|
| | 101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020 SB1725 Introduced 2/15/2019, by Sen. Antonio Muņoz SYNOPSIS AS INTRODUCED: |
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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 (rather than may delegate care and treatment responsibilities to a physician assistant). 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 medical practice. Deletes language providing that a physician may enter into collaborative agreements with no more than 7 full-time physician assistants. Amends the Physician Practice Act of 1987. Provides that a physician assistant in a health professional shortage area with a score greater than or equal to 12 shall own his or her own medical practice. Provides that medical and surgical services provided by a physician assistant include: obtaining and performing comprehensive health histories and physical examinations; evaluating, diagnosing, and providing medical treatment; ordering, performing, and interpreting diagnostic studies and therapeutic procedures; educating patients on health promotion and disease prevention; providing consultation upon request; and writing medical orders. Provides other provisions regarding scope of practice. Deletes language requiring: a written collaborative agreement for all physician assistants to practice in the State; and a written collaborative agreement to describe the working relationship of the physician assistant with the collaborating physician and the categories of care, treatment, or procedures to be provided by the physician assistant. Creates the Physician Assistant Medical Licensing Board (rather than the physician assistant advisory committee). Makes other changes. Effective January 1, 2020.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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1 | | AN ACT concerning regulation.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Medical Practice Act of 1987 is amended by |
5 | | changing Section 54.5 as follows:
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6 | | (225 ILCS 60/54.5)
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7 | | (Section scheduled to be repealed on December 31, 2019)
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8 | | Sec. 54.5. Physician delegation of authority to physician |
9 | | assistants, advanced practice registered nurses without full |
10 | | practice authority, and prescribing psychologists.
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11 | | (a) A physician licensed to practice medicine in all its |
12 | | branches may collaborate with a physician assistant under |
13 | | guidelines in accordance with the requirements of the Physician |
14 | | Assistant Practice Act 1987. Collaboration is for the purpose |
15 | | of providing medical consultation, and no employment |
16 | | relationship is required. A collaborative agreement shall |
17 | | conform to the requirements of Section 7 of the Physician |
18 | | Assistant Practice Act of 1987. The collaborative agreement |
19 | | shall be for services in the same area of practice or specialty |
20 | | as the collaborating physician in his or her clinical medical |
21 | | practice. A collaborative agreement shall be adequate with |
22 | | respect to collaboration with physician assistant if all of the |
23 | | 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 | | Physicians licensed to practice medicine in all its
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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).
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26 | | (a-5) (Blank). A physician licensed to practice medicine in |
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1 | | all its branches may collaborate with more than 7 physician |
2 | | assistants when the services are provided in a federal primary |
3 | | care health professional shortage area with a Health |
4 | | Professional Shortage Area score greater than or equal to 12, |
5 | | as determined by the United States Department of Health and |
6 | | Human Services. |
7 | | The collaborating physician must keep appropriate |
8 | | documentation of meeting this exemption and make it available |
9 | | to the Department upon request. |
10 | | (b) A physician licensed to practice medicine in all its
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11 | | branches in active clinical practice may collaborate with an |
12 | | advanced practice
registered nurse in accordance with the |
13 | | requirements of the Nurse Practice Act. Collaboration
is for |
14 | | the purpose of providing medical consultation,
and no |
15 | | employment relationship is required. A
written collaborative |
16 | | agreement shall
conform to the requirements of Section 65-35 of |
17 | | the Nurse Practice Act. The written collaborative agreement |
18 | | shall
be for
services in the same area of practice or specialty |
19 | | as the collaborating physician in
his or her clinical medical |
20 | | practice.
A written collaborative agreement shall be adequate |
21 | | with respect to collaboration
with advanced practice |
22 | | registered nurses if all of the following apply:
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23 | | (1) The agreement is written to promote the exercise of |
24 | | professional judgment by the advanced practice registered |
25 | | nurse commensurate with his or her education and |
26 | | experience.
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1 | | (2) The advanced practice registered nurse provides |
2 | | services based upon a written collaborative agreement with |
3 | | the collaborating physician, except as set forth in |
4 | | subsection (b-5) of this Section. With respect to labor and |
5 | | delivery, the collaborating physician must provide |
6 | | delivery services in order to participate with a certified |
7 | | nurse midwife. |
8 | | (3) Methods of communication are available with the |
9 | | collaborating physician in person or through |
10 | | telecommunications for consultation, collaboration, and |
11 | | referral as needed to address patient care needs.
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12 | | (b-5) An anesthesiologist or physician licensed to |
13 | | practice medicine in
all its branches may collaborate with a |
14 | | certified registered nurse anesthetist
in accordance with |
15 | | Section 65-35 of the Nurse Practice Act for the provision of |
16 | | anesthesia services. With respect to the provision of |
17 | | anesthesia services, the collaborating anesthesiologist or |
18 | | physician shall have training and experience in the delivery of |
19 | | anesthesia services consistent with Department rules. |
20 | | Collaboration shall be
adequate if:
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21 | | (1) an anesthesiologist or a physician
participates in |
22 | | the joint formulation and joint approval of orders or
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23 | | guidelines and periodically reviews such orders and the |
24 | | services provided
patients under such orders; and
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25 | | (2) for anesthesia services, the anesthesiologist
or |
26 | | physician participates through discussion of and agreement |
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1 | | with the
anesthesia plan and is physically present and |
2 | | available on the premises during
the delivery of anesthesia |
3 | | services for
diagnosis, consultation, and treatment of |
4 | | emergency medical conditions.
