The
state Association of Nurse Anesthetists brought an action against the Commissioner
of Health, Department of Health, and the Public Health Council, claiming that
the defendants' issuance of Clinical Guidelines for Office- based Surgery (promulgated
to "ensure that the public is adequately protected when undergoing surgery/invasive
procedures in private offices of health care practitioners"), were ultra
vires, or outside the Commission's authority. The Guidelines effectively prohibited
CRNAs from administering anesthesia for office-based surgery. The defendants'
conceded that they had no authority to regulate services in private physician
offices, but contended that the Guidelines were just suggestions, not regulations.
The Appeals Court held that the Guidelines were, in fact, regulations promulgated
with the intention of dictating the conduct of professionals conducting surgery
in private offices, and that the Commission impermissibly acted in the absence
of legislative guidance and contrary to an express legislative mandate prohibiting
the defendants from promulgating rules or regulations concerning the professional
misconduct of physicians.