Public Act 100-0418
 
SB0898 EnrolledLRB100 05745 SMS 15768 b

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    (Section scheduled to be repealed on January 1, 2026)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