Sen. Cristina Castro

Filed: 3/21/2023

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 2214

2    AMENDMENT NO. ______. Amend Senate Bill 2214 by replacing
3everything after the enacting clause with the following:
 
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

 

 

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1supervision of an anesthesiologist.
2    It is further declared to be a matter of public health and
3concern that the practice as a certified anesthesiologist
4assistant, as defined in this Act, merit and receive the
5confidence of the public and that only qualified persons be
6authorized to practice as a certified anesthesiologist
7assistant in this State. This Act shall be liberally construed
8to best carry out these subjects and purposes.
 
9    Section 10. Definitions. As used in this Act:
10    "Address of record" means the address recorded by the
11Department in the applicant's application file or the
12licensee's license file, as maintained by the Department's
13licensure maintenance unit.
14    "Anesthesiologist" means a physician licensed to practice
15medicine in all its branches by the Department who has
16completed a residency in anesthesiology approved by the
17American Board of Anesthesiology or the American Osteopathic
18Board of Anesthesiology, is board eligible or board certified,
19holds an unrestricted license, and is actively engaged in
20clinical practice.
21    "Board" means the Illinois State Medical Board constituted
22under the Medical Practice Act of 1987.
23    "Certified anesthesiologist assistant" means an individual
24licensed by the Department to provide anesthesia services
25under the supervision of an anesthesiologist.

 

 

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1    "Department" means the Department of Financial and
2Professional Regulation.
3    "Email address of record" means the designated email
4address recorded by the Department in the applicant's
5application file or the licensee's license file, as maintained
6by the Department's licensure maintenance unit.
7    "Secretary" means the Secretary of Financial and
8Professional Regulation.
9    "Supervision" means overseeing the activities of, and
10accepting responsibility for, the medical services rendered by
11the certified anesthesiologist assistant and maintaining
12physical proximity that allows the anesthesiologist to return
13to reestablish direct contact with the patient to meet medical
14needs and address any urgent or emergent clinical problems at
15all times that medical services are rendered by the certified
16anesthesiologist assistant.
 
17    Section 15. Address of record; email address of record.
18All applicants and licensees shall:
19        (1) provide a valid address and email address to the
20    Department, which shall serve as the address of record and
21    email address of record, respectively, at the time of
22    application for licensure or renewal of a license; and
23        (2) inform the Department of any change of address of
24    record or email address of record within 14 days after
25    such change either through the Department's website or by

 

 

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1    contacting the Department's licensure maintenance unit.
 
2    Section 20. Powers and duties of the Department. Subject
3to the provisions of this Act, the Department shall exercise
4the following functions, powers, and duties:
5        (1) Conduct or authorize examinations to ascertain the
6    qualifications and fitness of candidates for a license to
7    engage in the practice of certified anesthesiologist
8    assistant, pass upon the qualifications of applicants for
9    licenses, and issue licenses to those who are found to be
10    fit and qualified.
11        (2) Adopt rules required for the administration and
12    enforcement of this Act.
13        (3) Prescribe forms to be issued or electronic means
14    for the administration and enforcement of this Act and
15    rules adopted pursuant to this Act.
16        (4) Conduct investigations related to possible
17    violations of this Act and rules adopted pursuant to this
18    Act.
19        (5) Conduct hearings on proceedings to refuse to issue
20    or renew licenses or to revoke, suspend, place on
21    probation, reprimand, or otherwise discipline a license
22    under this Act or take other nondisciplinary action.
 
23    Section 25. Applicability. This Act does not prohibit:
24        (1) Any person licensed in this State under any other

 

 

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1    Act from engaging in the practice for which the person is
2    licensed.
3        (2) The practice as a certified anesthesiologist
4    assistant by a person who is employed by the United States
5    government or any bureau, division, or agency thereof
6    while in the discharge of the employee's official duties.
7        (3) The practice as a certified anesthesiologist
8    assistant that is included in the certified
9    anesthesiologist assistant's program of study by students
10    enrolled in schools.
 
11    Section 30. Title; advertising; billing.
12    (a) No certified anesthesiologist assistant shall use the
13title of doctor or associate with the licensee's name or any
14other term in the clinical setting or while in contact with
15patients under the licensee's care that would indicate to
16other persons that the licensee is qualified to engage in the
17general independent practice of anesthesiology or
18interventional pain management.
19    (b) A licensee shall include in every advertisement for
20services regulated under this Act the licensee's title as it
21appears on the license or the initials authorized under this
22Act.
23    (c) A certified anesthesiologist assistant shall not be
24allowed to bill patients or in any way charge for services.
25Nothing in this Act, however, shall be so construed as to

 

 

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1prevent the employer of a certified anesthesiologist assistant
2from charging for services rendered by the certified
3anesthesiologist assistant. Payment for services rendered by a
4certified anesthesiologist assistant shall be made to the
5certified anesthesiologist assistant's employer if the payor
6would have made payment had the services been provided by an
7anesthesiologist.
 
8    Section 35. Supervision requirements.
9    (a) As used in this Section, "supervision" means the use
10of the powers of direction and decision to coordinate, direct,
11and inspect the accomplishment of another, and to oversee the
12implementation of the anesthesiologist's intentions.
13    (b) A certified anesthesiologist assistant may deliver
14medical care only under the supervision of an anesthesiologist
15and only as described in a supervision agreement between the
16certified anesthesiologist assistant and an anesthesiologist
17who represents the certified anesthesiologist assistant's
18employer. The supervising anesthesiologist shall be
19immediately available at all times while supervising a
20certified anesthesiologist assistant. The Department shall
21establish by rule the maximum number of certified
22anesthesiologist assistants that may be supervised by the
23supervising anesthesiologist and that number shall align with
24the national standards and maximum ratio set by the Centers
25for Medicare and Medicaid Services.

 

 

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

 

 

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

 

 

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1qualified anesthesia providers an anesthesiologist may
2supervise.
3    (h) A student in an anesthesiologist assistant training
4program shall be identified as a student anesthesiologist
5assistant or an anesthesiologist assistant student and may not
6be identified as an "intern", "resident", or "fellow".
 
7    Section 40. Application for licensure. An application for
8an original license shall be made to the Department in writing
9on forms or electronically as prescribed by the Department and
10shall be accompanied by the required fee, which shall not be
11refundable. An application shall require information that, in
12the judgment of the Department, will enable the Department to
13pass on the qualifications of the applicant for a license.
14    An applicant has 3 years from the date of application to
15complete the application process. If the process has not been
16completed in 3 years, the application shall be denied, the fee
17shall be forfeited, and the applicant must reapply and meet
18the requirements in effect at the time of reapplication.
 
19    Section 45. Social security number on license application.
20In addition to any other information required to be contained
21in the application, every application for an original license
22under this Act shall include the applicant's social security
23number or federal individual taxpayer identification number,
24which shall be retained in the agency's records pertaining to

 

 

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1the license.
2    As soon as practical, the Department shall assign a
3customer's identification number to each applicant for a
4license. Every application for a renewal or restored license
5shall require the applicant's customer identification number.
 
