103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB2214

 

Introduced 2/10/2023, by Sen. Cristina Castro

 

SYNOPSIS AS INTRODUCED:
 
New Act
5 ILCS 80/4.43 new
210 ILCS 5/6.5
210 ILCS 85/10.7
225 ILCS 60/54.5
225 ILCS 60/54.7 new

    Creates the Certified Anesthesiologist Assistant Practice Act. Provides for the licensure of certified anesthesiologist assistants by the Department of Financial and Professional Regulation. Sets forth provisions concerning: administrative procedures; the applicability of the Act; using titles, advertising, and billing; supervision requirements; application for licensure; unlicensed practice, violations, and civil penalties; the Certified Anesthesiologist Assistant Advisory Committee; qualifications for licensure; the expiration and renewal of a license; the inactive status of a license; and grounds for disciplinary action. Amends the Medical Practice Act of 1987. Provides that, under delegation from a supervising anesthesiologist, a licensed certified anesthesiologist assistant is authorized to select, order, and administer drugs and apply the appropriate medical devices in the provision of anesthesia services under the anesthesia plan agreed to by the supervising anesthesiologist. Amends the Ambulatory Surgical Treatment Center Act and the Hospital Licensing Act. Provides that a licensed certified anesthesiologist assistant under the supervision of an anesthesiologist with clinical privileges granted by the medical staff and ambulatory surgical center or at the hospital may administer anesthesia services. Amends the Regulatory Sunset Act to provide for the repeal of the Certified Anesthesiologist Assistant Practice Act on January 1, 2033.


LRB103 06052 AMQ 51082 b

 

 

A BILL FOR

 

SB2214LRB103 06052 AMQ 51082 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Certified Anesthesiologist Assistant Practice Act.
 
6    Section 5. Findings. The practice of anesthesiology is the
7practice of medicine. The practice as a certified
8anesthesiologist assistant in this State is declared to affect
9the public health, safety, and welfare and to be subject to
10regulation and control in the public interest. The purpose and
11legislative intent of this Act is to encourage and promote the
12more effective utilization of the skills of anesthesiologists
13by enabling them to delegate certain medical care to certified
14anesthesiologist assistants where such delegation is
15consistent with the health and welfare of the patient and is
16conducted at the direction of and under the responsible
17supervision of an anesthesiologist.
18    It is further declared to be a matter of public health and
19concern that the practice as a certified anesthesiologist
20assistant, as defined in this Act, merit and receive the
21confidence of the public and that only qualified persons be
22authorized to practice as a certified anesthesiologist
23assistant in this State. This Act shall be liberally construed

 

 

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1to best carry out these subjects and purposes.
 
2    Section 10. Administrative Procedure Act. The Illinois
3Administrative Procedure Act is hereby expressly adopted and
4incorporated herein as if all of the provisions of that Act
5were included in this Act. The Secretary may adopt rules for
6the administration and enforcement of this Act and may
7prescribe forms to be issued in connection with this Act.
 
8    Section 15. Definitions. As used in this Act:
9    "Anesthesiologist" means a physician licensed to practice
10medicine in all its branches by the Department who has
11completed a residency in anesthesiology approved by the
12American Board of Anesthesiology or the American Osteopathic
13Board of Anesthesiology, is board eligible or board certified,
14holds an unrestricted license, and is actively engaged in
15clinical practice.
16    "Board" means the Illinois State Medical Board constituted
17under the Medical Practice Act of 1987.
18    "Certified anesthesiologist assistant" means an individual
19licensed by the Department to provide anesthesia services
20under the supervision of an anesthesiologist.
21    "Department" means the Department of Financial and
22Professional Regulation.
23    "Secretary" means the Secretary of Financial and
24Professional Regulation.

 

 

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1    "Supervision" means overseeing the activities of, and
2accepting responsibility for, the medical services rendered by
3the certified anesthesiologist assistant and maintaining
4physical proximity that allows the anesthesiologist to return
5to reestablish direct contact with the patient to meet medical
6needs and address any urgent or emergent clinical problems at
7all times that medical services are rendered by the certified
8anesthesiologist assistant.
 
9    Section 20. Applicability. This Act does not prohibit:
10        (1) Any person licensed in this State under any other
11    Act from engaging in the practice for which the person is
12    licensed.
13        (2) The practice as an certified anesthesiologist
14    assistant by a person who is employed by the United States
15    government or any bureau, division, or agency thereof
16    while in the discharge of the employee's official duties.
17        (3) The practice as a certified anesthesiologist
18    assistant that is included in the certified
19    anesthesiologist assistant's program of study by students
20    enrolled in schools.
 
21    Section 25. Title; advertising; billing.
22    (a) No certified anesthesiologist assistant shall use the
23title of doctor or associate with the licensee's name or any
24other term in the clinical setting or while in contact with

 

 

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1patients under the licensee's care that would indicate to
2other persons that the licensee is qualified to engage in the
3general independent practice of anesthesiology or
4interventional pain management.
5    (b) A licensee shall include in every advertisement for
6services regulated under this Act the licensee's title as it
7appears on the license or the initials authorized under this
8Act.
9    (c) A certified anesthesiologist assistant shall not be
10allowed to bill patients or in any way charge for services.
11Nothing in this Act, however, shall be so construed as to
12prevent the employer of a certified anesthesiologist assistant
13from charging for services rendered by the certified
14anesthesiologist assistant. Payment for services rendered by a
15certified anesthesiologist assistant shall be made to the
16certified anesthesiologist assistant's employer if the payor
17would have made payment had the services been provided by an
18anesthesiologist.
 
