Bill Text: IL SB2214 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Reinserts the provisions of the introduced bill with the following changes to the Certified Anesthesiologist Assistant Practice Act: Requires all anesthesiologist assistant applicants and licensees to (i) provide a valid address and email address to the Department of Financial and Professional Regulation, which shall serve as the address of record and email address of record, respectively, at the time of application for licensure or renewal of a license; and (ii) inform the Department of any change of address of record or email address of record within 14 days after such change. Adds provisions concerning the Department's powers and duties under the Act; rules on the maximum number of certified anesthesiologist assistants that may be supervised by a supervising anesthesiologist; qualifications for licensure; criminal history records background checks; the endorsement of certified anesthesiologist assistants licensed in other jurisdictions; fees and fines collected under the Act; Department rules on continuing education requirements; injunctions and cease and desist orders; Department investigations and hearings; records of proceedings; the Department's subpoena power; hearing findings and recommendations; hearing officer appointments; the restoration of a suspended or revoked license; the judicial review of final administrative decisions; confidentiality standards; home rule preemption; and other matters. Removes a provision establishing a Certified Anesthesiologist Assistant Advisory Committee. Further amends the Medical Practice Act of 1987. In provisions concerning the Illinois State Medical Board, changes the number of board members from 17 to 18. Changes the maximum number of members who must be State residents from 8 to 9. Provides that one board member shall be a certified anesthesiologist assistant licensed to practice in Illinois. Further amends the Regulatory Sunset Act. Provides for repeal of the Certified Anesthesiologist Assistant Practice Act on January 1, 2028 (rather than January 1, 2033).

Spectrum: Bipartisan Bill

Status: (Introduced) 2023-05-11 - Rule 3-9(a) / Re-referred to Assignments [SB2214 Detail]

Download: Illinois-2023-SB2214-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2214 Introduced 2/10/2023, by Sen. Cristina Castro SYNOPSIS AS INTRODUCED:
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.
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A BILL FOR
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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the
Certified Anesthesiologist Assistant Practice Act.
Section 5. Findings. The practice of anesthesiology is the
practice of medicine. The practice as a certified
anesthesiologist assistant in this State is declared to affect
the public health, safety, and welfare and to be subject to
regulation and control in the public interest. The purpose and
legislative intent of this Act is to encourage and promote the
more effective utilization of the skills of anesthesiologists
by enabling them to delegate certain medical care to certified
anesthesiologist assistants where such delegation is
consistent with the health and welfare of the patient and is
conducted at the direction of and under the responsible
supervision of an anesthesiologist.
It is further declared to be a matter of public health and
concern that the practice as a certified anesthesiologist
assistant, as defined in this Act, merit and receive the
confidence of the public and that only qualified persons be
authorized to practice as a certified anesthesiologist
assistant in this State. This Act shall be liberally construed

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to best carry out these subjects and purposes.
Section 10. Administrative Procedure Act. The Illinois
Administrative Procedure Act is hereby expressly adopted and
incorporated herein as if all of the provisions of that Act
were included in this Act. The Secretary may adopt rules for
the administration and enforcement of this Act and may
prescribe forms to be issued in connection with this Act.
Section 15. Definitions. As used in this Act:
"Anesthesiologist" means a physician licensed to practice
medicine in all its branches by the Department who has
completed a residency in anesthesiology approved by the
American Board of Anesthesiology or the American Osteopathic
Board of Anesthesiology, is board eligible or board certified,
holds an unrestricted license, and is actively engaged in
clinical practice.
"Board" means the Illinois State Medical Board constituted
under the Medical Practice Act of 1987.
"Certified anesthesiologist assistant" means an individual
licensed by the Department to provide anesthesia services
under the supervision of an anesthesiologist.
"Department" means the Department of Financial and
Professional Regulation.
"Secretary" means the Secretary of Financial and
Professional Regulation.

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"Supervision" means overseeing the activities of, and
accepting responsibility for, the medical services rendered by
the certified anesthesiologist assistant and maintaining
physical proximity that allows the anesthesiologist to return
to reestablish direct contact with the patient to meet medical
needs and address any urgent or emergent clinical problems at
all times that medical services are rendered by the certified
anesthesiologist assistant.
Section 20. Applicability. This Act does not prohibit:
(1) Any person licensed in this State under any other
Act from engaging in the practice for which the person is
licensed.
(2) The practice as an certified anesthesiologist
assistant by a person who is employed by the United States
government or any bureau, division, or agency thereof
while in the discharge of the employee's official duties.
(3) The practice as a certified anesthesiologist
assistant that is included in the certified
anesthesiologist assistant's program of study by students
enrolled in schools.
Section 25. Title; advertising; billing.
(a) No certified anesthesiologist assistant shall use the
title of doctor or associate with the licensee's name or any
other term in the clinical setting or while in contact with

