99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
HB3205

 

Introduced , by Rep. Michael J. Zalewski

 

SYNOPSIS AS INTRODUCED:
 
New Act
5 ILCS 80/4.36 new
210 ILCS 5/6.5
210 ILCS 85/10.7

    Creates the Anesthesiologist Assistant Practice Act. Provides for the licensure of anesthesiologist assistants by the Department of Financial and Professional Regulation. Sets forth provisions concerning qualifications, grounds for disciplinary action, and administrative procedures. Preempts home rule. Makes conforming changes in the Ambulatory Surgical Treatment Center Act and the Hospital Licensing Act. Amends the Regulatory Sunset Act to provide for repeal of the Anesthesiologist Assistant Practice Act on January 1, 2026. Effective immediately.


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CORRECTIONAL BUDGET AND IMPACT NOTE ACT MAY APPLY
FISCAL NOTE ACT MAY APPLY
HOME RULE NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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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
5Anesthesiologist Assistant Practice Act.
 
6    Section 5. Purpose and intent. The practice of
7anesthesiology is the practice of medicine. The practice as an
8anesthesiologist assistant in the State of Illinois is declared
9to affect the public health, safety, and welfare and to be
10subject to regulation and control in the public interest. The
11purpose and legislative intent of this Act is to encourage and
12promote the more effective utilization of the skills of
13anesthesiologists by enabling them to delegate certain medical
14care to anesthesiologist 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 an anesthesiologist assistant
20merit and receive the confidence of the public and that only a
21qualified person be authorized to practice as an
22anesthesiologist assistant in the State of Illinois. This Act
23shall be liberally construed to best carry out these subjects

 

 

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1and 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    "Address of Record" means the designated address recorded
10by the Department in the applicant's or licensee's application
11file or license file as maintained by the Department's
12licensure maintenance unit. It is the duty of the applicant or
13licensee to inform the Department of any change of address and
14those changes must be made either through the Department's
15website or by contacting the Department.
16    "Anesthesiologist" means a physician licensed to practice
17medicine in all its branches by the Department of Financial and
18Professional Regulation who has completed a residency in
19anesthesiology approved by the American Board of
20Anesthesiology or the American Osteopathic Board of
21Anesthesiology, or foreign equivalent, holds an unrestricted
22license, and is actively engaged in clinical practice.
23    "Anesthesiologist assistant" means an individual licensed
24by the Department of Financial and Professional Regulation to

 

 

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1assist in the delivery of medical care, including anesthesia
2services under the supervision of an anesthesiologist.
3    "Department" means the Department of Financial and
4Professional Regulation.
5    "Disciplinary Board" means the Medical Disciplinary Board
6constituted under the Medical Practice Act of 1987.
7    "Licensing Board" means the Medical Licensing Board
8constituted under the Medical Practice Act of 1987.
9    "Secretary" means the Secretary of Financial and
10Professional Regulation.
11    "Supervision" means overseeing the activities of, and
12accepting responsibility for, the medical services rendered by
13the anesthesiologist assistant and maintaining physical
14proximity that allows the anesthesiologist to return to
15reestablish direct contact with the patient to meet medical
16needs and address any urgent or emergent clinical problems at
17all times that medical services are rendered by the
18anesthesiologist assistant.
 
19    Section 20. Application of Act. This Act does not prohibit:
20        (1) any person licensed in this State under any other
21    Act from engaging in the practice for which he or she is
22    licensed;
23        (2) the practice as an anesthesiologist assistant by a
24    person who is employed by the United States government or
25    any bureau, division, or agency thereof while in the

 

 

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1    discharge of the employee's official duties; or
2        (3) the practice as an anesthesiologist assistant that
3    is included in their program of study by students enrolled
4    in schools or in refresher courses approved by the
5    Department.
 
6    Section 25. Title; advertising; billing.
7    (a) No anesthesiologist assistant shall use the title of
8doctor or associate with his or her name or any other term in
9the clinical setting or while in contact with patients under
10their care that would indicate to other persons that he or she
11is qualified to engage in the general independent practice of
12anesthesiology or interventional pain management.
13    (b) A licensee shall include in every advertisement for
14services regulated under this Act his or her title as it
15appears on the license or the initials authorized under this
16Act.
17    (c) An anesthesiologist assistant shall not be allowed to
18bill patients or in any way to charge for services. Nothing in
19this Act, however, shall be so construed as to prevent the
20employer of an anesthesiologist assistant from charging for
21services rendered by the anesthesiologist assistant. Payment
22for services rendered by an anesthesiologist assistant shall be
23made to his or her employer if the payor would have made
24payment had the services been provided by an anesthesiologist.
 

 

 

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1    Section 30. Supervision requirements.
2    (a) An anesthesiologist assistant may deliver medical care
3only under the supervision of an anesthesiologist and only as
4described in a supervision agreement between the
5anesthesiologist assistant and an anesthesiologist who
6represents the anesthesiologist assistant's employer. The
7supervising anesthesiologist shall be immediately available at
8all times while supervising an anesthesiologist assistant.
9    For the purposes of this Section, "immediately available"
10means the medically-directing anesthesiologist being in such
11physical proximity that allows the anesthesiologist to return
12to re-establish direct contact with the patient to meet the
13patient's medical needs and address any urgent or emergent
14problems. These responsibilities may also be met through
15careful coordination among anesthesiologists of the same group
16or department. Be it recognized that design and size of various
17facilities, severity of patient illnesses, and the complexity
18and demands of the particular surgical procedures make it
19impossible to define a specific time or distance for physical
20proximity.
21    (b) An anesthesiologist assistant's practice may not
22exceed his or her education and training, the scope of practice
23of the supervising anesthesiologist, and the practice outlined
24in the anesthesiologist assistant supervision agreement. A
25medical care task assigned by the supervising anesthesiologist
26to the anesthesiologist assistant may not be delegated by the

