101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB4692

 

Introduced 2/18/2020, by Rep. Kathleen Willis - Mary E. Flowers, Randy E. Frese, Terri Bryant, Dave Severin, et al.

 

SYNOPSIS AS INTRODUCED:
 
225 ILCS 60/54.5
225 ILCS 95/1  from Ch. 111, par. 4601
225 ILCS 95/4  from Ch. 111, par. 4604
225 ILCS 95/6  from Ch. 111, par. 4606
225 ILCS 95/7  from Ch. 111, par. 4607
225 ILCS 95/7.5
225 ILCS 95/7.7
225 ILCS 95/11  from Ch. 111, par. 4611

    Amends the Medical Practice Act of 1987. Provides that a physician licensed to practice medicine in all its branches may collaborate with a physician assistant if specified requirements are met for a collaborative agreement. Provides that a 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. Amends the Physician Assistant Practice Act of 1987. Deletes language requiring a collaborative agreement to be written for a physician assistant and changes requirements for the collaborative agreement. Provides that medical care provided by a physician assistant shall be consistent with the physician assistant's education, training, and experience. Makes changes to provisions concerning prescriptive authority of a physician assistant. Provides that in a hospital, hospital affiliate, or ambulatory surgical treatment center, the medical staff (instead of the attending physician) shall determine a physician assistant's role in providing care for patients. Changes the physician assistant advisory committee to the Physician Assistant Medical Licensing Board. Changes the membership and duties of the Board. Removes provisions concerning initial terms of office for Board members. Makes conforming and other changes. Effective January 1, 2021.


LRB101 20507 SPS 70104 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB4692LRB101 20507 SPS 70104 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Medical Practice Act of 1987 is amended by
5changing Section 54.5 as follows:
 
6    (225 ILCS 60/54.5)
7    (Section scheduled to be repealed on January 1, 2022)
8    Sec. 54.5. Physician delegation of authority to physician
9assistants, advanced practice registered nurses without full
10practice authority, and prescribing psychologists.
11    (a) A physician licensed to practice medicine in all its
12branches may collaborate with a physician assistant under
13guidelines in accordance with the requirements of the Physician
14Assistant Practice Act of 1987. Collaboration is for the
15purpose of providing medical consultation, and no employment
16relationship is required. A collaborative agreement shall
17conform to the requirements of Section 7 of the Physician
18Assistant Practice Act of 1987. The collaborative agreement
19shall be for services in the same area of practice or specialty
20as the collaborating physician in his or her clinical medical
21practice. A collaborative agreement shall be adequate with
22respect to collaboration with a physician assistant if all of
23the following apply:

 

 

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1        (1) The agreement is to promote the exercise of
2    professional judgment by the physician assistant
3    commensurate with his or her education and experience.
4        (2) The physician assistant provides services based
5    upon a collaborative agreement with the collaborating
6    physician, except as set forth in Section 7.7 of the
7    Physician Assistant Practice Act of 1987. With respect to
8    labor and delivery, the collaborating physician must
9    provide delivery services in order to participate with the
10    physician assistant.
11        (3) Methods of communication are available with the
12    collaborating physician in person or through
13    telecommunications for consultation, collaboration, and
14    referral as needed to address patient care needs.
15        (4) Physicians licensed to practice medicine in all its
16    branches may delegate care and treatment responsibilities
17    to a physician assistant under guidelines in accordance
18    with the requirements of the Physician Assistant Practice
19    Act of 1987. A physician licensed to practice medicine in
20    all its branches may enter into collaborative agreements
21    with no more than 7 full-time equivalent physician
22    assistants, except in a hospital, hospital affiliate, or
23    ambulatory surgical treatment center as set forth by
24    Section 7.7 of the Physician Assistant Practice Act of 1987
25    and as provided in subsection (a-5).
26    (a-5) A physician licensed to practice medicine in all its

 

 

