Illinois 2023-2024 Regular Session

Illinois Senate Bill SB2214 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2214 Introduced 2/10/2023, by Sen. Cristina Castro SYNOPSIS AS INTRODUCED: New Act5 ILCS 80/4.43 new 210 ILCS 5/6.5 210 ILCS 85/10.7 225 ILCS 60/54.5 225 ILCS 60/54.7 new Creates the Certified Anesthesiologist Assistant Practice Act. Provides for the licensure of certified anesthesiologist assistants by the Department of Financial and Professional Regulation. Sets forth provisions concerning: administrative procedures; the applicability of the Act; using titles, advertising, and billing; supervision requirements; application for licensure; unlicensed practice, violations, and civil penalties; the Certified Anesthesiologist Assistant Advisory Committee; qualifications for licensure; the expiration and renewal of a license; the inactive status of a license; and grounds for disciplinary action. Amends the Medical Practice Act of 1987. Provides that, under delegation from a supervising anesthesiologist, a licensed certified anesthesiologist assistant is authorized to select, order, and administer drugs and apply the appropriate medical devices in the provision of anesthesia services under the anesthesia plan agreed to by the supervising anesthesiologist. Amends the Ambulatory Surgical Treatment Center Act and the Hospital Licensing Act. Provides that a licensed certified anesthesiologist assistant under the supervision of an anesthesiologist with clinical privileges granted by the medical staff and ambulatory surgical center or at the hospital may administer anesthesia services. Amends the Regulatory Sunset Act to provide for the repeal of the Certified Anesthesiologist Assistant Practice Act on January 1, 2033. LRB103 06052 AMQ 51082 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2214 Introduced 2/10/2023, by Sen. Cristina Castro SYNOPSIS AS INTRODUCED: New Act5 ILCS 80/4.43 new 210 ILCS 5/6.5 210 ILCS 85/10.7 225 ILCS 60/54.5 225 ILCS 60/54.7 new New Act 5 ILCS 80/4.43 new 210 ILCS 5/6.5 210 ILCS 85/10.7 225 ILCS 60/54.5 225 ILCS 60/54.7 new Creates the Certified Anesthesiologist Assistant Practice Act. Provides for the licensure of certified anesthesiologist assistants by the Department of Financial and Professional Regulation. Sets forth provisions concerning: administrative procedures; the applicability of the Act; using titles, advertising, and billing; supervision requirements; application for licensure; unlicensed practice, violations, and civil penalties; the Certified Anesthesiologist Assistant Advisory Committee; qualifications for licensure; the expiration and renewal of a license; the inactive status of a license; and grounds for disciplinary action. Amends the Medical Practice Act of 1987. Provides that, under delegation from a supervising anesthesiologist, a licensed certified anesthesiologist assistant is authorized to select, order, and administer drugs and apply the appropriate medical devices in the provision of anesthesia services under the anesthesia plan agreed to by the supervising anesthesiologist. Amends the Ambulatory Surgical Treatment Center Act and the Hospital Licensing Act. Provides that a licensed certified anesthesiologist assistant under the supervision of an anesthesiologist with clinical privileges granted by the medical staff and ambulatory surgical center or at the hospital may administer anesthesia services. Amends the Regulatory Sunset Act to provide for the repeal of the Certified Anesthesiologist Assistant Practice Act on January 1, 2033. LRB103 06052 AMQ 51082 b LRB103 06052 AMQ 51082 b A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2214 Introduced 2/10/2023, by Sen. Cristina Castro SYNOPSIS AS INTRODUCED:
3	3	New Act5 ILCS 80/4.43 new 210 ILCS 5/6.5 210 ILCS 85/10.7 225 ILCS 60/54.5 225 ILCS 60/54.7 new New Act 5 ILCS 80/4.43 new 210 ILCS 5/6.5 210 ILCS 85/10.7 225 ILCS 60/54.5 225 ILCS 60/54.7 new
4	4	New Act
5	5	5 ILCS 80/4.43 new
6	6	210 ILCS 5/6.5
7	7	210 ILCS 85/10.7
8	8	225 ILCS 60/54.5
9	9	225 ILCS 60/54.7 new
10	10	Creates the Certified Anesthesiologist Assistant Practice Act. Provides for the licensure of certified anesthesiologist assistants by the Department of Financial and Professional Regulation. Sets forth provisions concerning: administrative procedures; the applicability of the Act; using titles, advertising, and billing; supervision requirements; application for licensure; unlicensed practice, violations, and civil penalties; the Certified Anesthesiologist Assistant Advisory Committee; qualifications for licensure; the expiration and renewal of a license; the inactive status of a license; and grounds for disciplinary action. Amends the Medical Practice Act of 1987. Provides that, under delegation from a supervising anesthesiologist, a licensed certified anesthesiologist assistant is authorized to select, order, and administer drugs and apply the appropriate medical devices in the provision of anesthesia services under the anesthesia plan agreed to by the supervising anesthesiologist. Amends the Ambulatory Surgical Treatment Center Act and the Hospital Licensing Act. Provides that a licensed certified anesthesiologist assistant under the supervision of an anesthesiologist with clinical privileges granted by the medical staff and ambulatory surgical center or at the hospital may administer anesthesia services. Amends the Regulatory Sunset Act to provide for the repeal of the Certified Anesthesiologist Assistant Practice Act on January 1, 2033.
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16	16	1 AN ACT concerning regulation.
17	17	2 Be it enacted by the People of the State of Illinois,
18	18	3 represented in the General Assembly:
19	19	4 Section 1. Short title. This Act may be cited as the
20	20	5 Certified Anesthesiologist Assistant Practice Act.
21	21	6 Section 5. Findings. The practice of anesthesiology is the
22	22	7 practice of medicine. The practice as a certified
23	23	8 anesthesiologist assistant in this State is declared to affect
24	24	9 the public health, safety, and welfare and to be subject to
25	25	10 regulation and control in the public interest. The purpose and
26	26	11 legislative intent of this Act is to encourage and promote the
27	27	12 more effective utilization of the skills of anesthesiologists
28	28	13 by enabling them to delegate certain medical care to certified
29	29	14 anesthesiologist assistants where such delegation is
30	30	15 consistent with the health and welfare of the patient and is
31	31	16 conducted at the direction of and under the responsible
32	32	17 supervision of an anesthesiologist.
33	33	18 It is further declared to be a matter of public health and
34	34	19 concern that the practice as a certified anesthesiologist
35	35	20 assistant, as defined in this Act, merit and receive the
36	36	21 confidence of the public and that only qualified persons be
37	37	22 authorized to practice as a certified anesthesiologist
38	38	23 assistant in this State. This Act shall be liberally construed
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42	42	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2214 Introduced 2/10/2023, by Sen. Cristina Castro SYNOPSIS AS INTRODUCED:
43	43	New Act5 ILCS 80/4.43 new 210 ILCS 5/6.5 210 ILCS 85/10.7 225 ILCS 60/54.5 225 ILCS 60/54.7 new New Act 5 ILCS 80/4.43 new 210 ILCS 5/6.5 210 ILCS 85/10.7 225 ILCS 60/54.5 225 ILCS 60/54.7 new
44	44	New Act
45	45	5 ILCS 80/4.43 new
46	46	210 ILCS 5/6.5
47	47	210 ILCS 85/10.7
48	48	225 ILCS 60/54.5
49	49	225 ILCS 60/54.7 new
50	50	Creates the Certified Anesthesiologist Assistant Practice Act. Provides for the licensure of certified anesthesiologist assistants by the Department of Financial and Professional Regulation. Sets forth provisions concerning: administrative procedures; the applicability of the Act; using titles, advertising, and billing; supervision requirements; application for licensure; unlicensed practice, violations, and civil penalties; the Certified Anesthesiologist Assistant Advisory Committee; qualifications for licensure; the expiration and renewal of a license; the inactive status of a license; and grounds for disciplinary action. Amends the Medical Practice Act of 1987. Provides that, under delegation from a supervising anesthesiologist, a licensed certified anesthesiologist assistant is authorized to select, order, and administer drugs and apply the appropriate medical devices in the provision of anesthesia services under the anesthesia plan agreed to by the supervising anesthesiologist. Amends the Ambulatory Surgical Treatment Center Act and the Hospital Licensing Act. Provides that a licensed certified anesthesiologist assistant under the supervision of an anesthesiologist with clinical privileges granted by the medical staff and ambulatory surgical center or at the hospital may administer anesthesia services. Amends the Regulatory Sunset Act to provide for the repeal of the Certified Anesthesiologist Assistant Practice Act on January 1, 2033.
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53	53	A BILL FOR
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59	59	New Act
60	60	5 ILCS 80/4.43 new
61	61	210 ILCS 5/6.5
62	62	210 ILCS 85/10.7
63	63	225 ILCS 60/54.5
64	64	225 ILCS 60/54.7 new
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83	83	1 to best carry out these subjects and purposes.
84	84	2 Section 10. Administrative Procedure Act. The Illinois
85	85	3 Administrative Procedure Act is hereby expressly adopted and
86	86	4 incorporated herein as if all of the provisions of that Act
87	87	5 were included in this Act. The Secretary may adopt rules for
88	88	6 the administration and enforcement of this Act and may
89	89	7 prescribe forms to be issued in connection with this Act.
