Limited CRNA Scope Changes, Disclosure of Drug Pricing Being Considered

[March 7, 2019]

SB 61 alters the prescribing authority to allow CRNAs to “select, order, and administer drugs other than anesthesia” in the immediate post-operative period. 

• The new scope would only apply to CRNAs who practice in a hospital, ambulatory surgical facility, or facility that is wholly or partially owned or controlled by a hospital or hospital operator.
• CRNAs in these settings would be required to be granted rights to practice this increased scope by their facility’s medical staff.
• The bill requires that a CRNA granted this additional scope must follow a protocol developed by their facility’s medical, nursing, and pharmacy directors. The protocol determines the specific drugs and allowed to be ordered and administered and the procedures must be followed by the CRNA.  Drugs that are controlled substances are prohibited from being included in any protocol.
• A physician, podiatrist, or dentist who supervises a CRNA with the increased scope may determine that it is not in the best interest of a specific patient for the CRNA to have this increased ability, which would then prevent the CRNA from practicing with the increased scope with that specific patient.The bill requires that the physician, podiatrist, or dentist document this patient-specific limitation of the CRNA’s scope in the patient’s medical record.

Also being considered is HB 63, dealing with disclosure of drug prices. The bill, which is on the Ohio House Health Committee agenda for March 12, requires a pharmacist to disclose to patients if their prescriptions would cost less if purchased without insurance coverage. Patient cannot be charged this higher price and should not be charged more than: 1) the cost of the prescription without insurance coverage, or 2) the reimbursement paid to the pharmacy for the prescription.

Also being heard in committee next week is HB 102, regarding Medicaid coverage of chiropractic services.  The bill would require Medicaid to cover chiropractic services for recipients, offering no less than 20 visits to any participating licensed chiropractor acting within their scope of practice. Medicaid would not be able to impose a prior authorization or referral requirements for these services.