Following the US Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, legal questions continue to arise about healthcare providers who prescribe abortion medications across state lines to patients in states with restrictive abortion laws. In response to the growing demand for telehealth reproductive health services, states such as New York, Massachusetts, Illinois, and California have enacted or proposed so-called “shield laws” to provide legal protections for these providers.
In a move to further shield practitioners from legal risks, Illinois is considering amending its existing shield law to mirror New York’s recently enacted law[1] allowing prescribers to request that pharmacies keep their names off prescription labels for the abortion medications mifepristone and misoprostol.
What is covered under the current Illinois shield law?
Currently, the Illinois shield law:
- Shields providers from foreign subpoenas, summons, or extraditions related to lawful reproductive care in Illinois;
- Establishes a counterclaim for providers who have a judgment entered against them in another state for reproductive health care that is legal in Illinois; and
- Prevents the Illinois Department of Financial and Professional Regulation (IDFPR) from taking action against practitioners based solely upon a person being disciplined in another state for providing or participating in any health care that is legal in Illinois.[2]
Considerations for an enhanced shield law
Illinois is considering bolstering its shield law in response to actions by Texas and Louisiana indicting a New York doctor for allegedly prescribing abortion pills across state borders. An amendment that would result in keeping prescribers’ names off abortion medications could have far-reaching consequences and is likely to face both legal and operational challenges regarding:
- Conflicting rules under federal frameworks, such as those of the Federal Drug Administration;
- Conflicting state law and state pharmacy board rules;
- Medical liability and malpractice claims;
- Informed consent and patient rights;
- Fraud and prescription verification;
- Pharmacy workflow and patient safety; and
- Prescription transfers and refills.
Because both federal and state laws and regulations typically mandate the inclusion of prescriber names on prescription labels, it remains to be seen how states like Illinois and New York can overcome the legal and operational obstacles that are sure to follow the enactment of such laws. In fact, New York’s governor, Kathy Hochul, is already working with legislators on a second bill that would ensure pharmacies cooperate with prescribers’ requests to keep their names off medication labels.
Cross-border prescriptions—opportunities and risks
The evolving legal framework for cross-border medication prescriptions presents both opportunities and risks for healthcare providers. While states enact or consider enacting further protections for reproductive health providers, such laws could have far-reaching implications for providers, as well as the pharmaceutical supply chain. Nixon Peabody will continue to monitor legislative and judicial developments related to cross-border abortion medication prescriptions.
- 2025 NY Assemb. Bill A2145A.
[Back to reference] - H.B. 4664, 103rd Gen. Assemb., Reg. Sess. (Il. 2023), codified at, e.g., 775 Ill. Comp. Stat. §§55/1-10, 55/1-20; 255 Ill. Comp. Stat. §60/22 (C).
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