19    Section 30. Supervision requirements.
20    (a) As used in this Section, "supervision" means the use
21of the powers of direction and decision to coordinate, direct,
22and inspect the accomplishment of another, and to oversee the
23implementation of the anesthesiologist's intentions.
24    (b) A certified anesthesiologist assistant may deliver
25medical care only under the supervision of an anesthesiologist

 

 

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1and only as described in a supervision agreement between the
2certified anesthesiologist assistant and an anesthesiologist
3who represents the certified anesthesiologist assistant's
4employer. The supervising anesthesiologist shall be
5immediately available at all times while supervising a
6certified anesthesiologist assistant.
7    For the purposes of this Section, "immediately available"
8means the medically directing anesthesiologist being in such
9physical proximity to allow the anesthesiologist to return to
10reestablish direct contact with the patient to meet the
11patient's medical needs and address any urgent or emergent
12problems. These responsibilities may also be met through
13careful coordination among anesthesiologists of the same group
14or department. It is recognized that the design and size of
15various facilities, the severity of patient illnesses, and the
16complexity and demands of the particular surgical procedures
17make it impossible to define a specific time or distance for
18physical proximity.
19    (c) A certified anesthesiologist assistant's practice may
20not exceed the licensee's education and training, the scope of
21practice of the supervising anesthesiologist, and the practice
22outlined in the certified anesthesiologist assistant
23supervision agreement. A medical care task assigned by the
24supervising anesthesiologist to the certified anesthesiologist
25assistant may not be delegated by the certified
26anesthesiologist assistant to another person, except for the

 

 

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1preceptorship of a student in an anesthesiologist assistant
2training program.
3    (d) A certified anesthesiologist assistant may assist only
4the supervising anesthesiologist in the delivery of medical
5care and may perform medical care tasks as well as any other
6tasks within the scope of training and education of the
7certified anesthesiologist assistant as assigned by the
8supervising anesthesiologist.
9    (e) An anesthesiologist who represents a certified
10anesthesiologist assistant's employer shall review the
11supervision agreement with the certified anesthesiologist
12assistant at least annually. The supervision agreement shall
13be available for inspection at the location where the
14certified anesthesiologist assistant practices. The
15supervision agreement may limit the practice of a certified
16anesthesiologist assistant to less than the full scope of
17practice authorized under this Act.
18    (f) A certified anesthesiologist assistant shall be
19employed by a health care provider that is licensed in this
20State for the primary purpose of providing the medical
21services of physicians or that is an entity. If a certified
22anesthesiologist assistant's employer is not an
23anesthesiologist, the employer shall provide for, and not
24interfere with, an anesthesiologist's supervision of the
25certified anesthesiologist assistant.
26    (g) A student in an anesthesiologist assistant training

 

 

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1program may assist only an anesthesiologist in the delivery of
2medical care and may perform only medical care tasks assigned
3by the anesthesiologist. An anesthesiologist may delegate the
4preceptorship of a student in an anesthesiologist assistant
5training program to a qualified anesthesia provider. This
6Section shall not be interpreted to limit the number of other
7qualified anesthesia providers an anesthesiologist may
8supervise.
9    (h) A student in an anesthesiologist assistant training
10program shall be identified as a student anesthesiologist
11assistant or an anesthesiologist assistant student and may not
12be identified as an "intern", "resident", or "fellow".
 
13    Section 35. Application for licensure. An application for
14an original license shall be made to the Department in writing
15on forms or electronically as prescribed by the Department and
16shall be accompanied by the required fee, which shall not be
17refundable. An application shall require information that, in
18the judgment of the Department, will enable the Department to
19pass on the qualifications of the applicant for a license. An
20application shall include evidence of passage of the
21examination of the National Commission for the Certification
22of Anesthesiologist Assistants, or its successor agency, and
23proof that the applicant holds a valid certificate issued by
24that Commission.
25    An applicant has 3 years from the date of application to

 

 

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1complete the application process. If the process has not been
2completed in 3 years, the application shall be denied, the fee
3shall be forfeited, and the applicant must reapply and meet
4the requirements in effect at the time of reapplication.
 
5    Section 40. Social security number on license application.
6In addition to any other information required to be contained
7in the application, every application for an original license
8under this Act shall include the applicant's social security
9number, which shall be retained in the agency's records
10pertaining to the license.
11    As soon as practical, the Department shall assign a
12customer's identification number to each applicant for a
13license. Every application for a renewal or restored license
14shall require the applicant's customer identification number.
 
15    Section 45. Identification. No person may designate
16oneself as a certified anesthesiologist assistant, use or
17assume the title "certified anesthesiologist assistant", or
18append to the person's name the words or letters "certified
19anesthesiologist assistant" or "C.A.A." or any other titles,
20letters, or designation that represents or may tend to
21represent the person as a certified anesthesiologist assistant
22unless the licensee is licensed as a certified
23anesthesiologist assistant by the Department. A certified
24anesthesiologist assistant shall be clearly identified as a

 

 

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1certified anesthesiologist assistant.
 
2    Section 50. Unlicensed practice; violation; civil penalty.
3    (a) Any person who practices, offers to practice, attempts
4to practice, or holds oneself out to practice as a certified
5anesthesiologist assistant without being licensed under this
6Act shall, in addition to any other penalty provided by law,
7pay a civil penalty to the Department in an amount not to
8exceed $10,000 for each offense as determined by the
9Department. The civil penalty shall be assessed by the
10Department after a hearing is held in accordance with the
11provisions set forth in this Act regarding the provision of a
12hearing for the discipline of a licensee.
13    (b) The Department has the authority and power to
14investigate any and all unlicensed activity.
15    (c) No person shall use any words, abbreviations, figures,
16letters, title, sign, card, or device tending to imply that
17the person is a certified anesthesiologist assistant,
18including, but not limited to, using the titles or initials
19"Certified Anesthesiologist Assistant" or "C.A.A.", or similar
20titles or initials, with the intention of indicating practice
21as a certified anesthesiologist assistant without meeting the
22requirements of this Act.
23    (d) The civil penalty shall be paid within 60 days after
24the effective date of the order imposing the civil penalty.
25The order shall constitute a judgment and may be filed and

 

 

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1execution had thereon in the same manner as any judgment from
2any court of record.
 
