CRNA Advocacy

CRNAs are licensed, independent anesthesia providers — but the rules governing their practice vary by state and federal policy. Here's what's happening, what it means for your career, and how to get involved.

Current Priority

Full-Practice Authority: The Core Issue

CMS regulations currently allow states to “opt out” of the federal physician supervision requirement for CRNAs — meaning CRNAs in opt-out states can practice fully independently. As of 2026, over half of U.S. states have opted out, but progress varies significantly. The AANA continues to push for a permanent federal removal of the supervision mandate.

28+: States Opted Out
50k+: Practicing CRNAs
100%: Rural Coverage CRNAs
$210k+: Median CRNA Salary

Key advocacy issues

Physician Supervision Opt-Out

States can formally opt out of the CMS physician supervision requirement, granting CRNAs independent practice authority. The AANA tracks state progress and provides toolkits for state-level advocacy.

AANA Advocacy Center →

Rural Health Access

CRNAs are the primary anesthesia providers in more than 65% of rural hospitals. Advocacy highlights CRNAs' essential role in care access for underserved communities.

Rural CRNA Data →

Opioid Crisis Response

CRNAs are at the forefront of non-opioid and regional anesthesia. AANA advocates for CRNA inclusion in federal pain-management and opioid policy.

Clinical Resources →

Medicare Reimbursement Parity

CRNAs advocate for equitable Medicare billing rights and oppose payment policies that favor physician anesthesiologists despite comparable outcomes.

CMS Policy Updates →

CRNA Workforce Pipeline

Advocates push for federal graduate nursing education funding, HRSA workforce grants, and loan-forgiveness targeting critical-care and anesthesia roles.

Workforce Advocacy →

AI & Technology in Anesthesia

AI-assisted anesthesia monitoring raises policy questions; AANA is engaged with FDA and CMS on classification and oversight.

AANA Practice News →

State full-practice authority

Opted out

AlaskaArizonaCaliforniaColoradoIdahoIowaKansasKentuckyMinnesotaMontanaNebraskaNew HampshireNew MexicoNorth DakotaOregonSouth DakotaWashingtonWisconsin

Active bill

TexasVirginiaGeorgiaNorth Carolina

Opted-out states allow CRNAs to practice without physician supervision under CMS rules. “Active Bill” = legislation introduced 2025–2026. Verify at aana.com/advocacy.

How to get involved

Contact Your Legislators

AANA's Grassroots Advocacy Center makes it easy to message your Senators and Representatives with pre-drafted notes on key CRNA issues. Under 5 minutes.

Action Center →

AANA Congressional Fly-In

Each spring, CRNAs and SRNA students go to D.C. to meet legislators directly.

AANA Meetings →

Join Your State Association

State associations lead opt-out campaigns; joining builds your network and keeps you current on local policy.

Find Your State →

Advocate on Social Media

Share your story, repost AANA content, engage in policy conversations. Visibility matters, especially in states with active bills.

AANA Advocacy Hub →

Stay Current with CRNA Policy News

The CRNA News Wire tracks legislation, CMS rule changes, and AANA updates.

Read CRNA News Wire

For informational purposes only. State opt-out status and legislation change frequently. Verify current status at aana.com/advocacy and your state's nurse anesthesia association. Boost CRNA is not affiliated with AANA.