Rep. Theresa Mah

Filed: 5/22/2017

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 898

2    AMENDMENT NO. ______. Amend Senate Bill 898 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Insurance Code is amended by
5adding Section 356z.25 as follows:
 
6    (215 ILCS 5/356z.25 new)
7    Sec. 356z.25. Dry needling by a physical therapist. A group
8or individual policy of accident and health insurance or a
9qualified health plan offered through the health insurance
10market place is not required to provide coverage for dry
11needling performed by a physical therapist as described in
12Section 1.5 of the Illinois Physical Therapy Act.
 
13    Section 10. The Illinois Physical Therapy Act is amended by
14changing Section 1 and by adding Section 1.5 as follows:
 

 

 

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1    (225 ILCS 90/1)  (from Ch. 111, par. 4251)
2    (Section scheduled to be repealed on January 1, 2026)
3    Sec. 1. Definitions. As used in this Act:
4    (1) "Physical therapy" means all of the following:
5        (A) Examining, evaluating, and testing individuals who
6    may have mechanical, physiological, or developmental
7    impairments, functional limitations, disabilities, or
8    other health and movement-related conditions, classifying
9    these disorders, determining a rehabilitation prognosis
10    and plan of therapeutic intervention, and assessing the
11    on-going effects of the interventions.
12        (B) Alleviating impairments, functional limitations,
13    or disabilities by designing, implementing, and modifying
14    therapeutic interventions that may include, but are not
15    limited to, the evaluation or treatment of a person through
16    the use of the effective properties of physical measures
17    and heat, cold, light, water, radiant energy, electricity,
18    sound, and air and use of therapeutic massage, therapeutic
19    exercise, mobilization, and rehabilitative procedures,
20    with or without assistive devices, for the purposes of
21    preventing, correcting, or alleviating a physical or
22    mental impairment, functional limitation, or disability.
23        (C) Reducing the risk of injury, impairment,
24    functional limitation, or disability, including the
25    promotion and maintenance of fitness, health, and
26    wellness.

 

 

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1        (D) Engaging in administration, consultation,
2    education, and research.
3    "Physical therapy" includes, but is not limited to: (a)
4performance of specialized tests and measurements, (b)
5administration of specialized treatment procedures, (c)
6interpretation of referrals from physicians, dentists,
7advanced practice nurses, physician assistants, and podiatric
8physicians, (d) establishment, and modification of physical
9therapy treatment programs, (e) administration of topical
10medication used in generally accepted physical therapy
11procedures when such medication is either prescribed by the
12patient's physician, licensed to practice medicine in all its
13branches, the patient's physician licensed to practice
14podiatric medicine, the patient's advanced practice nurse, the
15patient's physician assistant, or the patient's dentist or used
16following the physician's orders or written instructions, and
17(f) supervision or teaching of physical therapy, and (g) dry
18needling in accordance with Section 1.5. Physical therapy does
19not include radiology, electrosurgery, chiropractic technique
20or determination of a differential diagnosis; provided,
21however, the limitation on determining a differential
22diagnosis shall not in any manner limit a physical therapist
23licensed under this Act from performing an evaluation pursuant
24to such license. Nothing in this Section shall limit a physical
25therapist from employing appropriate physical therapy
26techniques that he or she is educated and licensed to perform.

 

 

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1A physical therapist shall refer to a licensed physician,
2advanced practice nurse, physician assistant, dentist,
3podiatric physician, other physical therapist, or other health
4care provider any patient whose medical condition should, at
5the time of evaluation or treatment, be determined to be beyond
6the scope of practice of the physical therapist.
7    (2) "Physical therapist" means a person who practices
8physical therapy and who has met all requirements as provided
9in this Act.
10    (3) "Department" means the Department of Professional
11Regulation.
12    (4) "Director" means the Director of Professional
13Regulation.
14    (5) "Board" means the Physical Therapy Licensing and
15Disciplinary Board approved by the Director.
16    (6) "Referral" means a written or oral authorization for
17physical therapy services for a patient by a physician,
18dentist, advanced practice nurse, physician assistant, or
19podiatric physician who maintains medical supervision of the
20patient and makes a diagnosis or verifies that the patient's
21condition is such that it may be treated by a physical
22therapist.
23    (7) "Documented current and relevant diagnosis" for the
24purpose of this Act means a diagnosis, substantiated by
25signature or oral verification of a physician, dentist,
26advanced practice nurse, physician assistant, or podiatric

 

 

