Bill Text: IL HB4637 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Physician Assistant Practice Act of 1987. Provides that a physician assistant may prescribe, dispense, order, administer, and procure drugs and medical devices without delegation of authority by a physician. Provides that a physician assistant may practice without a written collaborative agreement. Provides that a physician assistant who files with the Department of Financial and Professional Regulation a notarized attestation of completion of at least 250 hours of continuing education or training and at least 2,000 hours of clinical experience after first attaining national certification shall not require a written collaborative agreement. Makes changes in provisions concerning definitions; physician assistant title; collaboration requirements; written collaborative agreements, prescriptive authority, and physician assistants in hospitals, hospital affiliates, or ambulatory surgical treatment centers; inactive status; limitations; and grounds for disciplinary action. Amends the Illinois Controlled Substances Act to make corresponding changes.

Spectrum: Moderate Partisan Bill (Democrat 4-1)

Status: (Introduced) 2024-04-05 - Rule 19(a) / Re-referred to Rules Committee [HB4637 Detail]

Download: Illinois-2023-HB4637-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB4637 Introduced , by Rep. Fred Crespo SYNOPSIS AS INTRODUCED:
225 ILCS 95/4 from Ch. 111, par. 4604
225 ILCS 95/6 from Ch. 111, par. 4606
225 ILCS 95/7 from Ch. 111, par. 4607
225 ILCS 95/7.5
225 ILCS 95/7.7
225 ILCS 95/7.8 new
225 ILCS 95/7.9 new
225 ILCS 95/17 from Ch. 111, par. 4617
225 ILCS 95/20 from Ch. 111, par. 4620
225 ILCS 95/21 from Ch. 111, par. 4621
720 ILCS 570/102 from Ch. 56 1/2, par. 1102
720 ILCS 570/303.05
Amends the Physician Assistant Practice Act of 1987. Provides that a physician assistant may prescribe, dispense, order, administer, and procure drugs and medical devices without delegation of authority by a physician. Provides that a physician assistant may practice without a written collaborative agreement. Provides that a physician assistant who files with the Department of Financial and Professional Regulation a notarized attestation of completion of at least 250 hours of continuing education or training and at least 2,000 hours of clinical experience after first attaining national certification shall not require a written collaborative agreement. Makes changes in provisions concerning definitions; physician assistant title; collaboration requirements; written collaborative agreements, prescriptive authority, and physician assistants in hospitals, hospital affiliates, or ambulatory surgical treatment centers; inactive status; limitations; and grounds for disciplinary action. Amends the Illinois Controlled Substances Act to make corresponding changes.
LRB103 35424 SPS 65490 b
A BILL FOR
HB4637 LRB103 35424 SPS 65490 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Physician Assistant Practice Act of 1987 is
amended by changing Sections 4, 6, 7, 7.5, 7.7, 17, 20, and 21
and by adding Sections 7.8 and 7.9 as follows:
(225 ILCS 95/4) (from Ch. 111, par. 4604)
(Text of Section before amendment by P.A. 103-65)
(Section scheduled to be repealed on January 1, 2028)
Sec. 4. Definitions. In this Act:
1. "Department" means the Department of Financial and
Professional Regulation.
2. "Secretary" means the Secretary of Financial and
Professional Regulation.
3. "Physician assistant" means any person not holding an
active license or permit issued by the Department pursuant to
the Medical Practice Act of 1987 who has been certified as a
physician assistant by the National Commission on the
Certification of Physician Assistants or equivalent successor
agency and performs procedures in collaboration with a
physician as defined in this Act. A physician assistant may
perform such procedures within the specialty of the
collaborating physician, except that such physician shall

HB4637 - 2 - LRB103 35424 SPS 65490 b
exercise such direction, collaboration, and control over such
physician assistants as will assure that patients shall
receive quality medical care. Physician assistants shall be
capable of performing a variety of tasks within the specialty
of medical care in collaboration with a physician.
Collaboration with the physician assistant shall not be
construed to necessarily require the personal presence of the
collaborating physician at all times at the place where
services are rendered, as long as there is communication
available for consultation by radio, telephone or
telecommunications within established guidelines as determined
by the physician/physician assistant team. The collaborating
physician may delegate tasks and duties to the physician
assistant. Delegated tasks or duties shall be consistent with
physician assistant education, training, and experience. The
delegated tasks or duties shall be specific to the practice
setting and shall be implemented and reviewed under a written
collaborative agreement established by the physician or
physician/physician assistant team. A physician assistant,
acting as an agent of the physician, shall be permitted to
transmit the collaborating physician's orders as determined by
the institution's bylaws by-laws, policies, procedures, or job
description within which the physician/physician assistant
team practices. Physician assistants shall practice only in
accordance with a written collaborative agreement.
Any person who holds an active license or permit issued

HB4637 - 3 - LRB103 35424 SPS 65490 b
pursuant to the Medical Practice Act of 1987 shall have that
license automatically placed into inactive status upon
issuance of a physician assistant license. Any person who
holds an active license as a physician assistant who is issued
a license or permit pursuant to the Medical Practice Act of
1987 shall have his or her physician assistant license
automatically placed into inactive status.
3.5. "Physician assistant practice" means the performance
of procedures within the specialty of the collaborating
physician. Physician assistants shall be capable of performing
a variety of tasks within the specialty of medical care of the
collaborating physician. Collaboration with the physician
assistant shall not be construed to necessarily require the
personal presence of the collaborating physician at all times
at the place where services are rendered, as long as there is
communication available for consultation by radio, telephone,
telecommunications, or electronic communications. The
collaborating physician may delegate tasks and duties to the
physician assistant. Delegated tasks or duties shall be
consistent with physician assistant education, training, and
experience. The delegated tasks or duties shall be specific to
the practice setting and shall be implemented and reviewed
under a written collaborative agreement established by the
physician or physician/physician assistant team. A physician
assistant shall be permitted to transmit the collaborating
physician's orders as determined by the institution's bylaws,

HB4637 - 4 - LRB103 35424 SPS 65490 b
policies, or procedures or the job description within which
the physician/physician assistant team practices. Physician
assistants shall practice only in accordance with a written
collaborative agreement, except as provided in Section 7.5 of
this Act.
4. "Board" means the Medical Licensing Board constituted
under the Medical Practice Act of 1987.
5. (Blank).
6. "Physician" means a person licensed to practice
medicine in all of its branches under the Medical Practice Act
of 1987.
7. "Collaborating physician" means the physician who,
within his or her specialty and expertise, may delegate a
variety of tasks and procedures to the physician assistant.
Such tasks and procedures shall be delegated in accordance
with a written collaborative agreement.
8. (Blank).
9. "Address of record" means the designated address
recorded by the Department in the applicant's or licensee's
application file or license file maintained by the
Department's licensure maintenance unit.
10. "Hospital affiliate" means a corporation, partnership,
joint venture, limited liability company, or similar
organization, other than a hospital, that is devoted primarily
to the provision, management, or support of health care
services and that directly or indirectly controls, is

HB4637 - 5 - LRB103 35424 SPS 65490 b
controlled by, or is under common control of the hospital. For
the purposes of this definition, "control" means having at
least an equal or a majority ownership or membership interest.
A hospital affiliate shall be 100% owned or controlled by any
combination of hospitals, their parent corporations, or
physicians licensed to practice medicine in all its branches
in Illinois. "Hospital affiliate" does not include a health
maintenance organization regulated under the Health
Maintenance Organization Act.
11. "Email address of record" means the designated email
address recorded by the Department in the applicant's
application file or the licensee's license file, as maintained
by the Department's licensure maintenance unit.
(Source: P.A. 102-1117, eff. 1-13-23.)
(Text of Section after amendment by P.A. 103-65)
(Section scheduled to be repealed on January 1, 2028)
Sec. 4. Definitions. In this Act:
1. "Department" means the Department of Financial and
Professional Regulation.
2. "Secretary" means the Secretary of Financial and
Professional Regulation.
3. "Physician assistant" means any person not holding an
active license or permit issued by the Department pursuant to
the Medical Practice Act of 1987 who has been certified as a
physician assistant by the National Commission on the

HB4637 - 6 - LRB103 35424 SPS 65490 b
Certification of Physician Assistants or equivalent successor
agency. and performs procedures in collaboration with a
physician as defined in this Act. A physician assistant may
perform such procedures within the specialty of the
collaborating physician, except that such physician shall
exercise such direction, collaboration, and control over such
physician assistants as will assure that patients shall
receive quality medical care. Physician assistants shall be
capable of performing a variety of tasks within the specialty
of medical care in collaboration with a physician.
Collaboration with the physician assistant shall not be
construed to necessarily require the personal presence of the
collaborating physician at all times at the place where
services are rendered, as long as there is communication
available for consultation by radio, telephone or
telecommunications within established guidelines as determined
by the physician/physician assistant team. The collaborating
physician may delegate tasks and duties to the physician
assistant. Delegated tasks or duties shall be consistent with
physician assistant education, training, and experience. The
delegated tasks or duties shall be specific to the practice
setting and shall be implemented and reviewed under a written
collaborative agreement established by the physician or
physician/physician assistant team. A physician assistant,
acting as an agent of the physician, shall be permitted to
transmit the collaborating physician's orders as determined by

HB4637 - 7 - LRB103 35424 SPS 65490 b
the institution's by-laws, policies, procedures, or job
description within which the physician/physician assistant
team practices. Physician assistants shall practice only in
accordance with a written collaborative agreement.
Any person who holds an active license or permit issued
pursuant to the Medical Practice Act of 1987 shall have that
license automatically placed into inactive status upon
issuance of a physician assistant license. Any person who
holds an active license as a physician assistant who is issued
a license or permit pursuant to the Medical Practice Act of
1987 shall have his or her physician assistant license
automatically placed into inactive status.
3.5. "Physician assistant practice" means the performance
of any legal medical service for which the physician assistant
has been prepared by the physician assistant's education,
training, and experience and is competent to perform as
determined by the practice through employment agreement or
credentialing and privileging system of the licensed facility.
Medical and surgical services provided by physician assistants
include, but are not limited to:
(A) obtaining and performing comprehensive health
histories and physical examinations;
(B) evaluating, diagnosing, managing, and providing
medical treatment;
(C) ordering, performing, and interpreting diagnostic
studies and therapeutic procedures;

HB4637 - 8 - LRB103 35424 SPS 65490 b
(D) educating patients on health promotion and disease
prevention;
(E) providing consultation upon request;
(F) writing medical orders;
(G) prescribing, dispensing, ordering, administering,
and procuring drugs and medical devices; and
(H) assisting in surgery. procedures within the
specialty of the collaborating physician. Physician
assistants shall be capable of performing a variety of
tasks within the specialty of medical care of the
collaborating physician. Collaboration with the physician
assistant shall not be construed to necessarily require
the personal presence of the collaborating physician at
all times at the place where services are rendered, as
long as there is communication available for consultation
by radio, telephone, telecommunications, or electronic
communications. The collaborating physician may delegate
tasks and duties to the physician assistant. Delegated
tasks or duties shall be consistent with physician
assistant education, training, and experience. The
delegated tasks or duties shall be specific to the
practice setting and shall be implemented and reviewed
under a written collaborative agreement established by the
physician or physician/physician assistant team. A
physician assistant shall be permitted to transmit the
collaborating physician's orders as determined by the

HB4637 - 9 - LRB103 35424 SPS 65490 b
institution's bylaws, policies, or procedures or the job
description within which the physician/physician assistant
team practices. Physician assistants shall practice only
in accordance with a written collaborative agreement,
except as provided in Section 7.5 of this Act.
4. "Board" means the Illinois State Medical Board Medical
Licensing Board constituted under the Medical Practice Act of
1987.
5. (Blank).
6. "Physician" means a person licensed to practice
medicine in all of its branches under the Medical Practice Act
of 1987.
7. "Collaborating physician" means the physician who,
within his or her specialty and expertise, may delegate a
variety of tasks and procedures to the physician assistant.
Such tasks and procedures shall be delegated in accordance
with a written collaborative agreement when the agreement is
required under this Act.
8. (Blank).
9. "Address of record" means the designated address
recorded by the Department in the applicant's or licensee's
application file or license file maintained by the
Department's licensure maintenance unit.
10. "Hospital affiliate" means a corporation, partnership,
joint venture, limited liability company, or similar
organization, other than a hospital, that is devoted primarily

