Rep. Theresa Mah
Filed: 5/22/2017
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1 | AMENDMENT TO SENATE BILL 898
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2 | AMENDMENT NO. ______. Amend Senate Bill 898 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The Illinois Insurance Code is amended by | ||||||
5 | adding Section 356z.25 as follows: | ||||||
6 | (215 ILCS 5/356z.25 new) | ||||||
7 | Sec. 356z.25. Dry needling by a physical therapist. A group | ||||||
8 | or individual policy of accident and health insurance or a | ||||||
9 | qualified health plan offered through the health insurance | ||||||
10 | market place is not required to provide coverage for dry | ||||||
11 | needling performed by a physical therapist as described in | ||||||
12 | Section 1.5 of the Illinois Physical Therapy Act. | ||||||
13 | Section 10. The Illinois Physical Therapy Act is amended by | ||||||
14 | changing Section 1 and by adding Section 1.5 as follows:
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1 | (225 ILCS 90/1) (from Ch. 111, par. 4251)
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2 | (Section scheduled to be repealed on January 1, 2026)
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3 | Sec. 1. Definitions. As used in this Act:
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4 | (1) "Physical therapy" means all of the following: | ||||||
5 | (A) Examining, evaluating, and testing individuals who | ||||||
6 | may have mechanical, physiological, or developmental | ||||||
7 | impairments, functional limitations, disabilities, or | ||||||
8 | other health and movement-related conditions, classifying | ||||||
9 | these disorders, determining a rehabilitation prognosis | ||||||
10 | and plan of therapeutic intervention, and assessing the | ||||||
11 | on-going effects of the interventions. | ||||||
12 | (B) Alleviating impairments, functional limitations, | ||||||
13 | or disabilities by designing, implementing, and modifying | ||||||
14 | therapeutic interventions that may include, but are not | ||||||
15 | limited to, the evaluation or treatment of a person through | ||||||
16 | the use of the effective properties of physical measures | ||||||
17 | and heat, cold, light, water, radiant energy, electricity, | ||||||
18 | sound, and air and use of therapeutic massage, therapeutic | ||||||
19 | exercise, mobilization, and rehabilitative procedures, | ||||||
20 | with or without assistive devices, for the purposes of | ||||||
21 | preventing, correcting, or alleviating a physical or | ||||||
22 | mental impairment, functional limitation, or disability. | ||||||
23 | (C) Reducing the risk of injury, impairment, | ||||||
24 | functional limitation, or disability, including the | ||||||
25 | promotion and maintenance of fitness, health, and | ||||||
26 | wellness. |
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1 | (D) Engaging in administration, consultation, | ||||||
2 | education, and research.
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3 | " Physical therapy "
includes, but is not limited to: (a) | ||||||
4 | performance
of specialized tests and measurements, (b) | ||||||
5 | administration of specialized
treatment procedures, (c) | ||||||
6 | interpretation of referrals from physicians, dentists, | ||||||
7 | advanced practice nurses, physician assistants,
and podiatric | ||||||
8 | physicians, (d) establishment, and modification of physical | ||||||
9 | therapy
treatment programs, (e) administration of topical | ||||||
10 | medication used in generally
accepted physical therapy | ||||||
11 | procedures when such medication is either prescribed
by the | ||||||
12 | patient's physician, licensed to practice medicine in all its | ||||||
13 | branches,
the patient's physician licensed to practice | ||||||
14 | podiatric medicine, the patient's advanced practice nurse, the | ||||||
15 | patient's physician assistant, or the
patient's dentist or used | ||||||
16 | following the physician's orders or written instructions, and | ||||||
17 | (f) supervision or teaching of physical therapy , and (g) dry | ||||||
18 | needling in accordance with Section 1.5 .
