Video & Transcript Research : 'physician licensure'
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NM
Transcript Highlights:
- the board that would allow those physicians to practice here.
- This version of the Interstate Medical Licensure Compact Bill, Mr.
- access for physicians wishing to practice in New Mexico.
- physician is only licensed in four states.
- And I would hope that the business would pay for the licensures.
Keywords:
interstate medical licensure compact, physician licensure, medical license reciprocity, expedited licensure, medical practice act, New Mexico medical board, compact commission, physician mobility, telemedicine, license portability, background check, disciplinary action, joint investigation, reproductive health care, gender-affirming care, scope of practice, medical board transparency, multistate compact, licensure renewal, health care workforce
NM
Keywords:
interstate medical licensure compact, physician licensure, medical license reciprocity, expedited licensure, medical practice act, New Mexico medical board, compact commission, physician mobility, telemedicine, license portability, background check, disciplinary action, joint investigation, reproductive health care, gender-affirming care, scope of practice, medical board transparency, multistate compact, licensure renewal, health care workforce
NM
Transcript Highlights:
- They preserve state authority and ensure accountability for physicians.
- This version of the Interstate Medical Licensure Compact Bill, Mr.
- access for physicians wishing to practice in New Mexico.
- physician is only licensed in four states.
- And I would hope that the business would pay for the licensures.
Keywords:
interstate medical licensure compact, physician licensure, medical license reciprocity, expedited licensure, medical practice act, New Mexico medical board, compact commission, physician mobility, telemedicine, license portability, background check, disciplinary action, joint investigation, reproductive health care, gender-affirming care, scope of practice, medical board transparency, multistate compact, licensure renewal, health care workforce
HI
Hawaii 2026 Regular Session
CPN DEFER, CPN, CPN-TRS, EDT-CPN, CPN-HHS, HHS-CPN DEFER, CPN DEFER Public Hearings 02-18-2026
Commerce and Consumer Protection
Transcript Highlights:
- If not, we'll move to the last measure on this regular agenda, SB 3105 relating to the physician assistant
- licensure compact.
- our written support of the provisions reflected within SB 3105, which would enter Hawaii into the physician
- assistant licensure compact.
- need a sunrise analysis regarding the potential premium increase should we give our primary care physicians
Keywords:
cannabis, low-dose, personal use, cultivation, cannabis accessories, Hawaii cannabis law, medical cannabis, physician assistant, licensure compact, medical services, interstate practice, healthcare portability, military families, licensing authority, 912, senate, all
Summary:
The Senate Committee on Commerce and Consumer Protection reconsidered two condominium bills and adopted recommendations to pass both with amendments. For SB 2433, members approved amendments clarifying that condominium unit owners’ interests are to be recognized and protected in educational and related programs by the Real Estate Commission and DCCA, while making technical changes and changing the effective date. For SB 2838, the committee replaced the bill’s broader substantive language with a narrower requirement that associations provide electronic copies of specified documents, including master leases, reserve studies, audited financial statements, contracts, leases, and other agreements, along with technical changes and an amended effective date. Both measures were adopted unanimously by the members present, with Senator McKelvey excused.
The committee then heard SB 2710 on animal issues, which would define and regulate dog breeders, set care standards, create county licensing authority, require records, and establish an animal abuser registry and related penalties. Testimony was mixed: the Public Defender and the American Kennel Club opposed the bill, arguing for stronger enforcement of existing laws rather than harsher penalties and warning that the bill would burden responsible breeders; the Hawaiian Humane Society supported the bill’s breeder regulation and registry provisions but urged removal of the hoarding section; and the committee noted 26 written testimonies in support, 14 in opposition, and four comments. In decision-making, the committee passed SB 2710 with amendments that blanked the license fee, deleted the animal abuser registry and shelter/pet store/breeder compliance checks, struck the hoarding provisions and proposed criminal penalty changes, and made technical changes with a deferred effective date.
The committee also heard SB 2209 on rental discrimination, which would allow attorney’s fees to a prevailing party in source-of-income discrimination cases, and SB 2884, which would create a nonrefundable income tax credit for wind-resistant retrofits or hurricane shelters. The Hawaii Civil Rights Commission supported SB 2209, and the committee later passed it with a deferred effective date. SB 2884 drew support from DCCA’s Insurance Division, the Department of Taxation, HEMA, the Climate Change Mitigation and Adaptation Commission, and a public witness who urged hurricane preparedness; it was passed with the Department of Taxation’s proposed amendments and a deferred effective date.
