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


Sen. Ann Gillespie

Filed: 3/24/2023





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2    AMENDMENT NO. ______. Amend Senate Bill 218 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Physician Assistant Practice Act of 1987
5is amended by changing Sections 4 and 21 and by adding Sections
67.6 and 7.9 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8    (Section scheduled to be repealed on January 1, 2028)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



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1physician assistant by the National Commission on the
2Certification of Physician Assistants or equivalent successor
3agency and performs procedures in collaboration with a
4physician as defined in this Act. A physician assistant may
5perform such procedures within the specialty of the
6collaborating physician, except that such physician shall
7exercise such direction, collaboration, and control over such
8physician assistants as will assure that patients shall
9receive quality medical care. Physician assistants shall be
10capable of performing a variety of tasks within the specialty
11of medical care in collaboration with a physician.
12Collaboration with the physician assistant shall not be
13construed to necessarily require the personal presence of the
14collaborating physician at all times at the place where
15services are rendered, as long as there is communication
16available for consultation by radio, telephone or
17telecommunications within established guidelines as determined
18by the physician/physician assistant team. The collaborating
19physician may delegate tasks and duties to the physician
20assistant. Delegated tasks or duties shall be consistent with
21physician assistant education, training, and experience. The
22delegated tasks or duties shall be specific to the practice
23setting and shall be implemented and reviewed under a written
24collaborative agreement established by the physician or
25physician/physician assistant team. A physician assistant,
26acting as an agent of the physician, shall be permitted to



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1transmit the collaborating physician's orders as determined by
2the institution's by-laws, policies, procedures, or job
3description within which the physician/physician assistant
4team practices. Physician assistants shall practice only in
5accordance with a written collaborative agreement.
6    Any person who holds an active license or permit issued
7pursuant to the Medical Practice Act of 1987 shall have that
8license automatically placed into inactive status upon
9issuance of a physician assistant license. Any person who
10holds an active license as a physician assistant who is issued
11a license or permit pursuant to the Medical Practice Act of
121987 shall have his or her physician assistant license
13automatically placed into inactive status.
14    3.5. "Physician assistant practice" means the performance
15of procedures within the specialty of the collaborating
16physician. Physician assistants shall be capable of performing
17a variety of tasks within the specialty of medical care of the
18collaborating physician. Collaboration with the physician
19assistant shall not be construed to necessarily require the
20personal presence of the collaborating physician at all times
21at the place where services are rendered, as long as there is
22communication available for consultation by radio, telephone,
23telecommunications, or electronic communications. The
24collaborating physician may delegate tasks and duties to the
25physician assistant. Delegated tasks or duties shall be
26consistent with physician assistant education, training, and



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1experience. The delegated tasks or duties shall be specific to
2the practice setting and shall be implemented and reviewed
3under a written collaborative agreement established by the
4physician or physician/physician assistant team. A physician
5assistant shall be permitted to transmit the collaborating
6physician's orders as determined by the institution's bylaws,
7policies, or procedures or the job description within which
8the physician/physician assistant team practices. Physician
9assistants shall practice only in accordance with a written
10collaborative agreement, except as provided in Section 7.5 of
11this Act.
12    4. "Board" means the Medical Licensing Board constituted
13under the Medical Practice Act of 1987.
14    5. (Blank).
15    6. "Physician" means a person licensed to practice
16medicine in all of its branches under the Medical Practice Act
17of 1987.
18    7. "Collaborating physician" means the physician who,
19within his or her specialty and expertise, may delegate a
20variety of tasks and procedures to the physician assistant.
21Such tasks and procedures shall be delegated in accordance
22with a written collaborative agreement when such agreement is
23required under this Act.
24    8. (Blank).
25    9. "Address of record" means the designated address
26recorded by the Department in the applicant's or licensee's



