Full Text of HB4673 95th General Assembly
HB4673eng 95TH GENERAL ASSEMBLY
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HB4673 Engrossed |
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LRB095 15669 RAS 41674 b |
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| AN ACT concerning regulation.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Ambulatory Surgical Treatment Center Act is | 5 |
| amended by changing Section 6.5 as follows:
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| (210 ILCS 5/6.5)
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| Sec. 6.5. Clinical privileges; advanced practice nurses. | 8 |
| All ambulatory surgical treatment centers (ASTC) licensed | 9 |
| under this Act
shall
comply with the following requirements:
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| (1) No ASTC policy, rule, regulation, or practice shall be | 11 |
| inconsistent
with the provision of adequate collaboration and | 12 |
| consultation in accordance with Section 54.5 of the Medical
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| Practice Act of 1987.
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| (2) Operative surgical procedures shall be performed only | 15 |
| by a physician
licensed to
practice medicine in
all its | 16 |
| branches under the Medical Practice Act of 1987, a dentist
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| licensed under the
Illinois Dental Practice Act, or a | 18 |
| podiatrist licensed under the Podiatric
Medical Practice Act of | 19 |
| 1987,
with medical staff membership and surgical clinical | 20 |
| privileges granted by the
consulting
committee of the ASTC. A | 21 |
| licensed physician, dentist, or podiatrist may
be assisted by
a | 22 |
| physician licensed to practice medicine in all its branches, | 23 |
| dentist, dental
assistant,
podiatrist, licensed
advanced |
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HB4673 Engrossed |
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LRB095 15669 RAS 41674 b |
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| practice nurse, licensed physician assistant, licensed
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| registered nurse, licensed practical nurse,
surgical
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| assistant, surgical technician, or other individuals granted | 4 |
| clinical
privileges to assist in surgery
by the consulting | 5 |
| committee of the ASTC.
Payment for services rendered by an | 6 |
| assistant in surgery who is not an
ambulatory surgical | 7 |
| treatment center employee shall be paid
at the appropriate | 8 |
| non-physician modifier
rate if the payor would have made | 9 |
| payment had the same services been provided
by a physician.
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| (2.5) A registered nurse licensed under the Nurse Practice | 11 |
| Act and qualified by training and experience in operating room | 12 |
| nursing shall be present in the operating room and function as | 13 |
| the circulating nurse during all invasive or operative | 14 |
| procedures. For purposes of this paragraph (2.5), "circulating | 15 |
| nurse" means a registered nurse who is responsible for | 16 |
| coordinating all nursing care, patient safety needs, and the | 17 |
| needs of the surgical team in the operating room during an | 18 |
| invasive or operative procedure.
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| (3) An advanced practice nurse is not required to possess | 20 |
| prescriptive authority or a written collaborative agreement | 21 |
| meeting the requirements of the Nurse Practice Act to provide | 22 |
| advanced practice nursing services in an ambulatory surgical | 23 |
| treatment center. An advanced practice nurse must possess | 24 |
| clinical privileges granted by the consulting medical staff | 25 |
| committee and ambulatory surgical treatment center in order to | 26 |
| provide services. Individual advanced practice nurses may also |
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HB4673 Engrossed |
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LRB095 15669 RAS 41674 b |
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| be granted clinical privileges to order, select, and administer | 2 |
| medications, including controlled substances, to provide | 3 |
| delineated care. The attending physician must determine the | 4 |
| advance practice nurse's role in providing care for his or her | 5 |
| patients, except as otherwise provided in the consulting staff | 6 |
| policies. The consulting medical staff committee shall | 7 |
| periodically review the services of advanced practice nurses | 8 |
| granted privileges.
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| (4) The anesthesia service shall be under the direction of | 10 |
| a physician
licensed to practice
medicine in all its branches | 11 |
| who has had specialized preparation or experience
in the area
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| or who has completed a residency in anesthesiology. An | 13 |
| anesthesiologist, Board
certified or
Board eligible, is | 14 |
| recommended. Anesthesia services may
only be
administered | 15 |
| pursuant to the order of a physician licensed to practice | 16 |
| medicine
in all its
branches, licensed dentist, or licensed | 17 |
| podiatrist.
