Rep. Terra Costa Howard

Filed: 4/1/2024

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 3721

2    AMENDMENT NO. ______. Amend House Bill 3721 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. Short title. This Act may be cited as the
5Naturopathic Medical Practice Act.
 
6    Section 5. Purpose and findings. The practice of
7naturopathic medicine in the State is declared to affect the
8public health, safety, and welfare and to be subject to
9regulation and control in the public interest. It is further
10declared to be a matter of public interest that naturopathic
11doctors and the practice of naturopathic medicine, as defined
12in this Act, merit the confidence of the public, that only
13qualified persons be authorized to practice naturopathic
14medicine in the State, and that no person shall practice
15naturopathic medicine without a valid existing license to do
16so.

 

 

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1    The State is facing an unprecedented physician shortage in
2urban counties and an even higher shortage in rural counties.
3The COVID-19 pandemic increased that shortage exponentially.
4Naturopathic doctors with a proper scope of practice can help
5fill this void.
6    The General Assembly recognizes that naturopathic doctors
7comprise a distinct health care profession that affects the
8public health, safety, and welfare and that licensure of
9naturopathic doctors will increase freedom of choice in health
10care and help address the physician shortage in the State.
11This Act shall be liberally construed to best carry out these
12subjects and purposes.
 
13    Section 10. Definitions. In this Act:
14    "Approved naturopathic medical educational program" means
15an educational program that the Board has approved as meeting
16the requirements of Section 20 of this Act and that prepares
17naturopathic doctors for the practice of naturopathic
18medicine.
19    "Association" means an entity that is approved by the
20American Association of Naturopathic Physicians and that
21represents the interests of naturopathic doctors in this
22State.
23    "Board" means the Naturopathic Medical Board established
24under Section 55 of this Act.
25    "Clinical laboratory procedure" means the use of

 

 

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1venipuncture consistent with naturopathic medical practice,
2commonly used diagnostic modalities consistent with
3naturopathic practice, the recording of a patient's health
4history, physical examination, ordering and interpretation of
5radiographic diagnostics and other standard imaging and
6examination of body orifices, excluding endoscopy and
7colonoscopy. "Clinical laboratory procedure" includes the
8practice of obtaining samples of human tissues, except
9surgical excision beyond surgical excision that is authorized
10as a minor office procedure.
11    "Drug" has meaning given in Section 102 of the Illinois
12Controlled Substances Act.
13    "Homeopathic medicine" means a system of medicine based on
14the use of infinitesimal doses of substances capable of
15producing symptoms similar to those of the disease treated, as
16listed in the Homeopathic Pharmacopoeia of the United States.
17    "Hygiene" means the use of preventive techniques,
18including personal hygiene for asepsis, public health, and
19safety.
20    "Laboratory examination" means:
21        (1) phlebotomy;
22        (2) a clinical laboratory procedure;
23        (3) an orificial examination;
24        (4) a physiological function test; and
25        (5) a screening or test that is consistent with
26    naturopathic education and training.

 

 

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1    "Legend drug" has the same meaning as set forth in Section
23.23 of the Illinois Food, Drug and Cosmetic Act.
3    "License" means a license issued by the Board to an
4individual pursuant to this Act and rules authorizing that
5individual to practice naturopathic medicine in this State.
6    "Licensee" means a naturopathic doctor licensed by the
7Board to practice naturopathic medicine in this State.
8    "Minor office procedure" means minor surgical care and
9procedures, including:
10        (1) surgical care incidental to superficial
11    laceration, lesion, or abrasion, excluding surgical care
12    to treat a lesion suspected of malignancy;
13        (2) the removal of foreign bodies located in
14    superficial structures, excluding the globe of the eye;
15        (3) trigger point therapy;
16        (4) dermal stimulation;
17        (5) allergy testing and treatment; and
18        (6) the use of antiseptics and topical or local
19    anesthetics.
20    "Naturopathic doctor" means an individual licensed under
21this Act as a naturopathic doctor to practice naturopathic
22medicine in this State.
23    "Naturopathic medicine" means:
24        (1) a system of health care for the prevention,
25    diagnosis and treatment of human health conditions,
26    injury, and disease;

 

 

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1        (2) the promotion or restoration of health; and
2        (3) the support and stimulation of a patient's
3    inherent self-healing processes through patient education
4    and the use of naturopathic therapies and therapeutic
5    substances.
6    "Naturopathic physical medicine" means the use of one or
7more of the following physical agents in a manner consistent
8with naturopathic medical practice on a part or the whole of
9the body, by hand or by mechanical means, in the resolution of
10a human ailment or conditions:
11        (1) air;
12        (2) water;
13        (3) heat;
14        (4) cold;
15        (5) sound;
16        (6) light;
17        (7) electromagnetism;
18        (8) colon hydrotherapy;
19        (9) soft tissue therapy;
20        (10) joint mobilization;
21        (11) therapeutic exercise; or
22        (12) naturopathic manipulation.
23    "Naturopathic therapy" means the use of:
24        (1) naturopathic physical medicine;
25        (2) suggestion;
26        (3) hygiene;

 

 

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1        (4) a therapeutic substance;
2        (5) nutrition and food science;
3        (6) homeopathic medicine;
4        (7) a clinical laboratory procedure; or
5        (8) a minor office procedure.
6    "Nutrition and food science" means the prevention and
7treatment of disease or other human conditions through the use
8of food, water, herbs, roots, bark, or natural food elements.
9    "Prescription" has the same meaning as set forth in
10Section 3 of the Pharmacy Practice Act.
11    "Professional examination" means a competency based
12naturopathic doctor licensing examination as determined by
13Department rule.
14    "Suggestion" means a technique using:
15        (1) biofeedback;
16        (2) hypnosis;
17        (3) health education; or
18        (4) health counseling.
19    "Telehealth" or "telepractice" means the delivery of
20services under this Act by using electronic communication,
21information technologies, or other means between an individual
22licensed under this Act in one location and a patient or client
23in another location, with or without an intervening healthcare
24provider. "Telehealth" or "telepractice" includes direct,
25interactive patient encounters, asynchronous
26store-and-forward technologies, and remote monitoring.

