Full Text of HB5193 95th General Assembly
HB5193ham001 95TH GENERAL ASSEMBLY
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Health Care Availability and Access Committee
Filed: 3/11/2008
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09500HB5193ham001 |
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LRB095 15939 DRJ 48099 a |
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| AMENDMENT TO HOUSE BILL 5193
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| AMENDMENT NO. ______. Amend House Bill 5193 by replacing | 3 |
| everything after the enacting clause with the following:
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| "Section 5. The Hospital Licensing Act is amended by | 5 |
| changing Section 10.4 as follows:
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| (210 ILCS 85/10.4) (from Ch. 111 1/2, par. 151.4)
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| Sec. 10.4. Medical staff privileges.
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| (a) Any hospital licensed under this Act or any hospital | 9 |
| organized under the
University of Illinois Hospital Act shall, | 10 |
| prior to the granting of any medical
staff privileges to an | 11 |
| applicant, or renewing a current medical staff member's
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| privileges, request of the Director of Professional Regulation | 13 |
| information
concerning the licensure status and any | 14 |
| disciplinary action taken against the
applicant's or medical | 15 |
| staff member's license, except: (1) for medical personnel who
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| enter a hospital to obtain organs and tissues for transplant |
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| from a donor in accordance with the Illinois Anatomical Gift | 2 |
| Act; or (2) for medical personnel who have been granted | 3 |
| disaster privileges pursuant to the procedures and | 4 |
| requirements established by rules adopted by the Department. | 5 |
| Any hospital and any employees of the hospital or others | 6 |
| involved in granting privileges who, in good faith, grant | 7 |
| disaster privileges pursuant to this Section to respond to an | 8 |
| emergency shall not, as a result of their acts or omissions, be | 9 |
| liable for civil damages for granting or denying disaster | 10 |
| privileges except in the event of willful and wanton | 11 |
| misconduct, as that term is defined in Section 10.2 of this | 12 |
| Act. Individuals granted privileges who provide care in an | 13 |
| emergency situation, in good faith and without direct | 14 |
| compensation, shall not, as a result of their acts or | 15 |
| omissions, except for acts or omissions involving willful and | 16 |
| wanton misconduct, as that term is defined in Section 10.2 of | 17 |
| this Act, on the part of the person, be liable for civil | 18 |
| damages. The Director of
Professional Regulation shall | 19 |
| transmit, in writing and in a timely fashion,
such information | 20 |
| regarding the license of the applicant or the medical staff
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| member, including the record of imposition of any periods of
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| supervision or monitoring as a result of alcohol or
substance | 23 |
| abuse, as provided by Section 23 of the Medical
Practice Act of | 24 |
| 1987, and such information as may have been
submitted to the | 25 |
| Department indicating that the application
or medical staff | 26 |
| member has been denied, or has surrendered,
medical staff |
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| privileges at a hospital licensed under this
Act, or any | 2 |
| equivalent facility in another state or
territory of the United | 3 |
| States. The Director of Professional Regulation
shall define by | 4 |
| rule the period for timely response to such requests.
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| No transmittal of information by the Director of | 6 |
| Professional Regulation,
under this Section shall be to other | 7 |
| than the president, chief
operating officer, chief | 8 |
| administrative officer, or chief of
the medical staff of a | 9 |
| hospital licensed under this Act, a
hospital organized under | 10 |
| the University of Illinois Hospital Act, or a hospital
operated | 11 |
| by the United States, or any of its instrumentalities. The
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| information so transmitted shall be afforded the same status
as | 13 |
| is information concerning medical studies by Part 21 of Article | 14 |
| VIII of the
Code of Civil Procedure, as now or hereafter | 15 |
| amended.
