|
Rep. David Reis
Filed: 4/17/2015
| | 09900HB2194ham001 | | LRB099 08198 MLM 33874 a |
|
|
1 | | AMENDMENT TO HOUSE BILL 2194
|
2 | | AMENDMENT NO. ______. Amend House Bill 2194 by replacing |
3 | | everything after the enacting clause with the following:
|
4 | | "Section 5. The Medical Practice Act of 1987 is amended by |
5 | | changing Section 22 as follows:
|
6 | | (225 ILCS 60/22) (from Ch. 111, par. 4400-22)
|
7 | | (Section scheduled to be repealed on December 31, 2015)
|
8 | | Sec. 22. Disciplinary action.
|
9 | | (A) The Department may revoke, suspend, place on probation, |
10 | | reprimand, refuse to issue or renew, or take any other |
11 | | disciplinary or non-disciplinary action as the Department may |
12 | | deem proper
with regard to the license or permit of any person |
13 | | issued
under this Act, including imposing fines not to exceed |
14 | | $10,000 for each violation, upon any of the following grounds:
|
15 | | (1) Performance of an elective abortion in any place, |
16 | | locale,
facility, or
institution other than:
|
|
| | 09900HB2194ham001 | - 2 - | LRB099 08198 MLM 33874 a |
|
|
1 | | (a) a facility licensed pursuant to the Ambulatory |
2 | | Surgical Treatment
Center Act;
|
3 | | (b) an institution licensed under the Hospital |
4 | | Licensing Act;
|
5 | | (c) an ambulatory surgical treatment center or |
6 | | hospitalization or care
facility maintained by the |
7 | | State or any agency thereof, where such department
or |
8 | | agency has authority under law to establish and enforce |
9 | | standards for the
ambulatory surgical treatment |
10 | | centers, hospitalization, or care facilities
under its |
11 | | management and control;
|
12 | | (d) ambulatory surgical treatment centers, |
13 | | hospitalization or care
facilities maintained by the |
14 | | Federal Government; or
|
15 | | (e) ambulatory surgical treatment centers, |
16 | | hospitalization or care
facilities maintained by any |
17 | | university or college established under the laws
of |
18 | | this State and supported principally by public funds |
19 | | raised by
taxation.
|
20 | | (2) Performance of an abortion procedure in a wilful |
21 | | and wanton
manner on a
woman who was not pregnant at the |
22 | | time the abortion procedure was
performed.
|
23 | | (3) A plea of guilty or nolo contendere, finding of |
24 | | guilt, jury verdict, or entry of judgment or sentencing, |
25 | | including, but not limited to, convictions, preceding |
26 | | sentences of supervision, conditional discharge, or first |
|
| | 09900HB2194ham001 | - 3 - | LRB099 08198 MLM 33874 a |
|
|
1 | | offender probation, under the laws of any jurisdiction of |
2 | | the United States of any crime that is a felony.
|
3 | | (4) Gross negligence in practice under this Act.
|
4 | | (5) Engaging in dishonorable, unethical or |
5 | | unprofessional
conduct of a
character likely to deceive, |
6 | | defraud or harm the public.
|
7 | | (6) Obtaining any fee by fraud, deceit, or
|
8 | | misrepresentation.
|
9 | | (7) Habitual or excessive use or abuse of drugs defined |
10 | | in law
as
controlled substances, of alcohol, or of any |
11 | | other substances which results in
the inability to practice |
12 | | with reasonable judgment, skill or safety.
|
13 | | (8) Practicing under a false or, except as provided by |
14 | | law, an
assumed
name.
|
15 | | (9) Fraud or misrepresentation in applying for, or |
16 | | procuring, a
license
under this Act or in connection with |
17 | | applying for renewal of a license under
this Act.
|
18 | | (10) Making a false or misleading statement regarding |
19 | | their
skill or the
efficacy or value of the medicine, |
20 | | treatment, or remedy prescribed by them at
their direction |
21 | | in the treatment of any disease or other condition of the |
22 | | body
or mind.
|
23 | | (11) Allowing another person or organization to use |
24 | | their
license, procured
under this Act, to practice.