 

 

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1Telehealth or telepractice is not prohibited under this Act
2provided that the provision of telehealth or telepractice
3services is appropriate for the client and the level of care
4provided meets the required level of care for that client.
5Individuals providing services regulated by this Act via
6telepractice shall comply with and are subject to all
7licensing and disciplinary provisions of this Act.
8    "Therapeutic substance" means any of the following
9exemplified in a standard naturopathic medical text, journal,
10or pharmacopeia:
11        (1) a vitamin;
12        (2) a mineral;
13        (3) a nutraceutical;
14        (4) a botanical medicine;
15        (5) oxygen;
16        (6) a homeopathic medicine;
17        (7) a hormone;
18        (8) a hormonal or pharmaceutical contraceptive device;
19    or
20        (9) other physiologic substance.
 
21    Section 15. Qualifications for licensure. The Board shall
22license an applicant who:
23        (1) submits, in accordance with rules of the
24    Department, the following items to the Board:
25            (A) an application for licensure designed and

 

 

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1        approved by the Board and submitted in accordance with
2        rules of the Department;
3            (B) an application fee submitted in an amount and
4        manner established by rules of the Department;
5            (C) evidence that the applicant has graduated from
6        a Council on Naturopathic Medical Education or an
7        equivalent federally recognized accrediting body,
8        approved naturopathic medical education program;
9            (D) evidence that the applicant has passed a
10        professional examination authorized by rule of the
11        Department and administered by the North American
12        Board of Naturopathic Examiners or its successor;
13            (E) evidence that the applicant has passed a
14        pharmacy examination authorized by rules of the
15        Department and administered by the North American
16        Board of Naturopathic Examiners or its successor;
17            (F) evidence that the applicant has passed a minor
18        surgery examination authorized by rules of the
19        Department and administered by the North American
20        Board of Naturopathic Examiners or its successor; and
21            (G) evidence of professional liability insurance
22        with policy limits not less than prescribed by the
23        Department;
24        (2) is determined by the Board to be physically and
25    mentally capable of safely practicing naturopathic
26    medicine with or without reasonable accommodation; and

 

 

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1        (3) has not had a license to practice naturopathic
2    medicine or other health care license, registration, or
3    certificate refused, revoked, or suspended by any other
4    jurisdiction for reasons that relate to the applicant's
5    ability to skillfully and safely practice naturopathic
6    medicine unless that license, registration, or
7    certification has been restored to good standing by that
8    jurisdiction.
 
9    Section 20. Approved naturopathic medical educational
10program. The Department shall establish, by rule, guidelines
11for an approved naturopathic medical educational program,
12which guidelines shall meet the following requirements and the
13Department's specifications for the education of naturopathic
14doctors. The approved naturopathic medical educational program
15shall:
16        (1) offer graduate-level, full-time didactic and
17    supervised clinical training;
18        (2) be accredited, or have achieved candidacy status
19    for accreditation, by the Council on Naturopathic Medical
20    Education or an equivalent federally recognized
21    accrediting body for naturopathic medical programs that is
22    also recognized by the Department; and
23        (3) be conducted by an institution of higher
24    education, or a division of an institution of higher
25    education, that:

 

 

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1            (A) is accredited or is a candidate for
2        accreditation by a regional or national institutional
3        accrediting agency recognized by the United States
4        Secretary of Education or a diploma-granting,
5        degree-equivalent college or university; or
6            (B) meets equivalent standards for recognition of
7        accreditation established by rules of the Department
8        for medical education programs offered in Canada.
 
9    Section 25. Display of license. A licensee shall display
10the licensee's license in the licensee's place of business in
11a location clearly visible to the licensee's patients and
12shall also display evidence of the licensee having completed
13an approved naturopathic medical educational program.
 
14    Section 27. Written collaborative agreements.
15    (a) A written collaborative agreement is required for all
16naturopathic doctors engaged in clinical practice.
17    (b) A written collaborative agreement shall describe the
18relationship between the naturopathic doctor and the
19collaborating physician and shall describe the categories of
20care, treatment, or procedures to be provided by the
21naturopathic doctor. Collaboration does not require an
22employment relationship between the collaborating physician
23and the naturopathic doctor.
24    The collaborative relationship established under an

 

 

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1agreement shall not be construed to require the personal
2presence of a collaborating physician at the place where
3services are rendered. Methods of communication for
4consultation with the collaborating physician in person or by
5telecommunications or electronic communications shall be
6available as set forth in the written agreement.
7    (c) Absent an employment relationship, a written
8collaborative agreement under this Section may not:
9        (1) restrict the categories of patients of a
10    naturopathic doctor within the scope of the naturopathic
11    doctor's training and experience;
12        (2) limit third party payors or government health
13    programs; or
14        (3) limit the geographic area or practice location of
15    the naturopathic doctor in this State.
16    (d) A copy of the signed, written collaborative agreement
17must be available to the Department upon request from both the
18naturopathic doctor and the collaborating physician.
19    (e) Nothing in this Act shall be construed to limit the
20delegation of tasks or duties by a physician to a licensed
21practical nurse, a registered professional nurse, or other
22persons in accordance with Section 54.2 of the Medical
23Practice Act of 1987. Nothing in this Act shall be construed to
24limit the method of delegation that may be authorized by any
25means, including, but not limited to, verbal, written,
26electronic, or standing orders, protocols, or guidelines.

