101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB3355

 

Introduced , by Rep. Jay Hoffman

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Medical Practice Act of 1987. Provides that a physician licensed to practice medicine in all its branches may collaborate with a physician assistant (rather than may delegate care and treatment responsibilities to a physician assistant). Provides that a collaborative agreement shall be for services in the same area of practice or specialty as the collaborating physician in his or her medical practice. Deletes language providing that a physician may enter into collaborative agreements with no more than 7 full-time physician assistants. Amends the Physician Assistant Practice Act of 1987. Provides that a physician assistant in a health professional shortage area with a score greater than or equal to 12 shall own his or her own medical practice. Provides that medical and surgical services provided by a physician assistant include: obtaining and performing comprehensive health histories and physical examinations; evaluating, diagnosing, and providing medical treatment; ordering, performing, and interpreting diagnostic studies and therapeutic procedures; educating patients on health promotion and disease prevention; providing consultation upon request; and writing medical orders. Provides other provisions regarding scope of practice. Deletes language requiring: a written collaborative agreement for all physician assistants to practice in the State; a written collaborative agreement to describe the working relationship of the physician assistant with the collaborating physician and the categories of care, treatment, or procedures to be provided by the physician assistant; and the collaborating physician to file with the Department of Financial and Professional Regulation notice when employing, discharging, or collaborating with a physician assistant. Makes other changes. Effective January 1, 2020.


LRB101 11172 SMS 56411 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB3355LRB101 11172 SMS 56411 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Medical Practice Act of 1987 is amended by
5changing Section 54.5 as follows:
 
6    (225 ILCS 60/54.5)
7    (Section scheduled to be repealed on December 31, 2019)
8    Sec. 54.5. Physician delegation of authority to physician
9assistants, advanced practice registered nurses without full
10practice authority, and prescribing psychologists.
11    (a) A physician licensed to practice medicine in all its
12branches may collaborate with a physician assistant under
13guidelines in accordance with the requirements of the Physician
14Assistant Practice Act 1987. Collaboration is for the purpose
15of providing medical consultation, and no employment
16relationship is required. A collaborative agreement shall
17conform to the requirements of Section 7 of the Physician
18Assistant Practice Act of 1987. The collaborative agreement
19shall be for services in the same area of practice or specialty
20as the collaborating physician in his or her clinical medical
21practice. A collaborative agreement shall be adequate with
22respect to collaboration with physician assistant if all of the
23following apply:

 

 

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1        (1) The agreement is to promote the exercise of
2    professional judgment by the physician assistant
3    commensurate with his or her education and experience.
4        (2) The physician assistant provides services based
5    upon a collaborative agreement with the collaborating
6    physician, except as set forth in section 7.7 of the
7    Physician Assistant Practice Act of 1987. With respect to
8    labor and delivery, the collaborating physician must
9    provide delivery services in order to participate with the
10    physician assistant.
11        (3) Methods of communication are available with the
12    collaborating physician in person or through
13    telecommunications for consultation, collaboration, and
14    referral as needed to address patient care needs.
15    Physicians licensed to practice medicine in all its
16    branches may delegate care and treatment responsibilities
17    to a physician assistant under guidelines in accordance
18    with the requirements of the Physician Assistant Practice
19    Act of 1987. A physician licensed to practice medicine in
20    all its branches may enter into collaborative agreements
21    with no more than 7 full-time equivalent physician
22    assistants, except in a hospital, hospital affiliate, or
23    ambulatory surgical treatment center as set forth by
24    Section 7.7 of the Physician Assistant Practice Act of 1987
25    and as provided in subsection (a-5).
26    (a-5) (Blank). A physician licensed to practice medicine in

 

 

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1all its branches may collaborate with more than 7 physician
2assistants when the services are provided in a federal primary
3care health professional shortage area with a Health
4Professional Shortage Area score greater than or equal to 12,
5as determined by the United States Department of Health and
6Human Services.
7    The collaborating physician must keep appropriate
8documentation of meeting this exemption and make it available
9to the Department upon request.
10    (b) A physician licensed to practice medicine in all its
11branches in active clinical practice may collaborate with an
12advanced practice registered nurse in accordance with the
13requirements of the Nurse Practice Act. Collaboration is for
14the purpose of providing medical consultation, and no
15employment relationship is required. A written collaborative
16agreement shall conform to the requirements of Section 65-35 of
17the Nurse Practice Act. The written collaborative agreement
18shall be for services in the same area of practice or specialty
19as the collaborating physician in his or her clinical medical
20practice. A written collaborative agreement shall be adequate
21with respect to collaboration with advanced practice
22registered nurses if all of the following apply:
23        (1) The agreement is written to promote the exercise of
24    professional judgment by the advanced practice registered
25    nurse commensurate with his or her education and
26    experience.

