AANA’s dedication to our members never pauses—there is seldom “slow time” as we diligently assess, forecast, and advocate for legislative, regulatory, and CRNA practice priorities.
Fair reimbursement is always a main priority. As we have reported recently, commercial payers are reimbursing CRNAs/nurse anesthesiologists at lower rates than physician anesthesiologists for non–medically directed services (QZ HCPCS modifier). These policies are not only unfair and discriminatory to CRNAs/nurse anesthesiologists but also threaten access to care for vulnerable populations and the viability of healthcare systems in already stressed, underserved areas.
AANA is pushing back—collaborating with national partners, state associations, hospitals, surgery centers, rural stakeholders, and insurance commissioners. We need member stories about how reimbursement cuts from UHC, Cigna, Anthem, and others are affecting care delivery, staffing, and—most importantly—patient access. Please share your experience at info@aanadc.com.
As always, thank you for all you do and for supporting your colleagues and the profession through your AANA membership. AANA now represents more than 69,000 members—we are honored to serve you as your Board of Directors.
The CY 2026 Medicare PFS proposed rule contains several major policy proposals that could impact CRNA practice and reimbursement. AANA’s comments and recommendations make the following recommendations to CMS:
Ensure access for all Medicare Part B providers to meaningfully participate in Alternative Payment Models.
Work with Congress and other stakeholders to implement Medicare payment reform to ensure long-term, appropriate reimbursement for anesthesia services.
Utilize empirical data to support RUC survey data in the valuation of services paid under the Medicare PFS.
Implement payment methodologies for Software as a Service that incorporate principles that protect CRNAs’ essential clinical decision-making.
Avoid developing or implementing policies allowing for remote supervision of anesthesia services.
Include CRNAs as participants in the Low Back Pain cohort for the Ambulatory Specialty Model and make participation voluntary.
Ensure meaningful CRNA participation in the Medicare Quality Payment Program and maintain the use of clinically relevant anesthesia measures.
AANA will continue to engage with CMS on these and other payment and reimbursement policies that could impact CRNAs and will monitor the release of the CY 2026 Medicare Part B Physician Fee Schedule final rule, which is expected in November 2025.
CMS Releases Application for $50 Billion Rural Health Transformation Program
On Sept. 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released details on how states can apply for funding through the new $50 billion Rural Health Transformation (RHT) Program, established by the Working Families Tax Cuts Act. This rural health care program aims to help states strengthen rural health infrastructure, expand access, and improve care delivery and outcomes. States can apply for funds to improve rural care through five priority areas: preventive health, sustainable access, workforce development, innovative care models, and technology adoption. Applications are due Nov. 5, 2025, with awardees to be announced by Dec. 31, 2025, and funding to begin in FY 2026 and continue over five years.
AANA is actively working with state associations to consider how to leverage this program to support the CRNA workforce. Opportunities under consideration include expanding RRNA clinical training sites and scaling innovative care delivery models such as the efficiency-driven anesthesia model (EDAM) to strengthen access and sustainability in rural communities.
Reimbursement Limitation Removed from Colorado Worker Compensation Rules
The Colorado Department of Labor and Employment’s Division of Workers’ Compensation has adopted a rule removing the reimbursement cap for CRNA/nurse anesthesiologist services. Previously, if a CRNA was not medically directed by a physician anesthesiologist, reimbursement was limited to 90% of the maximum anesthesia value set by the state’s workers’ compensation rules. The Colorado Association of Nurse Anesthetists successfully advocated for the removal of this cap.
2024 MIPS Performance Feedback Information Is Published
The Department of Education is implementing provisions of H.R. 1, the One Big Beautiful Bill Act, which would cap student loan amounts based on whether a student is pursuing a “professional” degree.
The FGA team signed onto two coalition comment letters submitted to the Department’s advisory committee responsible for implementation recommendations. The first letter, signed by a broad range of healthcare professions, urged the committee to treat all post-baccalaureate degrees in licensed or credentialed healthcare fields as professional degrees. The second letter, from the Nursing Community Coalition, provides evidence that advanced nursing degrees meet the criteria for professional degrees.
The committee’s recommendations are just the first step in this process. FGA will continue to monitor the issue and advocate for future CRNA/nurse anesthesiologists.
Federal Government on Brink of Shutdown
The Federal Government remains on the brink of a shutdown, which would start on Wednesday, Oct. 1, unless Congress and the Administration are able to come to an agreement. Currently, neither the House nor the Senate has passed the required appropriations bills for Fiscal Year 2026, which begins on Oct. 1. On Sept. 19, the House passed a short-term Continuing Resolution (CR) that would fund the government at current levels until Nov. 21. The Senate voted on the same CR, but the vote failed, as did a vote on a Democratic led alternative.
Currently, Republicans leading both chambers are pushing for a “clean CR”—a resolution that continues current funding without policy changes. Democrats are seeking to include a renewal of health insurance tax credits, which are set to expire. The loss of these tax credits is estimated to lead to significant cost increases for health insurance and potentially the loss of insurance for millions.
On Tuesday, Sept. 23, President Trump called off a planned meeting with Congressional Leaders, making the likelihood of a shutdown greater. This week, neither the House nor the Senate are in session, further complicating efforts. Currently, the Administration and leaders at the Office of Management and Budget (OMB) and other agencies have significant latitude over decisions to furlough employees, and who may or may not be deemed essential workers. AANA will be monitoring the situation as it develops and will keep members who may be affected by the shutdown updated as we learn more information.
In addition to the effects on agencies, a shutdown would mean that AANA and other associations would have to pause both Congressional and Agency lobbying efforts until the government is reopened. The shutdown would also affect AANA’s political giving as well, which would be paused during a shutdown. If you have questions or concerns about a government shutdown, please reach out to the AANA Federal Government Affairs team at info@aanadc.com.
Significant News
Introducing Airway Exchange, a New Podcast
Airway Exchange, a new podcast from AANA and Beyond the Mask, premiered Tuesday, Sept. 23. It offers nurse anesthesia educators a platform to connect and foster a supportive community. New episodes drop every other Tuesday. The host team and guests bring academic excellence to fellow educators, CRNA/nurse anesthesiologists, and future CRNAs.
Hosts include Gregory B. Collins, DNP, CRNA; Nickie Damico, PhD, CRNA, CHSE, FAANA; Erin E. Martin, DNP, APRN, CRNA; and Louisa Dasher Martin, PhD, CRNA. Learn more.
Coming in November: Nominations Open for the 2026 Election
The nomination period for the AANA 2026 Election will run from Nov. 3, 2025, through Jan. 15, 2026. Nominations may be submitted by an individual member on their own behalf, by one member on behalf of another, or by a state association.
The following is an FEC required legal notification for CRNA-PAC. Gifts to political action committees are not tax deductible. Contributions to CRNA-PAC are for political purposes. All contributions to CRNA-PAC are voluntary. You may refuse to contribute without reprisal. The guidelines are merely suggestions. You are free to contribute more or less than the guidelines suggest and the association will not favor or disadvantage you by reason of the amount contributed or the decision not to contribute. Federal law requires CRNA-PAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. Each contributor must be a US Citizen.
American Association of Nurse Anesthesiology 10275 West Higgins Road, Suite 500 Rosemont, IL 60018
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