3    Section 55. Committee.
4    (a) There is established a Certified Anesthesiologist
5Assistant Advisory Committee to the Department and the Board.
6The Certified Anesthesiologist Assistant Advisory Committee
7may review and make recommendations to the Department and the
8Board regarding all matters relating to certified
9anesthesiologist assistants. These matters may include, but
10are not limited to:
11        (1) applications for licensure;
12        (2) disciplinary proceedings;
13        (3) renewal requirements; and
14        (4) any other issues pertaining to the regulation and
15    practice of certified anesthesiologist assistants in the
16    State.
17    (b) The Committee's membership shall consist of the
18following members appointed by the Governor and selected from
19a list of recommended appointees submitted by the president of
20a statewide academy or society representing certified
21anesthesiologist assistants:
22        (1) one member of the Board;
23        (2) two certified anesthesiologist assistants licensed
24    under this Act;
25        (3) one anesthesiologist; and

 

 

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1        (4) one public member.
2    Members shall be appointed for 3-year terms. The president
3of a statewide academy representing certified anesthesiologist
4assistants shall consider the recommendations of the president
5of a statewide academy or association representing
6anesthesiologists when recommending appointees under paragraph
7(2).
8    (c) Members of the Certified Anesthesiologist Assistant
9Advisory Committee shall have no liability for any action
10based upon a disciplinary proceeding or other activity
11performed in good faith as a member of the Committee.
 
12    Section 60. Qualifications for licensure. A person shall
13be qualified for licensure as a certified anesthesiologist
14assistant and the Department may issue a certified
15anesthesiologist assistant license to a person who:
16        (1) has applied in writing in form and substance
17    satisfactory to the Department and has not violated any of
18    the provisions of this Act or the rules adopted under this
19    Act; the Department may take into consideration any felony
20    conviction of the applicant, but such conviction shall not
21    operate as an absolute bar to licensure;
22        (2) has submitted evidence satisfactory to the
23    Department that the applicant has:
24            (A) obtained a master's degree;
25            (B) satisfactorily completed an anesthesiologist

 

 

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1        assistant program that is accredited by the Commission
2        on Accreditation of Allied Health Education Programs,
3        or its predecessor or successor entity; and
4            (C) passed the certifying examination administered
5        by and obtained active certification from the National
6        Commission for Certification of Anesthesiologist
7        Assistants or a successor entity; and
8        (3) complies with all applicable rules of the
9    Department.
 
10    Section 65. Endorsement. Upon payment of the required fee,
11the Department may, in its discretion, license as a certified
12anesthesiologist assistant an applicant who is a certified
13anesthesiologist assistant licensed in another jurisdiction if
14the requirements for licensure in that jurisdiction were at
15the time of licensure substantially equivalent to the
16requirement in force in this State on that date or equivalent
17to the requirements of this Act.
 
18    Section 70. Expiration and renewal of license. The
19expiration date and renewal period for each license issued
20under this Act shall be set by rule. Renewal shall be
21conditioned on paying the required fee and by meeting such
22other requirements as may be established by rule.
23    Any certified anesthesiologist assistant who has permitted
24the license to expire or who has had the license on inactive

 

 

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1status may have the license restored by making application to
2the Department and filing proof acceptable to the Department
3of the individual's fitness to have the license restored, and
4by paying the required fees. Proof of fitness may include
5sworn evidence certifying to active lawful practice in another
6jurisdiction.
7    If the certified anesthesiologist assistant has not
8maintained an active practice in another jurisdiction
9satisfactory to the Department, the Department shall
10determine, by an evaluation program established by rule, the
11individual's fitness for restoration of the license and shall
12establish procedures and requirements for such restoration.
13    However, any certified anesthesiologist assistant whose
14license expired while the individual was (i) in federal
15service on active duty with the Armed Forces of the United
16States, or the State Militia called into service or training,
17or (ii) in training or education under the supervision of the
18United States preliminary to induction into the military
19service, may have the individual's license restored without
20paying any lapsed renewal fees if within 2 years after
21honorable termination of such service, training, or education
22the individual furnishes the Department with satisfactory
23evidence to the effect that the individual has been so engaged
24and that the individual's service, training, or education has
25been so terminated.
 

 

 

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1    Section 75. Inactive status. Any certified
2anesthesiologist assistant who notifies the Department in
3writing on forms prescribed by the Department, may elect to
4place the license on an inactive status and shall, subject to
5rules of the Department, be excused from payment of renewal
6fees until the individual notifies the Department in writing
7of the individual's intention to restore the license.
8    Any certified anesthesiologist assistant requesting
9restoration from inactive status shall be required to pay the
10current renewal fee and shall be required to restore the
11license, as provided in Section 70.
12    Any certified anesthesiologist assistant whose license is
13in an inactive status shall not practice in this State.
14    Any certified anesthesiologist assistant who engages in
15practice while the license is lapsed or on inactive status
16shall be considered to be practicing without a license, which
17shall be grounds for discipline under Section 80.
 
18    Section 80. Grounds for disciplinary action.
19    (a) The Department may refuse to issue or renew, or may
20revoke, suspend, place on probation, reprimand, or take other
21disciplinary or non-disciplinary action with regard to any
22license issued under this Act as the Department may deem
23proper, including the issuance of fines not to exceed $10,000
24for each violation, for any one or a combination of the
25following causes:

 

 