 

 

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1anesthesiologist assistant to another person, except for the
2preceptorship of a student in an anesthesiologist assistant
3training program. An anesthesiologist assistant may perform
4such services within the specialty of the supervising
5anesthesiologist, except that the anesthesiologist shall
6exercise such direction, supervision and control over such
7anesthesiologist assistants as will ensure that patients shall
8receive quality medical care. Anesthesiologist assistants
9shall be capable of performing a variety of tasks within the
10specialty of medical care under the supervision of an
11anesthesiologist. The supervising anesthesiologist may
12delegate tasks and duties to the anesthesiologist assistant.
13Delegated tasks or duties shall be consistent with
14anesthesiologist assistant education, training, and
15experience. The delegated tasks or duties shall be specific to
16the practice setting and shall be implemented and reviewed
17under a written supervision agreement established by the
18anesthesiologist or anesthesiologist/anesthesiologist
19assistant team. An anesthesiologist assistant, acting as an
20agent of the anesthesiologist, shall be permitted to transmit
21the supervising anesthesiologist's orders as determined by the
22institution's by-laws, policies, procedures, or job
23description within which the anesthesiologist/
24anesthesiologist assistant team practices. Anesthesiologist
25assistants shall practice only in accordance with a written
26supervision agreement.

 

 

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

 

 

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1assistant or an anesthesiologist assistant student and may not
2be identified as an "intern", "resident", or "fellow".
 
3    Section 35. Application for licensure. Applications for
4original licenses shall be made to the Department in writing on
5forms prescribed by the Department and shall be accompanied by
6the required fee, which shall not be refundable. An application
7shall require information that, in the judgment of the
8Department, will enable the Department to pass on the
9qualifications of the applicant for a license. An application
10shall include evidence of meeting the qualifications for
11licensure in Section 60 of this Act.
12    Applicants have 3 years from the date of application to
13complete the application process. If the process has not been
14completed in 3 years, the application shall be denied, the fee
15shall be forfeited, and the applicant must reapply and meet the
16requirements in effect at the time of reapplication.
 
17    Section 40. Social Security number on license application.
18In addition to any other information required to be contained
19in the application, every application for an original license
20under this Act shall include the applicant's Social Security
21number, which shall be retained in the agency's records
22pertaining to the license.
23    As soon as practical, the Department shall assign a
24customer's identification number to each applicant for a

 

 

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1license. Every application for a renewal or restored license
2shall require the applicant's customer identification number.
 
3    Section 45. Identification. Beginning on January 1, 2016,
4no person may designate himself or herself as an
5anesthesiologist assistant or use or assume the title
6"anesthesiologist assistant" or append to the person's name the
7words or letters "anesthesiologist assistant" or "A.A." or any
8other titles, letters, or designation that represents or may
9tend to represent the person as an anesthesiologist assistant
10unless he or she is licensed as an anesthesiologist assistant
11by the Department. An anesthesiologist assistant shall be
12clearly identified as an anesthesiologist assistant.
 
13    Section 50. Unlicensed practice; violation; civil penalty.
14    (a) Beginning on January 1, 2016, any person who practices,
15offers to practice, attempts to practice, or holds oneself out
16to practice as a anesthesiologist assistant without being
17licensed under this Act shall, in addition to any other penalty
18provided by law, pay a civil penalty to the Department in an
19amount not to exceed $10,000 for each offense as determined by
20the Department. The civil penalty shall be assessed by the
21Department after a hearing is held in accordance with the
22provisions set forth in this Act regarding the provision of a
23hearing for the discipline of a licensee.
24    (b) The Department has the authority and power to

 

 

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1investigate any and all unlicensed activity.
2    (c) The civil penalty shall be paid within 60 days after
3the effective date of the order imposing the civil penalty. The
4order shall constitute a judgment and may be filed and
5execution had thereon in the same manner as any judgment from
6any court of record.
 
7    Section 55. Committee.
8    (a) There is established an Anesthesiologist Assistant
9Advisory Committee. The Anesthesiologist Assistant Advisory
10Committee may review and make recommendations to the Department
11and the Board regarding all matters relating to
12anesthesiologist assistants. These matters may include, but
13are not limited to:
14        (1) applications for licensure;
15        (2) disciplinary proceedings;
16        (3) renewal requirements; and
17        (4) any other issues pertaining to the regulation and
18    practice of anesthesiologist assistants in the State.
19    (b) The committee's membership shall consist of the
20following members appointed by the Governor for 3-year terms:
21        (1) one member of the Medical Licensing Board;
22        (2) one anesthesiologist assistant licensed under this
23    Act;
24        (3) two anesthesiologists; and
25        (4) one public member.

 

 

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1    The appointee under item (2) of this subsection (b) shall
2be selected from a list of recommended appointees submitted by
3a statewide association or society representing
4anesthesiologists.
5    The appointees under item (3) of this subsection (b) shall
6be selected from a list of recommended appointees submitted by
7a statewide association or society representing
8anesthesiologists.
9    (c) Members of the Anesthesiologist Assistant Advisory
10Committee shall have no liability for any action based upon a
11disciplinary proceeding or other activity performed in good
12faith as a member of the committee.
 
