Public Act 095-0911
 
HB4673 Enrolled LRB095 15669 RAS 41674 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 and
consultation 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 Nurse Practice
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) An advanced practice nurse is not required to possess
prescriptive authority or a written collaborative agreement
meeting the requirements of the Nurse Practice Act to provide
advanced practice nursing services in an ambulatory surgical
treatment center. An advanced practice nurse must possess
clinical privileges granted by the consulting medical staff
committee and ambulatory surgical treatment center in order to
provide services. Individual advanced practice nurses may also
be granted clinical privileges to order, select, and administer
medications, including controlled substances, to provide
delineated care. The attending physician must determine the
advance practice nurse's role in providing care for his or her
patients, except as otherwise provided in the consulting staff
policies. The consulting medical staff committee shall
periodically review the services of advanced practice nurses
granted privileges.
    (4) 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; or .
            (v) a podiatrist licensed under the Podiatric
        Medical Practice Act of 1987.
        (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 65-35 of the Nurse Practice 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. 94-915, eff. 1-1-07; 95-639, eff. 10-5-07.)
 
    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
and consultation 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 Nurse Practice
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) An advanced practice nurse is not required to possess
prescriptive authority or a written collaborative agreement
meeting the requirements of the Nurse Practice Act to provide
advanced practice nursing services in a hospital. An advanced
practice nurse must possess clinical privileges recommended by
the medical staff and granted by the hospital in order to
provide services. Individual advanced practice nurses may also
be granted clinical privileges to order, select, and administer
medications, including controlled substances, to provide
delineated care. The attending physician must determine the
advance practice nurse's role in providing care for his or her
patients, except as otherwise provided in medical staff bylaws.
The medical staff shall periodically review the services of
advanced practice nurses granted privileges. This review shall
be conducted in accordance with item (2) of subsection (a) of
Section 10.8 of this Act for advanced practice nurses employed
by the hospital.
    (4) 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; or .
            (v) a podiatrist licensed under the Podiatric
        Medical Practice Act of 1987.
        (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 65-35 of the Nurse Practice 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. 94-915, eff. 1-1-07; 95-639, eff. 10-5-07.)
 
    Section 99. Effective date. This Act takes effect upon
becoming law.

Effective Date: 8/26/2008