HB0758 • 2026

Medical Occupations

AN ACT to amend Tennessee Code Annotated, Title 4; Title 63 and Title 68, relative to anesthesiology.

Crime Education Healthcare

Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor: Vital, Briggs
Last action: 2025-02-13
Official status: Sponsor(s) Added.
Effective date: Not listed

Plain English Breakdown

The bill summary and text do not provide detailed information on the exact fees or renewal processes for anesthesiologist assistant licenses, which will be set by rules from the Board of Medical Examiners.

Medical Occupations: Anesthesiologist Assistants

This bill sets rules for anesthesiologist assistants in Tennessee, including licensing requirements and supervision by doctors.

What This Bill Does

Creates a new chapter in the state code to define terms related to anesthesiology practice.
Requires the Board of Medical Examiners to review and decide on qualifications for anesthesiologist assistant licenses.
Sets rules for issuing, renewing, revoking, and reinstating anesthesiologist assistant licenses.
Establishes a process for temporary licensing while applicants complete training or exams.

Who It Names or Affects

Anesthesiologist assistants applying for or holding licenses in Tennessee
The Board of Medical Examiners

Terms To Know

anesthesiologist assistant: A person who assists anesthesiologists under their supervision.
scope of practice: The specific tasks and responsibilities allowed for a professional in their field.

Limits and Unknowns

This bill only applies to certain counties in Tennessee.
It does not specify the exact fees or renewal processes, which will be set by rules from the Board of Medical Examiners.

Bill History

2025-03-26 Tennessee General Assembly
Assigned to General Subcommittee of Senate Health and Welfare Committee
2025-03-19 Tennessee General Assembly
Placed on Senate Health and Welfare Committee calendar for 3/26/2025
2025-02-13 Tennessee General Assembly
Sponsor(s) Added.
2025-02-12 Tennessee General Assembly
Passed on Second Consideration, refer to Senate Health and Welfare Committee
2025-02-10 Tennessee General Assembly
Assigned to s/c Health Subcommittee
2025-02-10 Tennessee General Assembly
Introduced, Passed on First Consideration
2025-02-06 Tennessee General Assembly
P2C, ref. to Health Committee- Government Operations for Review
2025-02-05 Tennessee General Assembly
Intro., P1C.
2025-02-04 Tennessee General Assembly
Filed for introduction
2025-01-29 Tennessee General Assembly
Filed for introduction

Official Summary Text

T
his bill
generally
establishes the scope of practice, licensure, and regulation for anesthesiologist assistants
. However, this bill only authorizes a person to engage in the practice of an
anesthesiologist assistant
in
Blount, Bradley, Davidson, Hamilton, Knox, Madison, Mau
ry, Montgomery, Rutherford, Sevier, Shelby, Sullivan, Sumner, Washington, Williamson,
and
Wilson count
ies
.

BOARD OF MEDICAL EXAMINERS

This bill requires the board of medical examiners
("board")
to review and determine the qualifications and fitness of
applicants for a license to practice as an anesthesiologist assistant. The board is required to
perform a number of duties, including g
rant
ing
, deny
ing
, renew
ing
, revok
ing
, and reinstat
ing
licenses
.

BOARD
MEMBERSHIP

Present law
requires
the board
to
co
nsist of 12 members, nine of whom must be licensed physicians meeting certain qualifications. Three members must be nonphysicians who are consumers of health care and who neither own nor have any financial or other interest in any health care facility or

business or school of medicine or other allied health care practitioner educational program and who must represent the public at large.

The bill adds that out of those three nonphysician members, two must meet the above-mentioned provision, while the thi
rd member must be a licensed anesthesiologist assistant, whose initial term begins upon the first expiration of a term of office for a nonphysician member who is serving on the board on January 1, 2026.