13    Section 60. Qualifications for licensure. A person shall be
14qualified for licensure as an anesthesiologist assistant and
15the Department may issue an anesthesiologist assistant license
16to a person who:
17        (1) has applied in writing in form and substance
18    satisfactory to the Department and has not violated any of
19    the provisions of this Act or the rules adopted under this
20    Act; the Department may take into consideration any felony
21    conviction of the applicant, but the conviction shall not
22    operate as an absolute bar to licensure;
23        (2) has submitted evidence satisfactory to the
24    Department that the applicant has:
25            (A) obtained a master's degree from an

 

 

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1        anesthesiologist assistant program that is accredited
2        by the Commission on Accreditation of Allied Health
3        Education Programs, or its predecessor or successor
4        entity; and
5            (c) passed the certifying examination administered
6        by and obtained active certification from the National
7        Commission on Certification of Anesthesiologist
8        Assistants or a successor entity; and
9        (3) complies with all applicable rules of the
10    Department.
 
11    Section 65. Fees.
12    (a) Fees collected for the administration of this Act shall
13be set by the Department by rule. All fees are not refundable.
14    (b) All moneys collected under this Act by the Department
15shall be deposited in the Illinois State Medical Disciplinary
16Fund in the State Treasury and used: (1) in the exercise of its
17powers and performance of its duties under this Act; (2) for
18costs directly related to license renewal of persons licensed
19under this Act; and (3) for costs related to the public
20purposes of the Department.
 
21    Section 70. Endorsement. Upon payment of the required fee,
22the Department may, in its discretion, license as an
23anesthesiologist assistant an applicant who is an
24anesthesiologist assistant licensed in another jurisdiction,

 

 

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1if the requirements for licensure in that jurisdiction were at
2the time of licensure substantially equivalent to the
3requirement in force in this State on that date or equivalent
4to the requirements of this Act.
 
5    Section 75. Expiration; renewal; restoration. The
6expiration date and renewal period for each license issued
7under this Act shall be set by rule. Renewal shall be
8conditioned on paying the required fee and meeting such other
9requirements as may be established by rule. Any
10anesthesiologist assistant who has permitted his or her license
11to expire or who has had his or her license on inactive status
12may have the license restored by making application to the
13Department and filing proof acceptable to the Department of his
14or her fitness to have the license restored, and by paying the
15required fees. Proof of fitness may include sworn evidence
16certifying to active lawful practice in another jurisdiction.
17If the anesthesiologist assistant has not maintained an active
18practice in another jurisdiction satisfactory to the
19Department, the Department shall determine, by an evaluation
20program established by rule, his or her fitness for restoration
21of the license and shall establish procedures and requirements
22for such restoration. However, any anesthesiologist assistant
23whose license expired while he or she was (1) in federal
24service on active duty with the Armed Forces of the United
25States, or the State Militia called into service or training,

 

 

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1or (2) in training or education under the supervision of the
2United States preliminary to induction into the military
3service, may have the license restored without paying any
4lapsed renewal fees if within 2 years after honorable
5termination of such service, training, or education he or she
6furnishes the Department with satisfactory evidence to the
7effect that he or she has been so engaged and that his or her
8service, training, or education has been so terminated.
 
9    Section 80. Inactive status. Any anesthesiologist
10assistant who notified the Department in writing on forms
11prescribed by the Department, may elect to place his or her
12license on an inactive status and shall, subject to rules of
13the Department, be excused from payment of renewal fees until
14he or she notifies the Department in writing of his or her
15intention to restore the license. Any anesthesiologist
16assistant requesting restoration from inactive status shall be
17required to pay the current renewal fee and shall be required
18to restore his or her license, as provided in Section 75 of
19this Act. Any anesthesiologist assistant whose license is in an
20inactive status shall not practice in the State of Illinois.
21Any licensee who shall engage in practice while his or her
22license is lapsed or on inactive status shall be considered to
23be practicing without a license, which shall be grounds for
24discipline under Section 95 of this Act.
 

 

 

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1    Section 85. Roster. The Department shall maintain a roster
2of the names and addresses of all licensees and of all persons
3whose licenses have been suspended or revoked. This roster
4shall be available upon written request and payment of the
5required fee.
 
6    Section 90. Corporate licensure prohibited. No
7corporation, which stated purpose includes, or which
8practices, or which holds itself out as available to practice
9as a anesthesiologist assistant, shall be issued a license by
10the Department, nor shall the Secretary of State approve or
11accept articles of incorporation for such a corporation.
 
12    Section 95. Grounds for disciplinary action.
13    (a) The Department may refuse to issue or to renew, or may
14revoke, suspend, place on probation, censure, or reprimand, or
15may take other disciplinary or non-disciplinary action with
16regard to any license issued under this Act as the Department
17may deem proper, including the issuance of fines not to exceed
18$10,000 for each violation, for any one or combination of the
19following:
20        (1) Material misstatement in furnishing information to
21    the Department.
22        (2) Violations of this Act or the rules adopted under
23    this Act.
24        (3) Conviction of or entry of a plea of guilty or nolo

 

 

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1    contendere to any crime that is a felony under the laws of
2    the United States or any state or territory thereof or that
3    is a misdemeanor of which an essential element is
4    dishonesty or that is directly related to the practice of
5    the profession.
6        (4) Making any misrepresentation for the purpose of
7    obtaining licenses.
8        (5) Professional incompetence.
9        (6) Aiding or assisting another person in violating any
10    provision of this Act or its rules.
11        (7) Failing, within 60 days, to provide information in
12    response to a written request made by the Department.
13        (8) Engaging in dishonorable, unethical, or
14    unprofessional conduct, as defined by rule, of a character
15    likely to deceive, defraud, or harm the public.
16        (9) Habitual or excessive use or addiction to alcohol,
17    narcotics, stimulants, or any other chemical agent or drug
18    that results in a anesthesiologist assistant's inability
19    to practice with reasonable judgment, skill, or safety.
20        (10) Discipline by another U.S. jurisdiction or
21    foreign nation, if at least one of the grounds for
22    discipline is the same or substantially equivalent to those
23    set forth in this Section.
24        (11) Directly or indirectly giving to or receiving from
25    any person, firm, corporation, partnership, or association
26    any fee, commission, rebate or other form of compensation

