Bill Text: IL HB5104 | 2011-2012 | 97th General Assembly | Chaptered

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Bill Title: Amends the Physician Assistant Practice Act of 1987. Removes the provision that a physician assistant shall not be allowed to bill patients or in any way charge for services. Removes language providing that a physician assistants may be employed by the Department of Corrections or the Department of Human Services for service in facilities maintained by such Departments and affiliated training facilities in programs conducted under the authority of the Director of Corrections or the Secretary of Human Services. Repeals the provision that provides a physician assistant may be employed by a jail or prison health facility. Effective immediately.

Spectrum: Slight Partisan Bill (Democrat 2-1)

Status: (Passed) 2012-08-24 - Public Act . . . . . . . . . 97-1071 [HB5104 Detail]

Download: Illinois-2011-HB5104-Chaptered.html

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Public Act 097-1071
HB5104 Enrolled LRB097 19244 CEL 64486 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. The Ambulatory Surgical Treatment Center Act is
amended by adding Section 6.6 as follows:
(210 ILCS 5/6.6 new)
Sec. 6.6. Clinical privileges; physician assistants. No
ambulatory surgical treatment center (ASTC) licensed under
this Act shall adopt any policy, rule, regulation, or practice
inconsistent with the provision of adequate supervision in
accordance with Section 54.5 of the Medical Practice Act of
1987 and the Physician Assistant Practice Act of 1987.
Section 3. The Hospital Licensing Act is amended by adding
Section 10.11 as follows:
(210 ILCS 85/10.11 new)
Sec. 10.11. Clinical privileges; physician assistants. No
hospital licensed under this Act shall adopt any policy, rule,
regulation, or practice inconsistent with the provision of
adequate supervision in accordance with Section 54.5 of the
Medical Practice Act of 1987 and the Physician Assistant
Practice Act of 1987.

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(Section scheduled to be repealed on December 31, 2012)
Sec. 54.5. Physician delegation of authority to physician
assistants and advanced practice nurses.
(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 supervising physician agreements with no more than 5
2 physician assistants as set forth in subsection (a) of
Section 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 nurse in accordance with the 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 the
collaborating physician generally provides to his or her
patients in the normal course of clinical medical practice. A

written collaborative agreement shall be adequate with respect
to collaboration with advanced practice nurses if all of the
following apply:
(1) The agreement is written to promote the exercise of
professional judgment by the advanced practice nurse
commensurate with his or her education and experience. The
agreement need not describe the exact steps that an
advanced practice nurse must take with respect to each
specific condition, disease, or symptom, but must specify
those procedures that require a physician's presence as the
procedures are being performed.
(2) Practice guidelines and orders are developed and
approved jointly by the advanced practice nurse and
collaborating physician, as needed, based on the practice
of the practitioners. Such guidelines and orders and the
patient services provided thereunder are periodically
reviewed by the collaborating physician.
(3) The advance practice nurse provides services the
collaborating physician generally provides to his or her
patients in the normal course of clinical practice, 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.
(4) The collaborating physician and advanced practice
nurse consult at least once a month to provide

collaboration and consultation.
(5) 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.
(6) The agreement contains provisions detailing notice
for termination or change of status involving a written
collaborative agreement, except when such notice is given
for just cause.
(b-5) An anesthesiologist or physician licensed to
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 supervising physician shall have access to the
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 nurse.
(d) (Blank).
(e) A physician shall not be liable for the acts or
omissions of a physician assistant or advanced practice 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 physician assistant or advanced
practice nurse to perform acts, unless the physician has reason
to believe the physician assistant or advanced practice 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 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 supervising physician may, but is not required to,
delegate prescriptive authority to a physician assistant as
part of a written supervision agreement, and the delegation of
prescriptive authority shall conform to the requirements of
Section 7.5 of the Physician Assistant Practice Act of 1987.
(Source: P.A. 96-618, eff. 1-1-10; 97-358, eff. 8-12-11.)
Section 10. The Physician Assistant Practice Act of 1987 is
amended by changing Sections 4 and 7 and by adding Section 7.7
as follows:
(225 ILCS 95/4) (from Ch. 111, par. 4604)
(Section scheduled to be repealed on January 1, 2018)
Sec. 4. 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 a physician
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 under the

