HB 2457
Initials CH Page 1 House Engrossed
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature
First Regular Session
House: ED DPA 8-0-2-0
HB 2457: anesthesiologist assistants; licensure
Sponsor: Representative Pingerelli, LD 28
House Engrossed
Overview
Adds anesthesiologist assistants (AAs) 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 for AAs.
History
Laws 2012, Chapter 152 authorizes a certified registered nurse anesthetist (CRNA) to administer
anesthetics under the direction of and in the presence of a physician or surgeon in connection
with the care of a patient or as part of a procedure performed by a physician or surgeon in
specified settings. A CRNA may perform other duties, including issuing a medication order for
drugs or medications, implementing an anesthetic plan of care for a patient and taking necessary
action in response to an emergency situation. 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. Statute asserts that
the physician or surgeon is not liable for any act or omission of a CRNA who orders or administers
anesthetics (A.R.S. § 32-1634.04).
The Board is charged with protecting the public from unlawful, unqualified or unprofessional
practitioners of allopathic medicine through licensure, regulation and rehabilitation of the
profession. Board duties include: 1) ordering and evaluating testing of licensed physicians and
candidates for licensure; 2) investigating acts of unprofessional conduct or incompetent medical
care; and 3) developing standards governing the profession (A.R.S. § 32-1403).
Provisions
Board Duties and Licensure
1. Directs the Board to determine the qualifications of applicants for an AA license. (Sec. 1)
2. Requires the Board to:
a) grant, deny, revoke, suspend, restrict or reinstate an AA license;
b) investigate allegations that an AA or supervising anesthesiologist engaged in conduct
constituting a ground for revocation;
c) conduct informal interviews and hearings;
d) adopt rules governing the practice of AAs; and
e) retain jurisdiction over only Board-licensed AAs, regardless of license status. (Sec. 1)
3. Instructs the Board to transfer any complaints against an osteopathic anesthesiologist to the
Arizona Board of Osteopathic Examiners in Medicine and Surgery. (Sec. 1)
4. Prohibits a person from practicing, using the title or representing themselves as an AA without
having a Board-granted license. (Sec. 1)
☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal Note HB 2457
Initials CH Page 2 House Engrossed
5. Authorizes the Board to grant an AA license to an applicant who:
a) graduated from an AA program accredited by the Commission on Accreditation of Allied
Health Education Programs (Commission);
b) satisfactorily completed a certification examination and application form; and
c) pays the required application and licensure fees. (Sec. 1)
6. Provides that a license is valid for two years and details license renewal procedures. (Sec. 1)
7. Allows the Board to issue a temporary license for not more than one year to an applicant who:
a) completes a temporary license application;
b) pays the required temporary license fee;
c) successfully completes a Commission- or Board-approved program for educating and
training AAs but who has not passed a certification exam; and
d) takes the next available certification exam after receiving a temporary license. (Sec. 1)
8. Authorizes the Board to reinstate a lapsed license if the applicant pays the Board-prescribed
reinstatement fee and meets the requirements for initial licensure. (Sec. 1)
Scope of Practice
9. Excludes a person enrolled in a Board-approved AA education program from scope of practice
specifications. (Sec. 1)
10. Stipulates an AA may only perform duties and responsibilities delegated by and under the
supervision of the supervising anesthesiologist. (Sec. 1)
11. States that the supervising anesthesiologist may supervise an AA in a manner consistent with
federal regulations adopted by the Centers for Medicare and Medicaid Services for
reimbursement for anesthesia service. (Sec. 1)
12. Requires the supervising anesthesiologist to be immediately available to the AA and able to
intervene if needed. (Sec. 1)
13. Prohibits an AA's practice from exceeding their education and training or the scope of practice
of the supervising anesthesiologist. (Sec. 1)
14. Restricts an AA from delegating a medical care task assigned to them by the supervising
anesthesiologist to another person. (Sec. 1)
15. Lists the duties the supervising anesthesiologist may delegate to the AA. (Sec. 1)
16. Clarifies an AA is not prevented from having access to and being able to obtain prescription
drugs as directed by the supervising anesthesiologist. (Sec. 1)
17. Defines anesthesiologist, AA, assists, certification examination, supervising anesthesiologist
and supervision. (Sec. 1)
Regulation and Restriction of Licenses
18. Authorizes the Board to refuse to renew or revoke, suspend or restrict a license or take other
disciplinary action. (Sec. 1)
19. Instructs the Board to adopt and enter its written order and findings if it is determined that any
action should be taken for an applicant or a current license holder. (Sec. 1)
20. Outlines the process and procedures for the Board to reinstate a revoked license. (Sec. 1)
21. Classifies any misrepresentation or unauthorized practice as an AA as a class 1 misdemeanor
and each violation as a separate offense. (Sec. 1)