HB 2457
Initials DC Page 1 Regulatory Affairs
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature
First Regular Session
HB 2457: anesthesiologist assistants; licensure
Sponsor: Representative Pingerelli, LD 28
Committee on Regulatory Affairs
Overview
Adds Anesthesiologist Assistants (AA) to the licensed and regulated professions, under the
Arizona Medical Board (Board), that may assist in the practice of medicine under a supervising
anesthesiologist. Details the scope of practice.
History
Laws 2017, Chapter 182, authorizes a Certified Registered Nurse Anesthetist (CRNA) to
administer anesthetics in the presence of and under the direction of a physician or surgeon. The
CRNA's scope of practice includes preoperative, intra-operative and postoperative care of a
patient or during a procedure performed while in a health care institution, licensed health care
professional's office or an ambulance. During this care, and in addition to statutorily related
duties, the CRNA may issue an order for medication or drugs, including controlled substances to
be administered by a licensed, certified or registered health care provider (Provider). Further,
statute asserts that the physician or surgeon is not liable for the acts or omissions of the CRNA
who orders or administers anesthetics in these settings (A.R.S. § 32-1634.04).
Provisions
1. Instructs the Board to determine the applicants that qualify for a license to practice as an AA
and authorizes the Board to retain jurisdiction throughout the licensing process. (Sec. 1)
2. Details Board duties as follows:
a) grant, deny, revoke, suspend or reinstate a license;
b) investigate allegations of misconduct that may constitute grounds to revoke a license;
c) conduct informal interviews and hearings;
d) adopt administrative rules that govern the practice of AAs; and
e) retain jurisdiction over licensees regardless of license status.
3. Prohibits a person from using a designation or title without first having a license.
4. Outlines specific requirements for licensure that include graduating from an accredited
program, passing the required certification exam, completing the application and paying the
required fees.
5. Prescribes a 2-year license period, renewable by January 31 every other year, and directs the
Board to provide written notification of renewals a minimum of one month prior to the license
expiration date.
6. Permits the Board to issue a temporary license for one year to a person who successfully
completes an accredited program but has not yet passed the certification examination, which
must be taken during the next available time period.
☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal Note HB 2457
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7. Authorizes the Board to reinstate a license that has lapsed if the person pays the prescribed
fee and meets all other Board requirements.
8. Defines pertinent terms.
Anesthesiologist Assistants & Supervising Anesthesiologists – Scope of Practice
9. Stipulates the AA may only perform duties delegated by the supervising anesthesiologist,
including assisting in the practice of medicine.
10. States that the supervising anesthesiologist may supervise an AA consistent with federal
regulations adopted by the Centers for Medicare and Medicaid Services for reimbursement of
anesthesia services.
11. Asserts that the supervising anesthesiologist must be immediately available to the AA and
able to intervene as needed.
12. Outlines the tasks that the supervising anesthesiologist may delegate to the AA as follows:
a) creating and implementing a patient's anesthesia care plan;
b) composing a patient history, progress notes and performing parts of a physical exam;
c) conducting anesthesia evaluations for both preoperative and postoperative care;
d) working on preoperative patient consultations;
e) ordering preoperative and perioperative medications, including controlled substances that
may be administered before the supervising anesthesiologist cosigns;
f) changing or discontinuing a medical treatment plan;
g) obtaining informed consent for anesthesia;
h) testing and calibrating anesthesia delivery systems and interpreting information;
i) integrating medically accepted monitoring techniques;
j) performing basic and advanced airway interventions;
k) establishing peripheral intravenous lines;
l) performing invasive procedures;
m) performing general and monitored anesthesia and anesthesia care;
n) administering anesthetic and accessory drugs;
o) administering vasoactive drugs to address patients' response to anesthesia;
p) performing epidural and spinal regional anesthesia;
q) obtaining blood samples;
r) performing, ordering and interpreting points of care throughout the operation;
s) initiating cardiopulmonary resuscitation in response to a life-threatening situation; and
t) supervising students and assistant students of anesthesiology and performing other tasks
in which the individual is trained and proficient. (Sec. 1)
Regulation and Restriction of Licenses
13. Describes the Board's ability to determine license status or take disciplinary action.
14. Requires the Board to record its written order and findings.
15. Outlines the process and procedures for reinstating a revoked license.
Penalty for Unauthorized Practice
16. Classifies any misrepresentation or unauthorized practice as an AA as a class 1 misdemeanor
and stipulates that each violation constitutes a separate offense.