 

 

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1    for any professional services not actually or personally
2    rendered. Nothing in this paragraph (11) affects any bona
3    fide independent contractor or employment arrangements,
4    which may include provisions for compensation, health
5    insurance, pension, or other employment benefits, with
6    persons or entities authorized under this Act for the
7    provision of services within the scope of the licensee's
8    practice under this Act.
9        (12) A finding by the Disciplinary Board that the
10    licensee, after having his or her license placed on
11    probationary status has violated the terms of probation.
12        (13) Abandonment of a patient.
13        (14) Willfully making or filing false records or
14    reports in his or her practice, including, but not limited
15    to, false records filed with state agencies or departments.
16        (15) Willfully failing to report an instance of
17    suspected child abuse or neglect as required by the Abused
18    and Neglected Child Reporting Act.
19        (16) Physical illness, or mental illness or impairment
20    that results in the inability to practice the profession
21    with reasonable judgment, skill, or safety, including, but
22    not limited to, deterioration through the aging process or
23    loss of motor skill.
24        (17) Being named as a perpetrator in an indicated
25    report by the Department of Children and Family Services
26    under the Abused and Neglected Child Reporting Act, and

 

 

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1    upon proof by clear and convincing evidence that the
2    licensee has caused a child to be an abused child or
3    neglected child as defined in the Abused and Neglected
4    Child Reporting Act.
5        (18) Gross negligence resulting in permanent injury or
6    death of a patient.
7        (19) Employment of fraud, deception, or any unlawful
8    means in applying for or securing a license as a
9    anesthesiologist assistant.
10        (20) Exceeding the authority delegated to him or her by
11    his or her supervising physician.
12        (21) Immoral conduct in the commission of any act, such
13    as sexual abuse, sexual misconduct or sexual exploitation
14    related to the licensee's practice.
15        (22) Practicing under a false or assumed name, except
16    as provided by law.
17        (23) Making a false or misleading statement regarding
18    his or her skill or the efficacy or value of the medicine,
19    treatment, or remedy prescribed by him or her in the course
20    of treatment.
21        (24) Allowing another person to use his or her license
22    to practice.
23        (25) A pattern of practice or other behavior that
24    demonstrates incapacity or incompetence to practice under
25    this Act.
26    (b) The Department may, without a hearing, refuse to issue

 

 

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1or renew or may suspend the license of any person who fails to
2file a return, or to pay the tax, penalty or interest shown in
3a filed return, or to pay any final assessment of the tax,
4penalty, or interest as required by any tax Act administered by
5the Illinois Department of Revenue, until such time as the
6requirements of any such tax Act are satisfied.
7    (c) The determination by a circuit court that a licensee is
8subject to involuntary admission or judicial admission as
9provided in the Mental Health and Developmental Disabilities
10Code operates as an automatic suspension. The suspension will
11end only upon a finding by a court that the patient is no
12longer subject to involuntary admission or judicial admission
13and issues an order so finding and discharging the patient, and
14upon the recommendation of the Disciplinary Board to the
15Secretary that the licensee be allowed to resume his or her
16practice.
17    (d) In enforcing this Section, the Department upon a
18showing of a possible violation may compel an individual
19licensed to practice under this Act, or who has applied for
20licensure under this Act, to submit to a mental or physical
21examination, or both, as required by and at the expense of the
22Department. The Department may order the examining physician to
23present testimony concerning the mental or physical
24examination of the licensee or applicant. No information shall
25be excluded by reason of any common law or statutory privilege
26relating to communications between the licensee or applicant

 

 

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1and the examining physician. The examining physicians shall be
2specifically designated by the Department. The individual to be
3examined may have, at his or her own expense, another physician
4of his or her choice present during all aspects of this
5examination. Failure of an individual to submit to a mental or
6physical examination, when directed, shall be grounds for
7suspension of his or her license until the individual submits
8to the examination if the Department finds, after notice and
9hearing, that the refusal to submit to the examination was
10without reasonable cause.
11    If the Department finds an individual unable to practice
12because of the reasons set forth in this Section, the
13Department may require that individual to submit to care,
14counseling, or treatment by physicians approved or designated
15by the Department, as a condition, term, or restriction for
16continued, reinstated, or renewed licensure to practice; or, in
17lieu of care, counseling, or treatment, the Department may file
18a complaint to immediately suspend, revoke, or otherwise
19discipline the license of the individual. An individual whose
20license was granted, continued, reinstated, renewed,
21disciplined, or supervised subject to such terms, conditions,
22or restrictions, and who fails to comply with such terms,
23conditions, or restrictions, shall be referred to the Secretary
24for a determination as to whether the individual shall have his
25or her license suspended immediately, pending a hearing by the
26Department.

 

 

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1    In instances in which the Secretary immediately suspends a
2person's license under this Section, a hearing on that person's
3license must be convened by the Department within 30 days after
4the suspension and completed without appreciable delay. The
5Department shall have the authority to review the subject
6individual's record of treatment and counseling regarding the
7impairment to the extent permitted by applicable federal
8statutes and regulations safeguarding the confidentiality of
9medical records.
10    An individual licensed under this Act and affected under
11this Section shall be afforded an opportunity to demonstrate to
12the Department that he or she can resume practice in compliance
13with acceptable and prevailing standards under the provisions
14of his or her license.
 