Finally, the committee heard SB 2922 on cooperative associations, which would create a general cooperative associations framework. DCCA offered comments, while the Hawaii Co-op Hui, Purple Maya Foundation, Enliven Cooperative, and Hawaii Farmers Union supported the measure and argued that current law is too limited for worker, producer, and multi-stakeholder co-ops. After discussion about using the existing chapter 421C structure rather than creating a new regulatory scheme, the committee passed SB 2922 with amendments adopting changes proposed in testimony from the Hawaii Farmers Union and deferred the effective date.
AZ
Arizona 2026 Regular Session
01/28/2026 - Senate Regulatory Affairs and Government Efficiency
Regulatory Affairs and Government Efficiency
Transcript Highlights:
- Madam Chair and members, Senate Bill 1238 adopts the Physician Assistant Licensure Compact, allowing
- physician assistants in participating states to obtain licensure in other compact states via a compact
- Assistants today in strong support of Senate Bill 1238, which is a physician assistant licensure compact
- Tom, the physician assistant always has to work under the supervision of a physician.
- So Arizona gets a score based on the practice abilities of physician assistants.
Keywords:
scrap metal theft, study committee, Arizona, regulated industries, public safety, underground utilities, utility locating, dig safe, call before you dig, 811, excavation safety, damage prevention, one-call center, locate request, white lining, large project coordination, buried infrastructure, subsurface utilities, utility marking, locator wire
Summary:
The Committee on Regulatory Affairs and Government Efficiency heard several bills and took action on three of them. Senate Bill 1137 would update underground facility excavation rules by requiring white lining before notice, creating coordination meeting requirements for large projects, adding an interactive response system, and directing the Arizona Corporation Commission to adopt rules. Supporters from SSC Underground, Arizona 811, and the Associated General Contractors said the bill would improve communication, reduce delays, and modernize the 811 system; the League of Arizona Cities and Towns raised concerns about staffing, project scope, meeting requirements, and liability, but said it was working on amendments. The committee passed SB 1137 on a 7-0 vote.
Senate Bill 1145 would shift licensing and regulation of behavior analysts to the Committee of Behavior Analysts under the Psychology Board, reduce the board from 10 to 8 members, and remove the requirement for two behavior analysts on the board. Supporters said the current structure creates delays and that the change would let the board focus on psychology issues while the committee handles behavior analyst matters. A self-advocate also supported the bill, citing long waitlists and the importance of behavior analysts for people on the autism spectrum. The committee passed SB 1145 on a 7-0 vote.
Senate Bill 1128 would create a study committee on scrap metal theft to review current laws, industry compliance costs, and penalties, and report recommendations by December 1, 2026. The Arizona Scrap Recyclers Association supported the bill as a way to evaluate whether current reforms remain effective, while members discussed the difficulty of tracing stolen metal and the need to keep the process bipartisan. The committee passed SB 1128 on a 7-0 vote. Senate Bill 1238, which adopts the Physician Assistant Licensure Compact to allow multistate licensure privileges, also received support from the Arizona State Association of Physician Assistants, who said it would improve workforce mobility, help military families, and expand access to care; the committee passed it on a 7-0 vote. The committee then held SB 1235 at the sponsor’s request and adjourned.
AL
Transcript Highlights:
- It just says they have to display in the waiting area whether physician is on duty in the emergency room
- <00:04:19.680>
is in the waiting area whether physician is in the waiting area whether physician - A licensed physician on site...
- Now, I think they have a physician there 24/7, but they're struggling financially.
- I couldn't have said it better myself. for rural physicians, we've got $203 for rural physicians, we've
Keywords:
HB128, Alabama Board of Nursing, Sunset Law, sunset review, nursing board, nurse licensure, registered nurse, RN, licensed practical nurse, LPN, advanced practice nursing, certified registered nurse anesthetist, CRNA, consumer member, board appointments, congressional districts, geographic representation, nursing regulation, nursing education programs, licensure compact
AL
Keywords:
inhalants, controlled substances, butyl nitrite, nitrous oxide, amyl nitrite, health, public safety, HB278, ivermectin, pharmacist, standing order, prescription drug, pharmacy, State Board of Pharmacy, physician assistant, nurse practitioner, CRNP, medical licensure, drug dispensing, adverse events
NM
New Mexico 2026 Regular Session
Senate - Health and Public Affairs Feb 9th, 2026 at 02:06 pm
Senate Health & Public Affairs
Transcript Highlights:
- Senator Soules, Senate Bill 222, Physician Residency Programs. Physician residency programs.
