Full Text of HB2495 101st General Assembly
HB2495ham001 101ST GENERAL ASSEMBLY | Rep. Kelly M. Cassidy Filed: 3/20/2019
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| 1 | | AMENDMENT TO HOUSE BILL 2495
| 2 | | AMENDMENT NO. ______. Amend House Bill 2495 by replacing | 3 | | line 23 on page 2 through line 8 on page 3 with the following:
| 4 | | ""Health care professional" means a person who is licensed | 5 | | as a physician, advanced practice registered nurse, or | 6 | | physician assistant."; and | 7 | | on page 3, line 13, by deleting "be of high quality,"; and | 8 | | on page 6, line 4, by deleting "best"; and | 9 | | on page 6, by replacing line 6 with the following: "standards | 10 | | of clinical practice consistent with the scope of his or her | 11 | | practice under the Medical Practice Act of 1987, the Nurse | 12 | | Practice Act, or the Physician Assistant Practice Act of | 13 | | 1987."; and | 14 | | on page 6, by replacing line 16 with the following: "patients |
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| 1 | | and health care professionals."; and | 2 | | on page 66, by replacing lines 8 through 11 with the following: | 3 | | " (b) Coverage for abortion care may not impose any | 4 | | deductible, coinsurance, waiting period, or other cost-sharing | 5 | | limitation that is greater than that required for other | 6 | | pregnancy-related benefits covered by the policy. "; and | 7 | | on page 96, line 22, after the period, by inserting the | 8 | | following: " The scope of practice of an advanced practice | 9 | | registered nurse does not include operative surgery. Nothing in | 10 | | this Section shall be construed to preclude an advanced | 11 | | practice registered nurse from assisting in surgery. "; and | 12 | | on page 99, by replacing lines 23 through 26 with the | 13 | | following: "nurse does not include operative surgery."; and | 14 | | on page 100, immediately below line 10, by inserting the | 15 | | following: | 16 | | "Section 910-53. The Physician Assistant Practice Act of | 17 | | 1987 is amended by changing Section 7.5 as follows:
| 18 | | (225 ILCS 95/7.5)
| 19 | | (Section scheduled to be repealed on January 1, 2028)
| 20 | | Sec. 7.5. Written collaborative agreements; prescriptive |
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| 1 | | authority. | 2 | | (a) A written collaborative agreement is required for all | 3 | | physician assistants to practice in the State, except as | 4 | | provided in Section 7.7 of this Act. | 5 | | (1) A written collaborative agreement shall describe | 6 | | the working relationship of the physician assistant with | 7 | | the collaborating physician and shall describe the | 8 | | categories of care, treatment, or procedures to be provided | 9 | | by the physician assistant.
The written collaborative | 10 | | agreement shall promote the exercise of professional | 11 | | judgment by the physician assistant commensurate with his | 12 | | or her education and experience. The services to be | 13 | | provided by the physician assistant shall be services that | 14 | | the collaborating physician is authorized to and generally | 15 | | provides to his or her patients in the normal course of his | 16 | | or her clinical medical practice. The written | 17 | | collaborative agreement need not describe the exact steps | 18 | | that a physician assistant must take with respect to each | 19 | | specific condition, disease, or symptom but must specify | 20 | | which authorized procedures require the presence of the | 21 | | collaborating physician as the procedures are being | 22 | | performed. The relationship under a written collaborative | 23 | | agreement shall not be construed to require the personal | 24 | | presence of a physician at the place where services are | 25 | | rendered. Methods of communication shall be available for | 26 | | consultation with the collaborating physician in person or |
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| 1 | | by telecommunications or electronic communications as set | 2 | | forth in the written collaborative agreement. For the | 3 | | purposes of this Act, "generally provides to his or her | 4 | | patients in the normal course of his or her clinical | 5 | | medical practice" means services, not specific tasks or | 6 | | duties, the collaborating physician routinely provides | 7 | | individually or through delegation to other persons so that | 8 | | the physician has the experience and ability to collaborate | 9 | | and provide consultation. | 10 | | (2) The written collaborative agreement shall be | 11 | | adequate if a physician does each of the following: | 12 | | (A) Participates in the joint formulation and | 13 | | joint approval of orders or guidelines with the | 14 | | physician assistant and he or she periodically reviews | 15 | | such orders and the services provided patients under | 16 | | such orders in accordance with accepted standards of | 17 | | medical practice and physician assistant practice. | 18 | | (B) Provides consultation at least once a month. | 19 | | (3) A copy of the signed, written collaborative | 20 | | agreement must be available to the Department upon request | 21 | | from both the physician assistant and the collaborating | 22 | | physician. | 23 | | (4) A physician assistant shall inform each | 24 | | collaborating physician of all written collaborative | 25 | | agreements he or she has signed and provide a copy of these | 26 | | to any collaborating physician upon request. |