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| (A) The individuals who, with clinical privileges | 19 |
| granted by the medical
staff and ASTC, may
administer | 20 |
| anesthesia services are limited to the
following:
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| (i) an anesthesiologist; or
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| (ii) a physician licensed to practice medicine in | 23 |
| all its branches; or
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| (iii) a dentist with authority to administer | 25 |
| anesthesia under Section
8.1 of the
Illinois Dental | 26 |
| Practice Act; or
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HB4673 Engrossed |
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LRB095 15669 RAS 41674 b |
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| (iv) a licensed certified registered nurse | 2 |
| anesthetist ; or . | 3 |
| (v) a podiatrist licensed under the Podiatric | 4 |
| Medical Practice Act of 1987.
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| (B) For anesthesia services, an anesthesiologist
shall
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| participate through discussion of and agreement with the | 7 |
| anesthesia plan and
shall remain physically present and be
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| available on
the premises during the delivery of anesthesia | 9 |
| services for
diagnosis, consultation, and treatment of | 10 |
| emergency medical
conditions.
In the absence of 24-hour | 11 |
| availability of anesthesiologists with clinical
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| privileges, an alternate policy (requiring
participation, | 13 |
| presence,
and availability of a
physician licensed to | 14 |
| practice medicine in all its
branches) shall be
developed | 15 |
| by the medical staff consulting committee in consultation | 16 |
| with the
anesthesia service and included in the medical
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| staff
consulting committee policies.
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| (C) A certified registered nurse anesthetist is not | 19 |
| required to possess
prescriptive authority or a written | 20 |
| collaborative agreement meeting the
requirements of | 21 |
| Section 65-35 of the Nurse Practice Act
to provide | 22 |
| anesthesia services
ordered by a licensed physician, | 23 |
| dentist, or podiatrist. Licensed certified
registered | 24 |
| nurse anesthetists are authorized to
select, order, and
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| administer drugs and apply the appropriate medical devices | 26 |
| in the provision of
anesthesia
services under the |
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HB4673 Engrossed |
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LRB095 15669 RAS 41674 b |
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| anesthesia plan agreed with by the
anesthesiologist or, in | 2 |
| the absence of an available anesthesiologist with
clinical | 3 |
| privileges,
agreed with by the
operating physician, | 4 |
| operating dentist, or operating podiatrist in accordance
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| with the medical
staff consulting committee policies of a | 6 |
| licensed ambulatory surgical treatment
center.
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| (Source: P.A. 94-915, eff. 1-1-07; 95-639, eff. 10-5-07.)
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| Section 10. The Hospital Licensing Act is amended by | 9 |
| changing Section 10.7 as follows:
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| (210 ILCS 85/10.7)
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| Sec. 10.7. Clinical privileges; advanced practice nurses.
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| All hospitals licensed under this Act shall comply with the | 13 |
| following
requirements:
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| (1) No hospital policy, rule, regulation, or practice
shall | 15 |
| be inconsistent
with the provision of adequate collaboration | 16 |
| and consultation in accordance with Section 54.5 of the
Medical | 17 |
| Practice Act of 1987.
| 18 |
| (2) Operative surgical procedures shall be performed only | 19 |
| by a physician
licensed to practice medicine in all its | 20 |
| branches under the Medical Practice
Act of 1987, a dentist | 21 |
| licensed under the Illinois Dental Practice Act, or a
| 22 |
| podiatrist licensed under the Podiatric Medical Practice Act of | 23 |
| 1987,
with medical staff membership and surgical clinical | 24 |
| privileges granted at the
hospital. A licensed physician, |
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HB4673 Engrossed |
- 6 - |
LRB095 15669 RAS 41674 b |
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| 1 |
| dentist, or podiatrist may be assisted by a
physician licensed | 2 |
| to practice medicine in all its branches, dentist, dental
| 3 |
| assistant, podiatrist, licensed advanced practice nurse, | 4 |
| licensed physician
assistant, licensed registered
nurse, | 5 |
| licensed practical nurse, surgical
assistant, surgical | 6 |
| technician, or other individuals granted clinical
privileges | 7 |
| to assist in surgery
at the hospital.
Payment for services | 8 |
| rendered by an assistant in surgery who is not a
hospital | 9 |
| employee shall be paid
at the appropriate non-physician | 10 |
| modifier rate if the payor would have
made payment had the same | 11 |
| services been provided by a physician.
| 12 |
| (2.5) A registered nurse licensed under the Nurse Practice | 13 |
| Act and qualified by training and experience in operating room | 14 |
| nursing shall be present in the operating room and function as | 15 |
| the circulating nurse during all invasive or operative | 16 |
| procedures. For purposes of this paragraph (2.5), "circulating | 17 |
| nurse" means a registered nurse who is responsible for | 18 |
| coordinating all nursing care, patient safety needs, and the | 19 |
| needs of the surgical team in the operating room during an | 20 |
| invasive or operative procedure.
