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Behavioral Health Providers
Prior Authorization Requirements For Providers Prescribing Buprenorphine-Containing Products

State law or statute prohibits or limits the use of prior authorization for buprenorphine containing products by either the state Medicaid plan or private insurance companies.

Individual and group health plans may not require prior authorization for FDA-approved substance use disorder medications (unless consistent with American Society of Addiction Medicine requirements). 215 Ill. Comp. Stat. 5/370c(b)(6.5)(a)

Prior authorization is prohibited on all "FDA-approved forms of medication-assisted treatment" for alcohol dependence or opioid dependence in Medicaid fee-for-service and Medicaid Managed Care. 305 Ill. Comp. Stat. 5/5-5

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Education Required for Addiction Counselor Credentialing

Illinois credentials five types of addiction counselors. Certified Associate Addictions Professionals (CAAPs), Certified Alcohol and Other Drug Abuse Counselors (CADCs), Certified Reciprocal Alcohol and Other Drug Abuse Counselors (CRADCs), Certified Supervisor Alcohol and Other Drug Abuse Counselors (CSADCs) and Certified Advanced Alcohol and Other Drug Abuse Counselors (CAADCs).

A CAAP requires a high school diploma and passage of an examination. There is no experience requirement, but ongoing supervision is required. A CADC requires a high school diploma, 225 hours of relevant education and 4,000 hours of experience. A higher-level degree can substitute the number of hours (i.e. a person with a bachelor's degree needs 2,000 hours). A CRADC requires a high school diploma, 300 hours of relevant education and 6,000 hours of experience. A higher-level degree can substitute the number of hours (i.e. a person with a bachelor's degree needs 2,000 hours). A CSADCs requires a high school diploma and 350 hours of relevant education. The counselor must be a CADC before applying for the CSADC credential. A CAADC requires a master's degree, 180 hours of relevant education and 2,000 hours of experience. 77 Ill. Adm. Code §2060.309 and Illinois Alcohol and Other Drug Abuse Professional Certification Association

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Licensed Professional Counselor Ability to Diagnose

A licensed professional counselor (LPC) may provide services to individuals, couples, groups, families, and organizations. Counseling includes the therapeutic process of conducting assessments and diagnosing for the purpose of establishing treatment goals and objectives. LPCs also plan, implement, and evaluate treatment plans using treatment interventions to facilitate human development and to identify and remediate mental, emotional, or behavioral disorders and associated distresses that interfere with mental health. 225 Ill. Comp. Stat. §107/10

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Peer Support Specialist Certification or Credentialing Authority

The standards and requirements for the certification of recovery support specialists and peer recovery specialists are developed and administered by a third-party, non-profit certification provider.

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Advanced Practice Registered Nurses
Certified Nurse Midwife Practice and Prescriptive Authority

Transition to independent practice and prescriptive period required.

Prior to independent practice, a written collaboration agreement is required and must describe the relationship between the NM and the supervising physician. The agreement must describe the categories of care, treatment or procedures that may be provided by the NM. Prescriptive authority must also be outlined in the collaborative agreement and may include prescription drugs and Schedules III-V substances. Schedule II controlled substances may still be prescribed if delegated by the supervising physician and if certain requirements outlined in the rules are met.

An APRN certified as an NM who files with the Department a notarized attestation of completion of at least 250 hours of continuing education or training and at least 4,000 hours of clinical experience after first attaining national certification shall not require a written collaborative agreement. 225 Ill. Comp. Stat. §65/65-35

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Nurse Practitioner Practice and Prescriptive Authority

Transition to independent practice and prescriptive period required.

Prior to independent practice, a written collaboration agreement is required and must describe the relationship between the NP and the supervising physician. The agreement must describe the categories of care, treatment or procedures that may be provided by the NP. Prescriptive authority must also be outlined in the collaborative agreement and may include prescription drugs and Schedules III-V substances. Schedule II controlled substances may still be prescribed if delegated by the supervising physician and if certain requirements outlined in the rules are met.

