TLDR
The AANA Mid-Year Assembly runs April 24 through 29, 2026, at the JW Marriott in Washington, DC. It is the profession's largest advocacy event, designed to train CRNAs for Capitol Hill visits that directly shape practice authority, federal reimbursement, and payer policy. The 2026 assembly convenes six months after UnitedHealthcare cut CRNA reimbursement to 85% of the physician rate, with other commercial insurers considering similar moves. Whether you attend or not, what happens in DC next week will affect how you practice and how much you bill for years to come.
The AANA Mid-Year Assembly 2026 runs April 24 through 29 at the JW Marriott in Washington, DC. It is the largest CRNA advocacy gathering in the country, where nurse anesthetists train for and conduct Capitol Hill visits to shape federal practice and reimbursement policy. The 2026 agenda arrives at a pivotal moment: commercial payers are cutting CRNA rates, Medicare conversion factors have declined, and multiple states have active FPA legislation pending.
A CRNA from Omaha lands at Reagan National on a Sunday afternoon in late April. She has never done this before. Tomorrow morning she will sit through advocacy training at the JW Marriott. By Tuesday she will walk through the tunnels beneath the Capitol in a suit, carrying a folder with the Nebraska congressional delegation's photos and a one-page leave-behind on CRNA practice authority. She will meet a legislative aide who has never met a CRNA. She will explain, in five minutes, why the 85% reimbursement cap matters and what it costs her rural hospital. She will ask for a specific vote on a specific bill. Then she will do it again in the next office.
That is the Mid-Year Assembly. Not a conference. Not a continuing education event. A training camp for legislative advocacy that ends with 1,000 CRNAs knocking on congressional doors in a single week.
What the Mid-Year Assembly Is
The Mid-Year Assembly is the American Association of Nurse Anesthesiology's annual advocacy event. It differs from the AANA Annual Congress (August, Boston in 2026) in focus and format. The Annual Congress is clinical, educational, and social. The Mid-Year Assembly is political. The opening days cover advocacy training: how to conduct a legislative visit, how to frame CRNA practice issues for non-clinical staffers, how to leave a persuasive one-page document with a busy aide. The closing days send attendees to the Capitol for coordinated visits across all 535 congressional offices.
Attendance is open to AANA members, SRNAs, and student nurse anesthesiologists. State associations coordinate delegations to maximize coverage of their congressional representatives. A Nebraska delegation of 15 CRNAs meets with both Nebraska senators and all three Nebraska House representatives. A California delegation of 100 CRNAs splits across 52 House offices and two Senate offices. Every U.S. senator and representative has the opportunity to hear directly from a CRNA constituent during Mid-Year Assembly week.
This matters because most federal legislation affecting CRNAs moves slowly and dies quietly. The Mid-Year Assembly is the mechanism that keeps CRNA issues visible to legislators who would otherwise have no reason to think about nurse anesthesia policy.
The 2026 Advocacy Agenda
The 2026 Mid-Year Assembly arrives at a consequential moment for CRNA practice and reimbursement. Three issues will dominate the hallway conversations and the leave-behinds.
Commercial payer reimbursement cuts. UnitedHealthcare implemented a 15% reduction to CRNA reimbursement under the QZ modifier in October 2025, capping CRNA payment at 85% of the physician rate. The cut applies in most states. The AANA has publicly opposed the policy. Other commercial insurers are watching. If Aetna, Cigna, or Blue Cross Blue Shield follows UHC's lead, the 85% cap becomes de facto standard across commercial insurance. The Mid-Year Assembly will coordinate advocacy to slow or reverse the trend and push for federal legislation that restricts payer-driven reimbursement discrimination based on provider type.
Medicare conversion factor trajectory. The 2026 Medicare anesthesia conversion factor is $20.50 per unit, a modest recovery from the 2025 low of $20.32 but still below the 2019 level of $22.27. Medicare payment has declined in real terms for a decade. CRNAs will press their representatives to support legislation that updates the conversion factor for inflation and protects anesthesia payment from budget neutrality cuts that have eroded rates year over year.
Practice authority at the state and federal level. Thirty-one states and D.C. grant CRNAs full practice authority through the CMS opt-out. Nineteen states still require physician supervision or delegation, including three of the largest CRNA markets (Texas, Florida, Tennessee). The federal opt-out mechanism remains intact, but advocates continue pushing for state-level expansion. Mid-Year Assembly delegations from supervision-required states will ask their federal representatives to support frameworks that encourage state-level CRNA independence.
Why It Matters If You Do Not Attend
Fewer than 5% of practicing CRNAs attend the Mid-Year Assembly in any given year. The other 95% benefit from the outcomes. Every federal policy win, every commercial payer reversal, every FPA state expansion began with CRNAs knocking on doors during Mid-Year Assembly week. The 85% Medicare CRNA reimbursement standard, the VA's CRNA practice authority, and the CMS opt-out itself all trace to years of Mid-Year Assembly advocacy.
