NC S385

Creates new statute requiring anesthesiologists supervising certified registered nurse anesthetists (CRNAs) to comply with Tax Equity and Fiscal Responsibility Act (TEFRA) requirements to bill third-party payors for medical direction services.

Establishes six compliance requirements for anesthesiologists: perform pre-anesthetic examination and evaluation, prescribe anesthesia plan, personally participate in most demanding procedures including induction and emergence, ensure non-performed procedures are completed by CRNAs or anesthesiologist assistants, monitor anesthesia administration at frequent intervals, and remain physically present for emergencies.

Limits anesthesiologist medical direction to up to four concurrent CRNA cases and requires health insurers to reimburse medical direction services at 50% of the rate an anesthesiologist would receive for performing services alone.

Applies the medical direction requirements to the State Health Plan, preferred health plans (PHPs), and directs the Department of Health and Human Services to review Medicaid policies for compliance with the 50% reimbursement rate and TEFRA requirements.

Effective October 1, 2023 for services rendered on or after that date; insurance contract provisions apply to policies issued, renewed, or amended on or after that date.