State of Illinois
92nd General Assembly
Legislation

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92_SB1798

 
                                               LRB9213323ACdv

 1        AN ACT concerning hospitals.

 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 and adding Section 10.5 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
10    shall,  prior to the granting of any medical staff privileges
11    to an applicant, or renewing a current medical staff member's
12    privileges,  request  of   the   Director   of   Professional
13    Regulation  information  concerning  the licensure status and
14    any disciplinary action  taken  against  the  applicant's  or
15    medical  staff member's license, except for medical personnel
16    who enter  a  hospital  to  obtain  organs  and  tissues  for
17    transplant  from  a  deceased  donor  in  accordance with the
18    Uniform Anatomical Gift Act.  The  Director  of  Professional
19    Regulation  shall  transmit,  in  writing  and  in  a  timely
20    fashion,  such  information  regarding  the  license  of  the
21    applicant  or  the medical staff member, including the record
22    of imposition of any periods of supervision or monitoring  as
23    a  result  of  alcohol  or  substance  abuse,  as provided by
24    Section 23 of the Medical Practice  Act  of  1987,  and  such
25    information  as  may  have  been  submitted to the Department
26    indicating that the application or medical staff  member  has
27    been  denied, or has surrendered, medical staff privileges at
28    a  hospital  licensed  under  this  Act,  or  any  equivalent
29    facility in another state or territory of the United  States.
30    The  Director of Professional Regulation shall define by rule
31    the period for timely response to such requests.
 
                            -2-                LRB9213323ACdv
 1        No  transmittal  of  information  by  the   Director   of
 2    Professional Regulation, under this Section shall be to other
 3    than   the   president,   chief   operating   officer,  chief
 4    administrative officer, or chief of the medical  staff  of  a
 5    hospital  licensed under this Act, a hospital organized under
 6    the University  of  Illinois  Hospital  Act,  or  a  hospital
 7    operated    by   the   United   States,   or   any   of   its
 8    instrumentalities.  The information so transmitted  shall  be
 9    afforded the same status as is information concerning medical
10    studies  by  Part  21  of  Article  VIII of the Code of Civil
11    Procedure, as now or hereafter amended.
12        (b)  All hospitals licensed under this Act, except county
13    hospitals as defined in subsection (c) of Section 15-1 of the
14    Illinois Public Aid Code, shall comply with, and the  medical
15    staff   bylaws   of   these  hospitals  shall  include  rules
16    consistent with, the provisions of this Section in  granting,
17    limiting,  renewing,  or denying medical staff membership and
18    clinical staff privileges.  Hospitals  that  require  medical
19    staff  members  to  possess  faculty  status  with a specific
20    institution of higher education are not  required  to  comply
21    with subsection (1) below when the physician does not possess
22    faculty status.
23             (1)  Minimum   procedures   for  pre-applicants  and
24        applicants for medical staff membership shall include the
25        following:
26                  (A)  Written   procedures   relating   to   the
27             acceptance  and  processing  of  pre-applicants   or
28             applicants   for  medical  staff  membership,  which
29             should be contained in medical staff bylaws.
30                  (B)  Written  procedures  to  be  followed   in
31             determining  a  pre-applicant's  or  an  applicant's
32             qualifications   for  being  granted  medical  staff
33             membership and privileges.
34                  (C)  Written  criteria  to   be   followed   in
 
