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

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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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: (Passed) 2018-08-16 - Public Act . . . . . . . . . 100-0897 [HB4643 Detail]

Download: Illinois-2017-HB4643-Engrossed.html

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(Section scheduled to be repealed on January 1, 2026)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

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

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

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

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

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receiving physical therapy. This does not apply to physical
therapy services related to fitness or wellness, unless the
patient presents with an ailment or injury.
(c) A physical therapist shall refer a patient to the
patient's treating health care professional of record or, in
the case where there is no health care professional of record,
to a health care professional of the patient's choice, if:
(1) the patient does not demonstrate measurable or
functional improvement after 10 visits or 15 business days,
whichever occurs first;
(2) the patient returns for services for the same or
similar condition after 30 calendar days of being
discharged by the physical therapist; or
(3) the patient's condition, at the time of evaluation
or services, is determined to be beyond the scope of
practice of the physical therapist.
(d) Wound debridement services may only be provided by a
physical therapist with written authorization from a health
care professional.
(e) A physical therapist will consult and collaborate with
the appropriate health care professionals on conditions
related to temporomandibular disorder.
(225 ILCS 90/17) (from Ch. 111, par. 4267)
(Section scheduled to be repealed on January 1, 2026)
Sec. 17. (1) The Department may refuse to issue or to

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renew, or may revoke, suspend, place on probation, reprimand,
or take other disciplinary action as the Department deems
appropriate, including the issuance of fines not to exceed
$5000, with regard to a license for any one or a combination of
the following:
A. Material misstatement in furnishing information to
the Department or otherwise making misleading, deceptive,
untrue, or fraudulent representations in violation of this
Act or otherwise in the practice of the profession;
B. Violations of this Act, or of the rules or
regulations promulgated hereunder;
C. Conviction of any crime under the laws of the United
States or any state or territory thereof which is a felony
or which is a misdemeanor, an essential element of which is
dishonesty, or of any crime which is directly related to
the practice of the profession; conviction, as used in this
paragraph, shall include a finding or verdict of guilty, an
admission of guilt or a plea of nolo contendere;
D. Making any misrepresentation for the purpose of
obtaining licenses, or violating any provision of this Act
or the rules promulgated thereunder pertaining to
advertising;
E. A pattern of practice or other behavior which
demonstrates incapacity or incompetency to practice under
this Act;
F. Aiding or assisting another person in violating any

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provision of this Act or Rules;
G. Failing, within 60 days, to provide information in
response to a written request made by the Department;
H. Engaging in dishonorable, unethical or
unprofessional conduct of a character likely to deceive,
defraud or harm the public. Unprofessional conduct shall
include any departure from or the failure to conform to the
minimal standards of acceptable and prevailing physical
therapy practice, in which proceeding actual injury to a
patient need not be established;
I. Unlawful distribution of any drug or narcotic, or
unlawful conversion of any drug or narcotic not belonging
to the person for such person's own use or benefit or for
other than medically accepted therapeutic purposes;
J. Habitual or excessive use or addiction to alcohol,
narcotics, stimulants, or any other chemical agent or drug
which results in a physical therapist's or physical
therapist assistant's inability to practice with
reasonable judgment, skill or safety;
K. Revocation or suspension of a license to practice
physical therapy as a physical therapist or physical
therapist assistant or the taking of other disciplinary
action by the proper licensing authority of another state,
territory or country;
L. Directly or indirectly giving to or receiving from
any person, firm, corporation, partnership, or association

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any fee, commission, rebate or other form of compensation
for any professional services not actually or personally
rendered. Nothing contained in this paragraph prohibits
persons holding valid and current licenses under this Act
from practicing physical therapy in partnership under a
partnership agreement, including a limited liability
partnership, a limited liability company, or a corporation
under the Professional Service Corporation Act or from
pooling, sharing, dividing, or apportioning the fees and
monies received by them or by the partnership, company, or
corporation in accordance with the partnership agreement
or the policies of the company or professional corporation.
Nothing in this paragraph (L) affects any bona fide
independent contractor or employment arrangements among
health care professionals, health facilities, health care
providers, or other entities, except as otherwise
prohibited by law. Any employment arrangements may include
provisions for compensation, health insurance, pension, or
other employment benefits for the provision of services
within the scope of the licensee's practice under this Act.
Nothing in this paragraph (L) shall be construed to require
an employment arrangement to receive professional fees for
services rendered;
M. A finding by the Board that the licensee after
having his or her license placed on probationary status has
violated the terms of probation;

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N. Abandonment of a patient;
O. Willfully failing to report an instance of suspected
child abuse or neglect as required by the Abused and
Neglected Child Reporting Act;
P. Willfully failing to report an instance of suspected
elder abuse or neglect as required by the Elder Abuse
Reporting Act;
Q. Physical illness, including but not limited to,
deterioration through the aging process, or loss of motor
skill which results in the inability to practice the
profession with reasonable judgement, skill or safety;
R. The use of any words (such as physical therapy,
physical therapist physiotherapy or physiotherapist),
abbreviations, figures or letters with the intention of
indicating practice as a licensed physical therapist
without a valid license as a physical therapist issued
under this Act;
S. The use of the term physical therapist assistant, or
abbreviations, figures, or letters with the intention of
indicating practice as a physical therapist assistant
without a valid license as a physical therapist assistant
issued under this Act;
T. Willfully violating or knowingly assisting in the
violation of any law of this State relating to the practice
of abortion;
U. Continued practice by a person knowingly having an

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infectious, communicable or contagious disease;
V. Having treated ailments of human beings otherwise
than by the practice of physical therapy as defined in this
Act, or having treated ailments of human beings as a
licensed physical therapist in violation of Section 1.2
independent of a documented referral or a documented
current and relevant diagnosis from a physician, dentist,
advanced practice registered nurse, physician assistant,
or podiatric physician, or having failed to notify the
physician, dentist, advanced practice registered nurse,
physician assistant, or podiatric physician who
established a documented current and relevant diagnosis
that the patient is receiving physical therapy pursuant to
that diagnosis;
W. Being named as a perpetrator in an indicated report
by the Department of Children and Family Services pursuant
to 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;
X. Interpretation of referrals, performance of
evaluation procedures, planning or making major
modifications of patient programs by a physical therapist
assistant;
Y. Failure by a physical therapist assistant and
supervising physical therapist to maintain continued

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contact, including periodic personal supervision and
instruction, to insure safety and welfare of patients;
Z. Violation of the Health Care Worker Self-Referral
Act.
(2) 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. Such suspension will
end only upon a finding by a court that the patient is no
longer subject to involuntary admission or judicial admission
and the issuance of an order so finding and discharging the
patient; and upon the recommendation of the Board to the
Director that the licensee be allowed to resume his practice.
(3) The Department may refuse to issue 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 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.
(Source: P.A. 100-513, eff. 1-1-18.)
Section 99. Effective date. This Act takes effect upon
becoming law.