The Issue of Independence by Nurse-anesthetists

The Minnesota Association of Nurse-Anesthetists has filed a lawsuit charging Allina Health Corporation, five group practices, four hospitals and 65 doctors with wrongfully billing Medicare for services actu whollyy provided by manifest registered nurse-anesthetists (Johnsson, 1997, p. 1). The civil suit, seeking o'er $1 billion in damages and fines, charges the defendants with submitting over 100,000 improper claims since 1991, a charge denied by the hospitals and doctors named in the suit. Those charged note that federal judges jilted two earlier versions of the complaint, in 1994 and 1995, contending in the latter that, "all the alleg

ations are totally without merit."

Greene, J. (1999). anesthesia turf war heats up in battle over supervision. Am. Med. News, 42, pp. 1-2.

Martin, S. (1998). Nurse-anesthetists want to go solo: proposal removes Medicare requirement for medico oversight. Am. Med.

News, 41, pp. 1-2.

In the current case, as many as 95 percent of the claims filed by anesthesiologists are alleged to be away (Johnsson, 1997, p. 2). Anesthesiologists can bill for full charges when they personally perform the procedure, and reduce charges when they medically direct procedures. In the cases cited, nurse-anesthetists say the claims they personally submitted bit filling in for absent physicians were either rejected as "double billing" or paid at a lower rate by Medicare carriers. Meanwhile, the carrier has taken no action for supposedly fraudul
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