Bill Text: IL HB4579 | 2019-2020 | 101st General Assembly | Introduced

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Bill Title: Amends the Nurse Practice Act. Provides that, in the case of anesthesia services provided by a certified registered nurse anesthetist, a physician, a dentist, or a podiatric physician must participate through discussion of and agreement with the anesthesia plan and remain available during the delivery of surgical anesthesia services for diagnosis, consultation, and treatment of emergency medical conditions (rather than an anesthesiologist, a physician, a dentist, or a podiatric physician must participate through discussion of and agreement with the anesthesia plan and remain physically present and available on the premises during the delivery of anesthesia services for diagnosis, consultation, and treatment of emergency medical conditions). Effective immediately.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced - Dead) 2020-06-23 - Rule 19(b) / Re-referred to Rules Committee [HB4579 Detail]

Download: Illinois-2019-HB4579-Introduced.html

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101ST GENERAL ASSEMBLY State of Illinois 2019 and 2020 HB4579 Introduced , by Rep. Anna Moeller SYNOPSIS AS INTRODUCED:
225 ILCS 65/65-35 was 225 ILCS 65/15-15
Amends the Nurse Practice Act. Provides that, in the case of anesthesia services provided by a certified registered nurse anesthetist, a physician, a dentist, or a podiatric physician must participate through discussion of and agreement with the anesthesia plan and remain available during the delivery of surgical anesthesia services for diagnosis, consultation, and treatment of emergency medical conditions (rather than an anesthesiologist, a physician, a dentist, or a podiatric physician must participate through discussion of and agreement with the anesthesia plan and remain physically present and available on the premises during the delivery of anesthesia services for diagnosis, consultation, and treatment of emergency medical conditions). Effective immediately.
LRB101 17274 SPS 66679 b
A BILL FOR
HB4579 LRB101 17274 SPS 66679 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Nurse Practice Act is amended by changing
Section 65-35 as follows:
(225 ILCS 65/65-35) (was 225 ILCS 65/15-15)
(Section scheduled to be repealed on January 1, 2028)
Sec. 65-35. Written collaborative agreements.
(a) A written collaborative agreement is required for all
advanced practice registered nurses engaged in clinical
practice prior to meeting the requirements of Section 65-43,
except for advanced practice registered nurses who are
privileged to practice in a hospital, hospital affiliate, or
ambulatory surgical treatment center.
(a-5) If an advanced practice registered nurse engages in
clinical practice outside of a hospital, hospital affiliate, or
ambulatory surgical treatment center in which he or she is
privileged to practice, the advanced practice registered nurse
must have a written collaborative agreement, except as set
forth in Section 65-43.
(b) A written collaborative agreement shall describe the
relationship of the advanced practice registered nurse with the
collaborating physician and shall describe the categories of

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care, treatment, or procedures to be provided by the advanced
practice registered nurse. A collaborative agreement with a
podiatric physician must be in accordance with subsection (c-5)
or (c-15) of this Section. A collaborative agreement with a
dentist must be in accordance with subsection (c-10) of this
Section. A collaborative agreement with a podiatric physician
must be in accordance with subsection (c-5) of this Section.
Collaboration does not require an employment relationship
between the collaborating physician and the advanced practice
registered nurse.
The collaborative relationship under an agreement shall
not be construed to require the personal presence of a
collaborating physician at the place where services are
rendered. Methods of communication shall be available for
consultation with the collaborating physician in person or by
telecommunications or electronic communications as set forth
in the written agreement.
(b-5) Absent an employment relationship, a written
collaborative agreement may not (1) restrict the categories of
patients of an advanced practice registered nurse within the
scope of the advanced practice registered nurses training and
experience, (2) limit third party payors or government health
programs, such as the medical assistance program or Medicare
with which the advanced practice registered nurse contracts, or
(3) limit the geographic area or practice location of the
advanced practice registered nurse in this State.