6    Section 50. Qualifications for licensure. A person shall
7be qualified for licensure as a certified anesthesiologist
8assistant and the Department may issue a certified
9anesthesiologist assistant license to such person, if the
10person has done all of the following:
11        (1) Applied in writing or electronically in a form and
12    substance satisfactory to the Department and has not
13    violated any of the provisions of this Act or the rules
14    adopted under this Act. The Department may take into
15    consideration any felony conviction of the applicant but
16    shall deny the application if any conviction constitutes a
17    bar to licensure or is otherwise prohibited as provided by
18    law.
19        (2) Submitted evidence satisfactory to the Department
20    that the applicant has:
21            (A) obtained a master's degree in anesthesia from
22        an anesthesiologist assistant program approved by the
23        Department; and
24            (B) passed an examination approved by the
25        Department.

 

 

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1        (3) Complied with all applicable rules of the
2    Department.
 
3    Section 55. Endorsement. Upon payment of the required fee,
4the Department may, in its discretion, license as a certified
5anesthesiologist assistant any person who is a certified
6anesthesiologist assistant licensed in another jurisdiction,
7if the requirements for licensure in that jurisdiction were on
8the date of licensure either substantially equivalent to the
9requirements in force in this State on that date or equivalent
10to the requirements of this Act and the rules adopted under
11this Act and not otherwise prohibited by law.
 
12    Section 60. Criminal history records background check.
13Each applicant for licensure under Sections 40, 50, and 55
14shall have the applicant's fingerprints submitted to the
15Illinois State Police in an electronic format that complies
16with the form and manner for requesting and furnishing
17criminal history record information as prescribed by the
18Illinois State Police. These fingerprints shall be checked
19against the Illinois State Police and Federal Bureau of
20Investigation criminal history record databases now and
21hereafter filed. The Illinois State Police shall charge
22applicants a fee for conducting the criminal history records
23check, which shall be deposited into the State Police Services
24Fund and shall not exceed the actual cost of the records check.

 

 

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1The Illinois State Police shall furnish, pursuant to positive
2identification, records of Illinois convictions to the
3Department. The Department may require applicants to pay a
4separate fingerprinting fee, either to the Department or to a
5vendor designated or approved by the Department. The
6Department, in its discretion, may allow an applicant who does
7not have reasonable access to a designated vendor to provide
8the applicant's fingerprints in an alternative manner. The
9Department may adopt any rules necessary to implement this
10Section.
 
11    Section 65. Fees; deposit of fees and fines.
12    (a) The fees for the administration and enforcement of
13this Act, including, but not limited to, fees for original
14licensure, renewal, and restoration, shall be set by rule. The
15fees shall not be refundable.
16    (b) All of the fees and fines collected under this Act
17shall be deposited into the Illinois State Medical
18Disciplinary Fund and be appropriated to the Department for
19the ordinary and contingent expenses of the Department in the
20administration and enforcement of this Act.
 
21    Section 70. Checks or order to Department dishonored
22because of insufficient funds. Any person who delivers a check
23or other payment to the Department that is returned to the
24Department unpaid by the financial institution upon which it

 

 

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1is drawn shall pay to the Department, in addition to the amount
2already owed to the Department, a fine of $50. The fines
3imposed by this Section are in addition to any other
4discipline provided under this Act for unlicensed practice or
5practice on a nonrenewed license. The Department shall notify
6the person that payment of fees and fines shall be paid to the
7Department by certified check or money order within 30
8calendar days after the notification. If, after the expiration
9of 30 days after the date of the notification, the person has
10failed to submit the necessary remittance, the Department
11shall automatically terminate the license or deny the
12application, without hearing. If, after termination or denial,
13the person seeks a license, the person shall apply to the
14Department for restoration or issuance of the license and pay
15all fees and fines due to the Department. The Department may
16establish a fee for the processing of an application for
17restoration of a license to pay all expenses of processing
18this application. The Secretary may waive the fines due under
19this Section in individual cases in which the Secretary finds
20that the fines would be unreasonable or unnecessarily
21burdensome.
 
22    Section 75. Identification. No person may designate
23oneself as a certified anesthesiologist assistant, use or
24assume the title "certified anesthesiologist assistant", or
25append to the person's name the words or letters "certified

 

 

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1anesthesiologist assistant" or "C.A.A." or any other titles,
2letters, or designation that represents or may tend to
3represent the person as a certified anesthesiologist assistant
4unless the person is licensed as a certified anesthesiologist
5assistant by the Department. A certified anesthesiologist
6assistant shall be clearly identified as a certified
7anesthesiologist assistant.
 
8    Section 80. Unlicensed practice; violation; civil penalty.
9    (a) Any person who practices, offers to practice, attempts
10to practice, or holds oneself out to practice as a certified
11anesthesiologist assistant without being licensed under this
12Act shall, in addition to any other penalty provided by law,
13pay a civil penalty to the Department in an amount not to
14exceed $10,000 for each offense as determined by the
15Department. The civil penalty shall be assessed by the
16Department after a hearing is held in accordance with the
17provisions set forth in this Act regarding the provision of a
18hearing for the discipline of a licensee.
19    (b) The Department has the authority and power to
20investigate any and all unlicensed activity.
21    (c) The civil penalty shall be paid within 60 days after
22the effective date of the order imposing the civil penalty.
23The order shall constitute a judgment and may be filed and
24execution had thereon in the same manner as any judgment from
25any court of record.
 

 

 

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1    Section 85. Expiration and renewal of license. The
2expiration date and renewal period for each license issued
3under this Act shall be set by rule. Renewal shall be
4conditioned on paying the required fee and by meeting such
5other requirements as may be established by law or rule,
6including completion of continuing education.
7    Any certified anesthesiologist assistant who has permitted
8the license to expire or who has had the license on inactive
9status may have the license restored by making application to
10the Department and filing proof acceptable to the Department
11of the individual's fitness to have the license restored, and
12by paying the required fees. Proof of fitness may include
13sworn evidence certifying to active lawful practice in another
14jurisdiction.
15    If the certified anesthesiologist assistant has not
16maintained an active practice in another jurisdiction
17satisfactory to the Department, the Department shall
18determine, by an evaluation program established by rule, the
19individual's fitness for restoration of the license and shall
20establish procedures and requirements for such restoration.
21    However, any certified anesthesiologist assistant whose
22license expired while the individual was (i) in federal
23service on active duty with the Armed Forces of the United
24States, or the State Militia called into service or training,
25or (ii) in training or education under the supervision of the

 

 

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1United States preliminary to induction into the military
2service, may have the individual's license restored without
3paying any lapsed renewal fees if within 2 years after
4honorable termination of such service, training, or education
5the individual furnishes the Department with satisfactory
6evidence to the effect that the individual has been so engaged
7and that the individual's service, training, or education has
8been so terminated.
 