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1branches may collaborate with more than 7 physician assistants
2when the services are provided in a federal primary care health
3professional shortage area with a Health Professional Shortage
4Area score greater than or equal to 12, as determined by the
5United States Department of Health and Human Services.
6    The collaborating physician must keep appropriate
7documentation of meeting this exemption and make it available
8to the Department upon request.
9    (b) A physician licensed to practice medicine in all its
10branches in active clinical practice may collaborate with an
11advanced practice registered nurse in accordance with the
12requirements of the Nurse Practice Act. Collaboration is for
13the purpose of providing medical consultation, and no
14employment relationship is required. A written collaborative
15agreement shall conform to the requirements of Section 65-35 of
16the Nurse Practice Act. The written collaborative agreement
17shall be for services in the same area of practice or specialty
18as the collaborating physician in his or her clinical medical
19practice. A written collaborative agreement shall be adequate
20with respect to collaboration with advanced practice
21registered nurses if all of the following apply:
22        (1) The agreement is written to promote the exercise of
23    professional judgment by the advanced practice registered
24    nurse commensurate with his or her education and
25    experience.
26        (2) The advanced practice registered nurse provides

 

 

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1    services based upon a written collaborative agreement with
2    the collaborating physician, except as set forth in
3    subsection (b-5) of this Section. With respect to labor and
4    delivery, the collaborating physician must provide
5    delivery services in order to participate with a certified
6    nurse midwife.
7        (3) Methods of communication are available with the
8    collaborating physician in person or through
9    telecommunications for consultation, collaboration, and
10    referral as needed to address patient care needs.
11    (b-5) An anesthesiologist or physician licensed to
12practice medicine in all its branches may collaborate with a
13certified registered nurse anesthetist in accordance with
14Section 65-35 of the Nurse Practice Act for the provision of
15anesthesia services. With respect to the provision of
16anesthesia services, the collaborating anesthesiologist or
17physician shall have training and experience in the delivery of
18anesthesia services consistent with Department rules.
19Collaboration shall be adequate if:
20        (1) an anesthesiologist or a physician participates in
21    the joint formulation and joint approval of orders or
22    guidelines and periodically reviews such orders and the
23    services provided patients under such orders; and
24        (2) for anesthesia services, the anesthesiologist or
25    physician participates through discussion of and agreement
26    with the anesthesia plan and is physically present and

 

 

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1    available on the premises during the delivery of anesthesia
2    services for diagnosis, consultation, and treatment of
3    emergency medical conditions. Anesthesia services in a
4    hospital shall be conducted in accordance with Section 10.7
5    of the Hospital Licensing Act and in an ambulatory surgical
6    treatment center in accordance with Section 6.5 of the
7    Ambulatory Surgical Treatment Center Act.
8    (b-10) The anesthesiologist or operating physician must
9agree with the anesthesia plan prior to the delivery of
10services.
11    (c) The collaborating physician shall have access to the
12medical records of all patients attended by a physician
13assistant. The collaborating physician shall have access to the
14medical records of all patients attended to by an advanced
15practice registered nurse.
16    (d) (Blank).
17    (e) A physician shall not be liable for the acts or
18omissions of a prescribing psychologist, physician assistant,
19or advanced practice registered nurse solely on the basis of
20having signed a supervision agreement or guidelines or a
21collaborative agreement, an order, a standing medical order, a
22standing delegation order, or other order or guideline
23authorizing a prescribing psychologist, physician assistant,
24or advanced practice registered nurse to perform acts, unless
25the physician has reason to believe the prescribing
26psychologist, physician assistant, or advanced practice

 

 

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1registered nurse lacked the competency to perform the act or
2acts or commits willful and wanton misconduct.
3    A physician shall not be liable for the acts or omissions
4of a physician assistant solely on the basis of having a
5collaborative agreement or guidelines, an order, a standing
6medical order, a standing delegation order, or other order or
7guideline authorizing a physician assistant to perform acts,
8unless the physician has reason to believe the physician
9assistant lacked the competency to perform the act or acts or
10commits willful and wanton misconduct.
11    (f) A collaborating physician may, but is not required to,
12delegate prescriptive authority to an advanced practice
13registered nurse as part of a written collaborative agreement,
14and the delegation of prescriptive authority shall conform to
15the requirements of Section 65-40 of the Nurse Practice Act.
16    (g) A collaborating physician may, but is not required to,
17delegate prescriptive authority to a physician assistant as
18part of a written collaborative agreement, and the delegation
19of prescriptive authority shall conform to the requirements of
20Section 7.5 of the Physician Assistant Practice Act of 1987.
21    (h) (Blank).
22    (i) A collaborating physician shall delegate prescriptive
23authority to a prescribing psychologist as part of a written
24collaborative agreement, and the delegation of prescriptive
25authority shall conform to the requirements of Section 4.3 of
26the Clinical Psychologist Licensing Act.

