Public Act 103-0065
 
SB0218 EnrolledLRB103 25028 AMQ 51362 b


  
    AN ACT concerning regulation.
  
 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:
  


 
    Section 5. The Physician Assistant Practice Act of 1987 is 
amended  by changing Sections 4, 7, 7.5, and 7.7 and  by adding 
Section 7.6 as follows:
 



    (225 ILCS 95/4)  (from Ch. 111, par. 4604)


    (Section scheduled to be repealed on January 1, 2028)

    Sec. 4. Definitions. In this Act: 

    1. "Department" means the Department of Financial and

Professional Regulation.

    2. "Secretary" means the Secretary
 of Financial and 
Professional Regulation.

    3. "Physician assistant" means any person not holding an 
active license or permit issued by the Department pursuant to 
the Medical Practice Act of 1987 who has been
certified as a 
physician assistant by the National Commission on the

Certification of Physician Assistants or equivalent successor 
agency and
performs procedures in collaboration with a 
physician as defined in this
Act.  A physician assistant may 
perform such procedures within the
specialty of the 
collaborating physician, except that such physician shall

exercise such direction, collaboration, and control over such 
physician
assistants as will assure that patients shall 
receive quality medical
care.  Physician assistants shall be 
capable of performing a variety of tasks
within the specialty 
of medical care in collaboration with a physician.

Collaboration with the physician assistant shall not be 
construed to
necessarily require the personal presence of the 
collaborating physician at
all times at the place where 
services are rendered, as long as there is
communication 
available for consultation by radio, telephone or

telecommunications within established guidelines as determined 
by the
physician/physician assistant team.  The collaborating 
physician may delegate
tasks and duties to the physician 
assistant.  Delegated tasks or duties
shall be consistent with 
physician assistant education, training, and
experience.  The 
delegated tasks or duties shall be specific to the
practice 
setting and shall be implemented and reviewed under a written 
collaborative agreement
established by the physician or 
physician/physician assistant team.  A
physician assistant, 
acting as an agent of the physician, shall be
permitted to 
transmit the collaborating physician's orders as determined by

the institution's by-laws, policies, procedures, or job 
description within
which the physician/physician assistant 
team practices.  Physician
assistants shall practice only in 
accordance with a written collaborative agreement.

    Any person who holds an active license or permit issued 
pursuant to the Medical Practice Act of 1987 shall have that 
license automatically placed into inactive status upon 
issuance of a physician assistant license. Any person who 
holds an active license as a physician assistant who is issued 
a license or permit pursuant to the Medical Practice Act of 
1987 shall have his or her physician assistant license 
automatically placed into inactive status. 
    3.5. "Physician assistant practice" means the performance 
of procedures within the specialty of the collaborating 
physician. Physician assistants shall be capable of performing 
a variety of tasks within the specialty of medical care of the 
collaborating physician. Collaboration with the physician 
assistant shall not be construed to necessarily require the 
personal presence of the collaborating physician at all times 
at the place where services are rendered, as long as there is 
communication available for consultation by radio, telephone, 
telecommunications, or electronic communications. The 
collaborating physician may delegate tasks and duties to the 
physician assistant. Delegated tasks or duties shall be 
consistent with physician assistant education, training, and 
experience. The delegated tasks or duties shall be specific to 
the practice setting and shall be implemented and reviewed 
under a written collaborative agreement established by the 
physician or physician/physician assistant team. A physician 
assistant shall be permitted to transmit the collaborating 
physician's orders as determined by the institution's bylaws, 
policies, or procedures or the job description within which 
the physician/physician assistant team practices. Physician 
assistants shall practice only in accordance with a written 
collaborative agreement, except as provided in Section 7.5 of 
this Act. 
    4. "Board" means the Medical Licensing Board
constituted 
under the Medical Practice Act of 1987.

    5. (Blank).

    6. "Physician" means a person licensed to
practice 
medicine in all of its branches under the Medical Practice Act 
of 1987.