15    Section 100. Suspension of license for failure to pay
16restitution. The Department, without further process or
17hearing, shall suspend the license or other authorization to
18practice of any person issued under this Act who has been
19certified by court order as not having paid restitution to a
20person under Section 8A-3.5 of the Illinois Public Aid Code or
21under Section 17-10.5 or 46-1 of the Criminal Code of 1961 or
22the Criminal Code of 2012. A person whose license or other
23authorization to practice is suspended under this Section is
24prohibited from practicing until the restitution is made in
25full.
 

 

 

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1    Section 105. Returned checks; fines. Any person who
2delivers a check or other payment to the Department that is
3returned to the Department unpaid by the financial institution
4upon which it is drawn shall pay to the Department, in addition
5to the amount already owed to the Department, a fine of $50.
6The fines imposed by this Section are in addition to any other
7discipline provided under this Act for unlicensed practice or
8practice on a nonrenewed license. The Department shall notify
9the person that payment of fees and fines shall be paid to the
10Department by certified check or money order within 30 calendar
11days of the notification. If, after the expiration of 30 days
12from the date of the notification, the person has failed to
13submit the necessary remittance, the Department shall
14automatically terminate the license or certificate or deny the
15application, without hearing. If, after termination or denial,
16the person seeks a license or certificate, he or she shall
17apply to the Department for restoration or issuance of the
18license or certificate and pay all fees and fines due to the
19Department. The Department may establish a fee for the
20processing of an application for restoration of a license or
21certificate to pay all expenses of processing this application.
22The Secretary may waive the fines due under this Section in
23individual cases where the Secretary finds that the fines would
24be unreasonable or unnecessarily burdensome.
 

 

 

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1    Section 110. Injunction.
2    (a) If any person violates the provision of this Act, the
3Secretary may, in the name of the People of the State of
4Illinois, through the Attorney General of the State of
5Illinois, or the State's Attorney of any county in which the
6action is brought, petition for an order enjoining the
7violation or for an order enforcing compliance with this Act.
8Upon the filing of a verified petition in court, the court may
9issue a temporary restraining order, without notice or bond,
10and may preliminarily and permanently enjoin such violation,
11and if it is established that such person has violated or is
12violating the injunction, the Court may punish the offender for
13contempt of court. Proceedings under this Section shall be in
14addition to, and not in lieu of, all other remedies and
15penalties provided by this Act.
16    (b) If any person shall practice as an anesthesiologist
17assistant or hold himself or herself out as an anesthesiologist
18assistant without being licensed under the provisions of this
19Act, then any licensed anesthesiologist assistant, any
20interested party or any person injured thereby may, in addition
21to the Secretary, petition for relief as provided in subsection
22(a) of this Section.
23    (c) Whenever in the opinion of the Department any person
24violates any provision of this Act, the Department may issue a
25rule to show cause why an order to cease and desist should not
26be entered against the person. The rule shall clearly set forth

 

 

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1the grounds relied upon by the Department and shall provide a
2period of 7 days from the date of the rule to file an answer to
3the satisfaction of the Department. Failure to answer to the
4satisfaction of the Department shall cause an order to cease
5and desist to be issued forthwith.
 
6    Section 115. Investigations; notice and hearing. The
7Department may investigate the actions of any applicant or of
8any person or persons holding or claiming to hold a license.
9The Department shall, before suspending, revoking, placing on
10probationary status, or taking any other disciplinary action as
11the Department may deem proper with regard to any license, at
12least 30 days prior to the date set for the hearing, notify the
13applicant or licensee in writing of any charges made and the
14time and place for a hearing of the charges before the
15Disciplinary Board, direct him or her to file his or her
16written answer thereto to the Disciplinary Board under oath
17within 20 days after the service on him or her of such notice
18and inform him or her that if he or she fails to file such
19answer default will be taken against him or her and his or her
20license may be suspended, revoked, placed on probationary
21status, or have other disciplinary action, including limiting
22the scope, nature or extent of his or her practice, as the
23Department may deem proper taken with regard thereto. Written
24notice may be served by personal delivery or certified or
25registered mail to the applicant or licensee at his or her last

 

 

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1address of record with the Department. At the time and place
2fixed in the notice, the Department shall proceed to hear the
3charges and the parties or their counsel shall be accorded
4ample opportunity to present such statements, testimony,
5evidence, and argument as may be pertinent to the charges or to
6the defense thereto. The Department may continue such hearing
7from time to time. In case the applicant or licensee, after
8receiving notice, fails to file an answer, his or her license
9may in the discretion of the Secretary, having received first
10the recommendation of the Disciplinary Board, be suspended,
11revoked, placed on probationary status, or the Secretary may
12take whatever disciplinary action as he or she may deem proper,
13including limiting the scope, nature, or extent of such
14person's practice, without a hearing, if the act or acts
15charged constitute sufficient grounds for such action under
16this Act. The written notice may be served by personal delivery
17or by certified mail to the accused's address of record.
 
18    Section 120. Record of proceedings. The Department, at its
19expense, shall preserve a record of all proceedings at the
20formal hearing of any case involving the refusal to issue or
21renew or discipline of a license. The notice of hearing,
22complaint, and all other documents in the nature of pleadings
23and written motions filed in the proceedings, the transcript of
24testimony, the report of the Disciplinary Board or hearing
25officer, and orders of the Department shall be the record of

 

 

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1the proceeding.
 