|
25 | | (12) Adverse action taken by another state or |
26 | | jurisdiction
against a license
or other authorization to |
|
| | 09900HB2194ham001 | - 4 - | LRB099 08198 MLM 33874 a |
|
|
1 | | practice as a medical doctor, doctor of osteopathy,
doctor |
2 | | of osteopathic medicine or
doctor of chiropractic, a |
3 | | certified copy of the record of the action taken by
the |
4 | | other state or jurisdiction being prima facie evidence |
5 | | thereof. This includes any adverse action taken by a State |
6 | | or federal agency that prohibits a medical doctor, doctor |
7 | | of osteopathy, doctor of osteopathic medicine, or doctor of |
8 | | chiropractic from providing services to the agency's |
9 | | participants.
|
10 | | (13) Violation of any provision of this Act or of the |
11 | | Medical
Practice Act
prior to the repeal of that Act, or |
12 | | violation of the rules, or a final
administrative action of |
13 | | the Secretary, after consideration of the
recommendation |
14 | | of the Disciplinary Board.
|
15 | | (14) Violation of the prohibition against fee |
16 | | splitting in Section 22.2 of this Act.
|
17 | | (15) A finding by the Disciplinary Board that the
|
18 | | registrant after
having his or her license placed on |
19 | | probationary status or subjected to
conditions or |
20 | | restrictions violated the terms of the probation or failed |
21 | | to
comply with such terms or conditions.
|
22 | | (16) Abandonment of a patient.
|
23 | | (17) Prescribing, selling, administering, |
24 | | distributing, giving
or
self-administering any drug |
25 | | classified as a controlled substance (designated
product) |
26 | | or narcotic for other than medically accepted therapeutic
|
|
| | 09900HB2194ham001 | - 5 - | LRB099 08198 MLM 33874 a |
|
|
1 | | purposes.
|
2 | | (18) Promotion of the sale of drugs, devices, |
3 | | appliances or
goods provided
for a patient in such manner |
4 | | as to exploit the patient for financial gain of
the |
5 | | physician.
|
6 | | (19) Offering, undertaking or agreeing to cure or treat
|
7 | | disease by a secret
method, procedure, treatment or |
8 | | medicine, or the treating, operating or
prescribing for any |
9 | | human condition by a method, means or procedure which the
|
10 | | licensee refuses to divulge upon demand of the Department.
|
11 | | (20) Immoral conduct in the commission of any act |
12 | | including,
but not limited to, commission of an act of |
13 | | sexual misconduct related to the
licensee's
practice.
|
14 | | (21) Wilfully making or filing false records or reports |
15 | | in his
or her
practice as a physician, including, but not |
16 | | limited to, false records to
support claims against the |
17 | | medical assistance program of the Department of Healthcare |
18 | | and Family Services (formerly Department of
Public Aid)
|
19 | | under the Illinois Public Aid Code.
|
20 | | (22) Wilful omission to file or record, or wilfully |
21 | | impeding
the filing or
recording, or inducing another |
22 | | person to omit to file or record, medical
reports as |
23 | | required by law, or wilfully failing to report an instance |
24 | | of
suspected abuse or neglect as required by law.
|
25 | | (23) Being named as a perpetrator in an indicated |
26 | | report by
the Department
of Children and Family Services |
|
| | 09900HB2194ham001 | - 6 - | LRB099 08198 MLM 33874 a |
|
|
1 | | under the Abused and Neglected Child Reporting
Act, and |
2 | | upon proof by clear and convincing evidence that the |
3 | | licensee has
caused a child to be an abused child or |
4 | | neglected child as defined in the
Abused and Neglected |
5 | | Child Reporting Act.
|
6 | | (24) Solicitation of professional patronage by any
|
7 | | corporation, agents or
persons, or profiting from those |
8 | | representing themselves to be agents of the
licensee.
|
9 | | (25) Gross and wilful and continued overcharging for
|
10 | | professional services,
including filing false statements |
11 | | for collection of fees for which services are
not rendered, |
12 | | including, but not limited to, filing such false statements |
13 | | for
collection of monies for services not rendered from the |
14 | | medical assistance
program of the Department of Healthcare |
15 | | and Family Services (formerly Department of Public Aid)
|
16 | | under the Illinois Public Aid
Code.
