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2017 Legislative Action Hub

  •  Independent Practice for Advanced Practice Nurses


    APRNs' top legislative priority this year had been to secure complete practice independence, but ISMS was able to prevent this dangerous and unwarranted expansion of their scope of practice. An ISMS-proposed alternative was agreed to by the nurses and the Illinois General Assembly. The amended bill passed both the House and the Senate and is currently on the governor’s desk awaiting signature. It is expected that HB 313 will be signed into law later this summer.

     Licensure of Lay Midwives

    HB 677 and SB 1754 would create a new profession of "certified midwives." ISMS, several other medical specialty groups, and a number of hospitals oppose these bills. The bills’ education and licensure requirements for certified midwives are notably absent, and even if specified would fall well below the standards for certified nurse midwives.  Aside from the lack of required training, this legislation would allow midwives to perform a wide range of medical services at home without the support of medical technology or other qualified professionals. Because of the significant risks that come with home birth, ISMS, along with groups serving mothers, opposes the creation of a new license that does not require essential training and authorizes the provision of medical services to women and children by unqualified individuals. It is expected that an amendment offered by the Illinois Trial Lawyers Association will be adopted to remove the liability protection for physicians that is currently provided in both bills.

    Due to ISMS' opposition, HB 677 was not called for a vote in the House Health Care Licenses Committee and therefore did not advance. SB 1754 did pass out of the Senate Licensed Activities and Pensions Committee, but was not called for a vote on the Senate floor.

     Licensure of Naturopaths

    SB 708  is a measure that would license "naturopaths” as physicians and allow them to provide a full range of medical services to patients in Illinois, including caring for children, those with chronic conditions like diabetes and cancer, and providing specialty care, such as gynecological services. ISMS opposed this legislation and it was stopped in committee.

     Mandatory Electronic Prescribing

    SB 2058 is an initiative of the Illinois Pharmacists Association and requires that, beginning on January 1, 2022, all prescription orders for drugs or medical devices must be electronically transmitted to the patient's pharmacy of choice. While ISMS encourages the use of electronic prescribing, mandating use and forcing offices to purchase what could be extremely expensive programs is not appropriate.  Due to ISMS’ opposition, the bill is currently being held in the Senate.

     Medicaid RFP

    This March, the Governor’s Office in conjunction with the Department of Healthcare and Family Services (HFS) submitted a $9 billion Request for Proposal (RFP) to fundamentally change how Medicaid Managed Care recipients access critical health care services. Aggressive implementation timelines have been put forth as the goal is to have the new Medicaid Managed Care Program functional by January 1, 2018. ISMS members have expressed great frustration with the current Managed Care Program and welcomed the program’s restructuring regarding the number of companies participating, numerous drug formularies, and separate credentialing requirements for each insurance provider. We looks forward to working with the Governor and the Administration on a Medicaid program that is attractive to physician participation. It is imperative that HFS maintains oversight with the new program instead of merely outsourcing those functions to commercial insurers.   

    ISMS is going to continue to monitor this process as the RFP moves forward. We have reviewed the model contract that HFS is proposing between the agency and the MCOs and it is still somewhat unclear whether this contract addresses our concerns about physician having to be credentialed with each separate MCO or whether they can be credentialed once by the state, applicable to all participating MCOS. While we are hopeful that one standardized baseline drug formulary may be required to be utilized by all MCOs, it appears that each MCO retains the authority to impose unique prior authorization processes. For doctors participating in multiple Medicaid MCOs, multiple credentialing requirements and different formularies and prior authorization protocols can pose a significant administrative burden and may create a significant disincentive to accepting Medicaid beneficiaries.

    More details will follow as information becomes available. 

     Network Adequacy and Transparency

    ISMS legislation – HB 311–  would ensure the adequacy, accessibility and transparency of health care services offered under a health care network plan by establishing standards of network adequacy and network transparency, and by establishing a process by which the Director of the Department of Insurance can enforce these standards. 
    HB 311 passed in both the House and the Senate and is currently on the governor’s desk awaiting signature. It is expected that HB 311 will be signed into law later this summer.