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(c) In the case of anesthesia services provided by a
certified registered nurse anesthetist, an anesthesiologist, a
physician, a dentist, or a podiatric physician must participate
through discussion of and agreement with the anesthesia plan
and remain physically present and available on the premises
during the delivery of surgical anesthesia services for
diagnosis, consultation, and treatment of emergency medical
conditions.
(c-5) A certified registered nurse anesthetist, who
provides anesthesia services outside of a hospital or
ambulatory surgical treatment center shall enter into a written
collaborative agreement with an anesthesiologist or the
physician licensed to practice medicine in all its branches or
the podiatric physician performing the procedure. Outside of a
hospital or ambulatory surgical treatment center, the
certified registered nurse anesthetist may provide only those
services that the collaborating podiatric physician is
authorized to provide pursuant to the Podiatric Medical
Practice Act of 1987 and rules adopted thereunder. A certified
registered nurse anesthetist may select, order, and administer
medication, including controlled substances, and apply
appropriate medical devices for delivery of anesthesia
services under the anesthesia plan agreed with by the
anesthesiologist or the operating physician or operating
podiatric physician.
(c-10) A certified registered nurse anesthetist who

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provides anesthesia services in a dental office shall enter
into a written collaborative agreement with an
anesthesiologist or the physician licensed to practice
medicine in all its branches or the operating dentist
performing the procedure. The agreement shall describe the
working relationship of the certified registered nurse
anesthetist and dentist and shall authorize the categories of
care, treatment, or procedures to be performed by the certified
registered nurse anesthetist. In a collaborating dentist's
office, the certified registered nurse anesthetist may only
provide those services that the operating dentist with the
appropriate permit is authorized to provide pursuant to the
Illinois Dental Practice Act and rules adopted thereunder. For
anesthesia services, an anesthesiologist, physician, or
operating dentist 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. A certified registered nurse
anesthetist may select, order, and administer medication,
including controlled substances, and apply appropriate medical
devices for delivery of anesthesia services under the
anesthesia plan agreed with by the operating dentist.
(c-15) An advanced practice registered nurse who had a
written collaborative agreement with a podiatric physician
immediately before the effective date of Public Act 100-513 may

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continue in that collaborative relationship or enter into a new
written collaborative relationship with a podiatric physician
under the requirements of this Section and Section 65-40, as
those Sections existed immediately before the amendment of
those Sections by Public Act 100-513 with regard to a written
collaborative agreement between an advanced practice
registered nurse and a podiatric physician.
(d) A copy of the signed, written collaborative agreement
must be available to the Department upon request from both the
advanced practice registered nurse and the collaborating
physician, dentist, or podiatric physician.
(e) Nothing in this Act shall be construed to limit the
delegation of tasks or duties by a physician to a licensed
practical nurse, a registered professional nurse, or other
persons in accordance with Section 54.2 of the Medical Practice
Act of 1987. Nothing in this Act shall be construed to limit
the method of delegation that may be authorized by any means,
including, but not limited to, oral, written, electronic,
standing orders, protocols, guidelines, or verbal orders.
(e-5) Nothing in this Act shall be construed to authorize
an advanced practice registered nurse to provide health care
services required by law or rule to be performed by a
physician. The scope of practice of an advanced practice
registered nurse does not include operative surgery. Nothing in
this Section shall be construed to preclude an advanced
practice registered nurse from assisting in surgery.

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(f) An advanced practice registered nurse shall inform each
collaborating physician, dentist, or podiatric physician of
all collaborative agreements he or she has signed and provide a
copy of these to any collaborating physician, dentist, or
podiatric physician upon request.
(g) (Blank).
(Source: P.A. 100-513, eff. 1-1-18; 100-577, eff. 1-26-18;
100-1096, eff. 8-26-18; 101-13, eff. 6-12-19.)
Section 99. Effective date. This Act takes effect upon
becoming law.