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Committee backs emergency rules to license anesthesiologist assistants after debate on CRNA training
Summary
A joint Government Operations Committee gave a positive recommendation to emergency rules implementing licensure for anesthesiologist assistants, amid debate over a provision that would bar CRNAs from training AA students; proponents said statute, not rule, controls supervision limits.
A joint Government Operations Committee on July 15 recommended emergency rules that establish licensure, supervision requirements, fees and scope of practice for anesthesiologist assistants, rules the Department of Health said implement 2025 Public Chapter 509.
Dr. Philip Hauser, a practicing anesthesiologist and president of the Tennessee Society of Anesthesiologists, told the committee the profession supports the rulemaking generally but asked the board to remove a provision (section 880.015.06, scope item 3) that would bar certified registered nurse anesthetists from training or supervising anesthesiologist assistant students. "Medical education has been a collaborative effort, for generations," Hauser said, urging that participation by CRNAs and other qualified professionals be left to hospital medical staff bylaws under the supervising anesthesiologist.
Doc Christian, the state’s first licensed certified anesthesiologist assistant and program director at Lipscomb University, said collaborative training with CRNAs is common in other states and that the disputed language had been added late in the process. "We take a collaborative approach in training our students," he said.
Dr. Samantha McLaren, vice chair of the Board of Medicine, told members the statute governing anesthesiologist assistants — Tennessee Code Annotated 63-21-104 — requires AAs to work under the supervision of an anesthesiologist and perform only duties delegated by that supervising physician. "That is the law that this supervising body for the state of Tennessee set down for us as the board of medical examiners," McLaren said.
Committee legal counsel Doug Geer advised members the rule cannot change what the statute prescribes. "It would be in contravention of the statute to do it by rule," Geer said, summarizing the legal limits on rewriting statutory requirements through rulemaking.
After brief discussion and procedural motions, the committee voted to give the rules a positive recommendation. A senate roll call recorded six ayes; a house voice vote recorded "Ayes have it." The recommendation moves the emergency rules forward for the next administrative steps.
The Department of Health and the Board of Medical Examiners said the emergency rules were drafted with input from stakeholders including the Tennessee Academy of Anesthesiologist Assistants and the Tennessee Society of Anesthesiologists, and that permanent rules mirroring the emergency rules have already undergone a prior rulemaking hearing.