 

 

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1    (j) As set forth in Section 22.2 of this Act, a licensee
2under this Act may not directly or indirectly divide, share, or
3split any professional fee or other form of compensation for
4professional services with anyone in exchange for a referral or
5otherwise, other than as provided in Section 22.2.
6(Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
7100-513, eff. 1-1-18; 100-605, eff. 1-1-19; 100-863, eff.
88-14-18.)
 
9    Section 10. The Physician Assistant Practice Act of 1987 is
10amended by changing Sections 1, 4, 6, 7, 7.5, 7.7, and 11 as
11follows:
 
12    (225 ILCS 95/1)  (from Ch. 111, par. 4601)
13    (Section scheduled to be repealed on January 1, 2028)
14    Sec. 1. Legislative purpose. The practice as a physician
15assistant in the State of Illinois is hereby declared to affect
16the public health, safety and welfare and to be subject to
17regulation and control in the public interest. The purpose and
18legislative intent of this Act is to encourage and promote the
19more effective utilization of the skills of physicians by
20enabling them to collaborate effectively and efficiently with
21delegate certain health tasks to physician assistants to
22provide medical care where such delegation is consistent with
23the health and welfare of the patient and is conducted at the
24direction of and under the responsible supervision of the

 

 

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1physician.
2    It is further declared to be a matter of public health and
3concern that the practice as a physician assistant, as defined
4in this Act, merit and receive the confidence of the public,
5that only qualified persons be authorized to practice as a
6physician assistant in the State of Illinois. This Act shall be
7liberally construed to best carry out these subjects and
8purposes.
9(Source: P.A. 100-453, eff. 8-25-17.)
 
10    (225 ILCS 95/4)  (from Ch. 111, par. 4604)
11    (Section scheduled to be repealed on January 1, 2028)
12    Sec. 4. Definitions. In this Act:
13    1. "Department" means the Department of Financial and
14Professional Regulation.
15    2. "Secretary" means the Secretary of Financial and
16Professional Regulation.
17    3. "Physician assistant" means any person not holding an
18active license or permit issued by the Department pursuant to
19the Medical Practice Act of 1987 who has been certified as a
20physician assistant by the National Commission on the
21Certification of Physician Assistants or equivalent successor
22agency and practices medicine performs procedures in
23collaboration with a physician as defined in this Act. A
24physician assistant may practice medicine perform such
25procedures within the specialty of the collaborating

 

 

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1physician, except that such physician shall exercise such
2direction, collaboration, and control over such physician
3assistants as will assure that patients shall receive quality
4medical care. Physician assistants shall be capable of
5performing a variety of tasks within their education, training,
6and experience the specialty of medical care in collaboration
7with a physician. Collaboration with the physician assistant
8shall not be construed to necessarily require the personal
9presence of the collaborating physician at all times at the
10place where services are rendered, as long as there is
11communication available for consultation by radio, telephone
12or telecommunications within established guidelines as
13determined by the physician/physician assistant team. Medical
14care provided by the physician assistant shall be consistent
15with the physician assistant's education, training, and
16experience. The physician assistant's medical tasks or duties
17The collaborating physician may delegate tasks and duties to
18the physician assistant. Delegated tasks or duties shall be
19consistent with physician assistant education, training, and
20experience. The delegated tasks or duties shall be specific to
21the practice setting and shall be implemented and reviewed
22under a written collaborative agreement established by the
23physician or physician/physician assistant team. A physician
24assistant, acting as an agent of the physician, shall be
25permitted to transmit the collaborating physician's orders as
26determined by the institution's by-laws, policies, procedures,

 

 