 

 

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1    (f) Nothing in this Act shall be construed to authorize a
2naturopathic doctor to provide health care services required
3by law or rule to be performed by a physician. The scope of
4practice of a naturopathic doctor does not include operative
5surgery. Nothing in this Section shall be construed to
6preclude a naturopathic doctor from assisting in surgery.
7    (g) A naturopathic doctor shall inform each collaborating
8physician, dentist, or podiatric physician of all
9collaborative agreements the naturopathic doctor has signed
10and provide a copy of those agreements to any collaborating
11physician, dentist, or podiatric physician upon request.
 
12    Section 30. Scope of practice.
13    (a) A licensee may practice naturopathic medicine to
14provide primary care in alignment with naturopathic medical
15education to:
16        (1) perform physical examinations;
17        (2) order laboratory examinations;
18        (3) order diagnostic imaging studies;
19        (4) interpret the results of laboratory examinations
20    for diagnostic purposes;
21        (5) order and, based on a radiologist's report, take
22    action on diagnostic imaging studies in a manner
23    consistent with naturopathic training;
24        (6) prescribe, administer, dispense, and order food,
25    extracts of food, nutraceuticals, vitamins, amino acids,

 

 

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1    minerals, enzymes, botanicals and their extracts,
2    botanical medicines, homeopathic medicines, dietary
3    supplements, and nonprescription drugs as defined by the
4    Federal Food, Drug, and Cosmetic Act;
5        (7) dispense and order all legend drugs in the regular
6    course of practicing naturopathic medicine. The dispensing
7    of such legend drugs shall be the personal act of the
8    person licensed under this Act and may not be delegated to
9    any other person not licensed under this Act or the
10    Pharmacy Practice Act unless such delegated dispensing
11    functions are under the direct supervision of the
12    physician authorized to dispense legend drugs. Except when
13    dispensing manufacturers' samples or other legend drugs in
14    a maximum 72 hour supply, persons licensed under this Act
15    shall maintain a book or file of prescriptions as required
16    in the Pharmacy Practice Act. Any person licensed under
17    this Act who dispenses any drug or medicine shall dispense
18    such drug or medicine in good faith and shall affix to the
19    box, bottle, vessel or package containing the same a label
20    indicating (i) the date on which such drug or medicine is
21    dispensed; (ii) the name of the patient; (iii) the last
22    name of the person dispensing such drug or medicine; (iv)
23    the directions for use thereof; and (v) the proprietary
24    name or names or, if there are none, the established name
25    or names of the drug or medicine, the dosage and quantity,
26    except as otherwise authorized by regulation of the

 

 

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1    Department;
2        (8) use routes of administration that include oral,
3    nasal, auricular, and intramuscular rules of
4    administration, consistent with the education and training
5    of a naturopathic doctor;
6        (9) administer intramuscular injections of vaccines;
7        (10) perform naturopathic physical medicine;
8        (11) employ the use of naturopathic therapy;
9        (12) use therapeutic devices, barrier contraception,
10    hormonal and pharmaceutical contraception, and durable
11    medical equipment; or
12        (13) perform minor office procedures that can be
13    performed with topicals or intramuscular injectables.
14    (b) A licensee may practice naturopathic medicine via
15telehealth services.
 
16    Section 35. Referral requirement. A licensee shall refer
17to a physician licensed to practice medicine in all of its
18branches under the Medical Practice Act of 1987 or an advanced
19practice registered nurse licensed under the Nurse Practice
20Act any patient whose medical condition is determined, at the
21time of evaluation or treatment, to be beyond the scope of
22practice of the licensee.
 
23    Section 40. Prohibitions. A licensee shall not:
24        (1) perform surgery outside of the scope of minor

 

 

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1    office procedures permitted in the employment of
2    naturopathic therapy;
3        (2) use general or spinal anesthetics;
4        (3) administer ionizing radioactive substances for
5    therapeutic purposes;
6        (4) perform a surgical procedure using a laser device;
7        (5) perform a surgical procedure involving any of the
8    following areas of the body that extend beyond superficial
9    tissue:
10            (A) eyes;
11            (B) ears;
12            (C) tendons;
13            (D) nerves;
14            (E) veins; or
15            (F) arteries;
16        (6) perform a surgical abortion;
17        (7) treat any lesion suspected of malignancy or
18    requiring surgical removal; or
19        (8) perform acupuncture.
 