|
17 | | (26) A pattern of practice or other behavior which
|
18 | | demonstrates
incapacity
or incompetence to practice under |
19 | | this Act.
|
20 | | (27) Mental illness or disability which results in the
|
21 | | inability to
practice under this Act with reasonable |
22 | | judgment, skill or safety.
|
23 | | (28) Physical illness, including, but not limited to,
|
24 | | deterioration through
the aging process, or loss of motor |
25 | | skill which results in a physician's
inability to practice |
26 | | under this Act with reasonable judgment, skill or
safety.
|
|
| | 09900HB2194ham001 | - 7 - | LRB099 08198 MLM 33874 a |
|
|
1 | | (29) Cheating on or attempt to subvert the licensing
|
2 | | examinations
administered under this Act.
|
3 | | (30) Wilfully or negligently violating the |
4 | | confidentiality
between
physician and patient except as |
5 | | required by law.
|
6 | | (31) The use of any false, fraudulent, or deceptive |
7 | | statement
in any
document connected with practice under |
8 | | this Act.
|
9 | | (32) Aiding and abetting an individual not licensed |
10 | | under this
Act in the
practice of a profession licensed |
11 | | under this Act.
|
12 | | (33) Violating state or federal laws or regulations |
13 | | relating
to controlled
substances, legend
drugs, or |
14 | | ephedra as defined in the Ephedra Prohibition Act.
|
15 | | (34) Failure to report to the Department any adverse |
16 | | final
action taken
against them by another licensing |
17 | | jurisdiction (any other state or any
territory of the |
18 | | United States or any foreign state or country), by any peer
|
19 | | review body, by any health care institution, by any |
20 | | professional society or
association related to practice |
21 | | under this Act, by any governmental agency, by
any law |
22 | | enforcement agency, or by any court for acts or conduct |
23 | | similar to acts
or conduct which would constitute grounds |
24 | | for action as defined in this
Section.
|
25 | | (35) Failure to report to the Department surrender of a
|
26 | | license or
authorization to practice as a medical doctor, a |
|
| | 09900HB2194ham001 | - 8 - | LRB099 08198 MLM 33874 a |
|
|
1 | | doctor of osteopathy, a
doctor of osteopathic medicine, or |
2 | | doctor
of chiropractic in another state or jurisdiction, or |
3 | | surrender of membership on
any medical staff or in any |
4 | | medical or professional association or society,
while |
5 | | under disciplinary investigation by any of those |
6 | | authorities or bodies,
for acts or conduct similar to acts |
7 | | or conduct which would constitute grounds
for action as |
8 | | defined in this Section.
|
9 | | (36) Failure to report to the Department any adverse |
10 | | judgment,
settlement,
or award arising from a liability |
11 | | claim related to acts or conduct similar to
acts or conduct |
12 | | which would constitute grounds for action as defined in |
13 | | this
Section.
|
14 | | (37) Failure to provide copies of medical records as |
15 | | required
by law.
|
16 | | (38) Failure to furnish the Department, its |
17 | | investigators or
representatives, relevant information, |
18 | | legally requested by the Department
after consultation |
19 | | with the Chief Medical Coordinator or the Deputy Medical
|
20 | | Coordinator.
|
21 | | (39) Violating the Health Care Worker Self-Referral
|
22 | | Act.
|
23 | | (40) Willful failure to provide notice when notice is |
24 | | required
under the
Parental Notice of Abortion Act of 1995.
|
25 | | (41) Failure to establish and maintain records of |
26 | | patient care and
treatment as required by this law.
|
|
| | 09900HB2194ham001 | - 9 - | LRB099 08198 MLM 33874 a |
|
|
1 | | (42) Entering into an excessive number of written |
2 | | collaborative
agreements with licensed advanced practice |
3 | | nurses resulting in an inability to
adequately |
4 | | collaborate.
|
5 | | (43) Repeated failure to adequately collaborate with a |
6 | | licensed advanced practice nurse. |
7 | | (44) Violating the Compassionate Use of Medical |
8 | | Cannabis Pilot Program Act.