LICENSURE

T
his bill authorizes t
he board
to
grant
an anesthesiologist assistant license to an applicant who meets
all of
the following requirements:



Graduated from an anesthesiologist assistant program accredited by the Commission on Accreditation of Allied Health Education Programs or its predecessor or successor organization
.



Satisfactorily completed a certification examination administered by the national Commission for the Certification of Anesthesiologist Assistants or another national certifying agency that has been reviewed and approved by the board
.



Completes an application form.



Pays the required application and licensure fees as prescribed by rule.

T
his bill provides that t
he license issued, including a temporary license, is valid for a period of two years and must be renewed every other
year on or before January 31 by completing a renewal application form and the prescribed renewal fee before the current license expires. The board is required to provide renewal notices to licensees at least one month before the expiration date. The bo
a
rd is also authorized to reinstate a lapsed license if the applicant pays a reinstatement fee and meets the requirements for initial licensure.

This bill authorizes the board to also issue a temporary license to a person who meets
all of
the following
criteria:



Completes a temporary license application
.



Pays the required temporary license fee as prescribed by rule
.



Successfully completes a Commission on Accreditation of Allied Health Education program or another board-approved program for educating and training anesthesiologist assistants but who has not passed. The person must take the next available certification examination after receiving a temporary license. A temporary license must not be issued for a period of more than one year and is subject to other requirements the board adopts by rule.

Th
is bill authorizes the
board
to
refuse to renew and
to
revoke, suspend, or restrict a license or take any other disciplinary action, including imposing conditions or restrictions on a license pursuant
to this bill and the rules adopted. If the board determines that a person is ineligible for licensure, that an application for licensure should be denied, that a license should be suspended, or that another action should be taken on a current license,
th
en
the board must adopt and enter its written order and findings.
If the board proposes to issue discipline on a current license, then a contested case hearing must be conducted pursuant to
the rules for contested hearings under the Uniform Administrative
Procedures Act
.

NEW LICENSE AFTER REVOCATION

T
his bill authorizes t
he board
to
issue a new license to an assistant whose license was previously revoked by the board if the applicant applies in writing to the board and demonstrates to the board's satisf
action that the applicant is completely rehabilitated with respect to the conduct that was the basis for the revocation. In making its decision, the board must determine
all of
the following matters:



That the applicant has not engaged in conduct during the revocation period that would constitute a basis for revocation pursuant to rules adopted by the board
.



If a criminal conviction was a basis of the revocation, that the applicant's civil rights have been fully restored pursuant to statute or another applicable recognized judicial
,
gubernatorial
, or presidential
order
.



That the applicant has made restitution to an aggrieved person as ordered by a court of competent jurisdiction
.



That the applicant demonstrates another standard of rehabilitation the board determines is appropriate.

Unless a license revocation was based on a conviction of a felony or an offense involving moral turpitude and that conviction has been reversed on ap
peal,
this bill prohibits
a person
whose license was revoked from
app
lying
for
a new
license
earlier
than two years after the date of revocation. If, however, a license revocation was based on a conviction of a felony or an offense involving moral turpitu
de and that conviction has been reversed on appeal, then the board must vacate its previous order to revoke the license and the anesthesiologist assistant may apply for
a new license
after the court enters the reversal. An applicant for
a new license afte
r revocation
must comply with all initial licensure requirements prescribed by this bill.

SCOPE OF PRACTICE

This bill authorizes an anesthesiologist assistant to assist in the practice of medicine only under the supervision of an anesthesiologist. The

anesthesiologist
assistant may perform only those duties and responsibilities delegated by the supervising anesthesiologist. The duty of supervision owed refers to the availability of a
n
anesthesiologist who can delegate, coordinate, direct, consult, or o
versee the implementation of the anesthesiologist
'
s intentions. The supervision may be in a manner consistent with federal rules or regulations for reimbursement for anesthesia services.

