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SB1637 - 572R - I Ver
REFERENCE TITLE:
dentists' responsibility; sedation; informed consent
State of Arizona
Senate
Fifty-seventh Legislature
Second Regular Session
2026
SB 1637
Introduced by
Senator
Shope
AN
ACT
Amending sections 32-1201 and 32-1272,
Arizona Revised Statutes; amending title 32, chapter 11, article 3, Arizona
Revised Statutes, by adding sections 32-1272.01, 32-1272.02 and 32-1273;
Amending sections 32-1459, 32-1664 and 32-1855.02, Arizona
Revised Statutes; relating to the state board of dental examiners.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 32-1201, Arizona Revised
Statutes, is amended to read:
START_STATUTE
32-1201.
Definitions
In this chapter, unless the context otherwise requires:
1. "Adverse event" means
any incident that occurs in a dental office or dental clinic during or as a
result of the administration of general anesthesia, deep sedation or moderate
sedation and that results in or requires an emergency medical response.
1.
2.
"Affiliated
practice dental hygienist" means any licensed dental hygienist who is
able, pursuant to section 32-1289.01, to initiate treatment based on the
dental hygienist's assessment of a patient's needs according to the terms of a
written affiliated practice agreement with a dentist, to treat the patient
without the presence of a dentist and to maintain a provider-patient
relationship.
2.
3.
"Auxiliary
personnel" means all dental assistants, dental technicians, dental x-ray
technicians and other persons employed by dentists or firms and businesses
providing dental services to dentists.
3.
4.
"Board"
means the state board of dental examiners.
4.
5.
"Business
entity" means a business organization that has an ownership that includes
any persons who are not licensed or certified to provide dental services in
this state, that offers to the public professional services regulated by the
board and that is established pursuant to the laws of any state or foreign
country.
5.
6.
"Dental
assistant" means any person who acts as an assistant to a dentist, dental
therapist or dental hygienist by rendering personal services to a patient that
involve close proximity to the patient while the patient is under treatment or
observation or undergoing diagnostic procedures.
6.
7.
"Dental
hygienist" means any person who is licensed and engaged in the general
practice of dental hygiene and all related and associated duties, including
educational, clinical and therapeutic dental hygiene procedures.
7.
8.
"Dental
incompetence" means lacking in sufficient dentistry knowledge or skills,
or both, in that field of dentistry in which the dentist, dental therapist,
denturist or dental hygienist concerned engages, to a degree likely to endanger
the health of that person's patients.
8.
9.
"Dental
laboratory technician" means any person, other than a licensed dentist,
who, pursuant to a written work order of a dentist, fabricates artificial
teeth, prosthetic appliances or other mechanical and artificial contrivances designed
to correct or alleviate injuries or defects, both developmental and acquired,
disorders or deficiencies of the human oral cavity, teeth, investing tissues,
maxilla or mandible or adjacent associated structures.
9.
10.
"Dental
therapist" means any person who is licensed and engaged in the general
practice of dental therapy and all related and associated duties, including
educational, clinical and therapeutic dental therapy procedures.
10.
11.
"Dental
x-ray laboratory technician" means any person, other than a licensed
dentist, who, pursuant to a written work order of a dentist, performs dental
and maxillofacial radiography, including cephalometrics, panoramic and
maxillofacial tomography and other dental related nonfluoroscopic diagnostic
imaging modalities.
11.
12.
"Dentistry",
"dentist" and "dental" mean the general practice of
dentistry and all specialties or restricted practices of dentistry.
12.
13.
"Denturist"
means a person practicing denture technology pursuant to article 5 of this
chapter.
13.
14.
"Disciplinary
action" means regulatory sanctions that are imposed by the board in
combination with, or as an alternative to, revocation or suspension of a
license and that may include:
(a) Imposition of an administrative penalty in an
amount not to exceed $2,000 for each violation of this chapter or rules adopted
under this chapter.
(b) Imposition of restrictions on the scope of
practice.
(c) Imposition of peer review and professional
education requirements.
(d) Imposition of censure or probation requirements
best adapted to protect the public welfare, which may include a requirement for
restitution to the patient resulting from violations of this chapter or rules
adopted under this chapter.
