Illinois 2023-2024 Regular Session

Illinois Senate Bill SB0218 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Public Act 103-0065
2	1		SB0218 EnrolledLRB103 25028 AMQ 51362 b SB0218 Enrolled LRB103 25028 AMQ 51362 b
3	2		SB0218 Enrolled LRB103 25028 AMQ 51362 b
4		-	AN ACT concerning regulation.
5		-	Be it enacted by the People of the State of Illinois,
6		-	represented in the General Assembly:
7		-	Section 5. The Physician Assistant Practice Act of 1987 is
8		-	amended by changing Sections 4, 7, 7.5, and 7.7 and by adding
9		-	Section 7.6 as follows:
10		-	(225 ILCS 95/4) (from Ch. 111, par. 4604)
11		-	(Section scheduled to be repealed on January 1, 2028)
12		-	Sec. 4. Definitions. In this Act:
13		-	1. "Department" means the Department of Financial and
14		-	Professional Regulation.
15		-	2. "Secretary" means the Secretary of Financial and
16		-	Professional Regulation.
17		-	3. "Physician assistant" means any person not holding an
18		-	active license or permit issued by the Department pursuant to
19		-	the Medical Practice Act of 1987 who has been certified as a
20		-	physician assistant by the National Commission on the
21		-	Certification of Physician Assistants or equivalent successor
22		-	agency and performs procedures in collaboration with a
23		-	physician as defined in this Act. A physician assistant may
24		-	perform such procedures within the specialty of the
25		-	collaborating physician, except that such physician shall
26		-	exercise such direction, collaboration, and control over such
	3	+	1 AN ACT concerning regulation.
	4	+	2 Be it enacted by the People of the State of Illinois,
	5	+	3 represented in the General Assembly:
	6	+	4 Section 5. The Physician Assistant Practice Act of 1987 is
	7	+	5 amended by changing Sections 4, 7, 7.5, and 7.7 and by adding
	8	+	6 Section 7.6 as follows:
	9	+	7 (225 ILCS 95/4) (from Ch. 111, par. 4604)
	10	+	8 (Section scheduled to be repealed on January 1, 2028)
	11	+	9 Sec. 4. Definitions. In this Act:
	12	+	10 1. "Department" means the Department of Financial and
	13	+	11 Professional Regulation.
	14	+	12 2. "Secretary" means the Secretary of Financial and
	15	+	13 Professional Regulation.
	16	+	14 3. "Physician assistant" means any person not holding an
	17	+	15 active license or permit issued by the Department pursuant to
	18	+	16 the Medical Practice Act of 1987 who has been certified as a
	19	+	17 physician assistant by the National Commission on the
	20	+	18 Certification of Physician Assistants or equivalent successor
	21	+	19 agency and performs procedures in collaboration with a
	22	+	20 physician as defined in this Act. A physician assistant may
	23	+	21 perform such procedures within the specialty of the
	24	+	22 collaborating physician, except that such physician shall
	25	+	23 exercise such direction, collaboration, and control over such
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33		-	physician assistants as will assure that patients shall
34		-	receive quality medical care. Physician assistants shall be
35		-	capable of performing a variety of tasks within the specialty
36		-	of medical care in collaboration with a physician.
37		-	Collaboration with the physician assistant shall not be
38		-	construed to necessarily require the personal presence of the
39		-	collaborating physician at all times at the place where
40		-	services are rendered, as long as there is communication
41		-	available for consultation by radio, telephone or
42		-	telecommunications within established guidelines as determined
43		-	by the physician/physician assistant team. The collaborating
44		-	physician may delegate tasks and duties to the physician
45		-	assistant. Delegated tasks or duties shall be consistent with
46		-	physician assistant education, training, and experience. The
47		-	delegated tasks or duties shall be specific to the practice
48		-	setting and shall be implemented and reviewed under a written
49		-	collaborative agreement established by the physician or
50		-	physician/physician assistant team. A physician assistant,
51		-	acting as an agent of the physician, shall be permitted to
52		-	transmit the collaborating physician's orders as determined by
53		-	the institution's by-laws, policies, procedures, or job
54		-	description within which the physician/physician assistant
55		-	team practices. Physician assistants shall practice only in
56		-	accordance with a written collaborative agreement.
57		-	Any person who holds an active license or permit issued
58		-	pursuant to the Medical Practice Act of 1987 shall have that
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	34	+	1 physician assistants as will assure that patients shall
	35	+	2 receive quality medical care. Physician assistants shall be
	36	+	3 capable of performing a variety of tasks within the specialty
	37	+	4 of medical care in collaboration with a physician.
	38	+	5 Collaboration with the physician assistant shall not be
	39	+	6 construed to necessarily require the personal presence of the
	40	+	7 collaborating physician at all times at the place where
	41	+	8 services are rendered, as long as there is communication
	42	+	9 available for consultation by radio, telephone or
	43	+	10 telecommunications within established guidelines as determined
	44	+	11 by the physician/physician assistant team. The collaborating
	45	+	12 physician may delegate tasks and duties to the physician
	46	+	13 assistant. Delegated tasks or duties shall be consistent with
	47	+	14 physician assistant education, training, and experience. The
	48	+	15 delegated tasks or duties shall be specific to the practice
	49	+	16 setting and shall be implemented and reviewed under a written
	50	+	17 collaborative agreement established by the physician or
	51	+	18 physician/physician assistant team. A physician assistant,
	52	+	19 acting as an agent of the physician, shall be permitted to
	53	+	20 transmit the collaborating physician's orders as determined by
	54	+	21 the institution's by-laws, policies, procedures, or job
	55	+	22 description within which the physician/physician assistant
	56	+	23 team practices. Physician assistants shall practice only in
	57	+	24 accordance with a written collaborative agreement.
	58	+	25 Any person who holds an active license or permit issued
	59	+	26 pursuant to the Medical Practice Act of 1987 shall have that
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61		-	license automatically placed into inactive status upon
62		-	issuance of a physician assistant license. Any person who
63		-	holds an active license as a physician assistant who is issued
64		-	a license or permit pursuant to the Medical Practice Act of
65		-	1987 shall have his or her physician assistant license
66		-	automatically placed into inactive status.