|
9 | | (45) Entering into an excessive number of written |
10 | | collaborative agreements with licensed prescribing |
11 | | psychologists resulting in an inability to adequately |
12 | | collaborate. |
13 | | (46) Repeated failure to adequately collaborate with a |
14 | | licensed prescribing psychologist. |
15 | | (47) Violating Section 3.3 of the Medical Patient |
16 | | Rights Act. |
17 | | Except
for actions involving the ground numbered (26), all |
18 | | proceedings to suspend,
revoke, place on probationary status, |
19 | | or take any
other disciplinary action as the Department may |
20 | | deem proper, with regard to a
license on any of the foregoing |
21 | | grounds, must be commenced within 5 years next
after receipt by |
22 | | the Department of a complaint alleging the commission of or
|
23 | | notice of the conviction order for any of the acts described |
24 | | herein. Except
for the grounds numbered (8), (9), (26), and |
25 | | (29), no action shall be commenced more
than 10 years after the |
26 | | date of the incident or act alleged to have violated
this |
|
| | 09900HB2194ham001 | - 10 - | LRB099 08198 MLM 33874 a |
|
|
1 | | Section. For actions involving the ground numbered (26), a |
2 | | pattern of practice or other behavior includes all incidents |
3 | | alleged to be part of the pattern of practice or other behavior |
4 | | that occurred, or a report pursuant to Section 23 of this Act |
5 | | received, within the 10-year period preceding the filing of the |
6 | | complaint. In the event of the settlement of any claim or cause |
7 | | of action
in favor of the claimant or the reduction to final |
8 | | judgment of any civil action
in favor of the plaintiff, such |
9 | | claim, cause of action or civil action being
grounded on the |
10 | | allegation that a person licensed under this Act was negligent
|
11 | | in providing care, the Department shall have an additional |
12 | | period of 2 years
from the date of notification to the |
13 | | Department under Section 23 of this Act
of such settlement or |
14 | | final judgment in which to investigate and
commence formal |
15 | | disciplinary proceedings under Section 36 of this Act, except
|
16 | | as otherwise provided by law. The time during which the holder |
17 | | of the license
was outside the State of Illinois shall not be |
18 | | included within any period of
time limiting the commencement of |
19 | | disciplinary action by the Department.
|
20 | | The entry of an order or judgment by any circuit court |
21 | | establishing that any
person holding a license under this Act |
22 | | is a person in need of mental treatment
operates as a |
23 | | suspension of that license. That person may resume their
|
24 | | practice only upon the entry of a Departmental order based upon |
25 | | a finding by
the Disciplinary Board that they have been |
26 | | determined to be recovered
from mental illness by the court and |
|
| | 09900HB2194ham001 | - 11 - | LRB099 08198 MLM 33874 a |
|
|
1 | | upon the Disciplinary Board's
recommendation that they be |
2 | | permitted to resume their practice.
|
3 | | The Department may refuse to issue or take disciplinary |
4 | | action concerning the license of any person
who fails to file a |
5 | | return, or to pay the tax, penalty or interest shown in a
filed |
6 | | return, or to pay any final assessment of tax, penalty or |
7 | | interest, as
required by any tax Act administered by the |
8 | | Illinois Department of Revenue,
until such time as the |
9 | | requirements of any such tax Act are satisfied as
determined by |
10 | | the Illinois Department of Revenue.
|
11 | | The Department, upon the recommendation of the |
12 | | Disciplinary Board, shall
adopt rules which set forth standards |
13 | | to be used in determining:
|
14 | | (a) when a person will be deemed sufficiently |
15 | | rehabilitated to warrant the
public trust;
|
16 | | (b) what constitutes dishonorable, unethical or |
17 | | unprofessional conduct of
a character likely to deceive, |
18 | | defraud, or harm the public;
|
19 | | (c) what constitutes immoral conduct in the commission |
20 | | of any act,
including, but not limited to, commission of an |
21 | | act of sexual misconduct
related
to the licensee's |
22 | | practice; and
|
23 | | (d) what constitutes gross negligence in the practice |
24 | | of medicine.
|
25 | | However, no such rule shall be admissible into evidence in |
26 | | any civil action
except for review of a licensing or other |
|
| | 09900HB2194ham001 | - 12 - | LRB099 08198 MLM 33874 a |
|
|
1 | | disciplinary action under this Act.