- We have a problem with physicians. This is a direct way to address that problem.
- In the 90s, they thought we were going to have too many physicians.
- This needs to be something that continues so that New Mexico has plenty of physicians.
- Most of the other issues—this is not the only thing that's going to solve our physician thing.
Keywords:
appropriation, local government, Las Vegas, Rodriguez Park, public facilities, zoning reform, building regulations, residential apartments, commercial use, multigenerational housing, local government authority, healthcare, urgent care, emergency services, feasibility study, medical facilities, physician training, medical residency, New Mexico, massage therapy
NM
New Mexico 2026 Regular Session
Senate - Health and Public Affairs Feb 13th, 2026 at 04:01 pm
Senate Health & Public Affairs
Transcript Highlights:
- Those clarifications came from changes that were made to the interstate physician licensure compact recently
- This mirrors the language that was included in the Interstate Physician Licensure Compact.
- This mirrors the language that was included in the Interstate Physician Licensure Compact.
- Physician assistant that is inconsistent with New Mexico law.
- to the pay and three-tier licensure system of educators.
Keywords:
physician assistants, interstate compact, medical services, licensure, cross-state practice, military families, regulatory authority, physical therapy, licensure compact, interstate practice, healthcare, military spouses, criminal background check, HB34, school nurse, school nurses, nurse licensure, charter school, charter schools, school district
MN
Transcript Highlights:
- And again, I'm not a physician, so maybe we want to have a physician come back, but it's my understanding
- ,<00:34:18.640>
so care And again, I'm not a physician, so care And again, I'm not a physician - <00:34:20.159>
come maybe we want to have a physician come maybe we want to have a physician - model under uh the physician model under uh the physician anesthesiologist.<01:40:36.720>
And - <01:41:12.520>
for <01:41:12.680>certified the licensure for certified the licensure
Keywords:
residential pools, swimming classes, certification, private business, health safety, health care, prior authorization, managed care, medical assistance, mental health, substance use treatment, chronic conditions, health insurance, insulin, healthcare access, pharmacy regulations, patient assistance, affordable medication, healthcare, pharmacy
Summary:
The committee met at 1:00 p.m., confirmed a quorum, and approved the April 8, 2026 minutes. The first bill heard was House File 4712, which was laid over after the committee adopted a DE2 amendment. Representative Schultz said the bill would create a narrow additional exception to public pool limitations so highly certified swimming instructors could use certain pools for specialized infant, youth, and developmental-disability swim instruction. The only testifier, Tessa Seppelt, described ISR instruction as water-safety and drowning-prevention training for very young children and children with developmental delays, and said access to appropriate facilities is the main barrier. Members raised questions about emergency egress, public safety, and insurance coverage, and the author said he would follow up on those concerns.
The committee then took up House File 4801, a bill by Representative Nadeau aimed at health care program integrity. He said it would align commercial and Medicaid partners to reduce waste, fraud, and abuse by changing prior authorization and retrospective review processes, improving data sharing on suspected fraud, addressing conflicting or duplicative services, allowing managed care organizations to verify provider credentials, and making risk corridors in MCO contracts permanent. The Minnesota Council of Health Plans supported the bill, saying it would help detect fraud and improve coordination, while the Minnesota chapter of the American Academy of Pediatrics opposed it, arguing that expanded prior authorization would delay care, increase physician burden, and harm children with chronic conditions. Members debated patient safety, fraud detection, and whether the bill would undermine recent prior-authorization reforms. The bill was laid over.
House File 3756, a technical update to the insulin safety net program, was also laid over. Representative Backer said the bill clarifies that a hospital-use intravenous insulin product is not part of the program because it is sold only to health care institutions and infused by practitioners, not dispensed to patients for self-use. The Board of Pharmacy testified that the language was drafted to avoid affecting future legitimate uses, and members asked whether the definition could limit new uses if treatments change. The committee then began House File 4860, but the transcript cuts off before the bill’s presentation is completed.
