Full Text of SB1563 095th General Assembly
SB1563 95TH GENERAL ASSEMBLY
|
|
|
95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008 SB1563
Introduced 2/9/2007, by Sen. Bill Brady SYNOPSIS AS INTRODUCED: |
|
210 ILCS 85/10.4 |
from Ch. 111 1/2, par. 151.4 |
|
Amends the Hospital Licensing Act. Provides that exclusive contracts for professional medical services may be entered into only for anesthesiology (excluding pain management), emergency medicine, neonatology, pathology, and radiology services.
|
| |
|
|
A BILL FOR
|
|
|
|
|
SB1563 |
|
LRB095 04848 DRJ 24910 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 5. The Hospital Licensing Act is amended by | 5 |
| changing Section 10.4 as follows:
| 6 |
| (210 ILCS 85/10.4) (from Ch. 111 1/2, par. 151.4)
| 7 |
| Sec. 10.4. Medical staff privileges.
| 8 |
| (a) Any hospital licensed under this Act or any hospital | 9 |
| organized under the
University of Illinois Hospital Act shall, | 10 |
| prior to the granting of any medical
staff privileges to an | 11 |
| applicant, or renewing a current medical staff member's
| 12 |
| privileges, request of the Director of Professional Regulation | 13 |
| information
concerning the licensure status and any | 14 |
| disciplinary action taken against the
applicant's or medical | 15 |
| staff member's license, except: (1) for medical personnel who
| 16 |
| enter a hospital to obtain organs and tissues for transplant | 17 |
| from a donor in accordance with the Illinois Anatomical Gift | 18 |
| Act; or (2) for medical personnel who have been granted | 19 |
| disaster privileges pursuant to the procedures and | 20 |
| requirements established by rules adopted by the Department. | 21 |
| Any hospital and any employees of the hospital or others | 22 |
| involved in granting privileges who
that , in good faith, grant
| 23 |
| grants disaster privileges pursuant to this Section to respond |
|
|
|
SB1563 |
- 2 - |
LRB095 04848 DRJ 24910 b |
|
| 1 |
| to an emergency shall not, as a result of their
his, her, or | 2 |
| its acts or omissions, be liable for civil damages for granting | 3 |
| or denying disaster privileges except in the event of willful | 4 |
| and wanton misconduct, as that term is defined in Section 10.2 | 5 |
| of this Act. Individuals granted privileges who provide care in | 6 |
| an emergency situation, in good faith and without direct | 7 |
| compensation, shall not, as a result of their
his or her acts | 8 |
| or omissions, except for acts or omissions involving willful | 9 |
| and wanton misconduct, as that term is defined in Section 10.2 | 10 |
| of this Act, on the part of the person, be liable for civil | 11 |
| damages. The Director of
Professional Regulation shall | 12 |
| transmit, in writing and in a timely fashion,
such information | 13 |
| regarding the license of the applicant or the medical staff
| 14 |
| member, including the record of imposition of any periods of
| 15 |
| supervision or monitoring as a result of alcohol or
substance | 16 |
| abuse, as provided by Section 23 of the Medical
Practice Act of | 17 |
| 1987, and such information as may have been
submitted to the | 18 |
| Department indicating that the application
or medical staff | 19 |
| member has been denied, or has surrendered,
medical staff | 20 |
| privileges at a hospital licensed under this
Act, or any | 21 |
| equivalent facility in another state or
territory of the United | 22 |
| States. The Director of Professional Regulation
shall define by | 23 |
| rule the period for timely response to such requests.
| 24 |
| No transmittal of information by the Director of | 25 |
| Professional Regulation,
under this Section shall be to other | 26 |
| than the president, chief
operating officer, chief |
|
|
|
SB1563 |
- 3 - |
LRB095 04848 DRJ 24910 b |
|
| 1 |
| administrative officer, or chief of
the medical staff of a | 2 |
| hospital licensed under this Act, a
hospital organized under | 3 |
| the University of Illinois Hospital Act, or a hospital
operated | 4 |
| by the United States, or any of its instrumentalities. The
| 5 |
| information so transmitted shall be afforded the same status
as | 6 |
| is information concerning medical studies by Part 21 of Article | 7 |
| VIII of the
Code of Civil Procedure, as now or hereafter | 8 |
| amended.
| 9 |
| (b) All hospitals licensed under this Act, except county | 10 |
| hospitals as
defined in subsection (c) of Section 15-1 of the | 11 |
| Illinois Public Aid Code,
shall comply with, and the medical | 12 |
| staff bylaws of these hospitals shall
include rules consistent | 13 |
| with, the provisions of this Section in granting,
limiting, | 14 |
| renewing, or denying medical staff membership and
clinical | 15 |
| staff privileges. Hospitals that require medical staff members | 16 |
| to
possess
faculty status with a specific institution of higher | 17 |
| education are not required
to comply with subsection (1) below | 18 |
| when the physician does not possess faculty
status.