2    Section 125. Attendance of witnesses; production of
3documents. Any circuit court may, upon application of the
4Department or its designee or of the applicant or licensee
5against whom proceedings pursuant to Section 115 of this Act
6are pending, enter an order requiring the attendance of
7witnesses and their testimony and the production of documents,
8papers, files, books, and records in connection with any
9hearing or investigation. The court may compel obedience to its
10order by proceedings for contempt.
 
11    Section 130. Subpoena power; oaths. The Department shall
12have power to subpoena and bring before it any person and to
13take testimony either orally or by deposition or both, with the
14same fees and mileage and in the same manner as prescribed by
15law in judicial proceedings in civil cases in circuit courts of
16this State.
17    The Secretary, the designated hearing officer, and any
18member of the Disciplinary Board designated by the Secretary
19shall each have power to administer oaths to witnesses at any
20hearing which the Department is authorized to conduct under
21this Act and any other oaths required or authorized to be
22administered by the Department under this Act.
 
23    Section 135. Findings and recommendations. At the

 

 

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1conclusion of the hearing the Disciplinary Board shall present
2to the Secretary a written report of its findings of fact,
3conclusions of law and recommendations. The report shall
4contain a finding whether or not the accused person violated
5this Act or failed to comply with the conditions required in
6this Act. The Disciplinary Board shall specify the nature of
7the violation or failure to comply, and shall make its
8recommendations to the Secretary.
9    The report of findings of fact, conclusions of law and
10recommendation of the Disciplinary Board shall be the basis for
11the Department's order or refusal or for the granting of a
12license or permit. If the Secretary disagrees in any regard
13with the report of the Disciplinary Board, the Secretary may
14issue an order in contravention thereof. The Secretary shall
15provide a written report to the Disciplinary Board on any
16deviation, and shall specify with particularity the reasons for
17such action in the final order. The finding is not admissible
18in evidence against the person in a criminal prosecution
19brought for the violation of this Act, but the hearing and
20finding are not a bar to a criminal prosecution brought for the
21violation of this Act.
 
22    Section 140. Hearing officer. Notwithstanding the
23provisions of Section 115 of this Act, the Secretary shall have
24the authority to appoint any attorney duly licensed to practice
25law in the State of Illinois to serve as the hearing officer in

 

 

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1any action for refusal to issue or renew, or for discipline of,
2a license. The Secretary shall notify the Disciplinary Board of
3any such appointment. The hearing officer shall have full
4authority to conduct the hearing. The hearing officer shall
5report his or her findings of fact, conclusions of law, and
6recommendations to the Disciplinary Board and the Secretary.
7The Disciplinary Board shall have 60 days from receipt of the
8report to review the report of the hearing officer and present
9their findings of fact, conclusions of law, and recommendations
10to the Secretary. If the Disciplinary Board fails to present
11its report within the 60 day period, the respondent may request
12in writing a direct appeal to the Secretary, in which case the
13Secretary shall, within 7 calendar days after the request,
14issue an order directing the Disciplinary Board to issue its
15findings of fact, conclusions of law, and recommendations to
16the Secretary within 30 calendar days after such order. If the
17Disciplinary Board fails to issue its findings of fact,
18conclusions of law, and recommendations within that time frame
19to the Secretary after the entry of such order, the Secretary
20shall, within 30 calendar days thereafter, issue an order based
21upon the report of the hearing officer and the record of the
22proceedings or issue an order remanding the matter back to the
23hearing officer for additional proceedings in accordance with
24the order. If (i) a direct appeal is requested, (ii) the
25Disciplinary Board fails to issue its findings of fact,
26conclusions of law, and recommendations within the 30-day

 

 

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1mandate from the Secretary or the Secretary fails to order the
2Disciplinary Board to do so, and (iii) the Secretary fails to
3issue an order within 30 calendar days thereafter, then the
4hearing officer's report is deemed accepted and a final
5decision of the Secretary. Notwithstanding any other provision
6of this Section, if the Secretary, upon review, determines that
7substantial justice has not been done in the revocation,
8suspension, or refusal to issue or renew a license or other
9disciplinary action taken as the result of the entry of the
10hearing officer's report, the Secretary may order a rehearing
11by the same or other examiners. If the Secretary disagrees in
12any regard with the report of the Disciplinary Board or hearing
13officer, he or she may issue an order in contravention thereof.
14The Secretary shall provide a written explanation to the
15Disciplinary Board on any such deviation, and shall specify
16with particularity the reasons for such action in the final
17order.
 
18    Section 145. Board; rehearing. In any case involving the
19refusal to issue or renew or discipline of a license, a copy of
20the Disciplinary Board's report shall be served upon the
21respondent by the Department, either personally or as provided
22in this Act for the service of the notice of hearing. Within 20
23days after such service, the respondent may present to the
24Department a motion in writing for a rehearing, which motion
25shall specify the particular grounds therefor. If no motion for

 

 

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1rehearing is filed, then upon the expiration of the time
2specified for filing such a motion, or if a motion for
3rehearing is denied, then upon such denial the Secretary may
4enter an order in accordance with recommendations of the
5Disciplinary Board except as provided in Section 130 or 135 of
6this Act. If the respondent shall order from the reporting
7service, and pay for a transcript of the record within the time
8for filing a motion for rehearing, the 20-day period within
9which such a motion may be filed shall commence upon the
10delivery of the transcript to the respondent.
 
