This legislation mandates the Secretary of Veterans Affairs to update existing directives concerning anesthesia and pain management services within the Veterans Health Administration. Specifically, it requires the VA to recognize certified registered nurse anesthetists (CRNAs) as licensed independent practitioners, aligning their practice standards with those of the Defense Health Agency. The bill establishes new requirements for all anesthesia professionals employed by the VA. It mandates that physician anesthesiologists be certified by the American Board of Anesthesiology and CRNAs by the Council on Certification of Nurse Anesthetists. Additionally, all anesthesia professionals must complete at least 25 hours of direct patient anesthesia care , excluding supervisory duties, with non-compliance leading to employment suspension. Furthermore, the legislation directs the Comptroller General of the United States to submit an annual, publicly available report. This report must include data on outcomes and a cost-effectiveness comparison of different anesthesia delivery models used in the Veterans Health Administration, such as those provided by anesthesiologists, supervised CRNAs, and unsupervised CRNAs, detailing costs and savings for taxpayers and veterans' households.