Anesthesia services in a |
5 | | hospital shall be conducted in accordance with
Section 10.7 |
6 | | of the Hospital Licensing Act and in an ambulatory surgical
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7 | | treatment center in accordance with Section 6.5 of the |
8 | | Ambulatory Surgical
Treatment Center Act.
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9 | | (b-10) The anesthesiologist or operating physician must |
10 | | agree with the
anesthesia plan prior to the delivery of |
11 | | services.
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12 | | (c) The collaborating physician shall have access to the
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13 | | medical records of all patients attended by a physician
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14 | | assistant. The collaborating physician shall have access to
the |
15 | | medical records of all patients attended to by an
advanced |
16 | | practice registered nurse.
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17 | | (d) (Blank).
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18 | | (e) A physician shall not be liable for the acts or
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19 | | omissions of a prescribing psychologist, physician assistant, |
20 | | or advanced practice
registered nurse solely on the basis of |
21 | | having signed a
supervision agreement or guidelines or a |
22 | | collaborative
agreement, an order, a standing medical order, a
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23 | | standing delegation order, or other order or guideline
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24 | | authorizing a prescribing psychologist, physician assistant, |
25 | | or advanced practice
registered nurse to perform acts, unless |
26 | | the physician has
reason to believe the prescribing |
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1 | | psychologist, physician assistant, or advanced
practice |
2 | | registered nurse lacked the competency to perform
the act or |
3 | | acts or commits willful and wanton misconduct.
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4 | | (f) A collaborating physician may, but is not required to, |
5 | | delegate prescriptive authority to an advanced practice |
6 | | registered nurse as part of a written collaborative agreement, |
7 | | and the delegation of prescriptive authority shall conform to |
8 | | the requirements of Section 65-40 of the Nurse Practice Act. |
9 | | (g) A collaborating physician may, but is not required to, |
10 | | delegate prescriptive authority to a physician assistant as |
11 | | part of a written collaborative agreement, and the delegation |
12 | | of prescriptive authority shall conform to the requirements of |
13 | | Section 7.5 of the Physician Assistant Practice Act of 1987. |
14 | | (h) (Blank). |
15 | | (i) A collaborating physician shall delegate prescriptive |
16 | | authority to a prescribing psychologist as part of a written |
17 | | collaborative agreement, and the delegation of prescriptive |
18 | | authority shall conform to the requirements of Section 4.3 of |
19 | | the Clinical Psychologist Licensing Act. |
20 | | (j) As set forth in Section 22.2 of this Act, a licensee |
21 | | under this Act may not directly or indirectly divide, share, or |
22 | | split any professional fee or other form of compensation for |
23 | | professional services with anyone in exchange for a referral or |
24 | | otherwise, other than as provided in Section 22.2. |
25 | | (Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17; |
26 | | 100-513, eff. 1-1-18; 100-605, eff. 1-1-19; 100-863, eff. |
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1 | | 8-14-18 .)
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2 | | Section 10. The Physician Assistant Practice Act of 1987 is |
3 | | amended by adding Section 6.1 and changing Sections 1, 4, 5, |
4 | | 5.5, 6, 7, 7.5, 7.7, 11, 21, and 22.1 as follows:
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5 | | (225 ILCS 95/1) (from Ch. 111, par. 4601)
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6 | | (Section scheduled to be repealed on January 1, 2028)
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7 | | Sec. 1. Legislative purpose. The practice as a physician |
8 | | assistant in the State of
Illinois is hereby declared to affect |
9 | | the public health, safety and welfare
and to be subject to |
10 | | regulation and control in the public interest. The
purpose and |
11 | | legislative intent of this Act is to encourage and promote the
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12 | | more effective utilization of the skills of physicians by |
13 | | enabling them to collaborate on
delegate certain health tasks |
14 | | to physician assistants where such delegation
is consistent |
15 | | with the health and welfare of the patient and is conducted
at |
16 | | the direction of and under the responsible supervision of the |
17 | | physician .
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18 | | It is further declared to be a matter of public health and |
19 | | concern that
the practice as a physician assistant, as defined |
20 | | in this Act, merit and
receive the confidence of the public, |
21 | | that only qualified persons be
authorized to practice as a |
22 | | physician assistant in the State of Illinois.
This Act shall be |
23 | | liberally construed to best carry out these subjects
and |
24 | | purposes.
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1 | | (Source: P.A. 100-453, eff. 8-25-17.)