67		-	3.5. "Physician assistant practice" means the performance
68		-	of procedures within the specialty of the collaborating
69		-	physician. Physician assistants shall be capable of performing
70		-	a variety of tasks within the specialty of medical care of the
71		-	collaborating physician. Collaboration with the physician
72		-	assistant shall not be construed to necessarily require the
73		-	personal presence of the collaborating physician at all times
74		-	at the place where services are rendered, as long as there is
75		-	communication available for consultation by radio, telephone,
76		-	telecommunications, or electronic communications. The
77		-	collaborating physician may delegate tasks and duties to the
78		-	physician assistant. Delegated tasks or duties shall be
79		-	consistent with physician assistant education, training, and
80		-	experience. The delegated tasks or duties shall be specific to
81		-	the practice setting and shall be implemented and reviewed
82		-	under a written collaborative agreement established by the
83		-	physician or physician/physician assistant team. A physician
84		-	assistant shall be permitted to transmit the collaborating
85		-	physician's orders as determined by the institution's bylaws,
86		-	policies, or procedures or the job description within which
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89		-	the physician/physician assistant team practices. Physician
90		-	assistants shall practice only in accordance with a written
91		-	collaborative agreement, except as provided in Section 7.5 of
92		-	this Act.
93		-	4. "Board" means the Medical Licensing Board constituted
94		-	under the Medical Practice Act of 1987.
95		-	5. (Blank).
96		-	6. "Physician" means a person licensed to practice
97		-	medicine in all of its branches under the Medical Practice Act
98		-	of 1987.
99		-	7. "Collaborating physician" means the physician who,
100		-	within his or her specialty and expertise, may delegate a
101		-	variety of tasks and procedures to the physician assistant.
102		-	Such tasks and procedures shall be delegated in accordance
103		-	with a written collaborative agreement.
104		-	8. (Blank).
105		-	9. "Address of record" means the designated address
106		-	recorded by the Department in the applicant's or licensee's
107		-	application file or license file maintained by the
108		-	Department's licensure maintenance unit.
109		-	10. "Hospital affiliate" means a corporation, partnership,
110		-	joint venture, limited liability company, or similar
111		-	organization, other than a hospital, that is devoted primarily
112		-	to the provision, management, or support of health care
113		-	services and that directly or indirectly controls, is
114		-	controlled by, or is under common control of the hospital. For
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117		-	the purposes of this definition, "control" means having at
118		-	least an equal or a majority ownership or membership interest.
119		-	A hospital affiliate shall be 100% owned or controlled by any
120		-	combination of hospitals, their parent corporations, or
121		-	physicians licensed to practice medicine in all its branches
122		-	in Illinois. "Hospital affiliate" does not include a health
123		-	maintenance organization regulated under the Health
124		-	Maintenance Organization Act.
125		-	11. "Email address of record" means the designated email
126		-	address recorded by the Department in the applicant's
127		-	application file or the licensee's license file, as maintained
128		-	by the Department's licensure maintenance unit.
129		-	12. "Federally qualified health center" means a health
130		-	center funded under Section 330 of the federal Public Health
131		-	Service Act.
132		-	(Source: P.A. 102-1117, eff. 1-13-23.)
133		-	(225 ILCS 95/7) (from Ch. 111, par. 4607)
134		-	(Section scheduled to be repealed on January 1, 2028)
135		-	Sec. 7. Collaboration requirements.
136		-	(a) A collaborating physician shall determine the number
137		-	of physician assistants to collaborate with, provided the
138		-	physician is able to provide adequate collaboration as
139		-	outlined in the written collaborative agreement required under
140		-	Section 7.5 of this Act and consideration is given to the
141		-	nature of the physician's practice, complexity of the patient
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	70	+	1 license automatically placed into inactive status upon
	71	+	2 issuance of a physician assistant license. Any person who
	72	+	3 holds an active license as a physician assistant who is issued
	73	+	4 a license or permit pursuant to the Medical Practice Act of
	74	+	5 1987 shall have his or her physician assistant license
	75	+	6 automatically placed into inactive status.
	76	+	7 3.5. "Physician assistant practice" means the performance
	77	+	8 of procedures within the specialty of the collaborating
	78	+	9 physician. Physician assistants shall be capable of performing
	79	+	10 a variety of tasks within the specialty of medical care of the
	80	+	11 collaborating physician. Collaboration with the physician
	81	+	12 assistant shall not be construed to necessarily require the
	82	+	13 personal presence of the collaborating physician at all times
	83	+	14 at the place where services are rendered, as long as there is
	84	+	15 communication available for consultation by radio, telephone,
	85	+	16 telecommunications, or electronic communications. The
	86	+	17 collaborating physician may delegate tasks and duties to the
	87	+	18 physician assistant. Delegated tasks or duties shall be
	88	+	19 consistent with physician assistant education, training, and
	89	+	20 experience. The delegated tasks or duties shall be specific to
	90	+	21 the practice setting and shall be implemented and reviewed
	91	+	22 under a written collaborative agreement established by the
	92	+	23 physician or physician/physician assistant team. A physician
	93	+	24 assistant shall be permitted to transmit the collaborating
	94	+	25 physician's orders as determined by the institution's bylaws,
	95	+	26 policies, or procedures or the job description within which
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144		-	population, and the experience of each physician assistant. A
145		-	collaborating physician may collaborate with a maximum of 7
146		-	full-time equivalent physician assistants as described in
147		-	Section 54.5 of the Medical Practice Act of 1987. As used in
148		-	this Section, "full-time equivalent" means the equivalent of
149		-	40 hours per week per individual. Physicians and physician
150		-	assistants who work in a hospital, hospital affiliate,
151		-	federally qualified health center, or ambulatory surgical
152		-	treatment center as defined by Section 7.7 of this Act are
153		-	exempt from the collaborative ratio restriction requirements
154		-	of this Section. A physician assistant shall be able to hold
155		-	more than one professional position. A collaborating physician
156		-	shall file a notice of collaboration of each physician
157		-	assistant according to the rules of the Department.
158		-	Physician assistants shall collaborate only with
159		-	physicians as defined in this Act who are engaged in clinical
160		-	practice, or in clinical practice in public health or other
161		-	community health facilities.
