This bill revises Tennessee’s physician employment rules for hospitals and hospital affiliates and creates a new licensure framework for anesthesiologist assistants. On the physician-employment side, it expands the circumstances under which hospitals may employ licensed physicians, including in smaller counties, in children’s hospitals, and in certain larger-county settings so long as the physicians are not in the restricted specialties of radiology, anesthesiology, pathology, or emergency medicine. It also preserves and clarifies limits on hospital interference with medical judgment and referral decisions, requiring written agreement to any referral restrictions, patient disclosure, and placing the burden of proof on the employing entity in disputes.
The bill adds a new chapter to Title 63 establishing licensure, supervision, discipline, and rulemaking authority for anesthesiologist assistants. It defines the profession, prohibits unlicensed practice and misuse of the title, sets education and certification requirements, allows temporary licenses, and requires a supervising anesthesiologist and written supervision agreement. The Board of Medical Examiners and the Department of Health are authorized to adopt rules, investigate complaints, and impose discipline, including revocation and reinstatement standards.
The bill also amends hospital-employment provisions in Title 68 to align with the physician-employment changes in Title 63. It continues to bar hospitals from employing radiologists, anesthesiologists, pathologists, and emergency physicians in most circumstances, but creates exceptions for children’s hospitals, research hospitals, and certain county-based situations. It further states that hospitals employing anesthesiologists must, where applicable, ensure compliance with Medicare payment conditions for anesthesia services.
Overall, the sentiment appears generally favorable, with the Senate Health and Welfare Committee recommending passage by an 8-1 vote. The committee vote suggests broad support for the bill’s hospital and workforce provisions, especially the formal recognition of anesthesiologist assistants and the clarification of hospital employment rules. No committee transcript was provided, so the discussion record does not show detailed floor or committee debate.
The main points of contention are likely the scope of hospital employment of physicians and the creation of a new mid-level anesthesia profession. The bill preserves long-standing restrictions on hospital employment of certain specialists while carving out exceptions, which may concern physician autonomy, hospital staffing flexibility, and specialty practice groups. The new licensure chapter may also raise questions about supervision, scope of practice, and patient safety, particularly regarding how much authority anesthesiologist assistants will have and how closely they must be overseen by anesthesiologists.
The bill amends Tennessee Code Annotated Titles 63 and 68 to change hospital physician-employment restrictions and to create a new state licensing system for anesthesiologist assistants. It affects hospitals, hospital affiliates, physicians in restricted specialties, the Board of Medical Examiners, and the Department of Health, while also establishing misdemeanor penalties for unlicensed practice or unauthorized employment of anesthesiologist assistants. The act takes effect in stages, with rulemaking provisions effective upon enactment, the anesthesiologist assistant chapter effective January 1, 2026, and the remaining provisions effective July 1, 2025.
The available voting history indicates generally positive momentum for the bill, as the Senate Health and Welfare Committee recommended passage with amendment by an 8-1 vote. That margin suggests substantial bipartisan or cross-branch support for the measure’s healthcare workforce and hospital-regulation changes. No committee transcript was provided, so there is no detailed record of arguments, but the vote pattern points to overall approval with limited opposition.
Likely areas of contention include whether hospitals should be allowed to employ physicians in the restricted specialties of radiology, anesthesiology, pathology, and emergency medicine, and whether the exceptions for children’s hospitals, research hospitals, and smaller counties are too broad or too narrow. Another potential dispute is the new anesthesiologist assistant licensure framework, especially the supervision requirements, the scope of delegated practice, and whether the profession should be regulated as a separate category under Tennessee law. The bill’s requirement that employing entities not interfere with medical judgment or referral decisions may also be contentious for hospital systems and physician employers.