Working with ASA's state components and grassroots members, the ASA Department of State Affairs faced another challenging and busy year. In 2021, the State Affairs team reviewed more than 2,000 pieces of legislation and at least 1,000 proposed regulations to assist state component societies as they work to protect patient safety in each state. Ultimately, State Affairs assisted state component societies in defeating several efforts to remove physician involvement from anesthesia care, no additional states opted out, and there were enhanced efforts in multiple states to protect against medical title misappropriation.

Opt-outs: So far this year, no governors have opted out of the Medicare patient safety requirement for physician supervision. Unfortunately, nurse anesthetists have used the COVID-19 pandemic to advocate for removing physician supervision via opt-out when, in reality, this does not expand access to care, but further jeopardizes patient safety. Additionally, nurse anesthetists in states where they have...

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