Bill Text: IL HB4643 | 2017-2018 | 100th General Assembly | Enrolled


Bill Title: Amends the Illinois Physical Therapy Act. Provides that the limitation on determining a differential diagnosis shall not in any manner limit a physical therapist from establishing a relevant diagnosis. In the definition of "documented current and relevant diagnosis" and in provisions concerning disciplinary actions, removes language requiring a diagnosis to be substantiated by a physician, dentist, advanced practice registered nurse, physician assistant, or podiatric physician. Effective immediately.

Spectrum: Slight Partisan Bill (Democrat 23-15)

Status: (Enrolled) 2018-06-21 - Sent to the Governor [HB4643 Detail]

Download: Illinois-2017-HB4643-Enrolled.html



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1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The Illinois Physical Therapy Act is amended by
5changing Sections 1 and 17 and by adding Section 1.2 as
6follows:
7 (225 ILCS 90/1) (from Ch. 111, par. 4251)
8 (Section scheduled to be repealed on January 1, 2026)
9 Sec. 1. Definitions. As used in this Act:
10 (1) "Physical therapy" means all of the following:
11 (A) Examining, evaluating, and testing individuals who
12 may have mechanical, physiological, or developmental
13 impairments, functional limitations, disabilities, or
14 other health and movement-related conditions, classifying
15 these disorders, determining a rehabilitation prognosis
16 and plan of therapeutic intervention, and assessing the
17 ongoing on-going effects of the interventions.
18 (B) Alleviating impairments, functional limitations,
19 or disabilities by designing, implementing, and modifying
20 therapeutic interventions that may include, but are not
21 limited to, the evaluation or treatment of a person through
22 the use of the effective properties of physical measures
23 and heat, cold, light, water, radiant energy, electricity,

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1 sound, and air and use of therapeutic massage, therapeutic
2 exercise, mobilization, and rehabilitative procedures,
3 with or without assistive devices, for the purposes of
4 preventing, correcting, or alleviating a physical or
5 mental impairment, functional limitation, or disability.
6 (C) Reducing the risk of injury, impairment,
7 functional limitation, or disability, including the
8 promotion and maintenance of fitness, health, and
9 wellness.
10 (D) Engaging in administration, consultation,
11 education, and research.
12 "Physical therapy" includes, but is not limited to: (a)
13performance of specialized tests and measurements, (b)
14administration of specialized treatment procedures, (c)
15interpretation of referrals from physicians, dentists,
16advanced practice registered nurses, physician assistants, and
17podiatric physicians, (d) establishment, and modification of
18physical therapy treatment programs, (e) administration of
19topical medication used in generally accepted physical therapy
20procedures when such medication is either prescribed by the
21patient's physician, licensed to practice medicine in all its
22branches, the patient's physician licensed to practice
23podiatric medicine, the patient's advanced practice registered
24nurse, the patient's physician assistant, or the patient's
25dentist or used following the physician's orders or written
26instructions, (f) supervision or teaching of physical therapy,

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1and (g) dry needling in accordance with Section 1.5. "Physical
2therapy" does not include radiology, electrosurgery,
3chiropractic technique or determination of a differential
4diagnosis; provided, however, the limitation on determining a
5differential diagnosis shall not in any manner limit a physical
6therapist licensed under this Act from performing an evaluation
7and establishing a physical therapy treatment plan pursuant to
8such license. Nothing in this Section shall limit a physical
9therapist from employing appropriate physical therapy
10techniques that he or she is educated and licensed to perform.
11A physical therapist shall refer to a licensed physician,
12advanced practice registered nurse, physician assistant,
13dentist, podiatric physician, other physical therapist, or
14other health care provider any patient whose medical condition
15should, at the time of evaluation or treatment, be determined
16to be beyond the scope of practice of the physical therapist.
17 (2) "Physical therapist" means a person who practices
18physical therapy and who has met all requirements as provided
19in this Act.
20 (3) "Department" means the Department of Professional
21Regulation.
22 (4) "Director" means the Director of Professional
23Regulation.
24 (5) "Board" means the Physical Therapy Licensing and
25Disciplinary Board approved by the Director.
26 (6) "Referral" means a written or oral authorization for

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1physical therapy services for a patient by a physician,
2dentist, advanced practice registered nurse, physician
3assistant, or podiatric physician who maintains medical
4supervision of the patient and makes a diagnosis or verifies
5that the patient's condition is such that it may be treated by
6a physical therapist.
7 (7) (Blank). "Documented current and relevant diagnosis"
8for the purpose of this Act means a diagnosis, substantiated by
9signature or oral verification of a physician, dentist,
10advanced practice registered nurse, physician assistant, or
11podiatric physician, that a patient's condition is such that it
12may be treated by physical therapy as defined in this Act,
13which diagnosis shall remain in effect until changed by the
14physician, dentist, advanced practice registered nurse,
15physician assistant, or podiatric physician.
16 (8) "State" includes:
17 (a) the states of the United States of America;
18 (b) the District of Columbia; and
19 (c) the Commonwealth of Puerto Rico.
20 (9) "Physical therapist assistant" means a person licensed
21to assist a physical therapist and who has met all requirements
22as provided in this Act and who works under the supervision of
23a licensed physical therapist to assist in implementing the
24physical therapy treatment program as established by the
25licensed physical therapist. The patient care activities
26provided by the physical therapist assistant shall not include