|
2 | | In enforcing this Section, the Disciplinary Board or the |
3 | | Licensing Board,
upon a showing of a possible violation, may |
4 | | compel, in the case of the Disciplinary Board, any individual |
5 | | who is licensed to
practice under this Act or holds a permit to |
6 | | practice under this Act, or, in the case of the Licensing |
7 | | Board, any individual who has applied for licensure or a permit
|
8 | | pursuant to this Act, to submit to a mental or physical |
9 | | examination and evaluation, or both,
which may include a |
10 | | substance abuse or sexual offender evaluation, as required by |
11 | | the Licensing Board or Disciplinary Board and at the expense of |
12 | | the Department. The Disciplinary Board or Licensing Board shall |
13 | | specifically designate the examining physician licensed to |
14 | | practice medicine in all of its branches or, if applicable, the |
15 | | multidisciplinary team involved in providing the mental or |
16 | | physical examination and evaluation, or both. The |
17 | | multidisciplinary team shall be led by a physician licensed to |
18 | | practice medicine in all of its branches and may consist of one |
19 | | or more or a combination of physicians licensed to practice |
20 | | medicine in all of its branches, licensed chiropractic |
21 | | physicians, licensed clinical psychologists, licensed clinical |
22 | | social workers, licensed clinical professional counselors, and |
23 | | other professional and administrative staff. Any examining |
24 | | physician or member of the multidisciplinary team may require |
25 | | any person ordered to submit to an examination and evaluation |
26 | | pursuant to this Section to submit to any additional |
|
| | 09900HB2194ham001 | - 13 - | LRB099 08198 MLM 33874 a |
|
|
1 | | supplemental testing deemed necessary to complete any |
2 | | examination or evaluation process, including, but not limited |
3 | | to, blood testing, urinalysis, psychological testing, or |
4 | | neuropsychological testing.
The Disciplinary Board, the |
5 | | Licensing Board, or the Department may order the examining
|
6 | | physician or any member of the multidisciplinary team to |
7 | | provide to the Department, the Disciplinary Board, or the |
8 | | Licensing Board any and all records, including business |
9 | | records, that relate to the examination and evaluation, |
10 | | including any supplemental testing performed. The Disciplinary |
11 | | Board, the Licensing Board, or the Department may order the |
12 | | examining physician or any member of the multidisciplinary team |
13 | | to present testimony concerning this examination
and |
14 | | evaluation of the licensee, permit holder, or applicant, |
15 | | including testimony concerning any supplemental testing or |
16 | | documents relating to the examination and evaluation. No |
17 | | information, report, record, or other documents in any way |
18 | | related to the examination and evaluation shall be excluded by |
19 | | reason of
any common
law or statutory privilege relating to |
20 | | communication between the licensee, permit holder, or
|
21 | | applicant and
the examining physician or any member of the |
22 | | multidisciplinary team.
No authorization is necessary from the |
23 | | licensee, permit holder, or applicant ordered to undergo an |
24 | | evaluation and examination for the examining physician or any |
25 | | member of the multidisciplinary team to provide information, |
26 | | reports, records, or other documents or to provide any |
|
| | 09900HB2194ham001 | - 14 - | LRB099 08198 MLM 33874 a |
|
|
1 | | testimony regarding the examination and evaluation. The |
2 | | individual to be examined may have, at his or her own expense, |
3 | | another
physician of his or her choice present during all |
4 | | aspects of the examination.