162		-	Nothing in this Act shall be construed to limit the
163		-	delegation of tasks or duties by a physician to a nurse or
164		-	other appropriately trained personnel.
165		-	Nothing in this Act shall be construed to prohibit the
166		-	employment of physician assistants by a hospital, nursing home
167		-	or other health care facility where such physician assistants
168		-	function under a collaborating physician.
169		-	A physician assistant may be employed by a practice group
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172		-	or other entity employing multiple physicians at one or more
173		-	locations. In that case, one of the physicians practicing at a
174		-	location shall be designated the collaborating physician. The
175		-	other physicians with that practice group or other entity who
176		-	practice in the same general type of practice or specialty as
177		-	the collaborating physician may collaborate with the physician
178		-	assistant with respect to their patients.
179		-	(b) A physician assistant licensed in this State, or
180		-	licensed or authorized to practice in any other U.S.
181		-	jurisdiction or credentialed by his or her federal employer as
182		-	a physician assistant, who is responding to a need for medical
183		-	care created by an emergency or by a state or local disaster
184		-	may render such care that the physician assistant is able to
185		-	provide without collaboration as it is defined in this Section
186		-	or with such collaboration as is available.
187		-	Any physician who collaborates with a physician assistant
188		-	providing medical care in response to such an emergency or
189		-	state or local disaster shall not be required to meet the
190		-	requirements set forth in this Section for a collaborating
191		-	physician.
192		-	(Source: P.A. 100-453, eff. 8-25-17; 100-605, eff. 1-1-19.)
193		-	(225 ILCS 95/7.5)
194		-	(Section scheduled to be repealed on January 1, 2028)
195		-	Sec. 7.5. Written collaborative agreements; prescriptive
196		-	authority.
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199		-	(a) A written collaborative agreement is required for all
200		-	physician assistants to practice in the State, except as
201		-	provided in Section 7.7 of this Act.
202		-	(1) A written collaborative agreement shall describe
203		-	the working relationship of the physician assistant with
204		-	the collaborating physician and shall describe the
205		-	categories of care, treatment, or procedures to be
206		-	provided by the physician assistant. The written
207		-	collaborative agreement shall promote the exercise of
208		-	professional judgment by the physician assistant
209		-	commensurate with his or her education and experience. The
210		-	services to be provided by the physician assistant shall
211		-	be services that the collaborating physician is authorized
212		-	to and generally provides to his or her patients in the
213		-	normal course of his or her clinical medical practice. The
214		-	written collaborative agreement need not describe the
215		-	exact steps that a physician assistant must take with
216		-	respect to each specific condition, disease, or symptom
217		-	but must specify which authorized procedures require the
218		-	presence of the collaborating physician as the procedures
219		-	are being performed. The relationship under a written
220		-	collaborative agreement shall not be construed to require
221		-	the personal presence of a physician at the place where
222		-	services are rendered. Methods of communication shall be
223		-	available for consultation with the collaborating
224		-	physician in person or by telecommunications or electronic
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	106	+	1 the physician/physician assistant team practices. Physician
	107	+	2 assistants shall practice only in accordance with a written
	108	+	3 collaborative agreement, except as provided in Section 7.5 of
	109	+	4 this Act.
	110	+	5 4. "Board" means the Medical Licensing Board constituted
	111	+	6 under the Medical Practice Act of 1987.
	112	+	7 5. (Blank).
	113	+	8 6. "Physician" means a person licensed to practice
	114	+	9 medicine in all of its branches under the Medical Practice Act
	115	+	10 of 1987.
	116	+	11 7. "Collaborating physician" means the physician who,
	117	+	12 within his or her specialty and expertise, may delegate a
	118	+	13 variety of tasks and procedures to the physician assistant.
	119	+	14 Such tasks and procedures shall be delegated in accordance
	120	+	15 with a written collaborative agreement.
	121	+	16 8. (Blank).
	122	+	17 9. "Address of record" means the designated address
	123	+	18 recorded by the Department in the applicant's or licensee's
	124	+	19 application file or license file maintained by the
	125	+	20 Department's licensure maintenance unit.
	126	+	21 10. "Hospital affiliate" means a corporation, partnership,
	127	+	22 joint venture, limited liability company, or similar
	128	+	23 organization, other than a hospital, that is devoted primarily
	129	+	24 to the provision, management, or support of health care
	130	+	25 services and that directly or indirectly controls, is
	131	+	26 controlled by, or is under common control of the hospital. For
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227		-	communications as set forth in the written collaborative
228		-	agreement. For the purposes of this Act, "generally
229		-	provides to his or her patients in the normal course of his
230		-	or her clinical medical practice" means services, not
231		-	specific tasks or duties, the collaborating physician
232		-	routinely provides individually or through delegation to
233		-	other persons so that the physician has the experience and
234		-	ability to collaborate and provide consultation.
235		-	(2) The written collaborative agreement shall be
236		-	adequate if a physician does each of the following:
237		-	(A) Participates in the joint formulation and
238		-	joint approval of orders or guidelines with the
239		-	physician assistant and he or she periodically reviews
240		-	such orders and the services provided patients under
241		-	such orders in accordance with accepted standards of
242		-	medical practice and physician assistant practice.
243		-	(B) Provides consultation at least once a month.
244		-	(3) A copy of the signed, written collaborative
245		-	agreement must be available to the Department upon request
246		-	from both the physician assistant and the collaborating
247		-	physician.
248		-	(4) A physician assistant shall inform each
249		-	collaborating physician of all written collaborative
250		-	agreements he or she has signed and provide a copy of these
251		-	to any collaborating physician upon request.
252		-	(b) A collaborating physician may, but is not required to,
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255		-	delegate prescriptive authority to a physician assistant as
256		-	part of a written collaborative agreement. This authority may,
257		-	but is not required to, include prescription of, selection of,
258		-	orders for, administration of, storage of, acceptance of
259		-	samples of, and dispensing medical devices, over the counter
260		-	medications, legend drugs, medical gases, and controlled
261		-	substances categorized as Schedule II through V controlled
262		-	substances, as defined in Article II of the Illinois
263		-	Controlled Substances Act, and other preparations, including,
264		-	but not limited to, botanical and herbal remedies. The
265		-	collaborating physician must have a valid, current Illinois
266		-	controlled substance license and federal registration with the
267		-	Drug Enforcement Administration to delegate the authority to
268		-	prescribe controlled substances.
