093_HB3618eng HB3618 Engrossed LRB093 10431 JAM 10685 b 1 AN ACT concerning public health. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Ambulatory Surgical Treatment Center Act 5 is amended by changing Section 6.5 as follows: 6 (210 ILCS 5/6.5) 7 Sec. 6.5. Clinical privileges; advanced practice nurses. 8 All ambulatory surgical treatment centers (ASTC) licensed 9 under this Act shall comply with the following requirements: 10 (1) No ASTC policy, rule, regulation, or practice shall 11 be inconsistent with the provision of adequate collaboration, 12 including medical direction of licensed advanced practice 13 nurses, in accordance with Section 54.5 of the Medical 14 Practice Act of 1987. 15 (2) Operative surgical procedures shall be performed 16 only by a physician licensed to practice medicine in all its 17 branches under the Medical Practice Act of 1987, a dentist 18 licensed under the Illinois Dental Practice Act, or a 19 podiatrist licensed under the Podiatric Medical Practice Act 20 of 1987, with medical staff membership and surgical clinical 21 privileges granted by the consulting committee of the ASTC. A 22 licensed physician, dentist, or podiatrist may be assisted by 23 a physician licensed to practice medicine in all its 24 branches, dentist, dental assistant, podiatrist, licensed 25 advanced practice nurse, licensed physician assistant, 26 licensed registered nurse, licensed practical nurse, surgical 27 assistant, surgical technician, or other individuals granted 28 clinical privileges to assist in surgery by the consulting 29 committee of the ASTC. Payment for services rendered by an 30 assistant in surgery who is not an ambulatory surgical 31 treatment center employee shall be paid at the appropriate HB3618 Engrossed -2- LRB093 10431 JAM 10685 b 1 non-physician modifier rate if the payor would have made 2 payment had the same services been provided by a physician. 3 (3) The anesthesia service shall be under the direction 4 of a physician licensed to practice medicine in all its 5 branches who has had specialized preparation or experience in 6 the area or who has completed a residency in anesthesiology. 7 An anesthesiologist, Board certified or Board eligible, is 8 recommended. Anesthesia services may only be administered 9 pursuant to the order of a physician licensed to practice 10 medicine in all its branches, licensed dentist, or licensed 11 podiatrist. 12 (A) The individuals who, with clinical privileges 13 granted by the medical staff and ASTC, may administer 14 anesthesia services are limited to the following: 15 (i) an anesthesiologist; or 16 (ii) a physician licensed to practice medicine 17 in all its branches; or 18 (iii) a dentist with authority to administer 19 anesthesia under Section 8.1 of the Illinois Dental 20 Practice Act; or 21 (iv) a licensed certified registered nurse 22 anesthetist. 23 (B) For anesthesia services, an anesthesiologist 24 shall participate through discussion of and agreement 25 with the anesthesia plan and shall remain physically 26 present and be available on the premises during the 27 delivery of anesthesia services for diagnosis, 28 consultation, and treatment of emergency medical 29 conditions. In the absence of 24-hour availability of 30 anesthesiologists with clinical privileges, an alternate 31 policy (requiring participation, presence, and 32 availability of a physician licensed to practice medicine 33 in all its branches) shall be developed by the medical 34 staff consulting committee in consultation with the HB3618 Engrossed -3- LRB093 10431 JAM 10685 b 1 anesthesia service and included in the medical staff 2 consulting committee policies. 3 (C) A certified registered nurse anesthetist is not 4 required to possess prescriptive authority or a written 5 collaborative agreement meeting the requirements of 6 Section 15-15 of the Nursing and Advanced Practice 7 Nursing Act to provide anesthesia services ordered by a 8 licensed physician, dentist, or podiatrist. Licensed 9 certified registered nurse anesthetists are authorized to 10 select, order, and administer drugs and apply the 11 appropriate medical devices in the provision of 12 anesthesia services under the anesthesia plan agreed with 13 by the anesthesiologist or, in the absence of an 14 available anesthesiologist with clinical privileges, 15 agreed with by the operating physician, operating 16 dentist, or operating podiatrist in accordance with the 17 medical staff consulting committee policies of a licensed 18 ambulatory surgical treatment center. 