Relating to the licensing and regulation of anesthesiologist assistants; requiring an occupational license; providing an administrative penalty; authorizing fees.

89(R) HB 5274 - Introduced version - Bill Text

89R971 JTZ-F

By: Cunningham

H.B. No. 5274

A BILL TO BE ENTITLED

AN ACT

relating to the licensing and regulation of anesthesiologist

assistants; requiring an occupational license; providing an

administrative penalty; authorizing fees.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subtitle C, Title 3, Occupations Code, is

amended by adding Chapter 207 to read as follows:

CHAPTER 207. ANESTHESIOLOGIST ASSISTANTS

SUBCHAPTER A. GENERAL PROVISIONS

Sec.

207.001.

SHORT TITLE. This chapter may be cited as the

Anesthesiologist Assistant Licensing Act.

Sec. 207.002. DEFINITIONS. In this chapter:

(1) "Anesthesiologist" means a physician who:

(A)

holds a license in good standing issued by

the medical board under Subtitle B;

(B) is certified in anesthesiology by:

(i)

the American Board of Physician

Specialties;

(ii)

the American Osteopathic Board of

Anesthesiology; or

(iii)

a certifying board recognized by the

medical board; and

(C)

has a medical practice in which the physician

regularly practices anesthesiology.

(2)

"Anesthesiologist assistant" means a person who

holds a license issued under this chapter.

(3)

"Anesthesiologist assistant board" means the

Texas Anesthesiologist Assistant Board.

(4) "Medical board" means the Texas Medical Board.

(5)

"Practice as an anesthesiologist assistant" means

personally performing a medical task delegated to the person by a

supervising anesthesiologist.

Sec.

207.003.

APPLICABILITY. (a) A person is not required

to hold a license issued under this chapter to practice as:

(1)

a technician, assistant, or employee of a

physician who performs delegated tasks but does not act as an

anesthesiologist assistant or represent that the person is an

anesthesiologist assistant; or

(2)

any other licensed health care worker acting

within the scope of that person's license if the person:

(A)

does not use the title "anesthesiologist

assistant" or the initials "C.A.A." or "A.A."; or

(B)

is not represented or designated as an

anesthesiologist assistant.

(b)

This chapter does not limit the employment arrangement

of an anesthesiologist assistant licensed under this chapter.

SUBCHAPTER B. TEXAS ANESTHESIOLOGIST ASSISTANT BOARD

Sec.

207.051.

ANESTHESIOLOGIST ASSISTANT BOARD. (a) The

Texas Anesthesiologist Assistant Board is an advisory board to the

medical board.

(b)

Chapter 2110, Government Code, does not apply to the

anesthesiologist assistant board.

Sec.

207.052.

APPOINTMENT OF BOARD. (a)

The

anesthesiologist assistant board consists of five members

appointed by the president of the medical board as follows:

(1) two anesthesiologist assistants;

(2) two anesthesiologists; and

(3)

one member who represents the public and is not

licensed or trained in a health care profession.

(b)

Appointments to the anesthesiologist assistant board

shall be made without regard to the race, color, disability, sex,

religion, age, or national origin of the appointee.

Sec.

207.053.

TERMS; VACANCIES. (a)

Members of the

anesthesiologist assistant board are appointed for staggered

six-year terms.

The terms of one or two members, as appropriate,

expire on February 1 of each odd-numbered year.

(b) A member may not serve more than:

(1) two consecutive full terms; or

(2) a total of three full terms.

(c)

If a vacancy occurs during a member's term, the

president of the medical board shall appoint a new member to serve

the unexpired term.

Sec. 207.054.

OFFICERS.

The president of the medical board

shall designate an anesthesiologist assistant member of the

anesthesiologist assistant board as the presiding officer of the

board to serve in that capacity at the will of the president.

The

anesthesiologist assistant board shall select from its membership a

secretary to serve a one-year term.

Sec.

207.055.

