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HB4402 • 2026

KIDNEY TREATMENT DELEGATE ACT

KIDNEY TREATMENT DELEGATE ACT

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Robert "Bob" Rita
Last action
2026-03-27
Official status
Rule 19(a) / Re-referred to Rules Committee
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

KIDNEY TREATMENT DELEGATE ACT

KIDNEY TREATMENT DELEGATE ACT

What This Bill Does

  • KIDNEY TREATMENT DELEGATE ACT

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2026-03-27 Illinois General Assembly

    Rule 19(a) / Re-referred to Rules Committee

  2. 2026-03-12 Illinois General Assembly

    Assigned to Health Care Licenses Committee

  3. 2026-01-14 Illinois General Assembly

    First Reading

  4. 2026-01-14 Illinois General Assembly

    Referred to Rules Committee

  5. 2026-01-13 Illinois General Assembly

    Filed with the Clerk by Rep. Robert "Bob" Rita

Official Summary Text

KIDNEY TREATMENT DELEGATE ACT

Current Bill Text

Read the full stored bill text
Illinois General Assembly - Full Text of HB4402

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4402

Introduced 1/14/2026, by Rep. Robert "Bob" Rita

SYNOPSIS AS INTRODUCED:

New Act
225 ILCS 65/70-5

was 225 ILCS 65/10-45

Creates the Kidney Disease Treatment Delegation Act. Provides that,
notwithstanding any provision of the Nurse Practice Act or any rule of the
Department of Financial and Professional Regulation to the contrary,
delegation, including, but not limited to, delegation of the performance
of central venous catheter procedures in a kidney disease treatment
center, shall only be allowed if the individual receiving delegation is a
licensed practical nurse who has obtained the proper training, education,
and experience or a certified dialysis technician who currently holds, or
is in the process of acquiring, the necessary experience to apply for and
obtain certification as a certified clinical hemodialysis technician by
the Nephrology Nursing Certification Commission or a Certified
Hemodialysis Technologist/Technician by the Board of Nephrology Examiners
Nursing and Technology. Sets forth additional provisions concerning
delegation of duties in a kidney disease treatment center. Provides that
the Department is authorized to adopt rules for the administration and
enforcement of the Act, and the rules may define standards and criteria for
the necessary training, education, and experience for licensed practical
nurses to obtain before receiving delegation under the Act. Amends the
Nurse Practice Act. Provides that a violation of the Kidney Disease
Treatment Delegation Act is grounds for disciplinary action. Effective
immediately.
LRB104 18157 BAB 31596 b

A BILL FOR

HB4402
LRB104 18157 BAB 31596 b
1

AN ACT concerning regulation.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 1.
Short title.
This Act may be cited as the
Kidney
5
Disease Treatment Delegation Act.

6

Section 2.
Purpose.
The purpose of this Act is to
7
safeguard individuals seeking kidney disease treatments in the
8
State of Illinois by ensuring that the professionals who
9
provide these services are licensed and trained.

10

Section 5.
Definitions.
In this Act:
11

"Advanced practice registered nurse" or "APRN" means a
12
person who has met the qualifications for a (i) certified
13
nurse midwife (CNM); (ii) certified nurse practitioner (CNP);
14
(iii) certified registered nurse anesthetist (CRNA); or (iv)
15
clinical nurse specialist (CNS) and has been licensed by the
16
Department under the Nurse Practice Act.
17

"Central venous catheter procedure" includes providing
18
dialysis through venous catheters, initiating and terminating
19
dialysis through those catheters, connecting and disconnecting
20
central venous catheter lines, and maintaining central venous
21
catheters through dressing changes and other care.
22

"Certified dialysis technician" means a person with an

HB4402
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LRB104 18157 BAB 31596 b
1
accredited high school diploma or State of Illinois High
2
School Diploma who has been certified by the Nephrology
3
Nursing Certification Commission as a certified clinical
4
hemodialysis technician or by the Board of Nephrology
5
Examiners Nursing and Technology as a certified hemodialysis
6
technologist/technician.
7

"Department" means the Department of Financial and
8
Professional Regulation.
9

"Kidney disease treatment center" has the meaning given to
10
that term in subsection (5) of Section 3 of the Illinois Health
11
Facilities Planning Act. "Kidney disease treatment center"
12
includes a treatment center that provides dialysis through
13
venous catheters, initiates and terminates dialysis through
14
those catheters, connects and disconnects central venous
15
catheter lines, and maintains central venous catheters through
16
dressing changes and other care.
17

"Physician" means a person licensed to practice medicine
18
in all its branches under the Medical Practice Act of 1987.
19

"Physician assistant" means a physician assistant licensed
20
under the Physician Assistant Practice Act of 1987.
21

"Practical nurse", "licensed practical nurse", or "LPN"
22
means a person who is licensed as a practical nurse under the
23
Nurse Practice Act and practices practical nursing as defined
24
in that Act.
25

"Registered nurse", "Registered Professional Nurse", or
26
"RN" means a person who is licensed as a professional nurse

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LRB104 18157 BAB 31596 b
1
under the Nurse Practice Act and practices nursing as defined
2
in that Act.

