Tennessee 2025-2026 Regular Session

Tennessee House Bill HB0758 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
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2	2	SENATE BILL 461
3	3	By Briggs
4	4
5	5	HOUSE BILL 758
6	6	By Vital
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8	8
9	9	HB0758
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13	13	AN ACT to amend Tennessee Code Annotated, Title 4;
14	14	Title 63 and Title 68, relative to anesthesiology.
15	15
16	16	BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
17	17	SECTION 1. Tennessee Code Annotated, Title 63, is amended by adding the following
18	18	as a new chapter:
19	19	63-21-101. Chapter definitions.
20	20	As used in this chapter:
21	21	(1) "Anesthesiologist" means a physician who is licensed pursuant to
22	22	chapter 6 or 9 of this title and who has completed a residency in anesthesiology
23	23	approved by the American Board of Anesthesiology or the American Osteopathic
24	24	Board of Anesthesiology;
25	25	(2) "Anesthesiologist assistant" means a person who meets the
26	26	requirements of § 63-21-103 and is board-approved to assist in the practice of
27	27	medicine under delegation of an anesthesiologist;
28	28	(3) "Assists" means, in regard to an anesthesiologist assistant, that the
29	29	anesthesiologist assistant personally performs those duties and responsibilities
30	30	delegated by the anesthesiologist;
31	31	(4) "Board" means the board of medical examiners established by
32	32	chapter 6, part 1 of this title;
33	33	(5) "Certification examination" means the initial certifying examination
34	34	approved by the board for the certification of anesthesiologist assistants,
35	35	including the examination administered by the National Commission for the
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40	40	Certification of Anesthesiologist Assistants or another national anesthesiologist
41	41	assistant certifying agency that has been reviewed and approved by the board;
42	42	and
43	43	(6) "Supervision" means the availability of an anesthesiologist who can
44	44	delegate, coordinate, direct, consult, or oversee the implementation of the
45	45	anesthesiologist's intentions.
46	46	63-21-102. Boards; powers and duties.
47	47	(a) The board shall review and determine the qualifications and fitness of all
48	48	persons applying for a license to practice as an anesthesiologist assistant.
49	49	(b) The board shall:
50	50	(1) Grant, deny, renew, revoke, and reinstate licenses;
51	51	(2) Set and collect fees for licensure under this chapter;
52	52	(3) Establish continuing education requirements for anesthesiologist
53	53	assistants;
54	54	(4) Investigate allegations that an anesthesiologist assistant or the
55	55	supervising anesthesiologist has engaged in conduct constituting a ground for
56	56	revocation;
57	57	(5) Conduct informal interviews and hearings;
58	58	(6) Take disciplinary or other administrative action, which must comply
59	59	with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to
60	60	enforce this chapter;
61	61	(7) Adopt rules governing the licensure and practice of anesthesiologist
62	62	assistants, and such other rules as are necessary to implement and enforce this
63	63	chapter; and
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68	68	(8) Retain jurisdiction over only those licensees to whom temporary or
69	69	full licenses are granted pursuant to this chapter, regardless of whether the
70	70	license has expired or lapsed, been retired, or was relinquished during or after
71	71	any alleged occurrence of conduct.
72	72	63-21-103. Licensure; unauthorized practice; use of title; duplicate license;
73	73	temporary licensure; fees.
74	74	(a) A person shall not practice in this state as an anesthesiologist assistant or
75	75	use the title or represent that the person is a certified anesthesiologist assistant,
76	76	anesthesiologist assistant, or use the abbreviations "C.A.A." or "A.A." without having a
77	77	license granted by the board pursuant to this chapter. A violation of this subsection (a)
78	78	is a Class B misdemeanor, punishable by a fine of not more than one thousand dollars
79	79	($1,000) or by a term of imprisonment for not more than one (1) year, or both. Each
80	80	violation of this subsection (a) constitutes a separate offense.
81	81	(b) The board may grant an anesthesiologist assistant license to an applicant
82	82	who:
83	83	(1) Graduated from an anesthesiologist assistant program accredited by
84	84	the Commission on Accreditation of Allied Health Education Programs or its
85	85	predecessor or successor organization;
86	86	(2) Satisfactorily completed a certification examination administered by
87	87	the National Commission for the Certification of Anesthesiologist Assistants or
88	88	another national certifying agency that has been reviewed and approved by the
89	89	board;
90	90	(3) Completes an application form; and
91	91	(4) Pays the required application and licensure fees as prescribed by the
92	92	board in rule.
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97	97	(c) A license issued pursuant to this chapter, other than a temporary license, is
98	98	valid for a period of two (2) years. A licensee shall renew the license every other year
99	99	on or before January 31 by completing and submitting to the board a renewal application
100	100	form as prescribed by the board and the prescribed renewal fee before the current
101	101	license expires. The board shall provide renewal notices to licensees at least one (1)
102	102	month before the expiration date.
