opposed by physician groups. In 2011, sixteen states granted CRNAs autonomy, allowing them to practice without anesthesiologist oversight. In 2017, there were 27 states in which CRNAs could independently practice (that is, "without a written collaborative agreement, supervision or conditions for practice"). In 2020, there was no physician supervision requirement for nurse anesthetists in ambulatory surgical facilities in 31 states In states that have opted out of supervision, the Joint Commission and CMS recognize CRNAs as licensed independent practitioners. In states requiring supervision, CRNAs have liability separate from supervising practitioners and are able to administer anesthesia independently of anesthesiologists. See also Anesthesiologist References Anesthesia Advanced practice registered nursing Hospital nursing