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2 | | (225 ILCS 95/4) (from Ch. 111, par. 4604)
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3 | | (Section scheduled to be repealed on January 1, 2028)
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4 | | Sec. 4. Definitions. In this Act:
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5 | | 1. "Department" means the Department of Financial and
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6 | | Professional Regulation.
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7 | | 2. "Secretary" means the Secretary
of Financial and |
8 | | Professional Regulation.
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9 | | 3. "Physician assistant" means any person not holding an |
10 | | active license or permit issued by the Department pursuant to |
11 | | the Medical Practice Act of 1987 who has been
certified as a |
12 | | physician assistant by the National Commission on the
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13 | | Certification of Physician Assistants or equivalent successor |
14 | | agency and
performs procedures in collaboration with a |
15 | | physician as defined in this
Act. A physician assistant may |
16 | | perform such procedures within the
specialty of the |
17 | | collaborating physician, except that such physician shall
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18 | | exercise such direction, collaboration, and control over such |
19 | | physician
assistants as will assure that patients shall receive |
20 | | quality medical
care. Physician assistants shall be capable of |
21 | | performing a variety of tasks
within the specialty of medical |
22 | | care in collaboration with a physician.
Collaboration with the |
23 | | physician assistant shall not be construed to
necessarily |
24 | | require the personal presence of the collaborating physician at
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25 | | all times at the place where services are rendered, as long as |
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1 | | there is
communication available for consultation by radio, |
2 | | telephone or
telecommunications within established guidelines |
3 | | as determined by the
physician/physician assistant team. The |
4 | | collaborating physician may collaborate on delegate
tasks and |
5 | | duties with to the physician assistant. Collaborated Delegated |
6 | | tasks or duties
shall be consistent with physician assistant |
7 | | education, training, and
experience. The collaborated |
8 | | delegated tasks or duties shall be specific to the
practice |
9 | | setting and shall be implemented and reviewed under a written |
10 | | collaborative agreement
established by the physician or |
11 | | physician/physician assistant team. A
physician assistant, |
12 | | acting as an agent of the physician, shall be
permitted to |
13 | | transmit the collaborating physician's orders as determined by
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14 | | the institution's by-laws, policies, procedures, or job |
15 | | description within
which the physician/physician assistant |
16 | | team practices. Physician
assistants shall practice only in |
17 | | accordance with a written collaborative agreement.
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18 | | Any person who holds an active license or permit issued |
19 | | pursuant to the Medical Practice Act of 1987 shall have that |
20 | | license automatically placed into inactive status upon |
21 | | issuance of a physician assistant license. Any person who holds |
22 | | an active license as a physician assistant who is issued a |
23 | | license or permit pursuant to the Medical Practice Act of 1987 |
24 | | shall have his or her physician assistant license automatically |
25 | | placed into inactive status. |
26 | | 3.5. "Physician assistant practice" means the performance |
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1 | | of procedures , including procedures in the behavioral and |
2 | | mental health services, within the specialty of the |
3 | | collaborating physician. Physician assistants shall be capable |
4 | | of performing a variety of tasks within the specialty of |
5 | | medical care of the collaborating physician. Collaboration |
6 | | with the physician assistant shall not be construed to |
7 | | necessarily require the personal presence of the collaborating |
8 | | physician at all times at the place where services are |
9 | | rendered, as long as there is communication available for |
10 | | consultation by radio, telephone, telecommunications, or |
11 | | electronic communications. The collaborating physician may |
12 | | collaborate on delegate tasks and duties with to the physician |
13 | | assistant . Delegated tasks or duties shall be consistent with |
14 | | physician assistant education, training, and experience. The |
15 | | delegated tasks or duties shall be specific to the practice |
16 | | setting and shall be implemented and reviewed under a written |
17 | | collaborative agreement established by the physician or |
18 | | physician/physician assistant team. A physician assistant |
19 | | shall be permitted to transmit the collaborating physician's |
20 | | orders as determined by the institution's bylaws, policies, or |
21 | | procedures or the job description within which the |
22 | | physician/physician assistant team practices. Physician |
23 | | assistants shall practice only in accordance with a written |
24 | | collaborative agreement, except as provided in Section 7.5 of |
25 | | this Act. |
26 | | 4. "Board" means the Medical Licensing Board
constituted |
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1 | | under the Medical Practice Act of 1987.
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2 | | 5. "Disciplinary Board" means the Medical Disciplinary |
3 | | Board constituted
under the Medical Practice Act of 1987.
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4 | | 6. "Physician" means a person licensed to
practice medicine |
5 | | in all of its branches under the Medical Practice Act of 1987.
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6 | | 7. "Collaborating physician" means the physician who, |
7 | | within
his or her specialty and expertise, may collaborate on |
8 | | delegate a variety of
tasks and procedures with to the |
9 | | physician assistant. Such tasks and
procedures shall be |
10 | | collaborated delegated in accordance with a written
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11 | | collaborative agreement.
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12 | | 8. (Blank).
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13 | | 9. "Address of record" means the designated address |
14 | | recorded by the Department in the applicant's or licensee's |
15 | | application file or license file maintained by the Department's |
16 | | licensure maintenance unit.