269		-	(1) To prescribe Schedule II, III, IV, or V controlled
270		-	substances under this Section, a physician assistant must
271		-	obtain a mid-level practitioner controlled substances
272		-	license. Medication orders issued by a physician assistant
273		-	shall be reviewed periodically by the collaborating
274		-	physician.
275		-	(2) The collaborating physician shall file with the
276		-	Department notice of delegation of prescriptive authority
277		-	to a physician assistant and termination of delegation,
278		-	specifying the authority delegated or terminated. Upon
279		-	receipt of this notice delegating authority to prescribe
280		-	controlled substances, the physician assistant shall be
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283		-	eligible to register for a mid-level practitioner
284		-	controlled substances license under Section 303.05 of the
285		-	Illinois Controlled Substances Act. Nothing in this Act
286		-	shall be construed to limit the delegation of tasks or
287		-	duties by the collaborating physician to a nurse or other
288		-	appropriately trained persons in accordance with Section
289		-	54.2 of the Medical Practice Act of 1987.
290		-	(3) In addition to the requirements of this subsection
291		-	(b), a collaborating physician may, but is not required
292		-	to, delegate authority to a physician assistant to
293		-	prescribe Schedule II controlled substances, if all of the
294		-	following conditions apply:
295		-	(A) Specific Schedule II controlled substances by
296		-	oral dosage or topical or transdermal application may
297		-	be delegated, provided that the delegated Schedule II
298		-	controlled substances are routinely prescribed by the
299		-	collaborating physician. This delegation must identify
300		-	the specific Schedule II controlled substances by
301		-	either brand name or generic name. Schedule II
302		-	controlled substances to be delivered by injection or
303		-	other route of administration may not be delegated.
304		-	(B) (Blank).
305		-	(C) Any prescription must be limited to no more
306		-	than a 30-day supply, with any continuation authorized
307		-	only after prior approval of the collaborating
308		-	physician.
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	142	+	1 the purposes of this definition, "control" means having at
	143	+	2 least an equal or a majority ownership or membership interest.
	144	+	3 A hospital affiliate shall be 100% owned or controlled by any
	145	+	4 combination of hospitals, their parent corporations, or
	146	+	5 physicians licensed to practice medicine in all its branches
	147	+	6 in Illinois. "Hospital affiliate" does not include a health
	148	+	7 maintenance organization regulated under the Health
	149	+	8 Maintenance Organization Act.
	150	+	9 11. "Email address of record" means the designated email
	151	+	10 address recorded by the Department in the applicant's
	152	+	11 application file or the licensee's license file, as maintained
	153	+	12 by the Department's licensure maintenance unit.
	154	+	13 12. "Federally qualified health center" means a health
	155	+	14 center funded under Section 330 of the federal Public Health
	156	+	15 Service Act.
	157	+	16 (Source: P.A. 102-1117, eff. 1-13-23.)
	158	+	17 (225 ILCS 95/7) (from Ch. 111, par. 4607)
	159	+	18 (Section scheduled to be repealed on January 1, 2028)
	160	+	19 Sec. 7. Collaboration requirements.
	161	+	20 (a) A collaborating physician shall determine the number
	162	+	21 of physician assistants to collaborate with, provided the
	163	+	22 physician is able to provide adequate collaboration as
	164	+	23 outlined in the written collaborative agreement required under
	165	+	24 Section 7.5 of this Act and consideration is given to the
	166	+	25 nature of the physician's practice, complexity of the patient
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310	168
311		-	(D) The physician assistant must discuss the
312		-	condition of any patients for whom a controlled
313		-	substance is prescribed monthly with the collaborating
314		-	physician.
315		-	(E) The physician assistant meets the education
316		-	requirements of Section 303.05 of the Illinois
317		-	Controlled Substances Act.
318		-	(c) Nothing in this Act shall be construed to limit the
319		-	delegation of tasks or duties by a physician to a licensed
320		-	practical nurse, a registered professional nurse, or other
321		-	persons. Nothing in this Act shall be construed to limit the
322		-	method of delegation that may be authorized by any means,
323		-	including, but not limited to, oral, written, electronic,
324		-	standing orders, protocols, guidelines, or verbal orders.
325		-	Nothing in this Act shall be construed to authorize a
326		-	physician assistant to provide health care services required
327		-	by law or rule to be performed by a physician. Nothing in this
328		-	Act shall be construed to authorize the delegation or
329		-	performance of operative surgery. Nothing in this Section
330		-	shall be construed to preclude a physician assistant from
331		-	assisting in surgery.
332		-	(c-5) Nothing in this Section shall be construed to apply
333		-	to any medication authority, including Schedule II controlled
334		-	substances of a licensed physician assistant for care provided
335		-	in a hospital, hospital affiliate, federally qualified health
336		-	center, or ambulatory surgical treatment center pursuant to
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338	170
339		-	Section 7.7 of this Act.
340		-	(d) (Blank).
341		-	(e) Nothing in this Section shall be construed to prohibit
342		-	generic substitution.
343		-	(Source: P.A. 101-13, eff. 6-12-19; 102-558, eff. 8-20-21.)
344		-	(225 ILCS 95/7.6 new)
345		-	Sec. 7.6. Written collaborative agreement; temporary
346		-	practice. Any physician assistant required to enter into a
347		-	written collaborative agreement with a collaborating physician
348		-	is authorized to continue to practice for up to 90 days after
349		-	the termination of a written collaborative agreement, provided
350		-	the physician assistant seeks any necessary collaboration at a
351		-	local hospital and refers patients who require services beyond
352		-	the training and experience of the physician assistant to a
353		-	physician or other health care provider.
354		-	(225 ILCS 95/7.7)
355		-	(Section scheduled to be repealed on January 1, 2028)
356		-	Sec. 7.7. Physician assistants in hospitals, hospital
357		-	affiliates, federally qualified health centers, or ambulatory
358		-	surgical treatment centers.