90	90	8 Section 15. Definitions. As used in this Act:
91	91	9 "Anesthesiologist" means a physician licensed to practice
92	92	10 medicine in all its branches by the Department who has
93	93	11 completed a residency in anesthesiology approved by the
94	94	12 American Board of Anesthesiology or the American Osteopathic
95	95	13 Board of Anesthesiology, is board eligible or board certified,
96	96	14 holds an unrestricted license, and is actively engaged in
97	97	15 clinical practice.
98	98	16 "Board" means the Illinois State Medical Board constituted
99	99	17 under the Medical Practice Act of 1987.
100	100	18 "Certified anesthesiologist assistant" means an individual
101	101	19 licensed by the Department to provide anesthesia services
102	102	20 under the supervision of an anesthesiologist.
103	103	21 "Department" means the Department of Financial and
104	104	22 Professional Regulation.
105	105	23 "Secretary" means the Secretary of Financial and
106	106	24 Professional Regulation.
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117	117	1 "Supervision" means overseeing the activities of, and
118	118	2 accepting responsibility for, the medical services rendered by
119	119	3 the certified anesthesiologist assistant and maintaining
120	120	4 physical proximity that allows the anesthesiologist to return
121	121	5 to reestablish direct contact with the patient to meet medical
122	122	6 needs and address any urgent or emergent clinical problems at
123	123	7 all times that medical services are rendered by the certified
124	124	8 anesthesiologist assistant.
125	125	9 Section 20. Applicability. This Act does not prohibit:
126	126	10 (1) Any person licensed in this State under any other
127	127	11 Act from engaging in the practice for which the person is
128	128	12 licensed.
129	129	13 (2) The practice as an certified anesthesiologist
130	130	14 assistant by a person who is employed by the United States
131	131	15 government or any bureau, division, or agency thereof
132	132	16 while in the discharge of the employee's official duties.
133	133	17 (3) The practice as a certified anesthesiologist
134	134	18 assistant that is included in the certified
135	135	19 anesthesiologist assistant's program of study by students
136	136	20 enrolled in schools.
137	137	21 Section 25. Title; advertising; billing.
138	138	22 (a) No certified anesthesiologist assistant shall use the
139	139	23 title of doctor or associate with the licensee's name or any
140	140	24 other term in the clinical setting or while in contact with
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151	151	1 patients under the licensee's care that would indicate to
152	152	2 other persons that the licensee is qualified to engage in the
153	153	3 general independent practice of anesthesiology or
154	154	4 interventional pain management.
155	155	5 (b) A licensee shall include in every advertisement for
156	156	6 services regulated under this Act the licensee's title as it
157	157	7 appears on the license or the initials authorized under this
158	158	8 Act.
159	159	9 (c) A certified anesthesiologist assistant shall not be
160	160	10 allowed to bill patients or in any way charge for services.
161	161	11 Nothing in this Act, however, shall be so construed as to
162	162	12 prevent the employer of a certified anesthesiologist assistant
163	163	13 from charging for services rendered by the certified
164	164	14 anesthesiologist assistant. Payment for services rendered by a
165	165	15 certified anesthesiologist assistant shall be made to the
166	166	16 certified anesthesiologist assistant's employer if the payor
167	167	17 would have made payment had the services been provided by an
168	168	18 anesthesiologist.
169	169	19 Section 30. Supervision requirements.
170	170	20 (a) As used in this Section, "supervision" means the use
171	171	21 of the powers of direction and decision to coordinate, direct,
172	172	22 and inspect the accomplishment of another, and to oversee the
173	173	23 implementation of the anesthesiologist's intentions.
174	174	24 (b) A certified anesthesiologist assistant may deliver
175	175	25 medical care only under the supervision of an anesthesiologist
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186	186	1 and only as described in a supervision agreement between the
187	187	2 certified anesthesiologist assistant and an anesthesiologist
188	188	3 who represents the certified anesthesiologist assistant's
189	189	4 employer. The supervising anesthesiologist shall be
190	190	5 immediately available at all times while supervising a
191	191	6 certified anesthesiologist assistant.
192	192	7 For the purposes of this Section, "immediately available"
193	193	8 means the medically directing anesthesiologist being in such
194	194	9 physical proximity to allow the anesthesiologist to return to
195	195	10 reestablish direct contact with the patient to meet the
196	196	11 patient's medical needs and address any urgent or emergent
197	197	12 problems. These responsibilities may also be met through
198	198	13 careful coordination among anesthesiologists of the same group
199	199	14 or department. It is recognized that the design and size of
200	200	15 various facilities, the severity of patient illnesses, and the
201	201	16 complexity and demands of the particular surgical procedures
202	202	17 make it impossible to define a specific time or distance for
203	203	18 physical proximity.
204	204	19 (c) A certified anesthesiologist assistant's practice may
205	205	20 not exceed the licensee's education and training, the scope of
206	206	21 practice of the supervising anesthesiologist, and the practice
207	207	22 outlined in the certified anesthesiologist assistant
208	208	23 supervision agreement. A medical care task assigned by the
209	209	24 supervising anesthesiologist to the certified anesthesiologist
210	210	25 assistant may not be delegated by the certified
211	211	26 anesthesiologist assistant to another person, except for the
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222	222	1 preceptorship of a student in an anesthesiologist assistant
223	223	2 training program.
224	224	3 (d) A certified anesthesiologist assistant may assist only
225	225	4 the supervising anesthesiologist in the delivery of medical
226	226	5 care and may perform medical care tasks as well as any other
227	227	6 tasks within the scope of training and education of the
228	228	7 certified anesthesiologist assistant as assigned by the
229	229	8 supervising anesthesiologist.
230	230	9 (e) An anesthesiologist who represents a certified
231	231	10 anesthesiologist assistant's employer shall review the
232	232	11 supervision agreement with the certified anesthesiologist
233	233	12 assistant at least annually. The supervision agreement shall
234	234	13 be available for inspection at the location where the
235	235	14 certified anesthesiologist assistant practices. The
236	236	15 supervision agreement may limit the practice of a certified
237	237	16 anesthesiologist assistant to less than the full scope of
238	238	17 practice authorized under this Act.
239	239	18 (f) A certified anesthesiologist assistant shall be
240	240	19 employed by a health care provider that is licensed in this
241	241	20 State for the primary purpose of providing the medical
242	242	21 services of physicians or that is an entity. If a certified
243	243	22 anesthesiologist assistant's employer is not an
244	244	23 anesthesiologist, the employer shall provide for, and not
245	245	24 interfere with, an anesthesiologist's supervision of the
246	246	25 certified anesthesiologist assistant.
247	247	26 (g) A student in an anesthesiologist assistant training
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258	258	1 program may assist only an anesthesiologist in the delivery of
259	259	2 medical care and may perform only medical care tasks assigned
260	260	3 by the anesthesiologist. An anesthesiologist may delegate the
261	261	4 preceptorship of a student in an anesthesiologist assistant
262	262	5 training program to a qualified anesthesia provider. This
263	263	6 Section shall not be interpreted to limit the number of other
264	264	7 qualified anesthesia providers an anesthesiologist may
265	265	8 supervise.
266	266	9 (h) A student in an anesthesiologist assistant training
267	267	10 program shall be identified as a student anesthesiologist
268	268	11 assistant or an anesthesiologist assistant student and may not
269	269	12 be identified as an "intern", "resident", or "fellow".
270	270	13 Section 35. Application for licensure. An application for
271	271	14 an original license shall be made to the Department in writing
272	272	15 on forms or electronically as prescribed by the Department and
273	273	16 shall be accompanied by the required fee, which shall not be
274	274	17 refundable. An application shall require information that, in
275	275	18 the judgment of the Department, will enable the Department to
276	276	19 pass on the qualifications of the applicant for a license. An
277	277	20 application shall include evidence of passage of the
278	278	21 examination of the National Commission for the Certification
279	279	22 of Anesthesiologist Assistants, or its successor agency, and
280	280	23 proof that the applicant holds a valid certificate issued by
281	281	24 that Commission.
282	282	25 An applicant has 3 years from the date of application to
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293	293	1 complete the application process. If the process has not been
294	294	2 completed in 3 years, the application shall be denied, the fee
295	295	3 shall be forfeited, and the applicant must reapply and meet
296	296	4 the requirements in effect at the time of reapplication.
297	297	5 Section 40. Social security number on license application.
298	298	6 In addition to any other information required to be contained
299	299	7 in the application, every application for an original license
300	300	8 under this Act shall include the applicant's social security
301	301	9 number, which shall be retained in the agency's records
302	302	10 pertaining to the license.
303	303	11 As soon as practical, the Department shall assign a
304	304	12 customer's identification number to each applicant for a
305	305	13 license. Every application for a renewal or restored license
306	306	14 shall require the applicant's customer identification number.
307	307	15 Section 45. Identification. No person may designate
308	308	16 oneself as a certified anesthesiologist assistant, use or
309	309	17 assume the title "certified anesthesiologist assistant", or
310	310	18 append to the person's name the words or letters "certified
311	311	19 anesthesiologist assistant" or "C.A.A." or any other titles,
312	312	20 letters, or designation that represents or may tend to
313	313	21 represent the person as a certified anesthesiologist assistant
314	314	22 unless the licensee is licensed as a certified
315	315	23 anesthesiologist assistant by the Department. A certified
316	316	24 anesthesiologist assistant shall be clearly identified as a
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327	327	1 certified anesthesiologist assistant.