This bill requires the supervising anesthesiologist to be immedi
ately available to the assistant who assists in the delivery of medical care such that the supervising anesthesiologist is able to intervene if needed. An assistant's practice must not exceed the assistant's education and training, and the scope of pract
i
ce of the supervising anesthesiologist. This bill prohibits a medical care task assigned by the supervising anesthesiologist to the assistant from being delegated by the assistant to another person.

This bill authorizes the following as delegable dutie
s:



Developing and implementing an anesthesia care plan for a patient
.



Obtaining a comprehensive patient history and performing relevant elements of a physical exam
.



Performing preoperative and postoperative anesthetic evaluations and maintaining patient progress notes.



Ordering and performing preoperative patient consultations
.



Ordering preoperative medications, including controlled substances, which may be administered before the supervising anesthesiologist cosigns
.



Changing or discontinuing a medical treatment plan after consulting with the supervising anesthesiologist.



Obtaining informed consent for anesthesia or related procedures.



Ordering the preoperative continuation of current medications, which may be administered before the supervising anesthesiologist cosigns
.



Pretesting and calibrating anesthesia delivery systems and obtaining and interpreting information from the systems and from monitors
.



Implementing medically accepted monitoring techniques
.



Performing basic and advanced airway interventions.



Establishing peripheral intravenous lines, including subcutaneous lidocaine use.



Performing invasive procedures.



Performing general anesthesia
.



Administering anesthetic drugs, adjuvant drugs, and accessory drugs
.



Administering vasoactive drugs and starting and titrating vasoactive infusions to treat patient responses to anesthesia
.



Performing, maintaining, evaluating, and managing epidural, spinal, and regional anesthesia
.



Performing monitored anesthesia care
.



Obtaining venous and arterial blood samples
.



Administering blood, blood products, and supportive fluids
.



Performing, ordering, and interpreting appropriate preoperative, point of care, intraoperative, or postoperative diagnostic tests or procedures
.



Obtaining and administering preoperative anesthesia and related pharmaceutical agents
.



Managing the patient while in the preoperative suite, recovery area, or labor suites
.



Ordering postoperative sedation, anxiolysis or analgesia, postoperative respiratory therapy and medicines to treat patient responses to anesthesia and ordering postoperative oxygen therapy, which may be administered before the supervising anesthesiologist cosigns
.



Initiating and managing cardiopulmonary resuscitation in response to a life-threatening situation
.



Participating in administrative, research, and clinical teaching activities
.



Performing such other tasks not prohibited by law that an anesthesiologist assistant has been trained and is proficient to perform.

This bill, however, does not prevent an anesthesiologist assistant from having access to and being able to obtain prescription drugs as directed by the
supervising anesthesiologist
.

PENALTIES

This bill prohibits a person from practicing in
this state
as
an anesthesiologist assistant or using the title or representing that the person is a certified anesthesiologist assistant, or using the abbreviations "C.A.A." or "A.A." without having a license granted by the board. A violation is a Class B misdemeanor,
punishable by a fine of not more than $1,000
,
a term of imprisonment for not more than one year, or both. Each violation constitutes a separate offense.

This bill also prohibits a supervising anesthesiologist from employing a person to practice as an a
nesthesiologist assistant who is not licensed pursuant to this bill. A violation is a Class B misdemeanor, punishable by a fine of not more than $1,000
,
a term of imprisonment for not more than one year, or both. Each violation constitutes a separate off
ense.

AUTHORITY TO PROMULGATE RULES

T
he bill authorizes t
he department of health and the board of medical examiners to promulgate rules to effectuate this
bill
.

