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Tennessee committee backs rules to license anesthesiologist assistants amid dispute over CRNA training
Summary
The joint Government Operations Committee gave a positive recommendation to emergency and mirror permanent rules implementing Public Chapter 509 to license anesthesiologist assistants (AA). Physicians and program directors urged allowing CRNAs to participate in AA training while the Tennessee Association of Nurse Anesthetists opposed CRNA supervision of AA students; legal counsel said statutory change would be required to alter supervision rules.
Chairman Jackson led the joint Government Operations Committee on July 15 as members considered emergency rules to implement Public Chapter 509, which established licensure for anesthesiologist assistants (AAs) effective January 2026. Olivia Johnson of the Department of Health summarized the package—licensure procedures, supervision requirements, fees, scope of practice and continuing education—and said permanent rules mirror the emergency rules.
The hearing drew competing views on whether certified registered nurse anesthetists (CRNAs) should be allowed to participate in AA student training. Dr. Philip Hauser, president of the Tennessee Society of Anesthesiologists, said he supported the rules "with the exception of section 088015.06.03, where it reads, under no circumstances should a CRNA be authorized to train or supervise licensed anesthesiologist assistants or persons enrolled in an anesthesiologist assistant education program approved by the board." He argued that participation by CRNAs and other qualified professionals should be left to hospital bylaws and the supervising anesthesiologist.
Todd (Doc) Christian, the state's first licensed CAA and Lipscomb program director, told the committee that collaborative training with CRNAs occurs in other states and that the contested language was added late in the emergency-rule draft. "In other states where we train, we do train with CRNAs," he said, explaining students are assigned one-on-one and are directly supervised in the operating room.
Tasha Alexander, speaking for the Tennessee Association of Nurse Anesthetists (CRNAs), said CRNAs have different training backgrounds and are often autonomous providers; for that reason, she said, training for AAs should be carried out by anesthesiologists, who will be their supervisors in Tennessee practice.
Dr. Samantha McLaren, vice chair of the Board of Medicine, cited Tennessee Code Annotated 63-21-104 and told the committee that "an anesthesiologist assistant may assist in the practice of medicine only under the supervision of an anesthesiologist," which shaped the board's drafting of the rules. Doug Gare with the Office of Legal Services said the statute controls and that changing who may supervise AA students would require a change in law rather than rulemaking; he added the attorney general had reviewed the rules for legality.
After questions and discussion from both chambers, Representative Renaud moved a positive recommendation; the Senate roll call recorded six ayes and the House voice vote carried. The committee forwarded the rule package with a positive recommendation to proceed through the administrative process. The department and board indicated permanent-rule filings will continue to mirror the emergency rules and will be subject to the normal public-comment tracks that follow.
