Tennessee 2025-2026 Regular Session

Tennessee Senate Bill SB0461 Compare Versions

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Version 2 (New)

Old	New		Differences
1	1
2		-	HOUSE BILL 758
3		-	By Vital
	2	+	<BillNo> <Sponsor>
4	3
5	4		SENATE BILL 461
6	5		By Briggs
7	6
8	7
9	8		SB0461
10	9		000215
11	10		- 1 -
12	11
13	12		AN ACT to amend Tennessee Code Annotated, Title 4;
14	13		Title 63 and Title 68, relative to anesthesiology.
15	14
16	15		BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
17	16		SECTION 1. Tennessee Code Annotated, Title 63, is amended by adding the following
18	17		as a new chapter:
19	18		63-21-101. Chapter definitions.
20	19		As used in this chapter:
21	20		(1) "Anesthesiologist" means a physician who is licensed pursuant to
22	21		chapter 6 or 9 of this title and who has completed a residency in anesthesiology
23	22		approved by the American Board of Anesthesiology or the American Osteopathic
24	23		Board of Anesthesiology;
25	24		(2) "Anesthesiologist assistant" means a person who meets the
26	25		requirements of § 63-21-103 and is board-approved to assist in the practice of
27	26		medicine under delegation of an anesthesiologist;
28	27		(3) "Assists" means, in regard to an anesthesiologist assistant, that the
29	28		anesthesiologist assistant personally performs those duties and responsibilities
30	29		delegated by the anesthesiologist;
31	30		(4) "Board" means the board of medical examiners established by
32	31		chapter 6, part 1 of this title;
33	32		(5) "Certification examination" means the initial certifying examination
34	33		approved by the board for the certification of anesthesiologist assistants,
35	34		including the examination administered by the National Commission for the
	35	+	Certification of Anesthesiologist Assistants or another national anesthesiologist
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40		-	Certification of Anesthesiologist Assistants or another national anesthesiologist
41	40		assistant certifying agency that has been reviewed and approved by the board;
42	41		and
43	42		(6) "Supervision" means the availability of an anesthesiologist who can
44	43		delegate, coordinate, direct, consult, or oversee the implementation of the
45	44		anesthesiologist's intentions.
46	45		63-21-102. Boards; powers and duties.
47	46		(a) The board shall review and determine the qualifications and fitness of all
48	47		persons applying for a license to practice as an anesthesiologist assistant.
49	48		(b) The board shall:
50	49		(1) Grant, deny, renew, revoke, and reinstate licenses;
51	50		(2) Set and collect fees for licensure under this chapter;
52	51		(3) Establish continuing education requirements for anesthesiologist
53	52		assistants;
54	53		(4) Investigate allegations that an anesthesiologist assistant or the
55	54		supervising anesthesiologist has engaged in conduct constituting a ground for
56	55		revocation;
57	56		(5) Conduct informal interviews and hearings;
58	57		(6) Take disciplinary or other administrative action, which must comply
59	58		with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to
60	59		enforce this chapter;
61	60		(7) Adopt rules governing the licensure and practice of anesthesiologist
62	61		assistants, and such other rules as are necessary to implement and enforce this
63	62		chapter; and
	63	+	(8) Retain jurisdiction over only those licensees to whom temporary or
	64	+	full licenses are granted pursuant to this chapter, regardless of whether the
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68		-	(8) Retain jurisdiction over only those licensees to whom temporary or
69		-	full licenses are granted pursuant to this chapter, regardless of whether the
70	69		license has expired or lapsed, been retired, or was relinquished during or after
71	70		any alleged occurrence of conduct.
72	71		63-21-103. Licensure; unauthorized practice; use of title; duplicate license;
73	72		temporary licensure; fees.
74	73		(a) A person shall not practice in this state as an anesthesiologist assistant or
75	74		use the title or represent that the person is a certified anesthesiologist assistant,
76	75		anesthesiologist assistant, or use the abbreviations "C.A.A." or "A.A." without having a
77	76		license granted by the board pursuant to this chapter. A violation of this subsection (a)
78	77		is a Class B misdemeanor, punishable by a fine of not more than one thousand dollars
79	78		($1,000) or by a term of imprisonment for not more than one (1) year, or both. Each
80	79		violation of this subsection (a) constitutes a separate offense.