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| 1 | | (b) A collaborating physician may, but is not required to, | 2 | | delegate prescriptive authority to a physician assistant as | 3 | | part of a written collaborative agreement. This authority may, | 4 | | but is not required to, include prescription of, selection of, | 5 | | orders for, administration of, storage of, acceptance of | 6 | | samples of, and dispensing medical devices, over the counter | 7 | | medications, legend drugs, medical gases, and controlled | 8 | | substances categorized as Schedule II through V controlled | 9 | | substances, as defined in Article II of the Illinois Controlled | 10 | | Substances Act, and other preparations, including, but not | 11 | | limited to, botanical and herbal remedies. The collaborating | 12 | | physician must have a valid, current Illinois controlled | 13 | | substance license and federal registration with the Drug | 14 | | Enforcement Agency to delegate the authority to prescribe | 15 | | controlled substances. | 16 | | (1) To prescribe Schedule II, III, IV, or V controlled | 17 | | substances under this
Section, a physician assistant must | 18 | | obtain a mid-level practitioner
controlled substances | 19 | | license. Medication orders issued by a
physician
assistant | 20 | | shall be reviewed
periodically by the collaborating | 21 | | physician. | 22 | | (2) The collaborating physician shall file
with the | 23 | | Department notice of delegation of prescriptive authority | 24 | | to a
physician assistant and
termination of delegation, | 25 | | specifying the authority delegated or terminated.
Upon | 26 | | receipt of this notice delegating authority to prescribe |
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| 1 | | controlled substances, the physician assistant shall be | 2 | | eligible to
register for a mid-level practitioner | 3 | | controlled substances license under
Section 303.05 of the | 4 | | Illinois Controlled Substances Act.
Nothing in this Act | 5 | | shall be construed to limit the delegation of tasks or
| 6 | | duties by the collaborating physician to a nurse or other | 7 | | appropriately trained
persons in accordance with Section | 8 | | 54.2 of the Medical Practice Act of 1987.
| 9 | | (3) In addition to the requirements of this subsection | 10 | | (b), a collaborating physician may, but is not required to, | 11 | | delegate authority to a physician assistant to prescribe | 12 | | Schedule II controlled substances, if all of the following | 13 | | conditions apply: | 14 | | (A) Specific Schedule II controlled substances by | 15 | | oral dosage or topical or transdermal application may | 16 | | be delegated, provided that the delegated Schedule II | 17 | | controlled substances are routinely prescribed by the | 18 | | collaborating physician. This delegation must identify | 19 | | the specific Schedule II controlled substances by | 20 | | either brand name or generic name. Schedule II | 21 | | controlled substances to be delivered by injection or | 22 | | other route of administration may not be delegated. | 23 | | (B) (Blank). | 24 | | (C) Any prescription must be limited to no more | 25 | | than a 30-day supply, with any continuation authorized | 26 | | only after prior approval of the collaborating |
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| 1 | | physician. | 2 | | (D) The physician assistant must discuss the | 3 | | condition of any patients for whom a controlled | 4 | | substance is prescribed monthly with the collaborating | 5 | | physician. | 6 | | (E) The physician assistant meets the education | 7 | | requirements of Section 303.05 of the Illinois | 8 | | Controlled Substances Act. | 9 | | (c) Nothing in this Act shall be construed to limit the | 10 | | delegation of tasks or duties by a physician to a licensed | 11 | | practical nurse, a registered professional nurse, or other | 12 | | persons. Nothing in this Act shall be construed to limit the | 13 | | method of delegation that may be authorized by any means, | 14 | | including, but not limited to, oral, written, electronic, | 15 | | standing orders, protocols, guidelines, or verbal orders. | 16 | | Nothing in this Act shall be construed to authorize a physician | 17 | | assistant to provide health care services required by law or | 18 | | rule to be performed by a physician. Nothing in this Act shall | 19 | | be construed to authorize the delegation or performance of | 20 | | operative surgery. Nothing in this Section shall be construed | 21 | | to preclude a physician assistant from assisting in surgery. | 22 | | (c-5) Nothing in this Section shall be construed to apply
| 23 | | to any medication authority, including Schedule II controlled
| 24 | | substances of a licensed physician assistant for care provided
| 25 | | in a hospital, hospital affiliate, or ambulatory surgical
| 26 | | treatment center pursuant to Section 7.7 of this Act.
