Illinois General Assembly - Full Text of SB2904
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Full Text of SB2904  100th General Assembly




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1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Medical Practice Act of 1987 is amended by
5changing Section 54.5 as follows:
6    (225 ILCS 60/54.5)
7    (Section scheduled to be repealed on December 31, 2019)
8    Sec. 54.5. Physician delegation of authority to physician
9assistants, advanced practice registered nurses without full
10practice authority, and prescribing psychologists.
11    (a) Physicians licensed to practice medicine in all its
12branches may delegate care and treatment responsibilities to a
13physician assistant under guidelines in accordance with the
14requirements of the Physician Assistant Practice Act of 1987. A
15physician licensed to practice medicine in all its branches may
16enter into collaborative agreements with no more than 5
17full-time equivalent physician assistants, except in a
18hospital, hospital affiliate, or ambulatory surgical treatment
19center as set forth by Section 7.7 of the Physician Assistant
20Practice Act of 1987.
21    (b) A physician licensed to practice medicine in all its
22branches in active clinical practice may collaborate with an
23advanced practice registered nurse in accordance with the



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



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



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



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1Section 7.5 of the Physician Assistant Practice Act of 1987.
2    (h) (Blank).
3    (i) A collaborating physician shall delegate prescriptive
4authority to a prescribing psychologist as part of a written
5collaborative agreement, and the delegation of prescriptive
6authority shall conform to the requirements of Section 4.3 of
7the Clinical Psychologist Licensing Act.
8    (j) As set forth in Section 22.2 of this Act, a licensee
9under this Act may not directly or indirectly divide, share, or
10split any professional fee or other form of compensation for
11professional services with anyone in exchange for a referral or
12otherwise, other than as provided in Section 22.2.
13(Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
14100-513, eff. 1-1-18; revised 9-29-17.)
15    Section 10. The Physician Assistant Practice Act of 1987 is
16amended by changing Section 7 as follows:
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 of
21physician assistants to collaborate with, provided the
22physician is able to provide adequate collaboration as outlined
23in the written collaborative agreement required under Section
247.5 of this Act and consideration is given to the nature of the



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



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