HB4637 - 10 - LRB103 35424 SPS 65490 b
to the provision, management, or support of health care
services and that directly or indirectly controls, is
controlled by, or is under common control of the hospital. For
the purposes of this definition, "control" means having at
least an equal or a majority ownership or membership interest.
A hospital affiliate shall be 100% owned or controlled by any
combination of hospitals, their parent corporations, or
physicians licensed to practice medicine in all its branches
in Illinois. "Hospital affiliate" does not include a health
maintenance organization regulated under the Health
Maintenance Organization Act.
11. "Email address of record" means the designated email
address recorded by the Department in the applicant's
application file or the licensee's license file, as maintained
by the Department's licensure maintenance unit.
12. "Federally qualified health center" means a health
center funded under Section 330 of the federal Public Health
Service Act.
(Source: P.A. 102-1117, eff. 1-13-23; 103-65, eff. 1-1-24.)
(225 ILCS 95/6) (from Ch. 111, par. 4606)
(Section scheduled to be repealed on January 1, 2028)
Sec. 6. Physician assistant title.
(a) No physician assistant shall use the title of doctor,
physician, or associate with his or her name or any other term
that would indicate to other persons that he or she is

HB4637 - 11 - LRB103 35424 SPS 65490 b
qualified to engage in the general practice of medicine.
(b) A physician assistant shall verbally identify himself
or herself as a physician assistant, including, when
applicable, specialty certification, to each patient.
(c) Nothing in this Act shall be construed to relieve a
physician assistant of the professional or legal
responsibility for the care and treatment of persons attended
by him or her.
(d) (Blank). The collaborating physician shall file with
the Department notice of employment, discharge, or
collaboration with a physician assistant within 60 days of
employment, discharge, or assumption of collaboration with a
physician assistant. Nothing in this Section shall prevent a
physician assistant from beginning his or her employment
before the notice of employment or collaboration has been
filed.
(Source: P.A. 102-735, eff. 1-1-23.)
(225 ILCS 95/7) (from Ch. 111, par. 4607)
(Text of Section before amendment by P.A. 103-65)
(Section scheduled to be repealed on January 1, 2028)
Sec. 7. Collaboration requirements.
(a) A collaborating physician shall determine the number
of physician assistants to collaborate with, provided the
physician is able to provide adequate collaboration as
outlined in the written collaborative agreement required under

HB4637 - 12 - LRB103 35424 SPS 65490 b
Section 7.5 of this Act and consideration is given to the
nature of the physician's practice, complexity of the patient
population, and the experience of each physician assistant. A
collaborating physician may collaborate with a maximum of 7
full-time equivalent physician assistants as described in
Section 54.5 of the Medical Practice Act of 1987. As used in
this Section, "full-time equivalent" means the equivalent of
40 hours per week per individual. Physicians and physician
assistants who work in a hospital, hospital affiliate, or
ambulatory surgical treatment center as defined by Section 7.7
of this Act are exempt from the collaborative ratio
restriction requirements of this Section. A physician
assistant shall be able to hold more than one professional
position. A collaborating physician shall file a notice of
collaboration of each physician assistant according to the
rules of the Department.
Physician assistants shall collaborate only with
physicians as defined in this Act who are engaged in clinical
practice, or in clinical practice in public health or other
community health facilities.
Nothing in this Act shall be construed to limit the
delegation of tasks or duties by a physician to a nurse or
other appropriately trained personnel.
Nothing in this Act shall be construed to prohibit the
employment of physician assistants by a hospital, nursing home
or other health care facility where such physician assistants

HB4637 - 13 - LRB103 35424 SPS 65490 b
function with under a collaborating physician.
A physician assistant may be employed by a practice group
or other entity employing multiple physicians at one or more
locations. In that case, one of the physicians practicing at a
location shall be designated the collaborating physician. The
other physicians with that practice group or other entity who
practice in the same general type of practice or specialty as
the collaborating physician may collaborate with the physician
assistant with respect to their patients.
(b) A physician assistant licensed in this State, or
licensed or authorized to practice in any other U.S.
jurisdiction or credentialed by his or her federal employer as
a physician assistant, who is responding to a need for medical
care created by an emergency or by a state or local disaster
may render such care that the physician assistant is able to
provide without collaboration as it is defined in this Section
or with such collaboration as is available.
Any physician who collaborates with a physician assistant
providing medical care in response to such an emergency or
state or local disaster shall not be required to meet the
requirements set forth in this Section for a collaborating
physician.
(Source: P.A. 100-453, eff. 8-25-17; 100-605, eff. 1-1-19.)
(Text of Section after amendment by P.A. 103-65)
(Section scheduled to be repealed on January 1, 2028)

HB4637 - 14 - LRB103 35424 SPS 65490 b
Sec. 7. Collaboration requirements.
(a) A written collaborative agreement is required for all
physician assistants engaged in clinical practice prior to
satisfying the requirements of Section 7.9, except for
physician assistants who practice in a hospital, hospital
affiliate, federally qualified health center, or ambulatory
surgical treatment center as provided in Section 7.7.
(b) (a) A collaborating physician shall determine the
number of physician assistants to collaborate with, provided
the physician is able to provide adequate collaboration as
outlined in the written collaborative agreement required under
Section 7.5 of this Act and consideration is given to the
nature of the physician's practice, complexity of the patient
population, and the experience of each physician assistant. A
collaborating physician may collaborate with a maximum of 7
full-time equivalent physician assistants as described in
Section 54.5 of the Medical Practice Act of 1987. As used in
this Section, "full-time equivalent" means the equivalent of
40 hours per week per individual. Physicians and physician
assistants who work in a hospital, hospital affiliate,
federally qualified health center, or ambulatory surgical
treatment center as defined by Section 7.7 of this Act are
exempt from the collaborative ratio restriction requirements
of this Section. A physician assistant shall be able to hold
more than one professional position. A collaborating physician
shall file a notice of collaboration of each physician

HB4637 - 15 - LRB103 35424 SPS 65490 b
assistant according to the rules of the Department.
(c) Physician assistants shall collaborate only with
physicians as defined in this Act who are engaged in clinical
practice, or in clinical practice in public health or other
community health facilities.
(d) Nothing in this Act shall be construed to limit the
delegation of tasks or duties by a physician to a nurse or
other appropriately trained personnel.
(e) Nothing in this Act shall be construed to prohibit the
employment of physician assistants by a hospital, nursing home
or other health care facility where such physician assistants
function with under a collaborating physician.
(f) A physician assistant may be employed by a practice
group or other entity employing multiple physicians at one or
more locations. In that case, one of the physicians practicing
at a location shall be designated the collaborating physician.
The other physicians with that practice group or other entity
who practice in the same general type of practice or specialty
as the collaborating physician may collaborate with the
physician assistant with respect to their patients.
(g) (b) A physician assistant licensed in this State, or
licensed or authorized to practice in any other U.S.
jurisdiction or credentialed by his or her federal employer as
a physician assistant, who is responding to a need for medical
care created by an emergency or by a state or local disaster
may render such care that the physician assistant is able to

HB4637 - 16 - LRB103 35424 SPS 65490 b
provide without collaboration as it is defined in this Section
or with such collaboration as is available.
(h) Any physician who collaborates with a physician
assistant providing medical care in response to such an
emergency or state or local disaster shall not be required to
meet the requirements set forth in this Section for a
collaborating physician.
(Source: P.A. 103-65, eff. 1-1-24.)
(225 ILCS 95/7.5)
(Text of Section before amendment by P.A. 103-65)
(Section scheduled to be repealed on January 1, 2028)
Sec. 7.5. Written collaborative agreements; prescriptive
authority.
(a) A written collaborative agreement is required for all
physician assistants to practice in the State, except as
provided in Section 7.7 of this Act.
(1) A written collaborative agreement shall describe
the working relationship of the physician assistant with
the collaborating physician and shall describe the
categories of care, treatment, or procedures to be
provided by the physician assistant. The written
collaborative agreement shall promote the exercise of
professional judgment by the physician assistant
commensurate with his or her education and experience. The
services to be provided by the physician assistant shall

HB4637 - 17 - LRB103 35424 SPS 65490 b
be services that the collaborating physician is authorized
to and generally provides to his or her patients in the
normal course of his or her clinical medical practice. The
written collaborative agreement need not describe the
exact steps that a physician assistant must take with
respect to each specific condition, disease, or symptom
but must specify which authorized procedures require the
presence of the collaborating physician as the procedures
are being performed. The relationship under a written
collaborative agreement shall not be construed to require
the personal presence of a physician at the place where
services are rendered. Methods of communication shall be
available for consultation with the collaborating
physician in person or by telecommunications or electronic
communications as set forth in the written collaborative
agreement. For the purposes of this Act, "generally
provides to his or her patients in the normal course of his
or her clinical medical practice" means services, not
specific tasks or duties, the collaborating physician
routinely provides individually or through delegation to
other persons so that the physician has the experience and
ability to collaborate and provide consultation.
(2) The written collaborative agreement shall be
adequate if a physician does each of the following:
(A) Participates in the joint formulation and
joint approval of orders or guidelines with the

HB4637 - 18 - LRB103 35424 SPS 65490 b
physician assistant and he or she periodically reviews
such orders and the services provided patients under
such orders in accordance with accepted standards of
medical practice and physician assistant practice.
(B) Provides consultation at least once a month.
(3) A copy of the signed, written collaborative
agreement must be available to the Department upon request
from both the physician assistant and the collaborating
physician.
(4) A physician assistant shall inform each
collaborating physician of all written collaborative
agreements he or she has signed and provide a copy of these
to any collaborating physician upon request.
(b) A collaborating physician may, but is not required to,
delegate prescriptive authority to a physician assistant as
part of a written collaborative agreement. This authority may,
but is not required to, include prescription of, selection of,
orders for, administration of, storage of, acceptance of
samples of, and dispensing medical devices, over-the-counter
over the counter medications, legend drugs, medical gases, and
controlled substances categorized as Schedule II through V
controlled substances, as defined in Article II of the
Illinois Controlled Substances Act, and other preparations,
including, but not limited to, botanical and herbal remedies.
The collaborating physician must have a valid, current
Illinois controlled substance license and federal registration

HB4637 - 19 - LRB103 35424 SPS 65490 b
with the Drug Enforcement Administration to delegate the
authority to prescribe controlled substances.
(1) To prescribe Schedule II, III, IV, or V controlled
substances under this Section, a physician assistant must
obtain a mid-level practitioner controlled substances
license. Medication orders issued by a physician assistant
shall be reviewed periodically by the collaborating
physician.
(2) The collaborating physician shall file with the
Department notice of delegation of prescriptive authority
to a physician assistant and termination of delegation,
specifying the authority delegated or terminated. Upon
receipt of this notice delegating authority to prescribe
controlled substances, the physician assistant shall be
eligible to register for a mid-level practitioner
controlled substances license under Section 303.05 of the
Illinois Controlled Substances Act. Nothing in this Act
shall be construed to limit the delegation of tasks or
duties by the collaborating physician to a nurse or other
appropriately trained persons in accordance with Section
54.2 of the Medical Practice Act of 1987.
(3) In addition to the requirements of this subsection
(b), a collaborating physician may, but is not required
to, delegate authority to a physician assistant to
prescribe Schedule II controlled substances, if all of the
following conditions apply:

HB4637 - 20 - LRB103 35424 SPS 65490 b
(A) Specific Schedule II controlled substances by
oral dosage or topical or transdermal application may
be delegated, provided that the delegated Schedule II
controlled substances are routinely prescribed by the
collaborating physician. This delegation must identify
the specific Schedule II controlled substances by
either brand name or generic name. Schedule II
controlled substances to be delivered by injection or
other route of administration may not be delegated.
(B) (Blank).
(C) Any prescription must be limited to no more
than a 30-day supply, with any continuation authorized
only after prior approval of the collaborating
physician.
(D) The physician assistant must discuss the
condition of any patients for whom a controlled
substance is prescribed monthly with the collaborating
physician.
(E) The physician assistant meets the education
requirements of Section 303.05 of the Illinois
Controlled Substances Act.
(c) Nothing in this Act shall be construed to limit the
delegation of tasks or duties by a physician to a licensed
practical nurse, a registered professional nurse, or other
persons. Nothing in this Act shall be construed to limit the
method of delegation that may be authorized by any means,