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1or job description within which the physician/physician
2assistant team practices. Physician assistants shall practice
3only in accordance with a written collaborative agreement.
4    Any person who holds an active license or permit issued
5pursuant to the Medical Practice Act of 1987 shall have that
6license automatically placed into inactive status upon
7issuance of a physician assistant license. Any person who holds
8an active license as a physician assistant who is issued a
9license or permit pursuant to the Medical Practice Act of 1987
10shall have his or her physician assistant license automatically
11placed into inactive status.
12    3.5. "Physician assistant practice" means the performance
13of procedures and the practice of medicine, including
14procedures in the behavioral and mental health services, within
15the specialty of the collaborating physician. Medical care
16provided by the physician assistant shall be consistent with
17the Physician assistants shall be capable of performing a
18variety of tasks within the specialty of medical care of the
19collaborating physician. Collaboration with the physician
20assistant shall not be construed to necessarily require the
21personal presence of the collaborating physician at all times
22at the place where services are rendered, as long as there is
23communication available for consultation by radio, telephone,
24telecommunications, or electronic communications. The
25collaborating physician may delegate tasks and duties to the
26physician assistant. Delegated tasks or duties shall be

 

 

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1consistent with physician assistant's assistant education,
2training, and experience. The delegated tasks or duties shall
3be specific to the practice setting and shall be implemented
4and reviewed under a written collaborative agreement
5established by the physician or physician/physician assistant
6team. A physician assistant shall be permitted to transmit the
7collaborating physician's orders as determined by the
8institution's bylaws, policies, or procedures or the job
9description within which the physician/physician assistant
10team practices. Physician assistants shall practice only in
11accordance with a written collaborative agreement, except as
12provided in Section 7.5 of this Act.
13    4. "Board" means the Medical Licensing Board constituted
14under the Medical Practice Act of 1987.
15    5. "Disciplinary Board" means the Medical Disciplinary
16Board constituted under the Medical Practice Act of 1987.
17    6. "Physician" means a person licensed to practice medicine
18in all of its branches under the Medical Practice Act of 1987.
19    7. "Collaborating physician" means the physician who,
20within his or her specialty and expertise, collaborates with a
21may delegate a variety of tasks and procedures to the physician
22assistant. Such collaboration tasks and procedures shall be
23delegated in accordance with a written collaborative
24agreement.
25    8. (Blank).
26    9. "Address of record" means the designated address

 

 

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1recorded by the Department in the applicant's or licensee's
2application file or license file maintained by the Department's
3licensure maintenance unit.
4    10. "Hospital affiliate" means a corporation, partnership,
5joint venture, limited liability company, or similar
6organization, other than a hospital, that is devoted primarily
7to the provision, management, or support of health care
8services and that directly or indirectly controls, is
9controlled by, or is under common control of the hospital. For
10the purposes of this definition, "control" means having at
11least an equal or a majority ownership or membership interest.
12A hospital affiliate shall be 100% owned or controlled by any
13combination of hospitals, their parent corporations, or
14physicians licensed to practice medicine in all its branches in
15Illinois. "Hospital affiliate" does not include a health
16maintenance organization regulated under the Health
17Maintenance Organization Act.
18    11. "Email address of record" means the designated email
19address recorded by the Department in the applicant's
20application file or the licensee's license file, as maintained
21by the Department's licensure maintenance unit.
22(Source: P.A. 99-330, eff. 1-1-16; 100-453, eff. 8-25-17.)
 
23    (225 ILCS 95/6)  (from Ch. 111, par. 4606)
24    (Section scheduled to be repealed on January 1, 2028)
25    Sec. 6. Physician assistant title.

 

 

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1    (a) No physician assistant shall use the title of doctor
2or , physician, or associate with his or her name or any other
3term that would indicate to other persons that he or she is
4qualified to engage in the general practice of medicine.
5    (b) A physician assistant shall verbally identify himself
6or herself as a physician assistant, including specialty
7certification, to each patient.
8    (c) Nothing in this Act shall be construed to relieve a
9physician assistant of the professional or legal
10responsibility for the care and treatment of persons attended
11by him or her.
12    (d) The collaborating physician shall file with the
13Department notice of employment, discharge, or collaboration
14with a physician assistant at the time of employment,
15discharge, or assumption of collaboration with a physician
16assistant.
17(Source: P.A. 100-453, eff. 8-25-17.)
 
