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92_SB1798eng SB1798 Engrossed 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 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) AAnyhospital licensed under this Act or any 9 hospital organized under the University of Illinois Hospital 10 Act shall, prior to the granting of any medical staff 11 privileges to an applicant, or renewing a current medical 12 staff member's privileges, request of the Director of 13 Professional Regulation information concerning the licensure 14 status and any disciplinary action taken against the 15 applicant's or medical staff member's license, except for 16 medical personnel who enter a hospital to obtain organs and 17 tissues for transplant from a deceased donor in accordance 18 with the Uniform Anatomical Gift Act. The Director of 19 Professional Regulation shall transmit, in writing and in a 20 timely 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. SB1798 Engrossed -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 SB1798 Engrossed -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 SB1798 Engrossed -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 and that 33 contract results in the total or partial 34 termination or reduction of medical staff SB1798 Engrossed -5- LRB9213323ACdv 1 membership or clinical privileges of a current 2 medical staff member, the hospital shall 3 provide the affected medical staff member 60 4 days prior notice of the effect on his or her 5 medical staff membership or privileges. An 6 affected medical staff member desiring a 7 hearing under subparagraph (C) of this 8 paragraph (2) must request the hearing within 9 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) SB1798 Engrossed -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. SB1798 Engrossed -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.)