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1        (1) Material misstatement in furnishing information to
2    the Department.
3        (2) Violations of this Act or the rules adopted under
4    this Act.
5        (3) Conviction by plea of guilty or nolo contendere,
6    finding of guilt, jury verdict, or entry of judgment or
7    sentencing, including, but not limited to, convictions,
8    preceding sentences of supervision, conditional discharge,
9    or first offender probation, under the laws of any
10    jurisdiction of the United States that is: (i) a felony;
11    or (ii) a misdemeanor an essential element of which is
12    dishonesty or that is directly related to the practice of
13    the profession.
14        (4) Making any misrepresentation for the purpose of
15    obtaining licenses.
16        (5) Professional incompetence.
17        (6) Aiding or assisting another person in violating
18    any provision of this Act or its rules.
19        (7) Failing, within 60 days, to provide information in
20    response to a written request made by the Department.
21        (8) Engaging in dishonorable, unethical, or
22    unprofessional conduct, as defined by rule, of a character
23    likely to deceive, defraud, or harm the public.
24        (9) Habitual or excessive use or addiction to alcohol,
25    narcotics, stimulants, or any other chemical agent or drug
26    that results in a certified anesthesiologist assistant's

 

 

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1    inability to practice with reasonable judgment, skill, or
2    safety.
3        (10) Discipline by another U.S. jurisdiction or
4    foreign nation, if at least one of the grounds for
5    discipline is the same or substantially equivalent to
6    those set forth in this Section.
7        (11) Directly or indirectly giving to or receiving
8    from any person, firm, corporation, partnership, or
9    association any fee, commission, rebate, or other form of
10    compensation for any professional services not actually or
11    personally rendered. Nothing in this paragraph affects any
12    bona fide independent contractor or employment
13    arrangements, which may include provisions for
14    compensation, health insurance, pension, or other
15    employment benefits, with persons or entities authorized
16    under this Act for the provision of services within the
17    scope of the licensee's practice under this Act.
18        (12) A finding by the Board that the licensee, after
19    having the licensee's license placed on probationary
20    status has violated the terms of probation.
21        (13) Abandonment of a patient.
22        (14) Willfully making or filing false records or
23    reports in the certified anesthesiologist assistant's
24    practice, including, but not limited to, false records
25    filed with State agencies or departments.
26        (15) Willfully failing to report an instance of

 

 

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1    suspected child abuse or neglect as required by the Abused
2    and Neglected Child Reporting Act.
3        (16) Physical illness or mental illness or impairment
4    that results in the inability to practice the profession
5    with reasonable judgment, skill, or safety, including, but
6    not limited to, deterioration through the aging process or
7    loss of motor skill.
8        (17) Being named as a perpetrator in an indicated
9    report by the Department of Children and Family Services
10    under the Abused and Neglected Child Reporting Act, and
11    upon proof by clear and convincing evidence that the
12    licensee has caused a child to be an abused child or
13    neglected child as defined in the Abused and Neglected
14    Child Reporting Act.
15        (18) Gross negligence resulting in the permanent
16    injury or death of a patient.
17        (19) Employment of fraud, deception, or any unlawful
18    means in applying for or securing a license as a certified
19    anesthesiologist assistant.
20        (20) Exceeding the authority delegated to the
21    certified anesthesiologist assistant by the certified
22    anesthesiologist assistant's supervising
23    anesthesiologist.
24        (21) Immoral conduct in the commission of any act,
25    such as sexual abuse, sexual misconduct, or sexual
26    exploitation related to the licensee's practice.

 

 

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1        (22) Violation of the Health Care Worker Self-Referral
2    Act.
3        (23) Practicing under a false or assumed name, except
4    as provided by law.
5        (24) Making a false or misleading statement regarding
6    the certified anesthesiologist assistant's skill or the
7    efficacy or value of the medicine, treatment, or remedy
8    prescribed by the certified anesthesiologist assistant in
9    the course of treatment.
10        (25) Allowing another person to use the certified
11    anesthesiologist assistant's license to practice.
12        (26) Prescribing, selling, administering,
13    distributing, giving, or self-administering a drug
14    classified as a controlled substance for other than
15    medically accepted therapeutic purposes.
16        (27) Promotion of the sale of drugs, devices,
17    appliances, or goods provided for a patient in a manner to
18    exploit the patient for financial gain.
19        (28) A pattern of practice or other behavior that
20    demonstrates incapacity or incompetence to practice under
21    this Act.
22        (29) Violating State or federal laws, rules, or
23    regulations relating to controlled substances or other
24    legend drugs or ephedra as defined in the Ephedra
25    Prohibition Act.
26        (30) Failure to establish and maintain records of

 

 

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1    patient care and treatment as required by law.
2        (31) Attempting to subvert or cheat on the examination
3    of the National Commission for Certification of
4    Anesthesiologist Assistants or its successor agency.
5        (32) Willfully or negligently violating the
6    confidentiality between the certified anesthesiologist
7    assistant and patient, except as required by law.
8        (33) Willfully failing to report an instance of
9    suspected abuse, neglect, financial exploitation, or
10    self-neglect of an eligible adult as defined in and
11    required by the Adult Protective Services Act.
12        (34) Being named as an abuser in a verified report by
13    the Department on Aging under the Adult Protective
14    Services Act and upon proof by clear and convincing
15    evidence that the licensee abused, neglected, or
16    financially exploited an eligible adult as defined in the
17    Adult Protective Services Act.
18        (35) Failure to report to the Department an adverse
19    final action taken against the certified anesthesiologist
20    assistant by another licensing jurisdiction of the United
21    States or a foreign state or country, a peer review body, a
22    health care institution, a professional society or
23    association, a governmental agency, a law enforcement
24    agency, or a court for acts or conduct similar to acts or
25    conduct that would constitute grounds for action under
26    this Section.

