Full Text of SB2238 94th General Assembly
SB2238enr 94TH GENERAL ASSEMBLY
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SB2238 Enrolled |
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LRB094 16983 DRJ 52263 b |
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| AN ACT concerning regulation.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Ambulatory Surgical Treatment Center Act is | 5 |
| amended by changing Section 6.5 as follows:
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| (210 ILCS 5/6.5)
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| 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:
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| (1) No ASTC policy, rule, regulation, or practice shall be | 11 |
| 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
Practice | 14 |
| Act of 1987.
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| (2) Operative surgical procedures shall be performed only | 16 |
| by a physician
licensed to
practice medicine in
all its | 17 |
| branches under the Medical Practice Act of 1987, a dentist
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| licensed under the
Illinois Dental Practice Act, or a | 19 |
| podiatrist licensed under the Podiatric
Medical Practice Act of | 20 |
| 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
a | 23 |
| physician licensed to practice medicine in all its branches, | 24 |
| dentist, dental
assistant,
podiatrist, licensed
advanced | 25 |
| practice nurse, licensed physician assistant, licensed
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| registered nurse, licensed practical nurse,
surgical
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| 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 | 32 |
| non-physician modifier
rate if the payor would have made |
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SB2238 Enrolled |
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LRB094 16983 DRJ 52263 b |
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| payment had the same services been provided
by a physician.
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| (2.5) A registered nurse licensed under the Nursing and | 3 |
| Advanced Practice Nursing Act and qualified by training and | 4 |
| experience in operating room nursing shall be present in the | 5 |
| operating room and function as the circulating nurse during all | 6 |
| invasive or operative procedures. For purposes of this | 7 |
| paragraph (2.5), "circulating nurse" means a registered nurse | 8 |
| who is responsible for coordinating all nursing care, patient | 9 |
| safety needs, and the needs of the surgical team in the | 10 |
| operating room during an invasive or operative procedure.
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| (3) The anesthesia service shall be under the direction of | 12 |
| a physician
licensed to practice
medicine in all its branches | 13 |
| who has had specialized preparation or experience
in the area
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| or who has completed a residency in anesthesiology. An | 15 |
| anesthesiologist, Board
certified or
Board eligible, is | 16 |
| recommended. Anesthesia services may
only be
administered | 17 |
| pursuant to the order of a physician licensed to practice | 18 |
| medicine
in all its
branches, licensed dentist, or licensed | 19 |
| podiatrist.
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| (A) The individuals who, with clinical privileges | 21 |
| granted by the medical
staff and ASTC, may
administer | 22 |
| anesthesia services are limited to the
following:
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| (i) an anesthesiologist; or
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| (ii) a physician licensed to practice medicine in | 25 |
| all its branches; or
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| (iii) a dentist with authority to administer | 27 |
| anesthesia under Section
8.1 of the
Illinois Dental | 28 |
| Practice Act; or
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| (iv) a licensed certified registered nurse | 30 |
| anesthetist.
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| (B) For anesthesia services, an anesthesiologist
shall
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| participate through discussion of and agreement with the | 33 |
| anesthesia plan and
shall remain physically present and be
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| available on
the premises during the delivery of anesthesia | 35 |
| services for
diagnosis, consultation, and treatment of | 36 |
| emergency medical
conditions.
In the absence of 24-hour |
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SB2238 Enrolled |
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LRB094 16983 DRJ 52263 b |
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| availability of anesthesiologists with clinical
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| privileges, an alternate policy (requiring
participation, | 3 |
| presence,
and availability of a
physician licensed to | 4 |
| practice medicine in all its
branches) shall be
developed | 5 |
| by the medical staff consulting committee in consultation | 6 |
| with the
anesthesia service and included in the medical
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| staff
consulting committee policies.
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| (C) A certified registered nurse anesthetist is not | 9 |
| required to possess
prescriptive authority or a written | 10 |
| collaborative agreement meeting the
requirements of | 11 |
| Section 15-15 of the Nursing and Advanced Practice Nursing | 12 |
| Act
to provide anesthesia services
ordered by a licensed | 13 |
| physician, dentist, or podiatrist. Licensed certified
| 14 |
| registered nurse anesthetists are authorized to
select, | 15 |
| order, and
administer drugs and apply the appropriate | 16 |
| medical devices in the provision of
anesthesia
services | 17 |
| under the anesthesia plan agreed with by the
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| anesthesiologist or, in the absence of an available | 19 |
| anesthesiologist with
clinical privileges,
agreed with by | 20 |
| the
operating physician, operating dentist, or operating | 21 |
| podiatrist in accordance
with the medical
staff consulting | 22 |
| committee policies of a licensed ambulatory surgical | 23 |
| treatment
center.
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| (Source: P.A. 93-352, eff. 1-1-04.)