20    Section 45. Exemptions. Nothing in this Act shall be
21construed to prohibit or to restrict:
22        (1) the practice of a health care profession by an
23    individual who is licensed, certified, or registered under
24    other laws of this State and who is performing services
25    within the individual's authorized scope of practice;

 

 

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1        (2) the practice of naturopathic medicine by a student
2    enrolled in an approved naturopathic medical educational
3    program if the practice of naturopathic medicine by a
4    student is performed pursuant to a course of instruction
5    or an assignment from an instructor at an accredited
6    university or college by an instructor duly licensed as a
7    health care provider in the State;
8        (3) any person who sells a vitamin or herb from
9    providing information about the vitamin or herb;
10        (4) the practice of naturopathic medicine by persons
11    who are licensed to practice in any other state or
12    district in the United States and who enter this State to
13    consult with a naturopathic doctor of this State if the
14    consultation is limited to an examination or
15    recommendation; or
16        (5) any person or practitioner who is not licensed as
17    a naturopathic doctor from recommending ayurvedic
18    medicine, herbal remedies, nutritional advice, homeopathy,
19    or other therapy that is within the scope of practice of
20    naturopathic medicine; however, the person or practitioner
21    shall not:
22            (A) use a title protected pursuant to Section 50
23        of this Act;
24            (B) represent or assume the character or
25        appearance of a licensee; or
26            (C) otherwise use a name, title, or other

 

 

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1        designation that indicates or implies that the person
2        is a licensee.
 
3    Section 50. Protected titles.
4    (a) A licensee shall use the title "naturopathic doctor",
5"naturopath", or "doctor of naturopathy" and the recognized
6abbreviation "N.D.".
7    (b) A licensee has the exclusive right to use the
8following terms in reference to the licensee's self:
9        (1) "naturopathic doctor";
10        (2) "doctor of naturopathic medicine";
11        (3) "doctor of naturopathy";
12        (4) "naturopath";
13        (5) "N.D."; and
14        (6) "ND".
15    (c) An individual represents the individual's self to be a
16naturopathic doctor or a naturopathic doctor when the
17individual uses or adopts any of the following terms in
18reference to the individual's self:
19        (1) "naturopathic doctor";
20        (2) "doctor of naturopathic medicine";
21        (3) "doctor of naturopathy";
22        (4) "naturopath";
23        (5) "N.D."; or
24        (6) "ND".
25    (d) An individual shall not represent the individual's

 

 

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1self to the public as a naturopathic doctor, a doctor of
2naturopathic medicine, a doctor of naturopathy, or as being
3otherwise authorized to practice naturopathic medicine in this
4State, unless the individual is a licensee.
 
5    Section 55. Naturopathic Medical Board.
6    (a) The Naturopathic Medical Board shall oversee:
7        (1) licensure of naturopathic doctors; and
8        (2) matters relating to training and licensure of
9    naturopathic doctors.
10    (b) Within 180 days after the effective date of this Act,
11the Governor shall appoint an initial Board consisting of 2
12members for terms of 4 years each, 3 members for terms of 3
13years each, and 4 members for terms of 2 years each. The
14initial Board shall consist of the following voting members:
15        (1) five licensed naturopathic doctors who are
16    residents of the State;
17        (2) two practicing physicians licensed to practice
18    medicine in all of its branches; and
19        (3) two public members who are residents of this
20    State, who are not, and never have been, a licensed health
21    care practitioner, and who do not have an interest in
22    naturopathic education, naturopathic medicine, or
23    naturopathic business or practice.
24    Members of the Board may be recommended to the Governor by
25the Illinois Association of Naturopathic Physicians.

 

 

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1    (c) As the terms of the initial Board members expire, the
2Governor shall appoint successors for terms of 4 years each as
3follows:
4        (1) five naturopathic doctors licensed pursuant to
5    this Act;
6        (2) two practicing physicians licensed to practice
7    medicine in all of its branches with experience working
8    with naturopathic doctors; and
9        (3) two public members that are residents of this
10    State who are not, and never have been, a licensed health
11    care practitioner and who do not have an interest in
12    naturopathic education, naturopathic medicine or
13    naturopathic business or practice.
14    (d) Within 30 days after the Board is established, the
15Board shall call the first meeting, at which meeting members
16shall elect a chair. The Board may hold meetings at the call of
17the chair or at the written request of any 2 members of the
18Board.
19    (e) Vacancies on the Board shall be filled from a list of
20not fewer than 3 candidates.
21    (f) A majority of the Board shall constitute a quorum.
22    (g) Members of the Board shall serve without compensation
23but may, at the discretion of the Board, be reimbursed for
24their expenses incurred in performing their duties.
25    (h) The Department of Financial and Professional
26Regulation shall provide administrative and other support to

 

 

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1the Board.
 
2    Section 60. Board duties. The Board shall have the
3following duties:
4        (1) regulating the licensure of naturopathic doctors
5    and determining the hours of continuing education units
6    required for maintaining licensure as a naturopathic
7    doctor;
8        (2) prescribing the manner in which records of
9    examinations and treatments shall be kept and maintained;
10        (3) establishing standards for professional
11    responsibility and conduct;
12        (4) identifying disciplinary actions and circumstances
13    that require disciplinary action;
14        (5) developing a means to provide information to all
15    licensees in this State;
16        (6) providing for the investigation of complaints
17    against licensees or persons holding themselves out as
18    naturopathic doctors in this State;
19        (7) providing for the publication of information for
20    the public about licensees and the practice of
21    naturopathic medicine in this State;
22        (8) providing for an orderly process for reinstatement
23    of a license;
24        (9) establishing criteria for advertising or
25    promotional materials;

 

 

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1        (10) establishing continuing education hours and
2    content;
3        (11) establishing procedures and standards for
4    reviewing licensing examination scores; and
5        (12) establishing procedures for reviewing transcripts
6    demonstrating completion of the approved naturopathic
7    medical educational program;
8        (13) establishing and maintaining a list of
9    naturopathic medical education programs that meet the
10    requirements of Section 20;
11        (14) establishing the requirements for issuance and
12    renewal of licenses; and
13        (15) any other matter necessary to implement this Act.
 