328	328	2 Section 50. Unlicensed practice; violation; civil penalty.
329	329	3 (a) Any person who practices, offers to practice, attempts
330	330	4 to practice, or holds oneself out to practice as a certified
331	331	5 anesthesiologist assistant without being licensed under this
332	332	6 Act shall, in addition to any other penalty provided by law,
333	333	7 pay a civil penalty to the Department in an amount not to
334	334	8 exceed $10,000 for each offense as determined by the
335	335	9 Department. The civil penalty shall be assessed by the
336	336	10 Department after a hearing is held in accordance with the
337	337	11 provisions set forth in this Act regarding the provision of a
338	338	12 hearing for the discipline of a licensee.
339	339	13 (b) The Department has the authority and power to
340	340	14 investigate any and all unlicensed activity.
341	341	15 (c) No person shall use any words, abbreviations, figures,
342	342	16 letters, title, sign, card, or device tending to imply that
343	343	17 the person is a certified anesthesiologist assistant,
344	344	18 including, but not limited to, using the titles or initials
345	345	19 "Certified Anesthesiologist Assistant" or "C.A.A.", or similar
346	346	20 titles or initials, with the intention of indicating practice
347	347	21 as a certified anesthesiologist assistant without meeting the
348	348	22 requirements of this Act.
349	349	23 (d) The civil penalty shall be paid within 60 days after
350	350	24 the effective date of the order imposing the civil penalty.
351	351	25 The order shall constitute a judgment and may be filed and
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362	362	1 execution had thereon in the same manner as any judgment from
363	363	2 any court of record.
364	364	3 Section 55. Committee.
365	365	4 (a) There is established a Certified Anesthesiologist
366	366	5 Assistant Advisory Committee to the Department and the Board.
367	367	6 The Certified Anesthesiologist Assistant Advisory Committee
368	368	7 may review and make recommendations to the Department and the
369	369	8 Board regarding all matters relating to certified
370	370	9 anesthesiologist assistants. These matters may include, but
371	371	10 are not limited to:
372	372	11 (1) applications for licensure;
373	373	12 (2) disciplinary proceedings;
374	374	13 (3) renewal requirements; and
375	375	14 (4) any other issues pertaining to the regulation and
376	376	15 practice of certified anesthesiologist assistants in the
377	377	16 State.
378	378	17 (b) The Committee's membership shall consist of the
379	379	18 following members appointed by the Governor and selected from
380	380	19 a list of recommended appointees submitted by the president of
381	381	20 a statewide academy or society representing certified
382	382	21 anesthesiologist assistants:
383	383	22 (1) one member of the Board;
384	384	23 (2) two certified anesthesiologist assistants licensed
385	385	24 under this Act;
386	386	25 (3) one anesthesiologist; and
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397	397	1 (4) one public member.
398	398	2 Members shall be appointed for 3-year terms. The president
399	399	3 of a statewide academy representing certified anesthesiologist
400	400	4 assistants shall consider the recommendations of the president
401	401	5 of a statewide academy or association representing
402	402	6 anesthesiologists when recommending appointees under paragraph
403	403	7 (2).
404	404	8 (c) Members of the Certified Anesthesiologist Assistant
405	405	9 Advisory Committee shall have no liability for any action
406	406	10 based upon a disciplinary proceeding or other activity
407	407	11 performed in good faith as a member of the Committee.
408	408	12 Section 60. Qualifications for licensure. A person shall
409	409	13 be qualified for licensure as a certified anesthesiologist
410	410	14 assistant and the Department may issue a certified
411	411	15 anesthesiologist assistant license to a person who:
412	412	16 (1) has applied in writing in form and substance
413	413	17 satisfactory to the Department and has not violated any of
414	414	18 the provisions of this Act or the rules adopted under this
415	415	19 Act; the Department may take into consideration any felony
416	416	20 conviction of the applicant, but such conviction shall not
417	417	21 operate as an absolute bar to licensure;
418	418	22 (2) has submitted evidence satisfactory to the
419	419	23 Department that the applicant has:
420	420	24 (A) obtained a master's degree;
421	421	25 (B) satisfactorily completed an anesthesiologist
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431	431	SB2214 - 12 - LRB103 06052 AMQ 51082 b
432	432	1 assistant program that is accredited by the Commission
433	433	2 on Accreditation of Allied Health Education Programs,
434	434	3 or its predecessor or successor entity; and
435	435	4 (C) passed the certifying examination administered
436	436	5 by and obtained active certification from the National
437	437	6 Commission for Certification of Anesthesiologist
438	438	7 Assistants or a successor entity; and
439	439	8 (3) complies with all applicable rules of the
440	440	9 Department.
441	441	10 Section 65. Endorsement. Upon payment of the required fee,
442	442	11 the Department may, in its discretion, license as a certified
443	443	12 anesthesiologist assistant an applicant who is a certified
444	444	13 anesthesiologist assistant licensed in another jurisdiction if
445	445	14 the requirements for licensure in that jurisdiction were at
446	446	15 the time of licensure substantially equivalent to the
447	447	16 requirement in force in this State on that date or equivalent
448	448	17 to the requirements of this Act.
449	449	18 Section 70. Expiration and renewal of license. The
450	450	19 expiration date and renewal period for each license issued
451	451	20 under this Act shall be set by rule. Renewal shall be
452	452	21 conditioned on paying the required fee and by meeting such
453	453	22 other requirements as may be established by rule.
454	454	23 Any certified anesthesiologist assistant who has permitted
455	455	24 the license to expire or who has had the license on inactive
456	456
457	457
458	458
459	459
460	460
461	461	SB2214 - 12 - LRB103 06052 AMQ 51082 b
462	462
463	463
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465	465	SB2214 - 13 - LRB103 06052 AMQ 51082 b
466	466	1 status may have the license restored by making application to
467	467	2 the Department and filing proof acceptable to the Department
468	468	3 of the individual's fitness to have the license restored, and
469	469	4 by paying the required fees. Proof of fitness may include
470	470	5 sworn evidence certifying to active lawful practice in another
471	471	6 jurisdiction.
472	472	7 If the certified anesthesiologist assistant has not
473	473	8 maintained an active practice in another jurisdiction
474	474	9 satisfactory to the Department, the Department shall
475	475	10 determine, by an evaluation program established by rule, the
476	476	11 individual's fitness for restoration of the license and shall
477	477	12 establish procedures and requirements for such restoration.
478	478	13 However, any certified anesthesiologist assistant whose
479	479	14 license expired while the individual was (i) in federal
480	480	15 service on active duty with the Armed Forces of the United
481	481	16 States, or the State Militia called into service or training,
482	482	17 or (ii) in training or education under the supervision of the
483	483	18 United States preliminary to induction into the military
484	484	19 service, may have the individual's license restored without
485	485	20 paying any lapsed renewal fees if within 2 years after
486	486	21 honorable termination of such service, training, or education
487	487	22 the individual furnishes the Department with satisfactory
488	488	23 evidence to the effect that the individual has been so engaged
489	489	24 and that the individual's service, training, or education has
490	490	25 been so terminated.
491	491
492	492
493	493
494	494
495	495
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497	497
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500	500	SB2214 - 14 - LRB103 06052 AMQ 51082 b
501	501	1 Section 75. Inactive status. Any certified
502	502	2 anesthesiologist assistant who notifies the Department in
503	503	3 writing on forms prescribed by the Department, may elect to
504	504	4 place the license on an inactive status and shall, subject to
505	505	5 rules of the Department, be excused from payment of renewal
506	506	6 fees until the individual notifies the Department in writing
507	507	7 of the individual's intention to restore the license.
508	508	8 Any certified anesthesiologist assistant requesting
509	509	9 restoration from inactive status shall be required to pay the
510	510	10 current renewal fee and shall be required to restore the
511	511	11 license, as provided in Section 70.
512	512	12 Any certified anesthesiologist assistant whose license is
513	513	13 in an inactive status shall not practice in this State.
514	514	14 Any certified anesthesiologist assistant who engages in
515	515	15 practice while the license is lapsed or on inactive status
516	516	16 shall be considered to be practicing without a license, which
517	517	17 shall be grounds for discipline under Section 80.
518	518	18 Section 80. Grounds for disciplinary action.
519	519	19 (a) The Department may refuse to issue or renew, or may
520	520	20 revoke, suspend, place on probation, reprimand, or take other
521	521	21 disciplinary or non-disciplinary action with regard to any
522	522	22 license issued under this Act as the Department may deem
523	523	23 proper, including the issuance of fines not to exceed $10,000
524	524	24 for each violation, for any one or a combination of the
525	525	25 following causes:
526	526
527	527
528	528
529	529
530	530
531	531	SB2214 - 14 - LRB103 06052 AMQ 51082 b
532	532
533	533
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535	535	SB2214 - 15 - LRB103 06052 AMQ 51082 b
536	536	1 (1) Material misstatement in furnishing information to
537	537	2 the Department.
538	538	3 (2) Violations of this Act or the rules adopted under
539	539	4 this Act.