Current Bill Text

Read the full stored bill text

SENATE BILL 461
By Briggs

HOUSE BILL 758
By Vital

HB0758
000215
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 4;
Title 63 and Title 68, relative to anesthesiology.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 63, is amended by adding the following
as a new chapter:
63-21-101. Chapter definitions.
As used in this chapter:
(1) "Anesthesiologist" means a physician who is licensed pursuant to
chapter 6 or 9 of this title and who has completed a residency in anesthesiology
approved by the American Board of Anesthesiology or the American Osteopathic
Board of Anesthesiology;
(2) "Anesthesiologist assistant" means a person who meets the
requirements of § 63-21-103 and is board-approved to assist in the practice of
medicine under delegation of an anesthesiologist;
(3) "Assists" means, in regard to an anesthesiologist assistant, that the
anesthesiologist assistant personally performs those duties and responsibilities
delegated by the anesthesiologist;
(4) "Board" means the board of medical examiners established by
chapter 6, part 1 of this title;
(5) "Certification examination" means the initial certifying examination
approved by the board for the certification of anesthesiologist assistants,
including the examination administered by the National Commission for the

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Certification of Anesthesiologist Assistants or another national anesthesiologist
assistant certifying agency that has been reviewed and approved by the board;
and
(6) "Supervision" means the availability of an anesthesiologist who can
delegate, coordinate, direct, consult, or oversee the implementation of the
anesthesiologist's intentions.
63-21-102. Boards; powers and duties.
(a) The board shall review and determine the qualifications and fitness of all
persons applying for a license to practice as an anesthesiologist assistant.
(b) The board shall:
(1) Grant, deny, renew, revoke, and reinstate licenses;
(2) Set and collect fees for licensure under this chapter;
(3) Establish continuing education requirements for anesthesiologist
assistants;
(4) Investigate allegations that an anesthesiologist assistant or the
supervising anesthesiologist has engaged in conduct constituting a ground for
revocation;
(5) Conduct informal interviews and hearings;
(6) Take disciplinary or other administrative action, which must comply
with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to
enforce this chapter;
(7) Adopt rules governing the licensure and practice of anesthesiologist
assistants, and such other rules as are necessary to implement and enforce this
chapter; and

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(8) Retain jurisdiction over only those licensees to whom temporary or
full licenses are granted pursuant to this chapter, regardless of whether the
license has expired or lapsed, been retired, or was relinquished during or after
any alleged occurrence of conduct.
63-21-103. Licensure; unauthorized practice; use of title; duplicate license;
temporary licensure; fees.
(a) A person shall not practice in this state as an anesthesiologist assistant or
use the title or represent that the person is a certified anesthesiologist assistant,
anesthesiologist assistant, or use the abbreviations "C.A.A." or "A.A." without having a
license granted by the board pursuant to this chapter. A violation of this subsection (a)
is a Class B misdemeanor, punishable by a fine of not more than one thousand dollars
($1,000) or by a term of imprisonment for not more than one (1) year, or both. Each
violation of this subsection (a) constitutes a separate offense.
(b) The board may grant an anesthesiologist assistant license to an applicant
who:
(1) Graduated from an anesthesiologist assistant program accredited by
the Commission on Accreditation of Allied Health Education Programs or its
predecessor or successor organization;
(2) Satisfactorily completed a certification examination administered by
the National Commission for the Certification of Anesthesiologist Assistants or
another national certifying agency that has been reviewed and approved by the
board;
(3) Completes an application form; and
(4) Pays the required application and licensure fees as prescribed by the
board in rule.

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(c) A license issued pursuant to this chapter, other than a temporary license, is
valid for a period of two (2) years. A licensee shall renew the license every other year
on or before January 31 by completing and submitting to the board a renewal application
form as prescribed by the board and the prescribed renewal fee before the current
license expires. The board shall provide renewal notices to licensees at least one (1)
month before the expiration date.
(d) The board may reinstate a lapsed license if the applicant pays a
reinstatement fee as prescribed by the board in rule and meets the requirements for
initial licensure.
(e) The board may issue a temporary license to a person who:
(1) Completes a temporary license application;
(2) Pays the required temporary license fee as prescribed by the board in
rule; and
(3) Successfully completes a Commission on Accreditation of Allied
Health Education program or another board-approved program for educating and
training anesthesiologist assistants but who has not passed a certification
examination. The person shall take the next available certification examination
after receiving a temporary license. A temporary license must not be issued for a
period of more than one (1) year and is subject to other requirements the board
adopts by rule.
63-21-104. Scope of practice.
(a) This section does not apply to persons who are enrolled in an
anesthesiologist assistant education program approved by the board.
(b) An anesthesiologist assistant may assist in the practice of medicine only
under the supervision of an anesthesiologist. The anesthesiologist assistant may

