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Public Act 92-0455
SB933 Enrolled LRB9205026LBmb
AN ACT concerning health facilities.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Hospital Licensing Act is amended by
adding Section 10.8 as follows:
(210 ILCS 85/10.8 new)
Sec. 10.8. Requirements for employment of physicians.
(a) Physician employment by hospitals and hospital
affiliates. Employing entities may employ physicians to
practice medicine in all of its branches provided that the
following requirements are met:
(1) The employed physician is a member of the
medical staff of either the hospital or hospital
affiliate. If a hospital affiliate decides to have a
medical staff, its medical staff shall be organized in
accordance with written bylaws where the affiliate
medical staff is responsible for making recommendations
to the governing body of the affiliate regarding all
quality assurance activities and safeguarding
professional autonomy. The affiliate medical staff
bylaws may not be unilaterally changed by the governing
body of the affiliate. Nothing in this Section requires
hospital affiliates to have a medical staff.
(2) Independent physicians, who are not employed by
an employing entity, periodically review the quality of
the medical services provided by the employed physician
to continuously improve patient care.
(3) The employing entity and the employed physician
sign a statement acknowledging that the employer shall
not unreasonably exercise control, direct, or interfere
with the employed physician's exercise and execution of
his or her professional judgment in a manner that
adversely affects the employed physician's ability to
provide quality care to patients. This signed statement
shall take the form of a provision in the physician's
employment contract or a separate signed document from
the employing entity to the employed physician. This
statement shall state: "As the employer of a physician,
(employer's name) shall not unreasonably exercise
control, direct, or interfere with the employed
physician's exercise and execution of his or her
professional judgment in a manner that adversely affects
the employed physician's ability to provide quality care
to patients."
(4) The employing entity shall establish a mutually
agreed upon independent review process with criteria
under which an employed physician may seek review of the
alleged violation of this Section by physicians who are
not employed by the employing entity. The affiliate may
arrange with the hospital medical staff to conduct these
reviews. The independent physicians shall make findings
and recommendations to the employing entity and the
employed physician within 30 days of the conclusion of
the gathering of the relevant information.
(b) Definitions. For the purpose of this Section:
"Employing entity" means a hospital licensed under the
Hospital Licensing Act or a hospital affiliate.
"Employed physician" means a physician who receives an
IRS W-2 form, or any successor federal income tax form, from
an employing entity.
"Hospital" means a hospital licensed under the Hospital
Licensing Act, except county hospitals as defined in
subsection (c) of Section 15-1 of the Public Aid Code.
"Hospital affiliate" means a corporation, partnership,
joint venture, limited liability company, or similar
organization, other than a hospital, that is devoted
primarily to the provision, management, or support of health
care services and that directly or indirectly controls, is
controlled by, or is under common control of the hospital.
"Control" means having at least an equal or a majority
ownership or membership interest. A hospital affiliate shall
be 100% owned or controlled by any combination of hospitals,
their parent corporations, or physicians licensed to practice
medicine in all its branches in Illinois. "Hospital
affiliate" does not include a health maintenance organization
regulated under the Health Maintenance Organization Act.
"Physician" means an individual licensed to practice
medicine in all its branches in Illinois.
"Professional judgment" means the exercise of a
physician's independent clinical judgment in providing
medically appropriate diagnoses, care, and treatment to a
particular patient at a particular time. Situations in which
an employing entity does not interfere with an employed
physician's professional judgment include, without
limitation, the following:
(1) practice restrictions based upon peer review of
the physician's clinical practice to assess quality of
care and utilization of resources in accordance with
applicable bylaws;
(2) supervision of physicians by appropriately
licensed medical directors, medical school faculty,
department chairpersons or directors, or supervising
physicians;
(3) written statements of ethical or religious
directives; and
(4) reasonable referral restrictions that do not,
in the reasonable professional judgment of the physician,
adversely affect the health or welfare of the patient.
(c) Private enforcement. An employed physician aggrieved
by a violation of this Act may seek to obtain an injunction
or reinstatement of employment with the employing entity as
the court may deem appropriate. Nothing in this Section
limits or abrogates any common law cause of action. Nothing
in this Section shall be deemed to alter the law of
negligence.
(d) Department enforcement. The Department may enforce
the provisions of this Section, but nothing in this Section
shall require or permit the Department to license, certify,
or otherwise investigate the activities of a hospital
affiliate not otherwise required to be licensed by the
Department.
(e) Retaliation prohibited. No employing entity shall
retaliate against any employed physician for requesting a
hearing or review under this Section. No action may be
taken that affects the ability of a physician to practice
during this review, except in circumstances where the medical
staff bylaws authorize summary suspension.
(f) Physician collaboration. No employing entity shall
adopt or enforce, either formally or informally, any
policy, rule, regulation, or practice inconsistent with the
provision of adequate collaboration, including medical
direction of licensed advanced practice nurses or
supervision of licensed physician assistants and delegation
to other personnel under Section 54.5 of the Medical Practice
Act of 1987.
(g) Physician disciplinary actions. Nothing in this
Section shall be construed to limit or prohibit the governing
body of an employing entity or its medical staff, if any,
from taking disciplinary actions against a physician as
permitted by law.
(h) Physician review. Nothing in this Section shall be
construed to prohibit a hospital or hospital affiliate from
making a determination not to pay for a particular health
care service or to prohibit a medical group, independent
practice association, hospital medical staff, or hospital
governing body from enforcing reasonable peer review or
utilization review protocols or determining whether the
employed physician complied with those protocols.
(i) Review. Nothing in this Section may be used or
construed to establish that any activity of a hospital or
hospital affiliate is subject to review under the Illinois
Health Facilities Planning Act.
(j) Rules. The Department shall adopt any rules
necessary to implement this Section.
Section 99. Effective date. This Act takes effect on
September 30, 2001.
Passed in the General Assembly May 30, 2001.
Approved August 21, 2001.
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