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F I S C A L I M P A C T R E P O R T





SPONSOR: SPAC DATE TYPED: 03/10/01 HB
SHORT TITLE: Anesthesiologist Assistants Act SB CS 370/SPACS/aSFl#1
ANALYST: Carrillo


APPROPRIATION



Appropriation Contained
Estimated Additional Impact
Recurring

or Non-Rec

Fund

Affected

FY01 FY02 FY01 FY02
$ 2.0 $ 1.0 Recurring Other State Funds



(Parenthesis ( ) Indicate Expenditure Decreases)







REVENUE



Estimated Revenue
Subsequent

Years Impact

Recurring

or Non-Rec

Fund

Affected

FY01 FY02
$ 0.3 Recurring Other State Funds



(Parenthesis ( ) Indicate Revenue Decreases)





SOURCES OF INFORMATION



Board of Medical Examiners



SUMMARY



     Synopsis of Senate Floor Amendment #1



The Senate Floor Amendment number 1 to Senate Public Affairs Committee substitute for Senate Bill 370:



Changes the reference from "operating suite" to "operating room"; and



Adds posing as a "certified registered nurse anesthetist" to the provisions to deny revoke or suspend a license to practice as an anesthesiologist assistant.



The remainder of the FIR is unchanged.



Synopsis of Bill



The Senate Public Affairs Committee substitute for Senate Bill 370 provides for the licensing of anesthesiologist assistants. The substitute bill limits licensing to individuals who work in a New Mexico university with a medical school (University of New Mexico).



The substitute bill includes an emergency clause.



Significant Issues



According to the Board of Medical Examiners staff, the University of New Mexico Hospital cannot be reimbursed for services provided by anesthesiologist assistants unless they are licensed practitioners. The substitute bill is a compromise worked out between certified nurse anesthetists and representatives of the UNMH anesthesia department. It include additional provisions to assure adequate supervision of anesthesiologist assistants and patient safety. From the perspective of the Board of Medical Examiners (who is required to implement the law) there are still several minor amendments that are required to clarify process.



FISCAL IMPLICATIONS



The substitute bill has no appropriation, the Board's staff indicates there will be minimal fiscal impact.



ADMINISTRATIVE IMPLICATIONS



The Board's staff states the substitute bill requires the licensure of a new category of care provider. Rules will need to be developed and adopted, forms will need to be developed, the licensing data base will need to be changed to include a new category, and the web site will need to be modified.



TECHNICAL ISSUES



The Board staff notes:



The substitute bill provides for the licensure of anesthesiologist assistants, the definition of "anesthesiologist assistant" refers to them as being "certified by the board." The word "certified" should be changed to "licensed."



Section 4(B) requires each anesthesiologist assistant to register with the Board on an annual basis and pay a late fee if they fail to register. However, the list of fees in Section 5(C) only indicates a late fee is required for failure to renew. If indeed the requirement is annual registration, the late fee paragraph needs to be amended.



Section 4(B), lines 7 through 9 indicate that failure to renew annually requires payment of a late fee or having the license placed on inactive status. Additional language needs To be added to Section 4 to provide for instances when an anesthesiologist assistant does not renew a license or place it on inactive status.



AMENDMENTS



The Board staff suggests:



Page 2, line 10, change the word "certified" to "licensed".



Page 6, line 12 after the word "year" and before the semicolon insert "or fails to annually register with the board as required;"



Page 5, add after B, "The board may, in its discretion, summarily suspend for non-renewal the license of any anesthesiologist assistant who has failed to renew his license or place it on inactive status within ninety days of expiration."



Section 6, page 7, paragraph C, line 6, insert the words "within two years" after the work "status". Add an additional paragraph D reading " An anesthesiologist assistant with a license expired for more than two years, regardless of status, must request reinstatement and comply with the reinstatement requirements defined by board rule.



WJC/njw