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patients under the licensee's care that would indicate to
other persons that the licensee is qualified to engage in the
general independent practice of anesthesiology or
interventional pain management.
(b) A licensee shall include in every advertisement for
services regulated under this Act the licensee's title as it
appears on the license or the initials authorized under this
Act.
(c) A certified anesthesiologist assistant shall not be
allowed to bill patients or in any way charge for services.
Nothing in this Act, however, shall be so construed as to
prevent the employer of a certified anesthesiologist assistant
from charging for services rendered by the certified
anesthesiologist assistant. Payment for services rendered by a
certified anesthesiologist assistant shall be made to the
certified anesthesiologist assistant's employer if the payor
would have made payment had the services been provided by an
anesthesiologist.
Section 30. Supervision requirements.
(a) As used in this Section, "supervision" means the use
of the powers of direction and decision to coordinate, direct,
and inspect the accomplishment of another, and to oversee the
implementation of the anesthesiologist's intentions.
(b) A certified anesthesiologist assistant may deliver
medical care only under the supervision of an anesthesiologist

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and only as described in a supervision agreement between the
certified anesthesiologist assistant and an anesthesiologist
who represents the certified anesthesiologist assistant's
employer. The supervising anesthesiologist shall be
immediately available at all times while supervising a
certified anesthesiologist assistant.
For the purposes of this Section, "immediately available"
means the medically directing anesthesiologist being in such
physical proximity to allow the anesthesiologist to return to
reestablish direct contact with the patient to meet the
patient's medical needs and address any urgent or emergent
problems. These responsibilities may also be met through
careful coordination among anesthesiologists of the same group
or department. It is recognized that the design and size of
various facilities, the severity of patient illnesses, and the
complexity and demands of the particular surgical procedures
make it impossible to define a specific time or distance for
physical proximity.
(c) A certified anesthesiologist assistant's practice may
not exceed the licensee's education and training, the scope of
practice of the supervising anesthesiologist, and the practice
outlined in the certified anesthesiologist assistant
supervision agreement. A medical care task assigned by the
supervising anesthesiologist to the certified anesthesiologist
assistant may not be delegated by the certified
anesthesiologist assistant to another person, except for the

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preceptorship of a student in an anesthesiologist assistant
training program.
(d) A certified anesthesiologist assistant may assist only
the supervising anesthesiologist in the delivery of medical
care and may perform medical care tasks as well as any other
tasks within the scope of training and education of the
certified anesthesiologist assistant as assigned by the
supervising anesthesiologist.
(e) An anesthesiologist who represents a certified
anesthesiologist assistant's employer shall review the
supervision agreement with the certified anesthesiologist
assistant at least annually. The supervision agreement shall
be available for inspection at the location where the
certified anesthesiologist assistant practices. The
supervision agreement may limit the practice of a certified
anesthesiologist assistant to less than the full scope of
practice authorized under this Act.
(f) A certified anesthesiologist assistant shall be
employed by a health care provider that is licensed in this
State for the primary purpose of providing the medical
services of physicians or that is an entity. If a certified
anesthesiologist assistant's employer is not an
anesthesiologist, the employer shall provide for, and not
interfere with, an anesthesiologist's supervision of the
certified anesthesiologist assistant.
(g) A student in an anesthesiologist assistant training

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program may assist only an anesthesiologist in the delivery of
medical care and may perform only medical care tasks assigned
by the anesthesiologist. An anesthesiologist may delegate the
preceptorship of a student in an anesthesiologist assistant
training program to a qualified anesthesia provider. This
Section shall not be interpreted to limit the number of other
qualified anesthesia providers an anesthesiologist may
supervise.
(h) A student in an anesthesiologist assistant training
program shall be identified as a student anesthesiologist
assistant or an anesthesiologist assistant student and may not
be identified as an "intern", "resident", or "fellow".
Section 35. Application for licensure. An application for
an original license shall be made to the Department in writing
on forms or electronically as prescribed by the Department and
shall be accompanied by the required fee, which shall not be
refundable. An application shall require information that, in
the judgment of the Department, will enable the Department to
pass on the qualifications of the applicant for a license. An
application shall include evidence of passage of the
examination of the National Commission for the Certification
of Anesthesiologist Assistants, or its successor agency, and
proof that the applicant holds a valid certificate issued by
that Commission.
An applicant has 3 years from the date of application to

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complete the application process. If the process has not been
completed in 3 years, the application shall be denied, the fee
shall be forfeited, and the applicant must reapply and meet
the requirements in effect at the time of reapplication.
Section 40. Social security number on license application.
In addition to any other information required to be contained
in the application, every application for an original license
under this Act shall include the applicant's social security
number, which shall be retained in the agency's records
pertaining to the license.
As soon as practical, the Department shall assign a
customer's identification number to each applicant for a
license. Every application for a renewal or restored license
shall require the applicant's customer identification number.
Section 45. Identification. No person may designate
oneself as a certified anesthesiologist assistant, use or
assume the title "certified anesthesiologist assistant", or
append to the person's name the words or letters "certified
anesthesiologist assistant" or "C.A.A." or any other titles,
letters, or designation that represents or may tend to
represent the person as a certified anesthesiologist assistant
unless the licensee is licensed as a certified
anesthesiologist assistant by the Department. A certified
anesthesiologist assistant shall be clearly identified as a