    7. "Collaborating physician" means the physician who, 
within
his or her specialty and expertise, may delegate a 
variety of
tasks and procedures to the physician assistant. 
Such tasks and
procedures shall be delegated in accordance 
with a written
collaborative agreement.

    8. (Blank).

    9. "Address of record" means the designated address 
recorded by the Department in the applicant's or licensee's 
application file or license file maintained by the 
Department's licensure maintenance unit.


    10. "Hospital affiliate" means a corporation, partnership, 
joint venture, limited liability company, or similar 
organization, other than a hospital, that is devoted primarily 
to the provision, management, or support of health care 
services and that directly or indirectly controls, is 
controlled by, or is under common control of the hospital. For 
the purposes of this definition, "control" means having at 
least an equal or a majority ownership or membership interest. 
A hospital affiliate shall be 100% owned or controlled by any 
combination of hospitals, their parent corporations, or 
physicians licensed to practice medicine in all its branches 
in Illinois. "Hospital affiliate" does not include a health 
maintenance organization regulated under the Health 
Maintenance Organization Act. 
    11. "Email address of record" means the designated email 
address recorded by the Department in the applicant's 
application file or the licensee's license file, as maintained 
by the Department's licensure maintenance unit. 
    12.   "Federally qualified health center" means a health 
center funded under Section 330 of the federal Public Health 
Service Act. 
(Source: P.A. 102-1117, eff. 1-13-23.)

 


    (225 ILCS 95/7)  (from Ch. 111, par. 4607)



    (Section scheduled to be repealed on January 1, 2028)

    Sec. 7. Collaboration requirements. 
    (a) A collaborating physician shall determine the number 
of physician assistants to collaborate with, provided the 
physician is able to provide adequate collaboration as 
outlined in the written collaborative agreement required under 
Section 7.5 of this Act and consideration is given to the 
nature of the physician's practice, complexity of the patient 
population, and the experience of each physician assistant. A 
collaborating physician may collaborate with a maximum of 7 
full-time equivalent physician assistants as described in 
Section 54.5 of the Medical Practice Act of 1987. As used in 
this Section, "full-time equivalent" means the equivalent of 
40 hours per week per individual. Physicians and physician 
assistants who work in a hospital, hospital affiliate, 
federally qualified health center, or ambulatory surgical 
treatment center as defined by Section 7.7 of this Act are 
exempt from the collaborative ratio restriction requirements 
of this Section. A physician assistant shall be able to
hold 
more than one professional position. A collaborating physician 
shall
file a notice of collaboration of each physician 
assistant according to the
rules of the Department.


    Physician assistants shall collaborate only with 
physicians as defined in
this Act
who are engaged in clinical 
practice, or in clinical practice in
public health or other 
community health facilities.

    Nothing in this Act shall be construed to limit the 
delegation of tasks or
duties by a physician to a nurse or 
other appropriately trained personnel.

    Nothing in this Act
shall be construed to prohibit the 
employment of physician assistants by
a hospital, nursing home 
or other health care facility where such physician
assistants 
function under a collaborating physician.


    A physician assistant may be employed by a practice group 
or other entity
employing multiple physicians at one or more 
locations.  In that case, one of
the
physicians practicing at a 
location shall be designated the collaborating
physician.  The 
other physicians with that practice group or other entity who

practice in the same general type of practice or specialty
as 
the collaborating physician may collaborate with the physician 
assistant with respect
to their patients.

    (b) A physician assistant licensed in this State, or 
licensed or authorized to practice in any other U.S. 
jurisdiction or credentialed by his or her federal employer as 
a physician assistant, who is responding to a need for medical 
care created by an emergency or by a state or local disaster 
may render such care that the physician assistant is able to 
provide without collaboration as it is defined in this Section 
or with such collaboration as is available.

