Full Text of HB4329 94th General Assembly
HB4329 94TH GENERAL ASSEMBLY
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94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006 HB4329
Introduced 12/29/2005, by Rep. Rich Brauer SYNOPSIS AS INTRODUCED: |
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210 ILCS 5/6.5 |
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225 ILCS 60/54.7 new |
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Amends the Ambulatory Surgical Treatment Center Act. In provisions concerning persons authorized to administer anesthesia services, provides that a registered nurse may administer conscious sedation under the following conditions: (1) the registered nurse has privileges granted by the medical staff and ambulatory surgical treatment center (ASTC) to administer conscious sedation; (2) the registered nurse is under the direct supervision of the operating physician or dentist during the delivery conscious sedation; (3) the registered nurse maintains current Advanced Cardiac Life Support certification; and (4) the operating physician has training and experience in the delivery of anesthesia services to patients by either possessing clinical privileges at the ASTC to administer anesthesia or completing a minimum of 8 hours of continuing education in the delivery of anesthesia, including the administration of conscious sedation within each 3-year license period. Also requires that a physician or dentist with authority to administer anesthesia maintain current Advanced Cardiac Life Support certification. Amends the Medical Practice Act of 1987. Provides that any physician may order and administer anesthesia services in accordance with his or her training or experience. Sets forth the conditions under which anesthesia services shall be administered in a hospital, in an ambulatory surgical treatment center, and in a physician's office. Defines "conscious sedation". Effective immediately.
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A BILL FOR
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HB4329 |
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LRB094 15818 DRJ 51034 b |
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| AN ACT in relation to 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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HB4329 |
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LRB094 15818 DRJ 51034 b |
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| payment had the same services been provided
by a physician.
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| (3) The anesthesia service shall be under the direction of | 3 |
| a physician
licensed to practice
medicine in all its branches | 4 |
| who has had specialized preparation or experience
in the area
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| or who has completed a residency in anesthesiology. An | 6 |
| anesthesiologist, Board
certified or
Board eligible, is | 7 |
| recommended. Anesthesia services may
only be
administered | 8 |
| pursuant to the order of a physician licensed to practice | 9 |
| medicine
in all its
branches, licensed dentist, or licensed | 10 |
| podiatrist.
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| (A) The individuals who, with clinical privileges | 12 |
| granted by the medical
staff and ASTC, may
administer | 13 |
| 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 | 16 |
| all its branches; or
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| (iii) a dentist with authority to administer | 18 |
| anesthesia under Section
8.1 of the
Illinois Dental | 19 |
| Practice Act; or
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| (iv) a licensed certified registered nurse | 21 |
| anesthetist ; or | 22 |
| (v) a registered nurse under the conditions set | 23 |
| forth in item (D) .
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| (B) For anesthesia services, an anesthesiologist
shall
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| participate through discussion of and agreement with the | 26 |
| anesthesia plan and
shall remain physically present and be
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| available on
the premises during the delivery of anesthesia | 28 |
| services for
diagnosis, consultation, and treatment of | 29 |
| emergency medical
conditions.
In the absence of 24-hour | 30 |
| availability of anesthesiologists with clinical
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| privileges, an alternate policy (requiring
participation, | 32 |
| presence,
and availability of a
physician licensed to | 33 |
| practice medicine in all its
branches) shall be
developed | 34 |
| by the medical staff consulting committee in consultation | 35 |
| with the
anesthesia service and included in the medical
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| staff
consulting committee policies.
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HB4329 |
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LRB094 15818 DRJ 51034 b |
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| (C) A certified registered nurse anesthetist is not | 2 |
| required to possess
prescriptive authority or a written | 3 |
| collaborative agreement meeting the
requirements of | 4 |
| Section 15-15 of the Nursing and Advanced Practice Nursing | 5 |
| Act
to provide anesthesia services
ordered by a licensed | 6 |
| physician, dentist, or podiatrist. Licensed certified
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| registered nurse anesthetists are authorized to
select, | 8 |
| order, and
administer drugs and apply the appropriate | 9 |
| medical devices in the provision of
anesthesia
services | 10 |
| under the anesthesia plan agreed with by the
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| anesthesiologist or, in the absence of an available | 12 |
| anesthesiologist with
clinical privileges,
agreed with by | 13 |
| the
operating physician, operating dentist, or operating | 14 |
| podiatrist in accordance
with the medical
staff consulting | 15 |
| committee policies of a licensed ambulatory surgical | 16 |
| treatment
center.
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| (D) A registered nurse may administer conscious | 18 |
| sedation, as defined in the Medical Practice Act of 1987, | 19 |
| under the following conditions:
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| (1) The registered nurse has privileges granted by | 21 |
| the medical staff and ASTC to administer conscious | 22 |
| sedation.
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| (2) The registered nurse is under the direct | 24 |
| supervision of the operating physician or dentist | 25 |
| during the delivery conscious sedation.
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| (3) The registered nurse maintains current | 27 |
| Advanced Cardiac Life Support certification.
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| (4) The operating physician has training and | 29 |
| experience in the delivery of anesthesia services to | 30 |
| patients by either possessing clinical privileges at | 31 |
| the ASTC to administer anesthesia or completing a | 32 |
| minimum of 8 hours of continuing education (CME) in the | 33 |
| delivery of anesthesia, including the administration | 34 |
| of conscious sedation within each 3-year license | 35 |
| period.
