Public Act 103-0228
 
SB1785 EnrolledLRB103 26967 AMQ 53333 b


  
    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    (Section scheduled to be repealed on January 1, 2027)


    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 7 
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 and as provided in subsection (a-5).

    (a-5) A physician licensed to practice medicine in all its 
branches may collaborate with more than 7 physician assistants 
when the services are provided in a federal primary care 
health professional shortage area with a Health Professional 
Shortage Area score greater than or equal to 12, as determined 
by the United States Department of Health and Human Services. 
    The collaborating physician must keep appropriate 
documentation of meeting this exemption and make it available 
to the Department upon request.
    (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 
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 for which the collaborating physician 
can provide adequate collaboration 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 
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

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 
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; 100-605, eff. 1-1-19; 100-863, eff. 
8-14-18.)