15. "Emergency medical
response" includes:
(
a
) The
initiation of emergency medical services by dialing the telephone number 911 or
a similar public dispatch.
(
b
) A patient
transport to a hospital or other emergency health care facility for medical
treatment, whether requested by the patient or not.
14.
16.
"Irregularities
in billing" means submitting any claim, bill or government assistance
claim to any patient, responsible party or third-party payor for dental
services rendered that is materially false with the intent to receive unearned
income as evidenced by any of the following:
(a) Charges for services not rendered.
(b) Any treatment date that does not accurately
reflect the date when the service and procedures were actually completed.
(c) Any description of a dental service or procedure
that does not accurately reflect the actual work completed.
(d) Any charge for a service or procedure that
cannot be clinically justified or determined to be necessary.
(e) Any statement that is material to the claim and
that the licensee knows is false or misleading.
(f) An abrogation of the copayment provisions of a
dental insurance contract by a waiver of all or a part of the copayment from
the patient if this results in an excessive or fraudulent charge to a third
party or if the waiver is used as an enticement to receive dental services from
that provider. This subdivision does not interfere with a
contractual relationship between a third-party payor and a licensee or
business entity registered with the board.
(g) Any other practice in billing that results in
excessive or fraudulent charges to the patient.
15.
17.
"Letter
of concern" means an advisory letter to notify a licensee or a registered
business entity that, while the evidence does not warrant disciplinary action,
the board believes that the licensee or registered business entity should
modify or eliminate certain practices and that continuation of the activities
that led to the information being submitted to the board may result in board
action against the practitioner's license or the business entity's
registration. A letter of concern is not a disciplinary
action. A letter of concern is a public document and may be used in
a future disciplinary action.
16.
18.
"Licensed"
means licensed pursuant to this chapter.
17.
19.
"Place
of practice" means each physical location at which a person who is
licensed pursuant to this chapter performs services subject to this chapter.
18.
20.
"Primary
mailing address" means the address on file with the board and to which
official board correspondence, notices or documents are delivered in a manner
determined by the board.
19.
21.
"Qualified
anesthesia provider" means any of the following:
(a) A licensee who holds a permit to administer
anesthesia and sedation from the board pursuant to section 32-1207.
(b) A physician who has completed residency training
in anesthesiology, who is licensed pursuant to chapter 13 or 17 of this title
and who is registered with the Arizona medical board or the Arizona board of
osteopathic examiners in medicine and surgery to administer anesthesia in
dental offices and dental clinics pursuant to section 32-1403 or 32-1803.
(c) A certified registered nurse anesthetist who has
a national board certification in anesthesiology, who is licensed pursuant to
chapter 15 of this title and who is registered with the Arizona state board of
nursing to administer anesthesia in dental offices and dental clinics pursuant
to section 32-1606.
20.
22.
"Recognized
continuing dental education" means continuing dental education as
prescribed by the board in rule.
21.
23.
"Recognized
dental hygiene school" means a school that has a dental hygiene program
with a minimum two academic year curriculum, or the equivalent of four
semesters, and that is approved by the board and accredited by the American dental
association commission on dental accreditation.
22.
24.
"Recognized
dental school" means a dental school that is accredited by the American
dental association commission on dental accreditation.
23.
25.
"Recognized
dental therapy school" means a school that is accredited or that has
received initial accreditation by the American dental association commission on
dental accreditation.
24.
26.
"Recognized
denturist school" means a denturist school that maintains standards of
entrance, study and graduation and that is accredited by the United States
department of education or the council on higher education accreditation.
25.
27.
"Supervised
personnel" means all dental hygienists, dental assistants, dental
laboratory technicians, dental therapists, denturists, dental x-ray
laboratory technicians and other persons supervised by licensed dentists.
26.
28.
"Teledentistry"
means the use of data transmitted through interactive audio, video or data
communications for the purposes of examination, diagnosis, treatment planning,
consultation and directing the delivery of treatment by dentists and dental
providers in settings permissible under this chapter or specified in rules
adopted by the board.
END_STATUTE
Sec. 2. Section 32-1272, Arizona Revised
Statutes, is amended to read:
START_STATUTE
32-1272.