An APRN certified as an NP who files with the Department a notarized attestation of completion of at least 250 hours of continuing education or training and at least 4,000 hours of clinical experience after first attaining national certification shall not require a written collaborative agreement. 225 Ill. Comp. Stat. §65/65-35

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Nurse Practitioner Authority to Sign POLST Forms

Patients are required to have a consultation with their health care provider, including NPs, prior to having the practitioner orders for life-sustaining treatment form signed. Ill. Rev. Stat. ch. 755 §40/65

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Nurse Practitioner as a Primary Care Provider

NPs are recognized in state policy as primary care providers. Maternal and Child Health primary care providers may include NPs. Ill. Admin. Code tit. 89, §140.924

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Optometrists
Authority to Perform Ophthalmic Procedures

Optometrists may only examine, diagnose and treat conditions of the visual system. 225 Ill. Comp. Stat. §80/24.2(c)(3) and 225 Ill. Comp. Stat. §80/24.2(f)

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Injectable Authority

Optometrists may use injections to counter anaphylactic reactions as well as the administration of the COVID-19 vaccine. 225 Ill. Comp. Stat. §80/15.1(a-5)

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Prescription of Controlled Substances

Optometrists may prescribe Schedule III-V controlled substances and also Schedule II hydrocodone or hydrocodone combination medications. 225 Ill. Comp. Stat. §80/15.1(a)

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Oral Health Providers
Dental Hygienists with Direct Access

Under a written public health supervision agreement, a qualified dental hygienist may provide services in public health settings without a dentist's presence, supervision or initial examination to patients who are Medicaid-eligible or uninsured with low incomes. 225 Ill. Comp. Stat. §25.18.1

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Dental Therapists

Statute does not identify dental therapists as an oral health provider.

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Practice of Teledentistry

Teledentistry uses telehealth systems and methodologies in dentistry and includes patient care and education. Services may be delivered using live video and store-and-forward modalities. 225 Ill. Comp. Stat. §25/4

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Pharmacists
Administration of COVID-19 Vaccine

Illinois has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

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Prescription Adaptation

Illinois does not allow pharmacists to modify prescriptions.

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Prescription of Hormonal Contraceptives

A pharmacist may dispense no more than a 12-month supply of hormonal contraceptives to a patient. A pharmacist must complete an educational training program that is related to the patient self-screening risk assessment, patient assessment contraceptive counseling and education, and dispensation of hormonal contraceptives. A pharmacist must have the patient complete the self-screening risk assessment tool. A pharmacist shall provide, during the patient assessment and consultation, counseling and education about all methods of contraception, including methods not covered under the standing order, and their proper use and effectiveness. 225 Ill. Comp. Stat. §85/43

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Prescription of Tobacco Cessation Aids

Illinois does not allow pharmacists to prescribe tobacco cessation aids.

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Physician Assistants
Physician Assistant Practice and Prescriptive Authority

Collaboration allowed with a physician for practice and prescriptive authority.

PAs shall be capable of performing a variety of tasks within the specialty of medical care in collaboration with a physician. The collaborating physician may delegate tasks and duties to the PA. Delegated tasks or duties shall be consistent with PA 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/PA team. 225 Ill. Comp. Stat. §95/4(3)

A collaborating physician may, but is not required to, delegate prescriptive authority to a PA 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 PA Laws and Regulations 23rd Edition, January 2023 through V controlled substances. 225 Ill. Comp. Stat. §95/7.5(b)

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Number of PAs Supervised

Statute limits the number of PAs a physician may supervise.

A collaborating physician may collaborate with a maximum of seven full-time equivalent PAs. 225 Ill. Comp. Stat. §95/7(a)

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Chart Co-Signatures

Chart co-signatures may be determined at the practice level.

The written collaborative agreement shall be adequate if a physician does each of the following: participates in the joint formulation and joint approval of orders or guidelines with the PA 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 PA practice. 225 Ill. Comp. Stat. §95/7.5(a)(2)(A)

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Adaptable Proximity Requirements

Statute allows adaptable proximity.

Collaboration with the PA 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/PA team. 225 Ill. Comp. Stat. §95/4(3)

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Scope of Practice Determination

A written collaborative agreement at the practice level shall describe the categories of care, treatment, or procedures to be provided by the physician assistant. 225 Ill. Comp. Stat. §95/7.5

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