 

 

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1        (36) Failure to provide copies of records of patient
2    care or treatment, except as required by law.
3        (37) Violating the Compassionate Use of Medical
4    Cannabis Program Act.
5    (b) The Department may, without a hearing, refuse to issue
6or renew or may suspend the license of any person who fails to
7file a return, or to pay the tax, penalty, or interest shown in
8a filed return, or to pay any final assessment of the tax,
9penalty, or interest as required by any tax Act administered
10by the Department of Revenue, until the requirements of any
11such tax Act are satisfied.
12    (c) The determination by a circuit court that a licensee
13is subject to involuntary admission or judicial admission as
14provided in the Mental Health and Developmental Disabilities
15Code operates as an automatic suspension. The suspension will
16end only upon a finding by a court that the patient is no
17longer subject to involuntary admission or judicial admission
18and issues an order so finding and discharging the patient,
19and upon the recommendation of the Board to the Secretary that
20the licensee be allowed to resume the licensee's practice.
21    (d) In enforcing this Section, the Department upon a
22showing of a possible violation may compel an individual
23licensed to practice under this Act, or who has applied for
24licensure under this Act, to submit to a mental or physical
25examination, or both, which may include a substance abuse or
26sexual offender evaluation, as required by and at the expense

 

 

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1of the Department.
2    The Department shall specifically designate the examining
3physician licensed to practice medicine in all of its branches
4or, if applicable, the multidisciplinary team involved in
5providing the mental or physical examination or both. The
6multidisciplinary team shall be led by a physician licensed to
7practice medicine in all of its branches and may consist of one
8or more or a combination of physicians licensed to practice
9medicine in all of its branches, licensed clinical
10psychologists, licensed clinical social workers, licensed
11clinical professional counselors, and other professional and
12administrative staff. Any examining physician or member of the
13multidisciplinary team may require any person ordered to
14submit to an examination pursuant to this Section to submit to
15any additional supplemental testing deemed necessary to
16complete any examination or evaluation process, including, but
17not limited to, blood testing, urinalysis, psychological
18testing, or neuropsychological testing.
19    The Department may order the examining physician or any
20member of the multidisciplinary team to provide to the
21Department any and all records, including business records,
22that relate to the examination and evaluation, including any
23supplemental testing performed.
24    The Department may order the examining physician or any
25member of the multidisciplinary team to present testimony
26concerning the mental or physical examination of the licensee

 

 

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1or applicant. No information, report, record, or other
2documents in any way related to the examination shall be
3excluded by reason of any common law or statutory privilege
4relating to communications between the licensee or applicant
5and the examining physician or any member of the
6multidisciplinary team. No authorization is necessary from the
7licensee or applicant ordered to undergo an examination for
8the examining physician or any member of the multidisciplinary
9team to provide information, reports, records, or other
10documents or to provide any testimony regarding the
11examination and evaluation.
12    The individual to be examined may have, at the
13individual's own expense, another physician of the
14individual's choice present during all aspects of this
15examination. However, that physician shall be present only to
16observe and may not interfere in any way with the examination.
17    Failure of an individual to submit to a mental or physical
18examination, when ordered, shall result in an automatic
19suspension of the individual's license until the individual
20submits to the examination.
21    If the Department finds an individual unable to practice
22because of the reasons set forth in this Section, the
23Department may require that individual to submit to care,
24counseling, or treatment by physicians approved or designated
25by the Department, as a condition, term, or restriction for
26continued, reinstated, or renewed licensure to practice; or,

 

 

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1in lieu of care, counseling, or treatment, the Department may
2file a complaint to immediately suspend, revoke, or otherwise
3discipline the license of the individual. An individual whose
4license was granted, continued, reinstated, renewed,
5disciplined, or supervised subject to such terms, conditions,
6or restrictions, and who fails to comply with such terms,
7conditions, or restrictions, shall be referred to the
8Secretary for a determination as to whether the individual
9shall have the individual's license suspended immediately,
10pending a hearing by the Department.
11    In instances in which the Secretary immediately suspends
12an individual's license under this Section, a hearing on that
13individual's license must be convened by the Department within
1430 days after the suspension and completed without appreciable
15delay. The Department shall have the authority to review the
16subject individual's record of treatment and counseling
17regarding the impairment to the extent permitted by applicable
18federal statutes and regulations safeguarding the
19confidentiality of medical records.
20    An individual licensed under this Act and affected under
21this Section shall be afforded an opportunity to demonstrate
22to the Department that the individual can resume practice in
23compliance with acceptable and prevailing standards under the
24provisions of the individual's license.
25    (e) An individual or organization acting in good faith,
26and not in a willful and wanton manner, in complying with this

 

 

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1Section by providing a report or other information to the
2Board, by assisting in the investigation or preparation of a
3report or information, by participating in proceedings of the
4Board, or by serving as a member of the Board, shall not be
5subject to criminal prosecution or civil damages as a result
6of such actions.
7    (f) Members of the Board shall be indemnified by the State
8for any actions occurring within the scope of services of the
9Board, done in good faith and not willful and wanton in nature.
10The Attorney General shall defend all such actions unless the
11Attorney General determines either that there would be a
12conflict of interest in such representation or that the
13actions complained of were not in good faith or were willful
14and wanton.
15    If the Attorney General declines representation, the
16member has the right to employ counsel of the member's choice,
17whose fees shall be provided by the State, after approval by
18the Attorney General, unless there is a determination by a
19court that the member's actions were not in good faith or were
20willful and wanton.
21    The member must notify the Attorney General within 7 days
22after receipt of notice of the initiation of any action
23involving services of the Board. Failure to so notify the
24Attorney General constitutes an absolute waiver of the right
25to a defense and indemnification.
26    The Attorney General shall determine, within 7 days after

 

 

SB2214- 25 -LRB103 06052 AMQ 51082 b

1receiving such notice, whether the Attorney General will
2undertake to represent the member.
 
3    Section 900. The Regulatory Sunset Act is amended by
4adding Section 4.43 as follows:
 
5    (5 ILCS 80/4.43 new)
6    Sec. 4.43. Act repealed on January 1, 2033. The following
7Act is repealed on January 1, 2033:
8    The Certified Anesthesiologist Assistant Practice Act.
 
