Top CSA Issues

The California Society of Anesthesiology is a trusted source of policy information to legislators and staff within the California State Legislature concerning the practice of physician-led anesthesiology.

Several key issues emerge each legislative session that impact how CSA members care of their patients, scope of practice, and operations of their business models. 

CSA’s objectives in the State Legislature are informed by the Legislative and Practice Affairs Division, chaired by Dr. Jeffrey Poage, and approved by the CSA Board of Directors.

CSA advocates work collaboratively with the California Medical Association and other members of “The House of Medicine” in Sacramento to advocate on behalf of the shared interests of patients and physicians.

Below are several issues of importance during the 2015-16 legislative session.  If you have additional questions, please contact CSA’s lobbyist, Bryce Docherty of KP Public Affairs, at

TAKE ACTION: Oppose Nurse Anesthetists Replacing Anesthesiologists in VA

The Department of Veterans Affairs (VA) has acted unilaterally to replace physician anesthesiologists with nurse anesthetists in VA facilities citing COVID-19. 

Please contact your lawmakers immediately to share your concerns and oppose this change.

Click here to take action

CSA Promotes Safe Dental Anesthesia 

In response to two highly publicized tragedies in which two young children died in California dental offices while undergoing anesthesia, the CSA has actively supported AB 2235, known as “Caleb’s Law”, authored by Assemblymember Tony Thurmond (D-Richmond). This new legislation seeks improved informed consent for parents of children scheduled to undergo dental procedures under anesthesia, along with improved data collection concerning critical incidents and adverse events.

Additionally, CSA leaders have actively engaged in stakeholder meetings at the Department of Consumer Affairs, and offered testimony on this important patient safety issue to the Dental Board of California (DBC).  On August 17, 2016, CSA submitted a letter (attached) outlining specific and stringent recommendations to the DBC on how to improve the permit process for provision of pediatric dental sedation and anesthesia, and how to improve safety in the delivery of anesthesia for pediatric dental and oral surgery care. The California component of the American Academy of Pediatrics (CA-AAP) submitted its own letter (attached) on this issue, in which it urged that the DBC “integrate into your subcommittee report, in full, the recommendations of the California Society of Anesthesiologists (CSA) in their August 17, 2016 letter of comment.” The DBC report and recommendations are expected to be available later this year.

CSA Endorses New Guidelines on Dental Sedation Personnel

AB 72 (Bonta) re: Out of Network Billing

CSA leaders and our lobbyists in Sacramento have been extremely active in advancing the principle of physician-led anesthesia care in the California Legislature. AB 72, aimed at protecting patients from “surprise bills” is headed to the Governor’s desk. The California Medical Association, informed by discussions with CSA and other hospital-based specialties, negotiated with health plans, labor and consumer groups to provide a more level playing field when a patient receives treatment at an in-network facility from an out-of-network provider.

Although CSA believes that AB 72 falls short of creating a real solution to the real problem of “surprise bills,” this legislation is a fairer way of addressing the problem that what CSA faced last year with AB 533. CSA will be deeply engaged in the administrative rule-making process in the next several months and years to ensure the proper definition of “average contracted rate” is adopted and implemented correctly.

CAPP – Protecting MICRA in California

CSA is an active member of the Californians Allied for Patient Protection (CAPP), which is the only broad-based organization of whose sole purpose is to protect access to health care and patient safety through California's Medical Injury Compensation Reform Act (MICRA).

MICRA's provisions work to ensure quality medical care for consumers, stabilize out-of-control medical liability costs to keep providers in practice, and preserve patients' access to fair compensation when they have justifiable claims.

Any changes to MICRA that would weaken its protections will result in higher health care costs overall, no improvement in quality, and reduced access to services. That is why CAPP's large and diverse coalition is committed to ensuring MICRA remains intact and viable in California. 

CSA contributes to CAPP through GASPAC, and CSA leaders participate in candidate interviews and other activities to ensure current and future legislators continue to support and protect MICRA.  For more information on CAPP, please visit their website at

See also: ASA Grassroots Network