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certified anesthesiologist assistant.
Section 50. Unlicensed practice; violation; civil penalty.
(a) Any person who practices, offers to practice, attempts
to practice, or holds oneself out to practice as a certified
anesthesiologist assistant without being licensed under this
Act shall, in addition to any other penalty provided by law,
pay a civil penalty to the Department in an amount not to
exceed $10,000 for each offense as determined by the
Department. The civil penalty shall be assessed by the
Department after a hearing is held in accordance with the
provisions set forth in this Act regarding the provision of a
hearing for the discipline of a licensee.
(b) The Department has the authority and power to
investigate any and all unlicensed activity.
(c) No person shall use any words, abbreviations, figures,
letters, title, sign, card, or device tending to imply that
the person is a certified anesthesiologist assistant,
including, but not limited to, using the titles or initials
"Certified Anesthesiologist Assistant" or "C.A.A.", or similar
titles or initials, with the intention of indicating practice
as a certified anesthesiologist assistant without meeting the
requirements of this Act.
(d) The civil penalty shall be paid within 60 days after
the effective date of the order imposing the civil penalty.
The order shall constitute a judgment and may be filed and

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execution had thereon in the same manner as any judgment from
any court of record.
Section 55. Committee.
(a) There is established a Certified Anesthesiologist
Assistant Advisory Committee to the Department and the Board.
The Certified Anesthesiologist Assistant Advisory Committee
may review and make recommendations to the Department and the
Board regarding all matters relating to certified
anesthesiologist assistants. These matters may include, but
are not limited to:
(1) applications for licensure;
(2) disciplinary proceedings;
(3) renewal requirements; and
(4) any other issues pertaining to the regulation and
practice of certified anesthesiologist assistants in the
State.
(b) The Committee's membership shall consist of the
following members appointed by the Governor and selected from
a list of recommended appointees submitted by the president of
a statewide academy or society representing certified
anesthesiologist assistants:
(1) one member of the Board;
(2) two certified anesthesiologist assistants licensed
under this Act;
(3) one anesthesiologist; and

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(4) one public member.
Members shall be appointed for 3-year terms. The president
of a statewide academy representing certified anesthesiologist
assistants shall consider the recommendations of the president
of a statewide academy or association representing
anesthesiologists when recommending appointees under paragraph
(2).
(c) Members of the Certified Anesthesiologist Assistant
Advisory Committee shall have no liability for any action
based upon a disciplinary proceeding or other activity
performed in good faith as a member of the Committee.
Section 60. Qualifications for licensure. A person shall
be qualified for licensure as a certified anesthesiologist
assistant and the Department may issue a certified
anesthesiologist assistant license to a person who:
(1) has applied in writing in form and substance
satisfactory to the Department and has not violated any of
the provisions of this Act or the rules adopted under this
Act; the Department may take into consideration any felony
conviction of the applicant, but such conviction shall not
operate as an absolute bar to licensure;
(2) has submitted evidence satisfactory to the
Department that the applicant has:
(A) obtained a master's degree;
(B) satisfactorily completed an anesthesiologist

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assistant program that is accredited by the Commission
on Accreditation of Allied Health Education Programs,
or its predecessor or successor entity; and
(C) passed the certifying examination administered
by and obtained active certification from the National
Commission for Certification of Anesthesiologist
Assistants or a successor entity; and
(3) complies with all applicable rules of the
Department.
Section 65. Endorsement. Upon payment of the required fee,
the Department may, in its discretion, license as a certified
anesthesiologist assistant an applicant who is a certified
anesthesiologist assistant licensed in another jurisdiction if
the requirements for licensure in that jurisdiction were at
the time of licensure substantially equivalent to the
requirement in force in this State on that date or equivalent
to the requirements of this Act.
Section 70. Expiration and renewal of license. The
expiration date and renewal period for each license issued
under this Act shall be set by rule. Renewal shall be
conditioned on paying the required fee and by meeting such
other requirements as may be established by rule.
Any certified anesthesiologist assistant who has permitted
the license to expire or who has had the license on inactive

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status may have the license restored by making application to
the Department and filing proof acceptable to the Department
of the individual's fitness to have the license restored, and
by paying the required fees. Proof of fitness may include
sworn evidence certifying to active lawful practice in another
jurisdiction.
If the certified anesthesiologist assistant has not
maintained an active practice in another jurisdiction
satisfactory to the Department, the Department shall
determine, by an evaluation program established by rule, the
individual's fitness for restoration of the license and shall
establish procedures and requirements for such restoration.
However, any certified anesthesiologist assistant whose
license expired while the individual was (i) in federal
service on active duty with the Armed Forces of the United
States, or the State Militia called into service or training,
or (ii) in training or education under the supervision of the
United States preliminary to induction into the military
service, may have the individual's license restored without
paying any lapsed renewal fees if within 2 years after
honorable termination of such service, training, or education
the individual furnishes the Department with satisfactory
evidence to the effect that the individual has been so engaged
and that the individual's service, training, or education has
been so terminated.