9    Section 905. The Ambulatory Surgical Treatment Center Act
10is amended by changing Section 6.5 as follows:
 
11    (210 ILCS 5/6.5)
12    Sec. 6.5. Clinical privileges; advanced practice
13registered nurses. All ambulatory surgical treatment centers
14(ASTC) licensed under this Act shall comply with the following
15requirements:
16        (1) No ASTC policy, rule, regulation, or practice
17    shall be inconsistent with the provision of adequate
18    collaboration and consultation in accordance with Section
19    54.5 of the Medical Practice Act of 1987.
20        (2) Operative surgical procedures shall be performed
21    only by a physician licensed to practice medicine in all
22    its branches under the Medical Practice Act of 1987, a

 

 

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1    dentist licensed under the Illinois Dental Practice Act,
2    or a podiatric physician licensed under the Podiatric
3    Medical Practice Act of 1987, with medical staff
4    membership and surgical clinical privileges granted by the
5    consulting committee of the ASTC. A licensed physician,
6    dentist, or podiatric physician may be assisted by a
7    physician licensed to practice medicine in all its
8    branches, dentist, dental assistant, podiatric physician,
9    licensed advanced practice registered nurse, licensed
10    physician assistant, licensed registered nurse, licensed
11    practical nurse, surgical assistant, surgical technician,
12    licensed certified anesthesiologist assistant, or other
13    individuals granted clinical privileges to assist in
14    surgery by the consulting committee of the ASTC. Payment
15    for services rendered by an assistant in surgery who is
16    not an ambulatory surgical treatment center employee shall
17    be paid at the appropriate non-physician modifier rate if
18    the payor would have made payment had the same services
19    been provided by a physician.
20        (2.5) A registered nurse licensed under the Nurse
21    Practice Act and qualified by training and experience in
22    operating room nursing shall be present in the operating
23    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
26    nurse who is responsible for coordinating all nursing

 

 

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1    care, patient safety needs, and the needs of the surgical
2    team in the operating room during an invasive or operative
3    procedure.
4        (3) An advanced practice registered nurse is not
5    required to possess prescriptive authority or a written
6    collaborative agreement meeting the requirements of the
7    Nurse Practice Act to provide advanced practice registered
8    nursing services in an ambulatory surgical treatment
9    center. An advanced practice registered nurse must possess
10    clinical privileges granted by the consulting medical
11    staff committee and ambulatory surgical treatment center
12    in order to provide services. Individual advanced practice
13    registered nurses may also be granted clinical privileges
14    to order, select, and administer medications, including
15    controlled substances, to provide delineated care. The
16    attending physician must determine the advanced practice
17    registered nurse's role in providing care for his or her
18    patients, except as otherwise provided in the consulting
19    staff policies. The consulting medical staff committee
20    shall periodically review the services of advanced
21    practice registered nurses granted privileges.
22        (4) The anesthesia service shall be under the
23    direction of a physician licensed to practice medicine in
24    all its branches who has had specialized preparation or
25    experience in the area or who has completed a residency in
26    anesthesiology. An anesthesiologist, Board certified or

 

 

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1    Board eligible, is recommended. Anesthesia services may
2    only be administered pursuant to the order of a physician
3    licensed to practice medicine in all its branches,
4    licensed dentist, or licensed podiatric physician.
5            (A) The individuals who, with clinical privileges
6        granted by the medical staff and ASTC, may administer
7        anesthesia services are limited to the following:
8                (i) an anesthesiologist; or
9                (ii) a physician licensed to practice medicine
10            in all its branches; or
11                (iii) a dentist with authority to administer
12            anesthesia under Section 8.1 of the Illinois
13            Dental Practice Act; or
14                (iv) a licensed certified registered nurse
15            anesthetist; or
16                (v) a podiatric physician licensed under the
17            Podiatric Medical Practice Act of 1987; or .
18                (vi) a licensed certified anesthesiologist
19            assistant under the supervision of an
20            anesthesiologist.
21            (B) For anesthesia services, an anesthesiologist
22        shall participate through discussion of and agreement
23        with the anesthesia plan and shall remain physically
24        present and be available on the premises during the
25        delivery of anesthesia services for diagnosis,
26        consultation, and treatment of emergency medical

 

 

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1        conditions. In the absence of 24-hour availability of
2        anesthesiologists with clinical privileges, an
3        alternate policy (requiring participation, presence,
4        and availability of a physician licensed to practice
5        medicine in all its branches) shall be developed by
6        the medical staff consulting committee in consultation
7        with the anesthesia service and included in the
8        medical staff consulting committee policies.
9            (C) A certified registered nurse anesthetist is
10        not required to possess prescriptive authority or a
11        written collaborative agreement meeting the
12        requirements of Section 65-35 of the Nurse Practice
13        Act to provide anesthesia services ordered by a
14        licensed physician, dentist, or podiatric physician.
15        Licensed certified registered nurse anesthetists are
16        authorized to select, order, and administer drugs and
17        apply the appropriate medical devices in the provision
18        of anesthesia services under the anesthesia plan
19        agreed with by the anesthesiologist or, in the absence
20        of an available anesthesiologist with clinical
21        privileges, agreed with by the operating physician,
22        operating dentist, or operating podiatric physician in
23        accordance with the medical staff consulting committee
24        policies of a licensed ambulatory surgical treatment
25        center.
26(Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
 

 

 

SB2214- 30 -LRB103 06052 AMQ 51082 b

1    Section 910. The Hospital Licensing Act is amended by
2changing Section 10.7 as follows:
 
3    (210 ILCS 85/10.7)
4    Sec. 10.7. Clinical privileges; advanced practice
5registered nurses. All hospitals licensed under this Act
6shall comply with the following requirements:
7        (1) No hospital policy, rule, regulation, or practice
8    shall be inconsistent with the provision of adequate
9    collaboration and consultation in accordance with Section
10    54.5 of the Medical Practice Act of 1987.
11        (2) Operative surgical procedures shall be performed
12    only by a physician licensed to practice medicine in all
13    its branches under the Medical Practice Act of 1987, a
14    dentist licensed under the Illinois Dental Practice Act,
15    or a podiatric physician licensed under the Podiatric
16    Medical Practice Act of 1987, with medical staff
17    membership and surgical clinical privileges granted at the
18    hospital. A licensed physician, dentist, or podiatric
19    physician may be assisted by a physician licensed to
20    practice medicine in all its branches, dentist, dental
21    assistant, podiatric physician, licensed advanced practice
22    registered nurse, licensed physician assistant, licensed
23    registered nurse, licensed practical nurse, surgical
24    assistant, surgical technician, licensed certified

