Official Summary Text
ON APRIL 16, 2025, THE HOUSE ADOPTED AMENDMENT #1 AND PASSED HOUSE BILL 979, AS AMENDED.
AMENDMENT #1 rewrites this bill to make vari
ous changes and additions to present law concerning health care.
Employment of Physicians
Present law provides that nothing prohibits a licensed hospital, or an affiliate of a hospital, from employing licensed physicians other than radiologists, anesthe
siologists, pathologists, or emergency physicians, to provide medical services, subject to certain conditions. This amendment instead provides that, subject to certain conditions, a licensed hospital, or an affiliate of a hospital, may employ licensed ph
y
sicians to provide medical services in:
(1) A hospital located in a county with a population of 105,000 or less;
(2) A hospital located in a county with a population of more than 105,000, if such licensed physicians are other than radiologists, anesth
esiologists, pathologists, or emergency physicians; or
(3) A hospital if such hospital is a children's hospital; provided, that any radiologists, anesthesiologists, pathologists, or emergency physicians employed by such children's hospital are board cert
ified or board eligible.
Present law generally prohibits employing entities from entering a non-compete agreement with a physician that the entity employs; provided, however an employing entity may impose reasonable geographic restrictions upon an employ
ed physician's practice upon the conclusion of the employment relationship, if the employing entity purchased the physician's practice. This amendment removes such provisions.
Present law specifies that the following are not prohibited from employing ph
ysicians:
(1) A licensed physician; or
(2) A group of licensed physicians, including, but not limited to, either of the following
(A) A physicians' professional corporation registered under present law; or
(B) A domestic nonprofit public benefit c
orporation:
(i) That is tax exempt under §
501(c)(3) of the Internal Revenue Code;
(ii) A purpose of which is to engage in medical education and medical research in conjunction with a college or university operating an accredited medical school in
Tennessee;
(iii) Whose physician-employees are restricted to the medical faculty of such a college or university; and
(iv) Which operates as a faculty practice plan for purposes of Title XVIII of the federal Social Security Act. Provided, that with re
spect to any such domestic nonprofit public benefit corporation, physician employees of any such faculty practice plan who practice in the specialties of radiology, pathology, anesthesiology or emergency medicine are restricted to practice as faculty prac
t
ice plan employees in those health care institutions, including but not limited to hospitals or surgery centers, in which they were practicing as employees of the nonprofit public benefit corporation on May 30, 1997.
This amendment revises a group, as de
scribed in (2)(B), to be a domestic nonprofit public benefit corporation:
(1) That is tax exempt under §
501(c)(3) of the Internal Revenue Code;
(2) A purpose of which is to engage in medical education and medical research in conjunction with a colleg
e or university operating an accredited medical school in this state; and
(3) Whose physician-employees practice through a faculty practice plan for purposes of Title XVIII of the federal Social Security Act, or any wholly owned subsidiary of the foregoi
ng 501(c)(3) institution.
This amendment specifies that hospitals that employ anesthesiologists are required, to the extent applicable, to ensure that an anesthesiologist is able to comply with Medicare conditions for payment for medically directed or pe
rsonally performed anesthesia services. This requirement does not prohibit a hospital from using other Medicare conditions of payment..
Anesthesiologist Assistants
This amendment creates a licensure system for persons to assist in the practice of medic
ine under delegation of an anesthesiologist as an anesthesiologist assistant. This amendment requires the board of medical examiners to review and determine the qualifications and fitness of all persons applying for a license to practice as an anesthesio
l
ogist assistant.
This amendment prohibits a person from practicing 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." o
r "A.A." without having a license granted by the board. A violation of such prohibition is a Class B misdemeanor, punishable by a fine of up to $1,000 or by a term of imprisonment for not more than one year, or both.
This amendment authorizes the board
of medical examiners to 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 suc
cessor 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 bo
ard;
(3) Completes an application form; and
(4) Pays the required application and licensure fees as prescribed by the board in rule.