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| (b) All hospitals licensed under this Act, except county | 17 |
| hospitals as
defined in subsection (c) of Section 15-1 of the | 18 |
| Illinois Public Aid Code,
shall comply with, and the medical | 19 |
| staff bylaws of these hospitals shall
include rules consistent | 20 |
| with, the provisions of this Section in granting,
limiting, | 21 |
| renewing, or denying medical staff membership and
clinical | 22 |
| staff privileges. Hospitals that require medical staff members | 23 |
| to
possess
faculty status with a specific institution of higher | 24 |
| education are not required
to comply with subsection (1) below | 25 |
| when the physician does not possess faculty
status.
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| (1) Minimum procedures for
pre-applicants and |
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| applicants for medical staff
membership shall include the | 2 |
| following:
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| (A) Written procedures relating to the acceptance | 4 |
| and processing of
pre-applicants or applicants for | 5 |
| medical staff membership, which should be
contained in
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| medical staff bylaws.
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| (B) Written procedures to be followed in | 8 |
| determining
a pre-applicant's or
an applicant's
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| qualifications for being granted medical staff | 10 |
| membership and privileges.
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| (C) Written criteria to be followed in evaluating
a | 12 |
| pre-applicant's or
an applicant's
qualifications.
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| (D) An evaluation of
a pre-applicant's or
an | 14 |
| applicant's current health status and current
license | 15 |
| status in Illinois.
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| (E) A written response to each
pre-applicant or
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| applicant that explains the reason or
reasons for any | 18 |
| adverse decision (including all reasons based in whole | 19 |
| or
in part on the applicant's medical qualifications or | 20 |
| any other basis,
including economic factors).
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| (2) Minimum procedures with respect to medical staff | 22 |
| and clinical
privilege determinations concerning current | 23 |
| members of the medical staff shall
include the following:
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| (A) A written notice of an adverse decision.
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| (B) An explanation of the reasons for an adverse | 26 |
| decision including all
reasons based on the quality of |
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| medical care or any other basis, including
economic | 2 |
| factors.
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| (C) A statement of the medical staff member's right | 4 |
| to request a fair
hearing on the adverse decision | 5 |
| before a hearing panel whose membership is
mutually | 6 |
| agreed upon by the medical staff and the hospital | 7 |
| governing board. The
hearing panel shall have | 8 |
| independent authority to recommend action to the
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| hospital governing board. Upon the request of the | 10 |
| medical staff member or the
hospital governing board, | 11 |
| the hearing panel shall make findings concerning the
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| nature of each basis for any adverse decision | 13 |
| recommended to and accepted by
the hospital governing | 14 |
| board.
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| (i) Nothing in this subparagraph (C) limits a | 16 |
| hospital's or medical
staff's right to summarily | 17 |
| suspend, without a prior hearing, a person's | 18 |
| medical
staff membership or clinical privileges if | 19 |
| the continuation of practice of a
medical staff | 20 |
| member constitutes an immediate danger to the | 21 |
| public, including
patients, visitors, and hospital | 22 |
| employees and staff. In the event that a hospital | 23 |
| or the medical staff imposes a summary suspension, | 24 |
| the Medical Executive Committee, or other | 25 |
| comparable governance committee of the medical | 26 |
| staff as specified in the bylaws, must meet as soon |
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| as is reasonably possible to review the suspension | 2 |
| and to recommend whether it should be affirmed, | 3 |
| lifted, expunged, or modified if the suspended | 4 |
| physician requests such review. A summary | 5 |
| suspension may not be implemented unless there is | 6 |
| actual documentation or other reliable information | 7 |
| that an immediate danger exists. This | 8 |
| documentation or information must be available at | 9 |
| the time the summary suspension decision is made | 10 |
| and when the decision is reviewed by the Medical | 11 |
| Executive Committee. If the Medical Executive | 12 |
| Committee recommends that the summary suspension | 13 |
| should be lifted, expunged, or modified, this | 14 |
| recommendation must be reviewed and considered by | 15 |
| the hospital governing board, or a committee of the | 16 |
| board, on an expedited basis. Nothing in this | 17 |
| subparagraph (C) shall affect the requirement that | 18 |
| any requested hearing must be commenced within 15 | 19 |
| days after the summary suspension and completed | 20 |
| without delay unless otherwise agreed to by the | 21 |
| parties. A fair hearing shall be
commenced within | 22 |
| 15 days after the suspension and completed without | 23 |
| delay , except that when the medical staff member's | 24 |
| license to practice has been suspended or revoked | 25 |
| by the State's licensing authority, no hearing | 26 |
| shall be necessary .