81	80		(b) The board may grant an anesthesiologist assistant license to an applicant
82	81		who:
83	82		(1) Graduated from an anesthesiologist assistant program accredited by
84	83		the Commission on Accreditation of Allied Health Education Programs or its
85	84		predecessor or successor organization;
86	85		(2) Satisfactorily completed a certification examination administered by
87	86		the National Commission for the Certification of Anesthesiologist Assistants or
88	87		another national certifying agency that has been reviewed and approved by the
89	88		board;
90	89		(3) Completes an application form; and
91	90		(4) Pays the required application and licensure fees as prescribed by the
92	91		board in rule.
	92	+	(c) A license issued pursuant to this chapter, other than a temporary license, is
	93	+	valid for a period of two (2) years. A licensee shall renew the license every other year
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97		-	(c) A license issued pursuant to this chapter, other than a temporary license, is
98		-	valid for a period of two (2) years. A licensee shall renew the license every other year
99	98		on or before January 31 by completing and submitting to the board a renewal application
100	99		form as prescribed by the board and the prescribed renewal fee before the current
101	100		license expires. The board shall provide renewal notices to licensees at least one (1)
102	101		month before the expiration date.
103	102		(d) The board may reinstate a lapsed license if the applicant pays a
104	103		reinstatement fee as prescribed by the board in rule and meets the requirements for
105	104		initial licensure.
106	105		(e) The board may issue a temporary license to a person who:
107	106		(1) Completes a temporary license application;
108	107		(2) Pays the required temporary license fee as prescribed by the board in
109	108		rule; and
110	109		(3) Successfully completes a Commission on Accreditation of Allied
111	110		Health Education program or another board-approved program for educating and
112	111		training anesthesiologist assistants but who has not passed a certification
113	112		examination. The person shall take the next available certification examination
114	113		after receiving a temporary license. A temporary license must not be issued for a
115	114		period of more than one (1) year and is subject to other requirements the board
116	115		adopts by rule.
117	116		63-21-104. Scope of practice.
118	117		(a) This section does not apply to persons who are enrolled in an
119	118		anesthesiologist assistant education program approved by the board.
120	119		(b) An anesthesiologist assistant may assist in the practice of medicine only
121	120		under the supervision of an anesthesiologist. The anesthesiologist assistant may
	121	+	perform only those duties and responsibilities delegated to the anesthesiologist assistant
	122	+	by the supervising anesthesiologist.
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126		-	perform only those duties and responsibilities delegated to the anesthesiologist assistant
127		-	by the supervising anesthesiologist.
128	127		(c) The supervising anesthesiologist may supervise anesthesiologist assistants
129	128		in a manner consistent with federal rules or regulations for reimbursement for anesthesia
130	129		services.
131	130		(d) The supervising anesthesiologist shall be immediately available to the
132	131		anesthesiologist assistant who assists in the delivery of medical care such that the
133	132		supervising anesthesiologist is able to intervene if needed.
134	133		(e) An anesthesiologist assistant's practice shall not exceed the assistant's
135	134		education and training, and the scope of practice of the supervising anesthesiologist. A
136	135		medical care task assigned by the supervising anesthesiologist to the anesthesiologist
137	136		assistant shall not be delegated by the anesthesiologist assistant to another person.
