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90_HB0408eng
210 ILCS 85/10.4 from Ch. 111 1/2, par. 151.4
Amends the Hospital Licensing Act to define "privilege"
as used in the provisions relating to medical staff
membership determinations.
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1 AN ACT to amend the Hospital Licensing Act by changing
2 Section 10.4.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Hospital Licensing Act is amended by
6 changing Section 10.4 as follows:
7 (210 ILCS 85/10.4) (from Ch. 111 1/2, par. 151.4)
8 Sec. 10.4. Medical staff privileges.
9 (a) Any hospital licensed under this Act or any hospital
10 organized under the University of Illinois Hospital Act
11 shall, prior to the granting of any medical staff privileges
12 to an applicant, or renewing a current medical staff member's
13 privileges, request of the Director of Professional
14 Regulation information concerning the licensure status and
15 any disciplinary action taken against the applicant's or
16 medical staff member's license, except for medical personnel
17 who enter a hospital to obtain organs and tissues for
18 transplant from a deceased donor in accordance with the
19 Uniform Anatomical Gift Act. The Director of Professional
20 Regulation shall transmit, in writing and in a timely
21 fashion, such information regarding the license of the
22 applicant or the medical staff member, including the record
23 of imposition of any periods of supervision or monitoring as
24 a result of alcohol or substance abuse, as provided by
25 Section 1-21 of the "Medical Practice Act of 1987", and such
26 information as may have been submitted to the Department
27 indicating that the application or medical staff member has
28 been denied, or has surrendered, medical staff privileges at
29 a hospital licensed under this Act, or any equivalent
30 facility in another state or territory of the United States.
31 The Director of Professional Regulation shall define by rule
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1 the period for timely response to such requests.
2 No transmittal of information by the Director of
3 Professional Regulation, under this Section shall be to other
4 than the president, chief operating officer, chief
5 administrative officer, or chief of the medical staff of a
6 hospital licensed under this Act, a hospital organized under
7 the University of Illinois Hospital Act, or a hospital
8 operated by the United States, or any of its
9 instrumentalities. The information so transmitted shall be
10 afforded the same status as is information concerning medical
11 studies by Part 21 of Article VIII of the Code of Civil
12 Procedure, as now or hereafter amended.
13 (b) All hospitals licensed under this Act, except county
14 hospitals as defined in subsection (c) of Section 15-1 of the
15 Illinois Public Aid Code, shall comply with, and the medical
16 staff bylaws of these hospitals shall include rules
17 consistent with, the provisions of this Section in granting,
18 limiting, renewing, or denying medical staff membership and
19 clinical clinic staff privileges.
20 (1) Minimum procedures for initial applicants for
21 medical staff membership shall include the following:
22 (A) Written procedures relating to the
23 acceptance and processing of initial applicants for
24 medical staff membership.
25 (B) Written procedures to be followed in
26 determining an applicant's qualifications for being
27 granted medical staff membership and privileges.
28 (C) Written criteria to be followed in
29 evaluating an applicant's qualifications.
30 (D) An evaluation of an applicant's current
31 health status and current license status in
32 Illinois.
33 (E) A written response to each applicant that
34 explains the reason or reasons for any adverse
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1 decision (including all reasons based in whole or in
2 part on the applicant's medical qualifications or
3 any other basis, including economic factors).
4 (2) Minimum procedures with respect to medical
5 staff and clinical privilege determinations concerning
6 current members of the medical staff shall include the
7 following:
8 (A) A written notice of an adverse decision by
9 the hospital governing board.
10 (B) An explanation of the reasons for an
11 adverse decision including all reasons based on the
12 quality of medical care or any other basis,
13 including economic factors.
14 (C) A statement of the medical staff member's
15 right to request a fair hearing on the adverse
16 decision before a hearing panel whose membership is
17 mutually agreed upon by the medical staff and the
18 hospital governing board. The hearing panel shall
19 have independent authority to recommend action to
20 the hospital governing board. Upon the request of
21 the medical staff member or the hospital governing
22 board, the hearing panel shall make findings
23 concerning the nature of each basis for any adverse
24 decision recommended to and accepted by the hospital
25 governing board.
26 (i) Nothing in this subparagraph (C)
27 limits a hospital's or medical staff's right to
28 summarily suspend, without a prior hearing, a
29 person's medical staff membership or clinical
30 privileges if the continuation of practice of a
31 medical staff member constitutes an immediate
32 danger to the public, including patients,
33 visitors, and hospital employees and staff. A
34 fair hearing shall be commenced within 15 days
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1 after the suspension and completed without
2 delay.
