Bill Text: IL SB0218 | 2023-2024 | 103rd General Assembly | Enrolled

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Physician Assistant Practice Act of 1987. Provides that 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. Provides that physicians and physician assistants who work in a federally qualified health center are exempt from specified collaborative ratio restriction requirements. Adds physician assistants providing services in federally qualified health centers to provisions that authorize certain physician assistants to provide services without a written collaborative agreement and to prescribe certain controlled substances. Defines "federally qualified health center". Makes conforming and other changes.

Spectrum: Slight Partisan Bill (Democrat 6-2)

Status: (Passed) 2023-06-09 - Public Act . . . . . . . . . 103-0065 [SB0218 Detail]

Download: Illinois-2023-SB0218-Enrolled.html

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(Section scheduled to be repealed on January 1, 2028)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

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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

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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

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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

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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

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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

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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.

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(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

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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,

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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

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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.

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(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

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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

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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.

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(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

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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

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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.)