18    (225 ILCS 95/7)  (from Ch. 111, par. 4607)
19    (Section scheduled to be repealed on January 1, 2028)
20    Sec. 7. Collaboration requirements.
21    (a) A collaborating physician shall determine the number of
22physician assistants to collaborate with, provided the
23physician is able to provide adequate collaboration as outlined
24in the written collaborative agreement required under Section
257.5 of this Act and consideration is given to the nature of the

 

 

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1physician's practice, complexity of the patient population,
2and the experience of each physician assistant. A collaborating
3physician may collaborate with a maximum of 7 full-time
4equivalent physician assistants as described in Section 54.5 of
5the Medical Practice Act of 1987. As used in this Section,
6"full-time equivalent" means the equivalent of 40 hours per
7week per individual. Physicians and physician assistants who
8work in a hospital, hospital affiliate, or ambulatory surgical
9treatment center as defined by Section 7.7 of this Act are
10exempt from the collaborative ratio restriction requirements
11of this Section. A physician assistant shall be able to hold
12more than one professional position. A collaborating physician
13shall file a notice of collaboration of each physician
14assistant according to the rules of the Department.
15    Physician assistants shall collaborate only with
16physicians as defined in this Act who are engaged in clinical
17practice, or in clinical practice in public health or other
18community health facilities.
19    Nothing in this Act shall be construed to limit the
20delegation of tasks or duties by a physician to a nurse or
21other appropriately trained personnel.
22    Nothing in this Act shall be construed to prohibit the
23employment of physician assistants by a hospital, nursing home
24or other health care facility where such physician assistants
25function under a collaborating physician.
26    A physician assistant may be employed by a practice group

 

 

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1or other entity employing multiple physicians at one or more
2locations. In that case, one of the physicians practicing at a
3location shall be designated the collaborating physician. The
4other physicians with that practice group or other entity who
5practice in the same general type of practice or specialty as
6the collaborating physician may collaborate with the physician
7assistant with respect to their patients.
8    (b) A physician assistant licensed in this State, or
9licensed or authorized to practice in any other U.S.
10jurisdiction or credentialed by his or her federal employer as
11a physician assistant, who is responding to a need for medical
12care created by an emergency or by a state or local disaster
13may render such care that the physician assistant is able to
14provide without collaboration as it is defined in this Section
15or with such collaboration as is available.
16    Any physician who collaborates with a physician assistant
17providing medical care in response to such an emergency or
18state or local disaster shall not be required to meet the
19requirements set forth in this Section for a collaborating
20physician.
21(Source: P.A. 100-453, eff. 8-25-17; 100-605, eff. 1-1-19.)
 
22    (225 ILCS 95/7.5)
23    (Section scheduled to be repealed on January 1, 2028)
24    Sec. 7.5. Collaborative Written collaborative agreements;
25prescriptive authority.

 

 

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1    (a) A written collaborative agreement is required for all
2physician assistants to practice in the State, except as
3provided in Section 7.7 of this Act.
4        (1) A written collaborative agreement shall describe
5    the working relationship of the physician assistant with
6    the collaborating physician and shall describe the
7    categories of care, treatment, or procedures to be provided
8    by the physician assistant. The written collaborative
9    agreement shall be established at the practice level and
10    shall promote the exercise of professional judgment by the
11    physician assistant commensurate with his or her education
12    and experience. The services to be provided by the
13    physician assistant shall be services that the
14    collaborating physician is authorized to and generally
15    provides to his or her patients in the normal course of his
16    or her clinical medical practice. The written
17    collaborative agreement need not describe the exact steps
18    that a physician assistant must take with respect to each
19    specific condition, disease, or symptom but must specify
20    which authorized procedures require the presence of the
21    collaborating physician as the procedures are being
22    performed. The relationship under a written collaborative
23    agreement shall not be construed to require the personal
24    presence of a physician at the place where services are
25    rendered. Methods of communication shall be available for
26    consultation with the collaborating physician in person or

 

 

