HB 251: Nurses; certified registered nurse anesthetist to order and administer anesthesia and an anesthesia plan under certain conditions; provide

Current Georgia law lets certified registered nurse anesthetists (CRNAs) administer anesthesia when a physician could lawfully do so, but only under a physician's direction and responsibility. This bill rewrites that law (O.C.G.A. § 43-26-11.1) to instead require that CRNAs act 'in coordination with' a physician, a looser standard than direct supervision. The bill adds new definitions for 'anesthesia plan' and 'coordination,' spelling out what planning and teamwork between a CRNA and physician should include, such as evaluating patients and developing treatment approaches together. It also lets healthcare facilities set their own policies on anesthesia care, and it shields physicians from liability for a CRNA's actions or mistakes when the physician is not the one delivering the anesthesia. The law would take effect as soon as the Governor signs it.

• Changes the legal standard for CRNA anesthesia care from physician 'direction and responsibility' to physician 'coordination,' a less supervisory relationship.
• Allows CRNAs to order anesthesia and create an anesthesia plan, not just administer anesthesia as before.
• Adds formal definitions for 'anesthesia plan' and 'coordination' to clarify what the new working relationship involves.
• Confirms healthcare facilities can still adopt their own internal policies governing how anesthesia is provided.
• Protects physicians from liability for a CRNA's acts or omissions when the physician is not personally delivering the anesthesia.

Certified registered nurse anesthetists, physicians who work with them on anesthesia care, hospitals and other healthcare facilities that set anesthesia policies, and patients who receive anesthesia during medical procedures in Georgia.

CRNAs would gain more independence in planning and administering anesthesia, potentially affecting staffing and workflow in operating rooms, especially in areas with fewer anesthesiologists. Physicians would face reduced liability exposure for CRNA-administered anesthesia they are not directly delivering.

• Section 1 revises O.C.G.A. § 43-26-11.1, replacing the requirement that anesthesia be given 'under the direction and responsibility of a duly licensed physician' with a requirement that it be given 'in coordination with a physician.'
• Subsection (a) defines 'anesthesia plan' as covering patient evaluation, referrals, choice of anesthetic agent and technique, and ordering related medications and tests.
• Subsection (a) also defines 'coordination' as a physician and CRNA working together, sharing information, and jointly developing or modifying the anesthesia plan.
• Subsection (c) preserves healthcare facilities' authority to set their own anesthesia-related policies.
• Subsection (d) shields a physician who is not delivering the anesthesia from liability for a CRNA's acts or omissions in administering it.
• Section 2 sets the effective date as the date the Governor signs the bill or it otherwise becomes law without signature.

1. 2025-02-06House Second Readers (House)
2. 2025-02-05House First Readers (House)
3. 2025-02-04House Hopper (House)

• Lauren McDonald (R, HD-026)Primary sponsor
• James Hatchett (R, HD-155)
• Alan Powell (R, HD-033)
• Mike Cheokas (R, HD-151)
• Stan Gunter (R, HD-008)
• David Wilkerson (D, HD-038)

• nurse anesthetists
• medical licensing
• anesthesia care
• hospital policy
• physician liability