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91_SB0953
LRB9100490ACsb
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 23 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 staff privileges. All hospitals shall consult with
20 the medical staff prior to closing membership in the entire
21 or any portion of the medical staff or department. If the
22 hospital closes membership in the medical staff, any portion
23 of the medical staff, or the department over the objections
24 of the medical staff, then the hospital shall provide a
25 detailed written explanation for the decision to the medical
26 staff 10 days prior to the effective date of any closure. No
27 applications need to be provided when membership in the
28 medical staff or any portion of the medical staff is closed.
29 (1) Minimum procedures for pre-applicants, those
30 requesting an application, and initial applicants for
31 medical staff membership shall include the following:
32 (A) Written procedures relating to the
33 acceptance and processing of pre-applicants or
34 initial applicants for medical staff membership,
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1 which should be contained in medical staff bylaws.
2 (B) Written procedures to be followed in
3 determining a pre-applicant's or an applicant's
4 qualifications for being granted medical staff
5 membership and privileges.
6 (C) Written criteria to be followed in
7 evaluating a pre-applicant's or an applicant's
8 qualifications.
9 (D) An evaluation of a pre-applicant's or an
10 applicant's current health status and current
11 license status in Illinois.
12 (E) A written response to each pre-applicant
13 or applicant that explains the reason or reasons for
14 any adverse decision (including all reasons based in
15 whole or in part on the applicant's medical
16 qualifications or any other basis, including
17 economic factors).
18 (2) Minimum procedures with respect to medical
19 staff and clinical privilege determinations concerning
20 current members of the medical staff shall include the
21 following:
22 (A) A written notice of an adverse decision by
23 the hospital governing board.
24 (B) An explanation of the reasons for an
25 adverse decision including all reasons based on the
26 quality of medical care or any other basis,
27 including economic factors.
28 (C) A statement of the medical staff member's
29 right to request a fair hearing on the adverse
30 decision before a hearing panel whose membership is
31 mutually agreed upon by the medical staff and the
32 hospital governing board. The hearing panel shall
33 have independent authority to recommend action to
34 the hospital governing board. Upon the request of
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1 the medical staff member or the hospital governing
2 board, the hearing panel shall make findings
3 concerning the nature of each basis for any adverse
4 decision recommended to and accepted by the hospital
5 governing board.
6 (i) Nothing in this subparagraph (C)
7 limits a hospital's or medical staff's right to
8 summarily suspend, without a prior hearing, a
9 person's medical staff membership or clinical
10 privileges if the continuation of practice of a
11 medical staff member constitutes an immediate
12 danger to the public, including patients,
13 visitors, and hospital employees and staff. A
14 fair hearing shall be commenced within 15 days
15 after the suspension and completed without
16 delay.
17 (ii) Nothing in this subparagraph (C)
18 limits a medical staff's right to permit, in
19 the medical staff bylaws, summary suspension of
20 membership or clinical privileges in designated
21 administrative circumstances as specifically
22 approved by the medical staff. This bylaw
23 provision must specifically describe both the
24 administrative circumstance that can result in
25 a summary suspension and the length of the
26 summary suspension. The opportunity for a fair
27 hearing is required for any administrative
28 summary suspension. Any requested hearing must
29 be commenced within 15 days after the summary
30 suspension and completed without delay. Adverse
31 decisions other than suspension or other
32 restrictions on the treatment or admission of
33 patients may be imposed summarily and without a
34 hearing under designated administrative
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1 circumstances as specifically provided for in
2 the medical staff bylaws as approved by the
3 medical staff.
4 (iii) If a hospital exercises its option
5 to enter into an exclusive contract and that
6 contract results in the total or partial
7 termination or reduction of medical staff
8 membership or clinical privileges of a current
9 medical staff member, the hospital shall
10 provide the affected medical staff member 60
11 days prior notice of the effect on his or her
12 medical staff membership or privileges. An
13 affected medical staff member desiring a
14 hearing under subparagraph (C) of this
15 paragraph (2) must request the hearing within
16 14 days after the date he or she is so
17 notified. The requested hearing shall be
18 commenced and completed (with a report and
19 recommendation to the affected medical staff
20 member, hospital governing board, and medical
21 staff) within 30 days after the date of the
22 medical staff member's request. If agreed upon
23 by both the medical staff and the hospital
24 governing board, the medical staff bylaws may
25 provide for longer time periods.
26 (D) A statement of the member's right to
27 inspect all pertinent information in the hospital's
28 possession with respect to the decision.
29 (E) A statement of the member's right to
30 present witnesses and other evidence at the hearing
31 on the decision.
32 (F) A written notice and written explanation
33 of the decision resulting from the hearing.
34 (F-5) A written notice of a final adverse
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1 decision by a hospital governing board.
2 (G) Notice given 15 days before implementation
3 of an adverse medical staff membership or clinical
4 privileges decision based substantially on economic
5 factors. This notice shall be given after the
6 medical staff member exhausts all applicable
7 procedures under this Section, including item (iii)
8 of subparagraph (C) of this paragraph (2), and under
9 the medical staff bylaws in order to allow
10 sufficient time for the orderly provision of patient
11 care.
12 (H) Nothing in this paragraph (2) of this
13 subsection (b) limits a medical staff member's right
14 to waive, in writing, the rights provided in
15 subparagraphs (A) through (G) of this paragraph (2)
16 of this subsection (b) upon being granted the
17 written exclusive right to provide particular
18 services at a hospital, either individually or as a
19 member of a group. If an exclusive contract is
20 signed by a representative of a group of physicians,
21 a waiver contained in the contract shall apply to
22 all members of the group unless stated otherwise in
23 the contract.
24 (3) Every adverse medical staff membership and
25 clinical privilege decision based substantially on
26 economic factors shall be reported to the Hospital
27 Licensing Board before the decision takes effect. These
28 reports shall not be disclosed in any form that reveals
29 the identity of any hospital or physician. These reports
30 shall be utilized to study the effects that hospital
31 medical staff membership and clinical privilege decisions
32 based upon economic factors have on access to care and
33 the availability of physician services. The Hospital
34 Licensing Board shall submit an initial study to the
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1 Governor and the General Assembly by January 1, 1996, and
2 subsequent reports shall be submitted periodically
3 thereafter.
4 (4) As used in this Section:
5 "Adverse decision" means a decision reducing,
6 restricting, suspending, revoking, denying, or not
7 renewing medical staff membership or clinical privileges.
8 "Economic factor" means any information or reasons
9 for decisions unrelated to quality of care or
10 professional competency.
11 "Privilege" means permission to provide medical or
12 other patient care services and permission to use
13 hospital resources, including equipment, facilities and
14 personnel that are necessary to effectively provide
15 medical or other patient care services. This definition
16 shall not be construed to require a hospital to acquire
17 additional equipment, facilities, or personnel to
18 accommodate the granting of privileges.
19 (Source: P.A. 90-14, eff. 7-1-97; 90-149, eff. 1-1-98;
20 90-655, eff. 7-30-98.)
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