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| Public Act 094-0915 |
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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 | ||||
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. | ||||
All ambulatory surgical treatment centers (ASTC) licensed | ||||
under this Act
shall
comply with the following requirements:
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(1) No ASTC policy, rule, regulation, or practice shall be | ||||
inconsistent
with the provision of adequate collaboration, | ||||
including medical direction of
licensed
advanced practice | ||||
nurses, in accordance with Section 54.5 of the Medical
Practice | ||||
Act of 1987.
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(2) Operative surgical procedures shall be performed only | ||||
by a physician
licensed to
practice medicine in
all its | ||||
branches under the Medical Practice Act of 1987, a dentist
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licensed under the
Illinois Dental Practice Act, or a | ||||
podiatrist licensed under the Podiatric
Medical Practice Act of | ||||
1987,
with medical staff membership and surgical clinical | ||||
privileges granted by the
consulting
committee of the ASTC. A | ||||
licensed physician, dentist, or podiatrist may
be assisted by
a | ||||
physician licensed to practice medicine in all its branches, | ||||
dentist, dental
assistant,
podiatrist, licensed
advanced | ||||
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 | ||||
clinical
privileges to assist in surgery
by the consulting | ||||
committee of the ASTC.
Payment for services rendered by an | ||||
assistant in surgery who is not an
ambulatory surgical | ||||
treatment center employee shall be paid
at the appropriate | ||||
non-physician modifier
rate if the payor would have made | ||||
payment had the same services been provided
by a physician.
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(2.5) A registered nurse licensed under the Nursing and | ||
Advanced Practice Nursing Act and qualified by training and | ||
experience in operating room nursing shall be present in the | ||
operating room and function as the circulating nurse during all | ||
invasive or operative procedures. For purposes of this | ||
paragraph (2.5), "circulating nurse" means a registered nurse | ||
who is responsible for coordinating all nursing care, patient | ||
safety needs, and the needs of the surgical team in the | ||
operating room during an invasive or operative procedure.
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(3) The anesthesia service shall be under the direction of | ||
a physician
licensed to practice
medicine in all its branches | ||
who has had specialized preparation or experience
in the area
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or who has completed a residency in anesthesiology. An | ||
anesthesiologist, Board
certified or
Board eligible, is | ||
recommended. Anesthesia services may
only be
administered | ||
pursuant to the order of a physician licensed to practice | ||
medicine
in all its
branches, licensed dentist, or licensed | ||
podiatrist.
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(A) The individuals who, with clinical privileges | ||
granted by the medical
staff and ASTC, may
administer | ||
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 | ||
all its branches; or
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(iii) a dentist with authority to administer | ||
anesthesia under Section
8.1 of the
Illinois Dental | ||
Practice Act; or
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(iv) a licensed certified registered nurse | ||
anesthetist.
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(B) For anesthesia services, an anesthesiologist
shall
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participate through discussion of and agreement with the | ||
anesthesia plan and
shall remain physically present and be
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available on
the premises during the delivery of anesthesia | ||
services for
diagnosis, consultation, and treatment of | ||
emergency medical
conditions.
In the absence of 24-hour | ||
availability of anesthesiologists with clinical
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privileges, an alternate policy (requiring
participation, | ||
presence,
and availability of a
physician licensed to | ||
practice medicine in all its
branches) shall be
developed | ||
by the medical staff consulting committee in consultation | ||
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 | ||
required to possess
prescriptive authority or a written | ||
collaborative agreement meeting the
requirements of | ||
Section 15-15 of the Nursing and Advanced Practice Nursing | ||
Act
to provide anesthesia services
ordered by a licensed | ||
physician, dentist, or podiatrist. Licensed certified
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registered nurse anesthetists are authorized to
select, | ||
order, and
administer drugs and apply the appropriate | ||
medical devices in the provision of
anesthesia
services | ||
under the anesthesia plan agreed with by the
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anesthesiologist or, in the absence of an available | ||
anesthesiologist with
clinical privileges,
agreed with by | ||
the
operating physician, operating dentist, or operating | ||
podiatrist in accordance
with the medical
staff consulting | ||
committee policies of a licensed ambulatory surgical | ||
treatment
center.
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(Source: P.A. 93-352, eff. 1-1-04.)