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Section 75. Inactive status. Any certified
anesthesiologist assistant who notifies the Department in
writing on forms prescribed by the Department, may elect to
place the license on an inactive status and shall, subject to
rules of the Department, be excused from payment of renewal
fees until the individual notifies the Department in writing
of the individual's intention to restore the license.
Any certified anesthesiologist assistant requesting
restoration from inactive status shall be required to pay the
current renewal fee and shall be required to restore the
license, as provided in Section 70.
Any certified anesthesiologist assistant whose license is
in an inactive status shall not practice in this State.
Any certified anesthesiologist assistant who engages in
practice while the license is lapsed or on inactive status
shall be considered to be practicing without a license, which
shall be grounds for discipline under Section 80.
Section 80. Grounds for disciplinary action.
(a) The Department may refuse to issue or renew, or may
revoke, suspend, place on probation, reprimand, or take other
disciplinary or non-disciplinary action with regard to any
license issued under this Act as the Department may deem
proper, including the issuance of fines not to exceed $10,000
for each violation, for any one or a combination of the
following causes:

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(1) Material misstatement in furnishing information to
the Department.
(2) Violations of this Act or the rules adopted under
this Act.
(3) Conviction by plea of guilty or nolo contendere,
finding of guilt, jury verdict, or entry of judgment or
sentencing, including, but not limited to, convictions,
preceding sentences of supervision, conditional discharge,
or first offender probation, under the laws of any
jurisdiction of the United States that is: (i) a felony;
or (ii) a misdemeanor an essential element of which is
dishonesty or that is directly related to the practice of
the profession.
(4) Making any misrepresentation for the purpose of
obtaining licenses.
(5) Professional incompetence.
(6) Aiding or assisting another person in violating
any provision of this Act or its rules.
(7) Failing, within 60 days, to provide information in
response to a written request made by the Department.
(8) Engaging in dishonorable, unethical, or
unprofessional conduct, as defined by rule, of a character
likely to deceive, defraud, or harm the public.
(9) Habitual or excessive use or addiction to alcohol,
narcotics, stimulants, or any other chemical agent or drug
that results in a certified anesthesiologist assistant's

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inability to practice with reasonable judgment, skill, or
safety.
(10) Discipline by another U.S. jurisdiction or
foreign nation, if at least one of the grounds for
discipline is the same or substantially equivalent to
those set forth in this Section.
(11) Directly or indirectly giving to or receiving
from any person, firm, corporation, partnership, or
association any fee, commission, rebate, or other form of
compensation for any professional services not actually or
personally rendered. Nothing in this paragraph affects any
bona fide independent contractor or employment
arrangements, which may include provisions for
compensation, health insurance, pension, or other
employment benefits, with persons or entities authorized
under this Act for the provision of services within the
scope of the licensee's practice under this Act.
(12) A finding by the Board that the licensee, after
having the licensee's license placed on probationary
status has violated the terms of probation.
(13) Abandonment of a patient.
(14) Willfully making or filing false records or
reports in the certified anesthesiologist assistant's
practice, including, but not limited to, false records
filed with State agencies or departments.
(15) Willfully failing to report an instance of

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suspected child abuse or neglect as required by the Abused
and Neglected Child Reporting Act.
(16) Physical illness or mental illness or impairment
that results in the inability to practice the profession
with reasonable judgment, skill, or safety, including, but
not limited to, deterioration through the aging process or
loss of motor skill.
(17) Being named as a perpetrator in an indicated
report by the Department of Children and Family Services
under the Abused and Neglected Child Reporting Act, and
upon proof by clear and convincing evidence that the
licensee has caused a child to be an abused child or
neglected child as defined in the Abused and Neglected
Child Reporting Act.
(18) Gross negligence resulting in the permanent
injury or death of a patient.
(19) Employment of fraud, deception, or any unlawful
means in applying for or securing a license as a certified
anesthesiologist assistant.
(20) Exceeding the authority delegated to the
certified anesthesiologist assistant by the certified
anesthesiologist assistant's supervising
anesthesiologist.
(21) Immoral conduct in the commission of any act,
such as sexual abuse, sexual misconduct, or sexual
exploitation related to the licensee's practice.