540	540	5 (3) Conviction by plea of guilty or nolo contendere,
541	541	6 finding of guilt, jury verdict, or entry of judgment or
542	542	7 sentencing, including, but not limited to, convictions,
543	543	8 preceding sentences of supervision, conditional discharge,
544	544	9 or first offender probation, under the laws of any
545	545	10 jurisdiction of the United States that is: (i) a felony;
546	546	11 or (ii) a misdemeanor an essential element of which is
547	547	12 dishonesty or that is directly related to the practice of
548	548	13 the profession.
549	549	14 (4) Making any misrepresentation for the purpose of
550	550	15 obtaining licenses.
551	551	16 (5) Professional incompetence.
552	552	17 (6) Aiding or assisting another person in violating
553	553	18 any provision of this Act or its rules.
554	554	19 (7) Failing, within 60 days, to provide information in
555	555	20 response to a written request made by the Department.
556	556	21 (8) Engaging in dishonorable, unethical, or
557	557	22 unprofessional conduct, as defined by rule, of a character
558	558	23 likely to deceive, defraud, or harm the public.
559	559	24 (9) Habitual or excessive use or addiction to alcohol,
560	560	25 narcotics, stimulants, or any other chemical agent or drug
561	561	26 that results in a certified anesthesiologist assistant's
562	562
563	563
564	564
565	565
566	566
567	567	SB2214 - 15 - LRB103 06052 AMQ 51082 b
568	568
569	569
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571	571	SB2214 - 16 - LRB103 06052 AMQ 51082 b
572	572	1 inability to practice with reasonable judgment, skill, or
573	573	2 safety.
574	574	3 (10) Discipline by another U.S. jurisdiction or
575	575	4 foreign nation, if at least one of the grounds for
576	576	5 discipline is the same or substantially equivalent to
577	577	6 those set forth in this Section.
578	578	7 (11) Directly or indirectly giving to or receiving
579	579	8 from any person, firm, corporation, partnership, or
580	580	9 association any fee, commission, rebate, or other form of
581	581	10 compensation for any professional services not actually or
582	582	11 personally rendered. Nothing in this paragraph affects any
583	583	12 bona fide independent contractor or employment
584	584	13 arrangements, which may include provisions for
585	585	14 compensation, health insurance, pension, or other
586	586	15 employment benefits, with persons or entities authorized
587	587	16 under this Act for the provision of services within the
588	588	17 scope of the licensee's practice under this Act.
589	589	18 (12) A finding by the Board that the licensee, after
590	590	19 having the licensee's license placed on probationary
591	591	20 status has violated the terms of probation.
592	592	21 (13) Abandonment of a patient.
593	593	22 (14) Willfully making or filing false records or
594	594	23 reports in the certified anesthesiologist assistant's
595	595	24 practice, including, but not limited to, false records
596	596	25 filed with State agencies or departments.
597	597	26 (15) Willfully failing to report an instance of
598	598
599	599
600	600
601	601
602	602
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604	604
605	605
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607	607	SB2214 - 17 - LRB103 06052 AMQ 51082 b
608	608	1 suspected child abuse or neglect as required by the Abused
609	609	2 and Neglected Child Reporting Act.
610	610	3 (16) Physical illness or mental illness or impairment
611	611	4 that results in the inability to practice the profession
612	612	5 with reasonable judgment, skill, or safety, including, but
613	613	6 not limited to, deterioration through the aging process or
614	614	7 loss of motor skill.
615	615	8 (17) Being named as a perpetrator in an indicated
616	616	9 report by the Department of Children and Family Services
617	617	10 under the Abused and Neglected Child Reporting Act, and
618	618	11 upon proof by clear and convincing evidence that the
619	619	12 licensee has caused a child to be an abused child or
620	620	13 neglected child as defined in the Abused and Neglected
621	621	14 Child Reporting Act.
622	622	15 (18) Gross negligence resulting in the permanent
623	623	16 injury or death of a patient.
624	624	17 (19) Employment of fraud, deception, or any unlawful
625	625	18 means in applying for or securing a license as a certified
626	626	19 anesthesiologist assistant.
627	627	20 (20) Exceeding the authority delegated to the
628	628	21 certified anesthesiologist assistant by the certified
629	629	22 anesthesiologist assistant's supervising
630	630	23 anesthesiologist.
631	631	24 (21) Immoral conduct in the commission of any act,
632	632	25 such as sexual abuse, sexual misconduct, or sexual
633	633	26 exploitation related to the licensee's practice.
634	634
635	635
636	636
637	637
638	638
639	639	SB2214 - 17 - LRB103 06052 AMQ 51082 b
640	640
641	641
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643	643	SB2214 - 18 - LRB103 06052 AMQ 51082 b
644	644	1 (22) Violation of the Health Care Worker Self-Referral
645	645	2 Act.
646	646	3 (23) Practicing under a false or assumed name, except
647	647	4 as provided by law.
648	648	5 (24) Making a false or misleading statement regarding
649	649	6 the certified anesthesiologist assistant's skill or the
650	650	7 efficacy or value of the medicine, treatment, or remedy
651	651	8 prescribed by the certified anesthesiologist assistant in
652	652	9 the course of treatment.
653	653	10 (25) Allowing another person to use the certified
654	654	11 anesthesiologist assistant's license to practice.
655	655	12 (26) Prescribing, selling, administering,
656	656	13 distributing, giving, or self-administering a drug
657	657	14 classified as a controlled substance for other than
658	658	15 medically accepted therapeutic purposes.
659	659	16 (27) Promotion of the sale of drugs, devices,
660	660	17 appliances, or goods provided for a patient in a manner to
661	661	18 exploit the patient for financial gain.
662	662	19 (28) A pattern of practice or other behavior that
663	663	20 demonstrates incapacity or incompetence to practice under
664	664	21 this Act.
665	665	22 (29) Violating State or federal laws, rules, or
666	666	23 regulations relating to controlled substances or other
667	667	24 legend drugs or ephedra as defined in the Ephedra
668	668	25 Prohibition Act.
669	669	26 (30) Failure to establish and maintain records of
670	670
671	671
672	672
673	673
674	674
675	675	SB2214 - 18 - LRB103 06052 AMQ 51082 b
676	676
677	677
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679	679	SB2214 - 19 - LRB103 06052 AMQ 51082 b
680	680	1 patient care and treatment as required by law.
681	681	2 (31) Attempting to subvert or cheat on the examination
682	682	3 of the National Commission for Certification of
683	683	4 Anesthesiologist Assistants or its successor agency.
684	684	5 (32) Willfully or negligently violating the
685	685	6 confidentiality between the certified anesthesiologist
686	686	7 assistant and patient, except as required by law.
687	687	8 (33) Willfully failing to report an instance of
688	688	9 suspected abuse, neglect, financial exploitation, or
689	689	10 self-neglect of an eligible adult as defined in and
690	690	11 required by the Adult Protective Services Act.
691	691	12 (34) Being named as an abuser in a verified report by
692	692	13 the Department on Aging under the Adult Protective
693	693	14 Services Act and upon proof by clear and convincing
694	694	15 evidence that the licensee abused, neglected, or
695	695	16 financially exploited an eligible adult as defined in the
696	696	17 Adult Protective Services Act.
697	697	18 (35) Failure to report to the Department an adverse
698	698	19 final action taken against the certified anesthesiologist
699	699	20 assistant by another licensing jurisdiction of the United
700	700	21 States or a foreign state or country, a peer review body, a
701	701	22 health care institution, a professional society or
702	702	23 association, a governmental agency, a law enforcement
703	703	24 agency, or a court for acts or conduct similar to acts or
704	704	25 conduct that would constitute grounds for action under
705	705	26 this Section.
706	706
707	707
708	708
709	709
710	710
711	711	SB2214 - 19 - LRB103 06052 AMQ 51082 b
712	712
713	713
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715	715	SB2214 - 20 - LRB103 06052 AMQ 51082 b
716	716	1 (36) Failure to provide copies of records of patient
717	717	2 care or treatment, except as required by law.
718	718	3 (37) Violating the Compassionate Use of Medical
719	719	4 Cannabis Program Act.
720	720	5 (b) The Department may, without a hearing, refuse to issue
721	721	6 or renew or may suspend the license of any person who fails to
722	722	7 file a return, or to pay the tax, penalty, or interest shown in
723	723	8 a filed return, or to pay any final assessment of the tax,
724	724	9 penalty, or interest as required by any tax Act administered
725	725	10 by the Department of Revenue, until the requirements of any
726	726	11 such tax Act are satisfied.
727	727	12 (c) The determination by a circuit court that a licensee
728	728	13 is subject to involuntary admission or judicial admission as
729	729	14 provided in the Mental Health and Developmental Disabilities
730	730	15 Code operates as an automatic suspension. The suspension will
731	731	16 end only upon a finding by a court that the patient is no
732	732	17 longer subject to involuntary admission or judicial admission
733	733	18 and issues an order so finding and discharging the patient,
734	734	19 and upon the recommendation of the Board to the Secretary that
735	735	20 the licensee be allowed to resume the licensee's practice.
