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90_HB2818 225 ILCS 60/23 from Ch. 111, par. 4400-23 225 ILCS 60/36 from Ch. 111, par. 4400-36 225 ILCS 60/38 from Ch. 111, par. 4400-38 Amends the Medical Practice Act of 1987. Authorizes the Department of Professional Regulation to inform patients of their right to give consent for the Department to obtain copies of the patients' hospital and medical records. Authorizes the Department and the Disciplinary Board to subpoena records in mandatory reporting cases alleging death or permanent injury. Provides that the subpoenaed information shall be kept confidential. LRB9008900JSgc LRB9008900JSgc 1 AN ACT to amend the Medical Practice Act of 1987 by 2 changing Sections 23, 36, and 38. 3 Be it enacted by the People of the State of Illinois, 4 represented in the General Assembly: 5 Section 5. The Medical Practice Act of 1987 is amended 6 by changing Sections 23, 36, and 38 as follows: 7 (225 ILCS 60/23) (from Ch. 111, par. 4400-23) 8 Sec. 23. Reports relating to professional conduct and 9 capacity. 10 (A) Entities required to report. 11 (1) Health care institutions. The chief 12 administrator or executive officer of any health care 13 institution licensed by the Illinois Department of Public 14 Health shall report to the Disciplinary Board when any 15 person's clinical privileges are terminated or are 16 restricted based on a final determination, in accordance 17 with that institution's by-laws or rules and regulations, 18 that a person has either committed an act or acts which 19 may directly threaten patient care, and not of an 20 administrative nature, or that a person may be mentally 21 or physically disabled in such a manner as to endanger 22 patients under that person's care. Such officer also 23 shall report if a person accepts voluntary termination or 24 restriction of clinical privileges in lieu of formal 25 action based upon conduct related directly to patient 26 care and not of an administrative nature, or in lieu of 27 formal action seeking to determine whether a person may 28 be mentally or physically disabled in such a manner as to 29 endanger patients under that person's care. The Medical 30 Disciplinary Board shall, by rule, provide for the 31 reporting to it of all instances in which a person, -2- LRB9008900JSgc 1 licensed under this Act, who is impaired by reason of 2 age, drug or alcohol abuse or physical or mental 3 impairment, is under supervision and, where appropriate, 4 is in a program of rehabilitation. Such reports shall be 5 strictly confidential and may be reviewed and considered 6 only by the members of the Disciplinary Board, or by 7 authorized staff as provided by rules of the Disciplinary 8 Board. Provisions shall be made for the periodic report 9 of the status of any such person not less than twice 10 annually in order that the Disciplinary Board shall have 11 current information upon which to determine the status of 12 any such person. Such initial and periodic reports of 13 impaired physicians shall not be considered records 14 within the meaning of The State Records Act and shall be 15 disposed of, following a determination by the 16 Disciplinary Board that such reports are no longer 17 required, in a manner and at such time as the 18 Disciplinary Board shall determine by rule. The filing 19 of such reports shall be construed as the filing of a 20 report for purposes of subsection (C) of this Section. 21 (2) Professional associations. The President or 22 chief executive officer of any association or society, of 23 persons licensed under this Act, operating within this 24 State shall report to the Disciplinary Board when the 25 association or society renders a final determination that 26 a person has committed unprofessional conduct related 27 directly to patient care or that a person may be mentally 28 or physically disabled in such a manner as to endanger 29 patients under that person's care. 30 (3) Professional liability insurers. Every 31 insurance company which offers policies of professional 32 liability insurance to persons licensed under this Act, 33 or any other entity which seeks to indemnify the 34 professional liability of a person licensed under this -3- LRB9008900JSgc 1 Act, shall report to the Disciplinary Board the 2 settlement of any claim or cause of action, or final 3 judgment rendered in any cause of action, which alleged 4 negligence in the furnishing of medical care by such 5 licensed person when such settlement or final judgment is 6 in favor of the plaintiff. 7 (4) State's Attorneys. The State's Attorney of 8 each county shall report to the Disciplinary Board all 9 instances in which a person licensed under this Act is 10 convicted or otherwise found guilty of the commission of 11 any felony. The State's Attorney of each county may 12 report to the Disciplinary Board through a verified 13 complaint any instance in which the State's Attorney 14 believes that a physician has willfully violated the 15 notice requirements of the Parental Notice of Abortion 16 Act of 1995. 