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1application file or license file maintained by the
2Department's licensure maintenance unit.
3    10. "Hospital affiliate" means a corporation, partnership,
4joint venture, limited liability company, or similar
5organization, other than a hospital, that is devoted primarily
6to the provision, management, or support of health care
7services and that directly or indirectly controls, is
8controlled by, or is under common control of the hospital. For
9the purposes of this definition, "control" means having at
10least an equal or a majority ownership or membership interest.
11A hospital affiliate shall be 100% owned or controlled by any
12combination of hospitals, their parent corporations, or
13physicians licensed to practice medicine in all its branches
14in Illinois. "Hospital affiliate" does not include a health
15maintenance organization regulated under the Health
16Maintenance Organization Act.
17    11. "Email address of record" means the designated email
18address recorded by the Department in the applicant's
19application file or the licensee's license file, as maintained
20by the Department's licensure maintenance unit.
21    12. "Federally qualified health center" means a facility
22that meets the definition in 42 U.S.C. 1396d(I)(2)(B).
23    13. "Rural health clinic" means a facility that meets the
24definition in 42 U.S.C. 1396d(I)(1).
25(Source: P.A. 102-1117, eff. 1-13-23.)



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1    (225 ILCS 95/7.6 new)
2    Sec. 7.6. Written collaborative agreement; temporary
3practice. Any physician assistant required to enter into a
4written collaborative agreement with a collaborating physician
5is authorized to continue to practice for up to 90 days after
6the termination of a collaborative agreement, provided the
7physician assistant seeks any necessary collaboration at a
8local hospital and refers patients who require services beyond
9the training and experience of the physician assistant to a
10physician or other health care provider.
11    (225 ILCS 95/7.9 new)
12    Sec. 7.9. Optimal practice authority.
13    (a) A physician assistant who practices in a federally
14qualified health center or a rural health clinic shall be
15deemed by law to possess the ability to practice without a
16written collaborative agreement as set forth in this Section.
17    (b) A physician assistant who files with the Department a
18notarized attestation of completion of at least 250 hours of
19continuing education or training and at least 4,000 hours of
20clinical experience after first attaining national
21certification shall not be required to practice with a written
22collaborative agreement. Documentation of successful
23completion shall be provided to the Department upon request.
24    (225 ILCS 95/21)  (from Ch. 111, par. 4621)



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1    (Section scheduled to be repealed on January 1, 2028)
2    Sec. 21. Grounds for disciplinary action.
3    (a) The Department may refuse to issue or to renew, or may
4revoke, suspend, place on probation, reprimand, or take other
5disciplinary or non-disciplinary action with regard to any
6license issued under this Act as the Department may deem
7proper, including the issuance of fines not to exceed $10,000
8for each violation, for any one or combination of the
9following causes:
10        (1) Material misstatement in furnishing information to
11    the Department.
12        (2) Violations of this Act, or the rules adopted under
13    this Act.
14        (3) Conviction by plea of guilty or nolo contendere,
15    finding of guilt, jury verdict, or entry of judgment or
16    sentencing, including, but not limited to, convictions,
17    preceding sentences of supervision, conditional discharge,
18    or first offender probation, under the laws of any
19    jurisdiction of the United States that is: (i) a felony;
20    or (ii) a misdemeanor, an essential element of which is
21    dishonesty, or that is directly related to the practice of
22    the profession.
23        (4) Making any misrepresentation for the purpose of
24    obtaining licenses.
25        (5) Professional incompetence.
26        (6) Aiding or assisting another person in violating



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1    any provision of this Act or its rules.
2        (7) Failing, within 60 days, to provide information in
3    response to a written request made by the Department.
4        (8) Engaging in dishonorable, unethical, or
5    unprofessional conduct, as defined by rule, of a character
6    likely to deceive, defraud, or harm the public.
7        (9) Habitual or excessive use or addiction to alcohol,
8    narcotics, stimulants, or any other chemical agent or drug
9    that results in a physician assistant's inability to
10    practice with reasonable judgment, skill, or safety.
11        (10) Discipline by another U.S. jurisdiction or
12    foreign nation, if at least one of the grounds for
13    discipline is the same or substantially equivalent to
14    those set forth in this Section.
15        (11) Directly or indirectly giving to or receiving
16    from any person, firm, corporation, partnership, or
17    association any fee, commission, rebate or other form of
18    compensation for any professional services not actually or
19    personally rendered. Nothing in this paragraph (11)
20    affects any bona fide independent contractor or employment
21    arrangements, which may include provisions for
22    compensation, health insurance, pension, or other
23    employment benefits, with persons or entities authorized
24    under this Act for the provision of services within the
25    scope of the licensee's practice under this Act.
26        (12) A finding by the Board that the licensee, after