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1physician, that a patient's condition is such that it may be
2treated by physical therapy as defined in this Act, which
3diagnosis shall remain in effect until changed by the
4physician, dentist, advanced practice nurse, physician
5assistant, or podiatric physician.
6    (8) "State" includes:
7        (a) the states of the United States of America;
8        (b) the District of Columbia; and
9        (c) the Commonwealth of Puerto Rico.
10    (9) "Physical therapist assistant" means a person licensed
11to assist a physical therapist and who has met all requirements
12as provided in this Act and who works under the supervision of
13a licensed physical therapist to assist in implementing the
14physical therapy treatment program as established by the
15licensed physical therapist. The patient care activities
16provided by the physical therapist assistant shall not include
17the interpretation of referrals, evaluation procedures, or the
18planning or major modification of patient programs.
19    (10) "Physical therapy aide" means a person who has
20received on the job training, specific to the facility in which
21he is employed.
22    (11) "Advanced practice nurse" means a person licensed as
23an advanced practice nurse under the Nurse Practice Act.
24    (12) "Physician assistant" means a person licensed under
25the Physician Assistant Practice Act of 1987.
26(Source: P.A. 98-214, eff. 8-9-13; 99-173, eff. 7-29-15;

 

 

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199-229, eff. 8-3-15; 99-642, eff. 7-28-16; revised 10-27-16.)
 
2    (225 ILCS 90/1.5 new)
3    Sec. 1.5. Dry needling.
4    (a) For the purpose of this Act, "dry needling", also known
5as intramuscular therapy, means an advanced needling skill or
6technique limited to the treatment of myofascial pain, using a
7single use, single insertion, sterile filiform needle (without
8the use of heat, cold, or any other added modality or
9medication), that is inserted into the skin or underlying
10tissues to stimulate trigger points. Dry needling may apply
11theory based only upon Western medical concepts, requires an
12examination and diagnosis, and treats specific anatomic
13entities selected according to physical signs. Dry needling
14does not include the stimulation of auricular points,
15utilization of distal points or non-local points, needle
16retention, application of retained electric stimulation leads,
17or the teaching or application of other acupuncture theory.
18    (b) A physical therapist licensed under this Act may only
19perform dry needling under the following conditions as
20determined by the Department by rule:
21        (1) Prior to completion of the education under
22    paragraph (2) of this subsection, successful completion of
23    50 hours of instruction in the following areas:
24            (A) the musculoskeletal and neuromuscular system;
25            (B) the anatomical basis of pain mechanisms,

 

 

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1        chronic pain, and referred pain;
2            (C) myofascial trigger point theory; and
3            (D) universal precautions.
4        (2) Completion of at least 30 hours of didactic course
5    work specific to dry needling.
6        (3) Successful completion of at least 54 practicum
7    hours in dry needling course work approved by the
8    Federation of State Boards of Physical Therapy or its
9    successor (or substantial equivalent), as determined by
10    the Department. Each instructional course shall specify
11    what anatomical regions are included in the instruction and
12    describe whether the course offers introductory or
13    advanced instruction in dry needling. Each instruction
14    course shall include the following areas:
15            (A) dry needling technique;
16            (B) dry needling indications and
17        contraindications;
18            (C) documentation of dry needling;
19            (D) management of adverse effects;
20            (E) practical psychomotor competency; and
21            (F) the Occupational Safety and Health
22        Administration's Bloodborne Pathogens standard.
23        Postgraduate classes qualifying for completion of the
24    mandated 54 hours of dry needling shall be in one or more
25    modules, with the initial module being no fewer than 27
26    hours, and therapists shall complete at least 54 hours in

 

 

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1    no more than 12 months.
2        (4) Completion of at least 200 patient treatment
3    sessions under supervision as determined by the Department
4    by rule.
5        (5) Successful completion of a competency examination
6    as approved by the Department.
7    Each licensee is responsible for maintaining records of the
8completion of the requirements of this subsection (b) and shall
9be prepared to produce such records upon request by the
10Department.
11    (c) A newly-licensed physical therapist shall not practice
12dry needling for at least one year from the date of initial
13licensure unless the practitioner can demonstrate compliance
14with subsection (b) through his or her pre-licensure
15educational coursework.
16    (d) Dry needling may only be performed by a licensed
17physical therapist and may not be delegated to a physical
18therapist assistant or support personnel.
19    (e) A physical therapist shall not advertise, describe to
20patients or the public, or otherwise represent that dry
21needling is acupuncture, nor shall he or she represent that he
22or she practices acupuncture unless separately licensed under
23the Acupuncture Practice Act.
 
24    Section 99. Effective date. This Act takes effect upon
25becoming law.".