| 21 |
| (3) An advanced practice nurse is not required to possess | 22 |
| prescriptive authority or a written collaborative agreement | 23 |
| meeting the requirements of the Nurse Practice Act to provide | 24 |
| advanced practice nursing services in a hospital. An advanced | 25 |
| practice nurse must possess clinical privileges recommended by | 26 |
| the medical staff and granted by the hospital in order to |
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HB4673 Engrossed |
- 7 - |
LRB095 15669 RAS 41674 b |
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| 1 |
| provide services. Individual advanced practice nurses may also | 2 |
| be granted clinical privileges to order, select, and administer | 3 |
| medications, including controlled substances, to provide | 4 |
| delineated care. The attending physician must determine the | 5 |
| advance practice nurse's role in providing care for his or her | 6 |
| patients, except as otherwise provided in medical staff bylaws. | 7 |
| The medical staff shall periodically review the services of | 8 |
| advanced practice nurses granted privileges. This review shall | 9 |
| be conducted in accordance with item (2) of subsection (a) of | 10 |
| Section 10.8 of this Act for advanced practice nurses employed | 11 |
| by the hospital.
| 12 |
| (4) The anesthesia service shall be under the direction of | 13 |
| a physician
licensed to practice
medicine in all its branches | 14 |
| who has had specialized preparation or
experience in the area
| 15 |
| or who has completed a residency in anesthesiology. An | 16 |
| anesthesiologist, Board
certified or Board eligible, is | 17 |
| recommended. Anesthesia services may
only be administered | 18 |
| pursuant to the order of a physician licensed to practice
| 19 |
| medicine in all its branches, licensed dentist, or licensed | 20 |
| podiatrist.
| 21 |
| (A) The individuals who, with clinical privileges | 22 |
| granted at the hospital,
may administer anesthesia | 23 |
| services are limited
to the following:
| 24 |
| (i) an anesthesiologist; or
| 25 |
| (ii) a physician licensed to practice medicine in | 26 |
| all its branches; or
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HB4673 Engrossed |
- 8 - |
LRB095 15669 RAS 41674 b |
|
| 1 |
| (iii) a dentist with authority to administer | 2 |
| anesthesia under Section
8.1 of
the Illinois Dental | 3 |
| Practice Act; or
| 4 |
| (iv) a licensed certified registered nurse | 5 |
| anesthetist ; or . | 6 |
| (v) a podiatrist licensed under the Podiatric | 7 |
| Medical Practice Act of 1987.
| 8 |
| (B) For anesthesia services, an anesthesiologist
shall
| 9 |
| participate through discussion of and agreement with the | 10 |
| anesthesia plan and
shall remain physically present and be
| 11 |
| available on
the premises during the delivery of anesthesia | 12 |
| services for
diagnosis, consultation, and treatment of | 13 |
| emergency medical conditions.
In the absence
of 24-hour | 14 |
| availability of
anesthesiologists with medical staff | 15 |
| privileges,
an alternate
policy (requiring participation, | 16 |
| presence, and availability of a physician
licensed to | 17 |
| practice
medicine in all its branches) shall be developed | 18 |
| by the medical staff and
licensed
hospital in consultation | 19 |
| with the anesthesia service.
| 20 |
| (C) A certified registered nurse anesthetist is not | 21 |
| required to possess
prescriptive authority or a written | 22 |
| collaborative agreement meeting
the requirements of | 23 |
| Section 65-35 of the Nurse Practice Act
to provide | 24 |
| anesthesia services
ordered by a licensed physician, | 25 |
| dentist, or podiatrist. Licensed certified
registered | 26 |
| nurse anesthetists are authorized to
select, order, and
|
|
|
|
HB4673 Engrossed |
- 9 - |
LRB095 15669 RAS 41674 b |
|
| 1 |
| administer drugs and apply the appropriate medical devices | 2 |
| in the provision of
anesthesia
services under the | 3 |
| anesthesia plan agreed with by the
anesthesiologist or, in | 4 |
| the absence of an available anesthesiologist with
clinical | 5 |
| privileges,
agreed with by the
operating physician, | 6 |
| operating dentist, or operating podiatrist in accordance
| 7 |
| with the hospital's alternative policy.
| 8 |
| (Source: P.A. 94-915, eff. 1-1-07; 95-639, eff. 10-5-07.)
| 9 |
| Section 99. Effective date. This Act takes effect upon | 10 |
| becoming law.
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