 

 

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1        (2) The advanced practice registered nurse provides
2    services based upon a written collaborative agreement with
3    the collaborating physician, except as set forth in
4    subsection (b-5) of this Section. With respect to labor and
5    delivery, the collaborating physician must provide
6    delivery services in order to participate with a certified
7    nurse midwife.
8        (3) Methods of communication are available with the
9    collaborating physician in person or through
10    telecommunications for consultation, collaboration, and
11    referral as needed to address patient care needs.
12    (b-5) An anesthesiologist or physician licensed to
13practice medicine in all its branches may collaborate with a
14certified registered nurse anesthetist in accordance with
15Section 65-35 of the Nurse Practice Act for the provision of
16anesthesia services. With respect to the provision of
17anesthesia services, the collaborating anesthesiologist or
18physician shall have training and experience in the delivery of
19anesthesia services consistent with Department rules.
20Collaboration shall be adequate if:
21        (1) an anesthesiologist or a physician participates in
22    the joint formulation and joint approval of orders or
23    guidelines and periodically reviews such orders and the
24    services provided patients under such orders; and
25        (2) for anesthesia services, the anesthesiologist or
26    physician participates through discussion of and agreement

 

 

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1    with the anesthesia plan and is physically present and
2    available on the premises during the delivery of anesthesia
3    services for diagnosis, consultation, and treatment of
4    emergency medical conditions. Anesthesia services in a
5    hospital shall be conducted in accordance with Section 10.7
6    of the Hospital Licensing Act and in an ambulatory surgical
7    treatment center in accordance with Section 6.5 of the
8    Ambulatory Surgical Treatment Center Act.
9    (b-10) The anesthesiologist or operating physician must
10agree with the anesthesia plan prior to the delivery of
11services.
12    (c) The collaborating physician shall have access to the
13medical records of all patients attended by a physician
14assistant. The collaborating physician shall have access to the
15medical records of all patients attended to by an advanced
16practice registered nurse.
17    (d) (Blank).
18    (e) A physician shall not be liable for the acts or
19omissions of a prescribing psychologist, physician assistant,
20or advanced practice registered nurse solely on the basis of
21having signed a supervision agreement or guidelines or a
22collaborative agreement, an order, a standing medical order, a
23standing delegation order, or other order or guideline
24authorizing a prescribing psychologist, physician assistant,
25or advanced practice registered nurse to perform acts, unless
26the physician has reason to believe the prescribing

 

 

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1psychologist, physician assistant, or advanced practice
2registered nurse lacked the competency to perform the act or
3acts or commits willful and wanton misconduct.
4    (f) A collaborating physician may, but is not required to,
5delegate prescriptive authority to an advanced practice
6registered nurse as part of a written collaborative agreement,
7and the delegation of prescriptive authority shall conform to
8the requirements of Section 65-40 of the Nurse Practice Act.
9    (g) A collaborating physician may, but is not required to,
10delegate prescriptive authority to a physician assistant as
11part of a written collaborative agreement, and the delegation
12of prescriptive authority shall conform to the requirements of
13Section 7.5 of the Physician Assistant Practice Act of 1987.
14    (h) (Blank).
15    (i) A collaborating physician shall delegate prescriptive
16authority to a prescribing psychologist as part of a written
17collaborative agreement, and the delegation of prescriptive
18authority shall conform to the requirements of Section 4.3 of
19the Clinical Psychologist Licensing Act.
20    (j) As set forth in Section 22.2 of this Act, a licensee
21under this Act may not directly or indirectly divide, share, or
22split any professional fee or other form of compensation for
23professional services with anyone in exchange for a referral or
24otherwise, other than as provided in Section 22.2.
25(Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
26100-513, eff. 1-1-18; 100-605, eff. 1-1-19; 100-863, eff.

 

 

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18-14-18.)
 