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17 | | 10. "Hospital affiliate" means a corporation, partnership, |
18 | | joint venture, limited liability company, or similar |
19 | | organization, other than a hospital, that is devoted primarily |
20 | | to the provision, management, or support of health care |
21 | | services and that directly or indirectly controls, is |
22 | | controlled by, or is under common control of the hospital. For |
23 | | the purposes of this definition, "control" means having at |
24 | | least an equal or a majority ownership or membership interest. |
25 | | A hospital affiliate shall be 100% owned or controlled by any |
26 | | combination of hospitals, their parent corporations, or |
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1 | | physicians licensed to practice medicine in all its branches in |
2 | | Illinois. "Hospital affiliate" does not include a health |
3 | | maintenance organization regulated under the Health |
4 | | Maintenance Organization Act. |
5 | | 11. "Email address of record" means the designated email |
6 | | address recorded by the Department in the applicant's |
7 | | application file or the licensee's license file, as maintained |
8 | | by the Department's licensure maintenance unit. |
9 | | (Source: P.A. 99-330, eff. 1-1-16; 100-453, eff. 8-25-17.)
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10 | | (225 ILCS 95/5.5) |
11 | | (Section scheduled to be repealed on January 1, 2028) |
12 | | Sec. 5.5. Billing. A physician assistant shall not be |
13 | | allowed to personally bill patients or in any way charge for |
14 | | services. The employer of a physician assistant may charge for |
15 | | services rendered by the physician assistant. All claims for |
16 | | services rendered by the physician assistant shall be submitted |
17 | | using the physician assistant's national provider |
18 | | identification number as the rendering provider whenever |
19 | | appropriate. Payment for services rendered by a physician |
20 | | assistant shall be made to his or her employer if the payor |
21 | | would have made payment had the services been provided by a |
22 | | physician licensed to provide medicine in all of its branches. |
23 | | A physician assistant in a health professional shortage area |
24 | | with a score greater than or equal to 12 shall own his or her |
25 | | own medical practice.
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1 | | (Source: P.A. 100-453, eff. 8-25-17; 100-559, eff. 12-8-17.)
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2 | | (225 ILCS 95/6) (from Ch. 111, par. 4606)
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3 | | (Section scheduled to be repealed on January 1, 2028)
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4 | | Sec. 6. Physician assistant title.
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5 | | (a) No physician assistant shall use
the title of doctor, |
6 | | physician, or associate with his or her name or any other term |
7 | | that
would indicate to other persons that he or she is |
8 | | qualified to engage in the
general practice of medicine.
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9 | | (b) A physician assistant shall verbally identify himself |
10 | | or herself as a physician assistant, including specialty |
11 | | certification, to each patient. |
12 | | (c) Nothing in this Act shall be construed to relieve a |
13 | | physician assistant of the professional or legal |
14 | | responsibility for the care and treatment of persons attended |
15 | | by him or her.
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16 | | (d) The collaborating physician shall file with the |
17 | | Department notice of
employment, discharge, or collaboration |
18 | | with a physician assistant at the
time of employment, |
19 | | discharge, or assumption of collaboration with a
physician |
20 | | assistant.
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21 | | (Source: P.A. 100-453, eff. 8-25-17.)
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22 | | (225 ILCS 95/6.1 new) |
23 | | Sec. 6.1. Scope of practice. |
24 | | (a) Medical and surgical services provided by a physician |
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1 | | assistant include, but are not limited to: |
2 | | (i) obtaining and performing comprehensive health |
3 | | histories and physical examinations; |
4 | | (ii) evaluating, diagnosing, managing, and providing |
5 | | medical treatment; |
6 | | (iii) ordering, performing, and interpreting |
7 | | diagnostic studies and therapeutic procedures; |
8 | | (iv) educating patients on health promotion and |
9 | | disease prevention; |
10 | | (v) providing consultation upon request; and |
11 | | (vi) writing medical orders. |
12 | | (b) A physician assistant may provide services in health |
13 | | care facilities or programs including, but not limited to, |
14 | | hospitals, nursing facilities, assisted living facilities, |
15 | | behavioral and mental health facilities, and hospices. |
16 | | (c) A physician assistant may obtain informed consent. |
17 | | (d) A physician assistant may supervise, delegate, and |
18 | | assign therapeutic and diagnostic measures to licensed or |
19 | | unlicensed personnel. |
20 | | (e) A physician assistant may certify the health or |
21 | | disability of a patient as required by any local, State, or |
22 | | federal program. |
23 | | (f) A physician assistant may authenticate any document |
24 | | with his or her signature, certification, stamp, verification, |
25 | | affidavit, or endorsement if it may be authenticated by the |
26 | | signature, certification, stamp, verification, affidavit, or |
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1 | | endorsement of a physician. |
2 | | (g) A physician assistant shall collaborate with, consult |
3 | | with, or refer to the appropriate member of the healthcare team |
4 | | as indicated by the patient's condition, the education, |
5 | | experience, and competencies of the physician assistant, and |
6 | | the standard of care. The degree of collaboration shall be |
7 | | determined by the practice which may include decisions made by |
8 | | the employer, group, hospital service, and the credentialing |
9 | | and privileging systems of licensed facilities. |
10 | | (h) A physician assistant is responsible for the care they |
11 | | provide.