                            -3-                LRB9213323ACdv
 1             evaluating   a  pre-applicant's  or  an  applicant's
 2             qualifications.
 3                  (D)  An evaluation of a pre-applicant's  or  an
 4             applicant's   current   health  status  and  current
 5             license status in Illinois.
 6                  (E)  A written response to  each  pre-applicant
 7             or applicant that explains the reason or reasons for
 8             any adverse decision (including all reasons based in
 9             whole   or   in  part  on  the  applicant's  medical
10             qualifications  or  any   other   basis,   including
11             economic factors).
12             (2)  Minimum  procedures  with  respect  to  medical
13        staff  and  clinical  privilege determinations concerning
14        current members of the medical staff  shall  include  the
15        following:
16                  (A)  A written notice of an adverse decision.
17                  (B)  An  explanation  of  the  reasons  for  an
18             adverse  decision including all reasons based on the
19             quality  of  medical  care  or  any   other   basis,
20             including economic factors.
21                  (C)  A  statement of the medical staff member's
22             right to request  a  fair  hearing  on  the  adverse
23             decision  before a hearing panel whose membership is
24             mutually agreed upon by the medical  staff  and  the
25             hospital  governing  board.  The hearing panel shall
26             have independent authority to  recommend  action  to
27             the  hospital  governing  board. Upon the request of
28             the medical staff member or the  hospital  governing
29             board,   the   hearing  panel  shall  make  findings
30             concerning the nature of each basis for any  adverse
31             decision recommended to and accepted by the hospital
32             governing board.
33                       (i)  Nothing   in  this  subparagraph  (C)
34                  limits a hospital's or medical staff's right to
 
                            -4-                LRB9213323ACdv
 1                  summarily suspend, without a prior  hearing,  a
 2                  person's  medical  staff membership or clinical
 3                  privileges if the continuation of practice of a
 4                  medical staff member constitutes  an  immediate
 5                  danger   to  the  public,  including  patients,
 6                  visitors, and hospital employees and  staff.  A
 7                  fair  hearing shall be commenced within 15 days
 8                  after  the  suspension  and  completed  without
 9                  delay.
10                       (ii)  Nothing  in  this  subparagraph  (C)
11                  limits a medical staff's right  to  permit,  in
12                  the medical staff bylaws, summary suspension of
13                  membership or clinical privileges in designated
14                  administrative  circumstances  as  specifically
15                  approved  by  the  medical  staff.  This  bylaw
16                  provision  must  specifically describe both the
17                  administrative circumstance that can result  in
18                  a  summary  suspension  and  the  length of the
19                  summary suspension. The opportunity for a  fair
20                  hearing  is  required  for  any  administrative
21                  summary  suspension. Any requested hearing must
22                  be commenced within 15 days after  the  summary
23                  suspension and completed without delay. Adverse
24                  decisions   other   than  suspension  or  other
25                  restrictions on the treatment or  admission  of
26                  patients may be imposed summarily and without a
27                  hearing    under    designated   administrative
28                  circumstances as specifically provided  for  in
29                  the  medical  staff  bylaws  as approved by the
30                  medical staff.
31                       (iii)  If a hospital exercises its  option
32                  to  enter  into  an  exclusive contract limited
33                  under Section 10.5 and that contract results in
34                  the total or partial termination  or  reduction
 
                            -5-                LRB9213323ACdv
 1                  of   medical   staff   membership  or  clinical
 2                  privileges of a current medical  staff  member,
 3                  the hospital shall provide the affected medical
 4                  staff member 60 days prior notice of the effect
 5                  on  his  or  her  medical  staff  membership or
 6                  privileges. An affected  medical  staff  member
 7                  desiring  a  hearing  under subparagraph (C) of
 8                  this paragraph (2)  must  request  the  hearing
 9                  within  14  days after the date he or she is so
10                  notified.  The  requested  hearing   shall   be
11                  commenced  and  completed  (with  a  report and
12                  recommendation to the  affected  medical  staff
13                  member,  hospital  governing board, and medical
14                  staff) within 30 days after  the  date  of  the
15                  medical  staff member's request. If agreed upon
16                  by both the  medical  staff  and  the  hospital
17                  governing  board,  the medical staff bylaws may
18                  provide for longer time periods.
19                  (D)  A  statement  of  the  member's  right  to
20             inspect all pertinent information in the  hospital's
21             possession with respect to the decision.
22                  (E)  A  statement  of  the  member's  right  to
23             present  witnesses and other evidence at the hearing
24             on the decision.
25                  (F)  A written notice and  written  explanation
26             of the decision resulting from the hearing.
27                  (F-5)  A  written  notice  of  a  final adverse
28             decision by a hospital governing board.
29                  (G)  Notice given 15 days before implementation
30             of an adverse medical staff membership  or  clinical
31             privileges  decision based substantially on economic
32             factors.  This  notice  shall  be  given  after  the
33             medical  staff  member   exhausts   all   applicable
34             procedures  under this Section, including item (iii)
 