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perform only those duties and responsibilities delegated to the anesthesiologist assistant
by the supervising anesthesiologist.
(c) The supervising anesthesiologist may supervise anesthesiologist assistants
in a manner consistent with federal rules or regulations for reimbursement for anesthesia
services.
(d) The supervising anesthesiologist shall be immediately available to the
anesthesiologist assistant who assists in the delivery of medical care such that the
supervising anesthesiologist is able to intervene if needed.
(e) An anesthesiologist assistant's practice shall not exceed the assistant's
education and training, and the scope of practice of the supervising anesthesiologist. A
medical care task assigned by the supervising anesthesiologist to the anesthesiologist
assistant shall not be delegated by the anesthesiologist assistant to another person.
(f) A supervising anesthesiologist may delegate to an anesthesiologist assistant
any of the following duties:
(1) Developing and implementing an anesthesia care plan for a patient;
(2) Obtaining a comprehensive patient history and performing relevant
elements of a physical exam;
(3) Performing preoperative and postoperative anesthetic evaluations
and maintaining patient progress notes;
(4) Ordering and performing preoperative patient consultations;
(5) Ordering preoperative medications, including controlled substances,
which may be administered before the supervising anesthesiologist cosigns;
(6) Changing or discontinuing a medical treatment plan after consulting
with the supervising anesthesiologist;
(7) Obtaining informed consent for anesthesia or related procedures;

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(8) Ordering the preoperative continuation of current medications, which
may be administered before the supervising anesthesiologist cosigns;
(9) Pretesting and calibrating anesthesia delivery systems and obtaining
and interpreting information from the systems and from monitors;
(10) Implementing medically accepted monitoring techniques;
(11) Performing basic and advanced airway interventions, including
endotracheal intubation, laryngeal mask insertion, and other advanced airways
techniques;
(12) Establishing peripheral intravenous lines, including subcutaneous
lidocaine use;
(13) Performing invasive procedures including arterial lines, central lines,
and Swan Ganz catheters;
(14) Performing general anesthesia, including induction, maintenance,
emergence, and procedures associated with general anesthesia, such as gastric
intubation;
(15) Administering anesthetic drugs, adjuvant drugs, and accessory
drugs;
(16) Administering vasoactive drugs and starting and titrating vasoactive
infusions to treat patient responses to anesthesia;
(17) Performing, maintaining, evaluating, and managing epidural, spinal,
and regional anesthesia, including catheters;
(18) Performing monitored anesthesia care;
(19) Obtaining venous and arterial blood samples;
(20) Administering blood, blood products, and supportive fluids;

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(21) Performing, ordering, and interpreting appropriate preoperative,
point of care, intraoperative, or postoperative diagnostic tests or procedures;
(22) Obtaining and administering preoperative anesthesia and related
pharmaceutical agents, including intravenous fluids and blood products;
(23) Managing the patient while in the preoperative suite, recovery area,
or labor suites;
(24) Ordering postoperative sedation, anxiolysis or analgesia,
postoperative respiratory therapy and medicines to treat patient responses to
anesthesia and ordering postoperative oxygen therapy, including initial ventilator
therapy, which may be administered before the supervising anesthesiologist
cosigns;
(25) Initiating and managing cardiopulmonary resuscitation in response
to a life-threatening situation;
(26) Participating in administrative, research, and clinical teaching
activities, including supervising student anesthesiologist assistants and other
students involved in anesthesia education; and
(27) Performing such other tasks not prohibited by law that an
anesthesiologist assistant has been trained and is proficient to perform.
(g) This chapter does not prevent an anesthesiologist assistant from having
access to and being able to obtain prescription drugs as directed by the supervising
anesthesiologist.
(h) A supervising anesthesiologist shall not employ a person to practice as an
anesthesiologist assistant who is not licensed pursuant to this chapter. A violation of this
subsection (h) is a Class B misdemeanor, punishable by a fine of not more than one