9    Section 90. Inactive status. Any certified
10anesthesiologist assistant who notifies the Department in
11writing on forms prescribed by the Department, may elect to
12place the license on an inactive status and shall, subject to
13rules of the Department, be excused from payment of renewal
14fees until the individual notifies the Department in writing
15of the individual's intention to restore the license.
16    Any certified anesthesiologist assistant requesting
17restoration from inactive status shall be required to pay the
18current renewal fee and shall be required to restore the
19license, as provided in Section 85.
20    Any certified anesthesiologist assistant whose license is
21in an inactive status shall not practice in this State.
22    Any certified anesthesiologist assistant who engages in
23practice while the license is lapsed or on inactive status
24shall be considered to be practicing without a license, which
25shall be grounds for discipline under Sections 80 and 95.
 

 

 

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1    Section 95. Grounds for disciplinary action.
2    (a) The Department may refuse to issue or renew, or may
3revoke, suspend, place on probation, reprimand, or take other
4disciplinary or nondisciplinary action with regard to any
5license issued under this Act as the Department may deem
6proper, including the issuance of fines not to exceed $10,000
7for each violation, for any one or a combination of the
8following causes:
9        (1) Material misstatement in furnishing information to
10    the Department.
11        (2) Violations of this Act or the rules adopted under
12    this Act.
13        (3) Conviction by plea of guilty or nolo contendere,
14    finding of guilt, jury verdict, or entry of judgment or
15    sentencing, including, but not limited to, convictions,
16    preceding sentences of supervision, conditional discharge,
17    or first offender probation, under the laws of any
18    jurisdiction of the United States that is: (i) a felony;
19    or (ii) a misdemeanor an essential element of which is
20    dishonesty or that is directly related to the practice of
21    the profession.
22        (4) Making any misrepresentation for the purpose of
23    obtaining licenses.
24        (5) Professional incompetence.
25        (6) Aiding or assisting another person in violating

 

 

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1    any provision of this Act or its rules.
2        (7) Failing, within 60 days, to provide information in
3    response to a written request made by the Department.
4        (8) Engaging in dishonorable, unethical, or
5    unprofessional conduct, as defined by rule, of a character
6    likely to deceive, defraud, or harm the public.
7        (9) Habitual or excessive use or addiction to alcohol,
8    narcotics, stimulants, or any other chemical agent or drug
9    that results in a certified anesthesiologist assistant's
10    inability to practice with reasonable judgment, skill, or
11    safety.
12        (10) Discipline by another U.S. jurisdiction or
13    foreign nation, if at least one of the grounds for
14    discipline is the same or substantially equivalent to
15    those set forth in this Section.
16        (11) Directly or indirectly giving to or receiving
17    from any person, firm, corporation, partnership, or
18    association any fee, commission, rebate, or other form of
19    compensation for any professional services not actually or
20    personally rendered. Nothing in this paragraph affects any
21    bona fide independent contractor or employment
22    arrangements, which may include provisions for
23    compensation, health insurance, pension, or other
24    employment benefits, with persons or entities authorized
25    under this Act for the provision of services within the
26    scope of the licensee's practice under this Act.

 

 

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1        (12) A finding by the Board that the licensee, after
2    having the licensee's license placed on probationary
3    status has violated the terms of probation.
4        (13) Abandonment of a patient.
5        (14) Willfully making or filing false records or
6    reports in the certified anesthesiologist assistant's
7    practice, including, but not limited to, false records
8    filed with State agencies or departments.
9        (15) Willfully failing to report an instance of
10    suspected child abuse or neglect as required by the Abused
11    and Neglected Child Reporting Act.
12        (16) Physical illness or mental illness or impairment
13    that results in the inability to practice the profession
14    with reasonable judgment, skill, or safety, including, but
15    not limited to, deterioration through the aging process or
16    loss of motor skill.
17        (17) Being named as a perpetrator in an indicated
18    report by the Department of Children and Family Services
19    under the Abused and Neglected Child Reporting Act, and
20    upon proof by clear and convincing evidence that the
21    licensee has caused a child to be an abused child or
22    neglected child as defined in the Abused and Neglected
23    Child Reporting Act.
24        (18) Gross negligence resulting in the permanent
25    injury or death of a patient.
26        (19) Employment of fraud, deception, or any unlawful

 

 

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1    means in applying for or securing a license as a certified
2    anesthesiologist assistant.
3        (20) Exceeding the authority delegated to the
4    certified anesthesiologist assistant by the certified
5    anesthesiologist assistant's supervising
6    anesthesiologist.
7        (21) Immoral conduct in the commission of any act,
8    such as sexual abuse, sexual misconduct, or sexual
9    exploitation related to the licensee's practice.
10        (22) Violation of the Health Care Worker Self-Referral
11    Act.
12        (23) Practicing under a false or assumed name, except
13    as provided by law.
14        (24) Making a false or misleading statement regarding
15    the certified anesthesiologist assistant's skill or the
16    efficacy or value of the medicine, treatment, or remedy
17    prescribed by the certified anesthesiologist assistant in
18    the course of treatment.
19        (25) Allowing another person to use the certified
20    anesthesiologist assistant's license to practice.
21        (26) Prescribing, selling, administering,
22    distributing, giving, or self-administering a drug
23    classified as a controlled substance for other than
24    medically accepted therapeutic purposes.
25        (27) Promotion of the sale of drugs, devices,
26    appliances, or goods provided for a patient in a manner to

 

 

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1    exploit the patient for financial gain.
2        (28) A pattern of practice or other behavior that
3    demonstrates incapacity or incompetence to practice under
4    this Act.
5        (29) Violating State or federal laws, rules, or
6    regulations relating to controlled substances or other
7    legend drugs or ephedra as defined in the Ephedra
8    Prohibition Act.
9        (30) Failure to establish and maintain records of
10    patient care and treatment as required by law.
11        (31) Attempting to subvert or cheat on the designated
12    examination for licensure.
13        (32) Willfully or negligently violating the
14    confidentiality between the certified anesthesiologist
15    assistant and patient, except as required by law.
16        (33) Willfully failing to report an instance of
17    suspected abuse, neglect, financial exploitation, or
18    self-neglect of an eligible adult as defined in and
19    required by the Adult Protective Services Act.
20        (34) Being named as an abuser in a verified report by
21    the Department on Aging under the Adult Protective
22    Services Act and upon proof by clear and convincing
23    evidence that the licensee abused, neglected, or
24    financially exploited an eligible adult as defined in the
25    Adult Protective Services Act.
26        (35) Failure to report to the Department an adverse

 

 