3

Section 10.
Regulation of delegation in kidney disease
4
treatment centers.
5

(a) Notwithstanding any provision of the Nurse Practice
6
Act or any rule of the Department to the contrary, an
7
individual working in a kidney disease treatment center shall
8
be considered a licensed individual for the purposes of
9
delegation under Section 50-75 of the Nurse Practice Act.
10

(b) Notwithstanding any provision of the Nurse Practice
11
Act or any rule of the Department to the contrary, delegation
12
under this Section, including, but not limited to, delegation
13
of the performance of central venous catheter procedures in a
14
kidney disease treatment center, shall only be allowed if the
15
individual receiving delegation is a licensed practical nurse
16
who has obtained the proper training, education, and
17
experience or a certified dialysis technician who currently
18
holds, or is in the process of acquiring, the necessary
19
experience to apply for and obtain one of the following
20
certifications:
21

(1) certified clinical hemodialysis technician by the
22

Nephrology Nursing Certification Commission; or
23

(2) certified hemodialysis technologist/technician by
24

the Board of Nephrology Examiners Nursing and Technology.
25

(c) Notwithstanding any provision of the Nurse Practice

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Act or any rule of the Department to the contrary, delegation
2
under this Section shall not include medication
3
administration, except for the administration of heparin and
4
saline for the purposes of performing dialysis treatments and
5
flushing lines and the application of topical anesthetics. All
6
patient care provided by a licensed practical nurse or a
7
certified dialysis technician practicing under this Section
8
shall be under the direct and immediate on-site supervision of
9
a licensed physician, advanced practice registered nurse,
10
physician assistant, or registered nurse. Additionally, the
11
following conditions must be present:
12

(1) the RN or APRN must complete an assessment of the
13

patient's nursing care needs prior to the delegation;
14

(2) the RN or APRN must have either instructed the
15

certified dialysis technician or LPN in the delegated
16

activity or verified the individual's competency to
17

perform the activity; and
18

(3) clinical competency of an individual delegated to
19

under this Section shall be documented and available and
20

verified at least annually by the individual's employer.
21

If the delegating party is a physician or physician
22

assistant, the physician or physician assistant shall act
23

in a similar manner as required by the Medical Practice
24

Act of 1987 and the Physician Assistant Practice Act of
25

1987.
26

(d) Delegation under this Section shall comply with

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Section 50-75 of the Nurse Practice Act and any rules adopted
2
under the Illinois Health Facilities Planning Act, the Nurse
3
Practice Act, and any other Illinois statute or rule regarding
4
the operation of a kidney disease treatment center as
5
described by this Section.
6

(e) Nothing in this Section shall be construed to apply to
7
any other facility or practice setting. This Section shall not
8
be construed as granting a license under the Nurse Practice
9
Act and shall not allow individuals receiving delegation under
10
this Section to use any title regulated by the Nurse Practice
11
Act. Nothing in this Act shall be construed to limit the
12
ability of a licensed physician to practice medicine in all
13
its branches.

14

Section 15.
Rulemaking.
The Department is authorized to
15
adopt rules for the administration and enforcement of this
16
Act. The rules may define standards and criteria for the
17
necessary training, education, and experience for licensed
18
practical nurses to obtain before receiving delegation under
19
this Act.

20

Section 20.
The Nurse Practice Act is amended by changing
21
Section 70-5 as follows:

22

(225 ILCS 65/70-5)

(was 225 ILCS 65/10-45)
23

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

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Sec. 70-5.
Grounds for disciplinary action.
2

(a) The Department may refuse to issue or to renew, or may
3
revoke, suspend, place on probation, reprimand, or take other
4
disciplinary or non-disciplinary action as the Department may
5
deem appropriate, including fines not to exceed $10,000 per
6
violation, with regard to a license for any one or combination
7
of the causes set forth in subsection (b) below. All fines
8
collected under this Section shall be deposited in the Nursing
9
Dedicated and Professional Fund.
10

