthetists and anesthesiologist assistants. To date, 20 jurisdictions authorize CAA practice.  

It is the position of the American Society of Anesthesiologists (ASA) that CAAs and nurse anesthetists have identical patient care responsibilities and technical capabilities. A 2018 study published in the peer-reviewed journal Anesthesiology confirmed this position when it examined care between a physician anesthesiologist and nurse anesthetist team and a physician anesthesiologist and CAA team. The results found “the specific composition of the anesthesia care team was not associated with any significant differences in mortality, length of stay, or inpatient spending.” 

To learn more about the importance of the patient centered, physician-led anesthesia care team, email [email protected].