SB 2128

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
(ii)  the American Osteopathic Board of
(iii)  a certifying board recognized by the
(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
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
(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
(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
(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
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
(3)  cannot, because of illness or disability,
discharge the member's duties for a substantial part of the member's
(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
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
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
(1)  the law governing anesthesiologist assistant
(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;
(A)  laws relating to open meetings, public
information, administrative procedure, and disclosing conflicts of
(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
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
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
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
(1)  an anesthesiologist assistant assist only an
(A)  physically present in the facility where the
anesthesiologist assistant is performing a medical task delegated
(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
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
(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
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
(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
Sec. 207.152.  ISSUANCE OF LICENSE.  The medical board shall
issue a license to an applicant who:
(1)  meets the eligibility requirements of Section
(2)  submits an application on a form prescribed by the
(3)  pays the required application and licensing fees;
(4)  submits to the board any other information the
board considers necessary to evaluate the applicant's
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
(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
(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
(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
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
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
(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
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
(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
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
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
(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.
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
(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
(a)  The Texas Medical Board is entitled to obtain criminal
history record information as provided by Subsection (b) that
(1)  an applicant for or holder of a license to practice
(2)  an applicant for or holder of a license to practice
(3)  an applicant for or holder of a license to practice
(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
(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
(9)  an applicant for or holder of a license to practice
(10)  an applicant for or holder of a license to
(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
(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,