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1    by telecommunications or electronic communications as set
2    forth in the written collaborative agreement. For the
3    purposes of this Act, "generally provides to his or her
4    patients in the normal course of his or her clinical
5    medical practice" means services, not specific tasks or
6    duties, the collaborating physician routinely provides
7    individually or through delegation to other persons so that
8    the physician has the experience and ability to collaborate
9    and provide consultation.
10        (2) The written collaborative agreement shall be
11    adequate if a physician does each of the following:
12            (A) Participates in the joint formulation and
13        joint approval of orders or guidelines with the
14        physician assistant and he or she periodically reviews
15        such orders and the services provided patients under
16        such orders in accordance with accepted standards of
17        medical practice and physician assistant practice.
18            (B) Provides consultation at least once a month.
19        (3) (Blank). A copy of the signed, written
20    collaborative agreement must be available to the
21    Department upon request from both the physician assistant
22    and the collaborating physician.
23        (4) A physician assistant shall, upon request, inform
24    each collaborating physician of all written collaborative
25    agreements into which he or she has entered signed and
26    provide a copy of these to any collaborating physician upon

 

 

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1    request.
2    (b) A collaborating physician may, but is not required to,
3delegate prescriptive authority to a physician assistant as
4part of a written collaborative agreement. This authority may,
5but is not required to, include prescription of, selection of,
6orders for, administration of, storage of, acceptance of
7samples of, and dispensing medical devices, over the counter
8medications, legend drugs, medical gases, and controlled
9substances categorized as Schedule II through V controlled
10substances, as defined in Article II of the Illinois Controlled
11Substances Act, and other preparations, including, but not
12limited to, botanical and herbal remedies. The physician
13assistant's collaborating physician must have a valid, current
14Illinois controlled substance license and federal registration
15with the Drug Enforcement Administration Agency to delegate the
16authority to prescribe controlled substances.
17        (1) To prescribe Schedule II, III, IV, or V controlled
18    substances under this Section, a physician assistant must
19    obtain a mid-level practitioner controlled substances
20    license. Medication orders issued by a physician assistant
21    shall be reviewed periodically by the collaborating
22    physician.
23        (2) The collaborating physician shall file with the
24    Department notice of delegation of prescriptive authority
25    to a physician assistant and termination of prescriptive
26    authority delegation, specifying the authority delegated

 

 

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1    or terminated. Upon receipt of this notice of prescriptive
2    authority delegating authority to prescribe controlled
3    substances, the physician assistant shall be eligible to
4    register for a mid-level practitioner controlled
5    substances license under Section 303.05 of the Illinois
6    Controlled Substances Act. Nothing in this Act shall be
7    construed to limit the delegation of tasks or duties by the
8    collaborating physician to a nurse or other appropriately
9    trained persons in accordance with Section 54.2 of the
10    Medical Practice Act of 1987.
11        (3) In addition to the requirements of this subsection
12    (b), a collaborating physician may, but is not required to,
13    specify that the physician assistant may delegate
14    authority to a physician assistant to prescribe Schedule II
15    controlled substances, if all of the following conditions
16    apply:
17            (A) A physician assistant may prescribe specific
18        Schedule II controlled substances by oral dosage or
19        topical or transdermal application if the Specific
20        Schedule II controlled substances by oral dosage or
21        topical or transdermal application may be delegated,
22        provided that the delegated Schedule II controlled
23        substances are routinely prescribed by the
24        collaborating physician. The This delegation must
25        identify the specific Schedule II controlled
26        substances must be identified by either brand name or

 

 

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1        generic name. A physician assistant may not prescribe
2        Schedule II controlled substances to be delivered by
3        injection or other route of administration may not be
4        delegated.
5            (B) (Blank).
6            (C) Any prescription must be limited to no more
7        than a 30-day supply, with any continuation authorized
8        only after prior approval of the collaborating
9        physician.
10            (D) The physician assistant must discuss the
11        condition of any patients for whom a controlled
12        substance is prescribed monthly with the collaborating
13        physician.
14            (E) The physician assistant meets the education
15        requirements of Section 303.05 of the Illinois
16        Controlled Substances Act.
17    (c) Nothing in this Act shall be construed to limit the
18delegation of tasks or duties by a physician to a licensed
19practical nurse, a registered professional nurse, or other
20persons. Nothing in this Act shall be construed to limit the
21means of collaboration between the physician assistant and the
22collaborating physician method of delegation that may be
23authorized by any means, including, but not limited to, oral,
24written, electronic, standing orders, protocols, guidelines,
25or verbal orders. Nothing in this Act shall be construed to
26authorize a physician assistant to provide health care services

 

 