    Any physician who collaborates with a physician assistant 
providing medical care in response to such an emergency or 
state or local disaster shall not be required to meet the 
requirements set forth in this Section for a collaborating 
physician.
(Source: P.A. 100-453, eff. 8-25-17; 100-605, eff. 1-1-19.)

 


    (225 ILCS 95/7.5)


    (Section scheduled to be repealed on January 1, 2028)

    Sec. 7.5. Written collaborative agreements; prescriptive 
authority. 
    (a) A written collaborative agreement is required for all 
physician assistants to practice in the State, except as 
provided in Section 7.7 of this Act.
        (1) A written collaborative agreement shall describe 
    the working relationship of the physician assistant with 
    the collaborating physician and shall describe the 
    categories of care, treatment, or procedures to be 
    provided by the physician assistant.
The written 
    collaborative agreement shall promote the exercise of 
    professional judgment by the physician assistant 
    commensurate with his or her education and experience.  The 
    services to be provided by the physician assistant shall 
    be services that the collaborating physician is authorized 
    to and generally provides to his or her patients in the 
    normal course of his or her clinical medical practice.  The 
    written collaborative agreement need not describe the 
    exact steps that a physician assistant must take with 
    respect to each specific condition, disease, or symptom 
    but must specify which authorized procedures require the 
    presence of the collaborating physician as the procedures 
    are being performed.  The relationship under a written 
    collaborative agreement shall not be construed to require 
    the personal presence of a physician at the place where 
    services are rendered.  Methods of communication shall be 
    available for consultation with the collaborating 
    physician in person or by telecommunications or electronic 
    communications as set forth in the written collaborative 
    agreement. For the purposes of this Act, "generally 
    provides to his or her patients in the normal course of his 
    or her clinical medical practice" means services, not 
    specific tasks or duties, the collaborating physician 
    routinely provides individually or through delegation to 
    other persons so that the physician has the experience and 
    ability to collaborate and provide consultation. 
        (2) The written collaborative agreement shall be 
    adequate if a physician does each of the following:
            (A)  Participates in the joint formulation and 
        joint approval of orders or guidelines with the 
        physician assistant and he or she periodically reviews 
        such orders and the services provided patients under 
        such orders in accordance with accepted standards of 
        medical practice and physician assistant practice.
            (B)  Provides consultation at least once a month. 
        (3) A copy of the signed, written collaborative 
    agreement must be available to the Department upon request 
    from both the physician assistant and the collaborating 
    physician.
        (4) A physician assistant shall inform each 
    collaborating physician of all written collaborative 
    agreements he or she has signed and provide a copy of these 
    to any collaborating physician upon request.
    (b) A collaborating physician may, but is not required to, 
delegate prescriptive authority to a physician assistant as 
part of a written collaborative agreement.  This authority may, 
but is not required to, include prescription of, selection of, 
orders for, administration of, storage of, acceptance of 
samples of, and dispensing medical devices, over the counter 
medications, legend drugs, medical gases, and controlled 
substances categorized as Schedule II through V controlled 
substances, as defined in Article II of the Illinois 
Controlled Substances Act, and other preparations, including, 
but not limited to, botanical and herbal remedies.  The 
collaborating physician must have a valid, current Illinois 
controlled substance license and federal registration with the 
Drug Enforcement Administration to delegate the authority to 
prescribe controlled substances. 
        (1) To prescribe Schedule II, III, IV, or V controlled 
    substances under this
Section, a physician assistant must 
    obtain a mid-level practitioner
controlled substances 
    license. Medication orders issued by a
physician
assistant 
    shall be reviewed
periodically by the collaborating 
    physician. 
        (2) The collaborating physician shall file
with the 
    Department notice of delegation of prescriptive authority 
    to a
physician assistant and
termination of delegation, 
    specifying the authority delegated or terminated.
Upon 
    receipt of this notice delegating authority to prescribe 
    controlled substances, the physician assistant shall be 
    eligible to
register for a mid-level practitioner 
    controlled substances license under
Section 303.05 of the 
    Illinois Controlled Substances Act.
Nothing in this Act 
    shall be construed to limit the delegation of tasks or

    duties by the collaborating physician to a nurse or other 
    appropriately trained
persons in accordance with Section 
    54.2 of the Medical Practice Act of 1987.