GROUNDS FOR REMOVAL. (a) It is a ground for

removal from the anesthesiologist assistant board that a member:

(1)

does not have at the time of taking office the

qualifications required by Section 207.052;

(2)

does not maintain during service on the

anesthesiologist assistant board the qualifications required by

Section 207.052;

(3)

cannot, because of illness or disability,

discharge the member's duties for a substantial part of the member's

term; or

(4)

is absent from more than half of the regularly

scheduled anesthesiologist assistant board meetings that the

member is eligible to attend during a calendar year without an

excuse approved by a majority vote of the board.

(b)

The validity of an action of the anesthesiologist

assistant board is not affected by the fact that it is taken when a

ground for removal of a board member exists.

(c)

If the executive director of the medical board has

knowledge that a potential ground for removal exists, the executive

director shall notify the presiding officer of the anesthesiologist

assistant board of the potential ground.

If the potential ground

for removal involves the presiding officer, the executive director

shall notify the next highest ranking officer of the

anesthesiologist assistant board, who shall then notify the

president of the medical board that a potential ground for removal

exists.

Sec. 207.056.

COMPENSATION; REIMBURSEMENT OF EXPENSES.

A

member of the anesthesiologist assistant board may not receive

compensation but is entitled to reimbursement for actual and

necessary expenses incurred in performing the functions of the

board, subject to the General Appropriations Act.

Sec.

207.057.

OPEN MEETINGS; ADMINISTRATIVE PROCEDURE LAW.

Except as otherwise provided by this chapter, the anesthesiologist

assistant board is subject to Chapters 551 and 2001, Government

Code.

Sec. 207.058.

TRAINING. (a) A person who is appointed to

and qualifies for office as a member of the anesthesiologist

assistant board may not vote, deliberate, or be counted as a member

in attendance at a meeting of the board until the person completes a

training program that complies with this section.

(b)

The training program must provide the person with

information regarding:

(1)

the law governing anesthesiologist assistant

board operations;

(2)

the programs, functions, rules, and budget of the

anesthesiologist assistant board;

(3)

the scope of and limitations on the rulemaking

authority of the anesthesiologist assistant board;

(4)

the results of the most recent formal audit of the

anesthesiologist assistant board;

(5) the requirements of:

(A)

laws relating to open meetings, public

information, administrative procedure, and disclosing conflicts of

interest; and

(B)

other laws applicable to members of the

anesthesiologist assistant board in performing their duties; and

(6)

any applicable ethics policies adopted by the

anesthesiologist assistant board or the Texas Ethics Commission.

(c)

A person appointed to the anesthesiologist assistant

board is entitled to reimbursement, as provided by the General

Appropriations Act, for the travel expenses incurred in attending

the training program regardless of whether the attendance at the

program occurs before or after the person qualifies for office.

(d)

The executive director of the medical board shall create

a training manual that includes the information required by

Subsection (b).

The executive director shall distribute a copy of

the training manual annually to each anesthesiologist assistant

board member.

On receipt of the training manual, each board member

shall sign and submit to the executive director a statement

acknowledging receipt of the training manual.

SUBCHAPTER C. POWERS AND DUTIES OF ANESTHESIOLOGIST ASSISTANT BOARD

AND MEDICAL BOARD

Sec.

207.101.

GENERAL POWERS AND DUTIES OF ANESTHESIOLOGIST

ASSISTANT BOARD; MEDICAL BOARD APPROVAL. (a)

The anesthesiologist

assistant board shall adopt rules that are reasonable and necessary

for the performance of the anesthesiologist assistant board's

duties under this chapter, as provided by Chapter 2001, Government

Code, including rules to establish:

(1) licensing, renewal, and other fees;

(2) license renewal dates; and

(3) procedures for disciplinary actions.

(b)

The medical board, by a majority vote, shall approve or

reject each rule adopted by the anesthesiologist assistant board.

If approved, the rule may take effect. If the rule is rejected, the

medical board shall return the rule to the anesthesiologist

assistant board for revision.

Sec.

207.102.