359		-	(a) A physician assistant may provide services in a
360		-	hospital as defined in the Hospital Licensing Act, a hospital
361		-	affiliate as defined in the University of Illinois Hospital
362		-	Act, a federally qualified health center, or a licensed
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363	173
364	174
365		-	ambulatory surgical treatment center as defined in the
366		-	Ambulatory Surgical Treatment Center Act without a written
367		-	collaborative agreement pursuant to Section 7.5 of this Act
368		-	only in accordance with this Section. A physician assistant
369		-	must possess clinical privileges recommended by (i) the
370		-	hospital medical staff and granted by the hospital, (ii) the
371		-	physician committee and federally qualified health center, or
372		-	(iii) the consulting medical staff committee and ambulatory
373		-	surgical treatment center in order to provide services. The
374		-	medical staff, physician committee, or consulting medical
375		-	staff committee shall periodically review the services of
376		-	physician assistants granted clinical privileges, including
377		-	any care provided in a hospital affiliate or federally
378		-	qualified health center. Authority may also be granted when
379		-	recommended by the hospital medical staff and granted by the
380		-	hospital, recommended by the physician committee and granted
381		-	by the federally qualified health center, or recommended by
382		-	the consulting medical staff committee and ambulatory surgical
383		-	treatment center to individual physician assistants to select,
384		-	order, and administer medications, including controlled
385		-	substances, to provide delineated care. In a hospital,
386		-	hospital affiliate, federally qualified health center, or
387		-	ambulatory surgical treatment center, the attending physician
388		-	shall determine a physician assistant's role in providing care
389		-	for his or her patients, except as otherwise provided in the
390		-	medical staff bylaws or consulting committee policies.
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	177	+	1 population, and the experience of each physician assistant. A
	178	+	2 collaborating physician may collaborate with a maximum of 7
	179	+	3 full-time equivalent physician assistants as described in
	180	+	4 Section 54.5 of the Medical Practice Act of 1987. As used in
	181	+	5 this Section, "full-time equivalent" means the equivalent of
	182	+	6 40 hours per week per individual. Physicians and physician
	183	+	7 assistants who work in a hospital, hospital affiliate,
	184	+	8 federally qualified health center, or ambulatory surgical
	185	+	9 treatment center as defined by Section 7.7 of this Act are
	186	+	10 exempt from the collaborative ratio restriction requirements
	187	+	11 of this Section. A physician assistant shall be able to hold
	188	+	12 more than one professional position. A collaborating physician
	189	+	13 shall file a notice of collaboration of each physician
	190	+	14 assistant according to the rules of the Department.
	191	+	15 Physician assistants shall collaborate only with
	192	+	16 physicians as defined in this Act who are engaged in clinical
	193	+	17 practice, or in clinical practice in public health or other
	194	+	18 community health facilities.
	195	+	19 Nothing in this Act shall be construed to limit the
	196	+	20 delegation of tasks or duties by a physician to a nurse or
	197	+	21 other appropriately trained personnel.
	198	+	22 Nothing in this Act shall be construed to prohibit the
	199	+	23 employment of physician assistants by a hospital, nursing home
	200	+	24 or other health care facility where such physician assistants
	201	+	25 function under a collaborating physician.
	202	+	26 A physician assistant may be employed by a practice group
391	203
392	204
393		-	(a-5) Physician assistants practicing in a hospital
394		-	affiliate or a federally qualified health center may be, but
395		-	are not required to be, granted authority to prescribe
396		-	Schedule II through V controlled substances when such
397		-	authority is recommended by the appropriate physician
398		-	committee of the hospital affiliate and granted by the
399		-	hospital affiliate or recommended by the physician committee
400		-	of the federally qualified health center and granted by the
401		-	federally qualified health center. This authority may, but is
402		-	not required to, include prescription of, selection of, orders
403		-	for, administration of, storage of, acceptance of samples of,
404		-	and dispensing over-the-counter medications, legend drugs,
405		-	medical gases, and controlled substances categorized as
406		-	Schedule II through V controlled substances, as defined in
407		-	Article II of the Illinois Controlled Substances Act, and
408		-	other preparations, including, but not limited to, botanical
409		-	and herbal remedies.
410		-	To prescribe controlled substances under this subsection
411		-	(a-5), a physician assistant must obtain a mid-level
412		-	practitioner controlled substance license. Medication orders
413		-	shall be reviewed periodically by the appropriate hospital
414		-	affiliate physicians committee or its physician designee or by
415		-	the physician committee of a federally qualified health
416		-	center.
417		-	The hospital affiliate or federally qualified health
418		-	center shall file with the Department notice of a grant of
419	205
420	206
421		-	prescriptive authority consistent with this subsection (a-5)
422		-	and termination of such a grant of authority in accordance
423		-	with rules of the Department. Upon receipt of this notice of
424		-	grant of authority to prescribe any Schedule II through V
425		-	controlled substances, the licensed physician assistant may
426		-	register for a mid-level practitioner controlled substance
427		-	license under Section 303.05 of the Illinois Controlled
428		-	Substances Act.
429		-	In addition, a hospital affiliate or a federally qualified
430		-	health center may, but is not required to, grant authority to a
431		-	physician assistant to prescribe any Schedule II controlled
432		-	substances if all of the following conditions apply:
433		-	(1) specific Schedule II controlled substances by oral
434		-	dosage or topical or transdermal application may be
435		-	designated, provided that the designated Schedule II
436		-	controlled substances are routinely prescribed by
437		-	physician assistants in their area of certification; this
438		-	grant of authority must identify the specific Schedule II
439		-	controlled substances by either brand name or generic
440		-	name; authority to prescribe or dispense Schedule II
441		-	controlled substances to be delivered by injection or
442		-	other route of administration may not be granted;
443		-	(2) any grant of authority must be controlled
444		-	substances limited to the practice of the physician
445		-	assistant;
446		-	(3) any prescription must be limited to no more than a
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447	209
448	210
449		-	30-day supply;
450		-	(4) the physician assistant must discuss the condition
451		-	of any patients for whom a controlled substance is
452		-	prescribed monthly with the appropriate physician
453		-	committee of the hospital affiliate or its physician
454		-	designee, or the physician committee of a federally
455		-	qualified health center; and
456		-	(5) the physician assistant must meet the education
457		-	requirements of Section 303.05 of the Illinois Controlled
458		-	Substances Act.