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1    final action taken against the certified anesthesiologist
2    assistant by another licensing jurisdiction of the United
3    States or a foreign state or country, a peer review body, a
4    health care institution, a professional society or
5    association, a governmental agency, a law enforcement
6    agency, or a court for acts or conduct similar to acts or
7    conduct that would constitute grounds for action under
8    this Section.
9        (36) Failure to provide copies of records of patient
10    care or treatment, except as required by law.
11        (37) Violating the Compassionate Use of Medical
12    Cannabis Program Act.
13    (b) The Department may, without a hearing, refuse to issue
14or renew or may suspend the license of any person who (i) fails
15to file a return, or to pay the tax, penalty, or interest shown
16in a filed return, or to pay any final assessment of the tax,
17penalty, or interest as required by any tax Act administered
18by the Department of Revenue, until the requirements of any
19such tax Act are satisfied or (ii) fails to pay any
20court-ordered child support as determined by a court order or
21by referral from the Department of Healthcare and Family
22Services, until the requirements of any such court order are
23satisfied.
24    (c) The determination by a circuit court that a licensee
25is subject to involuntary admission or judicial admission as
26provided in the Mental Health and Developmental Disabilities

 

 

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1Code operates as an automatic suspension. The suspension will
2end only upon a finding by a court that the patient is no
3longer subject to involuntary admission or judicial admission
4and issues an order so finding and discharging the patient,
5and upon the recommendation of the Board to the Secretary that
6the licensee be allowed to resume the licensee's practice.
7    (d) In enforcing this Section, the Department upon a
8showing of a possible violation may compel an individual
9licensed to practice under this Act, or who has applied for
10licensure under this Act, to submit to a mental or physical
11examination, or both, which may include a substance abuse or
12sexual offender evaluation, as required by and at the expense
13of the Department.
14    The Department shall specifically designate the examining
15physician licensed to practice medicine in all of its branches
16or, if applicable, the multidisciplinary team involved in
17providing the mental or physical examination or both. The
18multidisciplinary team shall be led by a physician licensed to
19practice medicine in all of its branches and may consist of one
20or more or a combination of physicians licensed to practice
21medicine in all of its branches, licensed clinical
22psychologists, licensed clinical social workers, licensed
23clinical professional counselors, and other professional and
24administrative staff. Any examining physician or member of the
25multidisciplinary team may require any person ordered to
26submit to an examination pursuant to this Section to submit to

 

 

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1any additional supplemental testing deemed necessary to
2complete any examination or evaluation process, including, but
3not limited to, blood testing, urinalysis, psychological
4testing, or neuropsychological testing.
5    The Department may order the examining physician or any
6member of the multidisciplinary team to provide to the
7Department any and all records, including business records,
8that relate to the examination and evaluation, including any
9supplemental testing performed.
10    The Department may order the examining physician or any
11member of the multidisciplinary team to present testimony
12concerning the mental or physical examination of the licensee
13or applicant. No information, report, record, or other
14documents in any way related to the examination shall be
15excluded by reason of any common law or statutory privilege
16relating to communications between the licensee or applicant
17and the examining physician or any member of the
18multidisciplinary team. No authorization is necessary from the
19licensee or applicant ordered to undergo an examination for
20the examining physician or any member of the multidisciplinary
21team to provide information, reports, records, or other
22documents or to provide any testimony regarding the
23examination and evaluation.
24    The individual to be examined may have, at the
25individual's own expense, another physician of the
26individual's choice present during all aspects of this

 

 

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1examination. However, that physician shall be present only to
2observe and may not interfere in any way with the examination.
3    Failure of an individual to submit to a mental or physical
4examination, when ordered, shall result in an automatic
5suspension of the individual's license until the individual
6submits to the examination.
7    If the Department finds an individual unable to practice
8because of the reasons set forth in this Section, the
9Department may require that individual to submit to care,
10counseling, or treatment by physicians approved or designated
11by the Department, as a condition, term, or restriction for
12continued, reinstated, or renewed licensure to practice; or,
13in lieu of care, counseling, or treatment, the Department may
14file a complaint to immediately suspend, revoke, or otherwise
15discipline the license of the individual. An individual whose
16license was granted, continued, reinstated, renewed,
17disciplined, or supervised subject to such terms, conditions,
18or restrictions, and who fails to comply with such terms,
19conditions, or restrictions, shall be referred to the
20Secretary for a determination as to whether the individual
21shall have the individual's license suspended immediately,
22pending a hearing by the Department.
23    In instances in which the Secretary immediately suspends
24an individual's license under this Section, a hearing on that
25individual's license must be convened by the Department within
2630 days after the suspension and completed without appreciable

 

 

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1delay. The Department shall have the authority to review the
2subject individual's record of treatment and counseling
3regarding the impairment to the extent permitted by applicable
4federal statutes and regulations safeguarding the
5confidentiality of medical records.
6    An individual licensed under this Act and affected under
7this Section shall be afforded an opportunity to demonstrate
8to the Department that the individual can resume practice in
9compliance with acceptable and prevailing standards under the
10provisions of the individual's license.
11    (e) An individual or organization acting in good faith,
12and not in a willful and wanton manner, in complying with this
13Section by providing a report or other information to the
14Board, by assisting in the investigation or preparation of a
15report or information, by participating in proceedings of the
16Board, or by serving as a member of the Board, shall not be
17subject to criminal prosecution or civil damages as a result
18of such actions.
19    (f) Members of the Board shall be indemnified by the State
20for any actions occurring within the scope of services of the
21Board, done in good faith and not willful and wanton in nature.
22The Attorney General shall defend all such actions unless the
23Attorney General determines either that there would be a
24conflict of interest in such representation or that the
25actions complained of were not in good faith or were willful
26and wanton.

 

 

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1    If the Attorney General declines representation, the
2member has the right to employ counsel of the member's choice,
3whose fees shall be provided by the State, after approval by
4the Attorney General, unless there is a determination by a
5court that the member's actions were not in good faith or were
6willful and wanton.
7    The member must notify the Attorney General within 7 days
8after receipt of notice of the initiation of any action
9involving services of the Board. Failure to so notify the
10Attorney General constitutes an absolute waiver of the right
11to a defense and indemnification.
12    The Attorney General shall determine, within 7 days after
13receiving such notice, whether the Attorney General will
14undertake to represent the member.
 
15    Section 100. Continuing education. The Department shall
16adopt rules for continuing education for persons licensed
17under this Act. The continuing education rules shall ensure
18that licensees are given the opportunity to participate in
19programs sponsored by or through their State or national
20professional organizations, hospitals, or other providers of
21continuing education. The rules shall also address waivers in
22part or in whole for good cause, including, but not limited to,
23illness or hardship. Each licensee is responsible for
24maintaining records of completion of continuing education and
25shall be prepared to produce the records when requested by the

 

 

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1Department.
 
2    Section 105. Violations; injunction; cease and desist
3order.
4    (a) If any person violates the provisions of this Act, the
5Secretary may, in the name of the People of the State of
6Illinois, through the Attorney General, petition for an order
7enjoining such violation or for an order enforcing compliance
8with this Act. Upon the filing of a verified petition, the
9court with appropriate jurisdiction may issue a temporary
10restraining order without notice or bond, and may
11preliminarily and permanently enjoin such violation. If it is
12established that such person has violated or is violating the
13injunction, the court may punish the offender for contempt of
14court. Proceedings under this Section shall be in addition to
15all other remedies and penalties provided by this Act.
16    (b) Whenever, in the opinion of the Department, a person
17violates any provision of this Act, the Department may issue a
18rule to show cause why an order to cease and desist should not
19be entered against such person. The rule shall clearly set
20forth the grounds relied upon by the Department and shall
21allow at least 7 days from the date of the rule to file an
22answer satisfactory to the Department. Failure to answer to
23the satisfaction of the Department shall cause an order to
24cease and desist to be issued.
 