If you cannot attend in person, the AANA offers remote participation options, including pre-written templates for constituent letters, scheduled virtual meetings with congressional staffers during the assembly week, and grassroots fundraising campaigns that fund the year's lobbying efforts. A CRNA in Bozeman who cannot fly to DC can still participate by sending a targeted letter to Senator Daines during the week the Montana delegation is meeting with his staff in person. The in-person visit and the constituent letter reinforce each other.
The CRNAs most likely to benefit from Mid-Year Assembly outcomes are the ones who never attend. A CRNA in rural Kentucky whose hospital depends on Medicare reimbursement will keep her job if the conversion factor is protected, regardless of whether she personally walks the halls of Congress. But the protection exists because other CRNAs made the trip on her behalf.
What the Assembly Produces
The Mid-Year Assembly produces three categories of output that shape CRNA practice for the year ahead.
Legislative momentum. Specific bills move or stall based on whether legislators hear from constituents. A single Capitol Hill visit rarely moves a bill, but 1,000 visits in one week creates a wave of staff reports, office memos, and constituent files that legislators read before casting votes. The CRNAs who benefit never see this mechanism work. They see the outcome: bills that protect practice authority pass, bills that restrict it stall.
Coalition building. The assembly brings CRNAs into contact with state association leaders, AANA federal policy staff, and allied healthcare advocacy groups. Those relationships produce coordinated responses when fast-moving policy threats emerge. The UHC reimbursement cut in October 2025 triggered a rapid AANA response because the networks built at prior Mid-Year Assemblies were already in place.
Institutional knowledge. SRNAs and newer CRNAs who attend learn how federal policy works. They return to their states with the framework to participate in state-level advocacy: testifying at state board hearings, contacting state legislators during FPA debates, and mentoring future advocates. The assembly is the entry point into a decade-long advocacy arc that most attendees continue long after their first trip to DC.
Two AANA Events, Two Different Purposes
The AANA holds two major annual events. The Mid-Year Assembly (April 24-29, 2026, Washington, DC) is political advocacy. The Annual Congress (August 14-18, 2026, Boston) is clinical education and professional networking. CRNAs planning travel around AANA events should understand that the two serve different purposes. Attending only the Annual Congress means missing the advocacy training that shapes the policy environment in which all CRNAs practice. Attending only the Mid-Year Assembly means missing the clinical content and hiring network that drives career moves and continuing education.
The CRNAs who get the most out of AANA membership attend both, even in years when the travel budget is tight. The Mid-Year Assembly is less expensive than the Annual Congress (shorter duration, fewer CE credits required), and many state associations offer stipends to members willing to represent their delegation.
Related resources: Full practice authority state guide, Anesthesia billing by payer and care model, The case for CRNA independence, Ninety days of CRNA data transparency.
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Frequently Asked Questions
When is the AANA Mid-Year Assembly 2026?
The AANA Mid-Year Assembly 2026 runs April 24 through 29, 2026, at the JW Marriott in Washington, DC. It is the American Association of Nurse Anesthesiology's annual advocacy event, where CRNAs and SRNAs train for and conduct coordinated Capitol Hill visits with their congressional representatives.
What is the difference between the AANA Mid-Year Assembly and the AANA Annual Congress?
The Mid-Year Assembly is political advocacy focused on Capitol Hill visits, federal legislation, and payer policy. It happens in April in Washington, DC. The Annual Congress is clinical education, continuing education credits, and professional networking. It happens in August (Boston in 2026). The two events serve different purposes, and CRNAs who want the full AANA experience attend both.
Who can attend the AANA Mid-Year Assembly?
AANA members, student registered nurse anesthetists (SRNAs), and student nurse anesthesiologists can attend. Most state associations coordinate delegations to maximize coverage of congressional offices, and many offer stipends or travel support to members willing to represent the state during Capitol Hill visits.
What are the 2026 CRNA advocacy priorities?
Three issues dominate the 2026 agenda: commercial payer reimbursement cuts (UnitedHealthcare reduced CRNA QZ rates to 85% of physician rates in October 2025), Medicare conversion factor protection (the 2026 rate of $20.50 per unit remains below 2019 levels), and practice authority expansion at the state level (19 states still require physician supervision or delegation, including Texas, Florida, and Tennessee).
Does the Mid-Year Assembly matter if I cannot attend?
Every CRNA benefits from Mid-Year Assembly outcomes, regardless of attendance. Fewer than 5% of practicing CRNAs attend in a given year, but the policy wins at federal and commercial payer levels affect every CRNA's practice authority and reimbursement. Remote participation options include constituent letters, virtual meetings with congressional staffers during assembly week, and contributions to the AANA's year-round lobbying efforts.