459		-	(b) A physician assistant granted authority to order
460		-	medications including controlled substances may complete
461		-	discharge prescriptions provided the prescription is in the
462		-	name of the physician assistant and the attending or
463		-	discharging physician.
464		-	(c) Physician assistants practicing in a hospital,
465		-	hospital affiliate, federally qualified health center, or an
466		-	ambulatory surgical treatment center are not required to
467		-	obtain a mid-level controlled substance license to order
468		-	controlled substances under Section 303.05 of the Illinois
469		-	Controlled Substances Act.
470		-	(Source: P.A. 100-453, eff. 8-25-17.)
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	213	+	1 or other entity employing multiple physicians at one or more
	214	+	2 locations. In that case, one of the physicians practicing at a
	215	+	3 location shall be designated the collaborating physician. The
	216	+	4 other physicians with that practice group or other entity who
	217	+	5 practice in the same general type of practice or specialty as
	218	+	6 the collaborating physician may collaborate with the physician
	219	+	7 assistant with respect to their patients.
	220	+	8 (b) A physician assistant licensed in this State, or
	221	+	9 licensed or authorized to practice in any other U.S.
	222	+	10 jurisdiction or credentialed by his or her federal employer as
	223	+	11 a physician assistant, who is responding to a need for medical
	224	+	12 care created by an emergency or by a state or local disaster
	225	+	13 may render such care that the physician assistant is able to
	226	+	14 provide without collaboration as it is defined in this Section
	227	+	15 or with such collaboration as is available.
	228	+	16 Any physician who collaborates with a physician assistant
	229	+	17 providing medical care in response to such an emergency or
	230	+	18 state or local disaster shall not be required to meet the
	231	+	19 requirements set forth in this Section for a collaborating
	232	+	20 physician.
	233	+	21 (Source: P.A. 100-453, eff. 8-25-17; 100-605, eff. 1-1-19.)
	234	+	22 (225 ILCS 95/7.5)
	235	+	23 (Section scheduled to be repealed on January 1, 2028)
	236	+	24 Sec. 7.5. Written collaborative agreements; prescriptive
	237	+	25 authority.
	238	+
	239	+
	240	+
	241	+
	242	+
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	244	+
	245	+
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	248	+	1 (a) A written collaborative agreement is required for all
	249	+	2 physician assistants to practice in the State, except as
	250	+	3 provided in Section 7.7 of this Act.
	251	+	4 (1) A written collaborative agreement shall describe
	252	+	5 the working relationship of the physician assistant with
	253	+	6 the collaborating physician and shall describe the
	254	+	7 categories of care, treatment, or procedures to be
	255	+	8 provided by the physician assistant. The written
	256	+	9 collaborative agreement shall promote the exercise of
	257	+	10 professional judgment by the physician assistant
	258	+	11 commensurate with his or her education and experience. The
	259	+	12 services to be provided by the physician assistant shall
	260	+	13 be services that the collaborating physician is authorized
	261	+	14 to and generally provides to his or her patients in the
	262	+	15 normal course of his or her clinical medical practice. The
	263	+	16 written collaborative agreement need not describe the
	264	+	17 exact steps that a physician assistant must take with
	265	+	18 respect to each specific condition, disease, or symptom
	266	+	19 but must specify which authorized procedures require the
	267	+	20 presence of the collaborating physician as the procedures
	268	+	21 are being performed. The relationship under a written
	269	+	22 collaborative agreement shall not be construed to require
	270	+	23 the personal presence of a physician at the place where
	271	+	24 services are rendered. Methods of communication shall be
	272	+	25 available for consultation with the collaborating
	273	+	26 physician in person or by telecommunications or electronic
	274	+
	275	+
	276	+
	277	+
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	280	+
	281	+
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	284	+	1 communications as set forth in the written collaborative
	285	+	2 agreement. For the purposes of this Act, "generally
	286	+	3 provides to his or her patients in the normal course of his
	287	+	4 or her clinical medical practice" means services, not
	288	+	5 specific tasks or duties, the collaborating physician
	289	+	6 routinely provides individually or through delegation to
	290	+	7 other persons so that the physician has the experience and
	291	+	8 ability to collaborate and provide consultation.
	292	+	9 (2) The written collaborative agreement shall be
	293	+	10 adequate if a physician does each of the following:
	294	+	11 (A) Participates in the joint formulation and
	295	+	12 joint approval of orders or guidelines with the
	296	+	13 physician assistant and he or she periodically reviews
	297	+	14 such orders and the services provided patients under
	298	+	15 such orders in accordance with accepted standards of
	299	+	16 medical practice and physician assistant practice.
	300	+	17 (B) Provides consultation at least once a month.
	301	+	18 (3) A copy of the signed, written collaborative
	302	+	19 agreement must be available to the Department upon request
	303	+	20 from both the physician assistant and the collaborating
	304	+	21 physician.
	305	+	22 (4) A physician assistant shall inform each
	306	+	23 collaborating physician of all written collaborative
	307	+	24 agreements he or she has signed and provide a copy of these
	308	+	25 to any collaborating physician upon request.
	309	+	26 (b) A collaborating physician may, but is not required to,
	310	+
	311	+
	312	+
	313	+
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	316	+
	317	+
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	320	+	1 delegate prescriptive authority to a physician assistant as
	321	+	2 part of a written collaborative agreement. This authority may,
	322	+	3 but is not required to, include prescription of, selection of,
	323	+	4 orders for, administration of, storage of, acceptance of
	324	+	5 samples of, and dispensing medical devices, over the counter
	325	+	6 medications, legend drugs, medical gases, and controlled
	326	+	7 substances categorized as Schedule II through V controlled
	327	+	8 substances, as defined in Article II of the Illinois
	328	+	9 Controlled Substances Act, and other preparations, including,
	329	+	10 but not limited to, botanical and herbal remedies. The
	330	+	11 collaborating physician must have a valid, current Illinois
	331	+	12 controlled substance license and federal registration with the
	332	+	13 Drug Enforcement Administration to delegate the authority to
	333	+	14 prescribe controlled substances.