19 (Source: P.A. 90-742, eff. 8-13-98; 91-414, eff. 8-6-99.) 20 Section 10. The Hospital Licensing Act is amended by 21 changing Section 10.7 as follows: 22 (210 ILCS 85/10.7) 23 Sec. 10.7. Clinical privileges; advanced practice 24 nurses. All hospitals licensed under this Act shall comply 25 with the following requirements: 26 (1) No hospital policy, rule, regulation, or practice 27 shall be inconsistent with the provision of adequate 28 collaboration, including medical direction of licensed 29 advanced practice nurses, in accordance with Section 54.5 of 30 the Medical Practice Act of 1987. 31 (2) Operative surgical procedures shall be performed 32 only by a physician licensed to practice medicine in all its HB3618 Engrossed -4- LRB093 10431 JAM 10685 b 1 branches under the Medical Practice Act of 1987, a dentist 2 licensed under the Illinois Dental Practice Act, or a 3 podiatrist licensed under the Podiatric Medical Practice Act 4 of 1987, with medical staff membership and surgical clinical 5 privileges granted at the hospital. A licensed physician, 6 dentist, or podiatrist may be assisted by a physician 7 licensed to practice medicine in all its branches, dentist, 8 dental assistant, podiatrist, licensed advanced practice 9 nurse, licensed physician assistant, licensed registered 10 nurse, licensed practical nurse, surgical assistant, surgical 11 technician, or other individuals granted clinical privileges 12 to assist in surgery at the hospital. Payment for services 13 rendered by an assistant in surgery who is not a hospital 14 employee shall be paid at the appropriate non-physician 15 modifier rate if the payor would have made payment had the 16 same services been provided by a physician. 17 (3) The anesthesia service shall be under the direction 18 of a physician licensed to practice medicine in all its 19 branches who has had specialized preparation or experience in 20 the area or who has completed a residency in anesthesiology. 21 An anesthesiologist, Board certified or Board eligible, is 22 recommended. Anesthesia services may only be administered 23 pursuant to the order of a physician licensed to practice 24 medicine in all its branches, licensed dentist, or licensed 25 podiatrist. 26 (A) The individuals who, with clinical privileges 27 granted at the hospital, may administer anesthesia 28 services are limited to the following: 29 (i) an anesthesiologist; or 30 (ii) a physician licensed to practice medicine 31 in all its branches; or 32 (iii) a dentist with authority to administer 33 anesthesia under Section 8.1 of the Illinois Dental 34 Practice Act; or HB3618 Engrossed -5- LRB093 10431 JAM 10685 b 1 (iv) a licensed certified registered nurse 2 anesthetist. 3 (B) For anesthesia services, an anesthesiologist 4 shall participate through discussion of and agreement 5 with the anesthesia plan and shall remain physically 6 present and be available on the premises during the 7 delivery of anesthesia services for diagnosis, 8 consultation, and treatment of emergency medical 9 conditions. In the absence of 24-hour availability of 10 anesthesiologists with medical staff privileges, an 11 alternate policy (requiring participation, presence, and 12 availability of a physician licensed to practice medicine 13 in all its branches) shall be developed by the medical 14 staff and licensed hospital in consultation with the 15 anesthesia service. 16 (C) A certified registered nurse anesthetist is not 17 required to possess prescriptive authority or a written 18 collaborative agreement meeting the requirements of 19 Section 15-15 of the Nursing and Advanced Practice 20 Nursing Act to provide anesthesia services ordered by a 21 licensed physician, dentist, or podiatrist. Licensed 22 certified registered nurse anesthetists are authorized to 23 select, order, and administer drugs and apply the 24 appropriate medical devices in the provision of 25 anesthesia services under the anesthesia plan agreed with 26 by the anesthesiologist or, in the absence of an 27 available anesthesiologist with clinical privileges, 28 agreed with by the operating physician, operating 29 dentist, or operating podiatrist in accordance with the 30 hospital's alternative policy. 31 (Source: P.A. 90-742, eff. 8-13-98; 91-414, eff. 8-6-99.)