HB4637 - 21 - LRB103 35424 SPS 65490 b
including, but not limited to, oral, written, electronic,
standing orders, protocols, guidelines, or verbal orders.
Nothing in this Act shall be construed to authorize a
physician assistant to provide health care services required
by law or rule to be performed by a physician. Nothing in this
Act shall be construed to authorize the delegation or
performance of operative surgery. Nothing in this Section
shall be construed to preclude a physician assistant from
assisting in surgery.
(c-5) Nothing in this Section shall be construed to apply
to any medication authority, including Schedule II controlled
substances of a licensed physician assistant for care provided
in a hospital, hospital affiliate, or ambulatory surgical
treatment center pursuant to Section 7.7 of this Act.
(d) (Blank).
(e) Nothing in this Section shall be construed to prohibit
generic substitution.
(Source: P.A. 101-13, eff. 6-12-19; 102-558, eff. 8-20-21;
revised 9-21-23.)
(Text of Section after amendment by P.A. 103-65)
(Section scheduled to be repealed on January 1, 2028)
Sec. 7.5. Written collaborative agreements; prescriptive
authority.
(a) A written collaborative agreement is required for all
physician assistants to practice in the State, except as

HB4637 - 22 - LRB103 35424 SPS 65490 b
provided in Sections Section 7.7 and 7.9 of this Act. When a
written collaborative agreement is required under this Act,
the following shall apply:
(1) A written collaborative agreement shall describe
the working relationship of the physician assistant with
the collaborating physician and shall describe the
categories of care, treatment, or procedures to be
provided by the physician assistant. The written
collaborative agreement shall promote the exercise of
professional judgment by the physician assistant
commensurate with his or her education and experience. The
services to be provided by the physician assistant shall
be services that the collaborating physician is authorized
to and generally provides to his or her patients in the
normal course of his or her clinical medical practice. The
written collaborative agreement need not describe the
exact steps that a physician assistant must take with
respect to each specific condition, disease, or symptom
but must specify which authorized procedures require the
presence of the collaborating physician as the procedures
are being performed. The relationship under a written
collaborative agreement shall not be construed to require
the personal presence of a physician at the place where
services are rendered. Methods of communication shall be
available for consultation with the collaborating
physician in person or by telecommunications or electronic

HB4637 - 23 - LRB103 35424 SPS 65490 b
communications as set forth in the written collaborative
agreement. For the purposes of this Act, "generally
provides to his or her patients in the normal course of his
or her clinical medical practice" means services, not
specific tasks or duties, the collaborating physician
routinely provides individually or through delegation to
other persons so that the physician has the experience and
ability to collaborate and provide consultation.
(2) (Blank). The written collaborative agreement shall
be adequate if a physician does each of the following:
(A) Participates in the joint formulation and
joint approval of orders or guidelines with the
physician assistant and he or she periodically reviews
such orders and the services provided patients under
such orders in accordance with accepted standards of
medical practice and physician assistant practice.
(B) Provides consultation at least once a month.
(3) A copy of the signed, written collaborative
agreement must be available to the Department upon request
from both the physician assistant and the collaborating
physician.
(4) A physician assistant shall inform each
collaborating physician of all written collaborative
agreements he or she has signed and provide a copy of these
to any collaborating physician upon request.
(b) To prescribe Schedule II, III, IV, or V controlled

HB4637 - 24 - LRB103 35424 SPS 65490 b
substances under this Section, a physician assistant must
obtain a mid-level practitioner controlled substances license.
A collaborating physician may, but is not required to,
delegate prescriptive authority to a physician assistant as
part of a written collaborative agreement. This authority may,
but is not required to, include prescription of, selection of,
orders for, administration of, storage of, acceptance of
samples of, and dispensing medical devices, over the counter
medications, legend drugs, medical gases, and controlled
substances categorized as Schedule II through V controlled
substances, as defined in Article II of the Illinois
Controlled Substances Act, and other preparations, including,
but not limited to, botanical and herbal remedies. The
collaborating physician must have a valid, current Illinois
controlled substance license and federal registration with the
Drug Enforcement Administration to delegate the authority to
prescribe controlled substances.
(1) To prescribe Schedule II, III, IV, or V controlled
substances under this Section, a physician assistant must
obtain a mid-level practitioner controlled substances
license. Medication orders issued by a physician assistant
shall be reviewed periodically by the collaborating
physician.
(2) The collaborating physician shall file with the
Department notice of delegation of prescriptive authority
to a physician assistant and termination of delegation,

HB4637 - 25 - LRB103 35424 SPS 65490 b
specifying the authority delegated or terminated. Upon
receipt of this notice delegating authority to prescribe
controlled substances, the physician assistant shall be
eligible to register for a mid-level practitioner
controlled substances license under Section 303.05 of the
Illinois Controlled Substances Act. Nothing in this Act
shall be construed to limit the delegation of tasks or
duties by the collaborating physician to a nurse or other
appropriately trained persons in accordance with Section
54.2 of the Medical Practice Act of 1987.
(3) In addition to the requirements of this subsection
(b), a collaborating physician may, but is not required
to, delegate authority to a physician assistant to
prescribe Schedule II controlled substances, if all of the
following conditions apply:
(A) Specific Schedule II controlled substances by
oral dosage or topical or transdermal application may
be delegated, provided that the delegated Schedule II
controlled substances are routinely prescribed by the
collaborating physician. This delegation must identify
the specific Schedule II controlled substances by
either brand name or generic name. Schedule II
controlled substances to be delivered by injection or
other route of administration may not be delegated.
(B) (Blank).
(C) Any prescription must be limited to no more

HB4637 - 26 - LRB103 35424 SPS 65490 b
than a 30-day supply, with any continuation authorized
only after prior approval of the collaborating
physician.
(D) The physician assistant must discuss the
condition of any patients for whom a controlled
substance is prescribed monthly with the collaborating
physician.
(E) The physician assistant meets the education
requirements of Section 303.05 of the Illinois
Controlled Substances Act.
(c) Nothing in this Act shall be construed to limit the
delegation of tasks or duties by a physician to a licensed
practical nurse, a registered professional nurse, or other
persons. Nothing in this Act shall be construed to limit the
method of delegation that may be authorized by any means,
including, but not limited to, oral, written, electronic,
standing orders, protocols, guidelines, or verbal orders.
Nothing in this Act shall be construed to authorize a
physician assistant to provide health care services required
by law or rule to be performed by a physician. Nothing in this
Act shall be construed to authorize the delegation or
performance of operative surgery. Nothing in this Section
shall be construed to preclude a physician assistant from
assisting in surgery.
(c-5) Nothing in this Section shall be construed to apply
to any medication authority, including Schedule II controlled

HB4637 - 27 - LRB103 35424 SPS 65490 b
substances of a licensed physician assistant for care provided
in a hospital, hospital affiliate, federally qualified health
center, or ambulatory surgical treatment center pursuant to
Section 7.7 of this Act, or to a physician assistant
satisfying the requirements of Section 7.9.
(d) (Blank).
(e) Nothing in this Section shall be construed to prohibit
generic substitution.
(f) Delegation of prescriptive authority by a physician is
not required under this Section.
(Source: P.A. 102-558, eff. 8-20-21; 103-65, eff. 1-1-24;
revised 9-21-23.)
(225 ILCS 95/7.7)
(Text of Section before amendment by P.A. 103-65)
(Section scheduled to be repealed on January 1, 2028)
Sec. 7.7. Physician assistants in hospitals, hospital
affiliates, or ambulatory surgical treatment centers.
(a) A physician assistant may provide services in a
hospital as defined in the Hospital Licensing Act, a hospital
affiliate as defined in the University of Illinois Hospital
Act, or a licensed ambulatory surgical treatment center as
defined in the Ambulatory Surgical Treatment Center Act
without a written collaborative agreement pursuant to Section
7.5 of this Act. A physician assistant must possess clinical
privileges recommended by the hospital medical staff and

HB4637 - 28 - LRB103 35424 SPS 65490 b
granted by the hospital or the consulting medical staff
committee and ambulatory surgical treatment center in order to
provide services. The medical staff or consulting medical
staff committee shall periodically review the services of
physician assistants granted clinical privileges, including
any care provided in a hospital affiliate. Authority may also
be granted when recommended by the hospital medical staff and
granted by the hospital or recommended by the consulting
medical staff committee and ambulatory surgical treatment
center to individual physician assistants to select, order,
and administer medications, including controlled substances,
to provide delineated care. In a hospital, hospital affiliate,
or ambulatory surgical treatment center, the attending
physician shall determine a physician assistant's role in
providing care for his or her patients, except as otherwise
provided in the medical staff bylaws or consulting committee
policies.
(a-5) Physician assistants practicing in a hospital
affiliate may be, but are not required to be, granted
authority to prescribe Schedule II through V controlled
substances when such authority is recommended by the
appropriate physician committee of the hospital affiliate and
granted by the hospital affiliate. This authority may, but is
not required to, include prescription of, selection of, orders
for, administration of, storage of, acceptance of samples of,
and dispensing over-the-counter medications, legend drugs,

HB4637 - 29 - LRB103 35424 SPS 65490 b
medical gases, and controlled substances categorized as
Schedule II through V controlled substances, as defined in
Article II of the Illinois Controlled Substances Act, and
other preparations, including, but not limited to, botanical
and herbal remedies.
To prescribe controlled substances under this subsection
(a-5), a physician assistant must obtain a mid-level
practitioner controlled substance license. Medication orders
shall be reviewed periodically by the appropriate hospital
affiliate physicians committee or its physician designee.
The hospital affiliate shall file with the Department
notice of a grant of prescriptive authority consistent with
this subsection (a-5) and termination of such a grant of
authority in accordance with rules of the Department. Upon
receipt of this notice of grant of authority to prescribe any
Schedule II through V controlled substances, the licensed
physician assistant may register for a mid-level practitioner
controlled substance license under Section 303.05 of the
Illinois Controlled Substances Act.
In addition, a hospital affiliate may, but is not required
to, grant authority to a physician assistant to prescribe any
Schedule II controlled substances if all of the following
conditions apply:
(1) specific Schedule II controlled substances by oral
dosage or topical or transdermal application may be
designated, provided that the designated Schedule II

HB4637 - 30 - LRB103 35424 SPS 65490 b
controlled substances are routinely prescribed by
physician assistants in their area of certification; this
grant of authority must identify the specific Schedule II
controlled substances by either brand name or generic
name; authority to prescribe or dispense Schedule II
controlled substances to be delivered by injection or
other route of administration may not be granted;
(2) any grant of authority must be controlled
substances limited to the practice of the physician
assistant;
(3) any prescription must be limited to no more than a
30-day supply;
(4) the physician assistant must discuss the condition
of any patients for whom a controlled substance is
prescribed monthly with the appropriate physician
committee of the hospital affiliate or its physician
designee; and
(5) the physician assistant must meet the education
requirements of Section 303.05 of the Illinois Controlled
Substances Act.
(b) A physician assistant granted authority to order
medications including controlled substances may complete
discharge prescriptions provided the prescription is in the
name of the physician assistant and the attending or
discharging physician.
(c) Physician assistants practicing in a hospital,

HB4637 - 31 - LRB103 35424 SPS 65490 b
hospital affiliate, or an ambulatory surgical treatment center
are not required to obtain a mid-level controlled substance
license to order controlled substances under Section 303.05 of
the Illinois Controlled Substances Act.
(Source: P.A. 100-453, eff. 8-25-17.)
(Text of Section after amendment by P.A. 103-65)
(Section scheduled to be repealed on January 1, 2028)
Sec. 7.7. Physician assistants in hospitals, hospital
affiliates, federally qualified health centers, or ambulatory
surgical treatment centers.
(a) A physician assistant may provide services in a
hospital as defined in the Hospital Licensing Act, a hospital
affiliate as defined in the University of Illinois Hospital
Act, a federally qualified health center, or a licensed
ambulatory surgical treatment center as defined in the
Ambulatory Surgical Treatment Center Act without a written
collaborative agreement pursuant to Section 7.5 of this Act
only in accordance with this Section. A physician assistant
must possess clinical privileges recommended by (i) the
hospital medical staff and granted by the hospital, (ii) the
physician committee and federally qualified health center, or
(iii) the consulting medical staff committee and ambulatory
surgical treatment center in order to provide services. The
medical staff, physician committee, or consulting medical
staff committee shall periodically review the services of