	334	+	15 (1) To prescribe Schedule II, III, IV, or V controlled
	335	+	16 substances under this Section, a physician assistant must
	336	+	17 obtain a mid-level practitioner controlled substances
	337	+	18 license. Medication orders issued by a physician assistant
	338	+	19 shall be reviewed periodically by the collaborating
	339	+	20 physician.
	340	+	21 (2) The collaborating physician shall file with the
	341	+	22 Department notice of delegation of prescriptive authority
	342	+	23 to a physician assistant and termination of delegation,
	343	+	24 specifying the authority delegated or terminated. Upon
	344	+	25 receipt of this notice delegating authority to prescribe
	345	+	26 controlled substances, the physician assistant shall be
	346	+
	347	+
	348	+
	349	+
	350	+
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	352	+
	353	+
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	356	+	1 eligible to register for a mid-level practitioner
	357	+	2 controlled substances license under Section 303.05 of the
	358	+	3 Illinois Controlled Substances Act. Nothing in this Act
	359	+	4 shall be construed to limit the delegation of tasks or
	360	+	5 duties by the collaborating physician to a nurse or other
	361	+	6 appropriately trained persons in accordance with Section
	362	+	7 54.2 of the Medical Practice Act of 1987.
	363	+	8 (3) In addition to the requirements of this subsection
	364	+	9 (b), a collaborating physician may, but is not required
	365	+	10 to, delegate authority to a physician assistant to
	366	+	11 prescribe Schedule II controlled substances, if all of the
	367	+	12 following conditions apply:
	368	+	13 (A) Specific Schedule II controlled substances by
	369	+	14 oral dosage or topical or transdermal application may
	370	+	15 be delegated, provided that the delegated Schedule II
	371	+	16 controlled substances are routinely prescribed by the
	372	+	17 collaborating physician. This delegation must identify
	373	+	18 the specific Schedule II controlled substances by
	374	+	19 either brand name or generic name. Schedule II
	375	+	20 controlled substances to be delivered by injection or
	376	+	21 other route of administration may not be delegated.
	377	+	22 (B) (Blank).
	378	+	23 (C) Any prescription must be limited to no more
	379	+	24 than a 30-day supply, with any continuation authorized
	380	+	25 only after prior approval of the collaborating
	381	+	26 physician.
	382	+
	383	+
	384	+
	385	+
	386	+
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	388	+
	389	+
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	392	+	1 (D) The physician assistant must discuss the
	393	+	2 condition of any patients for whom a controlled
	394	+	3 substance is prescribed monthly with the collaborating
	395	+	4 physician.
	396	+	5 (E) The physician assistant meets the education
	397	+	6 requirements of Section 303.05 of the Illinois
	398	+	7 Controlled Substances Act.
	399	+	8 (c) Nothing in this Act shall be construed to limit the
	400	+	9 delegation of tasks or duties by a physician to a licensed
	401	+	10 practical nurse, a registered professional nurse, or other
	402	+	11 persons. Nothing in this Act shall be construed to limit the
	403	+	12 method of delegation that may be authorized by any means,
	404	+	13 including, but not limited to, oral, written, electronic,
	405	+	14 standing orders, protocols, guidelines, or verbal orders.
	406	+	15 Nothing in this Act shall be construed to authorize a
	407	+	16 physician assistant to provide health care services required
	408	+	17 by law or rule to be performed by a physician. Nothing in this
	409	+	18 Act shall be construed to authorize the delegation or
	410	+	19 performance of operative surgery. Nothing in this Section
	411	+	20 shall be construed to preclude a physician assistant from
	412	+	21 assisting in surgery.
	413	+	22 (c-5) Nothing in this Section shall be construed to apply
	414	+	23 to any medication authority, including Schedule II controlled
	415	+	24 substances of a licensed physician assistant for care provided
	416	+	25 in a hospital, hospital affiliate, federally qualified health
	417	+	26 center, or ambulatory surgical treatment center pursuant to
	418	+
	419	+
	420	+
	421	+
	422	+
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	424	+
	425	+
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	428	+	1 Section 7.7 of this Act.
	429	+	2 (d) (Blank).
	430	+	3 (e) Nothing in this Section shall be construed to prohibit
	431	+	4 generic substitution.
	432	+	5 (Source: P.A. 101-13, eff. 6-12-19; 102-558, eff. 8-20-21.)
	433	+	6 (225 ILCS 95/7.6 new)
	434	+	7 Sec. 7.6. Written collaborative agreement; temporary
	435	+	8 practice. Any physician assistant required to enter into a
	436	+	9 written collaborative agreement with a collaborating physician
	437	+	10 is authorized to continue to practice for up to 90 days after
	438	+	11 the termination of a written collaborative agreement, provided
	439	+	12 the physician assistant seeks any necessary collaboration at a
	440	+	13 local hospital and refers patients who require services beyond
	441	+	14 the training and experience of the physician assistant to a
	442	+	15 physician or other health care provider.
	443	+	16 (225 ILCS 95/7.7)
	444	+	17 (Section scheduled to be repealed on January 1, 2028)
	445	+	18 Sec. 7.7. Physician assistants in hospitals, hospital
	446	+	19 affiliates, federally qualified health centers, or ambulatory
	447	+	20 surgical treatment centers.