OK
Oklahoma 2026 Regular Session
Health and Human Services REVISED Mar 2nd, 2026 at 02:00 pm
Health and Human Services
Transcript Highlights:
- Could this mandate require a physician or PA, etc., to spend their very precious patient contact time
Bills:
SB1328, SB1380, SB1436, SB1558, SB1572, SB1651, SB1805, SB1831, SB1836, SB2014, SB2023, SB2044, SB2179, SB933
Keywords:
parents' rights, healthcare consent, minors, medical records, protection, legal guardianship, hospital, fetal death, miscarriage, healthcare, state health department, vital records, patient rights, child care, licensing, definitions, foster care, child welfare, mental health, substance abuse
MN
Minnesota 2025-2026 Regular Session
House Health Finance and Policy Committee 3/11/26
Health Finance and Policy
Transcript Highlights:
- ,<00:23:14.799>
the with um the physicians, the with um the physicians, the chiropractors, - <00:24:04.240>
as relationship with the physicians as relationship with the physicians as - to the under level of physician group. to the under level of physician group.
- I have physicians who refer patients to me, and I refer patients to physicians.
- collaborative setting with physicians. collaborative setting with physicians.
Keywords:
hospital moratorium, hospital construction, bed capacity, hospital expansion, health care facilities, hospital licensing, safety-net hospital, level I trauma center, Ramsey County, Minnesota health law, hospital beds, new hospital exception, certificate of need, inpatient capacity, emergency care, trauma services, health system regulation, state moratorium, hospital modernization, health infrastructure
TX
Bills:
HB 44, HB 2200, HB 1612, HB 2747, HB 2038, HB 3717, HB 1431, HB 3800, HB 3801, HB 3560, HB 3246
Keywords:
cremation, natural organic reduction, health and safety, environmental concerns, funeral services, medical licensing, physician graduates, healthcare access, occupational licensing, foreign medical graduates, cell-cultured protein, food safety, human consumption, agriculture, food labeling, healthcare workforce, advisory board, Texas Workforce Commission, resource guide, education collaboration
FL
Transcript Highlights:
- According to research, best practices to reducing licensure barriers include promoting licensure reciprocity
- Regarding licensure, the Department of Health reviews applications for licensure and issues licenses,
- , two physicians who collaborate with physician assistants, two chiropractic physicians, and two physician
- , two physicians who collaborate with physician assistants, two chiropractic physicians, and two physician
- members to the medical licensure commission.
Keywords:
drowning prevention, water safety, swimming lessons, swim vouchers, child drowning, infant safety, toddler safety, pool safety, bath safety, safe bathing practices, postpartum education, newborn care, childbirth education, birth centers, home birth providers, Department of Health, public health, water competency, swim instruction, infant supervision
Summary:
The Senate Health Policy Committee met with a quorum and took up several health-related bills, with a strong focus on drowning prevention and patient safety. SB 428 by Senator Yarborough would expand Florida’s swim lesson voucher program from children ages 0-4 to ages 1-7. Supporters, including a pediatric emergency physician and YMCA leadership, cited Florida’s high child drowning rates and argued that swim lessons reduce risk and should be available to more children. Senator Harrell noted the need to consider increasing the program’s funding as eligibility expands. The bill was reported favorably.
The committee also heard SB 606 by Senator Smith, which adds drowning prevention and safe bathing education to postpartum materials provided by hospitals, birthing centers, and, after amendment, no longer home birth providers. A parent who lost a child to drowning testified in support, and senators emphasized the preventability of such deaths. The bill, as amended, was reported favorably as a committee substitute. SB 340 by Senator Harrell would require nursing students to complete a two-hour human trafficking course before licensure; after a strike-all amendment shifted the requirement from nursing programs to the students themselves, the bill received support from advocates and was reported favorably as a committee substitute.
The committee also considered SB 162 by Senator Davis, which would require hospitals and ambulatory surgical centers to adopt policies for using smoke evacuation systems during procedures that generate surgical smoke. The sponsor said the equipment is relatively inexpensive and already common in many facilities, while opponents and some senators questioned the medical evidence, enforcement, and possible impacts on rural and smaller facilities. Despite those concerns, the bill was reported favorably, with some members voting no. SB 192, presented by Senator Trumbull on behalf of Senator Martin, would remove the $1,500 cap on advances chiropractic physicians may collect for examinations or treatment; the Florida Chiropractic Society supported the change as pro-small-business, and the bill was reported favorably. The committee also received an OPAGA presentation comparing Florida’s health care practitioner regulation system with other states, focusing on board autonomy, rulemaking oversight, board composition, appointments, term limits, and funding mechanisms.