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1    having his or her license placed on probationary status,
2    has violated the terms of probation.
3        (13) Abandonment of a patient.
4        (14) Willfully making or filing false records or
5    reports in his or her practice, including but not limited
6    to false records filed with State agencies or departments.
7        (15) Willfully failing to report an instance of
8    suspected child abuse or neglect as required by the Abused
9    and Neglected Child Reporting Act.
10        (16) Physical illness, or mental illness or impairment
11    that results in the inability to practice the profession
12    with reasonable judgment, skill, or safety, including, but
13    not limited to, deterioration through the aging process or
14    loss of motor skill.
15        (17) Being named as a perpetrator in an indicated
16    report by the Department of Children and Family Services
17    under the Abused and Neglected Child Reporting Act, and
18    upon proof by clear and convincing evidence that the
19    licensee has caused a child to be an abused child or
20    neglected child as defined in the Abused and Neglected
21    Child Reporting Act.
22        (18) (Blank).
23        (19) Gross negligence resulting in permanent injury or
24    death of a patient.
25        (20) Employment of fraud, deception or any unlawful
26    means in applying for or securing a license as a physician



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1    assistant.
2        (21) Exceeding the authority delegated to him or her
3    by his or her collaborating physician in a written
4    collaborative agreement when such agreement is required
5    under this Act.
6        (22) Immoral conduct in the commission of any act,
7    such as sexual abuse, sexual misconduct, or sexual
8    exploitation related to the licensee's practice.
9        (23) Violation of the Health Care Worker Self-Referral
10    Act.
11        (24) Practicing under a false or assumed name, except
12    as provided by law.
13        (25) Making a false or misleading statement regarding
14    his or her skill or the efficacy or value of the medicine,
15    treatment, or remedy prescribed by him or her in the
16    course of treatment.
17        (26) Allowing another person to use his or her license
18    to practice.
19        (27) Prescribing, selling, administering,
20    distributing, giving, or self-administering a drug
21    classified as a controlled substance for other than
22    medically accepted therapeutic purposes.
23        (28) Promotion of the sale of drugs, devices,
24    appliances, or goods provided for a patient in a manner to
25    exploit the patient for financial gain.
26        (29) A pattern of practice or other behavior that



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1    demonstrates incapacity or incompetence to practice under
2    this Act.
3        (30) Violating State or federal laws or regulations
4    relating to controlled substances or other legend drugs or
5    ephedra as defined in the Ephedra Prohibition Act.
6        (31) Exceeding the prescriptive authority delegated by
7    the collaborating physician or violating the written
8    collaborative agreement delegating that authority.
9        (32) Practicing without providing to the Department a
10    notice of collaboration or delegation of prescriptive
11    authority.
12        (33) Failure to establish and maintain records of
13    patient care and treatment as required by law.
14        (34) Attempting to subvert or cheat on the examination
15    of the National Commission on Certification of Physician
16    Assistants or its successor agency.
17        (35) Willfully or negligently violating the
18    confidentiality between physician assistant and patient,
19    except as required by law.
20        (36) Willfully failing to report an instance of
21    suspected abuse, neglect, financial exploitation, or
22    self-neglect of an eligible adult as defined in and
23    required by the Adult Protective Services Act.
24        (37) Being named as an abuser in a verified report by
25    the Department on Aging under the Adult Protective
26    Services Act and upon proof by clear and convincing



