Advocacy
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.
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, more than half of U.S. states (27) have opted out, but progress varies significantly. The AANA continues to push for a permanent federal removal of the supervision mandate.
- 27
- States Opted Out
- 50k+
- Practicing CRNAs
- 100%
- Rural Coverage CRNAs
- $236,590
- Median CRNA Salary (BLS, May 2025)
Key advocacy issues
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 →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 →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 →CRNAs advocate for equitable Medicare billing rights and oppose payment policies that favor physician anesthesiologists despite comparable outcomes.
CMS Policy Updates →Advocates push for federal graduate nursing education funding, HRSA workforce grants, and loan-forgiveness targeting critical-care and anesthesia roles.
Workforce Advocacy →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
Active bill
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
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 →Each spring, CRNAs and SRNA students go to D.C. to meet legislators directly.
AANA Meetings →State associations lead opt-out campaigns; joining builds your network and keeps you current on local policy.
Find Your State →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.