2    Section 10. The Physician Assistant Practice Act of 1987 is
3amended by adding Section 6.1 and changing Sections 1, 4, 5,
45.5, 6, 7, 7.5, 7.7, 11, 21, and 22.1 as follows:
 
5    (225 ILCS 95/1)  (from Ch. 111, par. 4601)
6    (Section scheduled to be repealed on January 1, 2028)
7    Sec. 1. Legislative purpose. The practice as a physician
8assistant in the State of Illinois is hereby declared to affect
9the public health, safety and welfare and to be subject to
10regulation and control in the public interest. The purpose and
11legislative intent of this Act is to encourage and promote the
12more effective utilization of the skills of physicians by
13enabling them to collaborate on delegate certain health tasks
14to physician assistants where such delegation is consistent
15with the health and welfare of the patient and is conducted at
16the direction of and under the responsible supervision of the
17physician.
18    It is further declared to be a matter of public health and
19concern that the practice as a physician assistant, as defined
20in this Act, merit and receive the confidence of the public,
21that only qualified persons be authorized to practice as a
22physician assistant in the State of Illinois. This Act shall be
23liberally construed to best carry out these subjects and
24purposes.

 

 

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1(Source: P.A. 100-453, eff. 8-25-17.)
 
2    (225 ILCS 95/4)  (from Ch. 111, par. 4604)
3    (Section scheduled to be repealed on January 1, 2028)
4    Sec. 4. Definitions. In this Act:
5    1. "Department" means the Department of Financial and
6Professional Regulation.
7    2. "Secretary" means the Secretary of Financial and
8Professional Regulation.
9    3. "Physician assistant" means any person not holding an
10active license or permit issued by the Department pursuant to
11the Medical Practice Act of 1987 who has been certified as a
12physician assistant by the National Commission on the
13Certification of Physician Assistants or equivalent successor
14agency and practices medicine performs procedures in
15collaboration with a physician as defined in this Act. A
16physician assistant may practice medicine perform such
17procedures within the specialty of the collaborating
18physician, except that such physician shall exercise such
19direction, collaboration, and control over such physician
20assistants as will assure that patients shall receive quality
21medical care. Physician assistants shall be capable of
22performing a variety of tasks within their education, training,
23and experience the specialty of medical care in collaboration
24with a physician. Collaboration with the physician assistant
25shall not be construed to necessarily require the personal

 

 

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1presence of the collaborating physician at all times at the
2place where services are rendered, as long as there is
3communication available for consultation by radio, telephone
4or telecommunications within established guidelines as
5determined by the physician/physician assistant team. The
6collaborating physician may collaborate on delegate tasks and
7duties with to the physician assistant. Collaborated Delegated
8tasks or duties shall be consistent with physician assistant
9education, training, and experience. The collaborated
10delegated tasks or duties shall be specific to the practice
11setting and shall be implemented and reviewed under a written
12collaborative agreement established by the physician or
13physician/physician assistant team. A physician assistant,
14acting as an agent of the physician, shall be permitted to
15transmit the collaborating physician's orders as determined by
16the institution's by-laws, policies, procedures, or job
17description within which the physician/physician assistant
18team practices. Physician assistants shall practice only in
19accordance with a written collaborative agreement.
20    Any person who holds an active license or permit issued
21pursuant to the Medical Practice Act of 1987 shall have that
22license automatically placed into inactive status upon
23issuance of a physician assistant license. Any person who holds
24an active license as a physician assistant who is issued a
25license or permit pursuant to the Medical Practice Act of 1987
26shall have his or her physician assistant license automatically

 

 

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1placed into inactive status.
2    3.5. "Physician assistant practice" means the performance
3of procedures and the practice of medicine, including
4procedures in the behavioral and mental health services, within
5the specialty of the collaborating physician. Physician
6assistants shall be capable of performing a variety of tasks
7within the specialty of medical care of the collaborating
8physician. Collaboration with the physician assistant shall
9not be construed to necessarily require the personal presence
10of the collaborating physician at all times at the place where
11services are rendered, as long as there is communication
12available for consultation by radio, telephone,
13telecommunications, or electronic communications. The
14collaborating physician may collaborate on delegate tasks and
15duties with to the physician assistant. Delegated tasks or
16duties shall be consistent with physician assistant education,
17training, and experience. The delegated tasks or duties shall
18be specific to the practice setting and shall be implemented
19and reviewed under a written collaborative agreement
20established by the physician or physician/physician assistant
21team. A physician assistant shall be permitted to transmit the
22collaborating physician's orders as determined by the
23institution's bylaws, policies, or procedures or the job
24description within which the physician/physician assistant
25team practices. Physician assistants shall practice only in
26accordance with a written collaborative agreement, except as

 

 