 

 

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1    Section 110. Investigations; notice and hearing.
2    (a) The Department may investigate the actions of any
3applicant or of any person holding or claiming to hold a
4license under this Act.
5    (b) The Department shall, before disciplining an applicant
6or licensee, at least 30 days prior to the date set for the
7hearing: (i) notify, in writing, the accused of the charges
8made and the time and place for the hearing on the charges,
9(ii) direct the person to file a written answer to the charges
10under oath within 20 days after the service of the notice, and
11(iii) inform the applicant or licensee that failure to file an
12answer will result in a default being entered against the
13applicant or licensee.
14    (c) Written or electronic notice, and any notice in the
15subsequent proceeding, may be served by personal delivery, by
16email, or by mail to the applicant or licensee at the
17applicant's or licensee's address of record or email address
18of record.
19    (d) At the time and place fixed in the notice, the Board or
20hearing officer appointed by the Secretary shall proceed to
21hear the charges and the parties or their counsel shall be
22accorded ample opportunity to present any statements,
23testimony, evidence, and argument as may be pertinent to the
24charges or to their defense. The Board or hearing officer may
25continue the hearing from time to time.
26    (e) In case the person, after receiving the notice, fails

 

 

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1to file an answer, the person's license may, in the discretion
2of the Secretary, having first received the recommendation of
3the Board, be suspended, revoked, or placed on probationary
4status, or be subject to whatever disciplinary action the
5Secretary deems proper, including limiting the scope, nature,
6or extent of the person's practice or the imposition of a fine,
7without hearing, if the act or acts charged constitute
8sufficient grounds for that action under the Act.
 
9    Section 115. Record of proceedings; transcript. The
10Department, at its expense, shall preserve a record of all
11proceedings at the formal hearing of any case. The notice of
12hearing, complaint, all other documents in the nature of
13pleadings, written motions filed in the proceedings, the
14transcript of testimony, the report of the Board, and orders
15of the Department shall be in the record of such proceeding.
16The Department shall furnish a copy of the record to any person
17upon payment of the fee required under Section 2105-115 of the
18Department of Professional Regulation Law.
 
19    Section 120. Subpoenas; depositions; oaths. The Department
20shall have the power to subpoena and to bring before it any
21person and to take testimony either orally or by deposition,
22or both, with the same fees and mileage and in the same manner
23as prescribed in civil cases in the courts of this State.
24    The Secretary, the designated hearing officer, and every

 

 

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1member of the Board shall have power to administer oaths to
2witnesses at any hearing which the Department is authorized to
3conduct, and any other oath authorized in any Act administered
4by the Department.
 
5    Section 125. Compelling testimony. Any court, upon
6application of the Department, designated hearing officer, or
7the applicant or licensee against whom proceedings under this
8Act are pending, may enter an order requiring the attendance
9of witnesses and their testimony, and the production of
10papers, files, books, and records in connection with any
11hearing or investigation. The court may compel obedience to
12its order by proceedings for contempt.
 
13    Section 130. Findings and recommendations. At the
14conclusion of the hearing, the Board shall present to the
15Secretary a written report of its findings of fact,
16conclusions of law, and recommendations. The report shall
17contain a finding whether or not the licensee violated this
18Act or failed to comply with the conditions required in this
19Act. The Board shall specify the nature of the violation or
20failure to comply, and shall make its recommendations to the
21Secretary.
 
22    Section 135. Hearing; motion for rehearing.
23    (a) The Board or hearing officer appointed by the

 

 

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1Secretary shall hear evidence in support of the formal charges
2and evidence produced by the licensee. At the conclusion of
3the hearing, the Board shall present to the Secretary a
4written report of its findings of fact, conclusions of law,
5and recommendations.
6    (b) At the conclusion of the hearing, a copy of the hearing
7officer's or Board's report shall be served upon the applicant
8or licensee by the Department, either personally or as
9provided in this Act for the service of the notice of hearing.
10Within 20 calendar days after service, the applicant or
11licensee may present to the Secretary a motion in writing for a
12rehearing which shall specify the particular grounds for
13rehearing. The Department may respond to the motion for
14rehearing within 20 calendar days after its service on the
15Department. If no motion for rehearing is filed, then upon the
16expiration of the time specified for filing such a motion, or
17upon denial of a motion for rehearing, the Secretary may enter
18an order in accordance with the recommendations of the Board
19or hearing officer. If the applicant or licensee orders from
20the reporting service and pays for a transcript of the record
21within the time for filing a motion for rehearing, the 20-day
22period within which a motion may be filed shall commence upon
23the delivery of the transcript to the applicant or licensee.
24    (c) If the Secretary disagrees in any regard with the
25report of the Board, the Secretary may issue an order contrary
26to the report.

 

 

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1    (d) Whenever the Secretary is not satisfied that
2substantial justice has been done, the Secretary may order a
3rehearing by the same or another hearing officer.
4    (e) At any point in any investigation or disciplinary
5proceeding provided for in this Act, both parties may agree to
6a negotiated consent order. The consent order shall be final
7upon signature of the Secretary.
 
8    Section 140. Appointment of a hearing officer.
9Notwithstanding any other provision of this Act, the Secretary
10has the authority to appoint any attorney duly licensed to
11practice law in the State of Illinois to serve as the hearing
12officer in any action for refusal to issue or renew a license
13or to discipline a licensee. The hearing officer shall have
14full authority to conduct the hearing. The hearing officer
15shall report the hearing officer's findings of fact,
16conclusions of law, and recommendations to the Board.
 
17    Section 145. Order or certified copy thereof; prima facie
18proof. An order or a certified copy thereof, over the seal of
19the Department and purporting to be signed by the Secretary,
20shall be prima facie proof that:
21        (1) such signature is the genuine signature of the
22    Secretary;
23        (2) such Secretary is duly appointed and qualified;
24    and

 

 

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1        (3) the Board and the members thereof are qualified to
2    act.
 
3    Section 150. Restoration. At any time after the successful
4completion of the minimum term of probation, suspension, or
5revocation of any license, the Department may restore the
6license to the licensee upon the written recommendation of the
7Board unless after an investigation and hearing the Board or
8Secretary determines that restoration is not in the public
9interest. Where circumstances of suspension or revocation so
10indicate, the Secretary may require an examination of the
11licensee prior to restoring the license. No person whose
12license has been revoked as authorized in this Act may apply
13for restoration of that license until such time as provided
14for in the Civil Administrative Code of Illinois.
 
15    Section 155. Surrender of license. Upon the revocation or
16suspension of any license, the licensee shall immediately
17surrender the license to the Department. If the licensee fails
18to do so, the Department shall have the right to seize the
19license.
 