736	736	21 (d) In enforcing this Section, the Department upon a
737	737	22 showing of a possible violation may compel an individual
738	738	23 licensed to practice under this Act, or who has applied for
739	739	24 licensure under this Act, to submit to a mental or physical
740	740	25 examination, or both, which may include a substance abuse or
741	741	26 sexual offender evaluation, as required by and at the expense
742	742
743	743
744	744
745	745
746	746
747	747	SB2214 - 20 - LRB103 06052 AMQ 51082 b
748	748
749	749
750	750	SB2214- 21 -LRB103 06052 AMQ 51082 b SB2214 - 21 - LRB103 06052 AMQ 51082 b
751	751	SB2214 - 21 - LRB103 06052 AMQ 51082 b
752	752	1 of the Department.
753	753	2 The Department shall specifically designate the examining
754	754	3 physician licensed to practice medicine in all of its branches
755	755	4 or, if applicable, the multidisciplinary team involved in
756	756	5 providing the mental or physical examination or both. The
757	757	6 multidisciplinary team shall be led by a physician licensed to
758	758	7 practice medicine in all of its branches and may consist of one
759	759	8 or more or a combination of physicians licensed to practice
760	760	9 medicine in all of its branches, licensed clinical
761	761	10 psychologists, licensed clinical social workers, licensed
762	762	11 clinical professional counselors, and other professional and
763	763	12 administrative staff. Any examining physician or member of the
764	764	13 multidisciplinary team may require any person ordered to
765	765	14 submit to an examination pursuant to this Section to submit to
766	766	15 any additional supplemental testing deemed necessary to
767	767	16 complete any examination or evaluation process, including, but
768	768	17 not limited to, blood testing, urinalysis, psychological
769	769	18 testing, or neuropsychological testing.
770	770	19 The Department may order the examining physician or any
771	771	20 member of the multidisciplinary team to provide to the
772	772	21 Department any and all records, including business records,
773	773	22 that relate to the examination and evaluation, including any
774	774	23 supplemental testing performed.
775	775	24 The Department may order the examining physician or any
776	776	25 member of the multidisciplinary team to present testimony
777	777	26 concerning the mental or physical examination of the licensee
778	778
779	779
780	780
781	781
782	782
783	783	SB2214 - 21 - LRB103 06052 AMQ 51082 b
784	784
785	785
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787	787	SB2214 - 22 - LRB103 06052 AMQ 51082 b
788	788	1 or applicant. No information, report, record, or other
789	789	2 documents in any way related to the examination shall be
790	790	3 excluded by reason of any common law or statutory privilege
791	791	4 relating to communications between the licensee or applicant
792	792	5 and the examining physician or any member of the
793	793	6 multidisciplinary team. No authorization is necessary from the
794	794	7 licensee or applicant ordered to undergo an examination for
795	795	8 the examining physician or any member of the multidisciplinary
796	796	9 team to provide information, reports, records, or other
797	797	10 documents or to provide any testimony regarding the
798	798	11 examination and evaluation.
799	799	12 The individual to be examined may have, at the
800	800	13 individual's own expense, another physician of the
801	801	14 individual's choice present during all aspects of this
802	802	15 examination. However, that physician shall be present only to
803	803	16 observe and may not interfere in any way with the examination.
804	804	17 Failure of an individual to submit to a mental or physical
805	805	18 examination, when ordered, shall result in an automatic
806	806	19 suspension of the individual's license until the individual
807	807	20 submits to the examination.
808	808	21 If the Department finds an individual unable to practice
809	809	22 because of the reasons set forth in this Section, the
810	810	23 Department may require that individual to submit to care,
811	811	24 counseling, or treatment by physicians approved or designated
812	812	25 by the Department, as a condition, term, or restriction for
813	813	26 continued, reinstated, or renewed licensure to practice; or,
814	814
815	815
816	816
817	817
818	818
819	819	SB2214 - 22 - LRB103 06052 AMQ 51082 b
820	820
821	821
822	822	SB2214- 23 -LRB103 06052 AMQ 51082 b SB2214 - 23 - LRB103 06052 AMQ 51082 b
823	823	SB2214 - 23 - LRB103 06052 AMQ 51082 b
824	824	1 in lieu of care, counseling, or treatment, the Department may
825	825	2 file a complaint to immediately suspend, revoke, or otherwise
826	826	3 discipline the license of the individual. An individual whose
827	827	4 license was granted, continued, reinstated, renewed,
828	828	5 disciplined, or supervised subject to such terms, conditions,
829	829	6 or restrictions, and who fails to comply with such terms,
830	830	7 conditions, or restrictions, shall be referred to the
831	831	8 Secretary for a determination as to whether the individual
832	832	9 shall have the individual's license suspended immediately,
833	833	10 pending a hearing by the Department.
834	834	11 In instances in which the Secretary immediately suspends
835	835	12 an individual's license under this Section, a hearing on that
836	836	13 individual's license must be convened by the Department within
837	837	14 30 days after the suspension and completed without appreciable
838	838	15 delay. The Department shall have the authority to review the
839	839	16 subject individual's record of treatment and counseling
840	840	17 regarding the impairment to the extent permitted by applicable
841	841	18 federal statutes and regulations safeguarding the
842	842	19 confidentiality of medical records.
843	843	20 An individual licensed under this Act and affected under
844	844	21 this Section shall be afforded an opportunity to demonstrate
845	845	22 to the Department that the individual can resume practice in
846	846	23 compliance with acceptable and prevailing standards under the
847	847	24 provisions of the individual's license.
848	848	25 (e) An individual or organization acting in good faith,
849	849	26 and not in a willful and wanton manner, in complying with this
850	850
851	851
852	852
853	853
854	854
855	855	SB2214 - 23 - LRB103 06052 AMQ 51082 b
856	856
857	857
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859	859	SB2214 - 24 - LRB103 06052 AMQ 51082 b
860	860	1 Section by providing a report or other information to the
861	861	2 Board, by assisting in the investigation or preparation of a
862	862	3 report or information, by participating in proceedings of the
863	863	4 Board, or by serving as a member of the Board, shall not be
864	864	5 subject to criminal prosecution or civil damages as a result
865	865	6 of such actions.
866	866	7 (f) Members of the Board shall be indemnified by the State
867	867	8 for any actions occurring within the scope of services of the
868	868	9 Board, done in good faith and not willful and wanton in nature.
869	869	10 The Attorney General shall defend all such actions unless the
870	870	11 Attorney General determines either that there would be a
871	871	12 conflict of interest in such representation or that the
872	872	13 actions complained of were not in good faith or were willful
873	873	14 and wanton.
874	874	15 If the Attorney General declines representation, the
875	875	16 member has the right to employ counsel of the member's choice,
876	876	17 whose fees shall be provided by the State, after approval by
877	877	18 the Attorney General, unless there is a determination by a
878	878	19 court that the member's actions were not in good faith or were
879	879	20 willful and wanton.
880	880	21 The member must notify the Attorney General within 7 days
881	881	22 after receipt of notice of the initiation of any action
882	882	23 involving services of the Board. Failure to so notify the
883	883	24 Attorney General constitutes an absolute waiver of the right
884	884	25 to a defense and indemnification.
885	885	26 The Attorney General shall determine, within 7 days after
886	886
887	887
888	888
889	889
890	890
891	891	SB2214 - 24 - LRB103 06052 AMQ 51082 b
892	892
893	893
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895	895	SB2214 - 25 - LRB103 06052 AMQ 51082 b
896	896	1 receiving such notice, whether the Attorney General will
897	897	2 undertake to represent the member.
898	898	3 Section 900. The Regulatory Sunset Act is amended by
899	899	4 adding Section 4.43 as follows:
900	900	5 (5 ILCS 80/4.43 new)
901	901	6 Sec. 4.43. Act repealed on January 1, 2033. The following
902	902	7 Act is repealed on January 1, 2033:
903	903	8 The Certified Anesthesiologist Assistant Practice Act.
904	904	9 Section 905. The Ambulatory Surgical Treatment Center Act
905	905	10 is amended by changing Section 6.5 as follows:
906	906	11 (210 ILCS 5/6.5)
907	907	12 Sec. 6.5. Clinical privileges; advanced practice
908	908	13 registered nurses. All ambulatory surgical treatment centers
909	909	14 (ASTC) licensed under this Act shall comply with the following
910	910	15 requirements:
911	911	16 (1) No ASTC policy, rule, regulation, or practice
912	912	17 shall be inconsistent with the provision of adequate
913	913	18 collaboration and consultation in accordance with Section
914	914	19 54.5 of the Medical Practice Act of 1987.
915	915	20 (2) Operative surgical procedures shall be performed
916	916	21 only by a physician licensed to practice medicine in all
917	917	22 its branches under the Medical Practice Act of 1987, a
918	918
919	919
920	920
921	921
922	922
923	923	SB2214 - 25 - LRB103 06052 AMQ 51082 b
924	924
925	925
926	926	SB2214- 26 -LRB103 06052 AMQ 51082 b SB2214 - 26 - LRB103 06052 AMQ 51082 b
927	927	SB2214 - 26 - LRB103 06052 AMQ 51082 b
928	928	1 dentist licensed under the Illinois Dental Practice Act,
929	929	2 or a podiatric physician licensed under the Podiatric
930	930	3 Medical Practice Act of 1987, with medical staff
931	931	4 membership and surgical clinical privileges granted by the
932	932	5 consulting committee of the ASTC. A licensed physician,
933	933	6 dentist, or podiatric physician may be assisted by a
934	934	7 physician licensed to practice medicine in all its
935	935	8 branches, dentist, dental assistant, podiatric physician,
936	936	9 licensed advanced practice registered nurse, licensed
937	937	10 physician assistant, licensed registered nurse, licensed
938	938	11 practical nurse, surgical assistant, surgical technician,
939	939	12 licensed certified anesthesiologist assistant, or other
940	940	13 individuals granted clinical privileges to assist in
941	941	14 surgery by the consulting committee of the ASTC. Payment
942	942	15 for services rendered by an assistant in surgery who is
943	943	16 not an ambulatory surgical treatment center employee shall
944	944	17 be paid at the appropriate non-physician modifier rate if
945	945	18 the payor would have made payment had the same services
946	946	19 been provided by a physician.