AZ
Arizona 2026 Regular Session
03/04/2026 - Senate Health and Human Services
Health and Human Services
Transcript Highlights:
- In communities where there may be only one radiation oncologist within hours, the physician must be physically
- That means if that physician becomes ill, has an emergency, or must be away briefly, treatments may be
- That reality can disrupt a patient's care and make recruiting physicians to rural communities even more
- maintained with radiation therapists that are trained for that situation, and there will still be a physician
- like in an intensive care unit, you don't have an intensivist always there, but there's always a physician
Keywords:
radiation therapy, particle accelerator, critical access hospitals, patient care, rural healthcare, HB2178, Arizona, state agencies, chief medical officer, medical license, physician license, osteopathic license, licensure requirement, Title 41, Title 32, Arizona Revised Statutes, A.R.S. 41-5902, public health administration, agency leadership, state government personnel
Summary:
The Committee on Health and Human Services heard several bills and held HB 2307. HB 2049 would allow particle accelerator treatment for human diseases under general supervision in certain rural counties and critical access hospitals, with documentation, observation, and physician availability requirements. Supporters from the Arizona Hospital and Health Care Association and rural radiation oncologists said it would improve access to cancer care in underserved areas while maintaining safety. The committee also heard HB 2178, requiring state agency chief medical officers to hold an active medical license, and HB 2179, which separates air ambulance definitions and regulations from ground ambulances to clarify statute and align oversight with current practice; both were described as cleanup/common-sense measures and supported by the air medical industry.
The committee also heard HB 2322, which would require audio or video recording of DCS interviews with children subject to investigations, with limited exceptions for equipment failure or lack of access. Testimony in support came from a human trafficking survivor, a health care worker and counselor, and a foster parent/child welfare advocate, who argued recordings would improve accuracy, accountability, and child protection, and help preserve a child’s exact words. No opposition was presented. The bill includes a conditional enactment tied to future federal grant legislation and directs DCS to apply for grants if available.
After discussion, the committee voted unanimously to give HB 2049, HB 2178, HB 2179, and HB 2322 due pass recommendations, each by a 7-0 vote. The committee then announced HB 2307 would be held and adjourned.
AL
Keywords:
court costs, Choctaw County, jail funding, municipal court, criminal proceedings, education funding, student outcomes, K-12 education, RAISE Act, accountability, special education, English language learners, local education agency, respiratory therapy, respiratory therapist, respiratory care, licensure, licensing board, advanced practice provider, nurse practitioner
OK
Oklahoma 2026 Regular Session
Public Health REVISION 2- Meeting moved to room 4S5 Apr 1st, 2026 at 09:00 am
Public Health
Transcript Highlights:
- I mean, the cost will be appropriate to what the licensure fee is. That's what you're asking.
Bills:
SB206, SB904, SB933, SB1436, SB1500, SB1553, SB1557, SB1567, SB1644, SB1645, SB1651, SB1794, SB1833, SB1849, SB1984
Keywords:
SB206, emergency medical services, EMS, ambulance, 911 response, emergency response, essential services, federal funding, grant funding, public health, health care facility, municipality, county, ambulance service district, tribal entity, public entity, contract ambulance service, Oklahoma, 63 O.S. 2021 Section 1-2502, emergency clause
ND
North Dakota 2026 1st Special Session
House Floor Session Jan 23rd, 2026 at 09:00 am
North Dakota House Floor Meeting
Transcript Highlights:
- To amend and reenact sections 43-17-27.1 of the North Dakota Century Code relating to physician continuing
- This bill adds a requirement to the continuing education credits for physicians.
- Specifically, Section 1, subsection 2, requires that the board mandate physicians to complete a minimum
- , and physician assistants.
