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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Ambulatory Surgical Treatment Center Act is | ||||||
5 | amended by changing Section 6.5 as follows:
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6 | (210 ILCS 5/6.5)
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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:
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10 | (1) No ASTC policy, rule, regulation, or practice shall be | ||||||
11 | inconsistent
with the provision of adequate collaboration and | ||||||
12 | consultation in accordance with Section 54.5 of the Medical
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13 | Practice Act of 1987.
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14 | (2) Operative surgical procedures shall be performed only | ||||||
15 | by a physician
licensed to
practice medicine in
all its | ||||||
16 | branches under the Medical Practice Act of 1987, a dentist
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17 | licensed under the
Illinois Dental Practice Act, or a | ||||||
18 | podiatrist licensed under the Podiatric
Medical Practice Act of | ||||||
19 | 1987,
with medical staff membership and surgical clinical | ||||||
20 | privileges granted by the
consulting
committee of the ASTC. A | ||||||
21 | licensed physician, dentist, or podiatrist may
be assisted by
a | ||||||
22 | physician licensed to practice medicine in all its branches, | ||||||
23 | dentist, dental
assistant,
podiatrist, licensed
advanced |
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1 | practice nurse, licensed physician assistant, licensed
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2 | registered nurse, licensed practical nurse,
surgical
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3 | assistant, surgical technician, or other individuals granted | ||||||
4 | clinical
privileges to assist in surgery
by the consulting | ||||||
5 | committee of the ASTC.
Payment for services rendered by an | ||||||
6 | assistant in surgery who is not an
ambulatory surgical | ||||||
7 | treatment center employee shall be paid
at the appropriate | ||||||
8 | non-physician modifier
rate if the payor would have made | ||||||
9 | payment had the same services been provided
by a physician.
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10 | (2.5) A registered nurse licensed under the Nurse Practice | ||||||
11 | Act and qualified by training and experience in operating room | ||||||
12 | nursing shall be present in the operating room and function as | ||||||
13 | the circulating nurse during all invasive or operative | ||||||
14 | procedures. For purposes of this paragraph (2.5), "circulating | ||||||
15 | nurse" means a registered nurse who is responsible for | ||||||
16 | coordinating all nursing care, patient safety needs, and the | ||||||
17 | needs of the surgical team in the operating room during an | ||||||
18 | invasive or operative procedure.
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19 | (3) An advanced practice nurse is not required to possess | ||||||
20 | prescriptive authority or a written collaborative agreement | ||||||
21 | meeting the requirements of the Nurse Practice Act to provide | ||||||
22 | advanced practice nursing services in an ambulatory surgical | ||||||
23 | treatment center. An advanced practice nurse must possess | ||||||
24 | clinical privileges granted by the consulting medical staff | ||||||
25 | committee and ambulatory surgical treatment center in order to | ||||||
26 | provide services. Individual advanced practice nurses may also |
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1 | be granted clinical privileges to order, select, and administer | ||||||
2 | medications, including controlled substances, to provide | ||||||
3 | delineated care. The attending physician must determine the | ||||||
4 | advance practice nurse's role in providing care for his or her | ||||||
5 | patients, except as otherwise provided in the consulting staff | ||||||
6 | policies. The consulting medical staff committee shall | ||||||
7 | periodically review the services of advanced practice nurses | ||||||
8 | granted privileges.
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9 | (4) The anesthesia service shall be under the direction of | ||||||
10 | a physician
licensed to practice
medicine in all its branches | ||||||
11 | who has had specialized preparation or experience
in the area
| ||||||
12 | or who has completed a residency in anesthesiology. An | ||||||
13 | anesthesiologist, Board
certified or
Board eligible, is | ||||||
14 | recommended. Anesthesia services may
only be
administered | ||||||
15 | pursuant to the order of a physician licensed to practice | ||||||
16 | medicine
in all its
branches, licensed dentist, or licensed | ||||||
17 | podiatrist.
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18 | (A) The individuals who, with clinical privileges | ||||||
19 | granted by the medical
staff and ASTC, may
administer | ||||||
20 | anesthesia services are limited to the
following:
| ||||||
21 | (i) an anesthesiologist; or
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22 | (ii) a physician licensed to practice medicine in | ||||||
23 | all its branches; or
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24 | (iii) a dentist with authority to administer | ||||||
25 | anesthesia under Section
8.1 of the
Illinois Dental | ||||||
26 | Practice Act; or
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| |||||||
1 | (iv) a licensed certified registered nurse | ||||||
2 | anesthetist ; or . | ||||||
3 | (v) a podiatrist licensed under the Podiatric | ||||||
4 | Medical Practice Act of 1987.
