Ohio Legislation Preserves Physician Led Anesthesia Care

The Ohio Society of Anesthesiologists (OSA) successfully won critical patient safety provisions in House Bill 52 (HB 52), legislation that preserves physician led anesthesia care in Ohio. The new law continues the requirement that certified registered nurse anesthetists (CRNAs) practice within a defined relationship with a physician and does not allow nurse-only anesthesia.

HB 52 transitions CRNAs from a supervisory model to a collaborative framework with a physician, dentist, or podiatrist. OSA ensured the legislation includes clear limits that keep anesthesia care physician directed and patient centered. Under HB 52, a nurse anesthetist may provide anesthesia services only at the express request of a collaborating physician, dentist, or podiatrist, preserving health professional directed initiation of anesthesia care. When collaborating with a dentist, the nurse anesthetist’s scope of practice is limited to the anesthesia services the dentist is authorized to perform under the dentist’s own sedation or anesthesia permit. Nurse anesthetists may perform induction, maintenance, and emergence of general anesthesia only when the collaborating physician, dentist, or podiatrist is physically present in the facility, ensuring timely onsite clinical availability.

Additional patient protections include:

1. A prohibition on nurse anesthetists prescribing medications for use outside the facility
2. Authority for the collaborating physician, dentist, podiatrist, or facility to restrict activities not in the patient’s best interest
3. A requirement that nurse anesthetists document all anesthesia services they perform
4. Mandatory verbal and written disclosure to patients identifying who will administer their anesthesia prior to epidural, spinal, or general anesthesia

Many of these safeguards were absent from the bill as originally introduced. The law takes effect June 8, 2026.