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2015 Legislative Action Hub

  • The ISMS Legislative Action Hub tracks legislative issues important to the physician community. You can look up specific bills, ISMS positions and actions on those bills, and how legislators voted on each issue. 

    If you require additional information on an issue listed below or have a question about an issue not listed, please contact ISMS State Legislative Affairs at 800-782-4767.

    Please visit our Frequently Asked Questions to learn more about the ISMS Hub and the legislative process.

    To view federal advocacy efforts, visit the AMA Current Topics in Advocacy page.

    View/Download the 2015 End of Session Legislative Report

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    Updated as of August 11, 2015.

  •  A Trial Lawyer Effort to Repeal the Medical Studies Act

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    The Medical Studies Act has been relied upon by hospitals and medical staffs to protect peer review meetings and related documents from disclosure. The purpose of the Act is not to shield hospitals or physicians from liability, but to ensure that physicians will engage in effective examination of their peers in order to advance the quality of healthcare.  The Illinois Trial Lawyers Association introduced SB 1700 to repeal the Medical Studies Act and make peer review meetings discoverable.  Repeal of this act would not only dramatically increase lawsuits against physicians and hospitals, but would also severely harm the ability of health facilities and physicians to improve patient care. ISMS strongly opposed this bill, which stalled in the Senate Committee on Assignments.

     Biosimilars

    Senate Bill 455 imposes restrictions and requirements on pharmacists when they substitute "biologics, biosimilars and interchangeable products" for biological products.

    Biologics, biosimilars and interchangeable products are very complex drugs derived from living cells, which makes it impossible to produce a "generic" form of the drug. While similar to biological products, they are still therapeutically different and should not be treated as generic drugs.

    SB 455 passed both chambers and was signed by the governor.

    Bill Status of S.B. 455

     Dispensing Contact Lenses

    issue-opposeHouse Bill 2450 (Rep. Burke) and Senate Bill 1259 (Sen. Clayborne) would override protections currently in Illinois law and allow the dispensing of contact lenses at any location by unlicensed and unregulated individuals. Due to ISMS opposition, neither bill was called for a vote in committee.

     Extension of the Medical Practice Act

    issue-supportSenate Bill 814 (Sen. Martinez), an ISMS initiative, would extend the Illinois Medical Practice Act 10 years from Dec. 31, 2015, to Dec. 31, 2025. This bill was not called for a vote during the spring session. It is expected that this issue will be addressed in the fall veto session.

       Full Funding of the State Employee Group Health Plan

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      Physicians and health care facilities are owed tens of millions of dollars in payments under the Illinois' State Employee Group Health Plan. Most physicians are waiting as long as a year to be reimbursed for treating state employees. If not addressed, this failure to reimburse physicians and other professionals and providers for these services will create severe access issues. ISMS supports full funding for this program going forward, and strongly advocates that immediate action be taken to pay for care that has been provided.  

       Hepatitis C Screening Mandate

      Legislation (SB 661) passed in the Illinois General Assembly that would impose a mandate on primary care physicians and other primary care professionals to offer a Hepatitis C screening to patients born between 1945 and 1965. ISMS firmly opposes this mandate. On August 21, Governor Rauner vetoed SB 661. The sponsor of SB 661 has not filed a motion to override the governor’s veto. It appears that, for now, the mandate will not become law.

       Hospital Affiliate Definition

      The Illinois Hospital Licensing Act allows Advance Practice Nurses and Physician Assistants to practice at hospitals and hospital affiliates.  ISMS legal counsel has pointed out that the Nurse Practice Act and Physician Assistant Practice Act do not have a definition of the term “hospital affiliate.” ISMS supports Senate Bill 837, which adds a definition to ensure consistency in the application of both of these acts. S.B. 837 passed in both chambers and was signed by the governor.

      Bill Status of S.B. 837

       Immunizations for child care workers

      Senate Bill 986 requires employees of child care facilities to demonstrate proof that they received the Tdap (tetanus, diphtheria and pertussis) vaccine and the MMR (measles, mumps and rubella) vaccine if they care for children ages six and under. 

      Previously, Illinois had no specific vaccination requirements of child care facility employees. ISMS supported S.B. 986.

      SB 986 passed both chambers and was signed by the governor.

      Bill Status of S.B. 986

       Independent Practice of Advanced Practice Nurses

      House Bill 421, as amended, maintains the requirement that APNs must have a collaborative agreement with a physician if they practice outside of a hospital, hospital affiliate or ambulatory surgical treatment center, where they are required to be credentialed by medical staff. 

