I 119th CONGRESS 1st Session H. R. 2234 IN THE HOUSE OF REPRESENTATIVES March 18, 2025 Ms. Underwood (for herself and Mrs. Kiggans of Virginia ) introduced the following bill; which was referred to the Committee on Veterans' Affairs A BILL To direct the Secretary of Veterans Affairs to update certain standards regarding anesthesia and pain management services in the Veterans Health Administration.

1. Short title This Act may be cited as the Ensuring Veterans Timely Access to Anesthesia Care Act of 2025 . 2. Alignment of standards regarding certified registered nurse anesthetists in the Veterans Health Administration with standards of the Defense Health Agency The Secretary of Veterans Affairs shall update VHA Directive 1123 titled National Anesthesia Program, Department of Veterans Affairs Certified Registered Nurse Anesthetists Practice Guidelines (or any successor directive) to recognize, in the Veterans Health Administration, certified registered nurses anesthetists as licensed independent practitioners in a manner consistent with the practice standards described by section 3(f)(2) of Enclosure of Defense Health Agency Administrative Instruction 6025.07, dated November 8, 2023, as amended. 3. Requirements of anesthesia providers in the Veterans Health Administration (a) Certification The Secretary of Veterans Affairs shall require an anesthesia professional employed by the Secretary as— (1) a physician anesthesiologist to be certified by the American Board of Anesthesiology or a similar body determined by the Secretary; and (2) a certified registered nurse anesthetist to be certified by the Council on Certification of Nurse Anesthetists or the Council on Recertification of Nurse Anesthetists or a similar body determined by the Secretary. (b) Direct care The Secretary shall require an anesthesia professional described in subsection (a) to have completed at least 25 hours of direct patient anesthesia care (not including supervision of other anesthesia professionals). (c) Enforcement The Secretary shall suspend from employment in the Department of Veterans Affairs an anesthesia professional described in subsection (a) who has not complied with the requirements of this section. 4. GAO report on anesthesia delivery in the Veterans Health Administration Not later than one year after the date of the enactment of this Act, and annually thereafter, the Comptroller General of the United States shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report that contains the following, and which shall be made publicly available: (1) Data regarding outcomes regarding the following anesthesia models used in the Veterans Health Administration: (A) Delivery by an anesthesiologist. (B) Delivery by a certified registered nurse anesthetist under the supervision of a physician. (C) Delivery by a certified registered nurse anesthetist without supervision. (2) A comparison of the cost effectiveness of the models described in paragraph (1), including— (A) the estimated cost to medical facilities of the Department of Veterans Affairs and taxpayers for each such model; and (B) a breakdown of costs and savings to taxpayers and to veterans’ households associated with each such model.