With the April 2, 2026 deadline fast approaching, Ambulatory Surgery Centers (ASCs) and anesthesia groups in New Jersey should prepare for the expiration of COVID-19 emergency waivers impacting Certified Registered Nurse Anesthetists (CRNAs). The flexibilities introduced under Executive Order 112 will terminate, and pre-pandemic regulatory requirements will be reinstated.
During the pandemic, in some settings, CRNAs were permitted to practice without joint protocols and without the physical presence of a supervising physician anesthesiologist. With the waivers ending, New Jersey law will again require:
- Written joint protocols between CRNAs and collaborating physicians;
- Supervision by a physician anesthesiologist (not surgeons or other providers);
- Physical presence and immediate availability of the supervising physician during general anesthesia; and
- Compliance with applicable regulations, including N.J.A.C. 13:37-8.1, 13:35-4A.8, and 8:43A-12.5.
Facilities that relied on these flexibilities may need to adjust anesthesia coverage models, staffing, and scheduling. Existing anesthesia agreements should be reviewed to ensure alignment with reinstated supervision and compliance requirements. Failure to timely adapt may result in regulatory risk and operational disruption.
Pending legislation (S-2996/A-4052) could expand independent practice authority for advanced practice nurses, including CRNAs. However, the timing and scope of these changes remain uncertain, and providers should plan based on current law.
Before the expiration of the Executive Order on April 2, 2026, ASC operators and anesthesia groups should:
- Evaluate current CRNA supervision and staffing arrangements,
- Update or implement compliant joint protocols,
- Review and revise anesthesia services agreements, and
- Develop contingency plans if legislation is delayed or not enacted
How Frier Levitt Can Help
Frier Levitt advises ASCs and anesthesia providers on regulatory compliance, contracting, and operational strategy. As the April 2 deadline approaches, failure to act could result in significant compliance risk and operational disruption. Contact Frier Levitt immediately to evaluate your current structure and implement necessary changes.
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