HB4637 - 32 - LRB103 35424 SPS 65490 b
physician assistants granted clinical privileges, including
any care provided in a hospital affiliate or federally
qualified health center. A physician assistant practicing
under this Section may prescribe, select, order, and
administer medications, including controlled substances.
Authority may also be granted when recommended by the hospital
medical staff and granted by the hospital, recommended by the
physician committee and granted by the federally qualified
health center, or recommended by the consulting medical staff
committee and ambulatory surgical treatment center to
individual physician assistants to select, order, and
administer medications, including controlled substances, to
provide delineated care. In a hospital, hospital affiliate,
federally qualified health center, or ambulatory surgical
treatment center, the attending physician shall determine a
physician assistant's role in providing care for his or her
patients, except as otherwise provided in the medical staff
bylaws or consulting committee policies.
(a-5) Physician assistants practicing in a hospital
affiliate or a federally qualified health center may be, but
are not required to be, granted authority to prescribe
Schedule II through V controlled substances when such
authority is recommended by the appropriate physician
committee of the hospital affiliate and granted by the
hospital affiliate or recommended by the physician committee
of the federally qualified health center and granted by the

HB4637 - 33 - LRB103 35424 SPS 65490 b
federally qualified health center. This authority may, but is
not required to, include prescription of, selection of, orders
for, administration of, storage of, acceptance of samples of,
and dispensing over-the-counter medications, legend drugs,
medical gases, and controlled substances categorized as
Schedule II through V controlled substances, as defined in
Article II of the Illinois Controlled Substances Act, and
other preparations, including, but not limited to, botanical
and herbal remedies.
To prescribe controlled substances under this subsection
(a-5), a physician assistant must obtain a mid-level
practitioner controlled substance license. Medication orders
shall be reviewed periodically by the appropriate hospital
affiliate physicians committee or its physician designee or by
the physician committee of a federally qualified health
center.
The hospital affiliate or federally qualified health
center shall file with the Department notice of a grant of
prescriptive authority consistent with this subsection (a-5)
and termination of such a grant of authority in accordance
with rules of the Department. Upon receipt of this notice of
grant of authority to prescribe any Schedule II through V
controlled substances, the licensed physician assistant may
register for a mid-level practitioner controlled substance
license under Section 303.05 of the Illinois Controlled
Substances Act.

HB4637 - 34 - LRB103 35424 SPS 65490 b
In addition, a hospital affiliate or a federally qualified
health center may, but is not required to, grant authority to a
physician assistant to prescribe any Schedule II controlled
substances if all of the following conditions apply:
(1) specific Schedule II controlled substances by oral
dosage or topical or transdermal application may be
designated, provided that the designated Schedule II
controlled substances are routinely prescribed by
physician assistants in their area of certification; this
grant of authority must identify the specific Schedule II
controlled substances by either brand name or generic
name; authority to prescribe or dispense Schedule II
controlled substances to be delivered by injection or
other route of administration may not be granted;
(2) any grant of authority must be controlled
substances limited to the practice of the physician
assistant;
(3) any prescription must be limited to no more than a
30-day supply;
(4) the physician assistant must discuss the condition
of any patients for whom a controlled substance is
prescribed monthly with the appropriate physician
committee of the hospital affiliate or its physician
designee, or the physician committee of a federally
qualified health center; and
(5) the physician assistant must meet the education

HB4637 - 35 - LRB103 35424 SPS 65490 b
requirements of Section 303.05 of the Illinois Controlled
Substances Act.
(b) A physician assistant granted authority to order
medications including controlled substances may complete
discharge prescriptions provided the prescription is in the
name of the physician assistant and the attending or
discharging physician.
(c) Physician assistants practicing in a hospital,
hospital affiliate, federally qualified health center, or an
ambulatory surgical treatment center are not required to
obtain a mid-level controlled substance license to order
controlled substances under Section 303.05 of the Illinois
Controlled Substances Act.
(d) Delegation of prescriptive authority by a physician is
not required under this Section.
(Source: P.A. 103-65, eff. 1-1-24.)
(225 ILCS 95/7.8 new)
Sec. 7.8. Prescriptive authority. A physician assistant
may prescribe, dispense, order, administer, and procure drugs
and medical devices without delegation of authority by a
physician. The prescriptive authority may include prescribing
Schedule II, III, IV, and V controlled substances. To
prescribe Schedule II, III, IV, or V controlled substances
under this Act, a physician assistant must obtain a mid-level
practitioner controlled substances license. When a written

HB4637 - 36 - LRB103 35424 SPS 65490 b
collaborative agreement is required under this Act, delegation
of prescriptive authority by a physician is not required.
(225 ILCS 95/7.9 new)
Sec. 7.9. Optimal practice.
(a) A physician assistant may practice without a written
collaborative agreement as described in this Section.
(b) A physician assistant who files with the Department a
notarized attestation of completion of at least 250 hours of
continuing education or training and at least 2,000 hours of
clinical experience after first attaining national
certification shall not require a written collaborative
agreement. Documentation of successful completion shall be
provided to the Department upon request.
(c) The scope of practice of a physician assistant with
optimal practice includes:
(1) all matters defined as physician assistant
practice;
(2) practicing without a written collaborative
agreement in all practice settings consistent with this
Act;
(3) authority to prescribe both legend drugs and
Schedule II through V controlled substances, including
prescription of, selection of, orders for, administration
of, storage of, acceptance of samples of, and dispensing
over-the-counter medications, legend drugs, and controlled

HB4637 - 37 - LRB103 35424 SPS 65490 b
substances categorized as any Schedule II through V
controlled substances, as defined in Article II of the
Illinois Controlled Substances Act, and other
preparations, including, but not limited to, botanical and
herbal remedies; and
(4) authority to obtain an Illinois controlled
substance license and a federal Drug Enforcement
Administration number.
The scope of practice of a physician assistant does not
include operative surgery. Nothing in this Section shall be
construed to preclude a physician assistant from assisting in
surgery or performing other procedures as privileged by the
physician assistant's employer.
(d) The Department may adopt rules necessary to administer
this Section, including, but not limited to, requiring the
completion of forms and the payment of fees.
(e) Nothing in this Section shall be construed to prohibit
a physician assistant's employer from requiring a physician
assistant who satisfies the qualifications of subsection (b)
to practice with a written collaborative agreement.
(f) Nothing in this Act shall be construed to authorize a
physician assistant with optimal practice authority to provide
health care services required by law or rule to be performed by
a physician.
(225 ILCS 95/17) (from Ch. 111, par. 4617)

HB4637 - 38 - LRB103 35424 SPS 65490 b
(Section scheduled to be repealed on January 1, 2028)
Sec. 17. Inactive status. Any physician assistant who
notified the Department in writing on forms prescribed by the
Department, may elect to place his or her license on an
inactive status and shall, subject to rules of the Department,
be excused from payment of renewal fees until he or she
notifies the Department in writing of his or her intention to
restore the license. Any person who holds an active license or
permit issued under the Medical Practice Act of 1987 shall
have that license or permit automatically placed into inactive
status upon issuance of a physician assistant license. Any
person who holds an active license as a physician assistant
who is issued a license or permit under the Medical Practice
Act of 1987 shall have the physician assistant license
automatically placed into inactive status.
Any physician assistant requesting restoration from
inactive status shall be required to pay the current renewal
fee and shall be required to restore his or her license, as
provided in Section 16 of this Act.
Any physician assistant whose license is in an inactive
status shall not practice in the State of Illinois.
Any licensee who shall engage in practice while his or her
license is lapsed or on inactive status shall be considered to
be practicing without a license, which shall be grounds for
discipline under Section 21 of this Act.
(Source: P.A. 90-61, eff. 12-30-97.)

HB4637 - 39 - LRB103 35424 SPS 65490 b
(225 ILCS 95/20) (from Ch. 111, par. 4620)
(Section scheduled to be repealed on January 1, 2028)
Sec. 20. Limitations.
(a) No corporation, which stated purpose includes, or
which practices, or which holds itself out as available to
practice as a physician assistant or to practice any of the
functions described in Section 4 of this Act, shall be issued a
license by the Department, nor shall the Secretary of State
approve or accept articles of incorporation for such a
corporation.
(b) Pursuant to subparagraph (a) of paragraph (2) of
Section 3.6 of the Professional Service Corporation Act and
Section 2 of the Medical Corporation Act, a person licensed
under this Act may not own a corporation for the purposes of
practicing medicine.
(c) Pursuant to paragraph (2) of subsection (a) of Section
13 of the Professional Limited Liability Company Act, a person
licensed under this Act may not own a professional limited
liability company for the purposes of practicing medicine.
(Source: P.A. 85-981.)
(225 ILCS 95/21) (from Ch. 111, par. 4621)
(Section scheduled to be repealed on January 1, 2028)
Sec. 21. Grounds for disciplinary action.
(a) The Department may refuse to issue or to renew, or may

HB4637 - 40 - LRB103 35424 SPS 65490 b
revoke, suspend, place on probation, reprimand, or take other
disciplinary or non-disciplinary action with regard to any
license issued under this Act as the Department may deem
proper, including the issuance of fines not to exceed $10,000
for each violation, for any one or combination of the
following causes:
(1) Material misstatement in furnishing information to
the Department.
(2) Violations of this Act, or the rules adopted under
this Act.
(3) Conviction by plea of guilty or nolo contendere,
finding of guilt, jury verdict, or entry of judgment or
sentencing, including, but not limited to, convictions,
preceding sentences of supervision, conditional discharge,
or first offender probation, under the laws of any
jurisdiction of the United States that is: (i) a felony;
or (ii) a misdemeanor, an essential element of which is
dishonesty, or that is directly related to the practice of
the profession.
(4) Making any misrepresentation for the purpose of
obtaining licenses.
(5) Professional incompetence.
(6) Aiding or assisting another person in violating
any provision of this Act or its rules.
(7) Failing, within 60 days, to provide information in
response to a written request made by the Department.

HB4637 - 41 - LRB103 35424 SPS 65490 b
(8) Engaging in dishonorable, unethical, or
unprofessional conduct, as defined by rule, of a character
likely to deceive, defraud, or harm the public.
(9) Habitual or excessive use or addiction to alcohol,
narcotics, stimulants, or any other chemical agent or drug
that results in a physician assistant's inability to
practice with reasonable judgment, skill, or safety.
(10) Discipline by another U.S. jurisdiction or
foreign nation, if at least one of the grounds for
discipline is the same or substantially equivalent to
those set forth in this Section.
(11) Directly or indirectly giving to or receiving
from any person, firm, corporation, partnership, or
association any fee, commission, rebate or other form of
compensation for any professional services not actually or
personally rendered. Nothing in this paragraph (11)
affects any bona fide independent contractor or employment
arrangements, which may include provisions for
compensation, health insurance, pension, or other
employment benefits, with persons or entities authorized
under this Act for the provision of services within the
scope of the licensee's practice under this Act.
(12) A finding by the Board that the licensee, after
having his or her license placed on probationary status,
has violated the terms of probation.
(13) Abandonment of a patient.

HB4637 - 42 - LRB103 35424 SPS 65490 b
(14) Willfully making or filing false records or
reports in his or her practice, including, but not limited
to, false records filed with State agencies or
departments.
(15) Willfully failing to report an instance of
suspected child abuse or neglect as required by the Abused
and Neglected Child Reporting Act.
(16) Physical illness, or mental illness or impairment
that results in the inability to practice the profession
with reasonable judgment, skill, or safety, including, but
not limited to, deterioration through the aging process or
loss of motor skill.
(17) Being named as a perpetrator in an indicated
report by the Department of Children and Family Services
under the Abused and Neglected Child Reporting Act, and
upon proof by clear and convincing evidence that the
licensee has caused a child to be an abused child or
neglected child as defined in the Abused and Neglected
Child Reporting Act.
(18) (Blank).
(19) Gross negligence resulting in permanent injury or
death of a patient.
(20) Employment of fraud, deception or any unlawful
means in applying for or securing a license as a physician
assistant.
(21) Exceeding the authority delegated to him or her

HB4637 - 43 - LRB103 35424 SPS 65490 b
by his or her collaborating physician in a written
collaborative agreement, when the agreement is required
under this Act.
(22) Immoral conduct in the commission of any act,
such as sexual abuse, sexual misconduct, or sexual
exploitation related to the licensee's practice.
(23) Violation of the Health Care Worker Self-Referral
Act.
(24) Practicing under a false or assumed name, except
as provided by law.
(25) Making a false or misleading statement regarding
his or her skill or the efficacy or value of the medicine,
treatment, or remedy prescribed by him or her in the
course of treatment.
(26) Allowing another person to use his or her license
to practice.
(27) Prescribing, selling, administering,
distributing, giving, or self-administering a drug
classified as a controlled substance for other than
medically accepted therapeutic purposes.
(28) Promotion of the sale of drugs, devices,
appliances, or goods provided for a patient in a manner to
exploit the patient for financial gain.
(29) A pattern of practice or other behavior that
demonstrates incapacity or incompetence to practice under
this Act.