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1the interpretation of referrals, evaluation procedures, or the
2planning or major modification of patient programs.
3 (10) "Physical therapy aide" means a person who has
4received on the job training, specific to the facility in which
5he is employed.
6 (11) "Advanced practice registered nurse" means a person
7licensed as an advanced practice registered nurse under the
8Nurse Practice Act.
9 (12) "Physician assistant" means a person licensed under
10the Physician Assistant Practice Act of 1987.
11 (13) "Health care professional" means a physician,
12dentist, podiatric physician, advanced practice registered
13nurse, or physician assistant.
14(Source: P.A. 99-173, eff. 7-29-15; 99-229, eff. 8-3-15;
1599-642, eff. 7-28-16; 100-201, eff. 8-18-17; 100-418, eff.
168-25-17; 100-513, eff. 1-1-18; revised 9-29-17.)
17 (225 ILCS 90/1.2 new)
18 Sec. 1.2. Physical therapy services.
19 (a) A physical therapist may provide physical therapy
20services to a patient with or without a referral from a health
21care professional.
22 (b) A physical therapist providing services without a
23referral from a health care professional must notify the
24patient's treating health care professional within 5 business
25days after the patient's first visit that the patient is

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1receiving physical therapy. This does not apply to physical
2therapy services related to fitness or wellness, unless the
3patient presents with an ailment or injury.
4 (c) A physical therapist shall refer a patient to the
5patient's treating health care professional of record or, in
6the case where there is no health care professional of record,
7to a health care professional of the patient's choice, if:
8 (1) the patient does not demonstrate measurable or
9 functional improvement after 10 visits or 15 business days,
10 whichever occurs first, and continued improvement
11 thereafter;
12 (2) the patient returns for services for the same or
13 similar condition after 30 calendar days of being
14 discharged by the physical therapist; or
15 (3) the patient's condition, at the time of evaluation
16 or services, is determined to be beyond the scope of
17 practice of the physical therapist.
18 (d) Wound debridement services may only be provided by a
19physical therapist with written authorization from a health
20care professional.
21 (e) A physical therapist shall promptly consult and
22collaborate with the appropriate health care professional
23anytime a patient's condition indicates that it may be related
24to temporomandibular disorder so that a diagnosis can be made
25by that health care professional for an appropriate treatment
26plan.

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1 (225 ILCS 90/17) (from Ch. 111, par. 4267)
2 (Section scheduled to be repealed on January 1, 2026)
3 Sec. 17. (1) The Department may refuse to issue or to
4renew, or may revoke, suspend, place on probation, reprimand,
5or take other disciplinary action as the Department deems
6appropriate, including the issuance of fines not to exceed
7$5000, with regard to a license for any one or a combination of
8the following:
9 A. Material misstatement in furnishing information to
10 the Department or otherwise making misleading, deceptive,
11 untrue, or fraudulent representations in violation of this
12 Act or otherwise in the practice of the profession;
13 B. Violations of this Act, or of the rules or
14 regulations promulgated hereunder;
15 C. Conviction of any crime under the laws of the United
16 States or any state or territory thereof which is a felony
17 or which is a misdemeanor, an essential element of which is
18 dishonesty, or of any crime which is directly related to
19 the practice of the profession; conviction, as used in this
20 paragraph, shall include a finding or verdict of guilty, an
21 admission of guilt or a plea of nolo contendere;
22 D. Making any misrepresentation for the purpose of
23 obtaining licenses, or violating any provision of this Act
24 or the rules promulgated thereunder pertaining to
25 advertising;

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1 E. A pattern of practice or other behavior which
2 demonstrates incapacity or incompetency to practice under
3 this Act;
4 F. Aiding or assisting another person in violating any
5 provision of this Act or Rules;
6 G. Failing, within 60 days, to provide information in
7 response to a written request made by the Department;
8 H. Engaging in dishonorable, unethical or
9 unprofessional conduct of a character likely to deceive,
10 defraud or harm the public. Unprofessional conduct shall
11 include any departure from or the failure to conform to the
12 minimal standards of acceptable and prevailing physical
13 therapy practice, in which proceeding actual injury to a
14 patient need not be established;
15 I. Unlawful distribution of any drug or narcotic, or
16 unlawful conversion of any drug or narcotic not belonging
17 to the person for such person's own use or benefit or for
18 other than medically accepted therapeutic purposes;
19 J. Habitual or excessive use or addiction to alcohol,
20 narcotics, stimulants, or any other chemical agent or drug
21 which results in a physical therapist's or physical
22 therapist assistant's inability to practice with
23 reasonable judgment, skill or safety;
24 K. Revocation or suspension of a license to practice
25 physical therapy as a physical therapist or physical
26 therapist assistant or the taking of other disciplinary

