On February 27, 2017, Senate Bill 210 (“S.B. 210”) was introduced into the Nevada Legislature, which paves the way for expanded anesthesiology practice and patient care opportunities in the State of Nevada. Specifically, S.B. 210 provides for the licensure and regulation of anesthesiology assistants, a category of medical professionals who practice exclusively in the anesthesiology field. Under the proposed legislation, anesthesiology assistants would be permitted to practice under the direct supervision of a licensed physician anesthesiologist as part of an anesthesia care team designed to increase treatment capacity while improving practice efficiency through the use of highly skilled, lower cost providers.
The catalyst for S.B. 210 stems from ongoing financial constraints facing Nevada’s anesthesiology practitioners and increased demand for anesthesiology services, particularly among Medicaid enrollees. During Nevada’s 2010 special legislative session, Medicaid payments to physician anesthesiologists and nurse anesthetists were reduced by 50%, which led to a shortage of anesthesiology services for Nevada’s Medicaid participants. The state’s access to care dilemma was later exacerbated by the individual health insurance mandates under the Patient Protection and Affordable Care Act and Nevada’s expansion of Medicaid coverage in 2014, which increased Nevada’s Medicaid enrollment by over 60%.
In response, S.B. 210 provides physician anesthesiologists with the ability, but not the obligation, to increase the treatment capacity and operational efficiency of their practice through the use of anesthesiology assistants, a category of medical professionals currently recognized and licensed in 17 U.S. jurisdictions. Under the proposed legislation, anesthesiology assistants would be licensed by the Nevada State Board of Medical Examiners (the “Board”) and required to work in an anesthesia care team under the direct supervision of a physician anesthesiologist. Subject to regulations adopted by the Board, a single physician anesthesiologist would be authorized to supervise up to four anesthesiology assistants, thereby increasing the available anesthesia care while ensuring the physician’s availability to interact with patients and supervise anesthesiology assistants, as necessary.
Like the practice of office-based medicine, which has evolved to leverage care team models comprised of physicians, physicians assistants, nurse practitioners, and medical assistants for the delivery of timely and cost efficient patient care, the anesthesiology field is undergoing a service model transformation. While S.B. 210 has garnered support from a wide range of participants in this healthcare sector, the extent to which the Nevada legislature will expand the scope of practice for non-physicians remains unclear. If enacted, however, S.B. 210 will expand anesthesia care to Nevada residents, including underserved Medicaid participants, while presenting physician anesthesiologists with practice alternatives. Snell & Wilmer L.L.P. will continue to monitor S.B. 210 as the current legislative session progresses.