2026 -- H 7426

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2026

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- NURSE ANESTHETISTS

     Introduced By: Representatives Hopkins, Tanzi, Casimiro, J. Brien, Perez, Sanchez,
Cotter, and Roberts

     Date Introduced: January 30, 2026

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Sections 5-34.2-2 and 5-34.2-5 of the General Laws in Chapter 5-34.2 entitled

"Nurse Anesthetists" are hereby amended to read as follows:

     5-34.2-2. Definitions.

     (a)(1) “Board” means the board of nurse registration and nurse education established in §

5-34-4.

     (b)(2) “Certified registered nurse anesthetist” (CRNA) means a registered nurse who has

successfully met the requirements stated in this chapter.

     (c)(3) “Practice of certified registered nurse anesthesia” means providing certain healthcare

services in collaboration with anesthesiologists, licensed physicians, or licensed dentists in

accordance with § 5-31.1-1(17) which requires substantial specialized knowledge, judgment, and

skill related to the administration of anesthesia, including preoperative and postoperative

assessment of patients; administering anesthetics; monitoring patients during anesthesia;

management of fluid in intravenous therapy; and management of respiratory care. It also includes,

in connection with the immediate perioperative care of a patient, the ability to issue a medication

order for drugs or medications to be administered by a licensed, certified, or registered healthcare

provider; to order and evaluate laboratory and diagnostic test results and perform point-of-care

testing that the CRNA is qualified to perform; and order and evaluate radiographic imaging studies

that the CRNA is qualified to order and interpret. For the purposes of this section, the immediate

perioperative care of a patient shall be defined as the period commencing on the day prior to surgery

and ending upon discharge of the patient from post-anesthesia care. CRNAs shall comply with the

requirements set forth in this chapter, including § 5-34.2-5(b) regarding scope of practice and

prescriptive authority, and the requirements set forth in chapter 34 of this title, as applicable. In the

case of any conflict between this chapter and chapter 34 of this title with regard to the licensure

and practice of CRNAs, this chapter shall control.

     (4) “Non-supervised certified registered nurse anesthetist” or “non-supervised CRNA”

means a CRNA with not less than two (2) years’ supervised practice following certification from

the National Board of Certification and Recertification for Nurse Anesthetists and issuance of initial

licensure by the board pursuant to § 5-34-45.

     (5) “Supervised certified registered nurse anesthetist” or “supervised CRNA” means a

CRNA with less than two (2) years’ supervised practice following certification from the National

Board of Certification and Recertification for Nurse Anesthetists and issuance of initial licensure

by the board pursuant to § 5-34-45.

     5-34.2-5. Accountability — Scope of practice. Accountability -- Scope of practice --

prescriptive authority -- rulemaking authority.

     (a) Accountability. The certified registered nurse anesthetist (“CRNA”) shall be

responsible and accountable to the consumer for his or her the CRNA's practice of nurse anesthesia

as defined under this chapter.

     (b) Scope of practice and prescriptive authority.

     (1) A non-supervised CRNA shall have independent practice authority to deliver anesthesia

care, including the proper administration of the drugs or medicine necessary to deliver anesthesia

care, and related services across the lifespan in various settings based on the non-supervised

CRNA’s education, training and certification, without physician oversight.

     (2) A non-supervised CRNA may issue written prescriptions and medication orders and

order tests and therapeutics pursuant to guidelines mutually developed and agreed upon by the non-

supervised CRNA and the supervising CRNA or supervising physician. A prescription issued by a

non-supervised CRNA shall include the name of the supervising CRNA or the supervising

physician with whom the non-supervised CRNA mutually developed and agreed upon guidelines.

Nothing in this section shall require a non-supervised CRNA to obtain prescriptive authority to

deliver anesthesia care as provided in subsection (b)(1) of this section.

     (3) The board may allow a non-supervised CRNA to exercise independent practice

authority as provided in subsection (b)(1) of this section upon satisfactory demonstration of

alternative professional experience if the board determines that the CRNA has a demonstrated

record of safe prescribing and good conduct consistent with professional licensure obligations

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required by each jurisdiction in which the CRNA has been licensed.

     (4) A supervised CRNA shall practice under the supervision of a healthcare professional

who meets minimum qualification criteria promulgated by the board, which shall include a

minimum number of years of independent practice experience.

     (5) A hospital shall not limit the independent practice authority of a non-supervised CRNA.

     (c) This chapter and the rules and regulations of the board The governing board of a

licensed hospital or, in the case of a clinic or office a licensed anesthetist, physician, or dentist,

shall determine the scope of practice of the nurse anesthetists CRNAs. All responsibilities shall be

in writing in the form prescribed by hospital or office policy. Additionally, nurse anesthetists

CRNAs shall practice in accordance with the current American Association of Nurse Anesthetists

guidelines for nurse anesthesia practice if the nurse anesthetists those guidelines for nurse

anesthesia practice neither do not violate nor or contradict hospital, clinic, or physician- or dentist-

office bylaws, rules, regulations, and policies, nor this chapter.

     (d) The board is authorized and directed to promulgate rules and regulations to implement

this section.

     (e) The executive office of health and human services shall apply to the United States

Department of Health and Human Services for any amendment to the state Medicaid plan or for

any Medicaid waiver as necessary to implement this section. The executive office of health and

human services shall submit the Medicaid state plan amendment no later than September 1, 2026.

     SECTION 2. This act shall take effect on January 1, 2027.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- NURSE ANESTHETISTS

***

     This act would expand the scope of practice for nurse anesthetists with two (2) years or

more experience to remove the requirement of physician supervision. This act would also direct

the EOHHS to apply to the U.S. Department of Health and Human Services for any required

Medicaid waiver for CRNA reimbursement.

     This act would take effect on January 1, 2027.

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