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(22) Violation of the Health Care Worker Self-Referral
Act.
(23) Practicing under a false or assumed name, except
as provided by law.
(24) Making a false or misleading statement regarding
the certified anesthesiologist assistant's skill or the
efficacy or value of the medicine, treatment, or remedy
prescribed by the certified anesthesiologist assistant in
the course of treatment.
(25) Allowing another person to use the certified
anesthesiologist assistant's license to practice.
(26) Prescribing, selling, administering,
distributing, giving, or self-administering a drug
classified as a controlled substance for other than
medically accepted therapeutic purposes.
(27) Promotion of the sale of drugs, devices,
appliances, or goods provided for a patient in a manner to
exploit the patient for financial gain.
(28) A pattern of practice or other behavior that
demonstrates incapacity or incompetence to practice under
this Act.
(29) Violating State or federal laws, rules, or
regulations relating to controlled substances or other
legend drugs or ephedra as defined in the Ephedra
Prohibition Act.
(30) Failure to establish and maintain records of

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patient care and treatment as required by law.
(31) Attempting to subvert or cheat on the examination
of the National Commission for Certification of
Anesthesiologist Assistants or its successor agency.
(32) Willfully or negligently violating the
confidentiality between the certified anesthesiologist
assistant and patient, except as required by law.
(33) Willfully failing to report an instance of
suspected abuse, neglect, financial exploitation, or
self-neglect of an eligible adult as defined in and
required by the Adult Protective Services Act.
(34) Being named as an abuser in a verified report by
the Department on Aging under the Adult Protective
Services Act and upon proof by clear and convincing
evidence that the licensee abused, neglected, or
financially exploited an eligible adult as defined in the
Adult Protective Services Act.
(35) Failure to report to the Department an adverse
final action taken against the certified anesthesiologist
assistant by another licensing jurisdiction of the United
States or a foreign state or country, a peer review body, a
health care institution, a professional society or
association, a governmental agency, a law enforcement
agency, or a court for acts or conduct similar to acts or
conduct that would constitute grounds for action under
this Section.

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(36) Failure to provide copies of records of patient
care or treatment, except as required by law.
(37) Violating the Compassionate Use of Medical
Cannabis Program Act.
(b) The Department may, without a hearing, refuse to issue
or renew or may suspend the license of any person who fails to
file a return, or to pay the tax, penalty, or interest shown in
a filed return, or to pay any final assessment of the tax,
penalty, or interest as required by any tax Act administered
by the Department of Revenue, until the requirements of any
such tax Act are satisfied.
(c) The determination by a circuit court that a licensee
is subject to involuntary admission or judicial admission as
provided in the Mental Health and Developmental Disabilities
Code operates as an automatic suspension. The suspension will
end only upon a finding by a court that the patient is no
longer subject to involuntary admission or judicial admission
and issues an order so finding and discharging the patient,
and upon the recommendation of the Board to the Secretary that
the licensee be allowed to resume the licensee's practice.
(d) In enforcing this Section, the Department upon a
showing of a possible violation may compel an individual
licensed to practice under this Act, or who has applied for
licensure under this Act, to submit to a mental or physical
examination, or both, which may include a substance abuse or
sexual offender evaluation, as required by and at the expense

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of the Department.
The Department shall specifically designate the examining
physician licensed to practice medicine in all of its branches
or, if applicable, the multidisciplinary team involved in
providing the mental or physical examination or both. The
multidisciplinary team shall be led by a physician licensed to
practice medicine in all of its branches and may consist of one
or more or a combination of physicians licensed to practice
medicine in all of its branches, licensed clinical
psychologists, licensed clinical social workers, licensed
clinical professional counselors, and other professional and
administrative staff. Any examining physician or member of the
multidisciplinary team may require any person ordered to
submit to an examination pursuant to this Section to submit to
any additional supplemental testing deemed necessary to
complete any examination or evaluation process, including, but
not limited to, blood testing, urinalysis, psychological
testing, or neuropsychological testing.
The Department may order the examining physician or any
member of the multidisciplinary team to provide to the
Department any and all records, including business records,
that relate to the examination and evaluation, including any
supplemental testing performed.
The Department may order the examining physician or any
member of the multidisciplinary team to present testimony
concerning the mental or physical examination of the licensee

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or applicant. No information, report, record, or other
documents in any way related to the examination shall be
excluded by reason of any common law or statutory privilege
relating to communications between the licensee or applicant
and the examining physician or any member of the
multidisciplinary team. No authorization is necessary from the
licensee or applicant ordered to undergo an examination for
the examining physician or any member of the multidisciplinary
team to provide information, reports, records, or other
documents or to provide any testimony regarding the
examination and evaluation.
The individual to be examined may have, at the
individual's own expense, another physician of the
individual's choice present during all aspects of this
examination. However, that physician shall be present only to
observe and may not interfere in any way with the examination.
Failure of an individual to submit to a mental or physical
examination, when ordered, shall result in an automatic
suspension of the individual's license until the individual
submits to the examination.
If the Department finds an individual unable to practice
because of the reasons set forth in this Section, the
Department may require that individual to submit to care,
counseling, or treatment by physicians approved or designated
by the Department, as a condition, term, or restriction for
continued, reinstated, or renewed licensure to practice; or,

