State of Illinois
92nd General Assembly
Legislation

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92_SB1798eng

 
SB1798 Engrossed                               LRB9213323ACdv

 1        AN ACT concerning hospitals.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.   The  Hospital  Licensing  Act is amended by
 5    changing Section 10.4 as follows:

 6        (210 ILCS 85/10.4) (from Ch. 111 1/2, par. 151.4)
 7        Sec. 10.4. Medical staff privileges.
 8        (a)  A Any  hospital  licensed  under  this  Act  or  any
 9    hospital  organized under the University of Illinois Hospital
10    Act shall,  prior  to  the  granting  of  any  medical  staff
11    privileges  to  an  applicant,  or renewing a current medical
12    staff  member's  privileges,  request  of  the  Director   of
13    Professional  Regulation information concerning the licensure
14    status  and  any  disciplinary  action  taken   against   the
15    applicant's  or  medical  staff  member's license, except for
16    medical personnel who enter a hospital to obtain  organs  and
17    tissues  for  transplant  from a deceased donor in accordance
18    with  the  Uniform  Anatomical  Gift  Act.  The  Director  of
19    Professional Regulation shall transmit, in writing and  in  a
20    timely fashion, such information regarding the license of the
21    applicant  or  the medical staff member, including the record
22    of imposition of any periods of supervision or monitoring  as
23    a  result  of  alcohol  or  substance  abuse,  as provided by
24    Section 23 of the Medical Practice  Act  of  1987,  and  such
25    information  as  may  have  been  submitted to the Department
26    indicating that the application or medical staff  member  has
27    been  denied, or has surrendered, medical staff privileges at
28    a  hospital  licensed  under  this  Act,  or  any  equivalent
29    facility in another state or territory of the United  States.
30    The  Director of Professional Regulation shall define by rule
31    the period for timely response to such requests.
 
SB1798 Engrossed            -2-                LRB9213323ACdv
 1        No  transmittal  of  information  by  the   Director   of
 2    Professional Regulation, under this Section shall be to other
 3    than   the   president,   chief   operating   officer,  chief
 4    administrative officer, or chief of the medical  staff  of  a
 5    hospital  licensed under this Act, a hospital organized under
 6    the University  of  Illinois  Hospital  Act,  or  a  hospital
 7    operated    by   the   United   States,   or   any   of   its
 8    instrumentalities.  The information so transmitted  shall  be
 9    afforded the same status as is information concerning medical
10    studies  by  Part  21  of  Article  VIII of the Code of Civil
11    Procedure, as now or hereafter amended.
12        (b)  All hospitals licensed under this Act, except county
13    hospitals as defined in subsection (c) of Section 15-1 of the
14    Illinois Public Aid Code, shall comply with, and the  medical
15    staff   bylaws   of   these  hospitals  shall  include  rules
16    consistent with, the provisions of this Section in  granting,
17    limiting,  renewing,  or denying medical staff membership and
18    clinical staff privileges.  Hospitals  that  require  medical
19    staff  members  to  possess  faculty  status  with a specific
20    institution of higher education are not  required  to  comply
21    with subsection (1) below when the physician does not possess
22    faculty status.
23             (1)  Minimum   procedures   for  pre-applicants  and
24        applicants for medical staff membership shall include the
25        following:
26                  (A)  Written   procedures   relating   to   the
27             acceptance  and  processing  of  pre-applicants   or
28             applicants   for  medical  staff  membership,  which
29             should be contained in medical staff bylaws.
30                  (B)  Written  procedures  to  be  followed   in
31             determining  a  pre-applicant's  or  an  applicant's
32             qualifications   for  being  granted  medical  staff
33             membership and privileges.
34                  (C)  Written  criteria  to   be   followed   in
 