      In addition, the legislation:

      • Preserves that certified registered nurse anesthetists (CRNAs) maintain a written anesthesia plan with anesthesiologists. 

      • Makes no change to the law requiring delegation of prescriptive authority by a physician to allow APNs (other than CRNAs) to prescribe at a hospital affiliate if credentialed by the medical staff to do so.

      ISMS successfully negotiated with the Illinois Society for Advanced Practice Nursing to remove the objectionable aspects of this bill.


      House Bill 421 (Rep. Feigenholtz/Sen. Steans) as originally introduced would have removed the requirement that advanced practice nurses (APNs) practicing outside of a hospital, hospital affiliate, or ambulatory surgical center (ASTC) maintain a collaborative agreement with a collaborating physician. The bill would have also removed the requirement that certified registered nurse anesthetists (CRNAs) maintain a written anesthesia plan with anesthesiologists. These changes to current law would have allowed APNs to practice independent of physician input. ISMS strongly opposed HB 421 as introduced. At the request of legislators, ISMS agreed to meet with the Illinois Society for Advanced Practice Nursing (ISAPN) in an attempt to reach a compromise. ISMS and ISAPN met for months and agreed to language that:

      • Maintains current law requiring APNs to have a collaborative agreement with a physician if they are practicing outside of a hospital, hospital affiliate, or ASTC. In hospitals, hospital affiliates, and ASTCs, APNs continue to be credentialed by the medical staff.
      • Makes no changes whatsoever to the provision of anesthesia services by CRNAs.
      • Makes no changes to the law requiring delegation of prescriptive authority by a physician, but allows APNs (other than CRNAs) to prescribe at a hospital affiliate such as an urgent care center if credentialed by the medical staff to do so. Under a written collaborative agreement, an APN can only prescribe medications if the collaborating physician delegates authority to do so. Additional limitations exist on an APN’s ability to prescribe Schedule II controlled substances, including specific identification of the controlled substances prescribed and a prohibition on any delivery method other than oral, topical or transdermal application. These same restrictions will apply at the hospital affiliate.
      • Eliminates specified content in the collaborative agreement and allows the physician and the APN to more broadly determine their collaborative practice within the specialty area of the APN and the physician.
      • Eliminates contractual barriers that might prevent APNs from participating in Medicaid.
      • Allows for a 90-day transition period when, for any reason, a physician discontinues a collaborative agreement with an APN, provided the APN seeks any needed collaboration at a local hospital and refers patients who require services beyond the training and experience of the APN to a physician or other health care professional.
      • Deletes references in approximately 28 different acts where APNs and physician assistants are allowed to perform various functions, only if they are specifically mentioned in the collaborative agreement or the supervisory agreement with physician assistants. Most written collaborative agreements do not enumerate the particular patient services, but collaborating physicians routinely allow such services to be performed by the APN even though enumeration is required by the law. Nothing will prevent a physician from including any restrictions on practice or requirements for communication within the collaborative agreement.

      HB 421 as amended passed both chambers and was signed by the governor. 

      ISMS Position Paper on H.B. 421 (as introduced)
      Bill Status of H.B. 421
      Amended H.B. 421

       Licensure of Direct-entry Midwives

      issue-oppose2 Currently, individuals who want to practice midwifery in Illinois can become APNs certified as nurse midwives, and work under a collaborative agreement with a physician or be credentialed by the medical staff of a hospital.

      Illinois does not license "certified professional midwives" (CPMs). House Bill 424 (Rep. Morrison and Rep. Cassidy) was introduced in the Illinois legislature to license these midwives to provide prenatal, delivery, post-partum, and pediatric care – including the administration of prescription drugs and the performance of surgical procedures like episiotomies – without requiring the education and training required of certified nurse midwives.

      The education requirements for licensed advanced practice nurse midwives, which far exceed those required of certified midwives, protect patient safety. The education and training for CPMs falls short of the level which, even with collaborative agreement with a physician, would ensure proper patient care and safety.

      Physicians believe that licensure of "certified professional midwives" is a step backward in patient safety as it would allow the least-trained individuals to provide one of the most critical services to women in Illinois.

      ISMS strongly opposed this legislation, which was not called for a vote in committee. 

       Licensure of Naturopathic Physicians

      issue-oppose2ISMS strongly opposes House Bill 3508 and Senate Bill 1601, a measure that would amend the Illinois Medical Practice Act and license "naturopathic physicians” to practice medicine. In the face of ISMS opposition, the bill was never called for a vote in the House Health Care Licenses Committee. Senate Bill 1601 was debated in the Licensed Activities and Pension Committee, but was never called for a vote

       Licensure Suspension Without Due Process

      House Bill 1359 (Rep. Gabel) as originally introduced, proposed to automatically suspend a professional’s license under certain circumstances related to Medicaid or Medicare fraud, regardless of whether the professional intentionally or deliberately committed fraud.

