Colorado Medical Society, a Colorado Nonprofit Corporation, and the Colorado Society of Anesthesiologists, a Colorado Nonprofit Corporation, Petitioners:
John Hickenlooper, in his official capacity as the Governor of Colorado, and Intervenors-Respondents: Colorado Association of Nurse Anesthetists, Colorado Nurses Association, and Colorado Hospital Association, Respondent:
Certiorari to the Colorado Court of Appeals. Court of Appeals Case No. 11CA1005.
To recieve Medicare reimbursment, hospitals and other medical service providers must require certified registered nurse anesthetist (" CRNAs" ) who administer anesthesia to do so under physician supervision. However, states may opt out of this requirements if the governor submits a letter to the relevant federal agencies attesting that the opt-out is in the best interest of the state's citizens and is consistent with state law. In 2010, then-Governor Bill Ritter, Jr. sent such an opt-out letter, which attested that Colorado law permits CRNAs to administer anesthesia unsupervised.
Today we hold that the Governor's attestation to the federal agencies that Colorado law permits CRNAs to administer anesthesia without supervision is not a generally binding interpretation of Colorado law that is subject to de novo review. Instead, the attestation's sole effect is to exempt certain Colorado hospitals from the federal physician supervision requirement. This decision, if reviewable at all, is reviewable only for a gross abuse of discretion. Because the petitioners do not allege that such a gross abuse occurred here, we affirm the decision of the court of appeals affirming dismissal of the petitioners' claim.
Attorneys for Petitioner Colorado Medical Society: Martin Conklin P.C., John L. Conklin, Jerome R. Geraghty, Denver, Colorado.
Attorneys for Petitioner Colorado Society of Anesthesiologists: Sherman & Howard L.L.C., Joseph J. Bronesky, Frederick Y. Yu, Denver, Colorado.
Attorneys for Respondent: Cynthia H. Coffman, Attorney General, LeeAnn Morrill, First Assistant Attorney General, Matthew David Grove, Assistant Attorney General, Denver, Colorado.
Attorneys for Intervenor-Respondent Colorado Association of Nurse Anesthetists: Miles & Peters, P.C., Fred Miles, Peggy Kozal, Denver, Colorado.
Attorneys for Intervenor-Respondent Colorado Nurses Association: Caplan and Earnest LLC, W. Stuart Stuller, Linda L. Siderius, Boulder, Colorado.
Attorneys for Intervenor-Respondent Colorado Hospital Association: Polsinelli PC, Gerald Niederman, Bennett L. Cohen, Denver, Colorado.
Attorneys for Amici Curiae American Medical Association and American Society of Anesthesiologists: Kennedy Childs P.C., John R. Mann, Denver, Colorado.
Attorneys for Amicus Curiae American Hospital Association: Hogan Lovells U.S. LLP, Christopher O. Murray, Denver, Colorado.
Attorneys for Amici Curiae American Association of Nurse Anesthetists and American Nurses Association: Duane Morris LLP, Mark J. Silberman, Elinor L. Hart, Chicago, Illinois; Husch Blackwell, LLP Jeffrey D. Whitney, Denver, Colorado.
JUSTICE EID delivered the Opinion of the Court., JUSTICE MÁRQUEZ does not participate.