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in lieu of care, counseling, or treatment, the Department may
file a complaint to immediately suspend, revoke, or otherwise
discipline the license of the individual. An individual whose
license was granted, continued, reinstated, renewed,
disciplined, or supervised subject to such terms, conditions,
or restrictions, and who fails to comply with such terms,
conditions, or restrictions, shall be referred to the
Secretary for a determination as to whether the individual
shall have the individual's license suspended immediately,
pending a hearing by the Department.
In instances in which the Secretary immediately suspends
an individual's license under this Section, a hearing on that
individual's license must be convened by the Department within
30 days after the suspension and completed without appreciable
delay. The Department shall have the authority to review the
subject individual's record of treatment and counseling
regarding the impairment to the extent permitted by applicable
federal statutes and regulations safeguarding the
confidentiality of medical records.
An individual licensed under this Act and affected under
this Section shall be afforded an opportunity to demonstrate
to the Department that the individual can resume practice in
compliance with acceptable and prevailing standards under the
provisions of the individual's license.
(e) An individual or organization acting in good faith,
and not in a willful and wanton manner, in complying with this

SB2214 - 24 - LRB103 06052 AMQ 51082 b
Section by providing a report or other information to the
Board, by assisting in the investigation or preparation of a
report or information, by participating in proceedings of the
Board, or by serving as a member of the Board, shall not be
subject to criminal prosecution or civil damages as a result
of such actions.
(f) Members of the Board shall be indemnified by the State
for any actions occurring within the scope of services of the
Board, done in good faith and not willful and wanton in nature.
The Attorney General shall defend all such actions unless the
Attorney General determines either that there would be a
conflict of interest in such representation or that the
actions complained of were not in good faith or were willful
and wanton.
If the Attorney General declines representation, the
member has the right to employ counsel of the member's choice,
whose fees shall be provided by the State, after approval by
the Attorney General, unless there is a determination by a
court that the member's actions were not in good faith or were
willful and wanton.
The member must notify the Attorney General within 7 days
after receipt of notice of the initiation of any action
involving services of the Board. Failure to so notify the
Attorney General constitutes an absolute waiver of the right
to a defense and indemnification.
The Attorney General shall determine, within 7 days after

SB2214 - 25 - LRB103 06052 AMQ 51082 b
receiving such notice, whether the Attorney General will
undertake to represent the member.
Section 900. The Regulatory Sunset Act is amended by
adding Section 4.43 as follows:
(5 ILCS 80/4.43 new)
Sec. 4.43. Act repealed on January 1, 2033. The following
Act is repealed on January 1, 2033:
The Certified Anesthesiologist Assistant Practice Act.
Section 905. The Ambulatory Surgical Treatment Center Act
is amended by changing Section 6.5 as follows:
(210 ILCS 5/6.5)
Sec. 6.5. Clinical privileges; advanced practice
registered nurses. All ambulatory surgical treatment centers
(ASTC) licensed under this Act shall comply with the following
requirements:
(1) No ASTC policy, rule, regulation, or practice
shall be inconsistent with the provision of adequate
collaboration and consultation 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

SB2214 - 26 - LRB103 06052 AMQ 51082 b
dentist licensed under the Illinois Dental Practice Act,
or a podiatric physician 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 podiatric physician may be assisted by a
physician licensed to practice medicine in all its
branches, dentist, dental assistant, podiatric physician,
licensed advanced practice registered nurse, licensed
physician assistant, licensed registered nurse, licensed
practical nurse, surgical assistant, surgical technician,
licensed certified anesthesiologist assistant, 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.
(2.5) A registered nurse licensed under the Nurse
Practice 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

SB2214 - 27 - LRB103 06052 AMQ 51082 b
care, patient safety needs, and the needs of the surgical
team in the operating room during an invasive or operative
procedure.
(3) An advanced practice registered nurse is not
required to possess prescriptive authority or a written
collaborative agreement meeting the requirements of the
Nurse Practice Act to provide advanced practice registered
nursing services in an ambulatory surgical treatment
center. An advanced practice registered nurse must possess
clinical privileges granted by the consulting medical
staff committee and ambulatory surgical treatment center
in order to provide services. Individual advanced practice
registered nurses may also be granted clinical privileges
to order, select, and administer medications, including
controlled substances, to provide delineated care. The
attending physician must determine the advanced practice
registered nurse's role in providing care for his or her
patients, except as otherwise provided in the consulting
staff policies. The consulting medical staff committee
shall periodically review the services of advanced
practice registered nurses granted privileges.
(4) 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

SB2214 - 28 - LRB103 06052 AMQ 51082 b
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 podiatric physician.
(A) The individuals who, with clinical privileges
granted by the medical staff and ASTC, 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; or
(v) a podiatric physician licensed under the
Podiatric Medical Practice Act of 1987; or .
(vi) a licensed certified anesthesiologist
assistant under the supervision of an
anesthesiologist.
(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