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1provided in Section 7.5 of this Act.
2    4. "Board" means the Medical Licensing Board constituted
3under the Medical Practice Act of 1987.
4    5. "Disciplinary Board" means the Medical Disciplinary
5Board constituted under the Medical Practice Act of 1987.
6    6. "Physician" means a person licensed to practice medicine
7in all of its branches under the Medical Practice Act of 1987.
8    7. "Collaborating physician" means the physician who,
9within his or her specialty and expertise, may collaborate on
10delegate a variety of tasks and procedures with to the
11physician assistant. Such tasks and procedures shall be
12collaborated delegated in accordance with a written
13collaborative agreement.
14    8. (Blank).
15    9. "Address of record" means the designated address
16recorded by the Department in the applicant's or licensee's
17application file or license file maintained by the Department's
18licensure maintenance unit.
19    10. "Hospital affiliate" means a corporation, partnership,
20joint venture, limited liability company, or similar
21organization, other than a hospital, that is devoted primarily
22to the provision, management, or support of health care
23services and that directly or indirectly controls, is
24controlled by, or is under common control of the hospital. For
25the purposes of this definition, "control" means having at
26least an equal or a majority ownership or membership interest.

 

 

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1A hospital affiliate shall be 100% owned or controlled by any
2combination of hospitals, their parent corporations, or
3physicians licensed to practice medicine in all its branches in
4Illinois. "Hospital affiliate" does not include a health
5maintenance organization regulated under the Health
6Maintenance Organization Act.
7    11. "Email address of record" means the designated email
8address recorded by the Department in the applicant's
9application file or the licensee's license file, as maintained
10by the Department's licensure maintenance unit.
11(Source: P.A. 99-330, eff. 1-1-16; 100-453, eff. 8-25-17.)
 
12    (225 ILCS 95/5.5)
13    (Section scheduled to be repealed on January 1, 2028)
14    Sec. 5.5. Billing. A physician assistant shall not be
15allowed to personally bill patients or in any way charge for
16services rendered. The employer of a physician assistant may
17charge for services rendered by the physician assistant. All
18claims for services rendered by the physician assistant shall
19be submitted using the physician assistant's national provider
20identification number as the rendering provider whenever
21appropriate. Payment for services rendered by a physician
22assistant shall be made to his or her employer if the payor
23would have made payment had the services been provided by a
24physician licensed to provide medicine in all of its branches.
25A physician assistant in a health professional shortage area

 

 

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1with a score greater than or equal to 12 shall own his or her
2own medical practice.
3(Source: P.A. 100-453, eff. 8-25-17; 100-559, eff. 12-8-17.)
 
4    (225 ILCS 95/6)  (from Ch. 111, par. 4606)
5    (Section scheduled to be repealed on January 1, 2028)
6    Sec. 6. Physician assistant title.
7    (a) No physician assistant shall use the title of doctor,
8physician, or associate with his or her name or any other term
9that would indicate to other persons that he or she is
10qualified to engage in the general practice of medicine.
11    (b) A physician assistant shall verbally identify himself
12or herself as a physician assistant, including specialty
13certification, to each patient.
14    (c) Nothing in this Act shall be construed to relieve a
15physician assistant of the professional or legal
16responsibility for the care and treatment of persons attended
17by him or her.
18    (d) The collaborating physician shall file with the
19Department notice of employment, discharge, or collaboration
20with a physician assistant at the time of employment,
21discharge, or assumption of collaboration with a physician
22assistant.
23(Source: P.A. 100-453, eff. 8-25-17.)
 
24    (225 ILCS 95/6.1 new)

 

 

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1    Sec. 6.1. Scope of practice.
2    (a) Medical and surgical services provided by a physician
3assistant include, but are not limited to:
4        (i) obtaining and performing comprehensive health
5    histories and physical examinations;
6        (ii) evaluating, diagnosing, managing, and providing
7    medical treatment;
8        (iii) ordering, performing, and interpreting
9    diagnostic studies and therapeutic procedures;
10        (iv) educating patients on health promotion and
11    disease prevention;
12        (v) providing consultation upon request; and
13        (vi) writing medical orders.
14    (b) A physician assistant may provide services in health
15care facilities or programs including, but not limited to,
16hospitals, nursing facilities, assisted living facilities,
17behavioral and mental health facilities, and hospices.
18    (c) A physician assistant may obtain informed consent.
19    (d) A physician assistant may supervise, delegate, and
20assign therapeutic and diagnostic measures to licensed or
21unlicensed personnel.
22    (e) A physician assistant may certify the health or
23disability of a patient as required by any local, State, or
24federal program.
25    (f) A physician assistant may authenticate any document
26with his or her signature, certification, stamp, verification,

