Ensuring Veterans Timely Access to Anesthesia Care Act of 2025
- Sponsor
- Rep. Underwood, Lauren [D-IL-14]
- Committees
- Veterans' Affairs Committee (primary)
- Last action
- Jun 11, 2025
Bottom line
This bill aims to standardize and enhance anesthesia care quality and efficiency within the VA by aligning CRNA practice with Defense Health Agency standards, mandating specific certifications and clinical hours, and increasing transparency through GAO oversight.
What it actually does
This bill directs the Secretary of Veterans Affairs to update standards for Certified Registered Nurse Anesthetists (CRNAs) within the Veterans Health Administration (VHA), recognizing them as licensed independent practitioners consistent with Defense Health Agency (DHA) guidelines. It also mandates specific certification and direct patient care hour requirements for all anesthesia professionals and requires the Government Accountability Office (GAO) to annually report on the outcomes and cost-effectiveness of different anesthesia delivery models in the VHA.
Proponents argue
Supporters argue that this bill will improve veteran access to critical anesthesia care, especially in underserved areas, by allowing highly qualified CRNAs to practice to the full extent of their training, consistent with successful models in the Defense Health Agency. They also emphasize that the bill ensures high-quality care through mandatory certification and clinical hour requirements, while promoting transparency and accountability via annual GAO reports on cost-effectiveness and outcomes.
Opponents contend
Opponents, primarily physician anesthesiologist groups, contend that recognizing CRNAs as independent practitioners without physician supervision could compromise patient safety, particularly for veterans with complex medical conditions. They argue that a physician-led team model provides the optimal standard of care and that expanding CRNA autonomy might lead to adverse outcomes or a reduction in the quality of anesthesia services provided.
The bill is very short and clearly written, making it highly accessible for a thorough evaluation within a short timeframe.
Section 2
Alignment of CRNA Practice Standards with Defense Health Agency
This section directs the Secretary of Veterans Affairs to update VHA Directive 1123, which governs the National Anesthesia Program, to officially recognize Certified Registered Nurse Anesthetists (CRNAs) as licensed independent practitioners within the Veterans Health Administration. This update must be consistent with the practice standards already established by the Defense Health Agency (DHA), which generally allows CRNAs to practice without physician supervision. The intent is to standardize CRNA practice across federal healthcare systems.
Supporters argue
Supporters argue this provision modernizes VA healthcare by aligning with successful practices in the Defense Health Agency, which has demonstrated that CRNAs can safely and effectively provide anesthesia independently. They contend it will improve efficiency, expand access to care for veterans, and make the VA more competitive in recruiting and retaining CRNAs.
Critics contend
Opponents, primarily physician anesthesiologist groups, contend that removing physician supervision for CRNAs could compromise patient safety and quality of care, especially for veterans with complex medical histories. They argue that the physician-led care team model is the gold standard for anesthesia delivery.
Tradeoffs
This provision balances the goal of increasing access to care and potentially reducing costs by expanding CRNA autonomy against concerns about patient safety and the traditional physician-led model of anesthesia care.
Section 3
Mandatory Certification and Clinical Hour Requirements for Anesthesia Professionals
This section establishes mandatory requirements for all anesthesia professionals employed by the VA. Physician anesthesiologists must be certified by the American Board of Anesthesiology or a similar body, while CRNAs must be certified by the Council on Certification of Nurse Anesthetists or the Council on Recertification of Nurse Anesthetists or a similar body. Additionally, all anesthesia professionals are required to complete at least 25 hours of direct patient anesthesia care annually, explicitly excluding supervisory hours. Non-compliance with these requirements will result in suspension from VA employment.
Section 4
Annual GAO Report on Anesthesia Delivery Models and Cost-Effectiveness
This section mandates that the Comptroller General of the United States (GAO) submit an annual public report to the House and Senate Committees on Veterans' Affairs. The report must include data on outcomes and a comparison of the cost-effectiveness of three anesthesia models used in the VHA: delivery by an anesthesiologist, by a certified registered nurse anesthetist under physician supervision, and by a certified registered nurse anesthetist without supervision. The cost analysis must detail estimated costs to VA medical facilities, taxpayers, and a breakdown of costs and savings to taxpayers and veterans' households for each model.