Dental anesthesia; requirements; adverse events
A. A dental office or dental clinic at which general
anesthesia or sedation is administered must contain properly operating
equipment and supplies as prescribed by the board in rule and have proper
emergency response protocols in place, including advanced cardiac life support
and airway management and pediatric advanced life support, as applicable, when
administering general anesthesia or sedation as prescribed by the board in rule
that is consistent with the standards and practices recommended by the American
heart association.
B. A qualified anesthesia provider who is licensed
by the board and who fails to comply with the requirements of this section or
applicable board rules commits an act that constitutes a danger to the health,
welfare or safety of the public pursuant to section 32-1201.01.
C. If a qualified anesthesia provider who is not
licensed by the state board of dental examiners fails to comply with the
requirements of this section or applicable board rules, the state board of
dental examiners shall promptly report the qualified anesthesia provider's
conduct to the regulatory board that licenses the qualified anesthesia
provider. If an adverse
anesthesia outcome
event
involves a qualified anesthesia provider who is not
licensed by the state board of dental examiners, the state board of dental
examiners shall promptly report the adverse
anesthesia outcome
event
to the regulatory board that licenses the qualified
anesthesia provider.
D. If a death or an incident requiring
emergency medical response occurs in a dental office or dental clinic during
the administration of or recovery from general anesthesia or sedation by a
qualified anesthesia provider, the treating dentist shall submit a report of
the incident to the state board of dental examiners within seven business days
after the occurrence. If the incident involves a qualified
anesthesia provider who is not licensed by the state board of dental examiners,
the state board of dental examiners shall immediately forward a copy of the
incident report to the regulatory board that licenses the qualified anesthesia
provider.
END_STATUTE
Sec. 3. Title 32, chapter 11, article 3,
Arizona Revised Statutes, is amended by adding sections 32-1272.01, 32-1272.02
and 32-1273, to read:
START_STATUTE
32-1272.01.
Anesthesia and sedation informed consent; form requirements
A. Before administering general
anesthesia, deep sedation or moderate sedation in a dental office, the dentist
of record shall obtain, or verify that the qualified anesthesia provider has
obtained, a separate written informed consent for the anesthesia or sedation.
B. Informed consent obtained under
subsection A of this section must be documented on a form distinct from the
consent for the dental treatment and must, at a minimum:
1. Identify the specific level of
anesthesia or sedation to be administered.
2. Identify by name and professional
license type the qualified anesthesia provider who is responsible for
administering the anesthesia or sedation.
3. Disclose the material risks,
benefits and alternatives associated with the proposed anesthesia or sedation.
4. Confirm that the patient has
received and understands all preoperative and postoperative instructions.
END_STATUTE
START_STATUTE
32-1272.02.
Adverse events; failure to report; practice restrictions
A. If an adverse event occurs in a
dental office or dental clinic during the administration of or recovery from
anesthesia or sedation:
1. The treating dentist of record
shall submit a complete written report of the incident to the board within
seven business days after the adverse event occurs.
2. The qualified anesthesia provider
shall submit a complete written report of the adverse event to that provider's
own respective health profession regulatory board within seven business days
after the adverse event occurs.
B. If a dentist fails to report an
adverse event as required by this section, on review and a finding by the board
that the dentist knowingly failed to report, the board shall impose a mandatory
practice restriction on the dentist's license.
C. The failure of a qualified
anesthesia provider to report an adverse event as required by this section
shall be reported by the state board of dental examiners to the health
profession regulatory board that licenses the qualified anesthesia provider.
The state board of dental examiners shall recommend that the health profession
regulatory board that licenses the qualified anesthesia provider impose a
mandatory practice restriction for the failure to report.
END_STATUTE
START_STATUTE
32-1273.
Dentists of record; responsibility; patient care
A. Each patient shall have a dentist
of record. The dentist of record is the dentist who is ultimately responsible
for the dental treatment of the patient. The dentist of record must be
identified in the patient's dental record.
B. The dentist of record retains
ultimate responsibility for the overall safety and welfare of the patient
during any dental procedure, including procedures involving anesthesia or
sedation.