 

 

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1affidavit, or endorsement if it may be authenticated by the
2signature, certification, stamp, verification, affidavit, or
3endorsement of a physician.
4    (g) A physician assistant shall collaborate with, consult
5with, or refer to the appropriate member of the healthcare team
6as indicated by the patient's condition, the education,
7experience, and competencies of the physician assistant, and
8the standard of care. The degree of collaboration shall be
9determined by the practice which may include decisions made by
10the employer, group, hospital service, and the credentialing
11and privileging systems of licensed facilities.
12    (h) A physician assistant is responsible for the care they
13provide.
 
14    (225 ILCS 95/7)  (from Ch. 111, par. 4607)
15    (Section scheduled to be repealed on January 1, 2028)
16    Sec. 7. Collaboration requirements.
17    (a) A collaborating physician shall determine the number of
18physician assistants to collaborate with, provided the
19physician is able to provide adequate collaboration as outlined
20in the written collaborative agreement required under Section
217.5 of this Act and consideration is given to the nature of the
22physician's practice, complexity of the patient population,
23and the experience of each physician assistant. A collaborating
24physician may collaborate with a maximum of 7 full-time
25equivalent physician assistants as described in Section 54.5 of

 

 

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1the Medical Practice Act of 1987. As used in this Section,
2"full-time equivalent" means the equivalent of 40 hours per
3week per individual. Physicians and physician assistants who
4work in a hospital, hospital affiliate, or ambulatory surgical
5treatment center as defined by Section 7.7 of this Act are
6exempt from the collaborative ratio restriction requirements
7of this Section. A physician assistant shall be able to hold
8more than one professional position. A collaborating physician
9shall file a notice of collaboration of each physician
10assistant according to the rules of the Department.
11    Physician assistants shall collaborate only with
12physicians as defined in this Act who are engaged in clinical
13practice, or in clinical practice in public health or other
14community health facilities.
15    Nothing in this Act shall be construed to limit the
16delegation of tasks or duties by a physician to a nurse or
17other appropriately trained personnel.
18    Nothing in this Act shall be construed to prohibit the
19employment of physician assistants by a hospital, nursing home
20or other health care facility where such physician assistants
21function under a collaborating physician.
22    A physician assistant may be employed by a practice group
23or other entity employing multiple physicians at one or more
24locations. In that case, one of the physicians practicing at a
25location shall be designated the collaborating physician. The
26other physicians with that practice group or other entity who

 

 

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1practice in the same general type of practice or specialty as
2the collaborating physician may collaborate with the physician
3assistant with respect to their patients.
4    (b) A physician assistant licensed in this State, or
5licensed or authorized to practice in any other U.S.
6jurisdiction or credentialed by his or her federal employer as
7a physician assistant, who is responding to a need for medical
8care created by an emergency or by a state or local disaster
9may render such care that the physician assistant is able to
10provide without collaboration as it is defined in this Section
11or with such collaboration as is available.
12    Any physician who collaborates with a physician assistant
13providing medical care in response to such an emergency or
14state or local disaster shall not be required to meet the
15requirements set forth in this Section for a collaborating
16physician.
17(Source: P.A. 100-453, eff. 8-25-17; 100-605, eff. 1-1-19.)
 
18    (225 ILCS 95/7.5)
19    (Section scheduled to be repealed on January 1, 2028)
20    Sec. 7.5. Collaborative Written collaborative agreements;
21prescriptive authority.
22    (a) A written collaborative agreement is required for all
23physician assistants to practice in the State, except as
24provided in Section 7.7 of this Act.
25        (1) A written collaborative agreement shall describe

 

 

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1    the working relationship of the physician assistant with
2    the collaborating physician and shall describe the
3    categories of care, treatment, or procedures to be provided
4    by the physician assistant. The written collaborative
5    agreement shall be established at the practice level and
6    shall promote the exercise of professional judgment by the
7    physician assistant commensurate with his or her education
8    and experience. The services to be provided by the
9    physician assistant shall be services that the
10    collaborating physician is authorized to and generally
11    provides to his or her patients in the normal course of his
12    or her clinical medical practice. The written
13    collaborative agreement need not describe the exact steps
14    that a physician assistant must take with respect to each
15    specific condition, disease, or symptom but must specify
16    which authorized procedures require the presence of the
17    collaborating physician as the procedures are being
18    performed. The relationship under a written collaborative
19    agreement shall not be construed to require the personal
20    presence of a physician at the place where services are
21    rendered. Methods of communication shall be available for
22    consultation with the collaborating physician in person or
23    by telecommunications or electronic communications as set
24    forth in the written collaborative agreement. For the
25    purposes of this Act, "generally provides to his or her
26    patients in the normal course of his or her clinical