20    Section 160. Summary suspension of a license. The
21Secretary may summarily suspend the license of a certified
22anesthesiologist assistant without a hearing simultaneously
23with the institution of proceedings for a hearing provided for

 

 

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1in this Act if the Secretary finds that evidence in the
2Secretary's possession indicates that a licensee's
3continuation in practice would constitute an imminent danger
4to the public. In the event the Secretary summarily suspends
5such license without a hearing, a hearing by the Board or
6hearing officer shall be commenced within 30 calendar days
7after the suspension has occurred.
 
8    Section 165. Administrative review.
9    (a) All final administrative decisions of the Secretary
10are subject to judicial review pursuant to the Administrative
11Review Law and all rules adopted pursuant thereto. The term
12"administrative decision" is defined as in Section 3-101 of
13the Code of Civil Procedure.
14    (b) Proceedings for judicial review shall be commenced in
15the circuit court of the county in which the party applying for
16review resides, but if the party is not a resident of Illinois,
17the venue shall be in Sangamon County.
 
18    Section 170. Certification of record; costs. The
19Department shall not be required to certify any record to the
20court, to file an answer in court, or to otherwise appear in
21any court in a judicial review proceeding, unless and until
22the Department has received from the plaintiff payment of the
23cost of furnishing and certifying the record, which costs
24shall be determined by the Department. Failure on the part of

 

 

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1the plaintiff to file a receipt in court shall be grounds for
2dismissal of the action.
 
3    Section 175. Confidentiality. All information collected by
4the Department in the course of an examination or
5investigation of a licensee or applicant, including, but not
6limited to, any complaint against a licensee filed with the
7Department and information collected to investigate any such
8complaint, shall be maintained for the confidential use of the
9Department and shall not be disclosed. The Department may not
10disclose the information to anyone other than law enforcement
11officials, other regulatory agencies that have an appropriate
12regulatory interest as determined by the Secretary, or a party
13presenting a lawful subpoena to the Department. Information
14and documents disclosed to a federal, State, county, or local
15law enforcement agency shall not be disclosed by the agency
16for any purpose to any other agency or person. A formal
17complaint filed against a licensee by the Department or any
18order issued by the Department against a licensee or applicant
19shall be a public record, except as otherwise prohibited by
20law.
 
21    Section 180. Illinois Administrative Procedure Act. The
22Illinois Administrative Procedure Act is hereby expressly
23adopted and incorporated herein as if all of the provisions of
24that Act were included in this Act, except that the provision

 

 

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1of subsection (d) of Section 10-65 of the Illinois
2Administrative Procedure Act that provides that at hearings
3the licensee has the right to show compliance with all lawful
4requirements for retention, continuation, or renewal of the
5license is specifically excluded.
 
6    Section 185. Home rule. It is declared to be the public
7policy of this State, pursuant to paragraph (h) of Section 6 of
8Article VII of the Illinois Constitution of 1970, that any
9power or function set forth in this Act to be exercised by the
10State is an exclusive State power or function. Such power or
11function shall not be exercised concurrently, either directly
12or indirectly, by any unit of local government, including home
13rule units, except as otherwise provided in this Act.
 
14    "Section 900. The Regulatory Sunset Act is amended by
15changing Section 4.38 as follows:
 
16    (5 ILCS 80/4.38)
17    Sec. 4.38. Acts repealed on January 1, 2028. The following
18Acts are repealed on January 1, 2028:
19    The Acupuncture Practice Act.
20    The Behavior Analyst Licensing Act.
21    The Certified Anesthesiologist Assistant Practice Act.
22    The Clinical Social Work and Social Work Practice Act.
23    The Dietitian Nutritionist Practice Act.

 

 

10300SB2214sam002- 38 -LRB103 06052 SPS 59616 a

1    The Elevator Safety and Regulation Act.
2    The Fire Equipment Distributor and Employee Regulation Act
3of 2011.
4    The Funeral Directors and Embalmers Licensing Code.
5    The Home Medical Equipment and Services Provider License
6Act.
7    The Illinois Petroleum Education and Marketing Act.
8    The Illinois Speech-Language Pathology and Audiology
9Practice Act.
10    The Interpreter for the Deaf Licensure Act of 2007.
11    The Music Therapy Licensing and Practice Act.
12    The Naprapathic Practice Act.
13    The Nurse Practice Act.
14    The Nursing Home Administrators Licensing and Disciplinary
15Act.
16    The Pharmacy Practice Act.
17    The Physician Assistant Practice Act of 1987.
18    The Podiatric Medical Practice Act of 1987.
19    The Professional Counselor and Clinical Professional
20Counselor Licensing and Practice Act.
21    The Wholesale Drug Distribution Licensing Act.
22(Source: P.A. 102-715, eff. 4-29-22; 102-878, eff. 5-13-22;
23102-879, eff. 5-13-22; 102-880, eff. 5-13-22; 102-881, eff.
245-13-22; 102-882, eff. 5-13-22; 102-945, eff. 5-27-22;
25102-953, eff. 5-27-22; 102-993, eff. 5-27-22; revised
267-27-22.)".
 

 

 

10300SB2214sam002- 39 -LRB103 06052 SPS 59616 a

1    Section 905. The Ambulatory Surgical Treatment Center Act
2is amended by changing Section 6.5 as follows:
 
3    (210 ILCS 5/6.5)
4    Sec. 6.5. Clinical privileges; advanced practice
5registered nurses. All ambulatory surgical treatment centers
6(ASTC) licensed under this Act shall comply with the following
7requirements:
8        (1) No ASTC policy, rule, regulation, or practice
9    shall be inconsistent with the provision of adequate
10    collaboration and consultation in accordance with Section
11    54.5 of the Medical Practice Act of 1987.
12        (2) Operative surgical procedures shall be performed
13    only by a physician licensed to practice medicine in all
14    its branches under the Medical Practice Act of 1987, a
15    dentist licensed under the Illinois Dental Practice Act,
16    or a podiatric physician licensed under the Podiatric
17    Medical Practice Act of 1987, with medical staff
18    membership and surgical clinical privileges granted by the
19    consulting committee of the ASTC. A licensed physician,
20    dentist, or podiatric physician may be assisted by a
21    physician licensed to practice medicine in all its
22    branches, dentist, dental assistant, podiatric physician,
23    licensed advanced practice registered nurse, licensed
24    physician assistant, licensed registered nurse, licensed

 

 

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

 

 

10300SB2214sam002- 41 -LRB103 06052 SPS 59616 a

1    staff committee and ambulatory surgical treatment center
2    in order to provide services. Individual advanced practice
3    registered nurses may also be granted clinical privileges
4    to order, select, and administer medications, including
5    controlled substances, to provide delineated care. The
6    attending physician must determine the advanced practice
7    registered nurse's role in providing care for his or her
8    patients, except as otherwise provided in the consulting
9    staff policies. The consulting medical staff committee
10    shall periodically review the services of advanced
11    practice registered nurses granted privileges.
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 by the medical staff and ASTC, may administer
23        anesthesia 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