GUIDELINES FOR EARLY INVOLVEMENT IN

RULEMAKING PROCESS. (a) The anesthesiologist assistant board

shall adopt guidelines to establish procedures for receiving input

during the rulemaking process from individuals and groups that have

an interest in matters under the anesthesiologist assistant board's

jurisdiction. The guidelines must provide an opportunity for those

individuals and groups to provide input before the anesthesiologist

assistant board submits the rule to the medical board for approval.

(b)

A rule adopted or approved by the medical board may not

be challenged on the grounds that the anesthesiologist assistant

board did not comply with this section. If the anesthesiologist

assistant board was unable to solicit a significant amount of input

from the public or affected persons early in the rulemaking

process, the anesthesiologist assistant board shall state in

writing the reasons why the anesthesiologist assistant board was

unable to do so.

Sec.

207.103.

POWERS AND DUTIES OF MEDICAL BOARD RELATING

TO ANESTHESIOLOGIST ASSISTANTS. (a) The medical board shall

administer and enforce this chapter.

(b)

The medical board shall adopt rules consistent with this

chapter to regulate anesthesiologist assistants and

anesthesiologists who supervise anesthesiologist assistants.

(c)

The rules adopted by the medical board must include a

requirement that:

(1)

an anesthesiologist assistant assist only an

anesthesiologist who is:

(A)

physically present in the facility where the

anesthesiologist assistant is performing a medical task delegated

by the anesthesiologist; and

(B)

able to respond to a medically emergent issue

arising from the delegated medical task;

(2)

a supervising anesthesiologist supervise an

anesthesiologist assistant in a manner consistent with the

requirements for reimbursement of anesthesia services under

Medicaid and Medicare, as applicable; and

(3)

an anesthesiologist assistant shall maintain

compliance with all continuing medical education requirements

adopted under Section 207.157 and the recertification requirements

of the National Commission for Certification of Anesthesiologist

Assistants or its successor organization.

Sec.

207.104.

FEES. The anesthesiologist assistant board

shall set fees in amounts that are reasonable and necessary to cover

the costs of administering and enforcing this chapter without the

use of any other funds generated by the medical board.

Sec. 207.105.

RULES ON CONSEQUENCES OF CRIMINAL CONVICTION.

The anesthesiologist assistant board shall adopt rules and

guidelines as necessary to comply with Chapter 53, except to the

extent the requirements of this chapter are stricter than the

requirements of Chapter 53.

Sec. 207.106.

COMPLAINTS. The medical board shall maintain

a system to promptly and efficiently act on complaints filed with

the medical board regarding anesthesiologist assistants.

The

medical board shall maintain:

(1)

information about the parties to the complaint and

the subject matter of the complaint;

(2)

a summary of the results of the review or

investigation of the complaint; and

(3)

information about the disposition of the

complaint.

SUBCHAPTER D. LICENSE REQUIREMENTS, EXEMPTIONS, AND RENEWAL

Sec.

207.151.

LICENSE REQUIRED. (a)

A person may not

practice as an anesthesiologist assistant in this state unless the

person holds an anesthesiologist assistant license issued under

this chapter.

(b)

A person may not use the title "anesthesiologist

assistant"

or "certified anesthesiologist assistant"

or the

initials "C.A.A."

or "A.A."

or represent that the person is an

anesthesiologist assistant unless the person holds a license issued

under this chapter.

Sec.

207.152.

ISSUANCE OF LICENSE. The medical board shall

issue a license to an applicant who:

(1)

meets the eligibility requirements of Section

207.153;

(2)

submits an application on a form prescribed by the

board;

(3)

pays the required application and licensing fees;

and

(4)

submits to the board any other information the

board considers necessary to evaluate the applicant's

qualifications.

Sec.

207.153.

