ASA Scores Major Victory on Labor Epidural Supervision 

CMS recently issued revised Interpretative Guidelines (IGs) to the Hospital Conditions of Participation that contain major victories for ASA's regulatory lobbying efforts. These guidelines revise major sections of the December 2009 CMS Hospital Interpretative Guidelines. 

CMS has removed language specifically exempting labor epidurals from the physician supervision requirements. Hospitals are now required to "establish policies and procedures, based on nationally recognized guidelines, that address whether specific clinical situations involved anesthesia versus analgesia," as well as, "the minimum qualifications and supervision requirements for each category of practitioner who is permitted to provide analgesia services." 

When the 2009 IGs were released, ASA developed a comprehensive regulatory lobbying strategy, involving extensive comment letters, meetings and discussions with appropriate CMS officials, with the goal of making substantive changes to the IGs. ASA's focus in all of its efforts was consistently on patient safety and quality of care coupled with emphasis on anesthesia as a continuum with no clear boundaries. The strategy worked. 

ASA will soon release additional updates and information on other positive developments in the revised interpretive guidelines. 

Document Links
Anesthesia FAQs
Revised Hospital Anesthesia Services IGs
Advance copy of Revised Appendix A

Best Regards, 


Kenneth Elmassian, D.O., 
Director American Society of Anesthesiologists President, Michigan Society of Anesthesiologists
517 974 2377


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