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12 | | (225 ILCS 95/7) (from Ch. 111, par. 4607)
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13 | | (Section scheduled to be repealed on January 1, 2028)
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14 | | Sec. 7. Collaboration requirements. |
15 | | (a) A collaborating physician shall determine the number of |
16 | | physician assistants to collaborate with, provided the |
17 | | physician is able to provide adequate collaboration as outlined |
18 | | in the written collaborative agreement required under Section |
19 | | 7.5 of this Act and consideration is given to the nature of the |
20 | | physician's practice, complexity of the patient population, |
21 | | and the experience of each physician assistant. A collaborating |
22 | | physician may collaborate with a maximum of 7 full-time |
23 | | equivalent physician assistants as described in Section 54.5 of |
24 | | the Medical Practice Act of 1987. As used in this Section, |
25 | | "full-time equivalent" means the equivalent of 40 hours per |
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1 | | week per individual. Physicians and physician assistants who |
2 | | work in a hospital, hospital affiliate, or ambulatory surgical |
3 | | treatment center as defined by Section 7.7 of this Act are |
4 | | exempt from the collaborative ratio restriction requirements |
5 | | of this Section. A physician assistant shall be able to
hold |
6 | | more than one professional position. A collaborating physician |
7 | | shall
file a notice of collaboration of each physician |
8 | | assistant according to the
rules of the Department.
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9 | | Physician assistants shall collaborate only with |
10 | | physicians as defined in
this Act
who are engaged in clinical |
11 | | practice, or in clinical practice in
public health or other |
12 | | community health facilities.
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13 | | Nothing in this Act shall be construed to limit the |
14 | | delegation of tasks or
duties by a physician to a nurse or |
15 | | other appropriately trained personnel.
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16 | | Nothing in this Act
shall be construed to prohibit the |
17 | | employment of physician assistants by
a hospital, nursing home |
18 | | or other health care facility where such physician
assistants |
19 | | function under a collaborating physician .
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20 | | A physician assistant may be employed by a practice group |
21 | | or other entity
employing multiple physicians at one or more |
22 | | locations. In that case, one of
the
physicians practicing at a |
23 | | location shall be designated the collaborating
physician. The |
24 | | other physicians with that practice group or other entity who
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25 | | practice in the same general type of practice or specialty
as |
26 | | the collaborating physician may collaborate with the physician |
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1 | | assistant with respect
to their patients.
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2 | | (b) A physician assistant licensed in this State, or |
3 | | licensed or authorized to practice in any other U.S. |
4 | | jurisdiction or credentialed by his or her federal employer as |
5 | | a physician assistant, who is responding to a need for medical |
6 | | care created by an emergency or by a state or local disaster |
7 | | may render such care that the physician assistant is able to |
8 | | provide without collaboration as it is defined in this Section |
9 | | or with such collaboration as is available.
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10 | | Any physician who collaborates with a physician assistant |
11 | | providing medical care in response to such an emergency or |
12 | | state or local disaster shall not be required to meet the |
13 | | requirements set forth in this Section for a collaborating |
14 | | physician. |
15 | | (Source: P.A. 100-453, eff. 8-25-17; 100-605, eff. 1-1-19 .)
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16 | | (225 ILCS 95/7.5)
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17 | | (Section scheduled to be repealed on January 1, 2028)
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18 | | Sec. 7.5. Collaborative Written collaborative agreements; |
19 | | prescriptive authority. |
20 | | (a) A written collaborative agreement is required for all |
21 | | physician assistants to practice in the State, except as |
22 | | provided in Section 7.7 of this Act. |
23 | | (1) A written collaborative agreement shall describe |
24 | | the working relationship of the physician assistant with |
25 | | the collaborating physician and shall describe the |
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1 | | categories of care, treatment, or procedures to be provided |
2 | | by the physician assistant.