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thousand dollars ($1,000) or by a term of imprisonment for not more than one (1) year,
or both. Each violation of this subsection (h) constitutes a separate offense.
(i) A person shall not engage in the practice of an anesthesiologist assistant in a
county having a population of eighty-five thousand (85,000) or less, according to the
2020 federal census or a subsequent federal census.
63-21-105. Regulations.
(a) The board may refuse to renew and may revoke, suspend, or restrict a
license or take other disciplinary action, including imposing conditions or restrictions on a
license pursuant to this chapter and the rules adopted pursuant to this chapter.
(b) If the board determines that a person is ineligible for licensure, that an
application for licensure should be denied, that a license should be suspended, or that
another action should be taken on a current license, then the board shall adopt and
enter its written order and findings. If the board proposes to issue discipline on a current
license, then a contested case hearing must be conducted pursuant to title 4, chapter 5,
part 3.
63-21-106. Issuance of new license following revocation; requirements.
(a) The board may issue a new license to an anesthesiologist assistant whose
license was previously revoked by the board if the applicant applies in writing to the
board and demonstrates to the board's satisfaction that the applicant is completely
rehabilitated with respect to the conduct that was the basis for the revocation. In making
its decision, the board must determine:
(1) That the applicant has not engaged in conduct during the revocation
period that would constitute a basis for revocation pursuant to rules adopted by
the board;

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(2) If a criminal conviction was a basis of the revocation, that the
applicant's civil rights have been fully restored pursuant to statute or another
applicable recognized judicial, gubernatorial, or presidential order;
(3) That the applicant has made restitution to an aggrieved person as
ordered by a court of competent jurisdiction; and
(4) That the applicant demonstrates another standard of rehabilitation the
board determines is appropriate.
(b) Except as provided in subsection (c), a person whose license was revoked
shall not apply for a new license earlier than two (2) years after the date of revocation.
(c) If a license revocation was based on a conviction of a felony or an offense
involving moral turpitude and that conviction has been reversed on appeal, then the
board shall vacate its previous order to revoke the license and the anesthesiologist
assistant may apply for a new license after the court enters the reversal.
(d) An applicant for a new license after revocation shall comply with all initial
licensure requirements prescribed by this chapter and rules adopted by the board
pursuant to this chapter.
63-21-107. Authority to promulgate rules.
The department of health and the board of medical examiners are authorized to
promulgate rules to effectuate this chapter. The rules must be promulgated in
accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter
5.
SECTION 2. Tennessee Code Annotated, Section 63-6-101(a)(2), is amended by
deleting the subdivision and substituting instead:
(2) Three (3) members shall be nonphysicians as follows:

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(A) Two (2) members who are consumers of health care and who neither
own nor have any financial or other interest in a healthcare facility, business,
school of medicine, or other allied healthcare practitioner educational program
and who shall represent the public at large; and
(B) One (1) member who is an anesthesiologist assistant licensed under
§ 63-21-103, whose initial term begins upon the first expiration of a term of office
for a nonphysician member who is serving on the board on January 1, 2026.
SECTION 3. The headings in this act are for reference purposes only and do not
constitute a part of the law enacted by this act. However, the Tennessee Code Commission is
requested to include the headings in any compilation or publication containing this act.
SECTION 4. For purposes of promulgating rules, this act takes effect upon becoming a
law, the public welfare requiring it. For all other purposes, this act takes effect January 1, 2026,
the public welfare requiring it.