Illinois General Assembly - Full Text of SB0218
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Full Text of SB0218  103rd General Assembly




SB0218 EnrolledLRB103 25028 AMQ 51362 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Physician Assistant Practice Act of 1987 is
5amended by changing Sections 4, 7, 7.5, and 7.7 and by adding
6Section 7.6 as follows:
7    (225 ILCS 95/4)  (from Ch. 111, par. 4604)
8    (Section scheduled to be repealed on January 1, 2028)
9    Sec. 4. Definitions. In this Act:
10    1. "Department" means the Department of Financial and
11Professional Regulation.
12    2. "Secretary" means the Secretary of Financial and
13Professional Regulation.
14    3. "Physician assistant" means any person not holding an
15active license or permit issued by the Department pursuant to
16the Medical Practice Act of 1987 who has been certified as a
17physician assistant by the National Commission on the
18Certification of Physician Assistants or equivalent successor
19agency and performs procedures in collaboration with a
20physician as defined in this Act. A physician assistant may
21perform such procedures within the specialty of the
22collaborating physician, except that such physician shall
23exercise such direction, collaboration, and control over such



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1physician assistants as will assure that patients shall
2receive quality medical care. Physician assistants shall be
3capable of performing a variety of tasks within the specialty
4of medical care in collaboration with a physician.
5Collaboration with the physician assistant shall not be
6construed to necessarily require the personal presence of the
7collaborating physician at all times at the place where
8services are rendered, as long as there is communication
9available for consultation by radio, telephone or
10telecommunications within established guidelines as determined
11by the physician/physician assistant team. The collaborating
12physician may delegate tasks and duties to the physician
13assistant. Delegated tasks or duties shall be consistent with
14physician assistant education, training, and experience. The
15delegated tasks or duties shall be specific to the practice
16setting and shall be implemented and reviewed under a written
17collaborative agreement established by the physician or
18physician/physician assistant team. A physician assistant,
19acting as an agent of the physician, shall be permitted to
20transmit the collaborating physician's orders as determined by
21the institution's by-laws, policies, procedures, or job
22description within which the physician/physician assistant
23team practices. Physician assistants shall practice only in
24accordance with a written collaborative agreement.
25    Any person who holds an active license or permit issued
26pursuant to the Medical Practice Act of 1987 shall have that



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1license automatically placed into inactive status upon
2issuance of a physician assistant license. Any person who
3holds an active license as a physician assistant who is issued
4a license or permit pursuant to the Medical Practice Act of
51987 shall have his or her physician assistant license
6automatically placed into inactive status.
7    3.5. "Physician assistant practice" means the performance
8of procedures within the specialty of the collaborating
9physician. Physician assistants shall be capable of performing
10a variety of tasks within the specialty of medical care of the
11collaborating physician. Collaboration with the physician
12assistant shall not be construed to necessarily require the
13personal presence of the collaborating physician at all times
14at the place where services are rendered, as long as there is
15communication available for consultation by radio, telephone,
16telecommunications, or electronic communications. The
17collaborating physician may delegate tasks and duties to the
18physician assistant. Delegated tasks or duties shall be
19consistent with physician assistant education, training, and
20experience. The delegated tasks or duties shall be specific to
21the practice setting and shall be implemented and reviewed
22under a written collaborative agreement established by the
23physician or physician/physician assistant team. A physician
24assistant shall be permitted to transmit the collaborating
25physician's orders as determined by the institution's bylaws,
26policies, or procedures or the job description within which



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1the physician/physician assistant team practices. Physician
2assistants shall practice only in accordance with a written
3collaborative agreement, except as provided in Section 7.5 of
4this Act.
5    4. "Board" means the Medical Licensing Board constituted
6under the Medical Practice Act of 1987.
7    5. (Blank).
8    6. "Physician" means a person licensed to practice
9medicine in all of its branches under the Medical Practice Act
10of 1987.
11    7. "Collaborating physician" means the physician who,
12within his or her specialty and expertise, may delegate a
13variety of tasks and procedures to the physician assistant.
14Such tasks and procedures shall be delegated in accordance
15with a written collaborative agreement.
16    8. (Blank).
17    9. "Address of record" means the designated address
18recorded by the Department in the applicant's or licensee's
19application file or license file maintained by the
20Department's licensure maintenance unit.
21    10. "Hospital affiliate" means a corporation, partnership,
22joint venture, limited liability company, or similar
23organization, other than a hospital, that is devoted primarily
24to the provision, management, or support of health care
25services and that directly or indirectly controls, is
26controlled by, or is under common control of the hospital. For