103	103	(d) The board may reinstate a lapsed license if the applicant pays a
104	104	reinstatement fee as prescribed by the board in rule and meets the requirements for
105	105	initial licensure.
106	106	(e) The board may issue a temporary license to a person who:
107	107	(1) Completes a temporary license application;
108	108	(2) Pays the required temporary license fee as prescribed by the board in
109	109	rule; and
110	110	(3) Successfully completes a Commission on Accreditation of Allied
111	111	Health Education program or another board-approved program for educating and
112	112	training anesthesiologist assistants but who has not passed a certification
113	113	examination. The person shall take the next available certification examination
114	114	after receiving a temporary license. A temporary license must not be issued for a
115	115	period of more than one (1) year and is subject to other requirements the board
116	116	adopts by rule.
117	117	63-21-104. Scope of practice.
118	118	(a) This section does not apply to persons who are enrolled in an
119	119	anesthesiologist assistant education program approved by the board.
120	120	(b) An anesthesiologist assistant may assist in the practice of medicine only
121	121	under the supervision of an anesthesiologist. The anesthesiologist assistant may
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126	126	perform only those duties and responsibilities delegated to the anesthesiologist assistant
127	127	by the supervising anesthesiologist.
128	128	(c) The supervising anesthesiologist may supervise anesthesiologist assistants
129	129	in a manner consistent with federal rules or regulations for reimbursement for anesthesia
130	130	services.
131	131	(d) The supervising anesthesiologist shall be immediately available to the
132	132	anesthesiologist assistant who assists in the delivery of medical care such that the
133	133	supervising anesthesiologist is able to intervene if needed.
134	134	(e) An anesthesiologist assistant's practice shall not exceed the assistant's
135	135	education and training, and the scope of practice of the supervising anesthesiologist. A
136	136	medical care task assigned by the supervising anesthesiologist to the anesthesiologist
137	137	assistant shall not be delegated by the anesthesiologist assistant to another person.
138	138	(f) A supervising anesthesiologist may delegate to an anesthesiologist assistant
139	139	any of the following duties:
140	140	(1) Developing and implementing an anesthesia care plan for a patient;
141	141	(2) Obtaining a comprehensive patient history and performing relevant
142	142	elements of a physical exam;
143	143	(3) Performing preoperative and postoperative anesthetic evaluations
144	144	and maintaining patient progress notes;
145	145	(4) Ordering and performing preoperative patient consultations;
146	146	(5) Ordering preoperative medications, including controlled substances,
147	147	which may be administered before the supervising anesthesiologist cosigns;
148	148	(6) Changing or discontinuing a medical treatment plan after consulting
149	149	with the supervising anesthesiologist;
150	150	(7) Obtaining informed consent for anesthesia or related procedures;
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155	155	(8) Ordering the preoperative continuation of current medications, which
156	156	may be administered before the supervising anesthesiologist cosigns;
157	157	(9) Pretesting and calibrating anesthesia delivery systems and obtaining
158	158	and interpreting information from the systems and from monitors;
159	159	(10) Implementing medically accepted monitoring techniques;
160	160	(11) Performing basic and advanced airway interventions, including
161	161	endotracheal intubation, laryngeal mask insertion, and other advanced airways
162	162	techniques;
163	163	(12) Establishing peripheral intravenous lines, including subcutaneous
164	164	lidocaine use;
165	165	(13) Performing invasive procedures including arterial lines, central lines,
166	166	and Swan Ganz catheters;
167	167	(14) Performing general anesthesia, including induction, maintenance,
168	168	emergence, and procedures associated with general anesthesia, such as gastric
169	169	intubation;
170	170	(15) Administering anesthetic drugs, adjuvant drugs, and accessory
171	171	drugs;
172	172	(16) Administering vasoactive drugs and starting and titrating vasoactive
173	173	infusions to treat patient responses to anesthesia;
174	174	(17) Performing, maintaining, evaluating, and managing epidural, spinal,
175	175	and regional anesthesia, including catheters;
176	176	(18) Performing monitored anesthesia care;
177	177	(19) Obtaining venous and arterial blood samples;
178	178	(20) Administering blood, blood products, and supportive fluids;
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183	183	(21) Performing, ordering, and interpreting appropriate preoperative,
184	184	point of care, intraoperative, or postoperative diagnostic tests or procedures;
185	185	(22) Obtaining and administering preoperative anesthesia and related
186	186	pharmaceutical agents, including intravenous fluids and blood products;
187	187	(23) Managing the patient while in the preoperative suite, recovery area,
188	188	or labor suites;
189	189	(24) Ordering postoperative sedation, anxiolysis or analgesia,
190	190	postoperative respiratory therapy and medicines to treat patient responses to
191	191	anesthesia and ordering postoperative oxygen therapy, including initial ventilator
192	192	therapy, which may be administered before the supervising anesthesiologist
193	193	cosigns;
194	194	(25) Initiating and managing cardiopulmonary resuscitation in response
195	195	to a life-threatening situation;
196	196	(26) Participating in administrative, research, and clinical teaching
197	197	activities, including supervising student anesthesiologist assistants and other
198	198	students involved in anesthesia education; and
199	199	(27) Performing such other tasks not prohibited by law that an
200	200	anesthesiologist assistant has been trained and is proficient to perform.