14    Section 65. License expiration, renewal, denial,
15revocation, and continuing education.
16    (a) A license issued or renewed pursuant to this Act shall
17expire in a time frame determined by rule by the Department.
18    (b) The Board may renew the license of any licensee who,
19upon the expiration of the licensee's license:
20        (1) has submitted an application for renewal;
21        (2) has paid the renewal fee established by rules of
22    the Department;
23        (3) meets the qualifications for licensure set forth
24    in this Act and rules of the Department; and
25        (4) meets the continuing education requirements

 

 

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1    established by the Board.
2    (c) If the Board intends to refuse to issue or renew,
3revoke, or suspend a license, the Department shall grant the
4applicant or licensee an opportunity for a hearing.
 
5    Section 70. Grounds for disciplinary action.
6    (a) The Department may refuse to issue or to renew, or may
7revoke, suspend, place on probation, reprimand, or take other
8disciplinary or non-disciplinary action with regard to any
9license issued under this Act as the Department may deem
10proper, including the issuance of fines not to exceed $10,000
11for each violation, for any one or combination of the
12following causes:
13        (1) material misstatement in furnishing information to
14    the Department;
15        (2) violations of this Act, or the rules adopted under
16    this Act;
17        (3) conviction by plea of guilty or nolo contendere,
18    finding of guilt, jury verdict, or entry of judgment or
19    sentencing, including, but not limited to, convictions,
20    preceding sentences of supervision, conditional discharge,
21    or first offender probation, under the laws of any
22    jurisdiction of the United States that is: (i) a felony;
23    or (ii) a misdemeanor, an essential element of which is
24    dishonesty, or that is directly related to the practice of
25    the profession;

 

 

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1        (4) making any misrepresentation for the purpose of
2    obtaining licenses;
3        (5) professional incompetence;
4        (6) aiding or assisting another person in violating
5    any provision of this Act or its rules;
6        (7) failing, within 60 days, to provide information in
7    response to a written request made by the Department;
8        (8) engaging in dishonorable, unethical, or
9    unprofessional conduct, as defined by rule, of a character
10    likely to deceive, defraud, or harm the public.
11        (9) habitual or excessive use or addiction to alcohol,
12    narcotics, stimulants, or any other chemical agent or drug
13    that results in a naturopathic doctor's inability to
14    practice with reasonable judgment, skill, or safety;
15        (10) discipline by another U.S. jurisdiction or
16    foreign nation, if at least one of the grounds for
17    discipline is the same or substantially equivalent to
18    those set forth in this Section;
19        (11) directly or indirectly giving to or receiving
20    from any person, firm, corporation, partnership, or
21    association any fee, commission, rebate or other form of
22    compensation for any professional services not actually or
23    personally rendered. Nothing in this paragraph (11)
24    affects any bona fide independent contractor or employment
25    arrangements, which may include provisions for
26    compensation, health insurance, pension, or other

 

 

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1    employment benefits, with persons or entities authorized
2    under this Act for the provision of services within the
3    scope of the licensee's practice under this Act;
4        (12) abandonment of a patient;
5        (13) willfully making or filing false records or
6    reports in the individual's practice, including, but not
7    limited to, false records filed with state agencies or
8    departments;
9        (14) physical illness, or mental illness or impairment
10    that results in the inability to practice the profession
11    with reasonable judgment, skill, or safety, including, but
12    not limited to, deterioration through the aging process or
13    loss of motor skill;
14        (15) being named as a perpetrator in an indicated
15    report by the Department of Children and Family Services
16    under the Abused and Neglected Child Reporting Act, and
17    upon proof by clear and convincing evidence that the
18    licensee has caused a child to be an abused child or
19    neglected child as defined in the Abused and Neglected
20    Child Reporting Act;
21        (16) gross negligence resulting in permanent injury or
22    death of a patient;
23        (17) employment of fraud, deception or any unlawful
24    means in applying for or securing a license under this
25    Act;
26        (18) immoral conduct in the commission of any act,

 

 

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1    such as sexual abuse, sexual misconduct, or sexual
2    exploitation related to the licensee's practice;
3        (19) practicing under a false or assumed name, except
4    as provided by law;
5        (20) making a false or misleading statement regarding
6    the licensee's skill or the efficacy or value of the
7    treatment or remedy prescribed by the licensee in the
8    course of treatment;
9        (21) allowing another person to use the licensee's
10    license to practice;
11        (22) prescribing, selling, administering,
12    distributing, giving, or self-administering a drug
13    classified as a controlled substance;
14        (23) a pattern of practice or other behavior that
15    demonstrates incapacity or incompetence to practice under
16    this Act;
17        (24) violating State or federal laws or regulations
18    relating to controlled substances or other legend drugs or
19    ephedra as defined in the Ephedra Prohibition Act;
20        (25) failure to establish and maintain records of
21    patient care and treatment as required by law;
22        (26) attempting to subvert or cheat on the required
23    examinations;
24        (27) willfully failing to report an instance of
25    suspected abuse, neglect, financial exploitation, or
26    self-neglect of an eligible adult as defined in and