HB4637 - 44 - LRB103 35424 SPS 65490 b
(30) Violating State or federal laws or regulations
relating to controlled substances or other legend drugs or
ephedra as defined in the Ephedra Prohibition Act.
(31) (Blank). Exceeding the prescriptive authority
delegated by the collaborating physician or violating the
written collaborative agreement delegating that authority.
(32) (Blank). Practicing without providing to the
Department a notice of collaboration or delegation of
prescriptive authority.
(33) Failure to establish and maintain records of
patient care and treatment as required by law.
(34) Attempting to subvert or cheat on the examination
of the National Commission on Certification of Physician
Assistants or its successor agency.
(35) Willfully or negligently violating the
confidentiality between physician assistant and patient,
except as required by law.
(36) Willfully failing to report an instance of
suspected abuse, neglect, financial exploitation, or
self-neglect of an eligible adult as defined in and
required by the Adult Protective Services Act.
(37) Being named as an abuser in a verified report by
the Department on Aging under the Adult Protective
Services Act and upon proof by clear and convincing
evidence that the licensee abused, neglected, or
financially exploited an eligible adult as defined in the

HB4637 - 45 - LRB103 35424 SPS 65490 b
Adult Protective Services Act.
(38) Failure to report to the Department an adverse
final action taken against him or her by another licensing
jurisdiction of the United States or a foreign state or
country, a peer review body, a health care institution, a
professional society or association, a governmental
agency, a law enforcement agency, or a court acts or
conduct similar to acts or conduct that would constitute
grounds for action under this Section.
(39) Failure to provide copies of records of patient
care or treatment, except as required by law.
(40) (Blank). Entering into an excessive number of
written collaborative agreements with licensed physicians
resulting in an inability to adequately collaborate.
(41) (Blank). Repeated failure to adequately
collaborate with a collaborating physician.
(42) Violating the Compassionate Use of Medical
Cannabis Program Act.
(b) The Department may, without a hearing, refuse to issue
or renew or may suspend the license of any person who fails to
file a return, or to pay the tax, penalty or interest shown in
a filed return, or to pay any final assessment of the tax,
penalty, or interest as required by any tax Act administered
by the Illinois Department of Revenue, until such time as the
requirements of any such tax Act are satisfied.
(b-5) The Department shall not revoke, suspend, summarily

HB4637 - 46 - LRB103 35424 SPS 65490 b
suspend, place on prohibition, reprimand, refuse to issue or
renew, or take any other disciplinary or non-disciplinary
action against the license or permit issued under this Act to
practice as a physician assistant based solely upon the
physician assistant providing, authorizing, recommending,
aiding, assisting, referring for, or otherwise participating
in any health care service, so long as the care was not
unlawful under the laws of this State, regardless of whether
the patient was a resident of this State or another state.
(b-10) The Department shall not revoke, suspend, summarily
suspend, place on prohibition, reprimand, refuse to issue or
renew, or take any other disciplinary or non-disciplinary
action against the license or permit issued under this Act to
practice as a physician assistant based upon the physician
assistant's license being revoked or suspended, or the
physician assistant being otherwise disciplined by any other
state, if that revocation, suspension, or other form of
discipline was based solely on the physician assistant
violating another state's laws prohibiting the provision of,
authorization of, recommendation of, aiding or assisting in,
referring for, or participation in any health care service if
that health care service as provided would not have been
unlawful under the laws of this State and is consistent with
the standards of conduct for a physician assistant practicing
in Illinois.
(b-15) The conduct specified in subsections (b-5) and

HB4637 - 47 - LRB103 35424 SPS 65490 b
(b-10) shall not constitute grounds for suspension under
Section 22.13.
(b-20) An applicant seeking licensure, certification, or
authorization pursuant to this Act who has been subject to
disciplinary action by a duly authorized professional
disciplinary agency of another jurisdiction solely on the
basis of having provided, authorized, recommended, aided,
assisted, referred for, or otherwise participated in health
care shall not be denied such licensure, certification, or
authorization, unless the Department determines that such
action would have constituted professional misconduct in this
State; however, nothing in this Section shall be construed as
prohibiting the Department from evaluating the conduct of such
applicant and making a determination regarding the licensure,
certification, or authorization to practice a profession under
this Act.
(c) The determination by a circuit court that a licensee
is subject to involuntary admission or judicial admission as
provided in the Mental Health and Developmental Disabilities
Code operates as an automatic suspension. The suspension will
end only upon a finding by a court that the patient is no
longer subject to involuntary admission or judicial admission
and issues an order so finding and discharging the patient,
and upon the recommendation of the Board to the Secretary that
the licensee be allowed to resume his or her practice.
(d) In enforcing this Section, the Department upon a

HB4637 - 48 - LRB103 35424 SPS 65490 b
showing of a possible violation may compel an individual
licensed to practice under this Act, or who has applied for
licensure under this Act, to submit to a mental or physical
examination, or both, which may include a substance abuse or
sexual offender evaluation, as required by and at the expense
of the Department.
The Department shall specifically designate the examining
physician licensed to practice medicine in all of its branches
or, if applicable, the multidisciplinary team involved in
providing the mental or physical examination or both. The
multidisciplinary team shall be led by a physician licensed to
practice medicine in all of its branches and may consist of one
or more or a combination of physicians licensed to practice
medicine in all of its branches, licensed clinical
psychologists, licensed clinical social workers, licensed
clinical professional counselors, and other professional and
administrative staff. Any examining physician or member of the
multidisciplinary team may require any person ordered to
submit to an examination pursuant to this Section to submit to
any additional supplemental testing deemed necessary to
complete any examination or evaluation process, including, but
not limited to, blood testing, urinalysis, psychological
testing, or neuropsychological testing.
The Department may order the examining physician or any
member of the multidisciplinary team to provide to the
Department any and all records, including business records,

HB4637 - 49 - LRB103 35424 SPS 65490 b
that relate to the examination and evaluation, including any
supplemental testing performed.
The Department may order the examining physician or any
member of the multidisciplinary team to present testimony
concerning the mental or physical examination of the licensee
or applicant. No information, report, record, or other
documents in any way related to the examination shall be
excluded by reason of any common law or statutory privilege
relating to communications between the licensee or applicant
and the examining physician or any member of the
multidisciplinary team. No authorization is necessary from the
licensee or applicant ordered to undergo an examination for
the examining physician or any member of the multidisciplinary
team to provide information, reports, records, or other
documents or to provide any testimony regarding the
examination and evaluation.
The individual to be examined may have, at his or her own
expense, another physician of his or her choice present during
all aspects of this examination. However, that physician shall
be present only to observe and may not interfere in any way
with the examination.
Failure of an individual to submit to a mental or physical
examination, when ordered, shall result in an automatic
suspension of his or her license until the individual submits
to the examination.
If the Department finds an individual unable to practice

HB4637 - 50 - LRB103 35424 SPS 65490 b
because of the reasons set forth in this Section, the
Department may require that individual to submit to care,
counseling, or treatment by physicians approved or designated
by the Department, as a condition, term, or restriction for
continued, reinstated, or renewed licensure to practice; or,
in lieu of care, counseling, or treatment, the Department may
file a complaint to immediately suspend, revoke, or otherwise
discipline the license of the individual. An individual whose
license was granted, continued, reinstated, renewed,
disciplined, or supervised subject to such terms, conditions,
or restrictions, and who fails to comply with such terms,
conditions, or restrictions, shall be referred to the
Secretary for a determination as to whether the individual
shall have his or her license suspended immediately, pending a
hearing by the Department.
In instances in which the Secretary immediately suspends a
person's license under this Section, a hearing on that
person's license must be convened by the Department within 30
days after the suspension and completed without appreciable
delay. The Department shall have the authority to review the
subject individual's record of treatment and counseling
regarding the impairment to the extent permitted by applicable
federal statutes and regulations safeguarding the
confidentiality of medical records.
An individual licensed under this Act and affected under
this Section shall be afforded an opportunity to demonstrate

HB4637 - 51 - LRB103 35424 SPS 65490 b
to the Department that he or she can resume practice in
compliance with acceptable and prevailing standards under the
provisions of his or her license.
(e) An individual or organization acting in good faith,
and not in a willful and wanton manner, in complying with this
Section by providing a report or other information to the
Board, by assisting in the investigation or preparation of a
report or information, by participating in proceedings of the
Board, or by serving as a member of the Board, shall not be
subject to criminal prosecution or civil damages as a result
of such actions.
(f) Members of the Board shall be indemnified by the State
for any actions occurring within the scope of services on the
Board, done in good faith and not willful and wanton in nature.
The Attorney General shall defend all such actions unless he
or she determines either that there would be a conflict of
interest in such representation or that the actions complained
of were not in good faith or were willful and wanton.
If the Attorney General declines representation, the
member has the right to employ counsel of his or her choice,
whose fees shall be provided by the State, after approval by
the Attorney General, unless there is a determination by a
court that the member's actions were not in good faith or were
willful and wanton.
The member must notify the Attorney General within 7 days
after receipt of notice of the initiation of any action

HB4637 - 52 - LRB103 35424 SPS 65490 b
involving services of the Board. Failure to so notify the
Attorney General constitutes an absolute waiver of the right
to a defense and indemnification.
The Attorney General shall determine, within 7 days after
receiving such notice, whether he or she will undertake to
represent the member.
(g) The Department may adopt rules to implement the
changes made by this amendatory Act of the 102nd General
Assembly.
(Source: P.A. 101-363, eff. 8-9-19; 102-558, eff. 8-20-21;
102-1117, eff. 1-13-23.)
Section 10. The Illinois Controlled Substances Act is
amended by changing Sections 102 and 303.05 as follows:
(720 ILCS 570/102) (from Ch. 56 1/2, par. 1102)
Sec. 102. Definitions. As used in this Act, unless the
context otherwise requires:
(a) "Addict" means any person who habitually uses any
drug, chemical, substance or dangerous drug other than alcohol
so as to endanger the public morals, health, safety or welfare
or who is so far addicted to the use of a dangerous drug or
controlled substance other than alcohol as to have lost the
power of self control with reference to his or her addiction.
(b) "Administer" means the direct application of a
controlled substance, whether by injection, inhalation,

HB4637 - 53 - LRB103 35424 SPS 65490 b
ingestion, or any other means, to the body of a patient,
research subject, or animal (as defined by the Humane
Euthanasia in Animal Shelters Act) by:
(1) a practitioner (or, in his or her presence, by his
or her authorized agent),
(2) the patient or research subject pursuant to an
order, or
(3) a euthanasia technician as defined by the Humane
Euthanasia in Animal Shelters Act.
(c) "Agent" means an authorized person who acts on behalf
of or at the direction of a manufacturer, distributor,
dispenser, prescriber, or practitioner. It does not include a
common or contract carrier, public warehouseman or employee of
the carrier or warehouseman.
(c-1) "Anabolic Steroids" means any drug or hormonal
substance, chemically and pharmacologically related to
testosterone (other than estrogens, progestins,
corticosteroids, and dehydroepiandrosterone), and includes:
(i) 3[beta],17-dihydroxy-5a-androstane,
(ii) 3[alpha],17[beta]-dihydroxy-5a-androstane,
(iii) 5[alpha]-androstan-3,17-dione,
(iv) 1-androstenediol (3[beta],
17[beta]-dihydroxy-5[alpha]-androst-1-ene),
(v) 1-androstenediol (3[alpha],
17[beta]-dihydroxy-5[alpha]-androst-1-ene),
(vi) 4-androstenediol

HB4637 - 54 - LRB103 35424 SPS 65490 b
(3[beta],17[beta]-dihydroxy-androst-4-ene),
(vii) 5-androstenediol
(3[beta],17[beta]-dihydroxy-androst-5-ene),
(viii) 1-androstenedione
([5alpha]-androst-1-en-3,17-dione),
(ix) 4-androstenedione
(androst-4-en-3,17-dione),
(x) 5-androstenedione
(androst-5-en-3,17-dione),
(xi) bolasterone (7[alpha],17a-dimethyl-17[beta]-
hydroxyandrost-4-en-3-one),
(xii) boldenone (17[beta]-hydroxyandrost-
1,4,-diene-3-one),
(xiii) boldione (androsta-1,4-
diene-3,17-dione),
(xiv) calusterone (7[beta],17[alpha]-dimethyl-17
[beta]-hydroxyandrost-4-en-3-one),
(xv) clostebol (4-chloro-17[beta]-
hydroxyandrost-4-en-3-one),
(xvi) dehydrochloromethyltestosterone (4-chloro-
17[beta]-hydroxy-17[alpha]-methyl-
androst-1,4-dien-3-one),
(xvii) desoxymethyltestosterone
(17[alpha]-methyl-5[alpha]
-androst-2-en-17[beta]-ol)(a.k.a., madol),
(xviii) [delta]1-dihydrotestosterone (a.k.a.