- These policy bills included the Presidential Physical Fitness Program, Physician Assistant Licensure
Keywords:
presidential physical fitness test, physical education, fitness assessment, student fitness, school curriculum, graduation requirements, elementary school, middle school, high school, public schools, nonpublic schools, superintendent of public instruction, exceptions, disability accommodations, North Dakota studies, computer science, cybersecurity, health education, concept-based fitness class, school standards
Summary:
The North Dakota House convened in special session with prayer, roll call, and a quorum present, then took up several rural health-related bills. Senate Bill 2401, as amended, required physicians to complete one hour of continuing education in nutrition and metabolic health each renewal cycle and also added language allowing criminal history background checks for the Board of Occupational Therapy Practice. Supporters emphasized the role of nutrition in reducing chronic disease, and the bill passed 92-0.
The House then considered Senate Bill 2402, which expanded pharmacists’ limited prescriptive and therapeutic substitution authority for certain low-acuity conditions and clarified related lab-test and communication requirements. Members discussed examples such as motion sickness, cold sores, lice, hypoglycemia, COVID and flu testing, emergency access to medications and supplies, and limits excluding certain drug classes; the bill passed 91-1. Senate Bill 2403 created a temporary medical facility emergency operating loan option through the Bank of North Dakota for qualifying rural hospitals facing severe financial distress, with extensive debate over the targeted nature of the aid, anti-gifting concerns, repayment terms, and the hospital’s turnaround plan; it passed 80-12.
Senate Bill 2404 appropriated funds for NDIT to address federal digital accessibility requirements and for the Public Service Commission’s litigation efforts related to transmission costs, with a backup loan authorization available if needed; it passed 92-0. At the close of the session, leaders thanked members and staff for their work on the rural health transformation package, a committee notified the Governor and the Senate that the House had completed its business, absent members were excused, and the House adjourned sine die.
ND
North Dakota 2026 1st Special Session
House Floor Session Jan 21st, 2026 at 08:30 am
North Dakota House Floor Meeting
Keywords:
presidential physical fitness test, physical education, fitness assessment, student fitness, school curriculum, graduation requirements, elementary school, middle school, high school, public schools, nonpublic schools, superintendent of public instruction, exceptions, disability accommodations, North Dakota studies, computer science, cybersecurity, health education, concept-based fitness class, school standards
Summary:
The North Dakota House convened in special session with prayer, the Pledge of Allegiance, and the reading of communications from the Secretary of State and Governor Kelly Armstrong certifying the special session call. The governor’s executive order said the session was called to act on funding for the Rural Health Transformation Program so the state could accept and appropriate federal funds and avoid interruptions to government services. Three new members, Representatives McNally, Scraw, and Timmons, were sworn in, and the roll showed 91 members present, establishing a quorum.
The main business was a Rules Committee report outlining temporary special-session rules. The changes were designed to speed up floor action, including allowing second reading the same day a bill is reported from committee, final passage one day after first reading, and immediate transmission to the other chamber unless reconsideration is noticed. The report also replaced the regular standing committee structure with two joint committees: Joint Appropriations and Joint Policy, allowed remote testimony and remote member participation with approval, and limited bill introduction to Legislative Management-approved bills or bills approved by a two-thirds vote. Several deadline changes for resolutions and bill filing were also described, with some provisions delayed until the special session ends.
The House adopted the Rules Committee report after a motion by Representative Bosch and no opposition. During announcements, the clerk listed the membership of the Joint Appropriations and Joint Policy committees, and the Highway Patrol announced safety sessions for legislators in the Rough Rider Room at 11 a.m. that day and the next day. The House then recessed until the joint session scheduled for 10 a.m. the following day.
OK
Oklahoma 2026 Regular Session
Public Health REVISION 2- HB1912 - Added - Part 2 Feb 18th, 2026 at 10:10 am
Public Health
Transcript Highlights:
- Which can already be dispensed by a pharmacist with a prescription from a physician, but what other things
Bills:
HB4336, HB1818, HB3194, HB3538, HB3682, HB3762, HB3793, HB3930, HB3931, HB3934, HB4124, HB4200, HB4410, HB4457, HB4473, HB3884, HB1912
Keywords:
interventional pain management, pain management clinic, chronic pain, acute pain, spinal injections, epidural steroid injection, peripheral nerve block, nerve ablation, spinal cord stimulator, intrathecal infusion pump, endoscopic diskectomy, fluoroscopy, physician supervision, allopathic physician, osteopathic physician, CRNA, certified registered nurse anesthetist, nurse anesthetist, freestanding pain management facility, medical licensure