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| Public Act 103-0065
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| SB0218 Enrolled | LRB103 25028 AMQ 51362 b |
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Physician Assistant Practice Act of 1987 is |
amended by changing Sections 4, 7, 7.5, and 7.7 and by adding |
Section 7.6 as follows:
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(225 ILCS 95/4) (from Ch. 111, par. 4604)
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(Section scheduled to be repealed on January 1, 2028)
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Sec. 4. Definitions. In this Act:
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1. "Department" means the Department of Financial and
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Professional Regulation.
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2. "Secretary" means the Secretary
of Financial and |
Professional Regulation.
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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
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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
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exercise such direction, collaboration, and control over such |
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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.
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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
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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
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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.
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Any person who holds an active license or permit issued |
pursuant to the Medical Practice Act of 1987 shall have that |
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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, |
policies, or procedures or the job description within which |
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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.
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5. (Blank).
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6. "Physician" means a person licensed to
practice |
medicine in all of its branches under the Medical Practice Act |
of 1987.
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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.
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8. (Blank).
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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.
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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 |
controlled by, or is under common control of the hospital. For |
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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.)
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(225 ILCS 95/7) (from Ch. 111, par. 4607)
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(Section scheduled to be repealed on January 1, 2028)
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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 physician's practice, complexity of the patient |
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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 |
assistant according to the
rules of the Department.
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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.
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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.
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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.
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A physician assistant may be employed by a practice group |
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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
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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.
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(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.
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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.)
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(225 ILCS 95/7.5)
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(Section scheduled to be repealed on January 1, 2028)
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Sec. 7.5. Written collaborative agreements; prescriptive |
authority. |
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(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 |
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 |
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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 |
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, |
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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, |
specifying the authority delegated or terminated.
Upon |
receipt of this notice delegating authority to prescribe |
controlled substances, the physician assistant shall be |
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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
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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.
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(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 |
than a 30-day supply, with any continuation authorized |
only after prior approval of the collaborating |
physician. |
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(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
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to any medication authority, including Schedule II controlled
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substances of a licensed physician assistant for care provided
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in a hospital, hospital affiliate, federally qualified health |
center, or ambulatory surgical
treatment center pursuant to |
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Section 7.7 of this Act.
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(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.)
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(225 ILCS 95/7.6 new) |
Sec. 7.6. Written collaborative agreement; temporary |
practice. Any physician assistant required to enter into a |
written collaborative agreement with a collaborating physician |
is authorized to continue to practice for up to 90 days after |
the termination of a written collaborative agreement, provided |
the physician assistant seeks any necessary collaboration at a |
local hospital and refers patients who require services beyond |
the training and experience of the physician assistant to a |
physician or other health care provider.
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(225 ILCS 95/7.7) |
(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 |
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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 |
physician assistants granted clinical privileges, including |
any care provided in a hospital affiliate or federally |
qualified health center. 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. |
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(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 |
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 |
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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 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 |
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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 |
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.
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(Source: P.A. 100-453, eff. 8-25-17.)
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