| 19 |
| (1) Minimum procedures for
pre-applicants and | 20 |
| applicants for medical staff
membership shall include the | 21 |
| following:
| 22 |
| (A) Written procedures relating to the acceptance | 23 |
| and processing of
pre-applicants or applicants for | 24 |
| medical staff membership, which should be
contained in
| 25 |
| medical staff bylaws.
| 26 |
| (B) Written procedures to be followed in |
|
|
|
SB1563 |
- 4 - |
LRB095 04848 DRJ 24910 b |
|
| 1 |
| determining
a pre-applicant's or
an applicant's
| 2 |
| qualifications for being granted medical staff | 3 |
| membership and privileges.
| 4 |
| (C) Written criteria to be followed in evaluating
a | 5 |
| pre-applicant's or
an applicant's
qualifications.
| 6 |
| (D) An evaluation of
a pre-applicant's or
an | 7 |
| applicant's current health status and current
license | 8 |
| status in Illinois.
| 9 |
| (E) A written response to each
pre-applicant or
| 10 |
| applicant that explains the reason or
reasons for any | 11 |
| adverse decision (including all reasons based in whole | 12 |
| or
in part on the applicant's medical qualifications or | 13 |
| any other basis,
including economic factors).
| 14 |
| (2) Minimum procedures with respect to medical staff | 15 |
| and clinical
privilege determinations concerning current | 16 |
| members of the medical staff shall
include the following:
| 17 |
| (A) A written notice of an adverse decision.
| 18 |
| (B) An explanation of the reasons for an adverse | 19 |
| decision including all
reasons based on the quality of | 20 |
| medical care or any other basis, including
economic | 21 |
| factors.
| 22 |
| (C) A statement of the medical staff member's right | 23 |
| to request a fair
hearing on the adverse decision | 24 |
| before a hearing panel whose membership is
mutually | 25 |
| agreed upon by the medical staff and the hospital | 26 |
| governing board. The
hearing panel shall have |
|
|
|
SB1563 |
- 5 - |
LRB095 04848 DRJ 24910 b |
|
| 1 |
| independent authority to recommend action to the
| 2 |
| hospital governing board. Upon the request of the | 3 |
| medical staff member or the
hospital governing board, | 4 |
| the hearing panel shall make findings concerning the
| 5 |
| nature of each basis for any adverse decision | 6 |
| recommended to and accepted by
the hospital governing | 7 |
| board.
| 8 |
| (i) Nothing in this subparagraph (C) limits a | 9 |
| hospital's or medical
staff's right to summarily | 10 |
| suspend, without a prior hearing, a person's | 11 |
| medical
staff membership or clinical privileges if | 12 |
| the continuation of practice of a
medical staff | 13 |
| member constitutes an immediate danger to the | 14 |
| public, including
patients, visitors, and hospital | 15 |
| employees and staff. A fair hearing shall be
| 16 |
| commenced within 15 days after the suspension and | 17 |
| completed without delay.
| 18 |
| (ii) Nothing in this subparagraph (C) limits a | 19 |
| medical staff's right
to permit, in the medical | 20 |
| staff bylaws, summary suspension of membership or
| 21 |
| clinical privileges in designated administrative | 22 |
| circumstances as specifically
approved by the | 23 |
| medical staff. This bylaw provision must | 24 |
| specifically describe
both the administrative | 25 |
| circumstance that can result in a summary | 26 |
| suspension
and the length of the summary |
|
|
|
SB1563 |
- 6 - |
LRB095 04848 DRJ 24910 b |
|
| 1 |
| suspension. The opportunity for a fair hearing is
| 2 |
| required for any administrative summary | 3 |
| suspension. Any requested hearing must
be | 4 |
| commenced within 15 days after the summary | 5 |
| suspension and completed without
delay. Adverse | 6 |
| decisions other than suspension or other | 7 |
| restrictions on the
treatment or admission of | 8 |
| patients may be imposed summarily and without a
| 9 |
| hearing under designated administrative | 10 |
| circumstances as specifically provided
for in the | 11 |
| medical staff bylaws as approved by the medical | 12 |
| staff.
| 13 |
| (iii) If a hospital exercises its option to | 14 |
| enter into an exclusive
contract and that contract | 15 |
| results in the total or partial termination or
| 16 |
| reduction of medical staff membership or clinical | 17 |
| privileges of a current
medical staff member, the | 18 |
| hospital shall provide the affected medical staff
| 19 |
| member 60 days prior notice of the effect on his or | 20 |
| her medical staff
membership or privileges. An | 21 |
| affected medical staff member desiring a hearing
| 22 |
| under subparagraph (C) of this paragraph (2) must | 23 |
| request the hearing within 14
days after the date | 24 |
| he or she is so notified. The requested hearing | 25 |
| shall be
commenced and completed (with a report and | 26 |
| recommendation to the affected
medical staff |
|
|
|
SB1563 |
- 7 - |
LRB095 04848 DRJ 24910 b |
|
| 1 |
| member, hospital governing board, and medical | 2 |
| staff) within 30
days after the date of the medical | 3 |
| staff member's request. If agreed upon by
both the | 4 |
| medical staff and the hospital governing board, | 5 |
| the medical staff
bylaws may provide for longer | 6 |
| time periods. Exclusive contracts for professional | 7 |
| medical services may be entered into only for | 8 |
| anesthesiology (excluding pain management), | 9 |
| emergency medicine, neonatology, pathology, and | 10 |
| radiology services.
