VA Anesthesia Care Gets a Military Makeover: CRNAs Gain Independence, All Staff Must Prove 25 Hours of Hands-On Care

The “Ensuring Veterans Timely Access to Anesthesia Care Act of 2025” is a targeted update to how the Veterans Health Administration (VHA) staffs and manages anesthesia services. At its core, the bill does two big things: it aligns the VHA’s rules for Certified Registered Nurse Anesthetists (CRNAs) with the Defense Health Agency (DHA), effectively recognizing them as licensed independent practitioners, and it sets a new, mandatory minimum experience requirement for every single person who delivers anesthesia in the VA system.

Cutting the Red Tape for CRNAs

If you’ve ever had to wait for a procedure at the VA, you know access is key. Section 2 of this bill takes a direct swing at improving that access by updating VHA Directive 1123. It mandates that the VA treat CRNAs the same way the military health system (DHA) does—as independent practitioners. This is a game-changer for staffing. Instead of requiring a physician anesthesiologist to supervise every single case, CRNAs—who are already highly trained—can operate independently in the VA setting. For veterans, this could mean shorter wait times for surgeries and procedures, especially in rural or high-demand VA facilities where physician anesthesiologists might be scarce. It essentially lets the VHA use its existing, highly qualified staff more efficiently.

The New Bar for Anesthesia Staff: 25 Hours or Bust

Section 3 focuses squarely on quality control for everyone involved in anesthesia. It establishes clear, non-negotiable certification rules. Physician anesthesiologists must be certified by the American Board of Anesthesiology (or an approved equivalent), and CRNAs must be certified by the Council on Certification or Recertification of Nurse Anesthetists (or an approved equivalent). But here’s the kicker that affects the providers themselves: every single anesthesia professional, whether doctor or CRNA, must have completed at least 25 hours of hands-on patient anesthesia care. If they don't meet the certification or the 25-hour direct care requirement, Section 3 states they face mandatory and immediate suspension from their job within the VA. This is the bill’s check on competency, ensuring that everyone administering anesthesia has recent, practical experience. For veterans, this translates to a guaranteed minimum level of recent, practical experience from their provider.

Follow the Money: Mandatory Annual Cost Reports

Finally, Section 4 introduces a major transparency measure. It requires the Government Accountability Office (GAO) to produce an annual, public report comparing the cost-effectiveness of the three main ways anesthesia is delivered in the VHA: physician-led, CRNA-supervised, and CRNA-independent. This isn't just an internal audit; the report must detail the total costs for the VHA and taxpayers, and even break down how costs and savings affect veteran households. This provision aims to provide hard data on which delivery model is most efficient. It’s the policy equivalent of shining a bright light on the budget, forcing the VHA to justify its staffing models based on real-world costs and outcomes. This annual public report will be a key piece of accountability for taxpayers and policymakers alike.