Failure of any individual to submit |
5 | | to mental or physical examination and evaluation, or both, when
|
6 | | directed, shall result in an automatic suspension, without |
7 | | hearing, until such time
as the individual submits to the |
8 | | examination. If the Disciplinary Board or Licensing Board finds |
9 | | a physician unable
to practice following an examination and |
10 | | evaluation because of the reasons set forth in this Section, |
11 | | the Disciplinary
Board or Licensing Board shall require such |
12 | | physician to submit to care, counseling, or treatment
by |
13 | | physicians, or other health care professionals, approved or |
14 | | designated by the Disciplinary Board, as a condition
for |
15 | | issued, continued, reinstated, or renewed licensure to |
16 | | practice. Any physician,
whose license was granted pursuant to |
17 | | Sections 9, 17, or 19 of this Act, or,
continued, reinstated, |
18 | | renewed, disciplined or supervised, subject to such
terms, |
19 | | conditions or restrictions who shall fail to comply with such |
20 | | terms,
conditions or restrictions, or to complete a required |
21 | | program of care,
counseling, or treatment, as determined by the |
22 | | Chief Medical Coordinator or
Deputy Medical Coordinators, |
23 | | shall be referred to the Secretary for a
determination as to |
24 | | whether the licensee shall have their license suspended
|
25 | | immediately, pending a hearing by the Disciplinary Board. In |
26 | | instances in
which the Secretary immediately suspends a license |
|
| | 09900HB2194ham001 | - 15 - | LRB099 08198 MLM 33874 a |
|
|
1 | | under this Section, a hearing
upon such person's license must |
2 | | be convened by the Disciplinary Board within 15
days after such |
3 | | suspension and completed without appreciable delay. The
|
4 | | Disciplinary Board shall have the authority to review the |
5 | | subject physician's
record of treatment and counseling |
6 | | regarding the impairment, to the extent
permitted by applicable |
7 | | federal statutes and regulations safeguarding the
|
8 | | confidentiality of medical records.
|
9 | | An individual licensed under this Act, affected under this |
10 | | Section, shall be
afforded an opportunity to demonstrate to the |
11 | | Disciplinary Board that they can
resume practice in compliance |
12 | | with acceptable and prevailing standards under
the provisions |
13 | | of their license.
|
14 | | The Department may promulgate rules for the imposition of |
15 | | fines in
disciplinary cases, not to exceed
$10,000 for each |
16 | | violation of this Act. Fines
may be imposed in conjunction with |
17 | | other forms of disciplinary action, but
shall not be the |
18 | | exclusive disposition of any disciplinary action arising out
of |
19 | | conduct resulting in death or injury to a patient. Any funds |
20 | | collected from
such fines shall be deposited in the Medical |
21 | | Disciplinary Fund.
|
22 | | All fines imposed under this Section shall be paid within |
23 | | 60 days after the effective date of the order imposing the fine |
24 | | or in accordance with the terms set forth in the order imposing |
25 | | the fine. |
26 | | (B) The Department shall revoke the license or
permit |
|
| | 09900HB2194ham001 | - 16 - | LRB099 08198 MLM 33874 a |
|
|
1 | | issued under this Act to practice medicine or a chiropractic |
2 | | physician who
has been convicted a second time of committing |
3 | | any felony under the
Illinois Controlled Substances Act or the |
4 | | Methamphetamine Control and Community Protection Act, or who |
5 | | has been convicted a second time of
committing a Class 1 felony |
6 | | under Sections 8A-3 and 8A-6 of the Illinois Public
Aid Code. A |
7 | | person whose license or permit is revoked
under
this subsection |
8 | | B shall be prohibited from practicing
medicine or treating |
9 | | human ailments without the use of drugs and without
operative |
10 | | surgery.
|
11 | | (C) The Disciplinary Board shall recommend to the
|
12 | | Department civil
penalties and any other appropriate |
13 | | discipline in disciplinary cases when the
Board finds that a |
14 | | physician willfully performed an abortion with actual
|
15 | | knowledge that the person upon whom the abortion has been |
16 | | performed is a minor
or an incompetent person without notice as |
17 | | required under the Parental Notice
of Abortion Act of 1995. |
18 | | Upon the Board's recommendation, the Department shall
impose, |
19 | | for the first violation, a civil penalty of $1,000 and for a |
20 | | second or
subsequent violation, a civil penalty of $5,000.
|
21 | | (Source: P.A. 97-622, eff. 11-23-11; 98-601, eff. 12-30-13; |
22 | | 98-668, eff. 6-25-14; 98-1140, eff. 12-30-14.)