947	947	20 (2.5) A registered nurse licensed under the Nurse
948	948	21 Practice Act and qualified by training and experience in
949	949	22 operating room nursing shall be present in the operating
950	950	23 room and function as the circulating nurse during all
951	951	24 invasive or operative procedures. For purposes of this
952	952	25 paragraph (2.5), "circulating nurse" means a registered
953	953	26 nurse who is responsible for coordinating all nursing
954	954
955	955
956	956
957	957
958	958
959	959	SB2214 - 26 - LRB103 06052 AMQ 51082 b
960	960
961	961
962	962	SB2214- 27 -LRB103 06052 AMQ 51082 b SB2214 - 27 - LRB103 06052 AMQ 51082 b
963	963	SB2214 - 27 - LRB103 06052 AMQ 51082 b
964	964	1 care, patient safety needs, and the needs of the surgical
965	965	2 team in the operating room during an invasive or operative
966	966	3 procedure.
967	967	4 (3) An advanced practice registered nurse is not
968	968	5 required to possess prescriptive authority or a written
969	969	6 collaborative agreement meeting the requirements of the
970	970	7 Nurse Practice Act to provide advanced practice registered
971	971	8 nursing services in an ambulatory surgical treatment
972	972	9 center. An advanced practice registered nurse must possess
973	973	10 clinical privileges granted by the consulting medical
974	974	11 staff committee and ambulatory surgical treatment center
975	975	12 in order to provide services. Individual advanced practice
976	976	13 registered nurses may also be granted clinical privileges
977	977	14 to order, select, and administer medications, including
978	978	15 controlled substances, to provide delineated care. The
979	979	16 attending physician must determine the advanced practice
980	980	17 registered nurse's role in providing care for his or her
981	981	18 patients, except as otherwise provided in the consulting
982	982	19 staff policies. The consulting medical staff committee
983	983	20 shall periodically review the services of advanced
984	984	21 practice registered nurses granted privileges.
985	985	22 (4) The anesthesia service shall be under the
986	986	23 direction of a physician licensed to practice medicine in
987	987	24 all its branches who has had specialized preparation or
988	988	25 experience in the area or who has completed a residency in
989	989	26 anesthesiology. An anesthesiologist, Board certified or
990	990
991	991
992	992
993	993
994	994
995	995	SB2214 - 27 - LRB103 06052 AMQ 51082 b
996	996
997	997
998	998	SB2214- 28 -LRB103 06052 AMQ 51082 b SB2214 - 28 - LRB103 06052 AMQ 51082 b
999	999	SB2214 - 28 - LRB103 06052 AMQ 51082 b
1000	1000	1 Board eligible, is recommended. Anesthesia services may
1001	1001	2 only be administered pursuant to the order of a physician
1002	1002	3 licensed to practice medicine in all its branches,
1003	1003	4 licensed dentist, or licensed podiatric physician.
1004	1004	5 (A) The individuals who, with clinical privileges
1005	1005	6 granted by the medical staff and ASTC, may administer
1006	1006	7 anesthesia services are limited to the following:
1007	1007	8 (i) an anesthesiologist; or
1008	1008	9 (ii) a physician licensed to practice medicine
1009	1009	10 in all its branches; or
1010	1010	11 (iii) a dentist with authority to administer
1011	1011	12 anesthesia under Section 8.1 of the Illinois
1012	1012	13 Dental Practice Act; or
1013	1013	14 (iv) a licensed certified registered nurse
1014	1014	15 anesthetist; or
1015	1015	16 (v) a podiatric physician licensed under the
1016	1016	17 Podiatric Medical Practice Act of 1987; or .
1017	1017	18 (vi) a licensed certified anesthesiologist
1018	1018	19 assistant under the supervision of an
1019	1019	20 anesthesiologist.
1020	1020	21 (B) For anesthesia services, an anesthesiologist
1021	1021	22 shall participate through discussion of and agreement
1022	1022	23 with the anesthesia plan and shall remain physically
1023	1023	24 present and be available on the premises during the
1024	1024	25 delivery of anesthesia services for diagnosis,
1025	1025	26 consultation, and treatment of emergency medical
1026	1026
1027	1027
1028	1028
1029	1029
1030	1030
1031	1031	SB2214 - 28 - LRB103 06052 AMQ 51082 b
1032	1032
1033	1033
1034	1034	SB2214- 29 -LRB103 06052 AMQ 51082 b SB2214 - 29 - LRB103 06052 AMQ 51082 b
1035	1035	SB2214 - 29 - LRB103 06052 AMQ 51082 b
1036	1036	1 conditions. In the absence of 24-hour availability of
1037	1037	2 anesthesiologists with clinical privileges, an
1038	1038	3 alternate policy (requiring participation, presence,
1039	1039	4 and availability of a physician licensed to practice
1040	1040	5 medicine in all its branches) shall be developed by
1041	1041	6 the medical staff consulting committee in consultation
1042	1042	7 with the anesthesia service and included in the
1043	1043	8 medical staff consulting committee policies.
1044	1044	9 (C) A certified registered nurse anesthetist is
1045	1045	10 not required to possess prescriptive authority or a
1046	1046	11 written collaborative agreement meeting the
1047	1047	12 requirements of Section 65-35 of the Nurse Practice
1048	1048	13 Act to provide anesthesia services ordered by a
1049	1049	14 licensed physician, dentist, or podiatric physician.
1050	1050	15 Licensed certified registered nurse anesthetists are
1051	1051	16 authorized to select, order, and administer drugs and
1052	1052	17 apply the appropriate medical devices in the provision
1053	1053	18 of anesthesia services under the anesthesia plan
1054	1054	19 agreed with by the anesthesiologist or, in the absence
1055	1055	20 of an available anesthesiologist with clinical
1056	1056	21 privileges, agreed with by the operating physician,
1057	1057	22 operating dentist, or operating podiatric physician in
1058	1058	23 accordance with the medical staff consulting committee
1059	1059	24 policies of a licensed ambulatory surgical treatment
1060	1060	25 center.
1061	1061	26 (Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
1062	1062
1063	1063
1064	1064
1065	1065
1066	1066
1067	1067	SB2214 - 29 - LRB103 06052 AMQ 51082 b
1068	1068
1069	1069
1070	1070	SB2214- 30 -LRB103 06052 AMQ 51082 b SB2214 - 30 - LRB103 06052 AMQ 51082 b
1071	1071	SB2214 - 30 - LRB103 06052 AMQ 51082 b
1072	1072	1 Section 910. The Hospital Licensing Act is amended by
1073	1073	2 changing Section 10.7 as follows:
1074	1074	3 (210 ILCS 85/10.7)
1075	1075	4 Sec. 10.7. Clinical privileges; advanced practice
1076	1076	5 registered nurses. All hospitals licensed under this Act
1077	1077	6 shall comply with the following requirements:
1078	1078	7 (1) No hospital policy, rule, regulation, or practice
1079	1079	8 shall be inconsistent with the provision of adequate
1080	1080	9 collaboration and consultation in accordance with Section
1081	1081	10 54.5 of the Medical Practice Act of 1987.
1082	1082	11 (2) Operative surgical procedures shall be performed
1083	1083	12 only by a physician licensed to practice medicine in all
1084	1084	13 its branches under the Medical Practice Act of 1987, a
1085	1085	14 dentist licensed under the Illinois Dental Practice Act,
1086	1086	15 or a podiatric physician licensed under the Podiatric
1087	1087	16 Medical Practice Act of 1987, with medical staff
1088	1088	17 membership and surgical clinical privileges granted at the
1089	1089	18 hospital. A licensed physician, dentist, or podiatric
1090	1090	19 physician may be assisted by a physician licensed to
1091	1091	20 practice medicine in all its branches, dentist, dental
1092	1092	21 assistant, podiatric physician, licensed advanced practice
1093	1093	22 registered nurse, licensed physician assistant, licensed
1094	1094	23 registered nurse, licensed practical nurse, surgical
1095	1095	24 assistant, surgical technician, licensed certified
1096	1096
1097	1097
1098	1098
1099	1099
1100	1100
1101	1101	SB2214 - 30 - LRB103 06052 AMQ 51082 b
1102	1102
1103	1103
1104	1104	SB2214- 31 -LRB103 06052 AMQ 51082 b SB2214 - 31 - LRB103 06052 AMQ 51082 b
1105	1105	SB2214 - 31 - LRB103 06052 AMQ 51082 b
1106	1106	1 anesthesiologist assistant, or other individuals granted
1107	1107	2 clinical privileges to assist in surgery at the hospital.