 

 

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1    medical practice" means services, not specific tasks or
2    duties, the collaborating physician routinely provides
3    individually or through delegation to other persons so that
4    the physician has the experience and ability to collaborate
5    and provide consultation.
6        (2) The written collaborative agreement shall be
7    adequate if a physician does each of the following:
8            (A) Participates in the joint formulation and
9        joint approval of orders or guidelines with the
10        physician assistant and he or she periodically reviews
11        such orders and the services provided patients under
12        such orders in accordance with accepted standards of
13        medical practice and physician assistant practice.
14            (B) Provides consultation at least once a month.
15        (3) A copy of the signed, written collaborative
16    agreement must be available to the Department upon request
17    from both the physician assistant and the collaborating
18    physician.
19        (4) A physician assistant shall inform each
20    collaborating physician of all written collaborative
21    agreements he or she has signed and provide a copy of these
22    to any collaborating physician upon request.
23    (b) A collaborating physician may, but is not required to,
24delegate prescriptive authority to a physician assistant as
25part of a written collaborative agreement. This authority may,
26but is not required to, include prescription of, selection of,

 

 

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1orders for, administration of, storage of, acceptance of
2samples of, and dispensing medical devices, over the counter
3medications, legend drugs, medical gases, and controlled
4substances categorized as Schedule II through V controlled
5substances, as defined in Article II of the Illinois Controlled
6Substances Act, and other preparations, including, but not
7limited to, botanical and herbal remedies. The collaborating
8physician must have a valid, current Illinois controlled
9substance license and federal registration with the Drug
10Enforcement Agency to delegate the authority to prescribe
11controlled substances.
12        (1) To prescribe Schedule II, III, IV, or V controlled
13    substances under this Section, a physician assistant must
14    obtain a mid-level practitioner controlled substances
15    license. Medication orders issued by a physician assistant
16    shall be reviewed periodically by the collaborating
17    physician.
18        (2) The collaborating physician shall file with the
19    Department notice of delegation of prescriptive authority
20    to a physician assistant and termination of delegation,
21    specifying the authority delegated or terminated. Upon
22    receipt of this notice delegating authority to prescribe
23    controlled substances, the physician assistant shall be
24    eligible to register for a mid-level practitioner
25    controlled substances license under Section 303.05 of the
26    Illinois Controlled Substances Act. Nothing in this Act

 

 

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1    shall be construed to limit the delegation of tasks or
2    duties by the collaborating physician to a nurse or other
3    appropriately trained persons in accordance with Section
4    54.2 of the Medical Practice Act of 1987.
5        (3) In addition to the requirements of this subsection
6    (b), a collaborating physician may, but is not required to,
7    delegate authority to a physician assistant to prescribe
8    Schedule II controlled substances, if all of the following
9    conditions apply:
10            (A) Specific Schedule II controlled substances by
11        oral dosage or topical or transdermal application may
12        be delegated, provided that the delegated Schedule II
13        controlled substances are routinely prescribed by the
14        collaborating physician. This delegation must identify
15        the specific Schedule II controlled substances by
16        either brand name or generic name. Schedule II
17        controlled substances to be delivered by injection or
18        other route of administration may not be delegated.
19            (B) (Blank).
20            (C) Any prescription must be limited to no more
21        than a 30-day supply, with any continuation authorized
22        only after prior approval of the collaborating
23        physician.
24            (D) The physician assistant must discuss the
25        condition of any patients for whom a controlled
26        substance is prescribed monthly with the collaborating

 

 

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1        physician.
2            (E) The physician assistant meets the education
3        requirements of Section 303.05 of the Illinois
4        Controlled Substances Act.
5    (c) Nothing in this Act shall be construed to limit the
6delegation of tasks or duties by a physician to a licensed
7practical nurse, a registered professional nurse, or other
8persons. Nothing in this Act shall be construed to limit the
9method of delegation that may be authorized by any means,
10including, but not limited to, oral, written, electronic,
11standing orders, protocols, guidelines, or verbal orders.
12Nothing in this Act shall be construed to authorize a physician
13assistant to provide health care services required by law or
14rule to be performed by a physician.
15    (c-5) Nothing in this Section shall be construed to apply
16to any medication authority, including Schedule II controlled
17substances of a licensed physician assistant for care provided
18in a hospital, hospital affiliate, or ambulatory surgical
19treatment center pursuant to Section 7.7 of this Act.
20    (d) (Blank).
21    (e) Nothing in this Section shall be construed to prohibit
22generic substitution.
23(Source: P.A. 100-453, eff. 8-25-17.)
 
