101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB2328

 

Introduced , by Rep. André Thapedi

 

SYNOPSIS AS INTRODUCED:
 
210 ILCS 85/10.8

    Amends the Hospital Licensing Act. Provides that employment agreements between hospitals and physicians may not contain any provision to restrict the ability of a physician to leave employment with the hospital or hospital affiliate and immediately continue to practice in the same field of medicine in the same geographic area.


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A BILL FOR

 

HB2328LRB101 04960 CPF 49969 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Hospital Licensing Act is amended by
5changing Section 10.8 as follows:
 
6    (210 ILCS 85/10.8)
7    Sec. 10.8. Requirements for employment of physicians.
8    (a) Physician employment by hospitals and hospital
9affiliates. Employing entities may employ physicians to
10practice medicine in all of its branches provided that the
11following requirements are met:
12        (1) The employed physician is a member of the medical
13    staff of either the hospital or hospital affiliate. If a
14    hospital affiliate decides to have a medical staff, its
15    medical staff shall be organized in accordance with written
16    bylaws where the affiliate medical staff is responsible for
17    making recommendations to the governing body of the
18    affiliate regarding all quality assurance activities and
19    safeguarding professional autonomy. The affiliate medical
20    staff bylaws may not be unilaterally changed by the
21    governing body of the affiliate. Nothing in this Section
22    requires hospital affiliates to have a medical staff.
23        (2) Independent physicians, who are not employed by an

 

 

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1    employing entity, periodically review the quality of the
2    medical services provided by the employed physician to
3    continuously improve patient care.
4        (3) The employing entity and the employed physician
5    sign a statement acknowledging that the employer shall not
6    unreasonably exercise control, direct, or interfere with
7    the employed physician's exercise and execution of his or
8    her professional judgment in a manner that adversely
9    affects the employed physician's ability to provide
10    quality care to patients. This signed statement shall take
11    the form of a provision in the physician's employment
12    contract or a separate signed document from the employing
13    entity to the employed physician. This statement shall
14    state: "As the employer of a physician, (employer's name)
15    shall not unreasonably exercise control, direct, or
16    interfere with the employed physician's exercise and
17    execution of his or her professional judgment in a manner
18    that adversely affects the employed physician's ability to
19    provide quality care to patients." The employment
20    agreement may not contain any provision to restrict the
21    ability of a physician to leave employment with the
22    hospital or hospital affiliate and immediately continue to
23    practice in the same field of medicine in the same
24    geographic area, often referred to as restrictive
25    covenants or non-compete clauses.
26        (4) The employing entity shall establish a mutually

 

 

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1    agreed upon independent review process with criteria under
2    which an employed physician may seek review of the alleged
3    violation of this Section by physicians who are not
4    employed by the employing entity. The affiliate may arrange
5    with the hospital medical staff to conduct these reviews.
6    The independent physicians shall make findings and
7    recommendations to the employing entity and the employed
8    physician within 30 days of the conclusion of the gathering
9    of the relevant information.
10    (b) Definitions. For the purpose of this Section:
11    "Employing entity" means a hospital licensed under the
12Hospital Licensing Act or a hospital affiliate.
13    "Employed physician" means a physician who receives an IRS
14W-2 form, or any successor federal income tax form, from an
15employing entity.
16    "Hospital" means a hospital licensed under the Hospital
17Licensing Act, except county hospitals as defined in subsection
18(c) of Section 15-1 of the Illinois Public Aid Code.
19    "Hospital affiliate" means a corporation, partnership,
20joint venture, limited liability company, or similar
21organization, other than a hospital, that is devoted primarily
22to the provision, management, or support of health care
23services and that directly or indirectly controls, is
24controlled by, or is under common control of the hospital.
25"Control" means having at least an equal or a majority
26ownership or membership interest. A hospital affiliate shall be

 

 

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1100% owned or controlled by any combination of hospitals, their
2parent corporations, or physicians licensed to practice
3medicine in all its branches in Illinois. "Hospital affiliate"
4does not include a health maintenance organization regulated
5under the Health Maintenance Organization Act.
6    "Physician" means an individual licensed to practice
7medicine in all its branches in Illinois.
8    "Professional judgment" means the exercise of a
9physician's independent clinical judgment in providing
10medically appropriate diagnoses, care, and treatment to a
11particular patient at a particular time. Situations in which an
12employing entity does not interfere with an employed
13physician's professional judgment include, without limitation,
14the following:
15        (1) practice restrictions based upon peer review of the
16    physician's clinical practice to assess quality of care and
17    utilization of resources in accordance with applicable
18    bylaws;
19        (2) supervision of physicians by appropriately
20    licensed medical directors, medical school faculty,
21    department chairpersons or directors, or supervising
22    physicians;
23        (3) written statements of ethical or religious
24    directives; and
25        (4) reasonable referral restrictions that do not, in
26    the reasonable professional judgment of the physician,

 

 

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1    adversely affect the health or welfare of the patient.
2    (c) Private enforcement. An employed physician aggrieved
3by a violation of this Act may seek to obtain an injunction or
4reinstatement of employment with the employing entity as the
5court may deem appropriate. Nothing in this Section limits or
6abrogates any common law cause of action. Nothing in this
7Section shall be deemed to alter the law of negligence.
8    (d) Department enforcement. The Department may enforce the
9provisions of this Section, but nothing in this Section shall
10require or permit the Department to license, certify, or
11otherwise investigate the activities of a hospital affiliate
12not otherwise required to be licensed by the Department.
13    (e) Retaliation prohibited. No employing entity shall
14retaliate against any employed physician for requesting a
15hearing or review under this Section. No action may be taken
16that affects the ability of a physician to practice during this
17review, except in circumstances where the medical staff bylaws
18authorize summary suspension.
19    (f) Physician collaboration. No employing entity shall
20adopt or enforce, either formally or informally, any policy,
21rule, regulation, or practice inconsistent with the provision
22of adequate collaboration, including medical direction of
23licensed advanced practice registered nurses or supervision of
24licensed physician assistants and delegation to other
25personnel under Section 54.5 of the Medical Practice Act of
261987.

 

 

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1    (g) Physician disciplinary actions. Nothing in this
2Section shall be construed to limit or prohibit the governing
3body of an employing entity or its medical staff, if any, from
4taking disciplinary actions against a physician as permitted by
5law.
6    (h) Physician review. Nothing in this Section shall be
7construed to prohibit a hospital or hospital affiliate from
8making a determination not to pay for a particular health care
9service or to prohibit a medical group, independent practice
10association, hospital medical staff, or hospital governing
11body from enforcing reasonable peer review or utilization
12review protocols or determining whether the employed physician
13complied with those protocols.
14    (i) Review. Nothing in this Section may be used or
15construed to establish that any activity of a hospital or
16hospital affiliate is subject to review under the Illinois
17Health Facilities Planning Act.
18    (j) Rules. The Department shall adopt any rules necessary
19to implement this Section.
20(Source: P.A. 100-201, eff. 8-18-17; 100-513, eff. 1-1-18.)