HB4637 - 55 - LRB103 35424 SPS 65490 b
'1-testosterone') (17[beta]-hydroxy-
5[alpha]-androst-1-en-3-one),
(xix) 4-dihydrotestosterone (17[beta]-hydroxy-
androstan-3-one),
(xx) drostanolone (17[beta]-hydroxy-2[alpha]-methyl-
5[alpha]-androstan-3-one),
(xxi) ethylestrenol (17[alpha]-ethyl-17[beta]-
hydroxyestr-4-ene),
(xxii) fluoxymesterone (9-fluoro-17[alpha]-methyl-
1[beta],17[beta]-dihydroxyandrost-4-en-3-one),
(xxiii) formebolone (2-formyl-17[alpha]-methyl-11[alpha],
17[beta]-dihydroxyandrost-1,4-dien-3-one),
(xxiv) furazabol (17[alpha]-methyl-17[beta]-
hydroxyandrostano[2,3-c]-furazan),
(xxv) 13[beta]-ethyl-17[beta]-hydroxygon-4-en-3-one,
(xxvi) 4-hydroxytestosterone (4,17[beta]-dihydroxy-
androst-4-en-3-one),
(xxvii) 4-hydroxy-19-nortestosterone (4,17[beta]-
dihydroxy-estr-4-en-3-one),
(xxviii) mestanolone (17[alpha]-methyl-17[beta]-
hydroxy-5-androstan-3-one),
(xxix) mesterolone (1amethyl-17[beta]-hydroxy-
[5a]-androstan-3-one),
(xxx) methandienone (17[alpha]-methyl-17[beta]-
hydroxyandrost-1,4-dien-3-one),
(xxxi) methandriol (17[alpha]-methyl-3[beta],17[beta]-

HB4637 - 56 - LRB103 35424 SPS 65490 b
dihydroxyandrost-5-ene),
(xxxii) methenolone (1-methyl-17[beta]-hydroxy-
5[alpha]-androst-1-en-3-one),
(xxxiii) 17[alpha]-methyl-3[beta], 17[beta]-
dihydroxy-5a-androstane,
(xxxiv) 17[alpha]-methyl-3[alpha],17[beta]-dihydroxy
-5a-androstane,
(xxxv) 17[alpha]-methyl-3[beta],17[beta]-
dihydroxyandrost-4-ene),
(xxxvi) 17[alpha]-methyl-4-hydroxynandrolone (17[alpha]-
methyl-4-hydroxy-17[beta]-hydroxyestr-4-en-3-one),
(xxxvii) methyldienolone (17[alpha]-methyl-17[beta]-
hydroxyestra-4,9(10)-dien-3-one),
(xxxviii) methyltrienolone (17[alpha]-methyl-17[beta]-
hydroxyestra-4,9-11-trien-3-one),
(xxxix) methyltestosterone (17[alpha]-methyl-17[beta]-
hydroxyandrost-4-en-3-one),
(xl) mibolerone (7[alpha],17a-dimethyl-17[beta]-
hydroxyestr-4-en-3-one),
(xli) 17[alpha]-methyl-[delta]1-dihydrotestosterone
(17b[beta]-hydroxy-17[alpha]-methyl-5[alpha]-
androst-1-en-3-one)(a.k.a. '17-[alpha]-methyl-
1-testosterone'),
(xlii) nandrolone (17[beta]-hydroxyestr-4-en-3-one),
(xliii) 19-nor-4-androstenediol (3[beta], 17[beta]-
dihydroxyestr-4-ene),

HB4637 - 57 - LRB103 35424 SPS 65490 b
(xliv) 19-nor-4-androstenediol (3[alpha], 17[beta]-
dihydroxyestr-4-ene),
(xlv) 19-nor-5-androstenediol (3[beta], 17[beta]-
dihydroxyestr-5-ene),
(xlvi) 19-nor-5-androstenediol (3[alpha], 17[beta]-
dihydroxyestr-5-ene),
(xlvii) 19-nor-4,9(10)-androstadienedione
(estra-4,9(10)-diene-3,17-dione),
(xlviii) 19-nor-4-androstenedione (estr-4-
en-3,17-dione),
(xlix) 19-nor-5-androstenedione (estr-5-
en-3,17-dione),
(l) norbolethone (13[beta], 17a-diethyl-17[beta]-
hydroxygon-4-en-3-one),
(li) norclostebol (4-chloro-17[beta]-
hydroxyestr-4-en-3-one),
(lii) norethandrolone (17[alpha]-ethyl-17[beta]-
hydroxyestr-4-en-3-one),
(liii) normethandrolone (17[alpha]-methyl-17[beta]-
hydroxyestr-4-en-3-one),
(liv) oxandrolone (17[alpha]-methyl-17[beta]-hydroxy-
2-oxa-5[alpha]-androstan-3-one),
(lv) oxymesterone (17[alpha]-methyl-4,17[beta]-
dihydroxyandrost-4-en-3-one),
(lvi) oxymetholone (17[alpha]-methyl-2-hydroxymethylene-
17[beta]-hydroxy-(5[alpha]-androstan-3-one),

HB4637 - 58 - LRB103 35424 SPS 65490 b
(lvii) stanozolol (17[alpha]-methyl-17[beta]-hydroxy-
(5[alpha]-androst-2-eno[3,2-c]-pyrazole),
(lviii) stenbolone (17[beta]-hydroxy-2-methyl-
(5[alpha]-androst-1-en-3-one),
(lix) testolactone (13-hydroxy-3-oxo-13,17-
secoandrosta-1,4-dien-17-oic
acid lactone),
(lx) testosterone (17[beta]-hydroxyandrost-
4-en-3-one),
(lxi) tetrahydrogestrinone (13[beta], 17[alpha]-
diethyl-17[beta]-hydroxygon-
4,9,11-trien-3-one),
(lxii) trenbolone (17[beta]-hydroxyestr-4,9,
11-trien-3-one).
Any person who is otherwise lawfully in possession of an
anabolic steroid, or who otherwise lawfully manufactures,
distributes, dispenses, delivers, or possesses with intent to
deliver an anabolic steroid, which anabolic steroid is
expressly intended for and lawfully allowed to be administered
through implants to livestock or other nonhuman species, and
which is approved by the Secretary of Health and Human
Services for such administration, and which the person intends
to administer or have administered through such implants,
shall not be considered to be in unauthorized possession or to
unlawfully manufacture, distribute, dispense, deliver, or
possess with intent to deliver such anabolic steroid for

HB4637 - 59 - LRB103 35424 SPS 65490 b
purposes of this Act.
(d) "Administration" means the Drug Enforcement
Administration, United States Department of Justice, or its
successor agency.
(d-5) "Clinical Director, Prescription Monitoring Program"
means a Department of Human Services administrative employee
licensed to either prescribe or dispense controlled substances
who shall run the clinical aspects of the Department of Human
Services Prescription Monitoring Program and its Prescription
Information Library.
(d-10) "Compounding" means the preparation and mixing of
components, excluding flavorings, (1) as the result of a
prescriber's prescription drug order or initiative based on
the prescriber-patient-pharmacist relationship in the course
of professional practice or (2) for the purpose of, or
incident to, research, teaching, or chemical analysis and not
for sale or dispensing. "Compounding" includes the preparation
of drugs or devices in anticipation of receiving prescription
drug orders based on routine, regularly observed dispensing
patterns. Commercially available products may be compounded
for dispensing to individual patients only if both of the
following conditions are met: (i) the commercial product is
not reasonably available from normal distribution channels in
a timely manner to meet the patient's needs and (ii) the
prescribing practitioner has requested that the drug be
compounded.

HB4637 - 60 - LRB103 35424 SPS 65490 b
(e) "Control" means to add a drug or other substance, or
immediate precursor, to a Schedule whether by transfer from
another Schedule or otherwise.
(f) "Controlled Substance" means (i) a drug, substance,
immediate precursor, or synthetic drug in the Schedules of
Article II of this Act or (ii) a drug or other substance, or
immediate precursor, designated as a controlled substance by
the Department through administrative rule. The term does not
include distilled spirits, wine, malt beverages, or tobacco,
as those terms are defined or used in the Liquor Control Act of
1934 and the Tobacco Products Tax Act of 1995.
(f-5) "Controlled substance analog" means a substance:
(1) the chemical structure of which is substantially
similar to the chemical structure of a controlled
substance in Schedule I or II;
(2) which has a stimulant, depressant, or
hallucinogenic effect on the central nervous system that
is substantially similar to or greater than the stimulant,
depressant, or hallucinogenic effect on the central
nervous system of a controlled substance in Schedule I or
II; or
(3) with respect to a particular person, which such
person represents or intends to have a stimulant,
depressant, or hallucinogenic effect on the central
nervous system that is substantially similar to or greater
than the stimulant, depressant, or hallucinogenic effect

HB4637 - 61 - LRB103 35424 SPS 65490 b
on the central nervous system of a controlled substance in
Schedule I or II.
(g) "Counterfeit substance" means a controlled substance,
which, or the container or labeling of which, without
authorization bears the trademark, trade name, or other
identifying mark, imprint, number or device, or any likeness
thereof, of a manufacturer, distributor, or dispenser other
than the person who in fact manufactured, distributed, or
dispensed the substance.
(h) "Deliver" or "delivery" means the actual, constructive
or attempted transfer of possession of a controlled substance,
with or without consideration, whether or not there is an
agency relationship. "Deliver" or "delivery" does not include
the donation of drugs to the extent permitted under the
Illinois Drug Reuse Opportunity Program Act.
(i) "Department" means the Illinois Department of Human
Services (as successor to the Department of Alcoholism and
Substance Abuse) or its successor agency.
(j) (Blank).
(k) "Department of Corrections" means the Department of
Corrections of the State of Illinois or its successor agency.
(l) "Department of Financial and Professional Regulation"
means the Department of Financial and Professional Regulation
of the State of Illinois or its successor agency.
(m) "Depressant" means any drug that (i) causes an overall
depression of central nervous system functions, (ii) causes

HB4637 - 62 - LRB103 35424 SPS 65490 b
impaired consciousness and awareness, and (iii) can be
habit-forming or lead to a substance abuse problem, including,
but not limited to, alcohol, cannabis and its active
principles and their analogs, benzodiazepines and their
analogs, barbiturates and their analogs, opioids (natural and
synthetic) and their analogs, and chloral hydrate and similar
sedative hypnotics.
(n) (Blank).
(o) "Director" means the Director of the Illinois State
Police or his or her designated agents.
(p) "Dispense" means to deliver a controlled substance to
an ultimate user or research subject by or pursuant to the
lawful order of a prescriber, including the prescribing,
administering, packaging, labeling, or compounding necessary
to prepare the substance for that delivery.
(q) "Dispenser" means a practitioner who dispenses.
(r) "Distribute" means to deliver, other than by
administering or dispensing, a controlled substance.
(s) "Distributor" means a person who distributes.
(t) "Drug" means (1) substances recognized as drugs in the
official United States Pharmacopoeia, Official Homeopathic
Pharmacopoeia of the United States, or official National
Formulary, or any supplement to any of them; (2) substances
intended for use in diagnosis, cure, mitigation, treatment, or
prevention of disease in man or animals; (3) substances (other
than food) intended to affect the structure of any function of