The written collaborative |
3 | | agreement shall be established at the practice level and |
4 | | shall promote the exercise of professional judgment by the |
5 | | physician assistant commensurate with his or her education |
6 | | and experience. The services to be provided by the |
7 | | physician assistant shall be services that the |
8 | | collaborating physician is authorized to and generally |
9 | | provides to his or her patients in the normal course of his |
10 | | or her clinical medical practice. The written |
11 | | collaborative agreement need not describe the exact steps |
12 | | that a physician assistant must take with respect to each |
13 | | specific condition, disease, or symptom but must specify |
14 | | which authorized procedures require the presence of the |
15 | | collaborating physician as the procedures are being |
16 | | performed. The relationship under a written collaborative |
17 | | agreement shall not be construed to require the personal |
18 | | presence of a physician at the place where services are |
19 | | rendered. Methods of communication shall be available for |
20 | | consultation with the collaborating physician in person or |
21 | | by telecommunications or electronic communications as set |
22 | | forth in the written collaborative agreement. For the |
23 | | purposes of this Act, "generally provides to his or her |
24 | | patients in the normal course of his or her clinical |
25 | | medical practice" means services, not specific tasks or |
26 | | duties, the collaborating physician routinely provides |
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1 | | individually or through delegation to other persons so that |
2 | | the physician has the experience and ability to collaborate |
3 | | and provide consultation. |
4 | | (2) The written collaborative agreement shall be |
5 | | adequate if a physician does each of the following: |
6 | | (A) Participates in the joint formulation and |
7 | | joint approval of orders or guidelines with the |
8 | | physician assistant and he or she periodically reviews |
9 | | such orders and the services provided patients under |
10 | | such orders in accordance with accepted standards of |
11 | | medical practice and physician assistant practice. |
12 | | (B) Provides consultation at least once a month. |
13 | | (3) A copy of the signed, written collaborative |
14 | | agreement must be available to the Department upon request |
15 | | from both the physician assistant and the collaborating |
16 | | physician. |
17 | | (4) A physician assistant shall inform each |
18 | | collaborating physician of all written collaborative |
19 | | agreements he or she has signed and provide a copy of these |
20 | | to any collaborating physician upon request. |
21 | | (b) A collaborating physician may, but is not required to, |
22 | | delegate prescriptive authority to a physician assistant as |
23 | | part of a written collaborative agreement. This authority may, |
24 | | but is not required to, include prescription of, selection of, |
25 | | orders for, administration of, storage of, acceptance of |
26 | | samples of, and dispensing medical devices, over the counter |
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1 | | medications, legend drugs, medical gases, and controlled |
2 | | substances categorized as Schedule II through V controlled |
3 | | substances, as defined in Article II of the Illinois Controlled |
4 | | Substances Act, and other preparations, including, but not |
5 | | limited to, botanical and herbal remedies. The collaborating |
6 | | physician must have a valid, current Illinois controlled |
7 | | substance license and federal registration with the Drug |
8 | | Enforcement Agency to delegate the authority to prescribe |
9 | | controlled substances. |
10 | | (1) To prescribe Schedule II, III, IV, or V controlled |
11 | | substances under this
Section, a physician assistant must |
12 | | obtain a mid-level practitioner
controlled substances |
13 | | license. Medication orders issued by a
physician
assistant |
14 | | shall be reviewed
periodically by the collaborating |
15 | | physician. |
16 | | (2) The collaborating physician shall file
with the |
17 | | Department notice of delegation of prescriptive authority |
18 | | to a
physician assistant and
termination of delegation, |
19 | | specifying the authority delegated or terminated.
Upon |
20 | | receipt of this notice delegating authority to prescribe |
21 | | controlled substances, the physician assistant shall be |
22 | | eligible to
register for a mid-level practitioner |
23 | | controlled substances license under
Section 303.05 of the |
24 | | Illinois Controlled Substances Act.
Nothing in this Act |
25 | | shall be construed to limit the delegation of tasks or
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26 | | duties by the collaborating physician to a nurse or other |
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1 | | appropriately trained
persons in accordance with Section |
2 | | 54.2 of the Medical Practice Act of 1987.
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3 | | (3) In addition to the requirements of this subsection |
4 | | (b), a collaborating physician may, but is not required to, |
5 | | delegate authority to a physician assistant to prescribe |
6 | | Schedule II controlled substances, if all of the following |
7 | | conditions apply: |
8 | | (A) Specific Schedule II controlled substances by |
9 | | oral dosage or topical or transdermal application may |
10 | | be delegated, provided that the delegated Schedule II |
11 | | controlled substances are routinely prescribed by the |
12 | | collaborating physician. This delegation must identify |
13 | | the specific Schedule II controlled substances by |
14 | | either brand name or generic name. Schedule II |
15 | | controlled substances to be delivered by injection or |
16 | | other route of administration may not be delegated. |
17 | | (B) (Blank). |
18 | | (C) Any prescription must be limited to no more |
19 | | than a 30-day supply, with any continuation authorized |
20 | | only after prior approval of the collaborating |
21 | | physician. |
22 | | (D) The physician assistant must discuss the |
23 | | condition of any patients for whom a controlled |
24 | | substance is prescribed monthly with the collaborating |
25 | | physician. |
26 | | (E) The physician assistant meets the education |
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1 | | requirements of Section 303.05 of the Illinois |
2 | | Controlled Substances Act. |
3 | | (c) Nothing in this Act shall be construed to limit the |
4 | | delegation of tasks or duties by a physician to a licensed |
5 | | practical nurse, a registered professional nurse, or other |
6 | | persons. Nothing in this Act shall be construed to limit the |
7 | | method of delegation that may be authorized by any means, |
8 | | including, but not limited to, oral, written, electronic, |
9 | | standing orders, protocols, guidelines, or verbal orders. |
10 | | Nothing in this Act shall be construed to authorize a physician |
11 | | assistant to provide health care services required by law or |
12 | | rule to be performed by a physician. |
13 | | (c-5) Nothing in this Section shall be construed to apply
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14 | | to any medication authority, including Schedule II controlled
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15 | | substances of a licensed physician assistant for care provided
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16 | | in a hospital, hospital affiliate, or ambulatory surgical
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17 | | treatment center pursuant to Section 7.7 of this Act.