     Pharmacists Prescribing Birth Control

    issue-oppose2HB 274 would allow pharmacists to prescribe and dispense contraceptive drugs. ISMS is opposed expanding a pharmacist's scope of practice to include prescribing. Pharmacists are not trained to diagnose and treat conditions, diseases and other maladies of the human body, and allowing them to prescribe drugs exposes patients to risk. Moreover, this prescriptive authority would promote episodic care and diminish the physician-patient relationship.HB 2742 did not advance. The issues it is seeking to address will be considered in larger discussions within a task force created under House Bill 3462. 

     Physician Reporting to the Secretary of State’s Office

    issue-oppose2SB 655 requires physicians to report a driver suffering from a medical condition that is likely to cause loss of consciousness within 10 days of knowledge. The Secretary of State shall determine what conditions do not require reporting. Physicians have civil and criminal immunity for reporting only for liability from an accident. ISMS opposes this legislation. SB 655 was not called for a vote in the Senate Criminal Law Committee and was referred to the Committee on Assignments. No further action occurred.

     Prescribing Opioids

    Democratic and Republican legislators, state government agencies, and the Governor’s office continue to express serious concerns over the opioid crisis in Illinois and the current state of prescribing controlled substances. Physicians have typically helped develop policy and engaged in advocacy efforts to protect the public health of the citizens of Illinois. Despite these efforts, many policymakers support efforts that would limit the amount of opioids physicians can prescribe, as well as requiring physicians to check the prescription monitoring program. Other mandates, such as mandated CME on how to prescribe opioids, also continue to be discussed. 

    issue-opposeSB 2011

    SB 2011 is an initiative of the Lieutenant Governor's office and would limit a prescription of an opioid to no more than a 7-day supply. A prescriber may prescribe more than a 7-day supply of an opioid if it is required to treat the patient's acute medical condition or is necessary for chronic pain management, pain associated with a cancer diagnosis, or for palliative care. The prescriber must note the condition triggering the prescription of an opioid for more than a 7-day supply in the patient's medical record and the prescriber must indicate that a non-opioid alternative was not appropriate to address the medical condition. 

    issue-opposeSB 1607

    Amends the Illinois Controlled Substances Act. Requires that before issuing a prescription for a Schedule II, III, IV, or V controlled substance, the prescriber or his or her designee must access the prescription monitoring program to determine compliance with the pharmacy and medication shopping provisions of the Act. Provides that within one year of the effective date of the bill, the Department shall adopt rules requiring all Electronic Health Records Systems to interface with the Prescription Monitoring Program application program on or before January 1, 2021 to ensure that all providers have access to specific patient records during the treatment of their patients. These rules shall also address the electronic integration of pharmacy records with the Prescription Monitoring Program to allow for faster transmission of the information required under the Act. Provides that the Department shall establish actions to be taken if a prescriber's Electronic Health Records System does not effectively interface with the Prescription Monitoring Program within the required timeline.


    Various measures have been introduced and are moving through the legislative process to make statutory changes to Illinois' telehealth program. Proponents of these various initiatives contend that these bills are needed to expand access to care in Illinois.

    issue-oppose2SB 1811 Amendment #2

    SB 1811 amends the Medical Practice Act and places the following overly prescriptive requirements upon a physician practicing telemedicine:

    1. The physician must use the same standard of care as if the health care services were provided in person; and
    2. The physician shall not be required to conduct an in-person patient history or physical examination of the patient before engaging in a telemedicine encounter if the physician satisfies all of the following conditions:
      1. holds an unrestricted license to practice medicine issued under this Act;
      2. has access to the patient's medical records upon consent of the patient;
      3. creates a medical record on each patient and makes the record available to the Department of Financial and Professional Regulation upon request; and
      4. if necessary, provides a referral to a physician in this State or arranges follow-up care in this State as may be indicated.

    The bill also includes requirements regarding prescription of a controlled substance, location of patient and physician when services are provided, and documentation in patient's medical records of services rendered.

    issue-supportHB 2907/SB 2069

    These bills would allow Medicaid to reimburse for telehealth services when the licensed clinician leaves the room to perform other work or check on other patients. The goal is to increase access to behavioral health and other specialty care issues for patients enrolled in the Medicaid program.

     Workers' Compensation 'Reform'

    Discussions among legislators on how best to reform Illinois' Worker's Compensation Program continue to take place. ISMS is not only opposed to additional cuts to the medical fee schedule, but is also advocating for changes to how insurance companies accept and pay claims.  

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