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1the purposes of this definition, "control" means having at
2least an equal or a majority ownership or membership interest.
3A hospital affiliate shall be 100% owned or controlled by any
4combination of hospitals, their parent corporations, or
5physicians licensed to practice medicine in all its branches
6in Illinois. "Hospital affiliate" does not include a health
7maintenance organization regulated under the Health
8Maintenance Organization Act.
9    11. "Email address of record" means the designated email
10address recorded by the Department in the applicant's
11application file or the licensee's license file, as maintained
12by the Department's licensure maintenance unit.
13    12. "Federally qualified health center" means a health
14center funded under Section 330 of the federal Public Health
15Service Act.
16(Source: P.A. 102-1117, eff. 1-13-23.)
17    (225 ILCS 95/7)  (from Ch. 111, par. 4607)
18    (Section scheduled to be repealed on January 1, 2028)
19    Sec. 7. Collaboration requirements.
20    (a) A collaborating physician shall determine the number
21of physician assistants to collaborate with, provided the
22physician is able to provide adequate collaboration as
23outlined in the written collaborative agreement required under
24Section 7.5 of this Act and consideration is given to the
25nature of the physician's practice, complexity of the patient



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



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



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



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



SB0218 Enrolled- 10 -LRB103 25028 AMQ 51362 b

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



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1    eligible to register for a mid-level practitioner
2    controlled substances license under Section 303.05 of the
3    Illinois Controlled Substances Act. Nothing in this Act
4    shall be construed to limit the delegation of tasks or
5    duties by the collaborating physician to a nurse or other
6    appropriately trained persons in accordance with Section
7    54.2 of the Medical Practice Act of 1987.
8        (3) In addition to the requirements of this subsection
9    (b), a collaborating physician may, but is not required
10    to, delegate authority to a physician assistant to
11    prescribe Schedule II controlled substances, if all of the
12    following conditions apply:
13            (A) Specific Schedule II controlled substances by
14        oral dosage or topical or transdermal application may
15        be delegated, provided that the delegated Schedule II
16        controlled substances are routinely prescribed by the
17        collaborating physician. This delegation must identify
18        the specific Schedule II controlled substances by
19        either brand name or generic name. Schedule II
20        controlled substances to be delivered by injection or
21        other route of administration may not be delegated.
22            (B) (Blank).
23            (C) Any prescription must be limited to no more
24        than a 30-day supply, with any continuation authorized
25        only after prior approval of the collaborating
26        physician.



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1            (D) The physician assistant must discuss the
2        condition of any patients for whom a controlled
3        substance is prescribed monthly with the collaborating
4        physician.
5            (E) The physician assistant meets the education
6        requirements of Section 303.05 of the Illinois
7        Controlled Substances Act.
8    (c) Nothing in this Act shall be construed to limit the
9delegation of tasks or duties by a physician to a licensed
10practical nurse, a registered professional nurse, or other
11persons. Nothing in this Act shall be construed to limit the
12method of delegation that may be authorized by any means,
13including, but not limited to, oral, written, electronic,
14standing orders, protocols, guidelines, or verbal orders.
15Nothing in this Act shall be construed to authorize a
16physician assistant to provide health care services required
17by law or rule to be performed by a physician. Nothing in this
18Act shall be construed to authorize the delegation or
19performance of operative surgery. Nothing in this Section
20shall be construed to preclude a physician assistant from
21assisting in surgery.
22    (c-5) Nothing in this Section shall be construed to apply
23to any medication authority, including Schedule II controlled
24substances of a licensed physician assistant for care provided
25in a hospital, hospital affiliate, federally qualified health
26center, or ambulatory surgical treatment center pursuant to



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1Section 7.7 of this Act.
2    (d) (Blank).
3    (e) Nothing in this Section shall be construed to prohibit
4generic substitution.
5(Source: P.A. 101-13, eff. 6-12-19; 102-558, eff. 8-20-21.)
6    (225 ILCS 95/7.6 new)
7    Sec. 7.6. Written collaborative agreement; temporary
8practice. Any physician assistant required to enter into a
9written collaborative agreement with a collaborating physician
10is authorized to continue to practice for up to 90 days after
11the termination of a written collaborative agreement, provided
12the physician assistant seeks any necessary collaboration at a
13local hospital and refers patients who require services beyond
14the training and experience of the physician assistant to a
15physician or other health care provider.
16    (225 ILCS 95/7.7)
17    (Section scheduled to be repealed on January 1, 2028)
18    Sec. 7.7. Physician assistants in hospitals, hospital
19affiliates, federally qualified health centers, or ambulatory
20surgical treatment centers.
21    (a) A physician assistant may provide services in a
22hospital as defined in the Hospital Licensing Act, a hospital
23affiliate as defined in the University of Illinois Hospital
24Act, a federally qualified health center, or a licensed