(b) Grounds for disciplinary action include the following:
11

(1) Material deception in furnishing information to
12

the Department.
13

(2) Material violations of any provision of this Act
14

or violation of the rules of or final administrative
15

action of the Secretary, after consideration of the
16

recommendation of the Board.
17

(3) Conviction by plea of guilty or nolo contendere,
18

finding of guilt, jury verdict, or entry of judgment or by
19

sentencing of any crime, including, but not limited to,
20

convictions, preceding sentences of supervision,
21

conditional discharge, or first offender probation, under
22

the laws of any jurisdiction of the United States: (i)
23

that is a felony; or (ii) that is a misdemeanor, an
24

essential element of which is dishonesty, or that is
25

directly related to the practice of the profession.
26

(4) A pattern of practice or other behavior which

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1

demonstrates incapacity or incompetency to practice under
2

this Act.
3

(5) Knowingly aiding or assisting another person in
4

violating any provision of this Act or rules.
5

(6) Failing, within 90 days, to provide a response to
6

a request for information in response to a written request
7

made by the Department by certified or registered mail or
8

by email to the email address of record.
9

(7) Engaging in dishonorable, unethical, or
10

unprofessional conduct of a character likely to deceive,
11

defraud, or harm the public, as defined by rule.
12

(8) Unlawful taking, theft, selling, distributing, or
13

manufacturing of any drug, narcotic, or prescription
14

device.
15

(9) Habitual or excessive use or addiction to alcohol,
16

narcotics, stimulants, or any other chemical agent or drug
17

that could result in a licensee's inability to practice
18

with reasonable judgment, skill, or safety.
19

(10) Discipline by another U.S. jurisdiction or
20

foreign nation, if at least one of the grounds for the
21

discipline is the same or substantially equivalent to
22

those set forth in this Section.
23

(11) A finding that the licensee, after having her or
24

his license placed on probationary status or subject to
25

conditions or restrictions, has violated the terms of
26

probation or failed to comply with such terms or

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LRB104 18157 BAB 31596 b
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conditions.
2

(12) Being named as a perpetrator in an indicated
3

report by the Department of Children and Family Services
4

and under the Abused and Neglected Child Reporting Act,
5

and upon proof by clear and convincing evidence that the
6

licensee has caused a child to be an abused child or
7

neglected child as defined in the Abused and Neglected
8

Child Reporting Act.
9

(13) Willful omission to file or record, or willfully
10

impeding the filing or recording or inducing another
11

person to omit to file or record medical reports as
12

required by law.
13

(13.5) Willfully failing to report an instance of
14

suspected child abuse or neglect as required by the Abused
15

and Neglected Child Reporting Act.
16

(14) Gross negligence in the practice of practical,
17

professional, or advanced practice registered nursing.
18

(15) Holding oneself out to be practicing nursing
19

under any name other than one's own.
20

(16) Failure of a licensee to report to the Department
21

any adverse final action taken against him or her by
22

another licensing jurisdiction of the United States or any
23

foreign state or country, any peer review body, any health
24

care institution, any professional or nursing society or
25

association, any governmental agency, any law enforcement
26

agency, or any court or a nursing liability claim related

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LRB104 18157 BAB 31596 b
1

to acts or conduct similar to acts or conduct that would
2

constitute grounds for action as defined in this Section.
3

(17) Failure of a licensee to report to the Department
4

surrender by the licensee of a license or authorization to
5

practice nursing or advanced practice registered nursing
6

in another state or jurisdiction or current surrender by
7

the licensee of membership on any nursing staff or in any
8

nursing or advanced practice registered nursing or
9

professional association or society while under
10

disciplinary investigation by any of those authorities or
11

bodies for acts or conduct similar to acts or conduct that
12

would constitute grounds for action as defined by this
13

Section.
14

(18) Failing, within 60 days, to provide information
15

in response to a written request made by the Department.
16

(19) Failure to establish and maintain records of
17

patient care and treatment as required by law.
18

(20) Fraud, deceit, or misrepresentation in applying
19

for or procuring a license under this Act or in connection
20

with applying for renewal of a license under this Act.
21

(21) Allowing another person or organization to use
22

the licensee's license to deceive the public.
23

(22) Willfully making or filing false records or
24

reports in the licensee's practice, including, but not
25

limited to, false records to support claims against the
26

medical assistance program of the Department of Healthcare

HB4402
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LRB104 18157 BAB 31596 b
1