supervision of a physician as defined in this Act. A physician
assistant may perform such procedures within the specialty of
the supervising physician, except that such physician shall
exercise such direction, supervision 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 under the supervision of a physician. Supervision of the
physician assistant shall not be construed to necessarily
require the personal presence of the supervising 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
supervising 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 supervision 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 supervising physician's orders as
determined by 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 supervision agreement.
4. "Board" means the Medical Licensing Board constituted
under the Medical Practice Act of 1987.
5. "Disciplinary Board" means the Medical Disciplinary
Board constituted under the Medical Practice Act of 1987.
6. "Physician" means, for purposes of this Act, a person
licensed to practice medicine in all its branches under the
Medical Practice Act of 1987.
7. "Supervising Physician" means, for the purposes of this
Act, the primary supervising physician of a physician
assistant, who, within his 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 supervision agreement. The supervising physician
maintains the final responsibility for the care of the patient
and the performance of the physician assistant.
8. "Alternate supervising physician" means, for the
purpose of this Act, any physician designated by the
supervising physician to provide supervision in the event that
he or she is unable to provide that supervision. The Department
may further define "alternate supervising physician" by rule.
The alternate supervising physicians shall maintain all
the same responsibilities as the supervising physician.
Nothing in this Act shall be construed as relieving any
physician of the professional or legal responsibility for the
care and treatment of persons attended by him or by physician

assistants under his supervision. Nothing in this Act shall be
construed as to limit the reasonable number of alternate
supervising physicians, provided they are designated by the
supervising physician.
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. It is the duty of the applicant or
licensee to inform the Department of any change of address, and
such changes must be made either through the Department's
website or by contacting the Department's licensure
maintenance unit.
(Source: P.A. 95-703, eff. 12-31-07; 96-268, eff. 8-11-09.)
(225 ILCS 95/7) (from Ch. 111, par. 4607)
(Section scheduled to be repealed on January 1, 2018)
Sec. 7. Supervision requirements.
(a) A supervising physician shall determine the number of
physician assistants under his or her supervision provided the
physician is able to provide adequate supervision as outlined
in the written supervision 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 supervised physician assistant. A
supervising physician may supervise a maximum of 5 full-time
equivalent physician assistants; provided, however, this

number of physician assistants shall be reduced by the number
of collaborative agreements the supervising physician
maintains. A No more than 2 physician assistants shall be
supervised by the supervising physician, although a physician
assistant shall be able to hold more than one professional
position. A Each supervising physician shall file a notice of
supervision of each such physician assistant according to the
rules of the Department. However, the alternate supervising
physician may supervise more than 2 physician assistants when
the supervising physician is unable to provide such supervision
consistent with the definition of alternate physician in
Section 4. It is the responsibility of the supervising
physician to maintain documentation each time he or she has
designated an alternative supervising physician. This
documentation shall include the date alternate supervisory
control began, the date alternate supervisory control ended,
and any other changes. A supervising physician shall provide a
copy of this documentation to the Department, upon request.
Physician assistants shall be supervised only by
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 the supervision of a supervising physician.
Physician assistants may be employed by the Department of
Corrections or the Department of Human Services (as successor
to the Department of Mental Health and Developmental
Disabilities) for service in facilities maintained by such
Departments and affiliated training facilities in programs
conducted under the authority of the Director of Corrections or
the Secretary of Human Services. Each physician assistant
employed by the Department of Corrections or the Department of
Human Services (as successor to the Department of Mental Health
and Developmental Disabilities) shall be under the supervision
of a physician engaged in clinical practice and direct patient
care. Duties of each physician assistant employed by such
Departments are limited to those within the scope of practice
of the supervising physician who is fully responsible for all
physician assistant activities.
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 supervising physician. The
other physicians with that practice group or other entity who
practice in the same general type of practice or specialty as
the supervising physician may supervise the physician
assistant with respect to their patients without being deemed

alternate supervising physicians for the purpose of this Act.
(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 supervision as it is defined in this Section or
with such supervision as is available. For purposes of this
Section, an "emergency situation" shall not include one that
occurs in the place of one's employment.
Any physician who supervises 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 supervising
physician.
(Source: P.A. 95-703, eff. 12-31-07; 96-70, eff. 7-23-09.)
(225 ILCS 95/7.7 new)
Sec. 7.7. Physician assistants in hospitals, hospital
affiliates, or ambulatory surgical treatment centers.
(a) A physician assistant may provide services in a
hospital or a hospital affiliate as those terms are defined in
the Hospital Licensing Act or the University of Illinois
Hospital Act or a licensed ambulatory surgical treatment center
without a written supervision agreement pursuant to Section 7.5

of this Act. A physician assistant must possess clinical
privileges recommended by the hospital medical staff and
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.
(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, 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.
(225 ILCS 95/8 rep.)
Section 15. The Physician Assistant Practice Act of 1987 is
amended by repealing Section 8.
Section 99. Effective date. This Act takes effect upon
becoming law.