The full text of this amendment specifies various duties and powers for the board to exercise in the licensure and re
gulation of anesthesiologist assistants, including such subjects as disciplinary actions and temporary licensure. This amendment authorizes the board to promulgate rules together with the department of health.
The licensure requirement will not apply to
a person who is enrolled in an anesthesiologist assistant education program approved by the board.
Under this amendment, an anesthesiologist assistant may assist in the practice of medicine only under the supervision of an anesthesiologist and pursuant to a supervising agreement. The full text of this amendment specifies the requirements for adequate
s
upervision of an anesthesiologist assistant and the required contents for a supervising agreement.
The provisions of this amendment concerning licensure of anesthesiologist assistants take effect January 1, 2026.
Board of Medical Examiners
This amen
dment replaces one of the three nonphysician board members with a member who is an anesthesiologist assistant licensed under this amendment, whose initial term begins upon the first expiration of a term of office for a nonphysician member who is serving o
n
the board on January 1, 2026.
Regulation of Health and Related Facilities
This amendment makes changes to present law concerning regulation of health and related facilities to reflect the changes concerning hiring of certain medical providers that are
described in the section of this summary titled Employment of Physicians.
Effective Date
Except as otherwise specified in this summary, this amendment's provisions take effect upon becoming a law for rulemaking purposes and July 1, 2025, for the remaini
ng purposes.
ON APRIL 21, 2025, THE SENATE SUBSTITUTED HOUSE BILL 979 FOR SENATE BILL 764, ADOPTED AMENDMENTS #1 AND #2, AND PASSED HOUSE BILL 979, AS AMENDED.
AMENDMENT #1 makes the following revisions:
Removes the provision requiring hospitals that employ anesthesiologists to, to the extent applicable, ensure that an anesthesiologist is able to comply with medicare conditions for payment for medically directed or personally performed anesthesia services; provided that this provision does not prohibit a hospital from using other medicare conditions of payment.
Instead, requires hospitals that employ anesthesiologists to comply with applicable medicare conditions for payment.
Revises the definition of "board certified" to mean a physician who is board certified in the applicable medical specialty by the American Board of Medical Specialists or a comparable board.
Revises the definition of "board eligible" to mean a physician who has completed an approved residency but has not yet completed a medical specialty examination given by a board recognized by the American Board of Medical Specialists or a comparable board.
Revises the definition of "anesthesiologist" to mean a physician who is licensed in this state and who has completed a residency in anesthesiology approved by the American Board of Anesthesiology or the American Osteopathic Board of Anesthesiology and not some equivalent training in anesthesiology.
Requires the board of medical examiners to issue a license for an anesthesiologist assistant, other than a temporary license, pursuant to promulgated rules.
Provides that a violation of an anesthesiologist assistant not having a supervising agreement with a supervising anesthesiologist is a Class B misdemeanor, punishable by a fine of not more than $1,000. Each violation constitutes a separate offense.
Authorizes the department of health and the board of medical examiners to promulgate rules to effectuate the provisions relative to licensing anesthesiologist assistants.
AMENDMENT #2 remo
ves the provision replacing a nonphysician member of the board of medical examiners with a licensed anesthesiologist assistant.
ON APRIL 22, 2025, THE HOUSE NONCONCURRED IN SENATE AMENDMENTS # 1 AND 2.
ON APRIL 22, 2025, THE SENATE REFUSED TO RECEDE FR
OM ITS ADOPTION OF SENATE AMENDMENTS #1 AND #2.
ON APRIL 22, 2025, THE HOUSE REFUSED TO RECEDE IN ITS ACTIONS IN NONCONCURRING IN SENATE AMENDMENTS # 1 AND 2, AND APPOINTED A CONFERENCE COMMITTEE.
ON APRIL 22, 2025, THE SENATE APPOINTED A CONFERENCE CO
MMITTEE.
ON APRIL 22, 2025, THE HOUSE ADOPTED THE CONFERENCE COMMITTEE REPORT.
ON APRIL 22, 2025, THE SENATE ADOPTED THE CONFERENCE COMMITTEE REPORT.