1108	1108	3 Payment for services rendered by an assistant in surgery
1109	1109	4 who is not a hospital employee shall be paid at the
1110	1110	5 appropriate non-physician modifier rate if the payor would
1111	1111	6 have made payment had the same services been provided by a
1112	1112	7 physician.
1113	1113	8 (2.5) A registered nurse licensed under the Nurse
1114	1114	9 Practice Act and qualified by training and experience in
1115	1115	10 operating room nursing shall be present in the operating
1116	1116	11 room and function as the circulating nurse during all
1117	1117	12 invasive or operative procedures. For purposes of this
1118	1118	13 paragraph (2.5), "circulating nurse" means a registered
1119	1119	14 nurse who is responsible for coordinating all nursing
1120	1120	15 care, patient safety needs, and the needs of the surgical
1121	1121	16 team in the operating room during an invasive or operative
1122	1122	17 procedure.
1123	1123	18 (3) An advanced practice registered nurse is not
1124	1124	19 required to possess prescriptive authority or a written
1125	1125	20 collaborative agreement meeting the requirements of the
1126	1126	21 Nurse Practice Act to provide advanced practice registered
1127	1127	22 nursing services in a hospital. An advanced practice
1128	1128	23 registered nurse must possess clinical privileges
1129	1129	24 recommended by the medical staff and granted by the
1130	1130	25 hospital in order to provide services. Individual advanced
1131	1131	26 practice registered nurses may also be granted clinical
1132	1132
1133	1133
1134	1134
1135	1135
1136	1136
1137	1137	SB2214 - 31 - LRB103 06052 AMQ 51082 b
1138	1138
1139	1139
1140	1140	SB2214- 32 -LRB103 06052 AMQ 51082 b SB2214 - 32 - LRB103 06052 AMQ 51082 b
1141	1141	SB2214 - 32 - LRB103 06052 AMQ 51082 b
1142	1142	1 privileges to order, select, and administer medications,
1143	1143	2 including controlled substances, to provide delineated
1144	1144	3 care. The attending physician must determine the advanced
1145	1145	4 practice registered nurse's role in providing care for his
1146	1146	5 or her patients, except as otherwise provided in medical
1147	1147	6 staff bylaws. The medical staff shall periodically review
1148	1148	7 the services of advanced practice registered nurses
1149	1149	8 granted privileges. This review shall be conducted in
1150	1150	9 accordance with item (2) of subsection (a) of Section 10.8
1151	1151	10 of this Act for advanced practice registered nurses
1152	1152	11 employed by the hospital.
1153	1153	12 (4) The anesthesia service shall be under the
1154	1154	13 direction of a physician licensed to practice medicine in
1155	1155	14 all its branches who has had specialized preparation or
1156	1156	15 experience in the area or who has completed a residency in
1157	1157	16 anesthesiology. An anesthesiologist, Board certified or
1158	1158	17 Board eligible, is recommended. Anesthesia services may
1159	1159	18 only be administered pursuant to the order of a physician
1160	1160	19 licensed to practice medicine in all its branches,
1161	1161	20 licensed dentist, or licensed podiatric physician.
1162	1162	21 (A) The individuals who, with clinical privileges
1163	1163	22 granted at the hospital, may administer anesthesia
1164	1164	23 services are limited to the following:
1165	1165	24 (i) an anesthesiologist; or
1166	1166	25 (ii) a physician licensed to practice medicine
1167	1167	26 in all its branches; or
1168	1168
1169	1169
1170	1170
1171	1171
1172	1172
1173	1173	SB2214 - 32 - LRB103 06052 AMQ 51082 b
1174	1174
1175	1175
1176	1176	SB2214- 33 -LRB103 06052 AMQ 51082 b SB2214 - 33 - LRB103 06052 AMQ 51082 b
1177	1177	SB2214 - 33 - LRB103 06052 AMQ 51082 b
1178	1178	1 (iii) a dentist with authority to administer
1179	1179	2 anesthesia under Section 8.1 of the Illinois
1180	1180	3 Dental Practice Act; or
1181	1181	4 (iv) a licensed certified registered nurse
1182	1182	5 anesthetist; or
1183	1183	6 (v) a podiatric physician licensed under the
1184	1184	7 Podiatric Medical Practice Act of 1987; or .
1185	1185	8 (vi) a licensed certified anesthesiologist
1186	1186	9 assistant under the supervision of an
1187	1187	10 anesthesiologist.
1188	1188	11 (B) For anesthesia services, an anesthesiologist
1189	1189	12 shall participate through discussion of and agreement
1190	1190	13 with the anesthesia plan and shall remain physically
1191	1191	14 present and be available on the premises during the
1192	1192	15 delivery of anesthesia services for diagnosis,
1193	1193	16 consultation, and treatment of emergency medical
1194	1194	17 conditions. In the absence of 24-hour availability of
1195	1195	18 anesthesiologists with medical staff privileges, an
1196	1196	19 alternate policy (requiring participation, presence,
1197	1197	20 and availability of a physician licensed to practice
1198	1198	21 medicine in all its branches) shall be developed by
1199	1199	22 the medical staff and licensed hospital in
1200	1200	23 consultation with the anesthesia service.
1201	1201	24 (C) A certified registered nurse anesthetist is
1202	1202	25 not required to possess prescriptive authority or a
1203	1203	26 written collaborative agreement meeting the
1204	1204
1205	1205
1206	1206
1207	1207
1208	1208
1209	1209	SB2214 - 33 - LRB103 06052 AMQ 51082 b
1210	1210
1211	1211
1212	1212	SB2214- 34 -LRB103 06052 AMQ 51082 b SB2214 - 34 - LRB103 06052 AMQ 51082 b
1213	1213	SB2214 - 34 - LRB103 06052 AMQ 51082 b
1214	1214	1 requirements of Section 65-35 of the Nurse Practice
1215	1215	2 Act to provide anesthesia services ordered by a
1216	1216	3 licensed physician, dentist, or podiatric physician.
1217	1217	4 Licensed certified registered nurse anesthetists are
1218	1218	5 authorized to select, order, and administer drugs and
1219	1219	6 apply the appropriate medical devices in the provision
1220	1220	7 of anesthesia services under the anesthesia plan
1221	1221	8 agreed with by the anesthesiologist or, in the absence
1222	1222	9 of an available anesthesiologist with clinical
1223	1223	10 privileges, agreed with by the operating physician,
1224	1224	11 operating dentist, or operating podiatric physician in
1225	1225	12 accordance with the hospital's alternative policy.
1226	1226	13 (Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
1227	1227	14 Section 915. The Medical Practice Act of 1987 is amended
1228	1228	15 by changing Section 54.5 and by adding Section 54.7 as
1229	1229	16 follows:
1230	1230	17 (225 ILCS 60/54.5)
1231	1231	18 (Section scheduled to be repealed on January 1, 2027)
1232	1232	19 Sec. 54.5. Physician delegation of authority to physician
1233	1233	20 assistants, certified anesthesiologist assistants, advanced
1234	1234	21 practice registered nurses without full practice authority,
1235	1235	22 and prescribing psychologists.
1236	1236	23 (a) Physicians licensed to practice medicine in all its
1237	1237	24 branches may delegate care and treatment responsibilities to a
1238	1238
1239	1239
1240	1240
1241	1241
1242	1242
1243	1243	SB2214 - 34 - LRB103 06052 AMQ 51082 b
1244	1244
1245	1245
1246	1246	SB2214- 35 -LRB103 06052 AMQ 51082 b SB2214 - 35 - LRB103 06052 AMQ 51082 b
1247	1247	SB2214 - 35 - LRB103 06052 AMQ 51082 b
1248	1248	1 physician assistant under guidelines in accordance with the
1249	1249	2 requirements of the Physician Assistant Practice Act of 1987.
1250	1250	3 A physician licensed to practice medicine in all its branches
1251	1251	4 may enter into collaborative agreements with no more than 7
1252	1252	5 full-time equivalent physician assistants, except in a
1253	1253	6 hospital, hospital affiliate, or ambulatory surgical treatment
1254	1254	7 center as set forth by Section 7.7 of the Physician Assistant
1255	1255	8 Practice Act of 1987 and as provided in subsection (a-5).
1256	1256	9 (a-5) A physician licensed to practice medicine in all its
1257	1257	10 branches may collaborate with more than 7 physician assistants
1258	1258	11 when the services are provided in a federal primary care
1259	1259	12 health professional shortage area with a Health Professional
1260	1260	13 Shortage Area score greater than or equal to 12, as determined
1261	1261	14 by the United States Department of Health and Human Services.
1262	1262	15 The collaborating physician must keep appropriate
1263	1263	16 documentation of meeting this exemption and make it available
1264	1264	17 to the Department upon request.