      Currently, professional licensing laws already provide sufficient grounds for the IDFPR to seek to discipline professionals for fraudulent billing with the professional being afforded the right to due process in an administrative hearing. ISMS opposed HB 1359, as introduced, which would remove the due process afforded to health care professionals.

      IDFPR agreed to an amendment that clarified that a health care professional’s license can only be suspended at such time as a professional has been criminally convicted or entered a plea of guilty or nolo contendere of criminal insurance fraud. The amendment requires that a certified copy of the conviction or judgment be the basis for the suspension, and provides that if a licensee requests a hearing, then the sole purpose of the hearing shall be limited to determining the length of the suspension of the licensee's license.

      ISMS supported the bill as amended, which passed both chambers and was signed by the governor.

      ISMS Position Paper
      Bill Status of HB 1359

       Limiting Medical Record Copy Fees

      issue-oppose2House Bill 3845 (Rep. Sims) would supersede current regulations on fees that can be charged for copying medical records in connection with claims or appeals under provisions of Social Security Act, and instead force physician practices and other health care professionals to unfairly absorb the costs. Due to ISMS opposition, the bill was not called for a vote on the House Floor and was reassigned to the House Rules Committee.

       Medicaid

      More Illinois residents than originally projected are signing up for Medicaid as a result of the federal Affordable Care Act.

      ISMS remains hopeful that the State will closely monitor the demands this expansion places on our health care system.  Physicians remain concerned about low reimbursements that are often delayed for an extended period of time.  Given significant increase in Medicaid clients and inadequate rates, significant financial strains could be faced by physicians and their practices. 

      Adequate Medicaid funding for physician services is essential to access to care for Medicaid clients.  Currently, Illinois ranks in the bottom 10 states for reimbursement to physicians for Medicaid reimbursement.  An across the board fee increase has not occurred since 1999 when fees were increased 5%.  While there were increases to a dozen primary care services in 2006 as a result of a lawsuit claiming that low reimbursement caused inadequate access to care, rates still do not come close to covering the cost of providing the care.  Coupled with decreasing reimbursement from Medicare and private payers that has put increased financial pressure on physicians, it should not be surprising that most physicians limit the number of Medicaid patients in their practice. Obviously, any cuts to physician reimbursement will further decrease access to care for Medicaid patients.

      Primary care physicians received a two year increase in Medicaid rates paid for by the federal government with the expectation that states would begin to pay for this increase beginning this year.  ISMS hopes that the State acknowledges the correlation between the increase in rates and the improvement in access, and will reconsider its decision not to that retain that increase. 

      To ensure adequate access to all aspects of care, reimbursements to all physicians participating in Medicaid need to be increased. 

      Physicians also remain very concerned about reforms that limit Medicaid patients to four drugs a month.  ISMS introduced legislation in 2013 (HB 2352, Cassidy) that would have required Department of Healthcare and Family Services to, in consultation with statewide organizations representing prescribers, develop a protocol that expedites review and approval of prescriptions for psychiatric conditions and chronic conditions such as asthma, hypertension, and diabetes. It would have also permitted the Department to exempt, by rule, prescriptions for antibiotics and other categories from the 4-prescription limit. 

      While this legislation did not advance, ISMS is hopeful that the State will monitor and keep stakeholders updated as to how the limit impacts care, and take necessary steps to make any adjustments. 

       Out-of-state Athletic Team Physicians

      ISMS and the Illinois Association of Orthopedic Surgeons (IAOS) supports Senate Bill 785, legislation that would grant temporary licensure waivers for physicians who travel with their team to Illinois for an athletic event.  

      Under current Illinois statute, a team’s physicians could provide medical service in Illinois only if they hold a full and active license in Illinois.  This proves to be a significant barrier to many team physicians. 

      Specifically, legislation would allow athletic teams to use their team physicians while in Illinois for specific athletic events.  Out-of-state team physicians would have to meet the following conditions to receive a temporary licensure waiver: 

      • Must be licensed to practice medicine in another state;  
      • The team’s physician has an oral or written agreement with a sports team to provide health care services to the team members, coaching, and families traveling with the team for a specific sporting event to take place in Illinois;
      • The team’s health care professional would be prohibited from providing care or consultation to any Illinois resident, other than a person described in the Good Samaritan Act;
      • The waiver may not be longer than 10 days per individual sporting event.  The Secretary of the Illinois Department of Financial and Professional Regulation may grant extensions, but the total number of days, with extensions, cannot exceed 30 days.  
      • A team’s physician who is exempt from licensure requirements would not be authorized to practice at an Illinois health care clinic or facility, including an acute care facility.  