C. This section does not relieve a
qualified anesthesia provider of the qualified anesthesia provider's
responsibility for the safe delivery of anesthesia or sedation and for the
management of the patient's anesthetic care. The authority to delegate the
administration of anesthesia or sedation to a qualified anesthesia provider
does not relieve the dentist of record from the ultimate responsibility for the
care of the patient.
END_STATUTE
Sec. 4. Section 32-1459, Arizona Revised
Statutes, is amended to read:
START_STATUTE
32-1459.
Duty to report; definition
A.
If
a death or
an incident requiring emergency medical response
an
adverse event
occurs in a dental office or dental clinic during the
administration of or recovery from general anesthesia or sedation by a doctor
of medicine, the doctor of medicine shall, and any other person may, report the
death or incident
adverse event
to
the board within seven business days after the occurrence.
B. For the purposes of this section,
"adverse event" has the same meaning prescribed in section 32-1201.
END_STATUTE
Sec. 5. Section 32-1664, Arizona Revised
Statutes, is amended to read:
START_STATUTE
32-1664.
Investigation; hearing; notice; definition
A. In connection with an investigation, the board or
its duly authorized agents or employees may obtain any documents, reports,
records, papers, books and materials, including hospital records, medical staff
records and medical staff review committee records, or any other physical
evidence that indicates that a person or regulated party may have violated this
chapter or a rule adopted pursuant to this chapter:
1. By entering the premises, at any reasonable time,
and inspecting and copying materials in the possession of a regulated party
that relate to nursing competence, unprofessional conduct or the mental or
physical ability of a licensee to safely practice nursing.
2. By issuing a subpoena under the board's seal to
require the attendance and testimony of witnesses or to demand the production
for examination or copying of documents or any other physical evidence.� Within
five days after a person is served with a subpoena, that person may petition
the board to revoke, limit or modify the subpoena.� The board shall do so if in
its opinion the evidence required does not relate to unlawful practices covered
by this chapter, is not relevant to the charge that is the subject matter of
the hearing or investigation or does not describe with sufficient particularity
the physical evidence whose production is required.
3. By submitting a written request for the
information.
4. In the case of an applicant's or a regulated
party's personal medical records, as defined in section 12-2291, by any
means allowed by this section if the board either:
(a) Obtains from the applicant or regulated party,
or the health care decision maker of the applicant or regulated party, a
written authorization that satisfies the requirements of title 12, chapter 13,
article 7.1.
(b) Reasonably believes that the records relate to
information already in the board's possession regarding the competence,
unprofessional conduct or mental or physical ability of the applicant or
regulated party as it pertains to safe practice. If the board adopts
a substantive policy statement pursuant to section 41-1091, it may
authorize the executive director, or a designee in the absence of the executive
director, to make the determination of reasonable belief.
B. A regulated party and a health care institution
as defined in section 36-401 shall, and any other person may, report to
the board any information the licensee, certificate holder, health care
institution or individual may have that appears to show that a regulated party
or applicant is, was or may be a threat to the public health or safety.
C. If
a death or an incident requiring
emergency medical response
an adverse event
occurs
in a dental office or dental clinic during the administration of or recovery
from general anesthesia or sedation by a certified registered nurse
anesthetist, the certified registered nurse anesthetist shall, and any other
person may, report the
death or incident
adverse event
to the board within seven business days after the
occurrence.
D. The board retains
jurisdiction to proceed with an investigation or a disciplinary proceeding
against a regulated party whose license or certificate expired not more than
five years before the board initiates the investigation.
E. Any regulated party, health care institution or
other person that reports or provides information to the board in good faith is
not subject to civil liability.� If requested the board shall not disclose the
name of the reporter unless the information is essential to proceedings
conducted pursuant to this section.
F. Any regulated party or person who is subject to
an investigation may obtain representation by counsel.