SB2214 - 29 - LRB103 06052 AMQ 51082 b
conditions. In the absence of 24-hour availability of
anesthesiologists with clinical 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 staff consulting committee policies.
(C) A certified registered nurse anesthetist is
not required to possess prescriptive authority or a
written collaborative agreement meeting the
requirements of Section 65-35 of the Nurse Practice
Act to provide anesthesia services ordered by a
licensed physician, dentist, or podiatric physician.
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 podiatric physician in
accordance with the medical staff consulting committee
policies of a licensed ambulatory surgical treatment
center.
(Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)

SB2214 - 30 - LRB103 06052 AMQ 51082 b
Section 910. The Hospital Licensing Act is amended by
changing Section 10.7 as follows:
(210 ILCS 85/10.7)
Sec. 10.7. Clinical privileges; advanced practice
registered nurses. All hospitals licensed under this Act
shall comply with the following requirements:
(1) No hospital policy, rule, regulation, or practice
shall be inconsistent with the provision of adequate
collaboration and consultation 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 podiatric physician 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 podiatric
physician may be assisted by a physician licensed to
practice medicine in all its branches, dentist, dental
assistant, podiatric physician, licensed advanced practice
registered nurse, licensed physician assistant, licensed
registered nurse, licensed practical nurse, surgical
assistant, surgical technician, licensed certified

SB2214 - 31 - LRB103 06052 AMQ 51082 b
anesthesiologist assistant, 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 Nurse
Practice 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) An advanced practice registered nurse is not
required to possess prescriptive authority or a written
collaborative agreement meeting the requirements of the
Nurse Practice Act to provide advanced practice registered
nursing services in a hospital. An advanced practice
registered nurse must possess clinical privileges
recommended by the medical staff and granted by the
hospital in order to provide services. Individual advanced
practice registered nurses may also be granted clinical

SB2214 - 32 - LRB103 06052 AMQ 51082 b
privileges to order, select, and administer medications,
including controlled substances, to provide delineated
care. The attending physician must determine the advanced
practice registered nurse's role in providing care for his
or her patients, except as otherwise provided in medical
staff bylaws. The medical staff shall periodically review
the services of advanced practice registered nurses
granted privileges. This review shall be conducted in
accordance with item (2) of subsection (a) of Section 10.8
of this Act for advanced practice registered nurses
employed by the hospital.
(4) 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 podiatric physician.
(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

SB2214 - 33 - LRB103 06052 AMQ 51082 b
(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; or
(v) a podiatric physician licensed under the
Podiatric Medical Practice Act of 1987; or .
(vi) a licensed certified anesthesiologist
assistant under the supervision of an
anesthesiologist.
(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

SB2214 - 34 - LRB103 06052 AMQ 51082 b
requirements of Section 65-35 of the Nurse Practice
Act to provide anesthesia services ordered by a
licensed physician, dentist, or podiatric physician.
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 podiatric physician in
accordance with the hospital's alternative policy.
(Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
Section 915. The Medical Practice Act of 1987 is amended
by changing Section 54.5 and by adding Section 54.7 as
follows:
(225 ILCS 60/54.5)
(Section scheduled to be repealed on January 1, 2027)
Sec. 54.5. Physician delegation of authority to physician
assistants, certified anesthesiologist assistants, advanced
practice registered nurses without full practice authority,
and prescribing psychologists.
(a) Physicians licensed to practice medicine in all its
branches may delegate care and treatment responsibilities to a

SB2214 - 35 - LRB103 06052 AMQ 51082 b
physician assistant under guidelines in accordance with the
requirements of the Physician Assistant Practice Act of 1987.
A physician licensed to practice medicine in all its branches
may enter into collaborative agreements with no more than 7
full-time equivalent physician assistants, except in a
hospital, hospital affiliate, or ambulatory surgical treatment
center as set forth by Section 7.7 of the Physician Assistant
Practice Act of 1987 and as provided in subsection (a-5).
(a-5) A physician licensed to practice medicine in all its
branches may collaborate with more than 7 physician assistants
when the services are provided in a federal primary care
health professional shortage area with a Health Professional
Shortage Area score greater than or equal to 12, as determined
by the United States Department of Health and Human Services.
The collaborating physician must keep appropriate
documentation of meeting this exemption and make it available
to the Department upon request.
(b) A physician licensed to practice medicine in all its
branches in active clinical practice may collaborate with an
advanced practice registered nurse in accordance with the
requirements of the Nurse Practice Act. Collaboration is for
the purpose of providing medical consultation, and no
employment relationship is required. A written collaborative
agreement shall conform to the requirements of Section 65-35
of the Nurse Practice Act. The written collaborative agreement
shall be for services in the same area of practice or specialty

