Wisconsin’s APRN Modernization Act grants expanded autonomy for CRNAs

Wisconsin recently made significant strides in healthcare policy by granting Advanced Practice Registered Nurses (APRNs), including Certified Registered Nurse Anesthetists (CRNAs), greater autonomy. This development comes with the signing of Wisconsin Assembly Bill 257, also known as the APRN Modernization Act, on August 8, 2025, by Governor Tony Evers. The new law, which marks a progressive shift in healthcare delivery, allows these healthcare professionals to practice independently once they meet the prescribed educational and clinical practice requirements.

What Does the APRN Modernization Act Mean for CRNAs?

The APRN Modernization Act allows APRNs, including CRNAs, to practice independently without being in a collaborative agreement with a physician or dentist. This reform provides more freedom for CRNAs to deliver care based on their training and expertise. However, the law still requires CRNAs to complete a specific number of educational hours and practice hours with a physician or dentist before they can fully operate independently. Notably, the Act also sets out APRN licensure, education, and certification requirements in statute for the first time, ensuring these regulations are officially recognized and enforceable.

One of the most notable changes under the law is its recognition of APRNs with doctoral degrees. Starting in 2025, all nurse anesthesiology program graduates will earn a doctoral degree, allowing them to use the title “doctor” along with the specific field abbreviation. This is a substantial change in the professional identity of nurse anesthetists and a sign of the increasing complexity and responsibility of their role.

CRNAs Now Authorized to Provide Comprehensive Care

Under the new legislation, CRNAs are granted an expanded scope of practice that includes anesthesia care, pain management, and prescriptive authority. They are now recognized as key providers of anesthesia care in various settings, including hospitals, ambulatory surgery centers, outpatient clinics, and private offices. This also includes the authority to prescribe medication related to their scope of practice.

The law also addresses the specific situation of CRNAs who treat pain. If CRNAs are involved in pain management, they must work under a collaborative agreement with a physician unless they have met the qualifications for independent practice. This collaboration is still required in some healthcare settings, such as hospitals or hospital-associated clinics, or for those holding hospital privileges.

Impact on Rural Healthcare and Access to Care

For rural states like Wisconsin, the shortage of healthcare providers has always been a challenge. CRNAs play a crucial role in addressing this issue, especially in rural hospitals where they often serve as the primary providers of anesthesia. In these areas, access to healthcare can be limited, and the ability for CRNAs to practice independently can significantly enhance service delivery.

Christine Roth, CRNA and president of the Wisconsin Association of Nurse Anesthetists (WIANA), emphasized the importance of this legislation. She stated that Governor Evers’ actions ensure Wisconsin’s most vulnerable populations have access to high-quality, value-based care. By granting CRNAs the ability to practice to the full extent of their education and training, patients in Wisconsin will benefit from improved access to anesthesia services, particularly in underserved rural communities.

CRNAs Across the U.S. Play an Essential Role in Healthcare Delivery

The role of CRNAs in the U.S. healthcare system cannot be overstated. Every year, CRNAs safely administer more than 58 million anesthetics across a wide array of medical settings. From traditional hospital surgical suites to outpatient clinics, CRNAs are integral to the delivery of safe and efficient anesthesia. Their services are vital in various specialized medical settings, including dental, ophthalmological, podiatric, and plastic surgery offices. CRNAs are also a critical part of the U.S. military and public health services, delivering anesthesia care in some of the most challenging environments.

As the profession continues to evolve and expand, the APRN Modernization Act signals a significant step toward recognizing and maximizing the potential of CRNAs. The ability for these professionals to practice independently not only elevates their role in the healthcare system but also helps to meet the growing demand for anesthesia care in a rapidly changing medical landscape.

Expert Sentiment: Industry Applauds the Reform

The American Association of Nurse Anesthesiology (AANA) has voiced strong support for Governor Evers’ decision. AANA President Jan Setnor, MSN, CRNA, Col. (Ret), USAFR, NC, praised the law for acknowledging the important role CRNAs play in providing anesthesia care across Wisconsin and the U.S. Setnor highlighted that this legislation improves the efficiency and safety of anesthesia delivery, benefiting patients and healthcare systems alike.

The Future of CRNA Practice in Wisconsin and Beyond

The passage of the APRN Modernization Act in Wisconsin represents a pivotal moment for CRNAs, not only in the state but across the entire country. As healthcare systems grapple with workforce shortages, particularly in rural and underserved areas, the independence granted to CRNAs under this new law is poised to have far-reaching implications. By enabling CRNAs to practice without a supervisory agreement with a physician or dentist, the legislation increases their capacity to address gaps in anesthesia care, where demand is often high but supply is limited.

This move in Wisconsin could become a model for other states to follow, with the potential for nationwide change. Many states have already begun to examine the role of APRNs in the healthcare system, and the success of Wisconsin’s reforms may influence legislation in other regions. Experts anticipate that more states could enact similar policies, recognizing the value of expanding APRN practice to meet growing healthcare demands. This would lead to a broader trend of allowing CRNAs and other advanced practice nurses to operate independently, making healthcare more accessible, especially in rural and economically disadvantaged areas.

Furthermore, as more CRNAs gain the ability to practice independently, it is expected that their contributions to anesthesia care will be recognized more broadly. CRNAs will likely take on more leadership roles in both clinical and administrative settings, optimizing the delivery of anesthesia services across the healthcare continuum. The expanded autonomy could also result in an increase in educational and professional development opportunities, with CRNAs pursuing advanced degrees and certifications to further enhance their skill sets.

The long-term effect of these reforms may not only address the immediate need for anesthesia providers in rural hospitals but also contribute to the overall efficiency of healthcare delivery. By allowing CRNAs to work to the full extent of their training, healthcare institutions can increase patient access to high-quality anesthesia care while improving the efficiency of surgical and pain management services. In the coming years, the full integration of CRNAs into the healthcare workforce may help alleviate pressure on overburdened healthcare systems, particularly in rural regions where shortages of medical professionals are most pronounced.

Ultimately, as CRNAs continue to expand their roles, both in Wisconsin and beyond, they will play a crucial part in shaping the future of healthcare delivery, helping to meet the demands of a growing and aging population. By leveraging their training, expertise, and newfound autonomy, CRNAs are well-positioned to significantly improve patient outcomes and contribute to more resilient healthcare infrastructures nationwide.