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Section 10. The Hospital Licensing Act is amended by | ||
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. | ||
All hospitals licensed under this Act shall comply with the | ||
following
requirements:
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(1) No hospital policy, rule, regulation, or practice
shall | ||
be inconsistent
with the provision of adequate collaboration, | ||
including medical direction of
licensed advanced practice | ||
nurses, in accordance with Section 54.5 of the
Medical Practice | ||
Act of 1987.
| ||
(2) Operative surgical procedures shall be performed only | ||
by a physician
licensed to practice medicine in all its | ||
branches under the Medical Practice
Act of 1987, a dentist | ||
licensed under the Illinois Dental Practice Act, or a
| ||
podiatrist licensed under the Podiatric Medical Practice Act of | ||
1987,
with medical staff membership and surgical clinical | ||
privileges granted at the
hospital. A licensed physician, | ||
dentist, or podiatrist may be assisted by a
physician licensed | ||
to practice medicine in all its branches, dentist, dental
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assistant, podiatrist, licensed advanced practice nurse, | ||
licensed physician
assistant, licensed registered
nurse, | ||
licensed practical nurse, surgical
assistant, surgical | ||
technician, or other individuals granted clinical
privileges | ||
to assist in surgery
at the hospital.
Payment for services | ||
rendered by an assistant in surgery who is not a
hospital | ||
employee shall be paid
at the appropriate non-physician | ||
modifier rate if the payor would have
made payment had the same | ||
services been provided by a physician.
| ||
(2.5) A registered nurse licensed under the Nursing and | ||
Advanced Practice Nursing Act and qualified by training and | ||
experience in operating room nursing shall be present in the | ||
operating room and function as the circulating nurse during all | ||
invasive or operative procedures. For purposes of this | ||
paragraph (2.5), "circulating nurse" means a registered nurse | ||
who is responsible for coordinating all nursing care, patient | ||
safety needs, and the needs of the surgical team in the | ||
operating room during an invasive or operative procedure.
| ||
(3) The anesthesia service shall be under the direction of | ||
a physician
licensed to practice
medicine in all its branches | ||
who has had specialized preparation or
experience in the area
| ||
or who has completed a residency in anesthesiology. An | ||
anesthesiologist, Board
certified or Board eligible, is | ||
recommended. Anesthesia services may
only be administered | ||
pursuant to the order of a physician licensed to practice
| ||
medicine in all its branches, licensed dentist, or licensed | ||
podiatrist.
| ||
(A) The individuals who, with clinical privileges | ||
granted at the hospital,
may administer anesthesia | ||
services are limited
to the following:
| ||
(i) an anesthesiologist; or
| ||
(ii) a physician licensed to practice medicine in | ||
all its branches; or
| ||
(iii) a dentist with authority to administer | ||
anesthesia under Section
8.1 of
the Illinois Dental | ||
Practice Act; or
| ||
(iv) a licensed certified registered nurse | ||
anesthetist.
| ||
(B) For anesthesia services, an anesthesiologist
shall
| ||
participate through discussion of and agreement with the | ||
anesthesia plan and
shall remain physically present and be
| ||
available on
the premises during the delivery of anesthesia | ||
services for
diagnosis, consultation, and treatment of | ||
emergency medical conditions.
In the absence
of 24-hour | ||
availability of
anesthesiologists with medical staff | ||
privileges,
an alternate
policy (requiring participation, | ||
presence, and availability of a physician
licensed to | ||
practice
medicine in all its branches) shall be developed | ||
by the medical staff and
licensed
hospital in consultation | ||
with the anesthesia service.
| ||
(C) A certified registered nurse anesthetist is not | ||
required to possess
prescriptive authority or a written | ||
collaborative agreement meeting
the requirements of | ||
Section 15-15 of the Nursing and Advanced Practice Nursing
| ||
Act
to provide anesthesia services
ordered by a licensed | ||
physician, dentist, or podiatrist. Licensed certified
| ||
registered nurse anesthetists are authorized to
select, | ||
order, and
administer drugs and apply the appropriate | ||
medical devices in the provision of
anesthesia
services | ||
under the anesthesia plan agreed with by the
| ||
anesthesiologist or, in the absence of an available | ||
anesthesiologist with
clinical privileges,
agreed with by | ||
the
operating physician, operating dentist, or operating | ||
podiatrist in accordance
with the hospital's alternative | ||
policy.
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(Source: P.A. 93-352, eff. 1-1-04.)
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