HB4692- 21 -LRB101 20507 SPS 70104 b

1required by law or rule to be performed by a physician. Nothing
2in this Act shall be construed to authorize the delegation or
3performance of operative surgery. Nothing in this Section shall
4be construed to preclude a physician assistant from assisting
5in surgery.
6    (c-5) Nothing in this Section shall be construed to apply
7to any medication authority, including Schedule II controlled
8substances of a licensed physician assistant for care provided
9in a hospital, hospital affiliate, or ambulatory surgical
10treatment center pursuant to Section 7.7 of this Act.
11    (d) (Blank).
12    (e) Nothing in this Section shall be construed to prohibit
13generic substitution.
14(Source: P.A. 100-453, eff. 8-25-17; 101-13, eff. 6-12-19.)
 
15    (225 ILCS 95/7.7)
16    (Section scheduled to be repealed on January 1, 2028)
17    Sec. 7.7. Physician assistants in hospitals, hospital
18affiliates, or ambulatory surgical treatment centers.
19    (a) A physician assistant may provide services in a
20hospital as defined in the Hospital Licensing Act, a hospital
21affiliate as defined in the University of Illinois Hospital
22Act, or a licensed ambulatory surgical treatment center as
23defined in the Ambulatory Surgical Treatment Center Act without
24a written collaborative agreement pursuant to Section 7.5 of
25this Act. A physician assistant must possess clinical

 

 

HB4692- 22 -LRB101 20507 SPS 70104 b

1privileges recommended by the hospital medical staff and
2granted by the hospital or the consulting medical staff
3committee and ambulatory surgical treatment center in order to
4provide services. The medical staff or consulting medical staff
5committee shall periodically review the services of physician
6assistants granted clinical privileges, including any care
7provided in a hospital affiliate. Authority may also be granted
8when recommended by the hospital medical staff and granted by
9the hospital or recommended by the consulting medical staff
10committee and ambulatory surgical treatment center to
11individual physician assistants to select, order, and
12administer medications, including controlled substances, to
13provide delineated care. In a hospital, hospital affiliate, or
14ambulatory surgical treatment center, the medical staff
15attending physician shall determine a physician assistant's
16role in providing care for his or her patients, except as
17otherwise provided in the medical staff bylaws or consulting
18committee policies.
19    (a-5) Physician assistants practicing in a hospital
20affiliate may be, but are not required to be, granted authority
21to prescribe Schedule II through V controlled substances when
22such authority is recommended by the appropriate physician
23committee of the hospital affiliate and granted by the hospital
24affiliate. This authority may, but is not required to, include
25prescription of, selection of, orders for, administration of,
26storage of, acceptance of samples of, and dispensing

 

 

HB4692- 23 -LRB101 20507 SPS 70104 b

1over-the-counter medications, legend drugs, medical gases, and
2controlled substances categorized as Schedule II through V
3controlled substances, as defined in Article II of the Illinois
4Controlled Substances Act, and other preparations, including,
5but not limited to, botanical and herbal remedies.
6    To prescribe controlled substances under this subsection
7(a-5), a physician assistant must obtain a mid-level
8practitioner controlled substance license. Medication orders
9shall be reviewed periodically by the appropriate hospital
10affiliate physicians committee or its physician designee.
11    The hospital affiliate shall file with the Department
12notice of a grant of prescriptive authority consistent with
13this subsection (a-5) and termination of such a grant of
14authority in accordance with rules of the Department. Upon
15receipt of this notice of grant of authority to prescribe any
16Schedule II through V controlled substances, the licensed
17physician assistant may register for a mid-level practitioner
18controlled substance license under Section 303.05 of the
19Illinois Controlled Substances Act.
20    In addition, a hospital affiliate may, but is not required
21to, grant authority to a physician assistant to prescribe any
22Schedule II controlled substances if all of the following
23conditions apply:
24        (1) specific Schedule II controlled substances by oral
25    dosage or topical or transdermal application may be
26    designated, provided that the designated Schedule II

 

 