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1    evidence that the licensee abused, neglected, or
2    financially exploited an eligible adult as defined in the
3    Adult Protective Services Act.
4        (38) Failure to report to the Department an adverse
5    final action taken against him or her by another licensing
6    jurisdiction of the United States or a foreign state or
7    country, a peer review body, a health care institution, a
8    professional society or association, a governmental
9    agency, a law enforcement agency, or a court acts or
10    conduct similar to acts or conduct that would constitute
11    grounds for action under this Section.
12        (39) Failure to provide copies of records of patient
13    care or treatment, except as required by law.
14        (40) Entering into an excessive number of written
15    collaborative agreements with licensed physicians
16    resulting in an inability to adequately collaborate.
17        (41) Repeated failure to adequately collaborate with a
18    collaborating physician.
19        (42) Violating the Compassionate Use of Medical
20    Cannabis Program Act.
21    (b) The Department may, without a hearing, refuse to issue
22or renew or may suspend the license of any person who fails to
23file a return, or to pay the tax, penalty or interest shown in
24a filed return, or to pay any final assessment of the tax,
25penalty, or interest as required by any tax Act administered
26by the Illinois Department of Revenue, until such time as the



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1requirements of any such tax Act are satisfied.
2    (b-5) The Department shall not revoke, suspend, summarily
3suspend, place on prohibition, reprimand, refuse to issue or
4renew, or take any other disciplinary or non-disciplinary
5action against the license or permit issued under this Act to
6practice as a physician assistant based solely upon the
7physician assistant providing, authorizing, recommending,
8aiding, assisting, referring for, or otherwise participating
9in any health care service, so long as the care was not
10unlawful under the laws of this State, regardless of whether
11the patient was a resident of this State or another state.
12    (b-10) The Department shall not revoke, suspend, summarily
13suspend, place on prohibition, reprimand, refuse to issue or
14renew, or take any other disciplinary or non-disciplinary
15action against the license or permit issued under this Act to
16practice as a physician assistant based upon the physician
17assistant's license being revoked or suspended, or the
18physician assistant being otherwise disciplined by any other
19state, if that revocation, suspension, or other form of
20discipline was based solely on the physician assistant
21violating another state's laws prohibiting the provision of,
22authorization of, recommendation of, aiding or assisting in,
23referring for, or participation in any health care service if
24that health care service as provided would not have been
25unlawful under the laws of this State and is consistent with
26the standards of conduct for a physician assistant practicing



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1in Illinois.
2    (b-15) The conduct specified in subsections (b-5) and
3(b-10) shall not constitute grounds for suspension under
4Section 22.13.
5    (b-20) An applicant seeking licensure, certification, or
6authorization pursuant to this Act who has been subject to
7disciplinary action by a duly authorized professional
8disciplinary agency of another jurisdiction solely on the
9basis of having provided, authorized, recommended, aided,
10assisted, referred for, or otherwise participated in health
11care shall not be denied such licensure, certification, or
12authorization, unless the Department determines that such
13action would have constituted professional misconduct in this
14State; however, nothing in this Section shall be construed as
15prohibiting the Department from evaluating the conduct of such
16applicant and making a determination regarding the licensure,
17certification, or authorization to practice a profession under
18this Act.
19    (c) The determination by a circuit court that a licensee
20is subject to involuntary admission or judicial admission as
21provided in the Mental Health and Developmental Disabilities
22Code operates as an automatic suspension. The suspension will
23end only upon a finding by a court that the patient is no
24longer subject to involuntary admission or judicial admission
25and issues an order so finding and discharging the patient,
26and upon the recommendation of the Board to the Secretary that



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1the licensee be allowed to resume his or her practice.
2    (d) In enforcing this Section, the Department upon a
3showing of a possible violation may compel an individual
4licensed to practice under this Act, or who has applied for
5licensure under this Act, to submit to a mental or physical
6examination, or both, which may include a substance abuse or
7sexual offender evaluation, as required by and at the expense
8of the Department.
9    The Department shall specifically designate the examining
10physician licensed to practice medicine in all of its branches
11or, if applicable, the multidisciplinary team involved in
12providing the mental or physical examination or both. The
13multidisciplinary team shall be led by a physician licensed to
14practice medicine in all of its branches and may consist of one
15or more or a combination of physicians licensed to practice
16medicine in all of its branches, licensed clinical
17psychologists, licensed clinical social workers, licensed
18clinical professional counselors, and other professional and
19administrative staff. Any examining physician or member of the
20multidisciplinary team may require any person ordered to
21submit to an examination pursuant to this Section to submit to
22any additional supplemental testing deemed necessary to
23complete any examination or evaluation process, including, but
24not limited to, blood testing, urinalysis, psychological
25testing, or neuropsychological testing.
26    The Department may order the examining physician or any