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| In addition, the operating physician or dentist with |
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HB4329 |
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LRB094 15818 DRJ 51034 b |
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| authority to administer anesthesia under Section 8.1 of the | 2 |
| Illinois Dental Practice Act must maintain current Advanced | 3 |
| Cardiac Life Support certification. This training and | 4 |
| experience must be documented in the operating physician or | 5 |
| dentist clinical privilege file.
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| (Source: P.A. 93-352, eff. 1-1-04.)
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| Section 10. The Medical Practice Act of 1987 is amended by | 8 |
| adding Section 54.7 as follows: | 9 |
| (225 ILCS 60/54.7 new) | 10 |
| Sec. 54.7. Anesthesia services. | 11 |
| (a) Any physician may order and administer anesthesia | 12 |
| services in accordance with his or her training or experience. | 13 |
| (b) In a hospital setting, anesthesia services shall be | 14 |
| administered in accordance with Section 10.7 of the Hospital | 15 |
| Licensing Act. | 16 |
| (c) In an ambulatory surgical treatment center, anesthesia | 17 |
| services shall be administered in accordance with Section 6.5 | 18 |
| of the Ambulatory Surgical Treatment Center Act. | 19 |
| (d) In a physician's office, anesthesia services shall be | 20 |
| administered in accordance with the following: | 21 |
| (1) In a physician's office, the operating physician | 22 |
| shall have training and experience in the delivery of | 23 |
| anesthesia services in order to administer anesthesia or to | 24 |
| enter into a practice agreement with a certified registered | 25 |
| nurse anesthetist (CRNA) to provide anesthesia services in | 26 |
| the office pursuant to Section 54.5 of the Medical Practice | 27 |
| Act and Section 15-25 of the Nursing and Advanced Practice | 28 |
| Nursing Act. When an anesthesiologist is administering | 29 |
| anesthesia in a physician's office, the operating | 30 |
| physician is not required to have the training and | 31 |
| experience set forth in paragraph (2). A "physician's | 32 |
| office" is any practice location not regulated by Section | 33 |
| 10.7 of the Hospital Licensing Act or Section 6.5 of the | 34 |
| Ambulatory Surgical Treatment Center Act. |
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HB4329 |
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LRB094 15818 DRJ 51034 b |
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| (2) The training and experience requirements may be met | 2 |
| in the manner specified in either subparagraph (A) or | 3 |
| subparagraph (B): | 4 |
| (A) The physician maintains clinic privileges to | 5 |
| administer anesthesia services in a hospital licensed | 6 |
| in accordance with the Hospital Licensing Act or an | 7 |
| ambulatory surgical treatment center licensed in | 8 |
| accordance with the Ambulatory Surgical Treatment | 9 |
| Center Act; or | 10 |
| (B) Completion of continuing medical education: | 11 |
| (i) For conscious sedation only, the physician | 12 |
| shall complete a minimum of 8 hours of continuing | 13 |
| medical education (CME) in delivery of anesthesia, | 14 |
| including the administration of conscious sedation | 15 |
| within each 3-year license renewal period. | 16 |
| (ii) For deep sedation, regional anesthesia, | 17 |
| or general anesthesia, or any combination of | 18 |
| those, a physician shall complete a minimum of 34 | 19 |
| hours of continuing medical education in the | 20 |
| delivery of anesthesia services within each 3-year | 21 |
| license renewal period. Fulfillment of this | 22 |
| requirement shall satisfy the requirement of | 23 |
| subdivision (2)(B)(i) for the administration of | 24 |
| conscious sedation. | 25 |
| (iii) A continuing medical education program | 26 |
| shall be conducted by a university, professional | 27 |
| association, or hospital as a formal CME program. | 28 |
| (3) In a physician's office where anesthesia is | 29 |
| administered, all operating physicians and | 30 |
| anesthesiologists shall obtain Advanced Cardiac Life | 31 |
| Support (ACLS) certification and shall thereafter maintain | 32 |
| current ACLS certification. If the physician enters into a | 33 |
| practice agreement with a CRNA, the CRNA shall also have a | 34 |
| current ACLS certification. | 35 |
| (4) The ACLS certification and the physician training | 36 |
| and experience required by this Section shall be documented |
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HB4329 |
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LRB094 15818 DRJ 51034 b |
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| in the written practice agreement between the physician and | 2 |
| the CRNA. | 3 |
| (5) The continuing medical education required in | 4 |
| paragraph (2) and the ACLS training required in paragraph | 5 |
| (3) may be applied to fulfillment of the 150 hours of | 6 |
| continuing medical education required for renewal of a | 7 |
| license. | 8 |
| (6) For the provision of anesthesia services, the | 9 |
| operating physician or dentist shall participate through | 10 |
| discussion of and agreement with the anesthesia plan and | 11 |
| shall remain physically present and be available on the | 12 |
| premises during the delivery of anesthesia services for | 13 |
| diagnosis, consultation, and treatment of emergency | 14 |
| medical conditions. | 15 |
| (e) "Conscious sedation" means a drug-induced depression | 16 |
| of consciousness during which patients respond purposefully to | 17 |
| verbal commands, either alone or accompanied by light tactile | 18 |
| stimulation. No interventions are required to maintain a patent | 19 |
| airway and spontaneous ventilation is adequate. Cardiovascular | 20 |
| function is maintained.
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| Section 99. Effective date. This Act takes effect upon | 22 |
| becoming law.
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