Public Act 93-0352
HB3618 Enrolled LRB093 10431 JAM 10685 b
AN ACT concerning public health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Ambulatory Surgical Treatment Center Act
is amended by changing Section 6.5 as follows:
(210 ILCS 5/6.5)
Sec. 6.5. Clinical privileges; advanced practice nurses.
All ambulatory surgical treatment centers (ASTC) licensed
under this Act shall comply with the following requirements:
(1) No ASTC policy, rule, regulation, or practice shall
be inconsistent with the provision of adequate collaboration,
including medical direction of licensed advanced practice
nurses, in accordance with Section 54.5 of the Medical
Practice Act of 1987.
(2) Operative surgical procedures shall be performed
only by a physician licensed to practice medicine in all its
branches under the Medical Practice Act of 1987, a dentist
licensed under the Illinois Dental Practice Act, or a
podiatrist licensed under the Podiatric Medical Practice Act
of 1987, with medical staff membership and surgical clinical
privileges granted by the consulting committee of the ASTC. A
licensed physician, dentist, or podiatrist may be assisted by
a physician licensed to practice medicine in all its
branches, dentist, dental assistant, podiatrist, licensed
advanced practice nurse, licensed physician assistant,
licensed registered nurse, licensed practical nurse, surgical
assistant, surgical technician, or other individuals granted
clinical privileges to assist in surgery by the consulting
committee of the ASTC. Payment for services rendered by an
assistant in surgery who is not an ambulatory surgical
treatment center employee shall be paid at the appropriate
non-physician modifier rate if the payor would have made
payment had the same services been provided by a physician.
(3) The anesthesia service shall be under the direction
of a physician licensed to practice medicine in all its
branches who has had specialized preparation or experience in
the area or who has completed a residency in anesthesiology.
An anesthesiologist, Board certified or Board eligible, is
recommended. Anesthesia services may only be administered
pursuant to the order of a physician licensed to practice
medicine in all its branches, licensed dentist, or licensed
podiatrist.
(A) The individuals who, with clinical privileges
granted by the medical staff and ASTC, may administer
anesthesia services are limited to the following:
(i) an anesthesiologist; or
(ii) a physician licensed to practice medicine
in all its branches; or
(iii) a dentist with authority to administer
anesthesia under Section 8.1 of the Illinois Dental
Practice Act; or
(iv) a licensed certified registered nurse
anesthetist.
(B) For anesthesia services, an anesthesiologist
shall participate through discussion of and agreement
with the anesthesia plan and shall remain physically
present and be available on the premises during the
delivery of anesthesia services for diagnosis,
consultation, and treatment of emergency medical
conditions. In the absence of 24-hour availability of
anesthesiologists with clinical privileges, an alternate
policy (requiring participation, presence, and
availability of a physician licensed to practice medicine
in all its branches) shall be developed by the medical
staff consulting committee in consultation with the
anesthesia service and included in the medical staff
consulting committee policies.
(C) A certified registered nurse anesthetist is not
required to possess prescriptive authority or a written
collaborative agreement meeting the requirements of
Section 15-15 of the Nursing and Advanced Practice
Nursing Act to provide anesthesia services ordered by a
licensed physician, dentist, or podiatrist. Licensed
certified registered nurse anesthetists are authorized to
select, order, and administer drugs and apply the
appropriate medical devices in the provision of
anesthesia services under the anesthesia plan agreed with
by the anesthesiologist or, in the absence of an
available anesthesiologist with clinical privileges,
agreed with by the operating physician, operating
dentist, or operating podiatrist in accordance with the
medical staff consulting committee policies of a licensed
ambulatory surgical treatment center.
(Source: P.A. 90-742, eff. 8-13-98; 91-414, eff. 8-6-99.)
Section 10. The Hospital Licensing Act is amended by
changing Section 10.7 as follows:
(210 ILCS 85/10.7)
Sec. 10.7. Clinical privileges; advanced practice
nurses. All hospitals licensed under this Act shall comply
with the following requirements:
(1) No hospital policy, rule, regulation, or practice
shall be inconsistent with the provision of adequate
collaboration, including medical direction of licensed
advanced practice nurses, in accordance with Section 54.5 of
the Medical Practice Act of 1987.
(2) Operative surgical procedures shall be performed
only by a physician licensed to practice medicine in all its
branches under the Medical Practice Act of 1987, a dentist
licensed under the Illinois Dental Practice Act, or a
podiatrist licensed under the Podiatric Medical Practice Act
of 1987, with medical staff membership and surgical clinical
privileges granted at the hospital. A licensed physician,
dentist, or podiatrist may be assisted by a physician
licensed to practice medicine in all its branches, dentist,
dental assistant, podiatrist, licensed advanced practice
nurse, licensed physician assistant, licensed registered
nurse, licensed practical nurse, surgical assistant, surgical
technician, or other individuals granted clinical privileges
to assist in surgery at the hospital. Payment for services
rendered by an assistant in surgery who is not a hospital
employee shall be paid at the appropriate non-physician
modifier rate if the payor would have made payment had the
same services been provided by a physician.
(3) The anesthesia service shall be under the direction
of a physician licensed to practice medicine in all its
branches who has had specialized preparation or experience in
the area or who has completed a residency in anesthesiology.
An anesthesiologist, Board certified or Board eligible, is
recommended. Anesthesia services may only be administered
pursuant to the order of a physician licensed to practice
medicine in all its branches, licensed dentist, or licensed
podiatrist.
(A) The individuals who, with clinical privileges
granted at the hospital, may administer anesthesia
services are limited to the following:
(i) an anesthesiologist; or
(ii) a physician licensed to practice medicine
in all its branches; or
(iii) a dentist with authority to administer
anesthesia under Section 8.1 of the Illinois Dental
Practice Act; or
(iv) a licensed certified registered nurse
anesthetist.
(B) For anesthesia services, an anesthesiologist
shall participate through discussion of and agreement
with the anesthesia plan and shall remain physically
present and be available on the premises during the
delivery of anesthesia services for diagnosis,
consultation, and treatment of emergency medical
conditions. In the absence of 24-hour availability of
anesthesiologists with medical staff privileges, an
alternate policy (requiring participation, presence, and
availability of a physician licensed to practice medicine
in all its branches) shall be developed by the medical
staff and licensed hospital in consultation with the
anesthesia service.
(C) A certified registered nurse anesthetist is not
required to possess prescriptive authority or a written
collaborative agreement meeting the requirements of
Section 15-15 of the Nursing and Advanced Practice
Nursing Act to provide anesthesia services ordered by a
licensed physician, dentist, or podiatrist. Licensed
certified registered nurse anesthetists are authorized to
select, order, and administer drugs and apply the
appropriate medical devices in the provision of
anesthesia services under the anesthesia plan agreed with
by the anesthesiologist or, in the absence of an
available anesthesiologist with clinical privileges,
agreed with by the operating physician, operating
dentist, or operating podiatrist in accordance with the
hospital's alternative policy.
(Source: P.A. 90-742, eff. 8-13-98; 91-414, eff. 8-6-99.)