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| (ii) Nothing in this subparagraph (C) limits a | 2 |
| medical staff's right
to permit, in the medical | 3 |
| staff bylaws, summary suspension of membership or
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| clinical privileges in designated administrative | 5 |
| circumstances as specifically
approved by the | 6 |
| medical staff. This bylaw provision must | 7 |
| specifically describe
both the administrative | 8 |
| circumstance that can result in a summary | 9 |
| suspension
and the length of the summary | 10 |
| suspension. The opportunity for a fair hearing is
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| required for any administrative summary | 12 |
| suspension. Any requested hearing must
be | 13 |
| commenced within 15 days after the summary | 14 |
| suspension and completed without
delay. Adverse | 15 |
| decisions other than suspension or other | 16 |
| restrictions on the
treatment or admission of | 17 |
| patients may be imposed summarily and without a
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| hearing under designated administrative | 19 |
| circumstances as specifically provided
for in the | 20 |
| medical staff bylaws as approved by the medical | 21 |
| staff.
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| (iii) If a hospital exercises its option to | 23 |
| enter into an exclusive
contract and that contract | 24 |
| results in the total or partial termination or
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| reduction of medical staff membership or clinical | 26 |
| privileges of a current
medical staff member, the |
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| hospital shall provide the affected medical staff
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| member 60 days prior notice of the effect on his or | 3 |
| her medical staff
membership or privileges. An | 4 |
| affected medical staff member desiring a hearing
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| under subparagraph (C) of this paragraph (2) must | 6 |
| request the hearing within 14
days after the date | 7 |
| he or she is so notified. The requested hearing | 8 |
| shall be
commenced and completed (with a report and | 9 |
| recommendation to the affected
medical staff | 10 |
| member, hospital governing board, and medical | 11 |
| staff) within 30
days after the date of the medical | 12 |
| staff member's request. If agreed upon by
both the | 13 |
| medical staff and the hospital governing board, | 14 |
| the medical staff
bylaws may provide for longer | 15 |
| time periods.
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| (C-5) All peer review used for the purpose of | 17 |
| credentialing, privileging, disciplinary action, or | 18 |
| other recommendations affecting medical staff | 19 |
| membership or exercise of clinical privileges, whether | 20 |
| relying in whole or in part on internal or external | 21 |
| reviews, shall be conducted in accordance with the | 22 |
| medical staff bylaws and applicable rules, | 23 |
| regulations, or policies of the medical staff. If | 24 |
| external review is obtained, any adverse report | 25 |
| utilized shall be in writing and shall be made part of | 26 |
| the internal peer review process under the bylaws. The |
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| report shall also be shared with a medical staff peer | 2 |
| review committee and the individual under review. If | 3 |
| the medical staff peer review committee or the | 4 |
| individual under review prepares a written response to | 5 |
| the report of the external peer review within 30 days | 6 |
| after receiving such report, the governing board shall | 7 |
| consider the response prior to the implementation of | 8 |
| any final actions by the governing board which may | 9 |
| affect the individual's medical staff membership or | 10 |
| clinical privileges. Any peer review that involves | 11 |
| willful or wanton misconduct shall be subject to civil | 12 |
| damages as provided for under Section 10.2 of this Act.
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| (D) A statement of the member's right to inspect | 14 |
| all pertinent
information in the hospital's possession | 15 |
| with respect to the decision.