17 (5) State agencies. All agencies, boards, 18 commissions, departments, or other instrumentalities of 19 the government of the State of Illinois shall report to 20 the Disciplinary Board any instance arising in connection 21 with the operations of such agency, including the 22 administration of any law by such agency, in which a 23 person licensed under this Act has either committed an 24 act or acts which may be a violation of this Act or which 25 may constitute unprofessional conduct related directly to 26 patient care or which indicates that a person licensed 27 under this Act may be mentally or physically disabled in 28 such a manner as to endanger patients under that person's 29 care. 30 (B) Mandatory reporting. All reports required by items 31 (34), (35), and (36) of subsection (A) of Section 22 and by 32 Section 23 shall be submitted to the Disciplinary Board in a 33 timely fashion. The reports shall be filed in writing within 34 60 days after a determination that a report is required under -4- LRB9008900JSgc 1 this Act. All reports shall contain the following 2 information: 3 (1) The name, address and telephone number of the 4 person making the report. 5 (2) The name, address and telephone number of the 6 person who is the subject of the report. 7 (3) The name or other means of identification of 8 any patient or patients whose treatment is a subject of 9 the report, provided, however, no medical records may be 10 revealed without the written consent of the patient or 11 patients. The Department shall have the right to inform 12 patients of the right to provide written consent for the 13 Department to obtain copies of hospital and medical 14 records. When the Department has received written reports 15 concerning incidents required to be reported in items 16 (34), (35), and (36) of subsection (A) of Section 22, the 17 licensee's failure to report the incident to the 18 Department under those items shall not be the sole 19 grounds for disciplinary action. 20 (4) A brief description of the facts which gave 21 rise to the issuance of the report, including the dates 22 of any occurrences deemed to necessitate the filing of 23 the report. 24 (5) If court action is involved, the identity of 25 the court in which the action is filed, along with the 26 docket number and date of filing of the action. 27 (6) Any further pertinent information which the 28 reporting party deems to be an aid in the evaluation of 29 the report. 30 The Disciplinary Board or Department may exercise the 31 power under Section 38 of this Act to subpoena copies of 32 hospital or medical records in mandatory report cases 33 alleging death or permanent bodily injury when consent to 34 obtain records is not provided by a patient or legal -5- LRB9008900JSgc 1 representative. Appropriate rules shall be adopted by the 2 Department with the approval of the Disciplinary Board. 3 Nothing contained in this Section shall act to in any 4 way, waive or modify the confidentiality of medical reports 5 and committee reports to the extent provided by law. Any 6 information reported or disclosed shall be kept for the 7 confidential use of the Disciplinary Board, the Medical 8 Coordinators, the Disciplinary Board's attorneys, the medical 9 investigative staff, and authorized clerical staff, as 10 provided in this Act, and shall be afforded the same status 11 as is provided information concerning medical studies in Part 12 21 of Article VIII of the Code of Civil Procedure. 13 (C) Immunity from prosecution. Any individual or 14 organization acting in good faith, and not in a wilful and 15 wanton manner, in complying with this Act by providing any 16 report or other information to the Disciplinary Board, or 17 assisting in the investigation or preparation of such 18 information, or by participating in proceedings of the 19 Disciplinary Board, or by serving as a member of the 20 Disciplinary Board, shall not, as a result of such actions, 21 be subject to criminal prosecution or civil damages. 22 (D) Indemnification. Members of the Disciplinary Board, 23 the Medical Coordinators, the Disciplinary Board's attorneys, 24 the medical investigative staff, physicians retained under 25 contract to assist and advise the medical coordinators in the 26 investigation, and authorized clerical staff shall be 27 indemnified by the State for any actions occurring within the 28 scope of services on the Disciplinary Board, done in good 29 faith and not wilful and wanton in nature. The Attorney 30 General shall defend all such actions unless he or she 31 determines either that there would be a conflict of interest 32 in such representation or that the actions complained of were 33 not in good faith or were wilful and wanton. 34 Should the Attorney General decline representation, the -6- LRB9008900JSgc 1 member shall have the right to employ counsel of his or her 2 choice, whose fees shall be provided by the State, after 3 approval by the Attorney General, unless there is a 4 determination by a court that the member's actions were not 5 in good faith or were wilful and wanton. 6 The member must notify the Attorney General within 7 days 7 of receipt of notice of the initiation of any action 8 involving services of the Disciplinary Board. Failure to so 9 notify the Attorney General shall constitute an absolute 10 waiver of the right to a defense and indemnification. 11 The Attorney General shall determine within 7 days after 12 receiving such notice, whether he or she will undertake to 13 represent the member. 