 

 

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1    required by the Adult Protective Services Act;
2        (28) being named as an abuser in a verified report by
3    the Department on Aging under the Adult Protective
4    Services Act and upon proof by clear and convincing
5    evidence that the licensee abused, neglected, or
6    financially exploited an eligible adult as defined in the
7    Adult Protective Services Act;
8        (29) failure to report to the Department an adverse
9    final action taken against the individual by another
10    licensing jurisdiction of the United States or a foreign
11    state or country, a peer review body, a health care
12    institution, a professional society or association, a
13    governmental agency, a law enforcement agency, or a court
14    acts or conduct similar to acts or conduct that would
15    constitute grounds for action under this Section; and
16        (30) failure to provide copies of records of patient
17    care or treatment, except as required by law.
18    (b) The Department may refuse to issue or may suspend
19without hearing, as provided for in the Code of Civil
20Procedure, the license of any person who fails to file a
21return, or pay the tax, penalty, or interest shown in a filed
22return, or pay any final assessment of the tax, penalty, or
23interest as required by any tax Act administered by the
24Illinois Department of Revenue, until the requirements of any
25such tax Act are satisfied in accordance with subsection (g)
26of Section 2105-15 of the Civil Administrative Code of

 

 

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1Illinois.
2    (c) The determination by a circuit court that a licensee
3is subject to involuntary admission or judicial admission as
4provided in the Mental Health and Developmental Disabilities
5Code operates as an automatic suspension. The suspension will
6end only upon a finding by a court that the patient is no
7longer subject to involuntary admission or judicial admission
8and issues an order so finding and discharging the patient,
9and upon the recommendation of the Board to the Department
10that the licensee be allowed to resume the licensee's
11practice.
12    (d) In enforcing this Section, the Department upon a
13showing of a possible violation may compel an individual
14licensed to practice under this Act, or who has applied for
15licensure under this Act, to submit to a mental or physical
16examination, or both, which may include a substance abuse or
17sexual offender evaluation, as required by and at the expense
18of the Department.
19    The Department shall specifically designate the examining
20physician licensed to practice medicine in all of its branches
21or, if applicable, the multidisciplinary team involved in
22providing the mental or physical examination or both. The
23multidisciplinary team shall be led by a physician licensed to
24practice medicine in all of its branches and may consist of one
25or more or a combination of physicians licensed to practice
26medicine in all of its branches, licensed clinical

 

 

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1psychologists, licensed clinical social workers, licensed
2clinical professional counselors, and other professional and
3administrative staff. Any examining physician or member of the
4multidisciplinary team may require any person ordered to
5submit to an examination pursuant to this Section to submit to
6any additional supplemental testing deemed necessary to
7complete any examination or evaluation process, including, but
8not limited to, blood testing, urinalysis, psychological
9testing, or neuropsychological testing.
10    The Department may order the examining physician or any
11member of the multidisciplinary team to provide to the
12Department any and all records, including business records,
13that relate to the examination and evaluation, including any
14supplemental testing performed.
15    The Department may order the examining physician or any
16member of the multidisciplinary team to present testimony
17concerning the mental or physical examination of the licensee
18or applicant. No information, report, record, or other
19documents in any way related to the examination shall be
20excluded by reason of any common law or statutory privilege
21relating to communications between the licensee or applicant
22and the examining physician or any member of the
23multidisciplinary team. No authorization is necessary from the
24licensee or applicant ordered to undergo an examination for
25the examining physician or any member of the multidisciplinary
26team to provide information, reports, records, or other

 

 

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1documents or to provide any testimony regarding the
2examination and evaluation.
3    The individual to be examined may have, at the
4individual's own expense, another physician of the
5individual's choice present during all aspects of this
6examination. However, that physician shall be present only to
7observe and may not interfere in any way with the examination.
8    Failure of an individual to submit to a mental or physical
9examination, when ordered, shall result in an automatic
10suspension of the individual's license until the individual
11submits to the examination.
12    If the Department finds an individual unable to practice
13because of the reasons set forth in this Section, the
14Department may require that individual to submit to care,
15counseling, or treatment by physicians approved or designated
16by the Department, as a condition, term, or restriction for
17continued, reinstated, or renewed licensure to practice; or,
18in lieu of care, counseling, or treatment, the Department may
19file a complaint to immediately suspend, revoke, or otherwise
20discipline the license of the individual. An individual whose
21license was granted, continued, reinstated, renewed,
22disciplined, or supervised subject to such terms, conditions,
23or restrictions, and who fails to comply with such terms,
24conditions, or restrictions, shall be referred to the
25Secretary for a determination as to whether the individual
26shall have his or her license suspended immediately, pending a

 

 

