093_HB3618enr

 
HB3618 Enrolled                      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
 
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 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 Enrolled             -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 Enrolled             -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
 
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 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.)