Do CRNAs have independent prescriptive authority nationwide?

• A. All CRNAs have independent prescriptive authority nationwide.
• B. It varies by state; some grant independent prescriptive authority including controlled substances with or without physician collaboration; others limit to non-controlled substances or require supervision.
• C. No CRNA has prescriptive authority in any state.
• D. Prescriptive authority is the same across all states.

Answer: (B)

Prescriptive authority for CRNAs is determined by state law, not a federal standard. Some states grant independent prescribing rights to CRNAs, and this can include control of controlled substances, sometimes with required physician collaboration or supervision. Other states place limits, allowing prescribing only for non-controlled substances or requiring ongoing supervision or collaboration. Because each state sets its own rules, there is no nationwide, uniform authority.

That’s why the statement that there is nationwide independent prescriptive authority is incorrect, as is the idea that no CRNAs can prescribe at all, or that prescriptive authority is the same in every state. The correct view is that it varies by state and can differ in what can be prescribed and under what supervision.