HB4637 - 63 - LRB103 35424 SPS 65490 b
the body of man or animals and (4) substances intended for use
as a component of any article specified in clause (1), (2), or
(3) of this subsection. It does not include devices or their
components, parts, or accessories.
(t-3) "Electronic health record" or "EHR" means an
electronic record of health-related information on an
individual that is created, gathered, managed, and consulted
by authorized health care clinicians and staff.
(t-3.5) "Electronic health record system" or "EHR system"
means any computer-based system or combination of federally
certified Health IT Modules (defined at 42 CFR 170.102 or its
successor) used as a repository for electronic health records
and accessed or updated by a prescriber or authorized
surrogate in the ordinary course of his or her medical
practice. For purposes of connecting to the Prescription
Information Library maintained by the Bureau of Pharmacy and
Clinical Support Systems or its successor, an EHR system may
connect to the Prescription Information Library directly or
through all or part of a computer program or system that is a
federally certified Health IT Module maintained by a third
party and used by the EHR system to secure access to the
database.
(t-4) "Emergency medical services personnel" has the
meaning ascribed to it in the Emergency Medical Services (EMS)
Systems Act.
(t-5) "Euthanasia agency" means an entity certified by the

HB4637 - 64 - LRB103 35424 SPS 65490 b
Department of Financial and Professional Regulation for the
purpose of animal euthanasia that holds an animal control
facility license or animal shelter license under the Animal
Welfare Act. A euthanasia agency is authorized to purchase,
store, possess, and utilize Schedule II nonnarcotic and
Schedule III nonnarcotic drugs for the sole purpose of animal
euthanasia.
(t-10) "Euthanasia drugs" means Schedule II or Schedule
III substances (nonnarcotic controlled substances) that are
used by a euthanasia agency for the purpose of animal
euthanasia.
(u) "Good faith" means the prescribing or dispensing of a
controlled substance by a practitioner in the regular course
of professional treatment to or for any person who is under his
or her treatment for a pathology or condition other than that
individual's physical or psychological dependence upon or
addiction to a controlled substance, except as provided
herein: and application of the term to a pharmacist shall mean
the dispensing of a controlled substance pursuant to the
prescriber's order which in the professional judgment of the
pharmacist is lawful. The pharmacist shall be guided by
accepted professional standards, including, but not limited
to, the following, in making the judgment:
(1) lack of consistency of prescriber-patient
relationship,
(2) frequency of prescriptions for same drug by one

HB4637 - 65 - LRB103 35424 SPS 65490 b
prescriber for large numbers of patients,
(3) quantities beyond those normally prescribed,
(4) unusual dosages (recognizing that there may be
clinical circumstances where more or less than the usual
dose may be used legitimately),
(5) unusual geographic distances between patient,
pharmacist and prescriber,
(6) consistent prescribing of habit-forming drugs.
(u-0.5) "Hallucinogen" means a drug that causes markedly
altered sensory perception leading to hallucinations of any
type.
(u-1) "Home infusion services" means services provided by
a pharmacy in compounding solutions for direct administration
to a patient in a private residence, long-term care facility,
or hospice setting by means of parenteral, intravenous,
intramuscular, subcutaneous, or intraspinal infusion.
(u-5) "Illinois State Police" means the Illinois State
Police or its successor agency.
(v) "Immediate precursor" means a substance:
(1) which the Department has found to be and by rule
designated as being a principal compound used, or produced
primarily for use, in the manufacture of a controlled
substance;
(2) which is an immediate chemical intermediary used
or likely to be used in the manufacture of such controlled
substance; and

HB4637 - 66 - LRB103 35424 SPS 65490 b
(3) the control of which is necessary to prevent,
curtail or limit the manufacture of such controlled
substance.
(w) "Instructional activities" means the acts of teaching,
educating or instructing by practitioners using controlled
substances within educational facilities approved by the State
Board of Education or its successor agency.
(x) "Local authorities" means a duly organized State,
County or Municipal peace unit or police force.
(y) "Look-alike substance" means a substance, other than a
controlled substance which (1) by overall dosage unit
appearance, including shape, color, size, markings or lack
thereof, taste, consistency, or any other identifying physical
characteristic of the substance, would lead a reasonable
person to believe that the substance is a controlled
substance, or (2) is expressly or impliedly represented to be
a controlled substance or is distributed under circumstances
which would lead a reasonable person to believe that the
substance is a controlled substance. For the purpose of
determining whether the representations made or the
circumstances of the distribution would lead a reasonable
person to believe the substance to be a controlled substance
under this clause (2) of subsection (y), the court or other
authority may consider the following factors in addition to
any other factor that may be relevant:
(a) statements made by the owner or person in control

HB4637 - 67 - LRB103 35424 SPS 65490 b
of the substance concerning its nature, use or effect;
(b) statements made to the buyer or recipient that the
substance may be resold for profit;
(c) whether the substance is packaged in a manner
normally used for the illegal distribution of controlled
substances;
(d) whether the distribution or attempted distribution
included an exchange of or demand for money or other
property as consideration, and whether the amount of the
consideration was substantially greater than the
reasonable retail market value of the substance.
Clause (1) of this subsection (y) shall not apply to a
noncontrolled substance in its finished dosage form that was
initially introduced into commerce prior to the initial
introduction into commerce of a controlled substance in its
finished dosage form which it may substantially resemble.
Nothing in this subsection (y) prohibits the dispensing or
distributing of noncontrolled substances by persons authorized
to dispense and distribute controlled substances under this
Act, provided that such action would be deemed to be carried
out in good faith under subsection (u) if the substances
involved were controlled substances.
Nothing in this subsection (y) or in this Act prohibits
the manufacture, preparation, propagation, compounding,
processing, packaging, advertising or distribution of a drug
or drugs by any person registered pursuant to Section 510 of

HB4637 - 68 - LRB103 35424 SPS 65490 b
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360).
(y-1) "Mail-order pharmacy" means a pharmacy that is
located in a state of the United States that delivers,
dispenses or distributes, through the United States Postal
Service or other common carrier, to Illinois residents, any
substance which requires a prescription.
(z) "Manufacture" means the production, preparation,
propagation, compounding, conversion or processing of a
controlled substance other than methamphetamine, either
directly or indirectly, by extraction from substances of
natural origin, or independently by means of chemical
synthesis, or by a combination of extraction and chemical
synthesis, and includes any packaging or repackaging of the
substance or labeling of its container, except that this term
does not include:
(1) by an ultimate user, the preparation or
compounding of a controlled substance for his or her own
use;
(2) by a practitioner, or his or her authorized agent
under his or her supervision, the preparation,
compounding, packaging, or labeling of a controlled
substance:
(a) as an incident to his or her administering or
dispensing of a controlled substance in the course of
his or her professional practice; or
(b) as an incident to lawful research, teaching or

HB4637 - 69 - LRB103 35424 SPS 65490 b
chemical analysis and not for sale; or
(3) the packaging, repackaging, or labeling of drugs
only to the extent permitted under the Illinois Drug Reuse
Opportunity Program Act.
(z-1) (Blank).
(z-5) "Medication shopping" means the conduct prohibited
under subsection (a) of Section 314.5 of this Act.
(z-10) "Mid-level practitioner" means (i) a physician
assistant who has been delegated authority to prescribe
through a written delegation of authority by a physician
licensed to practice medicine in all of its branches, in
accordance with Section 7.5 of the Physician Assistant
Practice Act of 1987, (ii) an advanced practice registered
nurse who has been delegated authority to prescribe through a
written delegation of authority by a physician licensed to
practice medicine in all of its branches or by a podiatric
physician, in accordance with Section 65-40 of the Nurse
Practice Act, (iii) an advanced practice registered nurse
certified as a nurse practitioner, nurse midwife, or clinical
nurse specialist who has been granted authority to prescribe
by a hospital affiliate in accordance with Section 65-45 of
the Nurse Practice Act, (iv) an animal euthanasia agency, or
(v) a prescribing psychologist.
(aa) "Narcotic drug" means any of the following, whether
produced directly or indirectly by extraction from substances
of vegetable origin, or independently by means of chemical

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synthesis, or by a combination of extraction and chemical
synthesis:
(1) opium, opiates, derivatives of opium and opiates,
including their isomers, esters, ethers, salts, and salts
of isomers, esters, and ethers, whenever the existence of
such isomers, esters, ethers, and salts is possible within
the specific chemical designation; however the term
"narcotic drug" does not include the isoquinoline
alkaloids of opium;
(2) (blank);
(3) opium poppy and poppy straw;
(4) coca leaves, except coca leaves and extracts of
coca leaves from which substantially all of the cocaine
and ecgonine, and their isomers, derivatives and salts,
have been removed;
(5) cocaine, its salts, optical and geometric isomers,
and salts of isomers;
(6) ecgonine, its derivatives, their salts, isomers,
and salts of isomers;
(7) any compound, mixture, or preparation which
contains any quantity of any of the substances referred to
in subparagraphs (1) through (6).
(bb) "Nurse" means a registered nurse licensed under the
Nurse Practice Act.
(cc) (Blank).
(dd) "Opiate" means any substance having an addiction

HB4637 - 71 - LRB103 35424 SPS 65490 b
forming or addiction sustaining liability similar to morphine
or being capable of conversion into a drug having addiction
forming or addiction sustaining liability.
(ee) "Opium poppy" means the plant of the species Papaver
somniferum L., except its seeds.
(ee-5) "Oral dosage" means a tablet, capsule, elixir, or
solution or other liquid form of medication intended for
administration by mouth, but the term does not include a form
of medication intended for buccal, sublingual, or transmucosal
administration.
(ff) "Parole and Pardon Board" means the Parole and Pardon
Board of the State of Illinois or its successor agency.
(gg) "Person" means any individual, corporation,
mail-order pharmacy, government or governmental subdivision or
agency, business trust, estate, trust, partnership or
association, or any other entity.
(hh) "Pharmacist" means any person who holds a license or
certificate of registration as a registered pharmacist, a
local registered pharmacist or a registered assistant
pharmacist under the Pharmacy Practice Act.
(ii) "Pharmacy" means any store, ship or other place in
which pharmacy is authorized to be practiced under the
Pharmacy Practice Act.
(ii-5) "Pharmacy shopping" means the conduct prohibited
under subsection (b) of Section 314.5 of this Act.
(ii-10) "Physician" (except when the context otherwise

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requires) means a person licensed to practice medicine in all
of its branches.
(jj) "Poppy straw" means all parts, except the seeds, of
the opium poppy, after mowing.
(kk) "Practitioner" means a physician licensed to practice
medicine in all its branches, dentist, optometrist, podiatric
physician, veterinarian, scientific investigator, pharmacist,
physician assistant, advanced practice registered nurse,
licensed practical nurse, registered nurse, emergency medical
services personnel, hospital, laboratory, or pharmacy, or
other person licensed, registered, or otherwise lawfully
permitted by the United States or this State to distribute,
dispense, conduct research with respect to, administer or use
in teaching or chemical analysis, a controlled substance in
the course of professional practice or research.
(ll) "Pre-printed prescription" means a written
prescription upon which the designated drug has been indicated
prior to the time of issuance; the term does not mean a written
prescription that is individually generated by machine or
computer in the prescriber's office.
(mm) "Prescriber" means a physician licensed to practice
medicine in all its branches, dentist, optometrist,
prescribing psychologist licensed under Section 4.2 of the
Clinical Psychologist Licensing Act with prescriptive
authority delegated under Section 4.3 of the Clinical
Psychologist Licensing Act, podiatric physician, or