 

 

SB2214- 31 -LRB103 06052 AMQ 51082 b

1    anesthesiologist assistant, or other individuals granted
2    clinical privileges to assist in surgery at the hospital.
3    Payment for services rendered by an assistant in surgery
4    who is not a hospital employee shall be paid at the
5    appropriate non-physician modifier rate if the payor would
6    have made payment had the same services been provided by a
7    physician.
8        (2.5) A registered nurse licensed under the Nurse
9    Practice Act and qualified by training and experience in
10    operating room nursing shall be present in the operating
11    room and function as the circulating nurse during all
12    invasive or operative procedures. For purposes of this
13    paragraph (2.5), "circulating nurse" means a registered
14    nurse who is responsible for coordinating all nursing
15    care, patient safety needs, and the needs of the surgical
16    team in the operating room during an invasive or operative
17    procedure.
18        (3) An advanced practice registered nurse is not
19    required to possess prescriptive authority or a written
20    collaborative agreement meeting the requirements of the
21    Nurse Practice Act to provide advanced practice registered
22    nursing services in a hospital. An advanced practice
23    registered nurse must possess clinical privileges
24    recommended by the medical staff and granted by the
25    hospital in order to provide services. Individual advanced
26    practice registered nurses may also be granted clinical

 

 

SB2214- 32 -LRB103 06052 AMQ 51082 b

1    privileges to order, select, and administer medications,
2    including controlled substances, to provide delineated
3    care. The attending physician must determine the advanced
4    practice registered nurse's role in providing care for his
5    or her patients, except as otherwise provided in medical
6    staff bylaws. The medical staff shall periodically review
7    the services of advanced practice registered nurses
8    granted privileges. This review shall be conducted in
9    accordance with item (2) of subsection (a) of Section 10.8
10    of this Act for advanced practice registered nurses
11    employed by the hospital.
12        (4) The anesthesia service shall be under the
13    direction of a physician licensed to practice medicine in
14    all its branches who has had specialized preparation or
15    experience in the area or who has completed a residency in
16    anesthesiology. An anesthesiologist, Board certified or
17    Board eligible, is recommended. Anesthesia services may
18    only be administered pursuant to the order of a physician
19    licensed to practice medicine in all its branches,
20    licensed dentist, or licensed podiatric physician.
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
26            in all its branches; or

 

 

SB2214- 33 -LRB103 06052 AMQ 51082 b

1                (iii) a dentist with authority to administer
2            anesthesia under Section 8.1 of the Illinois
3            Dental Practice Act; or
4                (iv) a licensed certified registered nurse
5            anesthetist; or
6                (v) a podiatric physician licensed under the
7            Podiatric Medical Practice Act of 1987; or .
8                (vi) a licensed certified anesthesiologist
9            assistant under the supervision of an
10            anesthesiologist.
11            (B) For anesthesia services, an anesthesiologist
12        shall participate through discussion of and agreement
13        with the anesthesia plan and shall remain physically
14        present and be available on the premises during the
15        delivery of anesthesia services for diagnosis,
16        consultation, and treatment of emergency medical
17        conditions. In the absence of 24-hour availability of
18        anesthesiologists with medical staff privileges, an
19        alternate policy (requiring participation, presence,
20        and availability of a physician licensed to practice
21        medicine in all its branches) shall be developed by
22        the medical staff and licensed hospital in
23        consultation with the anesthesia service.
24            (C) A certified registered nurse anesthetist is
25        not required to possess prescriptive authority or a
26        written collaborative agreement meeting the

 

 

SB2214- 34 -LRB103 06052 AMQ 51082 b

1        requirements of Section 65-35 of the Nurse Practice
2        Act to provide anesthesia services ordered by a
3        licensed physician, dentist, or podiatric physician.
4        Licensed certified registered nurse anesthetists are
5        authorized to select, order, and administer drugs and
6        apply the appropriate medical devices in the provision
7        of anesthesia services under the anesthesia plan
8        agreed with by the anesthesiologist or, in the absence
9        of an available anesthesiologist with clinical
10        privileges, agreed with by the operating physician,
11        operating dentist, or operating podiatric physician in
12        accordance with the hospital's alternative policy.
13(Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
 
14    Section 915. The Medical Practice Act of 1987 is amended
15by changing Section 54.5 and by adding Section 54.7 as
16follows:
 
17    (225 ILCS 60/54.5)
18    (Section scheduled to be repealed on January 1, 2027)
19    Sec. 54.5. Physician delegation of authority to physician
20assistants, certified anesthesiologist assistants, advanced
21practice registered nurses without full practice authority,
22and prescribing psychologists.
23    (a) Physicians licensed to practice medicine in all its
24branches may delegate care and treatment responsibilities to a

 

 

SB2214- 35 -LRB103 06052 AMQ 51082 b

1physician assistant under guidelines in accordance with the
2requirements of the Physician Assistant Practice Act of 1987.
3A physician licensed to practice medicine in all its branches
4may enter into collaborative agreements with no more than 7
5full-time equivalent physician assistants, except in a
6hospital, hospital affiliate, or ambulatory surgical treatment
7center as set forth by Section 7.7 of the Physician Assistant
8Practice Act of 1987 and as provided in subsection (a-5).
9    (a-5) A physician licensed to practice medicine in all its
10branches may collaborate with more than 7 physician assistants
11when the services are provided in a federal primary care
12health professional shortage area with a Health Professional
13Shortage Area score greater than or equal to 12, as determined
14by the United States Department of Health and Human Services.
15    The collaborating physician must keep appropriate
16documentation of meeting this exemption and make it available
17to the Department upon request.
18    (b) A physician licensed to practice medicine in all its
19branches in active clinical practice may collaborate with an
20advanced practice registered nurse in accordance with the
21requirements of the Nurse Practice Act. Collaboration is for
22the purpose of providing medical consultation, and no
23employment relationship is required. A written collaborative
24agreement shall conform to the requirements of Section 65-35
25of the Nurse Practice Act. The written collaborative agreement
26shall be for services in the same area of practice or specialty