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1member of the multidisciplinary team to provide to the
2Department any and all records, including business records,
3that relate to the examination and evaluation, including any
4supplemental testing performed.
5    The Department may order the examining physician or any
6member of the multidisciplinary team to present testimony
7concerning the mental or physical examination of the licensee
8or applicant. No information, report, record, or other
9documents in any way related to the examination shall be
10excluded by reason of any common law or statutory privilege
11relating to communications between the licensee or applicant
12and the examining physician or any member of the
13multidisciplinary team. No authorization is necessary from the
14licensee or applicant ordered to undergo an examination for
15the examining physician or any member of the multidisciplinary
16team to provide information, reports, records, or other
17documents or to provide any testimony regarding the
18examination and evaluation.
19    The individual to be examined may have, at his or her own
20expense, another physician of his or her choice present during
21all aspects of this examination. However, that physician shall
22be present only to observe and may not interfere in any way
23with the examination.
24     Failure of an individual to submit to a mental or physical
25examination, when ordered, shall result in an automatic
26suspension of his or her license until the individual submits



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1to the examination.
2    If the Department finds an individual unable to practice
3because of the reasons set forth in this Section, the
4Department may require that individual to submit to care,
5counseling, or treatment by physicians approved or designated
6by the Department, as a condition, term, or restriction for
7continued, reinstated, or renewed licensure to practice; or,
8in lieu of care, counseling, or treatment, the Department may
9file a complaint to immediately suspend, revoke, or otherwise
10discipline the license of the individual. An individual whose
11license was granted, continued, reinstated, renewed,
12disciplined, or supervised subject to such terms, conditions,
13or restrictions, and who fails to comply with such terms,
14conditions, or restrictions, shall be referred to the
15Secretary for a determination as to whether the individual
16shall have his or her license suspended immediately, pending a
17hearing by the Department.
18    In instances in which the Secretary immediately suspends a
19person's license under this Section, a hearing on that
20person's license must be convened by the Department within 30
21days after the suspension and completed without appreciable
22delay. The Department shall have the authority to review the
23subject individual's record of treatment and counseling
24regarding the impairment to the extent permitted by applicable
25federal statutes and regulations safeguarding the
26confidentiality of medical records.



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1    An individual licensed under this Act and affected under
2this Section shall be afforded an opportunity to demonstrate
3to the Department that he or she can resume practice in
4compliance with acceptable and prevailing standards under the
5provisions of his or her license.
6    (e) An individual or organization acting in good faith,
7and not in a willful and wanton manner, in complying with this
8Section by providing a report or other information to the
9Board, by assisting in the investigation or preparation of a
10report or information, by participating in proceedings of the
11Board, or by serving as a member of the Board, shall not be
12subject to criminal prosecution or civil damages as a result
13of such actions.
14    (f) Members of the Board shall be indemnified by the State
15for any actions occurring within the scope of services on the
16Board, done in good faith and not willful and wanton in nature.
17The Attorney General shall defend all such actions unless he
18or she determines either that there would be a conflict of
19interest in such representation or that the actions complained
20of were not in good faith or were willful and wanton.
21    If the Attorney General declines representation, the
22member has the right to employ counsel of his or her choice,
23whose fees shall be provided by the State, after approval by
24the Attorney General, unless there is a determination by a
25court that the member's actions were not in good faith or were
26willful and wanton.



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1    The member must notify the Attorney General within 7 days
2after receipt of notice of the initiation of any action
3involving services of the Board. Failure to so notify the
4Attorney General constitutes an absolute waiver of the right
5to a defense and indemnification.
6    The Attorney General shall determine, within 7 days after
7receiving such notice, whether he or she will undertake to
8represent the member.
9    (g) The Department may adopt rules to implement the
10changes made by this amendatory Act of the 102nd General
12(Source: P.A. 101-363, eff. 8-9-19; 102-558, eff. 8-20-21;
13102-1117, eff. 1-13-23.)".