AN ACT RELATING TO BUSINESSES AND PROFESSIONS -- NURSE ANESTHETISTS (Expands the scope of practice for nurse anesthetists with two years’ or more experience to remove the requirement of physician supervision.)

H7426

2026 -- H 7426
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2026
____________
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:
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SECTION 1. Sections 5-34.2-2 and 5-34.2-5 of the General Laws in Chapter 5-34.2 entitled
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"Nurse Anesthetists" are hereby amended to read as follows:
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5-34.2-2. Definitions.
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(a)
(1)
“Board” means the board of nurse registration and nurse education established in §
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5-34-4.
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(b)
(2)
“Certified registered nurse anesthetist” (CRNA) means a registered nurse who has
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successfully met the requirements stated in this chapter.
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(c)
(3)
“Practice of certified registered nurse anesthesia” means providing certain healthcare
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services in collaboration with anesthesiologists, licensed physicians, or licensed dentists in
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accordance with § 5-31.1-1(17) which requires substantial specialized knowledge, judgment, and
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skill related to the administration of anesthesia, including preoperative and postoperative
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assessment of patients; administering anesthetics; monitoring patients during anesthesia;
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management of fluid in intravenous therapy; and management of respiratory care. It also includes,
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in connection with the immediate perioperative care of a patient, the ability to issue a medication
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order for drugs or medications to be administered by a licensed, certified, or registered healthcare
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provider; to order and evaluate laboratory and diagnostic test results and perform point-of-care
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testing that the CRNA is qualified to perform; and order and evaluate radiographic imaging studies
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that the CRNA is qualified to order and interpret. For the purposes of this section, the immediate
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perioperative care of a patient shall be defined as the period commencing on the day prior to surgery

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and ending upon discharge of the patient from post-anesthesia care. CRNAs shall comply with the
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requirements set forth in this chapter, including § 5-34.2-5(b) regarding scope of practice
and
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prescriptive authority
, and the requirements set forth in chapter 34 of this title, as applicable. In the
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case of any conflict between this chapter and chapter 34 of this title with regard to the licensure
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and practice of CRNAs, this chapter shall control.
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(4) “Non-supervised certified registered nurse anesthetist” or “non-supervised CRNA”
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means a CRNA with not less than two (2) years’ supervised practice following certification from
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the National Board of Certification and Recertification for Nurse Anesthetists and issuance of initial
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licensure by the board pursuant to § 5-34-45.
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(5) “Supervised certified registered nurse anesthetist” or “supervised CRNA” means a
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CRNA with less than two (2) years’ supervised practice following certification from the National
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Board of Certification and Recertification for Nurse Anesthetists and issuance of initial licensure
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by the board pursuant to § 5-34-45.
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5-34.2-5.
Accountability — Scope of practice.
Accountability -- Scope of practice --
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prescriptive authority -- rulemaking authority.
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(a) Accountability. The
certified registered
nurse anesthetist
(“CRNA”)
shall be
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responsible and accountable to the consumer for
his or her

the CRNA's
practice of nurse anesthesia
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as defined under this chapter.
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(b) Scope of practice
and prescriptive authority
.
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(1) A non-supervised CRNA shall have independent practice authority to deliver anesthesia
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care, including the proper administration of the drugs or medicine necessary to deliver anesthesia
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care, and related services across the lifespan in various settings based on the non-supervised
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CRNA’s education, training and certification, without physician oversight.
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(2) A non-supervised CRNA may issue written prescriptions and medication orders and
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order tests and therapeutics pursuant to guidelines mutually developed and agreed upon by the non-
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supervised CRNA and the supervising CRNA or supervising physician. A prescription issued by a
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non-supervised CRNA shall include the name of the supervising CRNA or the supervising
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physician with whom the non-supervised CRNA mutually developed and agreed upon guidelines.
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Nothing in this section shall require a non-supervised CRNA to obtain prescriptive authority to
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deliver anesthesia care as provided in subsection (b)(1) of this section.
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(3) The board may allow a non-supervised CRNA to exercise independent practice
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authority as provided in subsection (b)(1) of this section upon satisfactory demonstration of
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alternative professional experience if the board determines that the CRNA has a demonstrated
34
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.
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(4) A supervised CRNA shall practice under the supervision of a healthcare professional
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who meets minimum qualification criteria promulgated by the board, which shall include a
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minimum number of years of independent practice experience.
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(5) A hospital shall not limit the independent practice authority of a non-supervised CRNA.
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(c) This chapter and the rules and regulations of the board

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

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shall determine the scope of practice of
the nurse anesthetists

CRNAs
.
All responsibilities shall be
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in writing in the form prescribed by hospital or office policy.
Additionally,
nurse anesthetists

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CRNAs
shall practice in accordance with the current American Association of Nurse Anesthetists
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guidelines for nurse anesthesia practice if
the nurse anesthetists

those
guidelines for nurse
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anesthesia practice
neither

do not
violate
nor

or
contradict
hospital, clinic, or physician- or dentist-
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office bylaws, rules, regulations, and policies, nor
this chapter.
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(d) The board is authorized and directed to promulgate rules and regulations to implement
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this section.
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(e) The executive office of health and human services shall apply to the United States
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Department of Health and Human Services for any amendment to the state Medicaid plan or for
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any Medicaid waiver as necessary to implement this section. The executive office of health and
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human services shall submit the Medicaid state plan amendment no later than September 1, 2026.
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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
***
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This act would expand the scope of practice for nurse anesthetists with two (2) years or
2
more experience to remove the requirement of physician supervision. This act would also direct
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the EOHHS to apply to the U.S. Department of Health and Human Services for any required
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Medicaid waiver for CRNA reimbursement.
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This act would take effect on January 1, 2027.
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