| 11 |
| (D) A statement of the member's right to inspect | 12 |
| all pertinent
information in the hospital's possession | 13 |
| with respect to the decision.
| 14 |
| (E) A statement of the member's right to present | 15 |
| witnesses and other
evidence at the hearing on the | 16 |
| decision.
| 17 |
| (F) A written notice and written explanation of the | 18 |
| decision resulting
from the hearing.
| 19 |
| (F-5) A written notice of a final adverse decision | 20 |
| by a hospital
governing board.
| 21 |
| (G) Notice given 15 days before implementation of | 22 |
| an adverse medical
staff membership or clinical | 23 |
| privileges decision based substantially on
economic | 24 |
| factors. This notice shall be given after the medical | 25 |
| staff member
exhausts all applicable procedures under | 26 |
| this Section, including item (iii) of
subparagraph (C) |
|
|
|
SB1563 |
- 8 - |
LRB095 04848 DRJ 24910 b |
|
| 1 |
| of this paragraph (2), and under the medical staff | 2 |
| bylaws in
order to allow sufficient time for the | 3 |
| orderly provision of patient care.
| 4 |
| (H) Nothing in this paragraph (2) of this | 5 |
| subsection (b) limits a
medical staff member's right to | 6 |
| waive, in writing, the rights provided in
| 7 |
| subparagraphs (A) through (G) of this paragraph (2) of | 8 |
| this subsection (b) upon
being granted the written | 9 |
| exclusive right to provide particular services at a
| 10 |
| hospital, either individually or as a member of a | 11 |
| group. If an exclusive
contract is signed by a | 12 |
| representative of a group of physicians, a waiver
| 13 |
| contained in the contract shall apply to all members of | 14 |
| the group unless stated
otherwise in the contract.
| 15 |
| (3) Every adverse medical staff membership and | 16 |
| clinical privilege decision
based substantially on | 17 |
| economic factors shall be reported to the Hospital
| 18 |
| Licensing Board before the decision takes effect. These | 19 |
| reports shall not be
disclosed in any form that reveals the | 20 |
| identity of any hospital or physician.
These reports shall | 21 |
| be utilized to study the effects that hospital medical
| 22 |
| staff membership and clinical privilege decisions based | 23 |
| upon economic factors
have on access to care and the | 24 |
| availability of physician services. The
Hospital Licensing | 25 |
| Board shall submit an initial study to the Governor and the
| 26 |
| General Assembly by January 1, 1996, and subsequent reports |
|
|
|
SB1563 |
- 9 - |
LRB095 04848 DRJ 24910 b |
|
| 1 |
| shall be submitted
periodically thereafter.
| 2 |
| (4) As used in this Section:
| 3 |
| "Adverse decision" means a decision reducing, | 4 |
| restricting, suspending,
revoking, denying, or not | 5 |
| renewing medical staff membership or clinical
privileges.
| 6 |
| "Economic factor" means any information or reasons for | 7 |
| decisions unrelated
to quality of care or professional | 8 |
| competency.
| 9 |
| "Pre-applicant" means a physician licensed to practice | 10 |
| medicine in all
its
branches who requests an application | 11 |
| for medical staff membership or
privileges.
| 12 |
| "Privilege" means permission to provide
medical or | 13 |
| other patient care services and permission to use hospital
| 14 |
| resources, including equipment, facilities and personnel | 15 |
| that are necessary to
effectively provide medical or other | 16 |
| patient care services. This definition
shall not be | 17 |
| construed to
require a hospital to acquire additional | 18 |
| equipment, facilities, or personnel to
accommodate the | 19 |
| granting of privileges.
| 20 |
| (5) Any amendment to medical staff bylaws required | 21 |
| because of
this amendatory Act of the 91st General Assembly | 22 |
| shall be adopted on or
before July 1, 2001.
| 23 |
| (c) All hospitals shall consult with the medical staff | 24 |
| prior to closing
membership in the entire or any portion of the | 25 |
| medical staff or a department.
If
the hospital closes | 26 |
| membership in the medical staff, any portion of the medical
|
|
|
|
SB1563 |
- 10 - |
LRB095 04848 DRJ 24910 b |
|
| 1 |
| staff, or the department over the objections of the medical | 2 |
| staff, then the
hospital
shall provide a detailed written | 3 |
| explanation for the decision to the medical
staff
10 days prior | 4 |
| to the effective date of any closure. No applications need to | 5 |
| be
provided when membership in the medical staff or any | 6 |
| relevant portion of the
medical staff is closed.
| 7 |
| (Source: P.A. 93-794, eff. 7-22-04; 93-829, eff. 7-28-04; | 8 |
| revised 11-22-05.)
|
|