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1hearing by the Department.
2    In instances in which the Department immediately suspends
3a person's license under this Section, a hearing on that
4person's license must be convened by the Department within 30
5days after the suspension and completed without appreciable
6delay. The Department shall have the authority to review the
7subject individual's record of treatment and counseling
8regarding the impairment to the extent permitted by applicable
9federal statutes and regulations safeguarding the
10confidentiality of medical records.
11    An individual licensed under this Act and affected under
12this Section shall be afforded an opportunity to demonstrate
13to the Department that the individual can resume practice in
14compliance with acceptable and prevailing standards under the
15provisions of the individual's license.
16    (e) An individual or organization acting in good faith,
17and not in a willful and wanton manner, in complying with this
18Section by providing a report or other information to the
19Department, by assisting in the investigation or preparation
20of a report or information, by participating in proceedings of
21the Department, or by serving as a member of the Department,
22shall not be subject to criminal prosecution or civil damages
23as a result of such actions.
24    (f) Members of the Board and the Department shall be
25indemnified by the State for any actions occurring within the
26scope of services under the Act, done in good faith and not

 

 

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1willful and wanton in nature. The Attorney General shall
2defend all such actions unless the Attorney General determines
3either that there would be a conflict of interest in such
4representation or that the actions complained of were not in
5good faith or were willful and wanton.
6    If the Attorney General declines representation, the
7member has the right to employ counsel of the member's choice,
8whose fees shall be provided by the State, after approval by
9the Attorney General, unless there is a determination by a
10court that the member's actions were not in good faith or were
11willful and wanton.
12    The member must notify the Attorney General within 7 days
13after receipt of notice of the initiation of any action
14involving services of the Board. Failure to so notify the
15Attorney General constitutes an absolute waiver of the right
16to a defense and indemnification.
17    The Attorney General shall determine, within 7 days after
18receiving such notice, whether the Attorney General will
19undertake to represent the member.
 
20    Section 75. Investigation; notice; hearing. The Department
21may investigate the actions of any applicant or of any person
22or persons holding or claiming to hold a license. The
23Department shall, before suspending, revoking, placing on
24probationary status, or taking any other disciplinary action
25as the Department may deem proper with regard to any license,

 

 

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1at least 30 days prior to the date set for the hearing, notify
2the licensee in writing of any charges made and the time and
3place for a hearing of the charges before the Department,
4direct the licensee to file the licensee's written answer
5thereto to the Department under oath within 20 days after the
6service on the licensee of such notice and inform the licensee
7that if the licensee fails to file such answer, default will be
8taken against the licensee and the license may be suspended,
9revoked, placed on probationary status, or have other
10disciplinary action, including limiting the scope, nature or
11extent of the licensee's practice, as the Department may deem
12proper taken with regard thereto. Written or electronic notice
13may be served by personal delivery, email, or mail to the
14applicant or licensee at the licensee's address of record or
15email address of record. At the time and place fixed in the
16notice, the Department shall proceed to hear the charges and
17the parties or their counsel shall be accorded ample
18opportunity to present such statements, testimony, evidence,
19and argument as may be pertinent to the charges or to the
20defense thereto. The Department may continue such hearing from
21time to time. In case the applicant or licensee, after
22receiving notice, fails to file an answer, the licensee's
23license may in the discretion of the Secretary, having
24received first the recommendation of the Department, be
25suspended, revoked, placed on probationary status, or the
26Department may take whatever disciplinary action as the

 

 

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1Department may deem proper, including limiting the scope,
2nature, or extent of such person's practice, without a
3hearing, if the act or acts charged constitute sufficient
4grounds for such action under this Act.
 
5    Section 80. Record of proceedings. The Department, at its
6expense, shall preserve a record of all proceedings at the
7formal hearing of any case involving the refusal to issue or
8renew a license or discipline a licensee. The notice of
9hearing, complaint, and all other documents in the nature of
10pleadings and written motions filed in the proceedings, the
11transcript of testimony, the report of the Department, and
12orders of the Department shall be the record of such
13proceeding.
 
14    Section 85. Confidentiality. All information collected by
15the Department in the course of an examination or
16investigation of a licensee or applicant, including, but not
17limited to, any complaint against a licensee filed with the
18Department and information collected to investigate any such
19complaint, shall be maintained for the confidential use of the
20Department and shall not be disclosed. The Department shall
21not disclose the information to anyone other than law
22enforcement officials, regulatory agencies that have an
23appropriate regulatory interest as determined by the
24Department, or a party presenting a lawful subpoena to the

 

 

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1Department. Information and documents disclosed to a federal,
2State, county, or local law enforcement agency shall not be
3disclosed by the agency for any purpose to any other agency or
4person. A formal complaint filed against a licensee by the
5Department or any order issued by the Department against a
6licensee or applicant shall be a public record, except as
7otherwise prohibited by law.
 
8    Section 90. Illinois Administrative Procedure Act. The
9Illinois Administrative Procedure Act is expressly adopted and
10incorporated herein as if all of the provisions of that Act
11were included in this Act, except that the provision of
12paragraph (d) of Section 10-65 of the Illinois Administrative
13Procedure Act, which provides that at hearings the licensee or
14person holding a license has the right to show compliance with
15all lawful requirements for retention or continuation of the
16license, is specifically excluded. For the purpose of this
17Act, the notice required under Section 10-25 of the Illinois
18Administrative Procedure Act is deemed sufficient when
19personally served, mailed to the address of record of the
20applicant or licensee, or emailed to the email address of
21record of the applicant or licensee.
 