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1ambulatory surgical treatment center as defined in the
2Ambulatory Surgical Treatment Center Act without a written
3collaborative agreement pursuant to Section 7.5 of this Act
4only in accordance with this Section. A physician assistant
5must possess clinical privileges recommended by (i) the
6hospital medical staff and granted by the hospital, (ii) the
7physician committee and federally qualified health center, or
8(iii) the consulting medical staff committee and ambulatory
9surgical treatment center in order to provide services. The
10medical staff, physician committee, or consulting medical
11staff committee shall periodically review the services of
12physician assistants granted clinical privileges, including
13any care provided in a hospital affiliate or federally
14qualified health center. Authority may also be granted when
15recommended by the hospital medical staff and granted by the
16hospital, recommended by the physician committee and granted
17by the federally qualified health center, or recommended by
18the consulting medical staff committee and ambulatory surgical
19treatment center to individual physician assistants to select,
20order, and administer medications, including controlled
21substances, to provide delineated care. In a hospital,
22hospital affiliate, federally qualified health center, or
23ambulatory surgical treatment center, the attending physician
24shall determine a physician assistant's role in providing care
25for his or her patients, except as otherwise provided in the
26medical staff bylaws or consulting committee policies.



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1    (a-5) Physician assistants practicing in a hospital
2affiliate or a federally qualified health center may be, but
3are not required to be, granted authority to prescribe
4Schedule II through V controlled substances when such
5authority is recommended by the appropriate physician
6committee of the hospital affiliate and granted by the
7hospital affiliate or recommended by the physician committee
8of the federally qualified health center and granted by the
9federally qualified health center. This authority may, but is
10not required to, include prescription of, selection of, orders
11for, administration of, storage of, acceptance of samples of,
12and dispensing over-the-counter medications, legend drugs,
13medical gases, and controlled substances categorized as
14Schedule II through V controlled substances, as defined in
15Article II of the Illinois Controlled Substances Act, and
16other preparations, including, but not limited to, botanical
17and herbal remedies.
18    To prescribe controlled substances under this subsection
19(a-5), a physician assistant must obtain a mid-level
20practitioner controlled substance license. Medication orders
21shall be reviewed periodically by the appropriate hospital
22affiliate physicians committee or its physician designee or by
23the physician committee of a federally qualified health
25    The hospital affiliate or federally qualified health
26center shall file with the Department notice of a grant of



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1prescriptive authority consistent with this subsection (a-5)
2and termination of such a grant of authority in accordance
3with rules of the Department. Upon receipt of this notice of
4grant of authority to prescribe any Schedule II through V
5controlled substances, the licensed physician assistant may
6register for a mid-level practitioner controlled substance
7license under Section 303.05 of the Illinois Controlled
8Substances Act.
9    In addition, a hospital affiliate or a federally qualified
10health center may, but is not required to, grant authority to a
11physician assistant to prescribe any Schedule II controlled
12substances if all of the following conditions apply:
13        (1) specific Schedule II controlled substances by oral
14    dosage or topical or transdermal application may be
15    designated, provided that the designated Schedule II
16    controlled substances are routinely prescribed by
17    physician assistants in their area of certification; this
18    grant of authority must identify the specific Schedule II
19    controlled substances by either brand name or generic
20    name; authority to prescribe or dispense Schedule II
21    controlled substances to be delivered by injection or
22    other route of administration may not be granted;
23        (2) any grant of authority must be controlled
24    substances limited to the practice of the physician
25    assistant;
26        (3) any prescription must be limited to no more than a



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1    30-day supply;
2        (4) the physician assistant must discuss the condition
3    of any patients for whom a controlled substance is
4    prescribed monthly with the appropriate physician
5    committee of the hospital affiliate or its physician
6    designee, or the physician committee of a federally
7    qualified health center; and
8        (5) the physician assistant must meet the education
9    requirements of Section 303.05 of the Illinois Controlled
10    Substances Act.
11    (b) A physician assistant granted authority to order
12medications including controlled substances may complete
13discharge prescriptions provided the prescription is in the
14name of the physician assistant and the attending or
15discharging physician.
16    (c) Physician assistants practicing in a hospital,
17hospital affiliate, federally qualified health center, or an
18ambulatory surgical treatment center are not required to
19obtain a mid-level controlled substance license to order
20controlled substances under Section 303.05 of the Illinois
21Controlled Substances Act.
22(Source: P.A. 100-453, eff. 8-25-17.)