SB 461 - HB 758
FISCAL NOTE
Fiscal Review Committee
Tennessee General Assembly
March 20, 2025
Fiscal Analyst: Chris Higgins | Email: chris.higgins@capitol.tn.gov | Phone: 615-741-2564
SB 461 - HB 758
SUMMARY OF BILL: Requires the Board of Medical Examiners (BME) to review and
determine the qualifications and fitness of all persons applying for a license to practice as an
anesthesiologist assistant. Prohibits a person from practicing as an anesthesiologist assistant or using
the title or representing that the person is a certified anesthesiologist assistant or anesthesiologist
assistant without having a license granted by the BME. Establishes that a violation of such
restriction is Class B misdemeanor.
Establishes the scope of practice of anesthesiologist assistants, including which duties may be
delegated to an anesthesiologist assistant by a supervising anesthesiologist. Establishes that it is a
Class B misdemeanor offense for a supervising anesthesiologist to employ a person to practice as an
anesthesiologist assistant who is not licensed pursuant to the legislation. Prohibits a person from
engaging in the practice of an anesthesiologist assistant in a county having a population of 85,000 or
less.
Requires one of the nonphysician members on the BME to be a licensed anesthesiologist assistant,
whose initial term must begin upon the first expiration of a term of office for a nonphysician
member who is serving on the BME on January 1, 2026.
Authorizes the Department of Health and the BME to promulgate rules to effectuate the legislation.
For purposes of promulgating rules, the legislation takes effect upon becoming a law. For all other
purposes, takes effect January 1, 2026.
FISCAL IMPACT:
STATE GOVERNMENT
REVENUE Board of Medical Examiners
FY25-26 $51,100
EXPENDITURES Board of Medical Examiners
FY25-26 $51,100
Assumptions:
• The legislation does not increase the membership of the BME, it only specifies the
qualifications for a future appointee.
• The BME can promulgate rules governing the licensure and practice of anesthesiologist
assistants utilizing existing personnel and resources; however, the BME will be required to
SB 461 - HB 758 2
update its licensure software to create a new category for certified anesthesiologist
assistants.
• Based on information provided by DOH, the cost for a vendor to establish a new
profession in the Licensure and Regulatory System (LARS) is $51,114.
• There will be a one-time increase in expenditures to the BME of $51,114 in FY25-26.
• Pursuant to Tenn. Code Ann. § 4-29-121, all health-related boards are required to be self-
sufficient over any two-year period.
• It is assumed that any increase in expenditures will be offset by fees.
• The BME experienced a surplus of $1,121,526 in FY22-23, a surplus of $1,279,652 in
FY23-24, and had a cumulative reserve balance of $5,303,560 on June 30, 2024.
CERTIFICATION:
The information contained herein is true and correct to the best of my knowledge.
Bojan Savic, Executive Director