News in brief - Aug. 1, 2005

New Jersey Supreme Court lets CRNA supervision rules stand - Pa. Insurance Dept.: No step-up in insurance limits

New Jersey Supreme Court lets CRNA supervision rules stand

The New Jersey Supreme Court last month upheld tighter office supervision rules for certified registered nurse anesthetists as set by the State Board of Medical Examiners.

The court agreed with a lower court ruling, which said an anesthesiologist or a physician with anesthesia privileges must supervise a CRNA during procedures performed in offices with a single surgical suite. Surgeries in hospitals and ambulatory surgery centers already are regulated by state laws.

The rule, set by the state board, was a response to the growing number of procedures performed in small offices, said Joseph M. Gorrell, a Roseland, N.J., attorney who represented the New Jersey State Society of Anesthesiologists. The society argued in favor of tighter supervision rules.

Ervin Moss, MD, executive medical director for the New Jersey State Society of Anesthesiologists, said the court also had ruled that anesthesiologists were best qualified to protect patients and respond to complications that occur.

"The nurses tried to say their education is the same as a physician's," Dr. Moss said. "The court said education does matter, and a doctor is a doctor."

The New Jersey Assn. of Nurse Anesthetists had challenged the rules, saying they were not based on factual information and would harm the nursing profession in the state.

Pa. Insurance Dept.: No step-up in insurance limits

While the Pennsylvania medical liability insurance market is showing growth, there still is not yet enough capacity to warrant increasing the amount of coverage physicians need to purchase from private insurers, the state's insurance commissioner said.

In a report released last month, Insurance Commissioner Diane Koken said the market needs further study before a law takes effect mandating that private insurance limits be increased.

Current state law requires physicians to carry $1 million in medical liability insurance, half of which is purchased through the state-run Mcare Fund. The new law suggested raising the limit for private insurance to $750,000, with the remaining coverage coming from the state fund.

While the market has improved somewhat, "the available information does not allow a finding of sufficient additional capacity to allow a step-up in the basic insurance limit at this juncture," Koken wrote.

"To the contrary, because of the relatively new entries into the Pennsylvania market and the volatility of the financial results appurtenant to this market, additional seasoning is required."