 

 

SB2214- 36 -LRB103 06052 AMQ 51082 b

1as the collaborating physician in his or her clinical medical
2practice. A written collaborative agreement shall be adequate
3with respect to collaboration with advanced practice
4registered nurses if all of the following apply:
5        (1) The agreement is written to promote the exercise
6    of professional judgment by the advanced practice
7    registered nurse commensurate with his or her education
8    and experience.
9        (2) The advanced practice registered nurse provides
10    services based upon a written collaborative agreement with
11    the collaborating physician, except as set forth in
12    subsection (b-5) of this Section. With respect to labor
13    and delivery, the collaborating physician must provide
14    delivery services in order to participate with a certified
15    nurse midwife.
16        (3) Methods of communication are available with the
17    collaborating physician in person or through
18    telecommunications for consultation, collaboration, and
19    referral as needed to address patient care needs.
20    (b-5) An anesthesiologist or physician licensed to
21practice medicine in all its branches may collaborate with a
22certified registered nurse anesthetist in accordance with
23Section 65-35 of the Nurse Practice Act for the provision of
24anesthesia services. With respect to the provision of
25anesthesia services, the collaborating anesthesiologist or
26physician shall have training and experience in the delivery

 

 

SB2214- 37 -LRB103 06052 AMQ 51082 b

1of anesthesia services consistent with Department rules.
2Collaboration shall be adequate if:
3        (1) an anesthesiologist or a physician participates in
4    the joint formulation and joint approval of orders or
5    guidelines and periodically reviews such orders and the
6    services provided patients under such orders; and
7        (2) for anesthesia services, the anesthesiologist or
8    physician participates through discussion of and agreement
9    with the anesthesia plan and is physically present and
10    available on the premises during the delivery of
11    anesthesia services for diagnosis, consultation, and
12    treatment of emergency medical conditions. Anesthesia
13    services in a hospital shall be conducted in accordance
14    with Section 10.7 of the Hospital Licensing Act and in an
15    ambulatory surgical treatment center in accordance with
16    Section 6.5 of the Ambulatory Surgical Treatment Center
17    Act.
18    (b-10) The anesthesiologist or operating physician must
19agree with the anesthesia plan prior to the delivery of
20services.
21    (b-15) Under delegation from a supervising
22anesthesiologist, a certified anesthesiologist assistant
23licensed under the Certified Anesthesiologist Assistant
24Practice Act is authorized to select, order, and administer
25drugs, performing skill sets within the scope of the certified
26anesthesiologist assistant's education and training, and apply

 

 

SB2214- 38 -LRB103 06052 AMQ 51082 b

1the appropriate medical devices in the provision of anesthesia
2services under the anesthesia plan agreed to by the
3supervising anesthesiologist.
4    (c) The collaborating physician shall have access to the
5medical records of all patients attended by a physician
6assistant. The collaborating physician shall have access to
7the medical records of all patients attended to by an advanced
8practice registered nurse.
9    (d) (Blank).
10    (e) A physician shall not be liable for the acts or
11omissions of a prescribing psychologist, physician assistant,
12or advanced practice registered nurse solely on the basis of
13having signed a supervision agreement or guidelines or a
14collaborative agreement, an order, a standing medical order, a
15standing delegation order, or other order or guideline
16authorizing a prescribing psychologist, physician assistant,
17or advanced practice registered nurse to perform acts, unless
18the physician has reason to believe the prescribing
19psychologist, physician assistant, or advanced practice
20registered nurse lacked the competency to perform the act or
21acts or commits willful and wanton misconduct.
22    (f) A collaborating physician may, but is not required to,
23delegate prescriptive authority to an advanced practice
24registered nurse as part of a written collaborative agreement,
25and the delegation of prescriptive authority shall conform to
26the requirements of Section 65-40 of the Nurse Practice Act.

 

 

SB2214- 39 -LRB103 06052 AMQ 51082 b

1    (g) A collaborating physician may, but is not required to,
2delegate prescriptive authority to a physician assistant as
3part of a written collaborative agreement, and the delegation
4of prescriptive authority shall conform to the requirements of
5Section 7.5 of the Physician Assistant Practice Act of 1987.
6    (h) (Blank).
7    (i) A collaborating physician shall delegate prescriptive
8authority to a prescribing psychologist as part of a written
9collaborative agreement, and the delegation of prescriptive
10authority shall conform to the requirements of Section 4.3 of
11the Clinical Psychologist Licensing Act.
12    (j) As set forth in Section 22.2 of this Act, a licensee
13under this Act may not directly or indirectly divide, share,
14or split any professional fee or other form of compensation
15for professional services with anyone in exchange for a
16referral or otherwise, other than as provided in Section 22.2.
17(Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
18100-513, eff. 1-1-18; 100-605, eff. 1-1-19; 100-863, eff.
198-14-18.)
 
20    (225 ILCS 60/54.7 new)
21    Sec. 54.7. Certified anesthesiologist assistants;
22administration of anesthesia. Nothing in this Act precludes a
23certified anesthesiologist assistant licensed under the
24Certified Anesthesiologist Assistant Practice Act from
25selecting, ordering, and administering drugs, perform skill

 

 

SB2214- 40 -LRB103 06052 AMQ 51082 b

1sets within the scope of the certified anesthesiologist
2assistant's education and training, and applying the
3appropriate medical devices in the provision of anesthesia
4services under the anesthesia plan agreed to by the
5supervising anesthesiologist licensed to practice medicine in
6this State.