Bill Text: IL HB4815 | 2017-2018 | 100th General Assembly | Introduced

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Bill Title: Amends the Medical Practice Act of 1987 and the Physician Assistant Practice Act of 1987. Removes language providing that a collaborating physician may collaborate with a maximum of 5 full-time equivalent physician assistants.

Sponsorship: Moderate Partisan Bill (Democrat 7-2)

Status: (Failed) 2019-01-08 - Session Sine Die [HB4815 Detail]

Download: Illinois-2017-HB4815-Introduced.html

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100TH GENERAL ASSEMBLY State of Illinois 2017 and 2018 HB4815 Introduced , by Rep. Sara Feigenholtz SYNOPSIS AS INTRODUCED:
225 ILCS 60/54.5
225 ILCS 95/7 from Ch. 111, par. 4607
Amends the Physician Assistant Practice Act of 1987. Removes language providing that a collaborating physician may collaborate with a maximum of 5 full-time equivalent physician assistants. Amends the Medical Practice Act of 1987, removes language providing that a physician licensed to practice medicine in all its branches may enter into collaborative agreements with no more than 5 full-time equivalent physician assistants except in a hospital, hospital affiliate, or ambulatory surgical treatment center.
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A BILL FOR
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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 Medical Practice Act of 1987 is amended by
changing Section 54.5 as follows:
(225 ILCS 60/54.5)
(Section scheduled to be repealed on December 31, 2019)
Sec. 54.5. Physician delegation of authority to physician
assistants, advanced practice registered nurses without full
practice authority, and prescribing psychologists.
(a) Physicians licensed to practice medicine in all its
branches may delegate care and treatment responsibilities to a
physician assistant under guidelines in accordance with the
requirements of the Physician Assistant Practice Act of 1987. A
physician licensed to practice medicine in all its branches may
enter into collaborative agreements with no more than 5
full-time equivalent physician assistants, except in a
hospital, hospital affiliate, or ambulatory surgical treatment
center as set forth by Section 7.7 of the Physician Assistant
Practice Act of 1987.
(b) A physician licensed to practice medicine in all its
branches in active clinical practice may collaborate with an
advanced practice registered nurse in accordance with the

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requirements of the Nurse Practice Act. Collaboration is for
the purpose of providing medical consultation, and no
employment relationship is required. A written collaborative
agreement shall conform to the requirements of Section 65-35 of
the Nurse Practice Act. The written collaborative agreement
shall be for services in the same area of practice or specialty
as the collaborating physician in his or her clinical medical
practice. A written collaborative agreement shall be adequate
with respect to collaboration with advanced practice
registered nurses if all of the following apply:
(1) The agreement is written to promote the exercise of
professional judgment by the advanced practice registered
nurse commensurate with his or her education and
experience.
(2) The advanced practice registered nurse provides
services based upon a written collaborative agreement with
the collaborating physician, except as set forth in
subsection (b-5) of this Section. With respect to labor and
delivery, the collaborating physician must provide
delivery services in order to participate with a certified
nurse midwife.
(3) Methods of communication are available with the
collaborating physician in person or through
telecommunications for consultation, collaboration, and
referral as needed to address patient care needs.
(b-5) An anesthesiologist or physician licensed to

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practice medicine in all its branches may collaborate with a
certified registered nurse anesthetist in accordance with
Section 65-35 of the Nurse Practice Act for the provision of
anesthesia services. With respect to the provision of
anesthesia services, the collaborating anesthesiologist or
physician shall have training and experience in the delivery of
anesthesia services consistent with Department rules.
Collaboration shall be adequate if:
(1) an anesthesiologist or a physician participates in
the joint formulation and joint approval of orders or
guidelines and periodically reviews such orders and the
services provided patients under such orders; and
(2) for anesthesia services, the anesthesiologist or
physician participates through discussion of and agreement
with the anesthesia plan and is physically present and
available on the premises during the delivery of anesthesia
services for diagnosis, consultation, and treatment of
emergency medical conditions. Anesthesia services in a
hospital shall be conducted in accordance with Section 10.7
of the Hospital Licensing Act and in an ambulatory surgical
treatment center in accordance with Section 6.5 of the
Ambulatory Surgical Treatment Center Act.
(b-10) The anesthesiologist or operating physician must
agree with the anesthesia plan prior to the delivery of
services.
(c) The collaborating physician shall have access to the

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medical records of all patients attended by a physician
assistant. The collaborating physician shall have access to the
medical records of all patients attended to by an advanced
practice registered nurse.
(d) (Blank).
(e) A physician shall not be liable for the acts or
omissions of a prescribing psychologist, physician assistant,
or advanced practice registered nurse solely on the basis of
having signed a supervision agreement or guidelines or a
collaborative agreement, an order, a standing medical order, a
standing delegation order, or other order or guideline
authorizing a prescribing psychologist, physician assistant,
or advanced practice registered nurse to perform acts, unless
the physician has reason to believe the prescribing
psychologist, physician assistant, or advanced practice
registered nurse lacked the competency to perform the act or
acts or commits willful and wanton misconduct.
(f) 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.
(g) A collaborating physician may, but is not 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

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Section 7.5 of the Physician Assistant Practice Act of 1987.
(h) (Blank).
(i) A collaborating physician shall delegate prescriptive
authority to a prescribing psychologist as part of a written
collaborative agreement, and the delegation of prescriptive
authority shall conform to the requirements of Section 4.3 of
the Clinical Psychologist Licensing Act.
(j) As set forth in Section 22.2 of this Act, a licensee
under this Act may not directly or indirectly divide, share, or
split any professional fee or other form of compensation for
professional services with anyone in exchange for a referral or
otherwise, other than as provided in Section 22.2.
(Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
100-513, eff. 1-1-18; revised 9-29-17.)
Section 10. The Physician Assistant Practice Act of 1987 is
amended by changing Section 7 as follows:
(225 ILCS 95/7) (from Ch. 111, par. 4607)
(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 Section
7.5 of this Act and consideration is given to the nature of the

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physician's practice, complexity of the patient population,
and the experience of each physician assistant. A collaborating
physician may collaborate with a maximum of 5 full-time
equivalent physician assistants. 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
function under a collaborating physician.
A physician assistant may be employed by a practice group
or other entity employing multiple physicians at one or more

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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.)