HB4637 - 73 - LRB103 35424 SPS 65490 b
veterinarian who issues a prescription, a physician assistant
who issues a prescription for a controlled substance in
accordance with Section 303.05, a written delegation, and a
written collaborative agreement required under Section 7.5 of
the Physician Assistant Practice Act of 1987, an advanced
practice registered nurse with prescriptive authority
delegated under Section 65-40 of the Nurse Practice Act and in
accordance with Section 303.05, a written delegation, and a
written collaborative agreement under Section 65-35 of the
Nurse Practice Act, an advanced practice registered nurse
certified as a nurse practitioner, nurse midwife, or clinical
nurse specialist who has been granted authority to prescribe
by a hospital affiliate in accordance with Section 65-45 of
the Nurse Practice Act and in accordance with Section 303.05,
or an advanced practice registered nurse certified as a nurse
practitioner, nurse midwife, or clinical nurse specialist who
has full practice authority pursuant to Section 65-43 of the
Nurse Practice Act.
(nn) "Prescription" means a written, facsimile, or oral
order, or an electronic order that complies with applicable
federal requirements, of a physician licensed to practice
medicine in all its branches, dentist, podiatric physician or
veterinarian for any controlled substance, of an optometrist
in accordance with Section 15.1 of the Illinois Optometric
Practice Act of 1987, of a prescribing psychologist licensed
under Section 4.2 of the Clinical Psychologist Licensing Act

HB4637 - 74 - LRB103 35424 SPS 65490 b
with prescriptive authority delegated under Section 4.3 of the
Clinical Psychologist Licensing Act, of a physician assistant
for a controlled substance in accordance with Section 303.05,
a written delegation, and a written collaborative agreement
required under Section 7.5 of the Physician Assistant Practice
Act of 1987, of an advanced practice registered nurse with
prescriptive authority delegated under Section 65-40 of the
Nurse Practice Act who issues a prescription for a controlled
substance in accordance with Section 303.05, a written
delegation, and a written collaborative agreement under
Section 65-35 of the Nurse Practice Act, of an advanced
practice registered nurse certified as a nurse practitioner,
nurse midwife, or clinical nurse specialist who has been
granted authority to prescribe by a hospital affiliate in
accordance with Section 65-45 of the Nurse Practice Act and in
accordance with Section 303.05 when required by law, or of an
advanced practice registered nurse certified as a nurse
practitioner, nurse midwife, or clinical nurse specialist who
has full practice authority pursuant to Section 65-43 of the
Nurse Practice Act.
(nn-5) "Prescription Information Library" (PIL) means an
electronic library that contains reported controlled substance
data.
(nn-10) "Prescription Monitoring Program" (PMP) means the
entity that collects, tracks, and stores reported data on
controlled substances and select drugs pursuant to Section

HB4637 - 75 - LRB103 35424 SPS 65490 b
316.
(oo) "Production" or "produce" means manufacture,
planting, cultivating, growing, or harvesting of a controlled
substance other than methamphetamine.
(pp) "Registrant" means every person who is required to
register under Section 302 of this Act.
(qq) "Registry number" means the number assigned to each
person authorized to handle controlled substances under the
laws of the United States and of this State.
(qq-5) "Secretary" means, as the context requires, either
the Secretary of the Department or the Secretary of the
Department of Financial and Professional Regulation, and the
Secretary's designated agents.
(rr) "State" includes the State of Illinois and any state,
district, commonwealth, territory, insular possession thereof,
and any area subject to the legal authority of the United
States of America.
(rr-5) "Stimulant" means any drug that (i) causes an
overall excitation of central nervous system functions, (ii)
causes impaired consciousness and awareness, and (iii) can be
habit-forming or lead to a substance abuse problem, including,
but not limited to, amphetamines and their analogs,
methylphenidate and its analogs, cocaine, and phencyclidine
and its analogs.
(rr-10) "Synthetic drug" includes, but is not limited to,
any synthetic cannabinoids or piperazines or any synthetic

HB4637 - 76 - LRB103 35424 SPS 65490 b
cathinones as provided for in Schedule I.
(ss) "Ultimate user" means a person who lawfully possesses
a controlled substance for his or her own use or for the use of
a member of his or her household or for administering to an
animal owned by him or her or by a member of his or her
household.
(Source: P.A. 101-666, eff. 1-1-22; 102-389, eff. 1-1-22;
102-538, eff. 8-20-21; 102-813, eff. 5-13-22.)
(720 ILCS 570/303.05)
Sec. 303.05. Mid-level practitioner registration.
(a) The Department of Financial and Professional
Regulation shall register licensed physician assistants,
licensed advanced practice registered nurses, and prescribing
psychologists licensed under Section 4.2 of the Clinical
Psychologist Licensing Act to prescribe and dispense
controlled substances under Section 303 and euthanasia
agencies to purchase, store, or administer animal euthanasia
drugs under the following circumstances:
(1) with respect to physician assistants,
(A) the physician assistant has been delegated
written authority to prescribe any Schedule III
through V controlled substances by a physician
licensed to practice medicine in all its branches in
accordance with Section 7.5 of the Physician Assistant
Practice Act of 1987; and the physician assistant has

HB4637 - 77 - LRB103 35424 SPS 65490 b
completed the appropriate application forms and has
paid the required fees as set by rule; or
(B) the physician assistant has been delegated
authority by a collaborating physician licensed to
practice medicine in all its branches to prescribe or
dispense Schedule II controlled substances through a
written delegation of authority and under the
following conditions:
(i) Specific Schedule II controlled substances
by oral dosage or topical or transdermal
application may be delegated, provided that the
delegated Schedule II controlled substances are
routinely prescribed by the collaborating
physician. This delegation must identify the
specific Schedule II controlled substances by
either brand name or generic name. Schedule II
controlled substances to be delivered by injection
or other route of administration may not be
delegated;
(ii) any delegation must be of controlled
substances prescribed by the collaborating
physician;
(iii) all prescriptions must be limited to no
more than a 30-day supply, with any continuation
authorized only after prior approval of the
collaborating physician;

HB4637 - 78 - LRB103 35424 SPS 65490 b
(iv) the physician assistant must discuss the
condition of any patients for whom a controlled
substance is prescribed monthly with the
delegating physician;
(A) (v) the physician assistant must have
completed the appropriate application forms and paid
the required fees as set by rule;
(B) (vi) the physician assistant must provide
evidence of satisfactory completion of 45 contact
hours in pharmacology from any physician assistant
program accredited by the Accreditation Review
Commission on Education for the Physician Assistant
(ARC-PA), or its predecessor agency, for any new
license issued with Schedule II authority after the
effective date of this amendatory Act of the 97th
General Assembly; and
(C) (vii) the physician assistant must annually
complete at least 5 hours of continuing education in
pharmacology;
(2) with respect to advanced practice registered
nurses who do not meet the requirements of Section 65-43
of the Nurse Practice Act,
(A) the advanced practice registered nurse has
been delegated authority to prescribe any Schedule III
through V controlled substances by a collaborating
physician licensed to practice medicine in all its

HB4637 - 79 - LRB103 35424 SPS 65490 b
branches or a collaborating podiatric physician in
accordance with Section 65-40 of the Nurse Practice
Act. The advanced practice registered nurse has
completed the appropriate application forms and has
paid the required fees as set by rule; or
(B) the advanced practice registered nurse has
been delegated authority by a collaborating physician
licensed to practice medicine in all its branches to
prescribe or dispense Schedule II controlled
substances through a written delegation of authority
and under the following conditions:
(i) specific Schedule II controlled substances
by oral dosage or topical or transdermal
application may be delegated, provided that the
delegated Schedule II controlled substances are
routinely prescribed by the collaborating
physician. This delegation must identify the
specific Schedule II controlled substances by
either brand name or generic name. Schedule II
controlled substances to be delivered by injection
or other route of administration may not be
delegated;
(ii) any delegation must be of controlled
substances prescribed by the collaborating
physician;
(iii) all prescriptions must be limited to no

HB4637 - 80 - LRB103 35424 SPS 65490 b
more than a 30-day supply, with any continuation
authorized only after prior approval of the
collaborating physician;
(iv) the advanced practice registered nurse
must discuss the condition of any patients for
whom a controlled substance is prescribed monthly
with the delegating physician or in the course of
review as required by Section 65-40 of the Nurse
Practice Act;
(v) the advanced practice registered nurse
must have completed the appropriate application
forms and paid the required fees as set by rule;
(vi) the advanced practice registered nurse
must provide evidence of satisfactory completion
of at least 45 graduate contact hours in
pharmacology for any new license issued with
Schedule II authority after the effective date of
this amendatory Act of the 97th General Assembly;
and
(vii) the advanced practice registered nurse
must annually complete 5 hours of continuing
education in pharmacology;
(2.5) with respect to advanced practice registered
nurses certified as nurse practitioners, nurse midwives,
or clinical nurse specialists who do not meet the
requirements of Section 65-43 of the Nurse Practice Act

HB4637 - 81 - LRB103 35424 SPS 65490 b
practicing in a hospital affiliate,
(A) the advanced practice registered nurse
certified as a nurse practitioner, nurse midwife, or
clinical nurse specialist has been privileged to
prescribe any Schedule II through V controlled
substances by the hospital affiliate upon the
recommendation of the appropriate physician committee
of the hospital affiliate in accordance with Section
65-45 of the Nurse Practice Act, has completed the
appropriate application forms, and has paid the
required fees as set by rule; and
(B) an advanced practice registered nurse
certified as a nurse practitioner, nurse midwife, or
clinical nurse specialist has been privileged to
prescribe any Schedule II controlled substances by the
hospital affiliate upon the recommendation of the
appropriate physician committee of the hospital
affiliate, then the following conditions must be met:
(i) specific Schedule II controlled substances
by oral dosage or topical or transdermal
application may be designated, provided that the
designated Schedule II controlled substances are
routinely prescribed by advanced practice
registered nurses in their area of certification;
the privileging documents must identify the
specific Schedule II controlled substances by

HB4637 - 82 - LRB103 35424 SPS 65490 b
either brand name or generic name; privileges to
prescribe or dispense Schedule II controlled
substances to be delivered by injection or other
route of administration may not be granted;
(ii) any privileges must be controlled
substances limited to the practice of the advanced
practice registered nurse;
(iii) any prescription must be limited to no
more than a 30-day supply;
(iv) the advanced practice registered nurse
must discuss the condition of any patients for
whom a controlled substance is prescribed monthly
with the appropriate physician committee of the
hospital affiliate or its physician designee; and
(v) the advanced practice registered nurse
must meet the education requirements of this
Section;
(3) with respect to animal euthanasia agencies, the
euthanasia agency has obtained a license from the
Department of Financial and Professional Regulation and
obtained a registration number from the Department; or
(4) with respect to prescribing psychologists, the
prescribing psychologist has been delegated authority to
prescribe any nonnarcotic Schedule III through V
controlled substances by a collaborating physician
licensed to practice medicine in all its branches in

HB4637 - 83 - LRB103 35424 SPS 65490 b
accordance with Section 4.3 of the Clinical Psychologist
Licensing Act, and the prescribing psychologist has
completed the appropriate application forms and has paid
the required fees as set by rule.
(b) The mid-level practitioner shall only be licensed to
prescribe those schedules of controlled substances for which a
licensed physician has delegated prescriptive authority,
except that an animal euthanasia agency does not have any
prescriptive authority and a physician assistant shall have
prescriptive authority in accordance with the Physician
Assistant Practice Act of 1987 without delegation by a
physician. An A physician assistant and an advanced practice
registered nurse is are prohibited from prescribing
medications and controlled substances not set forth in the
required written delegation of authority or as authorized by
their practice Act.
(c) Upon completion of all registration requirements,
physician assistants, advanced practice registered nurses, and
animal euthanasia agencies may be issued a mid-level
practitioner controlled substances license for Illinois.
(d) A collaborating physician may, but is not required to,
delegate prescriptive authority to an advanced practice
registered nurse as part of a written collaborative agreement,
and the delegation of prescriptive authority shall conform to
the requirements of Section 65-40 of the Nurse Practice Act.
(e) (Blank). A collaborating physician may, but is not

HB4637 - 84 - LRB103 35424 SPS 65490 b
required to, delegate prescriptive authority to a physician
assistant as part of a written collaborative agreement, and
the delegation of prescriptive authority shall conform to the
requirements of Section 7.5 of the Physician Assistant
Practice Act of 1987.
(f) Nothing in this Section shall be construed to prohibit
generic substitution.
(Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
100-513, eff. 1-1-18; 100-863, eff. 8-14-18.)