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1 action by the proper licensing authority of another state,
2 territory or country;
3 L. Directly or indirectly giving to or receiving from
4 any person, firm, corporation, partnership, or association
5 any fee, commission, rebate or other form of compensation
6 for any professional services not actually or personally
7 rendered. Nothing contained in this paragraph prohibits
8 persons holding valid and current licenses under this Act
9 from practicing physical therapy in partnership under a
10 partnership agreement, including a limited liability
11 partnership, a limited liability company, or a corporation
12 under the Professional Service Corporation Act or from
13 pooling, sharing, dividing, or apportioning the fees and
14 monies received by them or by the partnership, company, or
15 corporation in accordance with the partnership agreement
16 or the policies of the company or professional corporation.
17 Nothing in this paragraph (L) affects any bona fide
18 independent contractor or employment arrangements among
19 health care professionals, health facilities, health care
20 providers, or other entities, except as otherwise
21 prohibited by law. Any employment arrangements may include
22 provisions for compensation, health insurance, pension, or
23 other employment benefits for the provision of services
24 within the scope of the licensee's practice under this Act.
25 Nothing in this paragraph (L) shall be construed to require
26 an employment arrangement to receive professional fees for

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1 services rendered;
2 M. A finding by the Board that the licensee after
3 having his or her license placed on probationary status has
4 violated the terms of probation;
5 N. Abandonment of a patient;
6 O. Willfully failing to report an instance of suspected
7 child abuse or neglect as required by the Abused and
8 Neglected Child Reporting Act;
9 P. Willfully failing to report an instance of suspected
10 elder abuse or neglect as required by the Elder Abuse
11 Reporting Act;
12 Q. Physical illness, including but not limited to,
13 deterioration through the aging process, or loss of motor
14 skill which results in the inability to practice the
15 profession with reasonable judgement, skill or safety;
16 R. The use of any words (such as physical therapy,
17 physical therapist physiotherapy or physiotherapist),
18 abbreviations, figures or letters with the intention of
19 indicating practice as a licensed physical therapist
20 without a valid license as a physical therapist issued
21 under this Act;
22 S. The use of the term physical therapist assistant, or
23 abbreviations, figures, or letters with the intention of
24 indicating practice as a physical therapist assistant
25 without a valid license as a physical therapist assistant
26 issued under this Act;

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1 T. Willfully violating or knowingly assisting in the
2 violation of any law of this State relating to the practice
3 of abortion;
4 U. Continued practice by a person knowingly having an
5 infectious, communicable or contagious disease;
6 V. Having treated ailments of human beings otherwise
7 than by the practice of physical therapy as defined in this
8 Act, or having treated ailments of human beings as a
9 licensed physical therapist in violation of Section 1.2
10 independent of a documented referral or a documented
11 current and relevant diagnosis from a physician, dentist,
12 advanced practice registered nurse, physician assistant,
13 or podiatric physician, or having failed to notify the
14 physician, dentist, advanced practice registered nurse,
15 physician assistant, or podiatric physician who
16 established a documented current and relevant diagnosis
17 that the patient is receiving physical therapy pursuant to
18 that diagnosis;
19 W. Being named as a perpetrator in an indicated report
20 by the Department of Children and Family Services pursuant
21 to the Abused and Neglected Child Reporting Act, and upon
22 proof by clear and convincing evidence that the licensee
23 has caused a child to be an abused child or neglected child
24 as defined in the Abused and Neglected Child Reporting Act;
25 X. Interpretation of referrals, performance of
26 evaluation procedures, planning or making major

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1 modifications of patient programs by a physical therapist
2 assistant;
3 Y. Failure by a physical therapist assistant and
4 supervising physical therapist to maintain continued
5 contact, including periodic personal supervision and
6 instruction, to insure safety and welfare of patients;
7 Z. Violation of the Health Care Worker Self-Referral
8 Act.
9 (2) The determination by a circuit court that a licensee is
10subject to involuntary admission or judicial admission as
11provided in the Mental Health and Developmental Disabilities
12Code operates as an automatic suspension. Such suspension will
13end only upon a finding by a court that the patient is no
14longer subject to involuntary admission or judicial admission
15and the issuance of an order so finding and discharging the
16patient; and upon the recommendation of the Board to the
17Director that the licensee be allowed to resume his practice.
18 (3) The Department may refuse to issue or may suspend the
19license of any person who fails to file a return, or to pay the
20tax, penalty or interest shown in a filed return, or to pay any
21final assessment of tax, penalty or interest, as required by
22any tax Act administered by the Illinois Department of Revenue,
23until such time as the requirements of any such tax Act are
24satisfied.
25(Source: P.A. 100-513, eff. 1-1-18.)
26 Section 99. Effective date. This Act takes effect upon

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1becoming law.
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