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5 | (B) For anesthesia services, an anesthesiologist
shall
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6 | participate through discussion of and agreement with the | ||||||
7 | anesthesia plan and
shall remain physically present and be
| ||||||
8 | available on
the premises during the delivery of anesthesia | ||||||
9 | services for
diagnosis, consultation, and treatment of | ||||||
10 | emergency medical
conditions.
In the absence of 24-hour | ||||||
11 | availability of anesthesiologists with clinical
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12 | privileges, an alternate policy (requiring
participation, | ||||||
13 | presence,
and availability of a
physician licensed to | ||||||
14 | practice medicine in all its
branches) shall be
developed | ||||||
15 | by the medical staff consulting committee in consultation | ||||||
16 | with the
anesthesia service and included in the medical
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17 | staff
consulting committee policies.
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18 | (C) A certified registered nurse anesthetist is not | ||||||
19 | required to possess
prescriptive authority or a written | ||||||
20 | collaborative agreement meeting the
requirements of | ||||||
21 | Section 65-35 of the Nurse Practice Act
to provide | ||||||
22 | anesthesia services
ordered by a licensed physician, | ||||||
23 | dentist, or podiatrist. Licensed certified
registered | ||||||
24 | nurse anesthetists are authorized to
select, order, and
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25 | administer drugs and apply the appropriate medical devices | ||||||
26 | in the provision of
anesthesia
services under the |
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1 | anesthesia plan agreed with by the
anesthesiologist or, in | ||||||
2 | the absence of an available anesthesiologist with
clinical | ||||||
3 | privileges,
agreed with by the
operating physician, | ||||||
4 | operating dentist, or operating podiatrist in accordance
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5 | with the medical
staff consulting committee policies of a | ||||||
6 | licensed ambulatory surgical treatment
center.
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7 | (Source: P.A. 94-915, eff. 1-1-07; 95-639, eff. 10-5-07.)
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8 | Section 10. The Hospital Licensing Act is amended by | ||||||
9 | changing Section 10.7 as follows:
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10 | (210 ILCS 85/10.7)
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11 | Sec. 10.7. Clinical privileges; advanced practice nurses.
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12 | All hospitals licensed under this Act shall comply with the | ||||||
13 | following
requirements:
| ||||||
14 | (1) No hospital policy, rule, regulation, or practice
shall | ||||||
15 | be inconsistent
with the provision of adequate collaboration | ||||||
16 | and consultation in accordance with Section 54.5 of the
Medical | ||||||
17 | Practice Act of 1987.
| ||||||
18 | (2) Operative surgical procedures shall be performed only | ||||||
19 | by a physician
licensed to practice medicine in all its | ||||||
20 | branches under the Medical Practice
Act of 1987, a dentist | ||||||
21 | licensed under the Illinois Dental Practice Act, or a
| ||||||
22 | podiatrist licensed under the Podiatric Medical Practice Act of | ||||||
23 | 1987,
with medical staff membership and surgical clinical | ||||||
24 | privileges granted at the
hospital. A licensed physician, |
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| |||||||
1 | dentist, or podiatrist may be assisted by a
physician licensed | ||||||
2 | to practice medicine in all its branches, dentist, dental
| ||||||
3 | assistant, podiatrist, licensed advanced practice nurse, | ||||||
4 | licensed physician
assistant, licensed registered
nurse, | ||||||
5 | licensed practical nurse, surgical
assistant, surgical | ||||||
6 | technician, or other individuals granted clinical
privileges | ||||||
7 | to assist in surgery
at the hospital.
Payment for services | ||||||
8 | rendered by an assistant in surgery who is not a
hospital | ||||||
9 | employee shall be paid
at the appropriate non-physician | ||||||
10 | modifier rate if the payor would have
made payment had the same | ||||||
11 | services been provided by a physician.
| ||||||
12 | (2.5) A registered nurse licensed under the Nurse Practice | ||||||
13 | Act and qualified by training and experience in operating room | ||||||
14 | nursing shall be present in the operating room and function as | ||||||
15 | the circulating nurse during all invasive or operative | ||||||
16 | procedures. For purposes of this paragraph (2.5), "circulating | ||||||
17 | nurse" means a registered nurse who is responsible for | ||||||
18 | coordinating all nursing care, patient safety needs, and the | ||||||
19 | needs of the surgical team in the operating room during an | ||||||
20 | invasive or operative procedure.