24    (225 ILCS 95/7.7)
25    (Section scheduled to be repealed on January 1, 2028)

 

 

HB3355- 23 -LRB101 11172 SMS 56411 b

1    Sec. 7.7. Physician assistants in hospitals, hospital
2affiliates, or ambulatory surgical treatment centers.
3    (a) A physician assistant may provide services in a
4hospital as defined in the Hospital Licensing Act, a hospital
5affiliate as defined in the University of Illinois Hospital
6Act, or a licensed ambulatory surgical treatment center as
7defined in the Ambulatory Surgical Treatment Center Act without
8a written collaborative agreement pursuant to Section 7.5 of
9this Act. A physician assistant must possess clinical
10privileges recommended by the hospital medical staff and
11granted by the hospital or the consulting medical staff
12committee and ambulatory surgical treatment center in order to
13provide services. The medical staff or consulting medical staff
14committee shall periodically review the services of physician
15assistants granted clinical privileges, including any care
16provided in a hospital affiliate. Authority may also be granted
17when recommended by the hospital medical staff and granted by
18the hospital or recommended by the consulting medical staff
19committee and ambulatory surgical treatment center to
20individual physician assistants to select, order, and
21administer medications, including controlled substances, to
22provide delineated care. In a hospital, hospital affiliate, or
23ambulatory surgical treatment center, the attending physician
24shall collaborate with a physician determine a physician
25assistant's role in providing care for his or her patients,
26except as otherwise provided in the medical staff bylaws or

 

 

HB3355- 24 -LRB101 11172 SMS 56411 b

1consulting committee policies.
2    (a-5) Physician assistants practicing in a hospital
3affiliate may be, but are not required to be, granted authority
4to prescribe Schedule II through V controlled substances when
5such authority is recommended by the appropriate physician
6committee of the hospital affiliate and granted by the hospital
7affiliate. This authority may, but is not required to, include
8prescription of, selection of, orders for, administration of,
9storage of, acceptance of samples of, and dispensing
10over-the-counter medications, legend drugs, medical gases, and
11controlled substances categorized as Schedule II through V
12controlled substances, as defined in Article II of the Illinois
13Controlled Substances Act, and other preparations, including,
14but not limited to, botanical and herbal remedies.
15    To prescribe controlled substances under this subsection
16(a-5), a physician assistant must obtain a mid-level
17practitioner controlled substance license. Medication orders
18shall be reviewed periodically by the appropriate hospital
19affiliate physicians committee or its physician designee.
20    The hospital affiliate shall file with the Department
21notice of a grant of prescriptive authority consistent with
22this subsection (a-5) and termination of such a grant of
23authority in accordance with rules of the Department. Upon
24receipt of this notice of grant of authority to prescribe any
25Schedule II through V controlled substances, the licensed
26physician assistant may register for a mid-level practitioner

 

 

HB3355- 25 -LRB101 11172 SMS 56411 b

1controlled substance license under Section 303.05 of the
2Illinois Controlled Substances Act.
3    In addition, a hospital affiliate may, but is not required
4to, grant authority to a physician assistant to prescribe any
5Schedule II controlled substances if all of the following
6conditions apply:
7        (1) specific Schedule II controlled substances by oral
8    dosage or topical or transdermal application may be
9    designated, provided that the designated Schedule II
10    controlled substances are routinely prescribed by
11    physician assistants in their area of certification; this
12    grant of authority must identify the specific Schedule II
13    controlled substances by either brand name or generic name;
14    authority to prescribe or dispense Schedule II controlled
15    substances to be delivered by injection or other route of
16    administration may not be granted;
17        (2) any grant of authority must be controlled
18    substances limited to the practice of the physician
19    assistant;
20        (3) any prescription must be limited to no more than a
21    30-day supply;
22        (4) the physician assistant must discuss the condition
23    of any patients for whom a controlled substance is
24    prescribed monthly with the appropriate physician
25    committee of the hospital affiliate or its physician
26    designee; and