	448	+	21 (a) A physician assistant may provide services in a
	449	+	22 hospital as defined in the Hospital Licensing Act, a hospital
	450	+	23 affiliate as defined in the University of Illinois Hospital
	451	+	24 Act, a federally qualified health center, or a licensed
	452	+
	453	+
	454	+
	455	+
	456	+
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	458	+
	459	+
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	462	+	1 ambulatory surgical treatment center as defined in the
	463	+	2 Ambulatory Surgical Treatment Center Act without a written
	464	+	3 collaborative agreement pursuant to Section 7.5 of this Act
	465	+	4 only in accordance with this Section. A physician assistant
	466	+	5 must possess clinical privileges recommended by (i) the
	467	+	6 hospital medical staff and granted by the hospital, (ii) the
	468	+	7 physician committee and federally qualified health center, or
	469	+	8 (iii) the consulting medical staff committee and ambulatory
	470	+	9 surgical treatment center in order to provide services. The
	471	+	10 medical staff, physician committee, or consulting medical
	472	+	11 staff committee shall periodically review the services of
	473	+	12 physician assistants granted clinical privileges, including
	474	+	13 any care provided in a hospital affiliate or federally
	475	+	14 qualified health center. Authority may also be granted when
	476	+	15 recommended by the hospital medical staff and granted by the
	477	+	16 hospital, recommended by the physician committee and granted
	478	+	17 by the federally qualified health center, or recommended by
	479	+	18 the consulting medical staff committee and ambulatory surgical
	480	+	19 treatment center to individual physician assistants to select,
	481	+	20 order, and administer medications, including controlled
	482	+	21 substances, to provide delineated care. In a hospital,
	483	+	22 hospital affiliate, federally qualified health center, or
	484	+	23 ambulatory surgical treatment center, the attending physician
	485	+	24 shall determine a physician assistant's role in providing care
	486	+	25 for his or her patients, except as otherwise provided in the
	487	+	26 medical staff bylaws or consulting committee policies.
	488	+
	489	+
	490	+
	491	+
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	494	+
	495	+
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	498	+	1 (a-5) Physician assistants practicing in a hospital
	499	+	2 affiliate or a federally qualified health center may be, but
	500	+	3 are not required to be, granted authority to prescribe
	501	+	4 Schedule II through V controlled substances when such
	502	+	5 authority is recommended by the appropriate physician
	503	+	6 committee of the hospital affiliate and granted by the
	504	+	7 hospital affiliate or recommended by the physician committee
	505	+	8 of the federally qualified health center and granted by the
	506	+	9 federally qualified health center. This authority may, but is
	507	+	10 not required to, include prescription of, selection of, orders
	508	+	11 for, administration of, storage of, acceptance of samples of,
	509	+	12 and dispensing over-the-counter medications, legend drugs,
	510	+	13 medical gases, and controlled substances categorized as
	511	+	14 Schedule II through V controlled substances, as defined in
	512	+	15 Article II of the Illinois Controlled Substances Act, and
	513	+	16 other preparations, including, but not limited to, botanical
	514	+	17 and herbal remedies.
	515	+	18 To prescribe controlled substances under this subsection
	516	+	19 (a-5), a physician assistant must obtain a mid-level
	517	+	20 practitioner controlled substance license. Medication orders
	518	+	21 shall be reviewed periodically by the appropriate hospital
	519	+	22 affiliate physicians committee or its physician designee or by
	520	+	23 the physician committee of a federally qualified health
	521	+	24 center.
	522	+	25 The hospital affiliate or federally qualified health
	523	+	26 center shall file with the Department notice of a grant of
	524	+
	525	+
	526	+
	527	+
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	530	+
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	534	+	1 prescriptive authority consistent with this subsection (a-5)
	535	+	2 and termination of such a grant of authority in accordance
	536	+	3 with rules of the Department. Upon receipt of this notice of
	537	+	4 grant of authority to prescribe any Schedule II through V
	538	+	5 controlled substances, the licensed physician assistant may
	539	+	6 register for a mid-level practitioner controlled substance
	540	+	7 license under Section 303.05 of the Illinois Controlled
	541	+	8 Substances Act.
	542	+	9 In addition, a hospital affiliate or a federally qualified
	543	+	10 health center may, but is not required to, grant authority to a
	544	+	11 physician assistant to prescribe any Schedule II controlled
	545	+	12 substances if all of the following conditions apply:
	546	+	13 (1) specific Schedule II controlled substances by oral
	547	+	14 dosage or topical or transdermal application may be
	548	+	15 designated, provided that the designated Schedule II
	549	+	16 controlled substances are routinely prescribed by
	550	+	17 physician assistants in their area of certification; this
	551	+	18 grant of authority must identify the specific Schedule II
	552	+	19 controlled substances by either brand name or generic
	553	+	20 name; authority to prescribe or dispense Schedule II
	554	+	21 controlled substances to be delivered by injection or
	555	+	22 other route of administration may not be granted;
	556	+	23 (2) any grant of authority must be controlled
	557	+	24 substances limited to the practice of the physician
	558	+	25 assistant;
	559	+	26 (3) any prescription must be limited to no more than a
	560	+
	561	+
	562	+
	563	+
	564	+
	565	+	SB0218 Enrolled - 16 - LRB103 25028 AMQ 51362 b
	566	+
	567	+
	568	+	SB0218 Enrolled- 17 -LRB103 25028 AMQ 51362 b SB0218 Enrolled - 17 - LRB103 25028 AMQ 51362 b
	569	+	SB0218 Enrolled - 17 - LRB103 25028 AMQ 51362 b
	570	+	1 30-day supply;
	571	+	2 (4) the physician assistant must discuss the condition
	572	+	3 of any patients for whom a controlled substance is
	573	+	4 prescribed monthly with the appropriate physician
	574	+	5 committee of the hospital affiliate or its physician
	575	+	6 designee, or the physician committee of a federally
	576	+	7 qualified health center; and
	577	+	8 (5) the physician assistant must meet the education
	578	+	9 requirements of Section 303.05 of the Illinois Controlled
	579	+	10 Substances Act.
	580	+	11 (b) A physician assistant granted authority to order
	581	+	12 medications including controlled substances may complete
	582	+	13 discharge prescriptions provided the prescription is in the
	583	+	14 name of the physician assistant and the attending or
	584	+	15 discharging physician.
	585	+	16 (c) Physician assistants practicing in a hospital,
	586	+	17 hospital affiliate, federally qualified health center, or an
	587	+	18 ambulatory surgical treatment center are not required to
	588	+	19 obtain a mid-level controlled substance license to order
	589	+	20 controlled substances under Section 303.05 of the Illinois
	590	+	21 Controlled Substances Act.
	591	+	22 (Source: P.A. 100-453, eff. 8-25-17.)
	592	+
	593	+
	594	+
	595	+
	596	+
	597	+	SB0218 Enrolled - 17 - LRB103 25028 AMQ 51362 b