Physical therapy does | ||||||
19 | not include radiology, electrosurgery, chiropractic
technique | ||||||
20 | or determination of a differential
diagnosis; provided, | ||||||
21 | however,
the limitation on determining a differential | ||||||
22 | diagnosis shall not in any
manner limit a physical therapist | ||||||
23 | licensed under this Act from performing
an evaluation pursuant | ||||||
24 | to such license. Nothing in this Section shall limit
a physical | ||||||
25 | therapist from employing appropriate physical therapy | ||||||
26 | techniques
that he or she is educated and licensed to perform. |
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1 | A physical therapist
shall refer to a licensed physician, | ||||||
2 | advanced practice nurse, physician assistant, dentist, | ||||||
3 | podiatric physician, other physical therapist, or other health | ||||||
4 | care provider any patient
whose medical condition should, at | ||||||
5 | the time of evaluation or treatment, be
determined to be beyond | ||||||
6 | the scope of practice of the physical therapist.
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7 | (2) "Physical therapist" means a person who practices | ||||||
8 | physical therapy
and who has met all requirements as provided | ||||||
9 | in this Act.
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10 | (3) "Department" means the Department of Professional | ||||||
11 | Regulation.
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12 | (4) "Director" means the Director of Professional | ||||||
13 | Regulation.
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14 | (5) "Board" means the Physical Therapy Licensing and | ||||||
15 | Disciplinary Board approved
by the Director.
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16 | (6) "Referral" means a written or oral authorization for | ||||||
17 | physical therapy services for a patient by a physician, | ||||||
18 | dentist, advanced practice nurse, physician assistant, or | ||||||
19 | podiatric physician who maintains medical supervision of the | ||||||
20 | patient and makes a diagnosis or verifies that the patient's | ||||||
21 | condition is such that it may be treated by a physical | ||||||
22 | therapist.
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23 | (7) "Documented current and relevant diagnosis" for the | ||||||
24 | purpose of
this Act means a diagnosis, substantiated by | ||||||
25 | signature or oral verification
of a physician, dentist, | ||||||
26 | advanced practice nurse, physician assistant, or podiatric |
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1 | physician, that a patient's condition is such
that it may be | ||||||
2 | treated by physical therapy as defined in this Act, which
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3 | diagnosis shall remain in effect until changed by the | ||||||
4 | physician, dentist, advanced practice nurse, physician | ||||||
5 | assistant,
or podiatric physician.
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6 | (8) "State" includes:
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7 | (a) the states of the United States of America;
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8 | (b) the District of Columbia; and
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9 | (c) the Commonwealth of Puerto Rico.
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10 | (9) "Physical therapist assistant" means a person licensed | ||||||
11 | to assist a
physical therapist and who has met all requirements | ||||||
12 | as provided in this Act
and who works under the supervision of | ||||||
13 | a licensed physical therapist to assist
in implementing the | ||||||
14 | physical therapy treatment program as established by the
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15 | licensed physical therapist. The patient care activities | ||||||
16 | provided by the
physical therapist assistant shall not include | ||||||
17 | the interpretation of referrals,
evaluation procedures, or the | ||||||
18 | planning or major modification of patient programs.
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19 | (10) "Physical therapy aide" means a person who has | ||||||
20 | received on
the job training, specific to the facility in which | ||||||
21 | he is employed.
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22 | (11) "Advanced practice nurse" means a person licensed as | ||||||
23 | an advanced practice nurse under the Nurse Practice Act. | ||||||
24 | (12) "Physician assistant" means a person licensed under | ||||||
25 | the Physician Assistant Practice Act of 1987.
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26 | (Source: P.A. 98-214, eff. 8-9-13; 99-173, eff. 7-29-15; |
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1 | 99-229, eff. 8-3-15; 99-642, eff. 7-28-16; revised 10-27-16.)