201	201	(g) This chapter does not prevent an anesthesiologist assistant from having
202	202	access to and being able to obtain prescription drugs as directed by the supervising
203	203	anesthesiologist.
204	204	(h) A supervising anesthesiologist shall not employ a person to practice as an
205	205	anesthesiologist assistant who is not licensed pursuant to this chapter. A violation of this
206	206	subsection (h) is a Class B misdemeanor, punishable by a fine of not more than one
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211	211	thousand dollars ($1,000) or by a term of imprisonment for not more than one (1) year,
212	212	or both. Each violation of this subsection (h) constitutes a separate offense.
213	213	(i) A person shall not engage in the practice of an anesthesiologist assistant in a
214	214	county having a population of eighty-five thousand (85,000) or less, according to the
215	215	2020 federal census or a subsequent federal census.
216	216	63-21-105. Regulations.
217	217	(a) The board may refuse to renew and may revoke, suspend, or restrict a
218	218	license or take other disciplinary action, including imposing conditions or restrictions on a
219	219	license pursuant to this chapter and the rules adopted pursuant to this chapter.
220	220	(b) If the board determines that a person is ineligible for licensure, that an
221	221	application for licensure should be denied, that a license should be suspended, or that
222	222	another action should be taken on a current license, then the board shall adopt and
223	223	enter its written order and findings. If the board proposes to issue discipline on a current
224	224	license, then a contested case hearing must be conducted pursuant to title 4, chapter 5,
225	225	part 3.
226	226	63-21-106. Issuance of new license following revocation; requirements.
227	227	(a) The board may issue a new license to an anesthesiologist assistant whose
228	228	license was previously revoked by the board if the applicant applies in writing to the
229	229	board and demonstrates to the board's satisfaction that the applicant is completely
230	230	rehabilitated with respect to the conduct that was the basis for the revocation. In making
231	231	its decision, the board must determine:
232	232	(1) That the applicant has not engaged in conduct during the revocation
233	233	period that would constitute a basis for revocation pursuant to rules adopted by
234	234	the board;
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239	239	(2) If a criminal conviction was a basis of the revocation, that the
240	240	applicant's civil rights have been fully restored pursuant to statute or another
241	241	applicable recognized judicial, gubernatorial, or presidential order;
242	242	(3) That the applicant has made restitution to an aggrieved person as
243	243	ordered by a court of competent jurisdiction; and
244	244	(4) That the applicant demonstrates another standard of rehabilitation the
245	245	board determines is appropriate.
246	246	(b) Except as provided in subsection (c), a person whose license was revoked
247	247	shall not apply for a new license earlier than two (2) years after the date of revocation.
248	248	(c) If a license revocation was based on a conviction of a felony or an offense
249	249	involving moral turpitude and that conviction has been reversed on appeal, then the
250	250	board shall vacate its previous order to revoke the license and the anesthesiologist
251	251	assistant may apply for a new license after the court enters the reversal.
252	252	(d) An applicant for a new license after revocation shall comply with all initial
253	253	licensure requirements prescribed by this chapter and rules adopted by the board
254	254	pursuant to this chapter.
255	255	63-21-107. Authority to promulgate rules.
256	256	The department of health and the board of medical examiners are authorized to
257	257	promulgate rules to effectuate this chapter. The rules must be promulgated in
258	258	accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter
259	259	5.
260	260	SECTION 2. Tennessee Code Annotated, Section 63-6-101(a)(2), is amended by
261	261	deleting the subdivision and substituting instead:
262	262	(2) Three (3) members shall be nonphysicians as follows:
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267	267	(A) Two (2) members who are consumers of health care and who neither
268	268	own nor have any financial or other interest in a healthcare facility, business,
269	269	school of medicine, or other allied healthcare practitioner educational program
270	270	and who shall represent the public at large; and
271	271	(B) One (1) member who is an anesthesiologist assistant licensed under
272	272	§ 63-21-103, whose initial term begins upon the first expiration of a term of office
273	273	for a nonphysician member who is serving on the board on January 1, 2026.
274	274	SECTION 3. The headings in this act are for reference purposes only and do not
275	275	constitute a part of the law enacted by this act. However, the Tennessee Code Commission is
276	276	requested to include the headings in any compilation or publication containing this act.
277	277	SECTION 4. For purposes of promulgating rules, this act takes effect upon becoming a
278	278	law, the public welfare requiring it. For all other purposes, this act takes effect January 1, 2026,
279	279	the public welfare requiring it.