SB1798 Engrossed            -3-                LRB9213323ACdv
 1             evaluating   a  pre-applicant's  or  an  applicant's
 2             qualifications.
 3                  (D)  An evaluation of a pre-applicant's  or  an
 4             applicant's   current   health  status  and  current
 5             license status in Illinois.
 6                  (E)  A written response to  each  pre-applicant
 7             or applicant that explains the reason or reasons for
 8             any adverse decision (including all reasons based in
 9             whole   or   in  part  on  the  applicant's  medical
10             qualifications  or  any   other   basis,   including
11             economic factors).
12             (2)  Minimum  procedures  with  respect  to  medical
13        staff  and  clinical  privilege determinations concerning
14        current members of the medical staff  shall  include  the
15        following:
16                  (A)  A written notice of an adverse decision.
17                  (B)  An  explanation  of  the  reasons  for  an
18             adverse  decision including all reasons based on the
19             quality  of  medical  care  or  any   other   basis,
20             including economic factors.
21                  (C)  A  statement of the medical staff member's
22             right to request  a  fair  hearing  on  the  adverse
23             decision  before a hearing panel whose membership is
24             mutually agreed upon by the medical  staff  and  the
25             hospital  governing  board.  The hearing panel shall
26             have independent authority to  recommend  action  to
27             the  hospital  governing  board. Upon the request of
28             the medical staff member or the  hospital  governing
29             board,   the   hearing  panel  shall  make  findings
30             concerning the nature of each basis for any  adverse
31             decision recommended to and accepted by the hospital
32             governing board.
33                       (i)  Nothing   in  this  subparagraph  (C)
34                  limits a hospital's or medical staff's right to
 
SB1798 Engrossed            -4-                LRB9213323ACdv
 1                  summarily suspend, without a prior  hearing,  a
 2                  person's  medical  staff membership or clinical
 3                  privileges if the continuation of practice of a
 4                  medical staff member constitutes  an  immediate
 5                  danger   to  the  public,  including  patients,
 6                  visitors, and hospital employees and  staff.  A
 7                  fair  hearing shall be commenced within 15 days
 8                  after  the  suspension  and  completed  without
 9                  delay.
10                       (ii)  Nothing  in  this  subparagraph  (C)
11                  limits a medical staff's right  to  permit,  in
12                  the medical staff bylaws, summary suspension of
13                  membership or clinical privileges in designated
14                  administrative  circumstances  as  specifically
15                  approved  by  the  medical  staff.  This  bylaw
16                  provision  must  specifically describe both the
17                  administrative circumstance that can result  in
18                  a  summary  suspension  and  the  length of the
19                  summary suspension. The opportunity for a  fair
20                  hearing  is  required  for  any  administrative
21                  summary  suspension. Any requested hearing must
22                  be commenced within 15 days after  the  summary
23                  suspension and completed without delay. Adverse
24                  decisions   other   than  suspension  or  other
25                  restrictions on the treatment or  admission  of
26                  patients may be imposed summarily and without a
27                  hearing    under    designated   administrative
28                  circumstances as specifically provided  for  in
29                  the  medical  staff  bylaws  as approved by the
30                  medical staff.
31                       (iii)  If a hospital exercises its  option
32                  to  enter  into  an exclusive contract and that
33                  contract  results  in  the  total  or   partial
34                  termination   or  reduction  of  medical  staff
 
SB1798 Engrossed            -5-                LRB9213323ACdv
 1                  membership or clinical privileges of a  current
 2                  medical   staff   member,  the  hospital  shall
 3                  provide the affected medical  staff  member  60
 4                  days  prior  notice of the effect on his or her
 5                  medical  staff  membership  or  privileges.  An
 6                  affected  medical  staff  member   desiring   a
 7                  hearing   under   subparagraph   (C)   of  this
 8                  paragraph (2) must request the  hearing  within
 9                  14  days  after  the  date  he  or  she  is  so
10                  notified.   The   requested  hearing  shall  be
11                  commenced and  completed  (with  a  report  and
12                  recommendation  to  the  affected medical staff
13                  member, hospital governing board,  and  medical
14                  staff)  within  30  days  after the date of the
15                  medical staff member's request. If agreed  upon
16                  by  both  the  medical  staff  and the hospital
17                  governing board, the medical staff  bylaws  may
18                  provide for longer time periods.
19                  (D)  A  statement  of  the  member's  right  to
20             inspect  all pertinent information in the hospital's
21             possession with respect to the decision.
22                  (E)  A  statement  of  the  member's  right  to
23             present witnesses and other evidence at the  hearing
24             on the decision.
25                  (F)  A  written  notice and written explanation
26             of the decision resulting from the hearing.
27                  (F-5)  A written  notice  of  a  final  adverse
28             decision by a hospital governing board.
29                  (G)  Notice given 15 days before implementation
30             of  an  adverse medical staff membership or clinical
31             privileges decision based substantially on  economic
32             factors.  This  notice  shall  be  given  after  the
33             medical   staff   member   exhausts  all  applicable
34             procedures under this Section, including item  (iii)
 