        (3)  In addition to the requirements of this subsection 
    (b), a collaborating physician may, but is not required 
    to, delegate authority to a physician assistant to 
    prescribe Schedule II controlled substances, if all of the 
    following conditions apply:
            (A) Specific Schedule II controlled substances by 
        oral dosage or topical or transdermal application may 
        be delegated, provided that the delegated Schedule II 
        controlled substances are routinely prescribed by the 
        collaborating physician. This delegation must identify 
        the specific Schedule II controlled substances by 
        either brand name or generic name. Schedule II 
        controlled substances to be delivered by injection or 
        other route of administration may not be delegated.
            (B) (Blank).
            (C)  Any prescription must be limited to no more 
        than a 30-day supply, with any continuation authorized 
        only after prior approval of the collaborating 
        physician.
            (D) The physician assistant must discuss the 
        condition of any patients for whom a  controlled 
        substance is prescribed monthly with the collaborating 
        physician.
            (E) The physician assistant meets the education 
        requirements of Section 303.05 of the Illinois 
        Controlled Substances Act. 
    (c) Nothing in this Act shall be construed to limit the 
delegation of tasks or duties by a physician to a licensed 
practical nurse, a registered professional nurse, or other 
persons. Nothing in this Act shall be construed to limit the 
method of delegation that may be authorized by any means, 
including, but not limited to, oral, written, electronic, 
standing orders, protocols, guidelines, or verbal orders. 
Nothing in this Act shall be construed to authorize a 
physician assistant to provide health care services required 
by law or rule to be performed by a physician. Nothing in this 
Act shall be construed to authorize the delegation or 
performance of operative surgery. Nothing in this Section 
shall be construed to preclude a physician assistant from 
assisting in surgery. 
    (c-5) Nothing in this Section shall be construed to apply

to any medication authority, including Schedule II controlled

substances of a licensed physician assistant for care provided

in a hospital, hospital affiliate, federally qualified health 
center, or ambulatory surgical
treatment center pursuant to 
Section 7.7 of this Act. 


    (d) (Blank). 
    (e) Nothing in this Section shall be construed to prohibit 
generic substitution. 
(Source: P.A. 101-13, eff. 6-12-19; 102-558, eff. 8-20-21.)

 
    (225 ILCS 95/7.6  new)
    Sec. 7.6. Written collaborative agreement; temporary 
practice. Any physician assistant required to enter into a 
written collaborative agreement with a collaborating physician 
is authorized to continue to practice for up to 90 days after 
the termination of a written collaborative agreement, provided 
the physician assistant seeks any necessary collaboration at a 
local hospital and refers patients who require services beyond 
the training and experience of the physician assistant to a 
physician or other health care provider.
 