14 (E) Deliberations of Disciplinary Board. Upon the 15 receipt of any report called for by this Act, other than 16 those reports of impaired persons licensed under this Act 17 required pursuant to the rules of the Disciplinary Board, the 18 Disciplinary Board shall notify in writing, by certified 19 mail, the person who is the subject of the report. Such 20 notification shall be made within 30 days of receipt by the 21 Disciplinary Board of the report. 22 The notification shall include a written notice setting 23 forth the person's right to examine the report. Included in 24 such notification shall be the address at which the file is 25 maintained, the name of the custodian of the reports, and the 26 telephone number at which the custodian may be reached. The 27 person who is the subject of the report shall submit a 28 written statement responding, clarifying, adding to, or 29 proposing the amending of the report previously filed. The 30 statement shall become a permanent part of the file and must 31 be received by the Disciplinary Board no more than 60 days 32 after the date on which the person was notified by the 33 Disciplinary Board of the existence of the original report. 34 The Disciplinary Board shall review all reports received -7- LRB9008900JSgc 1 by it, together with any supporting information and 2 responding statements submitted by persons who are the 3 subject of reports. The review by the Disciplinary Board 4 shall be in a timely manner but in no event, shall the 5 Disciplinary Board's initial review of the material contained 6 in each disciplinary file be less than 61 days nor more than 7 180 days after the receipt of the initial report by the 8 Disciplinary Board. 9 When the Disciplinary Board makes its initial review of 10 the materials contained within its disciplinary files, the 11 Disciplinary Board shall, in writing, make a determination as 12 to whether there are sufficient facts to warrant further 13 investigation or action. Failure to make such determination 14 within the time provided shall be deemed to be a 15 determination that there are not sufficient facts to warrant 16 further investigation or action. 17 Should the Disciplinary Board find that there are not 18 sufficient facts to warrant further investigation, or action, 19 the report shall be accepted for filing and the matter shall 20 be deemed closed and so reported to the Director. The 21 Director shall then have 30 days to accept the Medical 22 Disciplinary Board's decision or request further 23 investigation. The individual or entity filing the original 24 report or complaint and the person who is the subject of the 25 report or complaint shall be notified in writing by the 26 DirectorDisciplinary Boardof any final action on their 27 report or complaint. 28 (F) Summary reports. The Disciplinary Board shall 29 prepare, on a timely basis, but in no event less than one 30 every other month, a summary report of final actions taken 31 upon disciplinary files maintained by the Disciplinary Board. 32 The summary reports shall be sent by the Disciplinary Board 33 to every health care facility licensed by the Illinois 34 Department of Public Health, every professional association -8- LRB9008900JSgc 1 and society of persons licensed under this Act functioning on 2 a statewide basis in this State, the American Medical 3 Association, the American Osteopathic Association, the 4 American Chiropractic Association, all insurers providing 5 professional liability insurance to persons licensed under 6 this Act in the State of Illinois, the Federation of State 7 Medical Licensing Boards, and the Illinois Pharmacists 8 Association. 9 (G) Any violation of this Section shall be a Class A 10 misdemeanor. 11 (H) If any such person violates the provisions of this 12 Section an action may be brought in the name of the People of 13 the State of Illinois, through the Attorney General of the 14 State of Illinois, for an order enjoining such violation or 15 for an order enforcing compliance with this Section. Upon 16 filing of a verified petition in such court, the court may 17 issue a temporary restraining order without notice or bond 18 and may preliminarily or permanently enjoin such violation, 19 and if it is established that such person has violated or is 20 violating the injunction, the court may punish the offender 21 for contempt of court. Proceedings under this paragraph 22 shall be in addition to, and not in lieu of, all other 23 remedies and penalties provided for by this Section. 24 (Source: P.A. 89-18, eff. 6-1-95; 89-702, eff. 7-1-97.) 25 (225 ILCS 60/36) (from Ch. 111, par. 4400-36) 26 Sec. 36. Upon the motion of either the Department or the 27 Disciplinary Board or upon the verified complaint in writing 28 of any person setting forth facts which, if proven, would 29 constitute grounds for suspension or revocation under Section 30 22 of this Act, the Department shall investigate the actions 31 of any person, so accused, who holds or represents that they 32 hold a license. Such person is hereinafter called the 33 accused. -9- LRB9008900JSgc 1 The Department shall, before suspending, revoking, 2 placing on probationary status, or taking any other 3 disciplinary action as the Department may deem proper with 4 regard to any license at least 30 days prior to the date set 5 for the hearing, notify the accused in writing of any charges 6 made and the time and place for a hearing of the charges 7 before the Disciplinary Board, direct them to file their 8 written answer thereto to the Disciplinary Board under oath 9 within 20 days after the service on them of such notice and 10 inform them that if they fail to file such answer default 11 will be taken against them and their license may be 12 suspended, revoked, placed on probationary status, or have 13 other disciplinary action, including limiting the scope, 14 nature or extent of their practice, as the Department may 15 deem proper taken with regard thereto. 