HB4692- 24 -LRB101 20507 SPS 70104 b

1    controlled substances are routinely prescribed by
2    physician assistants in their area of certification; this
3    grant of authority must identify the specific Schedule II
4    controlled substances by either brand name or generic name;
5    authority to prescribe or dispense Schedule II controlled
6    substances to be delivered by injection or other route of
7    administration may not be granted;
8        (2) any grant of authority must be controlled
9    substances limited to the practice of the physician
10    assistant;
11        (3) any prescription must be limited to no more than a
12    30-day supply;
13        (4) the physician assistant must discuss the condition
14    of any patients for whom a controlled substance is
15    prescribed monthly with the appropriate physician
16    committee of the hospital affiliate or its physician
17    designee; and
18        (5) the physician assistant must meet the education
19    requirements of Section 303.05 of the Illinois Controlled
20    Substances Act.
21    (b) A physician assistant granted authority to order
22medications including controlled substances may complete
23discharge prescriptions provided the prescription is in the
24name of the physician assistant and the attending or
25discharging physician.
26    (c) Physician assistants practicing in a hospital,

 

 

HB4692- 25 -LRB101 20507 SPS 70104 b

1hospital affiliate, or an ambulatory surgical treatment center
2are not required to obtain a mid-level controlled substance
3license to order controlled substances under Section 303.05 of
4the Illinois Controlled Substances Act.
5(Source: P.A. 100-453, eff. 8-25-17.)
 
6    (225 ILCS 95/11)  (from Ch. 111, par. 4611)
7    (Section scheduled to be repealed on January 1, 2028)
8    Sec. 11. Physician Assistant Medical Licensing Board
9Committee. There is established a Physician Assistant Medical
10Licensing Board physician assistant advisory committee to the
11Department and the Medical Licensing Board. The Physician
12Assistant Medical Licensing Board may manage and regulate
13physician assistant advisory committee may review and make
14recommendations to the Department and the Board regarding all
15matters relating to physician assistants. Such matters may
16include, but not be limited to:
17        (1) applications for licensure;
18        (2) (blank); disciplinary proceedings;
19        (3) renewal requirements; and
20        (4) any other issues pertaining to the regulation and
21    practice of physician assistants in the State.
22    The Physician Assistant Medical Licensing Board physician
23assistant advisory committee shall be composed of 7 members.
24Two Three of the 7 members shall be physicians appointed by the
25Governor , 2 of whom shall be members of the Board and appointed

 

 

HB4692- 26 -LRB101 20507 SPS 70104 b

1to the advisory committee by the chairman. One physician, not a
2member of the Board, shall be a supervisor of a licensed
3physician assistant and shall be approved by the Governor from
4a list of Illinois physicians who collaborate with supervising
5licensed physician assistants. Four Three members shall be
6physician assistants, licensed under the law and appointed by
7the Governor from a list of 10 names recommended by the Board
8of Directors of the Illinois Academy of Physician Assistants.
9One member, not employed or having any material interest in any
10health care field, shall be appointed by the Governor and
11represent the public. The chairman of the Physician Assistant
12Medical Licensing Board physician assistant advisory committee
13shall be a member elected by a majority vote of the Physician
14Assistant Medical Licensing Board physician assistant advisory
15committee unless already a member of the Board. The Physician
16Assistant Medical Licensing Board physician assistant advisory
17committee is required to meet and report to the Department and
18the Board as physician assistant issues arise. The terms of
19office of each of the original 7 members shall be at staggered
20intervals. One physician and one physician assistant shall
21serve for a 2 year term. One physician and one physician
22assistant shall serve a 3 year term. One physician, one
23physician assistant and the public member shall serve a 4 year
24term. Upon the expiration of the term of any member, his
25successor shall be appointed for a term of 4 years in the same
26manner as the initial appointment. No member shall serve more

 

 

HB4692- 27 -LRB101 20507 SPS 70104 b

1than 2 consecutive terms.
2    Four members of the Physician Assistant Medical Licensing
3Board physician assistant advisory committee shall constitute
4a quorum. A quorum is required to perform all of the duties of
5the committee.
6    Members of the Physician Assistant Medical Licensing Board
7physician assistant advisory committee shall have no liability
8for any action based upon a disciplinary proceeding or other
9activity performed in good faith as a member of the committee.
10(Source: P.A. 95-703, eff. 12-31-07; 96-720, eff. 8-25-09.)
 
11    Section 99. Effective date. This Act takes effect January
121, 2021.