SB2214 - 36 - LRB103 06052 AMQ 51082 b
as the collaborating physician in his or her clinical medical
practice. A written collaborative agreement shall be adequate
with respect to collaboration with advanced practice
registered nurses if all of the following apply:
(1) The agreement is written to promote the exercise
of professional judgment by the advanced practice
registered nurse commensurate with his or her education
and experience.
(2) The advanced practice registered nurse provides
services based upon a written collaborative agreement with
the collaborating physician, except as set forth in
subsection (b-5) of this Section. With respect to labor
and delivery, the collaborating physician must provide
delivery services in order to participate with a certified
nurse midwife.
(3) Methods of communication are available with the
collaborating physician in person or through
telecommunications for consultation, collaboration, and
referral as needed to address patient care needs.
(b-5) An anesthesiologist or physician licensed to
practice medicine in all its branches may collaborate with a
certified registered nurse anesthetist in accordance with
Section 65-35 of the Nurse Practice Act for the provision of
anesthesia services. With respect to the provision of
anesthesia services, the collaborating anesthesiologist or
physician shall have training and experience in the delivery

SB2214 - 37 - LRB103 06052 AMQ 51082 b
of anesthesia services consistent with Department rules.
Collaboration shall be adequate if:
(1) an anesthesiologist or a physician participates in
the joint formulation and joint approval of orders or
guidelines and periodically reviews such orders and the
services provided patients under such orders; and
(2) for anesthesia services, the anesthesiologist or
physician participates through discussion of and agreement
with the anesthesia plan and is physically present and
available on the premises during the delivery of
anesthesia services for diagnosis, consultation, and
treatment of emergency medical conditions. Anesthesia
services in a hospital shall be conducted in accordance
with Section 10.7 of the Hospital Licensing Act and in an
ambulatory surgical treatment center in accordance with
Section 6.5 of the Ambulatory Surgical Treatment Center
Act.
(b-10) The anesthesiologist or operating physician must
agree with the anesthesia plan prior to the delivery of
services.
(b-15) Under delegation from a supervising
anesthesiologist, a certified anesthesiologist assistant
licensed under the Certified Anesthesiologist Assistant
Practice Act is authorized to select, order, and administer
drugs, performing skill sets within the scope of the certified
anesthesiologist assistant's education and training, and apply

SB2214 - 38 - LRB103 06052 AMQ 51082 b
the appropriate medical devices in the provision of anesthesia
services under the anesthesia plan agreed to by the
supervising anesthesiologist.
(c) The collaborating physician shall have access to the
medical records of all patients attended by a physician
assistant. The collaborating physician shall have access to
the medical records of all patients attended to by an advanced
practice registered nurse.
(d) (Blank).
(e) A physician shall not be liable for the acts or
omissions of a prescribing psychologist, physician assistant,
or advanced practice registered nurse solely on the basis of
having signed a supervision agreement or guidelines or a
collaborative agreement, an order, a standing medical order, a
standing delegation order, or other order or guideline
authorizing a prescribing psychologist, physician assistant,
or advanced practice registered nurse to perform acts, unless
the physician has reason to believe the prescribing
psychologist, physician assistant, or advanced practice
registered nurse lacked the competency to perform the act or
acts or commits willful and wanton misconduct.
(f) A collaborating physician may, but is not required to,
delegate prescriptive authority to an advanced practice
registered nurse as part of a written collaborative agreement,
and the delegation of prescriptive authority shall conform to
the requirements of Section 65-40 of the Nurse Practice Act.

SB2214 - 39 - LRB103 06052 AMQ 51082 b
(g) A collaborating physician may, but is not required to,
delegate prescriptive authority to a physician assistant as
part of a written collaborative agreement, and the delegation
of prescriptive authority shall conform to the requirements of
Section 7.5 of the Physician Assistant Practice Act of 1987.
(h) (Blank).
(i) A collaborating physician shall delegate prescriptive
authority to a prescribing psychologist as part of a written
collaborative agreement, and the delegation of prescriptive
authority shall conform to the requirements of Section 4.3 of
the Clinical Psychologist Licensing Act.
(j) As set forth in Section 22.2 of this Act, a licensee
under this Act may not directly or indirectly divide, share,
or split any professional fee or other form of compensation
for professional services with anyone in exchange for a
referral or otherwise, other than as provided in Section 22.2.
(Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
100-513, eff. 1-1-18; 100-605, eff. 1-1-19; 100-863, eff.
8-14-18.)
(225 ILCS 60/54.7 new)
Sec. 54.7. Certified anesthesiologist assistants;
administration of anesthesia. Nothing in this Act precludes a
certified anesthesiologist assistant licensed under the
Certified Anesthesiologist Assistant Practice Act from
selecting, ordering, and administering drugs, perform skill

SB2214 - 40 - LRB103 06052 AMQ 51082 b
sets within the scope of the certified anesthesiologist
assistant's education and training, and applying the
appropriate medical devices in the provision of anesthesia
services under the anesthesia plan agreed to by the
supervising anesthesiologist licensed to practice medicine in
this State.