16 Where a physician has been found, upon complaint and 17 investigation of the Department, and after hearing, to have 18 performed an abortion procedure in a wilful and wanton manner 19 upon a woman who was not pregnant at the time such abortion 20 procedure was performed, the Department shall automatically 21 revoke the license of such physician to practice medicine in 22 Illinois. 23 Such written notice and any notice in such proceedings 24 thereafter may be served by delivery of the same, personally, 25 to the accused person, or by mailing the same by registered 26 or certified mail to the address last theretofore specified 27 by the accused in their last notification to the Department. 28 All information gathered by the Department including 29 information subpoenaed under Section 23 or 38 of this Act and 30 the investigative file shall be kept for the confidential use 31 of the Disciplinary Board, the Medical Coordinators, the 32 Disciplinary Board's attorneys, the medical investigative 33 staff, and authorized clerical staff, as provided in this Act 34 and shall be afforded the same status as is provided -10- LRB9008900JSgc 1 information concerning medical studies in Part 21 of Article 2 VIII of the Code of Civil Procedure. 3 (Source: P.A. 85-4.) 4 (225 ILCS 60/38) (from Ch. 111, par. 4400-38) 5 Sec. 38. The Disciplinary Board or Department has power 6 to subpoena and bring before it any person in this State and 7 to take testimony either orally or by deposition, or both, 8 with the same fees and mileage and in the same manner as is 9 prescribed by law for judicial procedure in civil cases. 10 The Disciplinary Board, upon a determination that 11 probable cause exists that a violation of one or more of the 12 grounds for discipline listed in Section 22 has occurred or 13 is occurring, may subpoena the medical and hospital records 14 of individual patients of physicians licensed under this Act, 15 provided, that prior to the submission of such records to the 16 Disciplinary Board, all information indicating the identity 17 of the patient shall be removed and deleted. Notwithstanding 18 the foregoing, the Disciplinary Board and Department shall 19 possess the power to subpoena copies of hospital or medical 20 records in mandatory report cases under Section 23 alleging 21 death or permanent bodily injury when consent to obtain 22 records is not provided by a patient or legal representative. 23 All information including investigative files shall be 24 confidential and shall be afforded the same status as is 25 proved information concerning medical studies in Part 21 of 26 Article VIII of the Code of Civil Procedure. The use of such 27 records shall be restricted to members of the Disciplinary 28 Board, the medical coordinators, and appropriate staff of the 29 Department of Professional Regulation designated by the 30 Disciplinary Board for the purpose of determining the 31 existence of one or more grounds for discipline of the 32 physician as provided for by Section 22 of this Act. Any 33 such review of individual patients' records shall be -11- LRB9008900JSgc 1 conducted by the Disciplinary Board in strict 2 confidentiality, provided that such patient records shall be 3 admissible in a disciplinary hearing, before the Disciplinary 4 Board, when necessary to substantiate the grounds for 5 discipline alleged against the physician licensed under this 6 Act, and provided further, that nothing herein shall be 7 deemed to supersede the provisions of Part 21 of Article VIII 8 of the "Code of Civil Procedure", as now or hereafter 9 amended, to the extent applicable. 10 The Director, and any member of the Disciplinary Board 11 each have power to administer oaths at any hearing which the 12 Disciplinary Board or Department is authorized by law to 13 conduct. 14 The Disciplinary Board, upon a determination that 15 probable cause exists that a violation of one or more of the 16 grounds for discipline listed in Section 22 has occurred or 17 is occurring on the business premises of a physician licensed 18 under this Act, may issue an order authorizing an 19 appropriately qualified investigator employed by the 20 Department to enter upon the business premises with due 21 consideration for patient care of the subject of the 22 investigation so as to inspect the physical premises and 23 equipment and furnishings therein. No such order shall 24 include the right of inspection of business, medical, or 25 personnel records located on the premises. For purposes of 26 this Section, "business premises" is defined as the office or 27 offices where the physician conducts the practice of 28 medicine. Any such order shall expire and become void five 29 business days after its issuance by the Disciplinary Board. 30 The execution of any such order shall be valid only during 31 the normal business hours of the facility or office to be 32 inspected. 33 (Source: P.A. 85-1209.)