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| (E) A statement of the member's right to present | 17 |
| witnesses and other
evidence at the hearing on the | 18 |
| decision.
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| (F) A written notice and written explanation of the | 20 |
| decision resulting
from the hearing.
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| (F-5) A written notice of a final adverse decision | 22 |
| by a hospital
governing board.
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| (G) Notice given 15 days before implementation of | 24 |
| an adverse medical
staff membership or clinical | 25 |
| privileges decision based substantially on
economic | 26 |
| factors. This notice shall be given after the medical |
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| staff member
exhausts all applicable procedures under | 2 |
| this Section, including item (iii) of
subparagraph (C) | 3 |
| of this paragraph (2), and under the medical staff | 4 |
| bylaws in
order to allow sufficient time for the | 5 |
| orderly provision of patient care.
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| (H) Nothing in this paragraph (2) of this | 7 |
| subsection (b) limits a
medical staff member's right to | 8 |
| waive, in writing, the rights provided in
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| subparagraphs (A) through (G) of this paragraph (2) of | 10 |
| this subsection (b) upon
being granted the written | 11 |
| exclusive right to provide particular services at a
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| hospital, either individually or as a member of a | 13 |
| group. If an exclusive
contract is signed by a | 14 |
| representative of a group of physicians, a waiver
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| contained in the contract shall apply to all members of | 16 |
| the group unless stated
otherwise in the contract.
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| (3) Every adverse medical staff membership and | 18 |
| clinical privilege decision
based substantially on | 19 |
| economic factors shall be reported to the Hospital
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| Licensing Board before the decision takes effect. These | 21 |
| reports shall not be
disclosed in any form that reveals the | 22 |
| identity of any hospital or physician.
These reports shall | 23 |
| be utilized to study the effects that hospital medical
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| staff membership and clinical privilege decisions based | 25 |
| upon economic factors
have on access to care and the | 26 |
| availability of physician services. The
Hospital Licensing |
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| Board shall submit an initial study to the Governor and the
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| General Assembly by January 1, 1996, and subsequent reports | 3 |
| shall be submitted
periodically thereafter.
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| (4) As used in this Section:
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| "Adverse decision" means a decision reducing, | 6 |
| restricting, suspending,
revoking, denying, or not | 7 |
| renewing medical staff membership or clinical
privileges.
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| "Economic factor" means any information or reasons for | 9 |
| decisions unrelated
to quality of care or professional | 10 |
| competency.
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| "Pre-applicant" means a physician licensed to practice | 12 |
| medicine in all
its
branches who requests an application | 13 |
| for medical staff membership or
privileges.
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| "Privilege" means permission to provide
medical or | 15 |
| other patient care services and permission to use hospital
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| resources, including equipment, facilities and personnel | 17 |
| that are necessary to
effectively provide medical or other | 18 |
| patient care services. This definition
shall not be | 19 |
| construed to
require a hospital to acquire additional | 20 |
| equipment, facilities, or personnel to
accommodate the | 21 |
| granting of privileges.
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| (5) Any amendment to medical staff bylaws required | 23 |
| because of
this amendatory Act of the 91st General Assembly | 24 |
| shall be adopted on or
before July 1, 2001.
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| (c) All hospitals shall consult with the medical staff | 26 |
| prior to closing
membership in the entire or any portion of the |
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| medical staff or a department.
If
the hospital closes | 2 |
| membership in the medical staff, any portion of the medical
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| staff, or the department over the objections of the medical | 4 |
| staff, then the
hospital
shall provide a detailed written | 5 |
| explanation for the decision to the medical
staff
10 days prior | 6 |
| to the effective date of any closure. No applications need to | 7 |
| be
provided when membership in the medical staff or any | 8 |
| relevant portion of the
medical staff is closed.
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| (Source: P.A. 95-331, eff. 8-21-07.)
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| Section 99. Effective date. This Act takes effect June 1, | 11 |
| 2008.".
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