and Family Services (formerly Department of Public Aid)
2

under the Illinois Public Aid Code.
3

(23) Attempting to subvert or cheat on a licensing
4

examination administered under this Act.
5

(24) Immoral conduct in the commission of an act,
6

including, but not limited to, sexual abuse, sexual
7

misconduct, or sexual exploitation, related to the
8

licensee's practice.
9

(25) Willfully or negligently violating the
10

confidentiality between nurse and patient except as
11

required by law.
12

(26) Practicing under a false or assumed name, except
13

as provided by law.
14

(27) The use of any false, fraudulent, or deceptive
15

statement in any document connected with the licensee's
16

practice.
17

(28) Directly or indirectly giving to or receiving
18

from a person, firm, corporation, partnership, or
19

association a fee, commission, rebate, or other form of
20

compensation for professional services not actually or
21

personally rendered. Nothing in this paragraph (28)
22

affects any bona fide independent contractor or employment
23

arrangements among health care professionals, health
24

facilities, health care providers, or other entities,
25

except as otherwise prohibited by law. Any employment
26

arrangements may include provisions for compensation,

HB4402
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1

health insurance, pension, or other employment benefits
2

for the provision of services within the scope of the
3

licensee's practice under this Act. Nothing in this
4

paragraph (28) shall be construed to require an employment
5

arrangement to receive professional fees for services
6

rendered.
7

(29) A violation of the Health Care Worker
8

Self-Referral Act.
9

(30) Physical illness, mental illness, or disability
10

that results in the inability to practice the profession
11

with reasonable judgment, skill, or safety.
12

(31) Exceeding the terms of a collaborative agreement
13

or the prescriptive authority delegated to a licensee by
14

his or her collaborating physician or podiatric physician
15

in guidelines established under a written collaborative
16

agreement.
17

(32) Making a false or misleading statement regarding
18

a licensee's skill or the efficacy or value of the
19

medicine, treatment, or remedy prescribed by him or her in
20

the course of treatment.
21

(33) Prescribing, selling, administering,
22

distributing, giving, or self-administering a drug
23

classified as a controlled substance (designated product)
24

or narcotic for other than medically accepted therapeutic
25

purposes.
26

(34) Promotion of the sale of drugs, devices,

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LRB104 18157 BAB 31596 b
1

appliances, or goods provided for a patient in a manner to
2

exploit the patient for financial gain.
3

(35) Violating State or federal laws, rules, or
4

regulations relating to controlled substances.
5

(36) Willfully or negligently violating the
6

confidentiality between an advanced practice registered
7

nurse, collaborating physician, dentist, or podiatric
8

physician and a patient, except as required by law.
9

(37) Willfully failing to report an instance of
10

suspected abuse, neglect, financial exploitation, or
11

self-neglect of an eligible adult as defined in and
12

required by the Adult Protective Services Act.
13

(38) Being named as an abuser in a verified report by
14

the Department on Aging and under the Adult Protective
15

Services Act, and upon proof by clear and convincing
16

evidence that the licensee abused, neglected, or
17

financially exploited an eligible adult as defined in the
18

Adult Protective Services Act.
19

(39) A violation of any provision of this Act or any
20

rules adopted under this Act.
21

(40) Violating the Compassionate Use of Medical
22

Cannabis Program Act.
23

(41) Violating the Kidney Disease Treatment Delegation
24

Act.

25

(b-5) The Department shall not revoke, suspend, summarily
26
suspend, place on probation, reprimand, refuse to issue or

HB4402
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LRB104 18157 BAB 31596 b
1
renew, or take any other disciplinary or non-disciplinary
2
action against a person's authorization to practice under this
3
Act based solely upon the person providing, authorizing,
4
recommending, aiding, assisting, referring for, or otherwise
5
participating in any health care service, so long as the care
6
was not unlawful under the laws of this State, regardless of
7
whether the patient was a resident of this State or another
8
state.
9

(b-10) The Department shall not revoke, suspend, summarily
10
suspend, place on prohibition, reprimand, refuse to issue or
11
renew, or take any other disciplinary or non-disciplinary
12
action against a person's authorization to practice under this
13
Act based upon the person's license, registration, or permit
14
being revoked or suspended, or the person being otherwise
15
disciplined, by any other state if that revocation,
16
suspension, or other form of discipline was based solely on
17
the person violating another state's laws prohibiting the
18
provision of, authorization of, recommendation of, aiding or
19
assisting in, referring for, or participation in any health
20
care service if that health care service as provided would not
21
have been unlawful under the laws of this State and is
22
consistent with the applicable standard of conduct for the
23
person practicing in Illinois under this Act.
24

(b-15) The conduct specified in subsections (b-5) and
25
(b-10) shall not trigger reporting requirements under Section
26
65-65 or constitute grounds for suspension under Section