22    Section 95. The Medical Practice Act of 1987 is amended by
23changing Section 54.5 as follows:
 

 

 

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1    (225 ILCS 60/54.5)
2    (Section scheduled to be repealed on January 1, 2027)
3    Sec. 54.5. Physician delegation of authority to physician
4assistants, advanced practice registered nurses without full
5practice authority, and prescribing psychologists, and
6naturopathic doctors.
7    (a) Physicians licensed to practice medicine in all its
8branches may delegate care and treatment responsibilities to a
9physician assistant under guidelines in accordance with the
10requirements of the Physician Assistant Practice Act of 1987.
11A physician licensed to practice medicine in all its branches
12may enter into collaborative agreements with no more than 7
13full-time equivalent physician assistants, except in a
14hospital, hospital affiliate, or ambulatory surgical treatment
15center as set forth by Section 7.7 of the Physician Assistant
16Practice Act of 1987 and as provided in subsection (a-5).
17    (a-5) A physician licensed to practice medicine in all its
18branches may collaborate with more than 7 physician assistants
19when the services are provided in a federal primary care
20health professional shortage area with a Health Professional
21Shortage Area score greater than or equal to 12, as determined
22by the United States Department of Health and Human Services.
23    The collaborating physician must keep appropriate
24documentation of meeting this exemption and make it available
25to the Department upon request.
26    (b) A physician licensed to practice medicine in all its

 

 

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1branches in active clinical practice may collaborate with an
2advanced practice registered nurse in accordance with the
3requirements of the Nurse Practice Act. Collaboration is for
4the purpose of providing medical consultation, and no
5employment relationship is required. A written collaborative
6agreement shall conform to the requirements of Section 65-35
7of the Nurse Practice Act. The written collaborative agreement
8shall be for services for which the collaborating physician
9can provide adequate collaboration. A written collaborative
10agreement shall be adequate with respect to collaboration with
11advanced practice registered nurses if all of the following
12apply:
13        (1) The agreement is written to promote the exercise
14    of professional judgment by the advanced practice
15    registered nurse commensurate with his or her education
16    and experience.
17        (2) The advanced practice registered nurse provides
18    services based upon a written collaborative agreement with
19    the collaborating physician, except as set forth in
20    subsection (b-5) of this Section. With respect to labor
21    and delivery, the collaborating physician must provide
22    delivery services in order to participate with a certified
23    nurse midwife.
24        (3) Methods of communication are available with the
25    collaborating physician in person or through
26    telecommunications for consultation, collaboration, and

 

 

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1    referral as needed to address patient care needs.
2    (b-5) An anesthesiologist or physician licensed to
3practice medicine in all its branches may collaborate with a
4certified registered nurse anesthetist in accordance with
5Section 65-35 of the Nurse Practice Act for the provision of
6anesthesia services. With respect to the provision of
7anesthesia services, the collaborating anesthesiologist or
8physician shall have training and experience in the delivery
9of anesthesia services consistent with Department rules.
10Collaboration shall be adequate if:
11        (1) an anesthesiologist or a physician participates in
12    the joint formulation and joint approval of orders or
13    guidelines and periodically reviews such orders and the
14    services provided patients under such orders; and
15        (2) for anesthesia services, the anesthesiologist or
16    physician participates through discussion of and agreement
17    with the anesthesia plan and is physically present and
18    available on the premises during the delivery of
19    anesthesia services for diagnosis, consultation, and
20    treatment of emergency medical conditions. Anesthesia
21    services in a hospital shall be conducted in accordance
22    with Section 10.7 of the Hospital Licensing Act and in an
23    ambulatory surgical treatment center in accordance with
24    Section 6.5 of the Ambulatory Surgical Treatment Center
25    Act.
26    (b-10) The anesthesiologist or operating physician must

 

 

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1agree with the anesthesia plan prior to the delivery of
2services.
3    (c) A physician licensed to practice medicine in all its
4branches in active clinical practice may collaborate with a
5naturopathic doctor in accordance with the requirements of the
6Naturopathic Medical Practice Act. Collaboration is for the
7purpose of providing medical consultation, and no employment
8relationship is required. A written collaborative agreement
9shall conform to the requirements of Section 27 of the
10Naturopathic Medical Practice Act. The written collaborative
11agreement shall be for services for which the collaborating
12physician can provide adequate collaboration. A written
13collaborative agreement shall be adequate with respect to
14collaboration with naturopathic doctors if all of the
15following apply:
16        (1) The agreement is written to promote the exercise
17    of professional judgment by the naturopathic doctor
18    commensurate with his or her education and experience.
19        (2) The naturopathic doctor provides services based
20    upon a written collaborative agreement with the
21    collaborating physician.
22        (3) Methods of communication with the collaborating
23    physician in person or through telecommunications for
24    consultation, collaboration, and referral as needed to
25    address patient care needs are available.
26    (d) (c) The collaborating physician shall have access to

 

 

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

 

 

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1of prescriptive authority shall conform to the requirements of
2Section 7.5 of the Physician Assistant Practice Act of 1987.
3    (h) (Blank).
4    (i) A collaborating physician shall delegate prescriptive
5authority to a prescribing psychologist as part of a written
6collaborative agreement, and the delegation of prescriptive
7authority shall conform to the requirements of Section 4.3 of
8the Clinical Psychologist Licensing Act.
9    (j) As set forth in Section 22.2 of this Act, a licensee
10under this Act may not directly or indirectly divide, share,
11or split any professional fee or other form of compensation
12for professional services with anyone in exchange for a
13referral or otherwise, other than as provided in Section 22.2.
14(Source: P.A. 103-228, eff. 1-1-24.)
 
15    Section 999. Effective date. This Act takes effect upon
16becoming law.".