11    Section 150. Secretary; rehearing. Whenever the Secretary
12is satisfied that substantial justice has not been done in the
13revocation, suspension or refusal to issue or renew a license,
14the Secretary may order a rehearing by the same or another
15hearing officer or Disciplinary Board.
 
16    Section 155. Order or certified copy; prima facie proof. An
17order or a certified copy thereof, over the seal of the
18Department and purporting to be signed by the Secretary, shall
19be prima facie proof that:
20        (1) the signature is the genuine signature of the
21    Secretary;
22        (2) the Secretary is duly appointed and qualified; and
23        (3) the Disciplinary Board and the members thereof are
24    qualified to act.
 

 

 

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1    Section 160. Restoration of license. At any time after the
2suspension or revocation of any license the Department may
3restore it to the licensee, unless after an investigation and a
4hearing, the Department determines that restoration is not in
5the public interest. Where circumstances of suspension or
6revocation so indicate, the Department may require an
7examination of the licensee prior to restoring his or her
8license.
 
9    Section 165. Surrender of license. Upon the revocation or
10suspension of any license, the licensee shall immediately
11surrender the license to the Department. If the licensee fails
12to do so, the Department shall have the right to seize the
13license.
 
14    Section 170. Temporary suspension of a license. The
15Secretary may temporarily suspend the license of a
16anesthesiologist assistant without a hearing, simultaneously
17with the institution of proceedings for a hearing provided for
18in Section 115 of this Act if the Secretary finds that evidence
19in his possession indicates that continuation in practice would
20constitute an imminent danger to the public. In the event that
21the Secretary suspends, temporarily, the license without a
22hearing, a hearing by the Department must be held within 30
23days after such suspension has occurred and concluded without

 

 

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1appreciable delay.
 
2    Section 175. Administrative review; venue; certification
3of record. All final administrative decisions of the
4Department are subject to judicial review pursuant to the
5provisions of the Administrative Review Law, and all rules
6adopted pursuant thereto. The term "administrative decision"
7is defined as in Section 3-101 of the Code of Civil Procedure.
8    Proceedings for judicial review shall be commenced in the
9circuit court of the county in which the party applying for
10review resides; but if the party is not a resident of this
11State, venue shall be in Sangamon County.
12    The Department shall not be required to certify any record
13to the court or file any answer in court or otherwise appear in
14any court in a judicial review proceeding, unless and until the
15Department has received from the plaintiff payment of the costs
16of furnishing and certifying the record, which costs shall be
17determined by the Department. Failure on the part of the
18plaintiff to file a receipt in court shall be grounds for
19dismissal of the action.
 
20    Section 180. Penalties. A person who is found to have
21violated any provision of this Act is guilty of a Class A
22misdemeanor for the first offense and a Class 4 felony for the
23second and any subsequent offense.
 

 

 

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1    Section 185. Confidentiality. All information collected by
2the Department in the course of an examination or investigation
3of a licensee or applicant, including, but not limited to, any
4complaint against a licensee filed with the Department and
5information collected to investigate any such complaint, shall
6be maintained for the confidential use of the Department and
7shall not be disclosed. The Department may not disclose the
8information to anyone other than law enforcement officials,
9other regulatory agencies that have an appropriate regulatory
10interest as determined by the Secretary, or to a party
11presenting a lawful subpoena to the Department. Information and
12documents disclosed to a federal, State, county, or local law
13enforcement agency shall not be disclosed by the agency for any
14purpose to any other agency or person. A formal complaint filed
15against a licensee by the Department or any order issued by the
16Department against a licensee or applicant shall be a public
17record, except as otherwise prohibited by law.
 
18    Section 190. Home rule. The regulation and licensing of
19anesthesiologist assistants is an exclusive power and function
20of the State. A home rule unit may not regulate or license
21anesthesiologist assistants. This Section is a denial and
22limitation of home rule powers and functions under subsection
23(h) of Section 6 of Article VII of the Illinois Constitution.
 
24    Section 900. The Regulatory Sunset Act is amended by adding

 

 

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1Section 4.36 as follows:
 
2    (5 ILCS 80/4.36 new)
3    Sec. 4.36. Act repealed on January 1, 2026. The following
4Act is repealed on January 1, 2026:
5    The Anesthesiologist Assistant Practice Act.
 
6    Section 905. The Ambulatory Surgical Treatment Center Act
7is amended by changing Section 6.5 as follows:
 
8    (210 ILCS 5/6.5)
9    Sec. 6.5. Clinical privileges; advanced practice nurses.
10All ambulatory surgical treatment centers (ASTC) licensed
11under this Act shall comply with the following requirements:
12    (1) No ASTC policy, rule, regulation, or practice shall be
13inconsistent with the provision of adequate collaboration and
14consultation in accordance with Section 54.5 of the Medical
15Practice Act of 1987.
16    (2) Operative surgical procedures shall be performed only
17by a physician licensed to practice medicine in all its
18branches under the Medical Practice Act of 1987, a dentist
19licensed under the Illinois Dental Practice Act, or a podiatric
20physician licensed under the Podiatric Medical Practice Act of
211987, with medical staff membership and surgical clinical
22privileges granted by the consulting committee of the ASTC. A
23licensed physician, dentist, or podiatric physician may be

 

 

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

 

 

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

 

 