 

 

10300SB2214sam002- 42 -LRB103 06052 SPS 59616 a

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 clinical 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 consulting committee in consultation
23        with the anesthesia service and included in the
24        medical staff consulting committee policies.
25            (C) A certified registered nurse anesthetist is
26        not required to possess prescriptive authority or a

 

 

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1        written collaborative agreement meeting the
2        requirements of Section 65-35 of the Nurse Practice
3        Act to provide anesthesia services ordered by a
4        licensed physician, dentist, or podiatric physician.
5        Licensed certified registered nurse anesthetists are
6        authorized to select, order, and administer drugs and
7        apply the appropriate medical devices in the provision
8        of anesthesia services under the anesthesia plan
9        agreed with by the anesthesiologist or, in the absence
10        of an available anesthesiologist with clinical
11        privileges, agreed with by the operating physician,
12        operating dentist, or operating podiatric physician in
13        accordance with the medical staff consulting committee
14        policies of a licensed ambulatory surgical treatment
15        center.
16(Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
 
17    Section 910. The Hospital Licensing Act is amended by
18changing Section 10.7 as follows:
 
19    (210 ILCS 85/10.7)
20    Sec. 10.7. Clinical privileges; advanced practice
21registered nurses. All hospitals licensed under this Act
22shall comply with the following requirements:
23        (1) No hospital policy, rule, regulation, or practice
24    shall be inconsistent with the provision of adequate

 

 

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1    collaboration and consultation in accordance with Section
2    54.5 of the Medical Practice Act of 1987.
3        (2) Operative surgical procedures shall be performed
4    only by a physician licensed to practice medicine in all
5    its branches under the Medical Practice Act of 1987, a
6    dentist licensed under the Illinois Dental Practice Act,
7    or a podiatric physician licensed under the Podiatric
8    Medical Practice Act of 1987, with medical staff
9    membership and surgical clinical privileges granted at the
10    hospital. A licensed physician, dentist, or podiatric
11    physician may be assisted by a physician licensed to
12    practice medicine in all its branches, dentist, dental
13    assistant, podiatric physician, licensed advanced practice
14    registered nurse, licensed physician assistant, licensed
15    registered nurse, licensed practical nurse, surgical
16    assistant, surgical technician, licensed certified
17    anesthesiologist assistant, or other individuals granted
18    clinical privileges to assist in surgery at the hospital.
19    Payment for services rendered by an assistant in surgery
20    who is not a hospital employee shall be paid at the
21    appropriate non-physician modifier rate if the payor would
22    have made payment had the same services been provided by a
23    physician.
24        (2.5) A registered nurse licensed under the Nurse
25    Practice Act and qualified by training and experience in
26    operating room nursing shall be present in the operating

 

 

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1    room and function as the circulating nurse during all
2    invasive or operative procedures. For purposes of this
3    paragraph (2.5), "circulating nurse" means a registered
4    nurse who is responsible for coordinating all nursing
5    care, patient safety needs, and the needs of the surgical
6    team in the operating room during an invasive or operative
7    procedure.
8        (3) An advanced practice registered nurse is not
9    required to possess prescriptive authority or a written
10    collaborative agreement meeting the requirements of the
11    Nurse Practice Act to provide advanced practice registered
12    nursing services in a hospital. An advanced practice
13    registered nurse must possess clinical privileges
14    recommended by the medical staff and granted by the
15    hospital in order to provide services. Individual advanced
16    practice registered nurses may also be granted clinical
17    privileges to order, select, and administer medications,
18    including controlled substances, to provide delineated
19    care. The attending physician must determine the advanced
20    practice registered nurse's role in providing care for his
21    or her patients, except as otherwise provided in medical
22    staff bylaws. The medical staff shall periodically review
23    the services of advanced practice registered nurses
24    granted privileges. This review shall be conducted in
25    accordance with item (2) of subsection (a) of Section 10.8
26    of this Act for advanced practice registered nurses

 

 

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1    employed by the hospital.
2        (4) The anesthesia service shall be under the
3    direction of a physician licensed to practice medicine in
4    all its branches who has had specialized preparation or
5    experience in the area or who has completed a residency in
6    anesthesiology. An anesthesiologist, Board certified or
7    Board eligible, is recommended. Anesthesia services may
8    only be administered pursuant to the order of a physician
9    licensed to practice medicine in all its branches,
10    licensed dentist, or licensed podiatric physician.
11            (A) The individuals who, with clinical privileges
12        granted at the hospital, may administer anesthesia
13        services are limited to the following:
14                (i) an anesthesiologist; or
15                (ii) a physician licensed to practice medicine
16            in all its branches; or
17                (iii) a dentist with authority to administer
18            anesthesia under Section 8.1 of the Illinois
19            Dental Practice Act; or
20                (iv) a licensed certified registered nurse
21            anesthetist; or
22                (v) a podiatric physician licensed under the
23            Podiatric Medical Practice Act of 1987; or .
24                (vi) a licensed certified anesthesiologist
25            assistant under the supervision of an
26            anesthesiologist.

 

 

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1            (B) For anesthesia services, an anesthesiologist
2        shall participate through discussion of and agreement
3        with the anesthesia plan and shall remain physically
4        present and be available on the premises during the
5        delivery of anesthesia services for diagnosis,
6        consultation, and treatment of emergency medical
7        conditions. In the absence of 24-hour availability of
8        anesthesiologists with medical staff privileges, an
9        alternate policy (requiring participation, presence,
10        and availability of a physician licensed to practice
11        medicine in all its branches) shall be developed by
12        the medical staff and licensed hospital in
13        consultation with the anesthesia service.
14            (C) A certified registered nurse anesthetist is
15        not required to possess prescriptive authority or a
16        written collaborative agreement meeting the
17        requirements of Section 65-35 of the Nurse Practice
18        Act to provide anesthesia services ordered by a
19        licensed physician, dentist, or podiatric physician.
20        Licensed certified registered nurse anesthetists are
21        authorized to select, order, and administer drugs and
22        apply the appropriate medical devices in the provision
23        of anesthesia services under the anesthesia plan
24        agreed with by the anesthesiologist or, in the absence
25        of an available anesthesiologist with clinical
26        privileges, agreed with by the operating physician,

 

 

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1        operating dentist, or operating podiatric physician in
2        accordance with the hospital's alternative policy.
3(Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
 
4    Section 915. The Medical Practice Act of 1987 is amended
5by changing Sections 7.1 and 54.5 and by adding Section 54.7 as
6follows:
 
7    (225 ILCS 60/7.1)
8    (Section scheduled to be repealed on January 1, 2027)
9    Sec. 7.1. Medical Board.
10    (A) There is hereby created the Illinois State Medical
11Board. The Medical Board shall consist of 18 17 members, to be
12appointed by the Governor by and with the advice and consent of
13the Senate. All members shall be residents of the State, not
14more than 9 8 of whom shall be members of the same political
15party. All members shall be voting members. Eight members
16shall be physicians licensed to practice medicine in all of
17its branches in Illinois possessing the degree of doctor of
18medicine. Two members shall be physicians licensed to practice
19medicine in all its branches in Illinois possessing the degree
20of doctor of osteopathy or osteopathic medicine. Two of the
21physician members shall be physicians who collaborate with
22physician assistants. Two members shall be chiropractic
23physicians licensed to practice in Illinois and possessing the
24degree of doctor of chiropractic. Two members shall be