1265	1265	18 (b) A physician licensed to practice medicine in all its
1266	1266	19 branches in active clinical practice may collaborate with an
1267	1267	20 advanced practice registered nurse in accordance with the
1268	1268	21 requirements of the Nurse Practice Act. Collaboration is for
1269	1269	22 the purpose of providing medical consultation, and no
1270	1270	23 employment relationship is required. A written collaborative
1271	1271	24 agreement shall conform to the requirements of Section 65-35
1272	1272	25 of the Nurse Practice Act. The written collaborative agreement
1273	1273	26 shall be for services in the same area of practice or specialty
1274	1274
1275	1275
1276	1276
1277	1277
1278	1278
1279	1279	SB2214 - 35 - LRB103 06052 AMQ 51082 b
1280	1280
1281	1281
1282	1282	SB2214- 36 -LRB103 06052 AMQ 51082 b SB2214 - 36 - LRB103 06052 AMQ 51082 b
1283	1283	SB2214 - 36 - LRB103 06052 AMQ 51082 b
1284	1284	1 as the collaborating physician in his or her clinical medical
1285	1285	2 practice. A written collaborative agreement shall be adequate
1286	1286	3 with respect to collaboration with advanced practice
1287	1287	4 registered nurses if all of the following apply:
1288	1288	5 (1) The agreement is written to promote the exercise
1289	1289	6 of professional judgment by the advanced practice
1290	1290	7 registered nurse commensurate with his or her education
1291	1291	8 and experience.
1292	1292	9 (2) The advanced practice registered nurse provides
1293	1293	10 services based upon a written collaborative agreement with
1294	1294	11 the collaborating physician, except as set forth in
1295	1295	12 subsection (b-5) of this Section. With respect to labor
1296	1296	13 and delivery, the collaborating physician must provide
1297	1297	14 delivery services in order to participate with a certified
1298	1298	15 nurse midwife.
1299	1299	16 (3) Methods of communication are available with the
1300	1300	17 collaborating physician in person or through
1301	1301	18 telecommunications for consultation, collaboration, and
1302	1302	19 referral as needed to address patient care needs.
1303	1303	20 (b-5) An anesthesiologist or physician licensed to
1304	1304	21 practice medicine in all its branches may collaborate with a
1305	1305	22 certified registered nurse anesthetist in accordance with
1306	1306	23 Section 65-35 of the Nurse Practice Act for the provision of
1307	1307	24 anesthesia services. With respect to the provision of
1308	1308	25 anesthesia services, the collaborating anesthesiologist or
1309	1309	26 physician shall have training and experience in the delivery
1310	1310
1311	1311
1312	1312
1313	1313
1314	1314
1315	1315	SB2214 - 36 - LRB103 06052 AMQ 51082 b
1316	1316
1317	1317
1318	1318	SB2214- 37 -LRB103 06052 AMQ 51082 b SB2214 - 37 - LRB103 06052 AMQ 51082 b
1319	1319	SB2214 - 37 - LRB103 06052 AMQ 51082 b
1320	1320	1 of anesthesia services consistent with Department rules.
1321	1321	2 Collaboration shall be adequate if:
1322	1322	3 (1) an anesthesiologist or a physician participates in
1323	1323	4 the joint formulation and joint approval of orders or
1324	1324	5 guidelines and periodically reviews such orders and the
1325	1325	6 services provided patients under such orders; and
1326	1326	7 (2) for anesthesia services, the anesthesiologist or
1327	1327	8 physician participates through discussion of and agreement
1328	1328	9 with the anesthesia plan and is physically present and
1329	1329	10 available on the premises during the delivery of
1330	1330	11 anesthesia services for diagnosis, consultation, and
1331	1331	12 treatment of emergency medical conditions. Anesthesia
1332	1332	13 services in a hospital shall be conducted in accordance
1333	1333	14 with Section 10.7 of the Hospital Licensing Act and in an
1334	1334	15 ambulatory surgical treatment center in accordance with
1335	1335	16 Section 6.5 of the Ambulatory Surgical Treatment Center
1336	1336	17 Act.
1337	1337	18 (b-10) The anesthesiologist or operating physician must
1338	1338	19 agree with the anesthesia plan prior to the delivery of
1339	1339	20 services.
1340	1340	21 (b-15) Under delegation from a supervising
1341	1341	22 anesthesiologist, a certified anesthesiologist assistant
1342	1342	23 licensed under the Certified Anesthesiologist Assistant
1343	1343	24 Practice Act is authorized to select, order, and administer
1344	1344	25 drugs, performing skill sets within the scope of the certified
1345	1345	26 anesthesiologist assistant's education and training, and apply
1346	1346
1347	1347
1348	1348
1349	1349
1350	1350
1351	1351	SB2214 - 37 - LRB103 06052 AMQ 51082 b
1352	1352
1353	1353
1354	1354	SB2214- 38 -LRB103 06052 AMQ 51082 b SB2214 - 38 - LRB103 06052 AMQ 51082 b
1355	1355	SB2214 - 38 - LRB103 06052 AMQ 51082 b
1356	1356	1 the appropriate medical devices in the provision of anesthesia
1357	1357	2 services under the anesthesia plan agreed to by the
1358	1358	3 supervising anesthesiologist.
1359	1359	4 (c) The collaborating physician shall have access to the
1360	1360	5 medical records of all patients attended by a physician
1361	1361	6 assistant. The collaborating physician shall have access to
1362	1362	7 the medical records of all patients attended to by an advanced
1363	1363	8 practice registered nurse.
1364	1364	9 (d) (Blank).
1365	1365	10 (e) A physician shall not be liable for the acts or
1366	1366	11 omissions of a prescribing psychologist, physician assistant,
1367	1367	12 or advanced practice registered nurse solely on the basis of
1368	1368	13 having signed a supervision agreement or guidelines or a
1369	1369	14 collaborative agreement, an order, a standing medical order, a
1370	1370	15 standing delegation order, or other order or guideline
1371	1371	16 authorizing a prescribing psychologist, physician assistant,
1372	1372	17 or advanced practice registered nurse to perform acts, unless
1373	1373	18 the physician has reason to believe the prescribing
1374	1374	19 psychologist, physician assistant, or advanced practice
1375	1375	20 registered nurse lacked the competency to perform the act or
1376	1376	21 acts or commits willful and wanton misconduct.
1377	1377	22 (f) A collaborating physician may, but is not required to,
1378	1378	23 delegate prescriptive authority to an advanced practice
1379	1379	24 registered nurse as part of a written collaborative agreement,
1380	1380	25 and the delegation of prescriptive authority shall conform to
1381	1381	26 the requirements of Section 65-40 of the Nurse Practice Act.
1382	1382
1383	1383
1384	1384
1385	1385
1386	1386
1387	1387	SB2214 - 38 - LRB103 06052 AMQ 51082 b
1388	1388
1389	1389
1390	1390	SB2214- 39 -LRB103 06052 AMQ 51082 b SB2214 - 39 - LRB103 06052 AMQ 51082 b
1391	1391	SB2214 - 39 - LRB103 06052 AMQ 51082 b
1392	1392	1 (g) A collaborating physician may, but is not required to,
1393	1393	2 delegate prescriptive authority to a physician assistant as
1394	1394	3 part of a written collaborative agreement, and the delegation
1395	1395	4 of prescriptive authority shall conform to the requirements of
1396	1396	5 Section 7.5 of the Physician Assistant Practice Act of 1987.
1397	1397	6 (h) (Blank).
1398	1398	7 (i) A collaborating physician shall delegate prescriptive
1399	1399	8 authority to a prescribing psychologist as part of a written
1400	1400	9 collaborative agreement, and the delegation of prescriptive
1401	1401	10 authority shall conform to the requirements of Section 4.3 of
1402	1402	11 the Clinical Psychologist Licensing Act.
1403	1403	12 (j) As set forth in Section 22.2 of this Act, a licensee
1404	1404	13 under this Act may not directly or indirectly divide, share,
1405	1405	14 or split any professional fee or other form of compensation
1406	1406	15 for professional services with anyone in exchange for a
1407	1407	16 referral or otherwise, other than as provided in Section 22.2.
1408	1408	17 (Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
1409	1409	18 100-513, eff. 1-1-18; 100-605, eff. 1-1-19; 100-863, eff.
1410	1410	19 8-14-18.)
1411	1411	20 (225 ILCS 60/54.7 new)
1412	1412	21 Sec. 54.7. Certified anesthesiologist assistants;
1413	1413	22 administration of anesthesia. Nothing in this Act precludes a
1414	1414	23 certified anesthesiologist assistant licensed under the
1415	1415	24 Certified Anesthesiologist Assistant Practice Act from
1416	1416	25 selecting, ordering, and administering drugs, perform skill
1417	1417
1418	1418
1419	1419
1420	1420
1421	1421
1422	1422	SB2214 - 39 - LRB103 06052 AMQ 51082 b
1423	1423
1424	1424
1425	1425	SB2214- 40 -LRB103 06052 AMQ 51082 b SB2214 - 40 - LRB103 06052 AMQ 51082 b
1426	1426	SB2214 - 40 - LRB103 06052 AMQ 51082 b
1427	1427	1 sets within the scope of the certified anesthesiologist
1428	1428	2 assistant's education and training, and applying the
1429	1429	3 appropriate medical devices in the provision of anesthesia
1430	1430	4 services under the anesthesia plan agreed to by the
1431	1431	5 supervising anesthesiologist licensed to practice medicine in
1432	1432	6 this State.
1433	1433
1434	1434
1435	1435
1436	1436
1437	1437
1438	1438	SB2214 - 40 - LRB103 06052 AMQ 51082 b