                            -6-                LRB9213323ACdv
 1             of subparagraph (C) of this paragraph (2), and under
 2             the  medical  staff  bylaws  in   order   to   allow
 3             sufficient time for the orderly provision of patient
 4             care.
 5                  (H)  Nothing  in  this  paragraph  (2)  of this
 6             subsection (b) limits a medical staff member's right
 7             to  waive,  in  writing,  the  rights  provided   in
 8             subparagraphs  (A) through (G) of this paragraph (2)
 9             of  this  subsection  (b)  upon  being  granted  the
10             written  exclusive  right  to   provide   particular
11             services  at a hospital, either individually or as a
12             member of a  group.  If  an  exclusive  contract  is
13             signed by a representative of a group of physicians,
14             a  waiver  contained  in the contract shall apply to
15             all members of the group unless stated otherwise  in
16             the contract.
17             (3)  Every  adverse  medical  staff  membership  and
18        clinical   privilege   decision  based  substantially  on
19        economic  factors  shall  be  reported  to  the  Hospital
20        Licensing Board before the decision takes effect.   These
21        reports  shall  not be disclosed in any form that reveals
22        the identity of any hospital or physician.  These reports
23        shall be utilized to  study  the  effects  that  hospital
24        medical staff membership and clinical privilege decisions
25        based  upon  economic  factors have on access to care and
26        the availability of  physician  services.   The  Hospital
27        Licensing  Board  shall  submit  an  initial study to the
28        Governor and the General Assembly by January 1, 1996, and
29        subsequent  reports  shall  be   submitted   periodically
30        thereafter.
31             (4)  As used in this Section:
32             "Adverse   decision"   means  a  decision  reducing,
33        restricting,  suspending,  revoking,  denying,   or   not
34        renewing medical staff membership or clinical privileges.
 
                            -7-                LRB9213323ACdv
 1             "Economic  factor"  means any information or reasons
 2        for  decisions  unrelated   to   quality   of   care   or
 3        professional competency.
 4             "Pre-applicant"   means   a  physician  licensed  to
 5        practice medicine in all its  branches  who  requests  an
 6        application for medical staff membership or privileges.
 7             "Privilege"  means  permission to provide medical or
 8        other  patient  care  services  and  permission  to   use
 9        hospital  resources,  including equipment, facilities and
10        personnel  that  are  necessary  to  effectively  provide
11        medical or other patient care services.  This  definition
12        shall  not  be construed to require a hospital to acquire
13        additional  equipment,  facilities,   or   personnel   to
14        accommodate the granting of privileges.
15             (5)  Any  amendment to medical staff bylaws required
16        because of  this  amendatory  Act  of  the  91st  General
17        Assembly shall be adopted on or before July 1, 2001.
18        (c)  All  hospitals  shall consult with the medical staff
19    prior to closing membership in the entire or any  portion  of
20    the  medical  staff  or a department.  If the hospital closes
21    membership in the medical staff, any portion of  the  medical
22    staff,  or  the department over the objections of the medical
23    staff, then the hospital shall  provide  a  detailed  written
24    explanation  for  the  decision  to the medical staff 10 days
25    prior to the effective date of any closure.  No  applications
26    need  to  be provided when membership in the medical staff or
27    any relevant portion of the medical staff is closed.
28    (Source:  P.A.  90-14,  eff.  7-1-97;  90-149,  eff.  1-1-98;
29    90-655, eff. 7-30-98; 91-166, eff. 1-1-00.)

30        (210 ILCS 85/10.5 new)
31        Sec.  10.5.   Limitations  on  exclusive  contracts.   No
32    exclusive   contract   is  permissible  for  pain  management
33    services  performed  by  a  physician  licensed  to  practice
 
                            -8-                LRB9213323ACdv
 1    medicine in all its branches, including but  not  limited  to
 2    physicians practicing anesthesiology.

 3        Section  99.  Effective  date.   This Act takes effect on
 4    June 30, 2002.

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