Public Act 094-0915
 
SB2238 Enrolled LRB094 16983 DRJ 52263 b

    AN ACT concerning regulation.
 
    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.
    (2.5) A registered nurse licensed under the Nursing and
Advanced Practice Nursing Act and qualified by training and
experience in operating room nursing shall be present in the
operating room and function as the circulating nurse during all
invasive or operative procedures. For purposes of this
paragraph (2.5), "circulating nurse" means a registered nurse
who is responsible for coordinating all nursing care, patient
safety needs, and the needs of the surgical team in the
operating room during an invasive or operative procedure.
    (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. 93-352, eff. 1-1-04.)
 
    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.
    (2.5) A registered nurse licensed under the Nursing and
Advanced Practice Nursing Act and qualified by training and
experience in operating room nursing shall be present in the
operating room and function as the circulating nurse during all
invasive or operative procedures. For purposes of this
paragraph (2.5), "circulating nurse" means a registered nurse
who is responsible for coordinating all nursing care, patient
safety needs, and the needs of the surgical team in the
operating room during an invasive or operative procedure.
    (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. 93-352, eff. 1-1-04.)

Effective Date: 1/1/2007