|
23 | | Section 10. The Medical Patient Rights Act is amended by |
24 | | changing Section 3.3 as follows: |
|
| | 09900HB2194ham001 | - 17 - | LRB099 08198 MLM 33874 a |
|
|
1 | | (410 ILCS 50/3.3) |
2 | | Sec. 3.3. Prohibition on the markup of anatomic pathology |
3 | | services. |
4 | | (a) A physician who orders, but who does not supervise or |
5 | | perform, an anatomic pathology service shall disclose in a bill |
6 | | for such service presented to the patient: |
7 | | (1) the name and address of the physician or laboratory
|
8 | | that provided the anatomic pathology service; and |
9 | | (2) the actual amount paid or to be paid for each |
10 | | anatomic pathology service provided to the patient by the |
11 | | physician or laboratory that performed the service. |
12 | | (b) A physician subject to the requirement of subsection |
13 | | (a) of this Section when billing a patient, insurer, or |
14 | | third-party payer shall not markup, or directly or indirectly |
15 | | increase, the amount subject to disclosure under paragraph (2) |
16 | | of subsection (a) of this Section in any bill presented to a |
17 | | patient, insurer, or third-party payer. |
18 | | (c) This Section does not prohibit a referring physician |
19 | | from charging a specimen acquisition or processing charge if: |
20 | | (1) the charge is limited to actual costs incurred for |
21 | | specimen collection and transportation; and |
22 | | (2) the charge is separately coded or denoted as a |
23 | | service distinct from the performance of the anatomic |
24 | | pathology service, in conformance with the coding policies |
25 | | of the American Medical Association. |
26 | | (d) The requirements of this Section do not apply to an |
|
| | 09900HB2194ham001 | - 18 - | LRB099 08198 MLM 33874 a |
|
|
1 | | anatomic pathology service ordered or provided by: |
2 | | (1) facilities licensed under the Hospital Licensing |
3 | | Act or the University of Illinois Hospital Act or clinical |
4 | | laboratories owned, operated by, or operated within |
5 | | facilities licensed under the Hospital Licensing Act or the |
6 | | University of Illinois Hospital Act; |
7 | | (2) any public health clinic or nonprofit health |
8 | | clinic; or |
9 | | (3) any government agency, or their specified public or |
10 | | private agents. |
11 | | (e) No patient, insurer, or other third-party payer, shall |
12 | | be required to reimburse any licensed health care professional |
13 | | for charges or claims submitted in violation of this Section. |
14 | | (f) A person who receives a bill for an anatomic pathology |
15 | | service made in knowing and willful violation of this Section |
16 | | may maintain an action to recover the actual amount paid for |
17 | | the bill. |
18 | | (g) The Department of Financial and Professional |
19 | | Regulation Insurance shall enforce the provisions of this |
20 | | Section for any bill submitted to a payer in violation of this |
21 | | Section. A violation of this Section shall be a violation of |
22 | | the Medical Practice Act of 1987. |
23 | | (h) For the purposes of this Section, "anatomic pathology |
24 | | services" means: |
25 | | (1) histopathology or surgical pathology, meaning the |
26 | | gross and microscopic examination performed by a physician |
|
| | 09900HB2194ham001 | - 19 - | LRB099 08198 MLM 33874 a |
|
|
1 | | or under the supervision of a physician, including |
2 | | histologic processing; |
3 | | (2) cytopathology, meaning the microscopic examination |
4 | | of cells from (A) fluids, (B) aspirates, (C) washings, (D) |
5 | | brushings, or (E) smears, including the Pap smear test |
6 | | examination performed by a physician or under the |
7 | | supervision of a physician; |
8 | | (3) hematology, meaning the microscopic evaluation of |
9 | | bone marrow aspirates and biopsies performed by a |
10 | | physician, or under the supervision of a physician, and |
11 | | peripheral blood smears when the attending or treating |
12 | | physician or technologist requests that a blood smear be |
13 | | reviewed by a pathologist; |
14 | | (4) sub-cellular pathology or molecular pathology, |
15 | | meaning the assessment of a patient specimen for the |
16 | | detection, localization, measurement, or analysis of one |
17 | | or more protein or nucleic acid targets; and |
18 | | (5) blood-banking services performed by pathologists.
|
19 | | (Source: P.A. 98-1127, eff. 1-1-15.)
|
20 | | Section 99. Effective date. This Act takes effect upon |
21 | | becoming law.".
|