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2 | (225 ILCS 90/1.5 new) | ||||||
3 | Sec. 1.5. Dry needling. | ||||||
4 | (a) For the purpose of this Act, "dry needling", also known | ||||||
5 | as intramuscular therapy, means an advanced needling skill or | ||||||
6 | technique limited to the treatment of myofascial pain, using a | ||||||
7 | single use, single insertion, sterile filiform needle (without | ||||||
8 | the use of heat, cold, or any other added modality or | ||||||
9 | medication), that is inserted into the skin or underlying | ||||||
10 | tissues to stimulate trigger points. Dry needling may apply | ||||||
11 | theory based only upon Western medical concepts, requires an | ||||||
12 | examination and diagnosis, and treats specific anatomic | ||||||
13 | entities selected according to physical signs. Dry needling | ||||||
14 | does not include the stimulation of auricular points, | ||||||
15 | utilization of distal points or non-local points, needle | ||||||
16 | retention, application of retained electric stimulation leads, | ||||||
17 | or the teaching or application of other acupuncture theory. | ||||||
18 | (b) A physical therapist licensed under this Act may only | ||||||
19 | perform dry needling under the following conditions as | ||||||
20 | determined by the Department by rule: | ||||||
21 | (1) Prior to completion of the education under | ||||||
22 | paragraph (2) of this subsection, successful completion of | ||||||
23 | 50 hours of instruction in the following areas: | ||||||
24 | (A) the musculoskeletal and neuromuscular system; | ||||||
25 | (B) the anatomical basis of pain mechanisms, |
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1 | chronic pain, and referred pain; | ||||||
2 | (C) myofascial trigger point theory; and | ||||||
3 | (D) universal precautions. | ||||||
4 | (2) Completion of at least 30 hours of didactic course | ||||||
5 | work specific to dry needling. | ||||||
6 | (3) Successful completion of at least 54 practicum | ||||||
7 | hours in dry needling course work approved by the | ||||||
8 | Federation of State Boards of Physical Therapy or its | ||||||
9 | successor (or substantial equivalent), as determined by | ||||||
10 | the Department. Each instructional course shall specify | ||||||
11 | what anatomical regions are included in the instruction and | ||||||
12 | describe whether the course offers introductory or | ||||||
13 | advanced instruction in dry needling. Each instruction | ||||||
14 | course shall include the following areas: | ||||||
15 | (A) dry needling technique; | ||||||
16 | (B) dry needling indications and | ||||||
17 | contraindications; | ||||||
18 | (C) documentation of dry needling; | ||||||
19 | (D) management of adverse effects; | ||||||
20 | (E) practical psychomotor competency; and | ||||||
21 | (F) the Occupational Safety and Health | ||||||
22 | Administration's Bloodborne Pathogens standard. | ||||||
23 | Postgraduate classes qualifying for completion of the | ||||||
24 | mandated 54 hours of dry needling shall be in one or more | ||||||
25 | modules, with the initial module being no fewer than 27 | ||||||
26 | hours, and therapists shall complete at least 54 hours in |
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1 | no more than 12 months. | ||||||
2 | (4) Completion of at least 200 patient treatment | ||||||
3 | sessions under supervision as determined by the Department | ||||||
4 | by rule. | ||||||
5 | (5) Successful completion of a competency examination | ||||||
6 | as approved by the Department. | ||||||
7 | Each licensee is responsible for maintaining records of the | ||||||
8 | completion of the requirements of this subsection (b) and shall | ||||||
9 | be prepared to produce such records upon request by the | ||||||
10 | Department. | ||||||
11 | (c) A newly-licensed physical therapist shall not practice | ||||||
12 | dry needling for at least one year from the date of initial | ||||||
13 | licensure unless the practitioner can demonstrate compliance | ||||||
14 | with subsection (b) through his or her pre-licensure | ||||||
15 | educational coursework. | ||||||
16 | (d) Dry needling may only be performed by a licensed | ||||||
17 | physical therapist and may not be delegated to a physical | ||||||
18 | therapist assistant or support personnel. | ||||||
19 | (e) A physical therapist shall not advertise, describe to | ||||||
20 | patients or the public, or otherwise represent that dry | ||||||
21 | needling is acupuncture, nor shall he or she represent that he | ||||||
22 | or she practices acupuncture unless separately licensed under | ||||||
23 | the Acupuncture Practice Act.
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24 | Section 99. Effective date. This Act takes effect upon | ||||||
25 | becoming law.".
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