 

 

HB3355- 26 -LRB101 11172 SMS 56411 b

1        (5) the physician assistant must meet the education
2    requirements of Section 303.05 of the Illinois Controlled
3    Substances Act.
4    (b) A physician assistant granted authority to order
5medications including controlled substances may complete
6discharge prescriptions provided the prescription is in the
7name of the physician assistant and the attending or
8discharging physician.
9    (c) Physician assistants practicing in a hospital,
10hospital affiliate, or an ambulatory surgical treatment center
11are not required to obtain a mid-level controlled substance
12license to order controlled substances under Section 303.05 of
13the Illinois Controlled Substances Act.
14(Source: P.A. 100-453, eff. 8-25-17.)
 
15    (225 ILCS 95/11)  (from Ch. 111, par. 4611)
16    (Section scheduled to be repealed on January 1, 2028)
17    Sec. 11. Physician Assistant Medical Licensing Board
18Committee. There is established a Physician Assistant Medical
19Licensing Board physician assistant advisory committee to the
20Department and the Medical Licensing Board. The Physician
21Assistant Medical Licensing Board physician assistant advisory
22committee may manage and regulate review and make
23recommendations to the Department and the Board regarding all
24matters relating to physician assistants. Such matters may
25include, but not be limited to:

 

 

HB3355- 27 -LRB101 11172 SMS 56411 b

1        (1) applications for licensure;
2        (2) disciplinary proceedings;
3        (3) renewal requirements; and
4        (4) any other issues pertaining to the regulation and
5    practice of physician assistants in the State.
6    The Physician Assistant Medical Licensing Board physician
7assistant advisory committee shall be composed of 7 members.
8Three of the 7 members shall be physicians, 2 of whom shall be
9members of the Board and appointed to the advisory committee by
10the chairman. One physician, not a member of the Board, shall
11be a supervisor of a licensed physician assistant and shall be
12approved by the Governor from a list of Illinois physicians
13supervising licensed physician assistants. Three members shall
14be physician assistants, licensed under the law and appointed
15by the Governor from a list of 10 names recommended by the
16Board of Directors of the Illinois Academy of Physician
17Assistants. One member, not employed or having any material
18interest in any health care field, shall be appointed by the
19Governor and represent the public. The chairman of the
20Physician Assistant Medical Licensing Board physician
21assistant advisory committee shall be a member elected by a
22majority vote of the Physician Assistant Medical Licensing
23Board physician assistant advisory committee unless already a
24member of the Board. The Physician Assistant Medical Licensing
25Board physician assistant advisory committee is required to
26meet and report to the Department and the Board as physician

 

 

HB3355- 28 -LRB101 11172 SMS 56411 b

1assistant issues arise. The terms of office of each of the
2original 7 members shall be at staggered intervals. One
3physician and one physician assistant shall serve for a 2 year
4term. One physician and one physician assistant shall serve a 3
5year term. One physician, one physician assistant and the
6public member shall serve a 4 year term. Upon the expiration of
7the term of any member, his successor shall be appointed for a
8term of 4 years in the same manner as the initial appointment.
9No member shall serve more than 2 consecutive terms.
10    Four members of the Physician Assistant Medical Licensing
11Board physician assistant advisory committee shall constitute
12a quorum. A quorum is required to perform all of the duties of
13the committee.
14    Members of the Physician Assistant Medical Licensing Board
15physician assistant advisory committee shall have no liability
16for any action based upon a disciplinary proceeding or other
17activity performed in good faith as a member of the committee.
18(Source: P.A. 95-703, eff. 12-31-07; 96-720, eff. 8-25-09.)
 
19    Section 99. Effective date. This Act takes effect January
201, 2020.

 

 

HB3355- 29 -LRB101 11172 SMS 56411 b

1 INDEX
2 Statutes amended in order of appearance
3    225 ILCS 60/54.5
4    225 ILCS 95/1from Ch. 111, par. 4601
5    225 ILCS 95/4from Ch. 111, par. 4604
6    225 ILCS 95/5.5
7    225 ILCS 95/6from Ch. 111, par. 4606
8    225 ILCS 95/6.1 new
9    225 ILCS 95/7from Ch. 111, par. 4607
10    225 ILCS 95/7.5
11    225 ILCS 95/7.7
12    225 ILCS 95/11from Ch. 111, par. 4611

 

 

HB3355- 30 -LRB101 11172 SMS 56411 b

1 INDEX
2 Statutes amended in order of appearance
3    See Index