Nurse Anesthetists Sue California Over Rules Keeping Them Off Hospital Medical Staff

The California Association of Nurse Anesthesiology (CANA) is suing California health regulators over rules it says improperly exclude certified registered nurse anesthetists (CRNAs) from hospital medical staffs. Announced October 17, 2026, the case puts nurses’ role in hospital decision-making at the center of a legal fight.

CANA says the dispute has already affected patients. The complaint alleges that a May 2024 CDPH inspection prompted Doctors Medical Center in Modesto to remove all CRNAs from practice for roughly six weeks, disrupting more than 1,000 surgical cases. That is an allegation about an earlier enforcement episode, not a count tied to the new lawsuit.

The complaint was filed October 1st in San Francisco County Superior Court against the California Department of Public Health (CDPH) and California Office of Administrative Law. It seeks a court declaration invalidating four California Code of Regulations provisions that CANA argues improperly limit medical staff membership. CANA’s allegations have not been proven in court.

Want to see more Nurse.org articles in your Google results? Add us as a preferred source.

At the heart of CANA’s argument is a distinction between permission to provide anesthesia and membership in the medical staff that helps govern care. The association alleges CRNAs can receive clinical privileges while being excluded from decisions about quality, peer review, credentialing, and hospital policy.

CANA contends that state law allows medical staffs to include qualified licensed practitioners, and that CDPH’s narrower regulations exceed the department’s authority. The association says it first petitioned the state, through CDPH’s predecessor agency, in July 1988. CANA petitioned CDPH again in December 2023, and the American Nurses Association\California filed a similar petition in May 2024. CDPH denied both in September 2025, which CANA cites as the trigger for going to court.

“CDPH’s authority over hospital facilities does not grant it authority over the determination of which individual licensed practitioners the medical staff has deemed ‘competent in their respective fields and worthy in professional ethics,’” Katherine Bowles, J.D., CANA’s counsel, said in the announcement. “That power lies entirely with the medical staff, established within California law as an independent, self-governing legal entity.”

CANA Executive Director Alison Trejo added that “these structural barriers place an undue burden on hospital medical staff and have already caused dangerous disruptions in patient care.” She argues that aligning the regulations with state law would improve governance and patient safety.

The filing also alleges financial harm to individual CRNAs. One member, identified in the complaint only as D.V., reportedly lost approximately $4,000 to $6,000 per week for several weeks after enforcement at the Modesto hospital removed all CRNAs from practice for about six weeks in 2024. That account is an allegation in the complaint and has not been independently verified.

CDPH has not responded publicly to the October 1 complaint. The department has, however, previously set out its legal reasoning on this question. In petition denials published in California’s October 24, 2025, Regulatory Notice Register, CDPH cited its authority to regulate general acute care hospitals and rejected requests from CANA and the American Nurses Association\California to broaden medical staff membership.

The department’s explanation focused on Assembly Bill 890.

CDPH said AB 890 and related Business and Professions Code sections created a new certification process for nurse practitioners who meet specific experience, training, and other requirements, and granted medical staff eligibility to that subset of NPs. CDPH argued that extending medical staff privileges to all advanced licensed providers, as the petitions requested, would undermine that targeted framework and go beyond what lawmakers authorized. The department did acknowledge that some title 22 regulations may need revision to align with AB 890.

Those documents explain the earlier petition decisions and are not a response to the new complaint. Becker’s Hospital Review reported that it had contacted CANA, CDPH, and the Office of Administrative Law for additional information. CDPH’s position on the underlying enforcement history offers one view of the surgery disruption claim.

Becker’s July 30, 2024, reporting attributed the nearly 1,000 canceled surgeries figure to a letter from California Assemblymembers Heath Flora and Juan Alanis. The letter concerned CRNA credentialing confusion following enforcement at Doctors Medical Center in Modesto.

In that same 2024 report, CDPH said its responsibility was to ensure facilities complied with state and federal requirements and to investigate allegations of noncompliance. The American Society of Anesthesiologists, through then-president Ronald Harter, MD, supported CDPH and CMS’s work to identify what ASA characterized as CRNA patient-safety deficiencies at two California hospitals. These competing accounts predate the current lawsuit and should not be read as a judicial finding for either side.

>>Listen to The Latest Nurse News Podcast

For CRNAs, the practical question is who gets to help shape the policies governing their work. CANA’s requested relief targets the regulations themselves, making this a case to watch for nurses interested in hospital governance, professional standing, and access to anesthesia services.

For nurses reviewing a job or a proposed policy change, useful questions include:

• What clinical privileges does the position carry?
• Is medical staff membership available?
• Who represents nursing expertise in decisions about anesthesia care?

CRNAs should ask the credentialing office for the applicable written policies.

The next development to watch is how the agencies answer the complaint and how the court addresses CANA’s request. The filed complaint is a request for relief, not an order changing hospital policy. Keep that distinction in mind when discussing the case at work.

🤔 Should CRNAs with hospital privileges also have a voice on the medical staff that sets care policies? Share your perspective in the comments.