| ||||||
21 | (3) An advanced practice nurse is not required to possess | ||||||
22 | prescriptive authority or a written collaborative agreement | ||||||
23 | meeting the requirements of the Nurse Practice Act to provide | ||||||
24 | advanced practice nursing services in a hospital. An advanced | ||||||
25 | practice nurse must possess clinical privileges recommended by | ||||||
26 | the medical staff and granted by the hospital in order to |
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| |||||||
1 | provide services. Individual advanced practice nurses may also | ||||||
2 | be granted clinical privileges to order, select, and administer | ||||||
3 | medications, including controlled substances, to provide | ||||||
4 | delineated care. The attending physician must determine the | ||||||
5 | advance practice nurse's role in providing care for his or her | ||||||
6 | patients, except as otherwise provided in medical staff bylaws. | ||||||
7 | The medical staff shall periodically review the services of | ||||||
8 | advanced practice nurses granted privileges. This review shall | ||||||
9 | be conducted in accordance with item (2) of subsection (a) of | ||||||
10 | Section 10.8 of this Act for advanced practice nurses employed | ||||||
11 | by the hospital.
| ||||||
12 | (4) The anesthesia service shall be under the direction of | ||||||
13 | a physician
licensed to practice
medicine in all its branches | ||||||
14 | who has had specialized preparation or
experience in the area
| ||||||
15 | or who has completed a residency in anesthesiology. An | ||||||
16 | anesthesiologist, Board
certified or Board eligible, is | ||||||
17 | recommended. Anesthesia services may
only be administered | ||||||
18 | pursuant to the order of a physician licensed to practice
| ||||||
19 | medicine in all its branches, licensed dentist, or licensed | ||||||
20 | podiatrist.
| ||||||
21 | (A) The individuals who, with clinical privileges | ||||||
22 | granted at the hospital,
may administer anesthesia | ||||||
23 | services are limited
to the following:
| ||||||
24 | (i) an anesthesiologist; or
| ||||||
25 | (ii) a physician licensed to practice medicine in | ||||||
26 | all its branches; or
|
| |||||||
| |||||||
1 | (iii) a dentist with authority to administer | ||||||
2 | anesthesia under Section
8.1 of
the Illinois Dental | ||||||
3 | Practice Act; or
| ||||||
4 | (iv) a licensed certified registered nurse | ||||||
5 | anesthetist ; or . | ||||||
6 | (v) a podiatrist licensed under the Podiatric | ||||||
7 | Medical Practice Act of 1987.
| ||||||
8 | (B) For anesthesia services, an anesthesiologist
shall
| ||||||
9 | participate through discussion of and agreement with the | ||||||
10 | anesthesia plan and
shall remain physically present and be
| ||||||
11 | available on
the premises during the delivery of anesthesia | ||||||
12 | services for
diagnosis, consultation, and treatment of | ||||||
13 | emergency medical conditions.
In the absence
of 24-hour | ||||||
14 | availability of
anesthesiologists with medical staff | ||||||
15 | privileges,
an alternate
policy (requiring participation, | ||||||
16 | presence, and availability of a physician
licensed to | ||||||
17 | practice
medicine in all its branches) shall be developed | ||||||
18 | by the medical staff and
licensed
hospital in consultation | ||||||
19 | with the anesthesia service.
| ||||||
20 | (C) A certified registered nurse anesthetist is not | ||||||
21 | required to possess
prescriptive authority or a written | ||||||
22 | collaborative agreement meeting
the requirements of | ||||||
23 | Section 65-35 of the Nurse Practice Act
to provide | ||||||
24 | anesthesia services
ordered by a licensed physician, | ||||||
25 | dentist, or podiatrist. Licensed certified
registered | ||||||
26 | nurse anesthetists are authorized to
select, order, and
|
| |||||||
| |||||||
1 | administer drugs and apply the appropriate medical devices | ||||||
2 | in the provision of
anesthesia
services under the | ||||||
3 | anesthesia plan agreed with by the
anesthesiologist or, in | ||||||
4 | the absence of an available anesthesiologist with
clinical | ||||||
5 | privileges,
agreed with by the
operating physician, | ||||||
6 | operating dentist, or operating podiatrist in accordance
| ||||||
7 | with the hospital's alternative policy.
| ||||||
8 | (Source: P.A. 94-915, eff. 1-1-07; 95-639, eff. 10-5-07.)
| ||||||
9 | Section 99. Effective date. This Act takes effect upon | ||||||
10 | becoming law.
|