HB4402
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LRB104 18157 BAB 31596 b
1
70-60.
2

(b-20) An applicant seeking licensure, certification, or
3
authorization under this Act who has been subject to
4
disciplinary action by a duly authorized professional
5
disciplinary agency of another jurisdiction solely on the
6
basis of having provided, authorized, recommended, aided,
7
assisted, referred for, or otherwise participated in health
8
care shall not be denied such licensure, certification, or
9
authorization, unless the Department determines that such
10
action would have constituted professional misconduct in this
11
State; however, nothing in this Section shall be construed as
12
prohibiting the Department from evaluating the conduct of such
13
applicant and making a determination regarding the licensure,
14
certification, or authorization to practice a profession under
15
this Act.
16

(c) The determination by a circuit court that a licensee
17
is subject to involuntary admission or judicial admission as
18
provided in the Mental Health and Developmental Disabilities
19
Code, as amended, operates as an automatic suspension. The
20
suspension will end only upon a finding by a court that the
21
patient is no longer subject to involuntary admission or
22
judicial admission and issues an order so finding and
23
discharging the patient; and upon the recommendation of the
24
Board to the Secretary that the licensee be allowed to resume
25
his or her practice.
26

(d) The Department may refuse to issue or may suspend or

HB4402
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LRB104 18157 BAB 31596 b
1
otherwise discipline the license of any person who fails to
2
file a return, or to pay the tax, penalty, or interest shown in
3
a filed return, or to pay any final assessment of the tax,
4
penalty, or interest as required by any tax Act administered
5
by the Department of Revenue, until such time as the
6
requirements of any such tax Act are satisfied.
7

(e) In enforcing this Act, the Department, upon a showing
8
of a possible violation, may compel an individual licensed to
9
practice under this Act or who has applied for licensure under
10
this Act, to submit to a mental or physical examination, or
11
both, as required by and at the expense of the Department. The
12
Department may order the examining physician to present
13
testimony concerning the mental or physical examination of the
14
licensee or applicant. No information shall be excluded by
15
reason of any common law or statutory privilege relating to
16
communications between the licensee or applicant and the
17
examining physician. The examining physicians shall be
18
specifically designated by the Department. The individual to
19
be examined may have, at his or her own expense, another
20
physician of his or her choice present during all aspects of
21
this examination. Failure of an individual to submit to a
22
mental or physical examination, when directed, shall result in
23
an automatic suspension without hearing.
24

All substance-related violations shall mandate an
25
automatic substance abuse assessment. Failure to submit to an
26
assessment by a licensed physician who is certified as an

HB4402
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LRB104 18157 BAB 31596 b
1
addictionist or an advanced practice registered nurse with
2
specialty certification in addictions may be grounds for an
3
automatic suspension, as defined by rule.
4

If the Department finds an individual unable to practice
5
or unfit for duty because of the reasons set forth in this
6
subsection (e), the Department may require that individual to
7
submit to a substance abuse evaluation or treatment by
8
individuals or programs approved or designated by the
9
Department, as a condition, term, or restriction for
10
continued, restored, or renewed licensure to practice; or, in
11
lieu of evaluation or treatment, the Department may file, or
12
the Board may recommend to the Department to file, a complaint
13
to immediately suspend, revoke, or otherwise discipline the
14
license of the individual. An individual whose license was
15
granted, continued, restored, renewed, disciplined, or
16
supervised subject to such terms, conditions, or restrictions,
17
and who fails to comply with such terms, conditions, or
18
restrictions, shall be referred to the Secretary for a
19
determination as to whether the individual shall have his or
20
her license suspended immediately, pending a hearing by the
21
Department.
22

In instances in which the Secretary immediately suspends a
23
person's license under this subsection (e), a hearing on that
24
person's license must be convened by the Department within 15
25
days after the suspension and completed without appreciable
26
delay. The Department and Board shall have the authority to

HB4402
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LRB104 18157 BAB 31596 b
1
review the subject individual's record of treatment and
2
counseling regarding the impairment to the extent permitted by
3
applicable federal statutes and regulations safeguarding the
4
confidentiality of medical records.
5

An individual licensed under this Act and affected under
6
this subsection (e) shall be afforded an opportunity to
7
demonstrate to the Department that he or she can resume
8
practice in compliance with nursing standards under the
9
provisions of his or her license.
10

(f) The Department may adopt rules to implement,
11
administer, and enforce this Section.
12
(Source: P.A. 104-432, eff. 1-1-26
.)

13

Section 99.
Effective date.
This Act takes effect upon
14
becoming law.

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