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| Section 10. The Hospital Licensing Act is amended by | 26 |
| changing Section 10.7 as follows:
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| (210 ILCS 85/10.7)
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| Sec. 10.7. Clinical privileges; advanced practice nurses. | 29 |
| All hospitals licensed under this Act shall comply with the | 30 |
| following
requirements:
| 31 |
| (1) No hospital policy, rule, regulation, or practice
shall | 32 |
| be inconsistent
with the provision of adequate collaboration, | 33 |
| including medical direction of
licensed advanced practice | 34 |
| nurses, in accordance with Section 54.5 of the
Medical Practice |
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|
|
SB2238 Enrolled |
- 4 - |
LRB094 16983 DRJ 52263 b |
|
| 1 |
| Act of 1987.
| 2 |
| (2) Operative surgical procedures shall be performed only | 3 |
| by a physician
licensed to practice medicine in all its | 4 |
| branches under the Medical Practice
Act of 1987, a dentist | 5 |
| licensed under the Illinois Dental Practice Act, or a
| 6 |
| podiatrist licensed under the Podiatric Medical Practice Act of | 7 |
| 1987,
with medical staff membership and surgical clinical | 8 |
| privileges granted at the
hospital. A licensed physician, | 9 |
| dentist, or podiatrist may be assisted by a
physician licensed | 10 |
| to practice medicine in all its branches, dentist, dental
| 11 |
| assistant, podiatrist, licensed advanced practice nurse, | 12 |
| licensed physician
assistant, licensed registered
nurse, | 13 |
| licensed practical nurse, surgical
assistant, surgical | 14 |
| technician, or other individuals granted clinical
privileges | 15 |
| to assist in surgery
at the hospital.
Payment for services | 16 |
| rendered by an assistant in surgery who is not a
hospital | 17 |
| employee shall be paid
at the appropriate non-physician | 18 |
| modifier rate if the payor would have
made payment had the same | 19 |
| services been provided by a physician.
| 20 |
| (2.5) A registered nurse licensed under the Nursing and | 21 |
| Advanced Practice Nursing Act and qualified by training and | 22 |
| experience in operating room nursing shall be present in the | 23 |
| operating room and function as the circulating nurse during all | 24 |
| invasive or operative procedures. For purposes of this | 25 |
| paragraph (2.5), "circulating nurse" means a registered nurse | 26 |
| who is responsible for coordinating all nursing care, patient | 27 |
| safety needs, and the needs of the surgical team in the | 28 |
| operating room during an invasive or operative procedure.
| 29 |
| (3) The anesthesia service shall be under the direction of | 30 |
| a physician
licensed to practice
medicine in all its branches | 31 |
| who has had specialized preparation or
experience in the area
| 32 |
| or who has completed a residency in anesthesiology. An | 33 |
| anesthesiologist, Board
certified or Board eligible, is | 34 |
| recommended. Anesthesia services may
only be administered | 35 |
| pursuant to the order of a physician licensed to practice
| 36 |
| medicine in all its branches, licensed dentist, or licensed |
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SB2238 Enrolled |
- 5 - |
LRB094 16983 DRJ 52263 b |
|
| 1 |
| podiatrist.
| 2 |
| (A) The individuals who, with clinical privileges | 3 |
| granted at the hospital,
may administer anesthesia | 4 |
| services are limited
to the following:
| 5 |
| (i) an anesthesiologist; or
| 6 |
| (ii) a physician licensed to practice medicine in | 7 |
| all its branches; or
| 8 |
| (iii) a dentist with authority to administer | 9 |
| anesthesia under Section
8.1 of
the Illinois Dental | 10 |
| Practice Act; or
| 11 |
| (iv) a licensed certified registered nurse | 12 |
| anesthetist.
| 13 |
| (B) For anesthesia services, an anesthesiologist
shall
| 14 |
| participate through discussion of and agreement with the | 15 |
| anesthesia plan and
shall remain physically present and be
| 16 |
| available on
the premises during the delivery of anesthesia | 17 |
| services for
diagnosis, consultation, and treatment of | 18 |
| emergency medical conditions.
In the absence
of 24-hour | 19 |
| availability of
anesthesiologists with medical staff | 20 |
| privileges,
an alternate
policy (requiring participation, | 21 |
| presence, and availability of a physician
licensed to | 22 |
| practice
medicine in all its branches) shall be developed | 23 |
| by the medical staff and
licensed
hospital in consultation | 24 |
| with the anesthesia service.
| 25 |
| (C) A certified registered nurse anesthetist is not | 26 |
| required to possess
prescriptive authority or a written | 27 |
| collaborative agreement meeting
the requirements of | 28 |
| Section 15-15 of the Nursing and Advanced Practice Nursing
| 29 |
| Act
to provide anesthesia services
ordered by a licensed | 30 |
| physician, dentist, or podiatrist. Licensed certified
| 31 |
| registered nurse anesthetists are authorized to
select, | 32 |
| order, and
administer drugs and apply the appropriate | 33 |
| medical devices in the provision of
anesthesia
services | 34 |
| under the anesthesia plan agreed with by the
| 35 |
| anesthesiologist or, in the absence of an available | 36 |
| anesthesiologist with
clinical privileges,
agreed with by |
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SB2238 Enrolled |
- 6 - |
LRB094 16983 DRJ 52263 b |
|
| 1 |
| the
operating physician, operating dentist, or operating | 2 |
| podiatrist in accordance
with the hospital's alternative | 3 |
| policy.
| 4 |
| (Source: P.A. 93-352, eff. 1-1-04.)
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