138	137		(f) A supervising anesthesiologist may delegate to an anesthesiologist assistant
139	138		any of the following duties:
140	139		(1) Developing and implementing an anesthesia care plan for a patient;
141	140		(2) Obtaining a comprehensive patient history and performing relevant
142	141		elements of a physical exam;
143	142		(3) Performing preoperative and postoperative anesthetic evaluations
144	143		and maintaining patient progress notes;
145	144		(4) Ordering and performing preoperative patient consultations;
146	145		(5) Ordering preoperative medications, including controlled substances,
147	146		which may be administered before the supervising anesthesiologist cosigns;
148	147		(6) Changing or discontinuing a medical treatment plan after consulting
149	148		with the supervising anesthesiologist;
150	149		(7) Obtaining informed consent for anesthesia or related procedures;
	150	+	(8) Ordering the preoperative continuation of current medications, which
	151	+	may be administered before the supervising anesthesiologist cosigns;
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155		-	(8) Ordering the preoperative continuation of current medications, which
156		-	may be administered before the supervising anesthesiologist cosigns;
157	156		(9) Pretesting and calibrating anesthesia delivery systems and obtaining
158	157		and interpreting information from the systems and from monitors;
159	158		(10) Implementing medically accepted monitoring techniques;
160	159		(11) Performing basic and advanced airway interventions, including
161	160		endotracheal intubation, laryngeal mask insertion, and other advanced airways
162	161		techniques;
163	162		(12) Establishing peripheral intravenous lines, including subcutaneous
164	163		lidocaine use;
165	164		(13) Performing invasive procedures including arterial lines, central lines,
166	165		and Swan Ganz catheters;
167	166		(14) Performing general anesthesia, including induction, maintenance,
168	167		emergence, and procedures associated with general anesthesia, such as gastric
169	168		intubation;
170	169		(15) Administering anesthetic drugs, adjuvant drugs, and accessory
171	170		drugs;
172	171		(16) Administering vasoactive drugs and starting and titrating vasoactive
173	172		infusions to treat patient responses to anesthesia;
174	173		(17) Performing, maintaining, evaluating, and managing epidural, spinal,
175	174		and regional anesthesia, including catheters;
176	175		(18) Performing monitored anesthesia care;
177	176		(19) Obtaining venous and arterial blood samples;
178	177		(20) Administering blood, blood products, and supportive fluids;
	178	+	(21) Performing, ordering, and interpreting appropriate preoperative,
	179	+	point of care, intraoperative, or postoperative diagnostic tests or procedures;
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183		-	(21) Performing, ordering, and interpreting appropriate preoperative,
184		-	point of care, intraoperative, or postoperative diagnostic tests or procedures;
185	184		(22) Obtaining and administering preoperative anesthesia and related
186	185		pharmaceutical agents, including intravenous fluids and blood products;
187	186		(23) Managing the patient while in the preoperative suite, recovery area,
188	187		or labor suites;
189	188		(24) Ordering postoperative sedation, anxiolysis or analgesia,
190	189		postoperative respiratory therapy and medicines to treat patient responses to
191	190		anesthesia and ordering postoperative oxygen therapy, including initial ventilator
192	191		therapy, which may be administered before the supervising anesthesiologist
193	192		cosigns;
194	193		(25) Initiating and managing cardiopulmonary resuscitation in response
195	194		to a life-threatening situation;
196	195		(26) Participating in administrative, research, and clinical teaching
197	196		activities, including supervising student anesthesiologist assistants and other
198	197		students involved in anesthesia education; and
199	198		(27) Performing such other tasks not prohibited by law that an
200	199		anesthesiologist assistant has been trained and is proficient to perform.
201	200		(g) This chapter does not prevent an anesthesiologist assistant from having
202	201		access to and being able to obtain prescription drugs as directed by the supervising
203	202		anesthesiologist.
204	203		(h) A supervising anesthesiologist shall not employ a person to practice as an
205	204		anesthesiologist assistant who is not licensed pursuant to this chapter. A violation of this
206	205		subsection (h) is a Class B misdemeanor, punishable by a fine of not more than one
	206	+	thousand dollars ($1,000) or by a term of imprisonment for not more than one (1) year,
	207	+	or both. Each violation of this subsection (h) constitutes a separate offense.
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211		-	thousand dollars ($1,000) or by a term of imprisonment for not more than one (1) year,
212		-	or both. Each violation of this subsection (h) constitutes a separate offense.
213	212		(i) A person shall not engage in the practice of an anesthesiologist assistant in a
214	213		county having a population of eighty-five thousand (85,000) or less, according to the
215	214		2020 federal census or a subsequent federal census.
216	215		63-21-105. Regulations.
