MI HB4709

Establishes licensure requirements for certified anesthesiologist assistants (CAAs), including completion of approved graduate training, certifying examination, and advanced cardiac life-support course.

Allows CAAs to practice anesthesiology under direct supervision of an anesthesiologist who must be immediately available; permits one supervising anesthesiologist to oversee multiple CAAs except in emergencies.

Permits critical access hospitals with documented anesthesiologist shortages to use collaborative agreements allowing nurse anesthetists to provide anesthesia services without a physically present supervising physician in certain low-risk situations, subject to approval by medical boards.

Requires prescribers dispensing controlled substances to ask patients about other controlled substance use and maintain separate records of acquisition, dispensing, and disposition for at least 5 years.

Adds fees for CAA licensure ($75 application, $60 annual license, $25 educational limited license) and modifies nursing specialty certification fees; establishes July 2024 deadline for CAA regulations and licensing implementation.