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| 1 | | (d) (Blank). | 2 | | (e) Nothing in this Section shall be construed to prohibit | 3 | | generic substitution. | 4 | | (Source: P.A. 100-453, eff. 8-25-17.)"; and
| 5 | | on page 116, immediately below line 14, by inserting the | 6 | | following: | 7 | | "Section 910-73. The Health Care Right of Conscience Act is | 8 | | amended by changing Section 3 as follows:
| 9 | | (745 ILCS 70/3) (from Ch. 111 1/2, par. 5303)
| 10 | | Sec. 3. Definitions. As used in this Act, unless the | 11 | | context clearly
otherwise
requires:
| 12 | | (a) "Health care" means any phase of patient care, | 13 | | including
but
not limited to, testing; diagnosis; | 14 | | prognosis; ancillary research;
instructions; family | 15 | | planning, counselling, referrals, or any other
advice in | 16 | | connection with the use or procurement of contraceptives | 17 | | and
sterilization or abortion procedures; medication; or | 18 | | surgery or other
care or treatment rendered by a physician | 19 | | or physicians, nurses,
paraprofessionals or health care | 20 | | facility, intended for the
physical,
emotional, and mental | 21 | | well-being of persons; or an abortion as defined by the | 22 | | Reproductive Health Act;
| 23 | | (b) "Physician" means any person who is licensed by the |
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| 1 | | State of Illinois under the
Medical Practice Act of 1987;
| 2 | | (c) "Health care personnel" means any nurse, nurses'
| 3 | | aide, medical school
student, professional, | 4 | | paraprofessional or any other person who
furnishes, or | 5 | | assists in the furnishing of, health care
services;
| 6 | | (d) "Health care facility" means any public or private
| 7 | | hospital, clinic,
center, medical school, medical training | 8 | | institution, laboratory or
diagnostic
facility, | 9 | | physician's office, infirmary, dispensary, ambulatory | 10 | | surgical
treatment center or other institution or location | 11 | | wherein health care
services are provided to any person, | 12 | | including physician organizations and
associations, | 13 | | networks, joint ventures, and all
other combinations of | 14 | | those organizations;
| 15 | | (e) "Conscience" means a sincerely held set of moral | 16 | | convictions
arising from belief in and relation to God, or | 17 | | which, though not so
derived, arises from a place in the | 18 | | life of its possessor
parallel to
that filled by God among | 19 | | adherents to religious faiths;
| 20 | | (f) "Health care payer" means a health maintenance | 21 | | organization, insurance
company, management services | 22 | | organization, or any other entity that pays for
or arranges | 23 | | for the payment of any health care or medical care service,
| 24 | | procedure, or product; and
| 25 | | (g) "Undue delay" means unreasonable delay that causes | 26 | | impairment of the patient's health. |
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| 1 | | The above definitions include not only the traditional | 2 | | combinations and forms
of these persons and organizations but | 3 | | also all new and emerging forms and
combinations of these | 4 | | persons and organizations.
| 5 | | (Source: P.A. 99-690, eff. 1-1-17 .)".
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