CRNA · Maine
Collaborative Practice Agreement for Certified Registered Nurse Anesthetists in Maine
Yes, a written physician agreement is required. Maine does not name a specific instrument.
Outside a critical-access/rural-hospital setting, a CRNA remains 'responsible and accountable to a licensed physician or dentist' for aspects of anesthesia practice requiring execution of the medical regimen (32 M.R.S. § 2211) — effectively supervised_only. Only in the qualifying rural/CAH setting may a CRNA formulate and implement a patient-specific anesthesia plan (P.L. enacting 'An Act Regarding Anesthesia Care in Rural Maine').
Independent practice requires: practicing in a critical access hospital, or a hospital located in a rural area, and acting in accordance with that facility's bylaws/policies — a practice-setting fact rather than an hours/experience threshold.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
outside a critical access hospital / rural hospital: On-site presence required
32 M.R.S. § 2211 requires the CRNA be accountable to a supervising physician/dentist for executing the medical regimen — exact proximity mechanics (vs. a telecommunication standard) were not independently confirmed in this pass; coded ON_SITE as the more conservative reading pending verification.
in a qualifying critical access hospital or rural hospital: No proximity requirement
The CRNA may formulate/implement a patient-specific anesthesia plan per facility bylaws/policies, without the standard physician/dentist accountability relationship.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
in a qualifying critical access hospital or rural hospital: Covered by the practice agreement · controlled substances permitted
DEA Schedules III, IIIN, IV, and V only — maximum 4-day supply, no refills, and only for a patient for whom the CRNA has an established client/patient record. No Schedule II authority.
outside a critical access hospital / rural hospital: Covered by the practice agreement · no controlled-substance authority
No independent prescriptive authority — administers anesthesia-related drugs as executed under the supervising physician/dentist's medical regimen.
Written agreement
Required
Required outside the rural/critical-access-hospital carve-out — a CRNA is accountable to a supervising physician or dentist by default; that accountability relationship doesn't apply the same way within a qualifying rural/CAH setting.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Not independently confirmed in this pass — treat CRNA practice-entity ownership as an open item given CRNAs' generally supervised status outside the rural/CAH carve-out.
Legal sources for these rules (3)
- 32 M.R.S. § 2211 — Certified Registered Nurse Anesthetists
- An Act Regarding Anesthesia Care in Rural Maine (SP0387/LD 1166)
- AANA — Maine state practice pagesecondary
What a collaborating physician costs here
Typical monthly cost in Maine
$500 – $600
Estimate for one Certified Registered Nurse Anesthetist. This state's rules add a restrictive-tier premium.
About Maine's rules
Maine's provider categories follow different independence models: NPs graduate to full practice after 24 months of registered (not written-agreement) supervision; PAs graduate after 4,000 documented clinical hours but still need a lighter 'practice agreement' afterward; CNMs/CNSs appear independent from initial licensure; and CRNAs remain physician/dentist-accountable except in critical-access/rural hospitals. Do not assume a single APRN framework applies uniformly.
Other clinicians in Maine: see the state overview.