G. On determination of reasonable cause, the board,
or if delegated by the board the executive director, may require a licensee,
certificate holder or applicant to undergo at the expense of the licensee,
certificate holder or applicant any combination of mental, physical or
psychological examinations, assessments or skills evaluations necessary to
determine the person's competence or ability to practice safely.� These
examinations may include bodily fluid testing and other examinations known to
detect the presence of alcohol or drugs.� If the executive director orders the
licensee, applicant or certificate holder to undertake an examination,
assessment or evaluation pursuant to this subsection, and the licensee,
certificate holder or applicant fails to affirm to the board in writing within
fifteen days after receipt of the notice of the order that the licensee,
certificate holder or applicant intends to comply with the order, the executive
director shall refer the matter to the board to allow the board to determine
whether to issue an order pursuant to this subsection. At each
regular meeting of the board the executive director shall report to the board
data concerning orders issued by the executive director pursuant to this
subsection since the last regular meeting of the board and any other data
requested by the board.
H. The board shall provide the investigative report
if requested pursuant to section 32-3206.
I. If after completing its investigation the board
finds that the information provided pursuant to this section is not of
sufficient seriousness to merit disciplinary action against the regulated party
or applicant, it may take either of the following actions:
1. Dismiss if in the opinion of the board the
information is without merit.
2. File a letter of concern if in the opinion of the
board there is insufficient evidence to support disciplinary action against the
regulated party or applicant but sufficient evidence for the board to notify
the regulated party or applicant of its concern.
J. Except as provided pursuant to section 32-1663,
subsection F and subsection K of this section, if the investigation in the
opinion of the board reveals reasonable grounds to support the charge, the
regulated party is entitled to an administrative hearing pursuant to title 41,
chapter 6, article 10. If notice of the hearing is served by
certified mail, service is complete on the date the notice is placed in the
mail.
K. A regulated party shall respond in writing to the
board within thirty days after notice of the hearing is served as prescribed in
subsection J of this section.� The board may consider a regulated party's
failure to respond within this time as an admission by default to the
allegations stated in the complaint. The board may then take disciplinary
actions allowed by this chapter without conducting a hearing.
L. An administrative law judge or a panel of board
members may conduct hearings pursuant to this section.
M. In any matters pending before it, the board may
issue subpoenas under its seal to compel the attendance of witnesses.
N. Patient records, including clinical records,
medical reports, laboratory statements and reports, any file, film, other
report or oral statement relating to diagnostic findings or treatment of
patients, any information from which a patient or a patient's family might be
identified or information received and records kept by the board as a result of
the investigation procedure outlined in this chapter are not available to the
public and are not subject to discovery in civil or criminal proceedings.
O. Hospital records, medical staff records, medical
staff review committee records, testimony concerning these records and
proceedings related to the creation of these records shall not be available to
the public.� They shall be kept confidential by the board and shall be subject
to the same provisions concerning discovery and use in legal actions as are the
original records in the possession and control of hospitals, their medical
staffs and their medical staff review committees.� The board shall use these
records and testimony during the course of investigations and proceedings
pursuant to this chapter.
P. If the regulated party is found to have committed
an act of unprofessional conduct or to have violated this chapter or a rule
adopted pursuant to this chapter, the board may take disciplinary action.
Q. The board may subsequently issue a denied license
or certificate and may reissue a revoked or voluntarily surrendered license or
certificate.
R. On application by the board to any superior court
judge, a person who without just cause fails to comply with a subpoena issued
pursuant to this section may be ordered by the judge to comply with the
subpoena and punished by the court for failing to comply.� Subpoenas shall be
served by regular or certified mail or in the manner required by the Arizona
rules of civil procedure.
S. The board may share investigative information
that is confidential under subsections N and O of this section with other
state, federal and international health care agencies and with state, federal
and international law enforcement authorities if the recipient is subject to
confidentiality requirements similar to those established by this section.� A
disclosure made by the board pursuant to this subsection is not a waiver of the
confidentiality requirements established by this section.
T. For the purposes of this section,
"adverse event" has the same meaning prescribed in section 32-1201.
END_STATUTE
Sec. 6. Section 32-1855.02, Arizona Revised
Statutes, is amended to read:
START_STATUTE
32-1855.02.
Physicians; duty to report; definition
A.
If
a death or
an incident requiring emergency medical response
an
adverse event
occurs in a dental office or dental clinic during the
administration of or recovery from general anesthesia or sedation by a
physician, the physician shall, and any other person may, report the
death or incident
adverse event
to the
board within seven business days after the occurrence.
B. For the purposes of this section,
"adverse event" has the same meaning prescribed in section 32-1201.
END_STATUTE