Nurses who are trained as anesthetists do not need a doctor's supervision to give anesthetics to California hospital patients, the First District Court of Appeal in San Francisco ruled Thursday. The decision by was particularly important for rural areas, where nurses commonly administer anesthesia in hospitals, under a doctor's orders but without in-person supervision. The ruling allows that practice to continue. Federal law denies Medicare reimbursements to hospitals that allow nurses to give anesthesia without supervision, but allows a state's governor to opt out. California is one of 16 states to opt out, an action taken by Gov. Arnold Schwarzenegger in June 2009 and supported by his successor, Jerry Brown.