ELIGIBILITY REQUIREMENTS. To be eligible for

a license under this chapter, an applicant must:

(1)

submit proof of completion of a graduate level

training program accredited by the Commission on Accreditation of

Allied Health Education Programs or its successor organization;

(2)

pass a certifying examination administered by the

National Commission for Certification of Anesthesiologist

Assistants or its successor organization not later than the first

anniversary of the date of completion of the training program

required under Subdivision (1);

(3)

submit proof of current certification from the

National Commission for Certification of Anesthesiologist

Assistants or its successor organization; and

(4)

meet any additional qualifications adopted by rule

by the anesthesiologist assistant board.

Sec.

207.154.

CRIMINAL HISTORY RECORD INFORMATION

REQUIREMENT FOR LICENSE ISSUANCE. (a) The medical board shall

require that an applicant for a license submit a complete and

legible set of fingerprints, on a form prescribed by the medical

board, to the medical board or to the Department of Public Safety

for the purpose of obtaining criminal history record information

from the Department of Public Safety and the Federal Bureau of

Investigation.

(b)

The medical board may not issue a license to a person who

does not comply with the requirement of Subsection (a).

(c)

The medical board shall conduct a criminal history

record information check of each applicant for a license using

information:

(1) provided by the individual under this section; and

(2)

made available to the medical board by the

Department of Public Safety, the Federal Bureau of Investigation,

and any other criminal justice agency under Chapter 411, Government

Code.

(d) The medical board may:

(1)

enter into an agreement with the Department of

Public Safety to administer a criminal history record information

check required under this section; and

(2)

authorize the Department of Public Safety to

collect from each applicant the costs incurred by the Department of

Public Safety in conducting the criminal history record information

check.

Sec.

207.155.

EXEMPTIONS FROM LICENSING REQUIREMENT FOR

CERTAIN ANESTHESIOLOGIST ASSISTANTS. A person is not required to

hold a license issued under this chapter to practice as an

anesthesiologist assistant student enrolled in an anesthesiologist

assistant educational program accredited by the Commission on

Accreditation of Allied Health Education Programs or its successor

organization.

Sec.

207.156.

LICENSE RENEWAL. (a) A license issued under

this chapter is valid for a term of two or more years, as determined

by anesthesiologist assistant board rule.

(b)

On notification from the medical board, a person who

holds a license under this chapter may renew the license by:

(1) paying the required renewal fee;

(2) submitting the appropriate form; and

(3)

meeting any other requirement established by

anesthesiologist assistant board rule.

(c)

The anesthesiologist assistant board by rule may adopt a

system under which licenses expire on various dates during the

year.

(d)

A person who is otherwise eligible to renew a license

may renew an unexpired license by paying the required renewal fee to

the medical board before the expiration date of the license.

A

person whose license has expired may not engage in activities that

require a license until the license has been renewed.

(e)

A person whose license is expired may renew the license

by paying to the medical board a fee that is equal to 1-1/2 times the

renewal fee for the license.

Sec.

207.157.

CONTINUING MEDICAL EDUCATION REQUIREMENTS.

The medical board by rule shall adopt, monitor, and enforce a

reporting program for the continuing medical education of

anesthesiologist assistants.

The medical board shall adopt and

administer rules that:

(1)

establish the number of hours of continuing

medical education the medical board determines appropriate as a

prerequisite to the renewal of a license under this chapter;

(2)

require at least one-half of the hours of

continuing medical education established under Subdivision (1) to

be approved by the medical board; and

(3)

adopt a process to assess an anesthesiologist

assistant's participation in continuing medical education courses.

Sec.

207.158.

REFUSAL FOR VIOLATION OF BOARD ORDER.

The

medical board may refuse to renew a license issued under this

chapter if the license holder is in violation of a medical board

order.

SUBCHAPTER E. PRACTICE BY LICENSE HOLDER

Sec.

207.201.

NOTICE OF INTENT TO PRACTICE. Before

beginning practice, each anesthesiologist assistant licensed under

this chapter must submit on a form prescribed by the

anesthesiologist assistant board notice of the license holder's

intent to practice. The notice must include the name, business

address, license number, and telephone number of the

anesthesiologist assistant.

Sec.

207.202.

