The Colorado Supreme Court yesterday upheld the governor’s authority to exercise the opt out of Medicare’s physician supervision requirement for certified registered nurse anesthetists. The decision, applauded by the Colorado Hospital Association, allows CRNAs to practice in rural and critical access hospitals without direct physician supervision under rules developed by each facility in consultation with the medical staff. “CHA firmly believes it is more important than ever that qualified health care practitioners, including CRNAs, be permitted to practice up to the maximum level of care delivery permitted under their respective licenses,” said CHA President and CEO Steven Summer. “CHA has vigorously supported this Medicare opt-out determination through all three court proceedings and applauds the Supreme Court’s final ruling. CHA believes this will allow Colorado’s rural and critical access hospitals to better serve their communities by providing quality, affordable care at a local level.” AHA last year filed a friend-of-the-court brief urging the court to uphold the governor’s authority to exercise the opt out to improve access to care for rural residents. A number of states have opted out of the Medicare rule since it became an option in 2001. Colorado’s 2010 opt-out request was made by then-Gov. Bill Ritter Jr.