    (225 ILCS 95/7.7)
    (Section scheduled to be repealed on January 1, 2028)
    Sec. 7.7. Physician assistants in hospitals, hospital 
affiliates, federally qualified health centers, or ambulatory 
surgical treatment centers.
    (a) A physician assistant may provide services in a 
hospital as defined in the Hospital Licensing Act, a hospital 
affiliate as defined in the University of Illinois Hospital 
Act, a federally qualified health center, or a licensed 
ambulatory surgical treatment center as defined in the 
Ambulatory Surgical Treatment Center Act without a written 
collaborative agreement pursuant to Section 7.5 of this Act 
only in accordance with this Section. A physician assistant 
must possess clinical privileges recommended by (i) the 
hospital medical staff and granted by the hospital, (ii) the 
physician committee and federally qualified health center, or 
(iii) the consulting medical staff committee and ambulatory 
surgical treatment center in order to provide services. The 
medical staff, physician committee, or consulting medical 
staff committee shall periodically review the services of 
physician assistants granted clinical privileges, including 
any care provided in a hospital affiliate or federally 
qualified health center. Authority may also be granted when 
recommended by the hospital medical staff and granted by the 
hospital, recommended by the physician committee and granted 
by the federally qualified health center, or recommended by 
the consulting medical staff committee and ambulatory surgical 
treatment center to individual physician assistants to select, 
order, and administer medications, including controlled 
substances, to provide delineated care. In a hospital, 
hospital affiliate, federally qualified health center, or 
ambulatory surgical treatment center, the attending physician 
shall determine a physician assistant's role in providing care 
for his or her patients, except as otherwise provided in the 
medical staff bylaws or consulting committee policies.
    (a-5) Physician assistants practicing in a hospital 
affiliate or a federally qualified health center may be, but 
are not required to be, granted authority to prescribe 
Schedule II through V controlled substances when such 
authority is recommended by the appropriate physician 
committee of the hospital affiliate and granted by the 
hospital affiliate or recommended by the physician committee 
of the federally qualified health center and granted by the 
federally qualified health center. This authority may, but is 
not required to, include prescription of, selection of, orders 
for, administration of,
storage of, acceptance of samples of, 
and dispensing over-the-counter medications, legend drugs, 
medical gases, and controlled substances categorized as 
Schedule II through V controlled substances, as defined in 
Article II of the Illinois Controlled Substances Act, and 
other preparations, including, but not limited to, botanical 
and herbal remedies.
    To prescribe controlled substances under this subsection 
(a-5), a physician assistant must obtain a mid-level 
practitioner controlled substance license. Medication orders 
shall be reviewed periodically by the appropriate hospital 
affiliate physicians committee or its physician designee or by 
the physician committee of a federally qualified health 
center.
    The hospital affiliate or federally qualified health 
center shall file with the Department notice of a grant of 
prescriptive authority consistent with this subsection (a-5) 
and termination of such a grant of authority in accordance 
with rules of the Department. Upon receipt of this notice of 
grant of authority to prescribe any Schedule II through V 
controlled substances, the licensed physician assistant may 
register for a mid-level practitioner controlled substance 
license under Section 303.05 of the Illinois Controlled 
Substances Act.
    In addition, a hospital affiliate or a federally qualified 
health center may, but is not required to, grant authority to a 
physician assistant to prescribe any Schedule II controlled 
substances if all of the following conditions apply:
        (1) specific Schedule II controlled substances by oral 
    dosage or topical or transdermal application may be 
    designated, provided that the designated Schedule II 
    controlled substances are routinely prescribed by 
    physician assistants in their area of certification; this 
    grant of authority must identify the specific Schedule II 
    controlled substances by either brand name or generic 
    name; authority to prescribe or dispense Schedule II 
    controlled substances to be delivered by injection or 
    other route of administration may not be granted;
        (2) any grant of authority must be controlled 
    substances limited to the practice of the physician 
    assistant;
        (3) any prescription must be limited to no more than a 
    30-day supply;
        (4) the physician assistant must discuss the condition 
    of any patients for whom a controlled substance is 
    prescribed monthly with the appropriate physician 
    committee of the hospital affiliate or its physician 
    designee, or the physician committee of a federally 
    qualified health center; and
        (5) the physician assistant must meet the education 
    requirements of Section 303.05 of the Illinois Controlled 
    Substances Act. 
    (b) A physician assistant granted authority to order 
medications including controlled substances may complete 
discharge prescriptions provided the prescription is in the 
name of the physician assistant and the attending or 
discharging physician. 
    (c) Physician assistants practicing in a hospital, 
hospital affiliate, federally qualified health center, or an 
ambulatory surgical treatment center are not required to 
obtain a mid-level controlled substance license to order 
controlled substances under Section 303.05 of the Illinois 
Controlled Substances Act. 

(Source: P.A. 100-453, eff. 8-25-17.)