SCOPE OF PRACTICE. (a)

An anesthesiologist

assistant may assist the supervising anesthesiologist and perform

duties delegated by the supervising anesthesiologist, including

the development and implementation of a patient's anesthesia care

plan that is consistent with the rules adopted under this chapter.

(b)

An anesthesiologist assistant who assists an

anesthesiologist is not considered to be engaged in the practice of

medicine.

(c)

This chapter does not limit or expand the scope of

practice of a physician assistant.

Sec.

207.203.

NAME TAG. A person acting within the scope of

a license issued under this chapter shall wear a name tag

identifying the person as an anesthesiologist assistant.

Sec.

207.204.

IDENTIFICATION OF STUDENT. A student in an

anesthesiologist assistant training program shall be identified as

a student anesthesiologist assistant or an anesthesiologist

assistant student. A student may not use or permit to be used on the

student's behalf the term "intern," "resident," or "fellow," or

another term that identifies the student as a physician or surgeon.

SUBCHAPTER F. ENFORCEMENT

Sec.

207.251.

ADMINISTRATIVE PENALTY. (a) The medical

board by order may impose an administrative penalty against a

person who violates this chapter or a rule or order adopted under

this chapter.

(b)

The medical board shall impose the penalty in the same

manner and using the same procedures as Subchapter A, Chapter 165.

SECTION 2. Section 411.12510(a), Government Code, is

amended to read as follows:

(a) The Texas Medical Board is entitled to obtain criminal

history record information as provided by Subsection (b) that

relates to a person who is:

(1) an applicant for or holder of a license to practice

medicine;

(2) an applicant for or holder of a license to practice

as a physician assistant;

(3) an applicant for or holder of a license to practice

as an acupuncturist;

(4) an applicant for or holder of a certificate to

practice as an acudetox specialist;

(5) an applicant for or holder of a license to practice

as a surgical assistant;

(6) an applicant for or holder of a general

certificate to perform radiologic procedures, limited certificate

to perform radiologic procedures only on specific parts of the

body, or radiologist assistant certificate;

(7) an applicant for or holder of a placement on the

registry of noncertified technicians;

(8) an employee of an applicant for a hardship

exemption;

(9) an applicant for or holder of a license to practice

as a medical physicist;

(10) an applicant for or holder of a license to

practice as a perfusionist;

(11) an applicant for or holder of a license to

practice as a respiratory care practitioner; [
and
]

(12) an applicant for or holder of a pain management

clinic certificate
; and

(13)

an applicant for or holder of a license to

practice as an anesthesiologist assistant
.

SECTION 3. (a) As soon as practicable after the effective

date of this Act, the president of the Texas Medical Board shall

appoint five members to the Texas Anesthesiologist Assistant Board

in accordance with Chapter 207, Occupations Code, as added by this

Act. In making the initial appointments, the president of the Texas

Medical Board shall designate two members for terms expiring

January 31, 2027, two members for terms expiring January 31, 2029,

and one member for a term expiring January 31, 2031.

(b) Notwithstanding Section 207.052(a), Occupations Code,

as added by this Act, a person practicing as an anesthesiologist

assistant is eligible for appointment as an initial member of the

Texas Anesthesiologist Assistant Board regardless of whether the

person holds an anesthesiologist assistant license issued under

Chapter 207, Occupations Code, as added by this Act.

SECTION 4. Not later than June 1, 2026, the Texas Medical

Board with the advice of the Texas Anesthesiologist Assistant Board

shall adopt the rules, procedures, and fees necessary to administer

Chapter 207, Occupations Code, as added by this Act.

SECTION 5. Notwithstanding Chapter 207, Occupations Code,

as added by this Act, an anesthesiologist assistant is not required

to hold a license under that chapter to practice as an

anesthesiologist assistant in this state before September 1, 2026.

SECTION 6. (a) Except as provided by Subsection (b) of this

section, this Act takes effect September 1, 2025.

(b) Section 207.151 and Subchapter F, Chapter 207,

Occupations Code, as added by this Act, take effect September 1,

2026.