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18 | | (d) (Blank). |
19 | | (e) Nothing in this Section shall be construed to prohibit |
20 | | generic substitution. |
21 | | (Source: P.A. 100-453, eff. 8-25-17.)
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22 | | (225 ILCS 95/7.7) |
23 | | (Section scheduled to be repealed on January 1, 2028) |
24 | | Sec. 7.7. Physician assistants in hospitals, hospital |
25 | | affiliates, or ambulatory surgical treatment centers. |
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1 | | (a) A physician assistant may provide services in a |
2 | | hospital as defined in the Hospital Licensing Act, a hospital |
3 | | affiliate as defined in the University of Illinois Hospital |
4 | | Act, or a licensed ambulatory surgical treatment center as |
5 | | defined in the Ambulatory Surgical Treatment Center Act without |
6 | | a written collaborative agreement pursuant to Section 7.5 of |
7 | | this Act. A physician assistant must possess clinical |
8 | | privileges recommended by the hospital medical staff and |
9 | | granted by the hospital or the consulting medical staff |
10 | | committee and ambulatory surgical treatment center in order to |
11 | | provide services. The medical staff or consulting medical staff |
12 | | committee shall periodically review the services of physician |
13 | | assistants granted clinical privileges, including any care |
14 | | provided in a hospital affiliate. Authority may also be granted |
15 | | when recommended by the hospital medical staff and granted by |
16 | | the hospital or recommended by the consulting medical staff |
17 | | committee and ambulatory surgical treatment center to |
18 | | individual physician assistants to select, order, and |
19 | | administer medications, including controlled substances, to |
20 | | provide delineated care. In a hospital, hospital affiliate, or |
21 | | ambulatory surgical treatment center, the attending physician |
22 | | shall collaborate with a physician determine a physician |
23 | | assistant's role in providing care for his or her patients, |
24 | | except as otherwise provided in the medical staff bylaws or |
25 | | consulting committee policies. |
26 | | (a-5) Physician assistants practicing in a hospital |
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1 | | affiliate may be, but are not required to be, granted authority |
2 | | to prescribe Schedule II through V controlled substances when |
3 | | such authority is recommended by the appropriate physician |
4 | | committee of the hospital affiliate and granted by the hospital |
5 | | affiliate. This authority may, but is not required to, include |
6 | | prescription of, selection of, orders for, administration of,
|
7 | | storage of, acceptance of samples of, and dispensing |
8 | | over-the-counter medications, legend drugs, medical gases, and |
9 | | controlled substances categorized as Schedule II through V |
10 | | controlled substances, as defined in Article II of the Illinois |
11 | | Controlled Substances Act, and other preparations, including, |
12 | | but not limited to, botanical and herbal remedies. |
13 | | To prescribe controlled substances under this subsection |
14 | | (a-5), a physician assistant must obtain a mid-level |
15 | | practitioner controlled substance license. Medication orders |
16 | | shall be reviewed periodically by the appropriate hospital |
17 | | affiliate physicians committee or its physician designee. |
18 | | The hospital affiliate shall file with the Department |
19 | | notice of a grant of prescriptive authority consistent with |
20 | | this subsection (a-5) and termination of such a grant of |
21 | | authority in accordance with rules of the Department. Upon |
22 | | receipt of this notice of grant of authority to prescribe any |
23 | | Schedule II through V controlled substances, the licensed |
24 | | physician assistant may register for a mid-level practitioner |
25 | | controlled substance license under Section 303.05 of the |
26 | | Illinois Controlled Substances Act. |
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1 | | In addition, a hospital affiliate may, but is not required |
2 | | to, grant authority to a physician assistant to prescribe any |
3 | | Schedule II controlled substances if all of the following |
4 | | conditions apply: |
5 | | (1) specific Schedule II controlled substances by oral |
6 | | dosage or topical or transdermal application may be |
7 | | designated, provided that the designated Schedule II |
8 | | controlled substances are routinely prescribed by |
9 | | physician assistants in their area of certification; this |
10 | | grant of authority must identify the specific Schedule II |
11 | | controlled substances by either brand name or generic name; |
12 | | authority to prescribe or dispense Schedule II controlled |
13 | | substances to be delivered by injection or other route of |
14 | | administration may not be granted; |
15 | | (2) any grant of authority must be controlled |
16 | | substances limited to the practice of the physician |
17 | | assistant; |
18 | | (3) any prescription must be limited to no more than a |
19 | | 30-day supply; |
20 | | (4) the physician assistant must discuss the condition |
21 | | of any patients for whom a controlled substance is |
22 | | prescribed monthly with the appropriate physician |
23 | | committee of the hospital affiliate or its physician |
24 | | designee; and |
25 | | (5) the physician assistant must meet the education |
26 | | requirements of Section 303.05 of the Illinois Controlled |
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1 | | Substances Act. |
2 | | (b) A physician assistant granted authority to order |
3 | | medications including controlled substances may complete |
4 | | discharge prescriptions provided the prescription is in the |
5 | | name of the physician assistant and the attending or |
6 | | discharging physician. |
7 | | (c) Physician assistants practicing in a hospital, |
8 | | hospital affiliate, or an ambulatory surgical treatment center |
9 | | are not required to obtain a mid-level controlled substance |
10 | | license to order controlled substances under Section 303.05 of |
11 | | the Illinois Controlled Substances Act.