3 (ii) Nothing in this subparagraph (C)
4 limits a medical staff's right to permit, in
5 the medical staff bylaws, summary suspension of
6 membership or clinical privileges in designated
7 administrative circumstances as specifically
8 approved by the medical staff. This bylaw
9 provision must specifically describe both the
10 administrative circumstance that can result in
11 a summary suspension and the length of the
12 summary suspension. The opportunity for a fair
13 hearing is required for any administrative
14 summary suspension. Any requested hearing must
15 be commenced within 15 days after the summary
16 suspension and completed without delay. Adverse
17 decisions other than suspension or other
18 restrictions on the treatment or admission of
19 patients may be imposed summarily and without a
20 hearing under designated administrative
21 circumstances as specifically provided for in
22 the medical staff bylaws as approved by the
23 medical staff.
24 (iii) If a hospital exercises its option
25 to enter into an exclusive contract and that
26 contract results in the total or partial
27 termination or reduction of medical staff
28 membership or clinical privileges of a current
29 medical staff member, the hospital shall
30 provide the affected medical staff member 60
31 days prior notice of the effect on his or her
32 medical staff membership or privileges. An
33 affected medical staff member desiring a
34 hearing under subparagraph (C) of this
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1 paragraph (2) must request the hearing within
2 14 days after the date he or she is so
3 notified. The requested hearing shall be
4 commenced and completed (with a report and
5 recommendation to the affected medical staff
6 member, hospital governing board, and medical
7 staff) within 30 days after the date of the
8 medical staff member's request. If agreed upon
9 by both the medical staff and the hospital
10 governing board, the medical staff bylaws may
11 provide for longer time periods.
12 (D) A statement of the member's right to
13 inspect all pertinent information in the hospital's
14 possession with respect to the decision.
15 (E) A statement of the member's right to
16 present witnesses and other evidence at the hearing
17 on the decision.
18 (F) A written notice and written explanation
19 of the decision resulting from the hearing.
20 (G) Notice given 15 days before implementation
21 of an adverse medical staff membership or clinical
22 privileges decision based substantially on economic
23 factors. This notice shall be given after the
24 medical staff member exhausts all applicable
25 procedures under this Section, including item (iii)
26 of subparagraph (C) of this paragraph (2), and under
27 the medical staff bylaws in order to allow
28 sufficient time for the orderly provision of patient
29 care.
30 (H) Nothing in this paragraph (2) of this
31 subsection (b) limits a medical staff member's right
32 to waive, in writing, the rights provided in
33 subparagraphs (A) through (G) of this paragraph (2)
34 of this subsection (b) upon being granted the
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1 written exclusive right to provide particular
2 services at a hospital, either individually or as a
3 member of a group. If an exclusive contract is
4 signed by a representative of a group of physicians,
5 a waiver contained in the contract shall apply to
6 all members of the group unless stated otherwise in
7 the contract.
8 (3) Every adverse medical staff membership and
9 clinical privilege decision based substantially on
10 economic factors shall be reported to the Hospital
11 Licensing Board before the decision takes effect. These
12 reports shall not be disclosed in any form that reveals
13 the identity of any hospital or physician. These reports
14 shall be utilized to study the effects that hospital
15 medical staff membership and clinical privilege decisions
16 based upon economic factors have on access to care and
17 the availability of physician services. The Hospital
18 Licensing Board shall submit an initial study to the
19 Governor and the General Assembly by January 1, 1996, and
20 subsequent reports shall be submitted periodically
21 thereafter.
22 (4) As used in this Section:
23 "Adverse decision" means a decision reducing,
24 restricting, suspending, revoking, denying, or not
25 renewing medical staff membership or clinical privileges.
26 "Economic factor" means any information or reasons
27 for decisions unrelated to quality of care or
28 professional competency.
29 "Privilege" means permission to provide medical or
30 other patient care services and permission to use
31 hospital resources, including equipment, facilities and
32 personnel that are necessary to effectively provide
33 medical or other patient care services. This definition
34 shall not be construed to require a hospital to acquire
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1 additional equipment, facilities, or personnel to
2 accommodate the granting of privileges.
3 (Source: P.A. 88-654, eff. 1-1-95.)