 

 

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1physician assistants licensed to practice in Illinois. One
2member shall be a certified anesthesiologist assistant
3licensed to practice in Illinois. Three members shall be
4members of the public, who shall not be engaged in any way,
5directly or indirectly, as providers of health care.
6    (B) Members of the Medical Board shall be appointed for
7terms of 4 years. Upon the expiration of the term of any
8member, their successor shall be appointed for a term of 4
9years by the Governor by and with the advice and consent of the
10Senate. The Governor shall fill any vacancy for the remainder
11of the unexpired term with the advice and consent of the
12Senate. Upon recommendation of the Medical Board, any member
13of the Medical Board may be removed by the Governor for
14misfeasance, malfeasance, or willful neglect of duty, after
15notice, and a public hearing, unless such notice and hearing
16shall be expressly waived in writing. Each member shall serve
17on the Medical Board until their successor is appointed and
18qualified. No member of the Medical Board shall serve more
19than 2 consecutive 4-year terms.
20    In making appointments the Governor shall attempt to
21ensure that the various social and geographic regions of the
22State of Illinois are properly represented.
23    In making the designation of persons to act for the
24several professions represented on the Medical Board, the
25Governor shall give due consideration to recommendations by
26members of the respective professions and by organizations

 

 

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1therein.
2    (C) The Medical Board shall annually elect one of its
3voting members as chairperson and one as vice chairperson. No
4officer shall be elected more than twice in succession to the
5same office. Each officer shall serve until their successor
6has been elected and qualified.
7    (D) A majority of the Medical Board members currently
8appointed shall constitute a quorum. A vacancy in the
9membership of the Medical Board shall not impair the right of a
10quorum to exercise all the rights and perform all the duties of
11the Medical Board. Any action taken by the Medical Board under
12this Act may be authorized by resolution at any regular or
13special meeting and each such resolution shall take effect
14immediately. The Medical Board shall meet at least quarterly.
15    (E) Each member shall be paid their necessary expenses
16while engaged in the performance of their duties.
17    (F) The Secretary shall select a Chief Medical Coordinator
18and not less than 2 Deputy Medical Coordinators who shall not
19be members of the Medical Board. Each medical coordinator
20shall be a physician licensed to practice medicine in all of
21its branches, and the Secretary shall set their rates of
22compensation. The Secretary shall assign at least one medical
23coordinator to a region composed of Cook County and such other
24counties as the Secretary may deem appropriate, and such
25medical coordinator or coordinators shall locate their office
26in Chicago. The Secretary shall assign at least one medical

 

 

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1coordinator to a region composed of the balance of counties in
2the State, and such medical coordinator or coordinators shall
3locate their office in Springfield. The Chief Medical
4Coordinator shall be the chief enforcement officer of this
5Act. None of the functions, powers, or duties of the
6Department with respect to policies regarding enforcement or
7discipline under this Act, including the adoption of such
8rules as may be necessary for the administration of this Act,
9shall be exercised by the Department except upon review of the
10Medical Board.
11    (G) The Secretary shall employ, in conformity with the
12Personnel Code, investigators who are college graduates with
13at least 2 years of investigative experience or one year of
14advanced medical education. Upon the written request of the
15Medical Board, the Secretary shall employ, in conformity with
16the Personnel Code, such other professional, technical,
17investigative, and clerical help, either on a full or
18part-time basis as the Medical Board deems necessary for the
19proper performance of its duties.
20    (H) Upon the specific request of the Medical Board, signed
21by either the chairperson, vice chairperson, or a medical
22coordinator of the Medical Board, the Department of Human
23Services, the Department of Healthcare and Family Services,
24the Department of State Police, or any other law enforcement
25agency located in this State shall make available any and all
26information that they have in their possession regarding a

 

 

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1particular case then under investigation by the Medical Board.
2    (I) Members of the Medical Board shall be immune from suit
3in any action based upon any disciplinary proceedings or other
4acts performed in good faith as members of the Medical Board.
5    (J) The Medical Board may compile and establish a
6statewide roster of physicians and other medical
7professionals, including the several medical specialties, of
8such physicians and medical professionals, who have agreed to
9serve from time to time as advisors to the medical
10coordinators. Such advisors shall assist the medical
11coordinators or the Medical Board in their investigations and
12participation in complaints against physicians. Such advisors
13shall serve under contract and shall be reimbursed at a
14reasonable rate for the services provided, plus reasonable
15expenses incurred. While serving in this capacity, the
16advisor, for any act undertaken in good faith and in the
17conduct of his or her duties under this Section, shall be
18immune from civil suit.
19(Source: P.A. 102-20, eff. 1-1-22.)
 
20    (225 ILCS 60/54.5)
21    (Section scheduled to be repealed on January 1, 2027)
22    Sec. 54.5. Physician delegation of authority to physician
23assistants, certified anesthesiologist assistants, advanced
24practice registered nurses without full practice authority,
25and prescribing psychologists.

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1and the delegation of prescriptive authority shall conform to
2the requirements of Section 65-40 of the Nurse Practice Act.
3    (g) A collaborating physician may, but is not required to,
4delegate prescriptive authority to a physician assistant as
5part of a written collaborative agreement, and the delegation
6of prescriptive authority shall conform to the requirements of
7Section 7.5 of the Physician Assistant Practice Act of 1987.
8    (h) (Blank).
9    (i) A collaborating physician shall delegate prescriptive
10authority to a prescribing psychologist as part of a written
11collaborative agreement, and the delegation of prescriptive
12authority shall conform to the requirements of Section 4.3 of
13the Clinical Psychologist Licensing Act.
14    (j) As set forth in Section 22.2 of this Act, a licensee
15under this Act may not directly or indirectly divide, share,
16or split any professional fee or other form of compensation
17for professional services with anyone in exchange for a
18referral or otherwise, other than as provided in Section 22.2.
19(Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
20100-513, eff. 1-1-18; 100-605, eff. 1-1-19; 100-863, eff.
218-14-18.)
 
22    (225 ILCS 60/54.7 new)
23    Sec. 54.7. Certified anesthesiologist assistants;
24administration of anesthesia. Nothing in this Act precludes a
25certified anesthesiologist assistant licensed under the

 

 

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1Certified Anesthesiologist Assistant Practice Act from
2selecting, ordering, and administering drugs, perform skill
3sets within the scope of the certified anesthesiologist
4assistant's education and training, and applying the
5appropriate medical devices in the provision of anesthesia
6services under the anesthesia plan agreed to by the
7supervising anesthesiologist licensed to practice medicine in
8this State.".