      SB 785 passed both chambers and was signed by the governor.

      Bill Status of S.B. 785

       Pharmacists Seek Authority to Vaccinate Children

      issue-oppose2 ISMS has joined a number of specialty physician societies in opposing House Bill 3627 (Rep. Evans ), legislation that would allow pharmacists to vaccinate patients ages 10 – 13 with the meningococcal vaccine.

      At age 11, most children in Illinois need their 6th grade physical, with their Tdap and meningococcal vaccine.  Currently, pharmacists are limited to administering the influenza and Tdap vaccines to children ages 10 to 13.  Physicians are concerned that removing any restriction on the type of vaccination administered does not adequately protect a child’s health. 

      Children need annual comprehensive physician examinations.  Immunizations should remain part of those examinations.  When it comes to treating children, a shot is not just a shot; it is an opportunity for the child’s physical wellbeing to be assessed by qualified health care professionals.  Pharmacists are not qualified to provide that service. 

      House Bill 3627 takes a piecemeal approach to medical care and will take more children out of the medical home. This bill stalled in committee.

      ISMS Position Paper
      Bill  Status of HB 3627

       Prescribing Opioids

      House Bill 1 (Rep. Lang/Sen. Kotowski) is a comprehensive package designed to address heroin and opioid abuse and addiction in Illinois. The legislation arose out of numerous meetings of the House Bipartisan Heroin Crisis Task Force where members heard testimony from State agencies, the Illinois State Medical Society and associations representing coroners, pharmacists, judges, prosecutors, police officers, educators, and counselors, as well as treatment centers, policy organizations, affected family members and addicts.

      ISMS was instrumental in amending a large portion of the bill and removing provisions that would have criminalized the practice of medicine, required physicians to take continuing medical education on the dangers of opioids and drug addiction, required physicians to offer mental health screening prior to prescribing opioids, limited the amount of opioids a physician could prescribe, and granted the IDFPR broad authority to obtain and use prescribing habits of physicians as reported by the Prescription Monitoring Program (PMP).  ISMS supported HB 1, as amended.

      On August 24, 2015, Governor Rauner issued an amendatory veto of the bill making two significant changes. However, the House and Senate sponsors were successful overriding Governor Rauner’s amendatory veto. HB 1 is law as Public Act 99-480, effective immediately.

      ISMS Analysis

       Rights of Plaintiffs and Defendants

      issue-oppose2Two bills have been introduced that will negatively impact “respondents” in litigation.  The respondent is an interested party in litigation who may or may not become a defendant.  Respondent are not the defendant and only required to admit facts for a case.  ISMS opposes the change proposed under HB 95 and HB 96 (both introduced by Rep Thapedi).  HB 96 would change Illinois law so that inadvertent or an improperly phrased response could result in an admission of liability against the respondent even if the facts are not true.  

      ISMS objected to removing language regarding the plaintiff’s right to have an attorney or other person present during a physical or mental health exam, and language providing that persons or organizations shall not have to furnish claims, loss or risk management information.  Both of these provisions were amended back into the bills. ISMS was neutral on the bills as amended, which passed and were signed into law. 

       Topical Eye Medication

      House Bill 3137 creates the Topical Eye Medication Act and prohibits Illinois health insurers that provide coverage for prescription topical eye medication from denying coverage for refills when certain conditions are met.

      The purpose of this bill is to ensure that patients who have difficulty administering prescription eye drops to themselves are not prohibited from purchasing timely refills for topical eye medication. For example, if the medication is inadvertently wasted, the patient will be able to purchase a refill than the prescription refill date. An initiative of the Illinois Society of Eye Physicians and Surgeons, ISMS supported this bill.

      HB 3137 was signed by the governor.

      Bill Status of H.B. 3137 

       Work Comp Reform Under Consideration in Springfield

      issue-oppose2Lawmakers in Springfield are considering another legislative effort to reform the workers’ compensation system. Of chief concern to physicians, who are dedicated to healing workplace injuries and returning injured workers to gainful employment, is a proposal for as much as a 60% reduction in the Medical Fee Schedule. This cut would be in addition to the 30% reduction that was imposed upon the entire Medical Fee Schedule in 2011.

      While the legislative leaders and representatives from the governor’s office continue to meet over these and other issues, it is unknown at this time what, if anything, will be agreed to. 



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