SB1798 Engrossed            -6-                LRB9213323ACdv
 1             of subparagraph (C) of this paragraph (2), and under
 2             the   medical   staff   bylaws  in  order  to  allow
 3             sufficient time for the orderly provision of patient
 4             care.
 5                  (H)  Nothing in  this  paragraph  (2)  of  this
 6             subsection (b) limits a medical staff member's right
 7             to   waive,  in  writing,  the  rights  provided  in
 8             subparagraphs (A) through (G) of this paragraph  (2)
 9             of  this  subsection  (b)  upon  being  granted  the
10             written   exclusive   right  to  provide  particular
11             services at a hospital, either individually or as  a
12             member  of  a  group.  If  an  exclusive contract is
13             signed by a representative of a group of physicians,
14             a waiver contained in the contract  shall  apply  to
15             all  members of the group unless stated otherwise in
16             the contract.
17             (3)  Every  adverse  medical  staff  membership  and
18        clinical  privilege  decision  based   substantially   on
19        economic  factors  shall  be  reported  to  the  Hospital
20        Licensing  Board before the decision takes effect.  These
21        reports shall not be disclosed in any form  that  reveals
22        the identity of any hospital or physician.  These reports
23        shall  be  utilized  to  study  the effects that hospital
24        medical staff membership and clinical privilege decisions
25        based upon economic factors have on access  to  care  and
26        the  availability  of  physician  services.  The Hospital
27        Licensing Board shall submit  an  initial  study  to  the
28        Governor and the General Assembly by January 1, 1996, and
29        subsequent   reports   shall  be  submitted  periodically
30        thereafter.
31             (4)  As used in this Section:
32             "Adverse  decision"  means  a   decision   reducing,
33        restricting,   suspending,   revoking,  denying,  or  not
34        renewing medical staff membership or clinical privileges.
 
SB1798 Engrossed            -7-                LRB9213323ACdv
 1             "Economic factor" means any information  or  reasons
 2        for   decisions   unrelated   to   quality   of  care  or
 3        professional competency.
 4             "Pre-applicant"  means  a  physician   licensed   to
 5        practice  medicine  in  all  its branches who requests an
 6        application for medical staff membership or privileges.
 7             "Privilege" means permission to provide  medical  or
 8        other   patient  care  services  and  permission  to  use
 9        hospital resources, including equipment,  facilities  and
10        personnel  that  are  necessary  to  effectively  provide
11        medical  or  other patient care services. This definition
12        shall not be construed to require a hospital  to  acquire
13        additional   equipment,   facilities,   or  personnel  to
14        accommodate the granting of privileges.
15             (5)  Any amendment to medical staff bylaws  required
16        because  of  this  amendatory  Act  of  the  91st General
17        Assembly shall be adopted on or before July 1, 2001.
18        (c)  All hospitals shall consult with the  medical  staff
19    prior  to  closing membership in the entire or any portion of
20    the medical staff or a department.  If  the  hospital  closes
21    membership  in  the medical staff, any portion of the medical
22    staff, or the department over the objections of  the  medical
23    staff,  then  the  hospital  shall provide a detailed written
24    explanation for the decision to the  medical  staff  10  days
25    prior  to the effective date of any closure.  No applications
26    need to be provided when membership in the medical  staff  or
27    any relevant portion of the medical staff is closed.
28    (Source:  P.A.  90-14,  eff.  7-1-97;  90-149,  eff.  1-1-98;
29    90-655, eff. 7-30-98; 91-166, eff. 1-1-00.)

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