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1            (iii) a dentist with authority to administer
2        anesthesia under Section 8.1 of the Illinois Dental
3        Practice Act; or
4            (iv) a licensed certified registered nurse
5        anesthetist; or
6            (v) a podiatric physician licensed under the
7        Podiatric Medical Practice Act of 1987.
8            (vi) a licensed anesthesiologist assistant under
9        the supervision of an anesthesiologist.
10        (B) For anesthesia services, an anesthesiologist shall
11    participate through discussion of and agreement with the
12    anesthesia plan and shall remain physically present and be
13    available on the premises during the delivery of anesthesia
14    services for diagnosis, consultation, and treatment of
15    emergency medical conditions. In the absence of 24-hour
16    availability of anesthesiologists with clinical
17    privileges, an alternate policy (requiring participation,
18    presence, and availability of a physician licensed to
19    practice medicine in all its branches) shall be developed
20    by the medical staff consulting committee in consultation
21    with the anesthesia service and included in the medical
22    staff consulting committee policies.
23        (C) A certified registered nurse anesthetist is not
24    required to possess prescriptive authority or a written
25    collaborative agreement meeting the requirements of
26    Section 65-35 of the Nurse Practice Act to provide

 

 

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1    anesthesia services ordered by a licensed physician,
2    dentist, or podiatric physician. Licensed certified
3    registered nurse anesthetists are authorized to select,
4    order, and administer drugs and apply the appropriate
5    medical devices in the provision of anesthesia services
6    under the anesthesia plan agreed with by the
7    anesthesiologist or, in the absence of an available
8    anesthesiologist with clinical privileges, agreed with by
9    the operating physician, operating dentist, or operating
10    podiatric physician in accordance with the medical staff
11    consulting committee policies of a licensed ambulatory
12    surgical treatment center.
13(Source: P.A. 98-214, eff. 8-9-13.)
 
14    Section 910. The Hospital Licensing Act is amended by
15changing Section 10.7 as follows:
 
16    (210 ILCS 85/10.7)
17    Sec. 10.7. Clinical privileges; advanced practice nurses.
18All hospitals licensed under this Act shall comply with the
19following requirements:
20    (1) No hospital policy, rule, regulation, or practice shall
21be inconsistent with the provision of adequate collaboration
22and consultation in accordance with Section 54.5 of the Medical
23Practice Act of 1987.
24    (2) Operative surgical procedures shall be performed only

 

 

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1by a physician licensed to practice medicine in all its
2branches under the Medical Practice Act of 1987, a dentist
3licensed under the Illinois Dental Practice Act, or a podiatric
4physician licensed under the Podiatric Medical Practice Act of
51987, with medical staff membership and surgical clinical
6privileges granted at the hospital. A licensed physician,
7dentist, or podiatric physician may be assisted by a physician
8licensed to practice medicine in all its branches, dentist,
9dental assistant, podiatric physician, licensed advanced
10practice nurse, licensed physician assistant, licensed
11registered nurse, licensed practical nurse, licensed
12anesthesiologist assistant, surgical assistant, surgical
13technician, or other individuals granted clinical privileges
14to assist in surgery at the hospital. Payment for services
15rendered by an assistant in surgery who is not a hospital
16employee shall be paid at the appropriate non-physician
17modifier rate if the payor would have made payment had the same
18services been provided by a physician.
19    (2.5) A registered nurse licensed under the Nurse Practice
20Act and qualified by training and experience in operating room
21nursing shall be present in the operating room and function as
22the circulating nurse during all invasive or operative
23procedures. For purposes of this paragraph (2.5), "circulating
24nurse" means a registered nurse who is responsible for
25coordinating all nursing care, patient safety needs, and the
26needs of the surgical team in the operating room during an

 

 

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1invasive or operative procedure.
2    (3) An advanced practice nurse is not required to possess
3prescriptive authority or a written collaborative agreement
4meeting the requirements of the Nurse Practice Act to provide
5advanced practice nursing services in a hospital. An advanced
6practice nurse must possess clinical privileges recommended by
7the medical staff and granted by the hospital in order to
8provide services. Individual advanced practice nurses may also
9be granted clinical privileges to order, select, and administer
10medications, including controlled substances, to provide
11delineated care. The attending physician must determine the
12advance practice nurse's role in providing care for his or her
13patients, except as otherwise provided in medical staff bylaws.
14The medical staff shall periodically review the services of
15advanced practice nurses granted privileges. This review shall
16be conducted in accordance with item (2) of subsection (a) of
17Section 10.8 of this Act for advanced practice nurses employed
18by the hospital.
19    (4) The anesthesia service shall be under the direction of
20a physician licensed to practice medicine in all its branches
21who has had specialized preparation or experience in the area
22or who has completed a residency in anesthesiology. An
23anesthesiologist, Board certified or Board eligible, is
24recommended. Anesthesia services may only be administered
25pursuant to the order of a physician licensed to practice
26medicine in all its branches, licensed dentist, or licensed

 

 

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

 

 

HB3205- 42 -LRB099 04463 HAF 24491 b

1    by the medical staff and licensed hospital in consultation
2    with the anesthesia service.
3        (C) A certified registered nurse anesthetist is not
4    required to possess prescriptive authority or a written
5    collaborative agreement meeting the requirements of
6    Section 65-35 of the Nurse Practice Act to provide
7    anesthesia services ordered by a licensed physician,
8    dentist, or podiatric physician. Licensed certified
9    registered nurse anesthetists are authorized to select,
10    order, and administer drugs and apply the appropriate
11    medical devices in the provision of anesthesia services
12    under the anesthesia plan agreed with by the
13    anesthesiologist or, in the absence of an available
14    anesthesiologist with clinical privileges, agreed with by
15    the operating physician, operating dentist, or operating
16    podiatric physician in accordance with the hospital's
17    alternative policy.
18(Source: P.A. 98-214, eff. 8-9-13.)
 
19    Section 999. Effective date. This Act takes effect upon
20becoming law.