217	216		(a) The board may refuse to renew and may revoke, suspend, or restrict a
218	217		license or take other disciplinary action, including imposing conditions or restrictions on a
219	218		license pursuant to this chapter and the rules adopted pursuant to this chapter.
220	219		(b) If the board determines that a person is ineligible for licensure, that an
221	220		application for licensure should be denied, that a license should be suspended, or that
222	221		another action should be taken on a current license, then the board shall adopt and
223	222		enter its written order and findings. If the board proposes to issue discipline on a current
224	223		license, then a contested case hearing must be conducted pursuant to title 4, chapter 5,
225	224		part 3.
226	225		63-21-106. Issuance of new license following revocation; requirements.
227	226		(a) The board may issue a new license to an anesthesiologist assistant whose
228	227		license was previously revoked by the board if the applicant applies in writing to the
229	228		board and demonstrates to the board's satisfaction that the applicant is completely
230	229		rehabilitated with respect to the conduct that was the basis for the revocation. In making
231	230		its decision, the board must determine:
232	231		(1) That the applicant has not engaged in conduct during the revocation
233	232		period that would constitute a basis for revocation pursuant to rules adopted by
234	233		the board;
	234	+	(2) If a criminal conviction was a basis of the revocation, that the
	235	+	applicant's civil rights have been fully restored pursuant to statute or another
	236	+	applicable recognized judicial, gubernatorial, or presidential order;
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239		-	(2) If a criminal conviction was a basis of the revocation, that the
240		-	applicant's civil rights have been fully restored pursuant to statute or another
241		-	applicable recognized judicial, gubernatorial, or presidential order;
242	241		(3) That the applicant has made restitution to an aggrieved person as
243	242		ordered by a court of competent jurisdiction; and
244	243		(4) That the applicant demonstrates another standard of rehabilitation the
245	244		board determines is appropriate.
246	245		(b) Except as provided in subsection (c), a person whose license was revoked
247	246		shall not apply for a new license earlier than two (2) years after the date of revocation.
248	247		(c) If a license revocation was based on a conviction of a felony or an offense
249	248		involving moral turpitude and that conviction has been reversed on appeal, then the
250	249		board shall vacate its previous order to revoke the license and the anesthesiologist
251	250		assistant may apply for a new license after the court enters the reversal.
252	251		(d) An applicant for a new license after revocation shall comply with all initial
253	252		licensure requirements prescribed by this chapter and rules adopted by the board
254	253		pursuant to this chapter.
255	254		63-21-107. Authority to promulgate rules.
256	255		The department of health and the board of medical examiners are authorized to
257	256		promulgate rules to effectuate this chapter. The rules must be promulgated in
258	257		accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter
259	258		5.
260	259		SECTION 2. Tennessee Code Annotated, Section 63-6-101(a)(2), is amended by
261	260		deleting the subdivision and substituting instead:
262	261		(2) Three (3) members shall be nonphysicians as follows:
	262	+	(A) Two (2) members who are consumers of health care and who neither
	263	+	own nor have any financial or other interest in a healthcare facility, business,
	264	+	school of medicine, or other allied healthcare practitioner educational program
	265	+	and who shall represent the public at large; and
263	266
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267		-	(A) Two (2) members who are consumers of health care and who neither
268		-	own nor have any financial or other interest in a healthcare facility, business,
269		-	school of medicine, or other allied healthcare practitioner educational program
270		-	and who shall represent the public at large; and
271	270		(B) One (1) member who is an anesthesiologist assistant licensed under
272	271		§ 63-21-103, whose initial term begins upon the first expiration of a term of office
273	272		for a nonphysician member who is serving on the board on January 1, 2026.
274	273		SECTION 3. The headings in this act are for reference purposes only and do not
275	274		constitute a part of the law enacted by this act. However, the Tennessee Code Commission is
276	275		requested to include the headings in any compilation or publication containing this act.
277	276		SECTION 4. For purposes of promulgating rules, this act takes effect upon becoming a
278	277		law, the public welfare requiring it. For all other purposes, this act takes effect January 1, 2026,
279	278		the public welfare requiring it.