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12 | | (Source: P.A. 100-453, eff. 8-25-17.)
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13 | | (225 ILCS 95/11) (from Ch. 111, par. 4611)
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14 | | (Section scheduled to be repealed on January 1, 2028)
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15 | | Sec. 11. Physician Assistant Medical Licensing Board |
16 | | Committee . There is established a Physician Assistant Medical |
17 | | Licensing Board physician assistant advisory
committee
to the |
18 | | Department and the Medical Licensing Board. The Physician |
19 | | Assistant Medical Licensing Board physician assistant advisory
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20 | | committee may manage and regulate review and make |
21 | | recommendations to the
Department and the Board regarding all |
22 | | matters relating to physician assistants. Such matters may |
23 | | include, but not be limited to: |
24 | | (1) applications for licensure; |
25 | | (2) disciplinary proceedings; |
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1 | | (3) renewal requirements; and |
2 | | (4) any other issues pertaining to the regulation and |
3 | | practice of physician assistants in the State. |
4 | | The Physician Assistant Medical Licensing Board
physician |
5 | | assistant advisory committee shall be composed of 7 members.
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6 | | Three of the 7 members shall be physicians , 2 of whom shall be |
7 | | members of
the Board and appointed to the advisory committee by
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8 | | the chairman. One physician, not a member of the Board,
shall |
9 | | be a supervisor of a licensed physician assistant and
shall be |
10 | | approved by the Governor from a list of Illinois physicians
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11 | | supervising licensed physician assistants. Three members shall |
12 | | be
physician assistants, licensed under the law and appointed |
13 | | by the Governor
from a list of 10 names recommended by the |
14 | | Board of Directors of the
Illinois Academy of Physician |
15 | | Assistants. One member, not employed or
having any material |
16 | | interest in any health care field, shall be appointed
by the |
17 | | Governor and represent the public. The chairman of the |
18 | | Physician Assistant Medical Licensing Board physician
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19 | | assistant advisory committee shall be a member elected by a |
20 | | majority vote
of the Physician Assistant Medical Licensing |
21 | | Board physician assistant advisory committee unless already a |
22 | | member of
the Board . The Physician Assistant Medical Licensing |
23 | | Board physician assistant advisory committee
is required to |
24 | | meet and report to the Department and the Board as physician |
25 | | assistant issues arise. The terms of office of each of the
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26 | | original 7 members shall be at staggered intervals. One |
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1 | | physician and one
physician assistant shall serve for a 2 year |
2 | | term. One physician and one
physician assistant shall serve a 3 |
3 | | year term. One physician, one physician
assistant and the |
4 | | public member shall serve a 4 year term. Upon the
expiration of |
5 | | the term of any member, his successor shall be appointed for
a |
6 | | term of 4 years in the same manner as the initial appointment. |
7 | | No member
shall serve more than 2 consecutive terms.
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8 | | Four members of the Physician Assistant Medical Licensing |
9 | | Board physician assistant advisory committee
shall constitute |
10 | | a quorum. A quorum is required to perform all of the duties of |
11 | | the committee.
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12 | | Members of the Physician Assistant Medical Licensing Board |
13 | | physician assistant advisory committee shall have no liability
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14 | | for any
action based upon a disciplinary proceeding or other |
15 | | activity performed in good
faith as a member of the committee.
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16 | | (Source: P.A. 95-703, eff. 12-31-07; 96-720, eff. 8-25-09 .)
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17 | | Section 99. Effective date. This Act takes effect January |
18 | | 1, 2020.
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| 1 | |
INDEX
| 2 | |
Statutes amended in order of appearance
| | 3 | | 225 ILCS 60/54.5 | | | 4 | | 225 ILCS 95/1 | from Ch. 111, par. 4601 | | 5 | | 225 ILCS 95/4 | from Ch. 111, par. 4604 | | 6 | | 225 ILCS 95/5.5 | | | 7 | | 225 ILCS 95/6 | from Ch. 111, par. 4606 | | 8 | | 225 ILCS 95/6.1 new | | | 9 | | 225 ILCS 95/7 | from Ch. 111, par. 4607 | | 10 | | 225 ILCS 95/7.5 | | | 11 | | 225 ILCS 95/7.7 | | | 12 | | 225 ILCS 95/11 | from Ch. 111, par. 4611 |
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