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92_SB0933enr SB933 Enrolled LRB9205026LBmb 1 AN ACT concerning health facilities. 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 adding Section 10.8 as follows: 6 (210 ILCS 85/10.8 new) 7 Sec. 10.8. Requirements for employment of physicians. 8 (a) Physician employment by hospitals and hospital 9 affiliates. Employing entities may employ physicians to 10 practice medicine in all of its branches provided that the 11 following requirements are met: 12 (1) The employed physician is a member of the 13 medical staff of either the hospital or hospital 14 affiliate. If a hospital affiliate decides to have a 15 medical staff, its medical staff shall be organized in 16 accordance with written bylaws where the affiliate 17 medical staff is responsible for making recommendations 18 to the governing body of the affiliate regarding all 19 quality assurance activities and safeguarding 20 professional autonomy. The affiliate medical staff 21 bylaws may not be unilaterally changed by the governing 22 body of the affiliate. Nothing in this Section requires 23 hospital affiliates to have a medical staff. 24 (2) Independent physicians, who are not employed by 25 an employing entity, periodically review the quality of 26 the medical services provided by the employed physician 27 to continuously improve patient care. 28 (3) The employing entity and the employed physician 29 sign a statement acknowledging that the employer shall 30 not unreasonably exercise control, direct, or interfere 31 with the employed physician's exercise and execution of SB933 Enrolled -2- LRB9205026LBmb 1 his or her professional judgment in a manner that 2 adversely affects the employed physician's ability to 3 provide quality care to patients. This signed statement 4 shall take the form of a provision in the physician's 5 employment contract or a separate signed document from 6 the employing entity to the employed physician. This 7 statement shall state: "As the employer of a physician, 8 (employer's name) shall not unreasonably exercise 9 control, direct, or interfere with the employed 10 physician's exercise and execution of his or her 11 professional judgment in a manner that adversely affects 12 the employed physician's ability to provide quality care 13 to patients." 14 (4) The employing entity shall establish a mutually 15 agreed upon independent review process with criteria 16 under which an employed physician may seek review of the 17 alleged violation of this Section by physicians who are 18 not employed by the employing entity. The affiliate may 19 arrange with the hospital medical staff to conduct these 20 reviews. The independent physicians shall make findings 21 and recommendations to the employing entity and the 22 employed physician within 30 days of the conclusion of 23 the gathering of the relevant information. 24 (b) Definitions. For the purpose of this Section: 25 "Employing entity" means a hospital licensed under the 26 Hospital Licensing Act or a hospital affiliate. 27 "Employed physician" means a physician who receives an 28 IRS W-2 form, or any successor federal income tax form, from 29 an employing entity. 30 "Hospital" means a hospital licensed under the Hospital 31 Licensing Act, except county hospitals as defined in 32 subsection (c) of Section 15-1 of the Public Aid Code. 33 "Hospital affiliate" means a corporation, partnership, 34 joint venture, limited liability company, or similar SB933 Enrolled -3- LRB9205026LBmb 1 organization, other than a hospital, that is devoted 2 primarily to the provision, management, or support of health 3 care services and that directly or indirectly controls, is 4 controlled by, or is under common control of the hospital. 5 "Control" means having at least an equal or a majority 6 ownership or membership interest. A hospital affiliate shall 7 be 100% owned or controlled by any combination of hospitals, 8 their parent corporations, or physicians licensed to practice 9 medicine in all its branches in Illinois. "Hospital 10 affiliate" does not include a health maintenance organization 11 regulated under the Health Maintenance Organization Act. 12 "Physician" means an individual licensed to practice 13 medicine in all its branches in Illinois. 14 "Professional judgment" means the exercise of a 15 physician's independent clinical judgment in providing 16 medically appropriate diagnoses, care, and treatment to a 17 particular patient at a particular time. Situations in which 18 an employing entity does not interfere with an employed 19 physician's professional judgment include, without 20 limitation, the following: 21 (1) practice restrictions based upon peer review of 22 the physician's clinical practice to assess quality of 23 care and utilization of resources in accordance with 24 applicable bylaws; 25 (2) supervision of physicians by appropriately 26 licensed medical directors, medical school faculty, 27 department chairpersons or directors, or supervising 28 physicians; 29 (3) written statements of ethical or religious 30 directives; and 31 (4) reasonable referral restrictions that do not, 32 in the reasonable professional judgment of the physician, 33 adversely affect the health or welfare of the patient. 34 (c) Private enforcement. An employed physician aggrieved SB933 Enrolled -4- LRB9205026LBmb 1 by a violation of this Act may seek to obtain an injunction 2 or reinstatement of employment with the employing entity as 3 the court may deem appropriate. Nothing in this Section 4 limits or abrogates any common law cause of action. Nothing 5 in this Section shall be deemed to alter the law of 6 negligence. 7 (d) Department enforcement. The Department may enforce 8 the provisions of this Section, but nothing in this Section 9 shall require or permit the Department to license, certify, 10 or otherwise investigate the activities of a hospital 11 affiliate not otherwise required to be licensed by the 12 Department. 13 (e) Retaliation prohibited. No employing entity shall 14 retaliate against any employed physician for requesting a 15 hearing or review under this Section. No action may be 16 taken that affects the ability of a physician to practice 17 during this review, except in circumstances where the medical 18 staff bylaws authorize summary suspension. 19 (f) Physician collaboration. No employing entity shall 20 adopt or enforce, either formally or informally, any 21 policy, rule, regulation, or practice inconsistent with the 22 provision of adequate collaboration, including medical 23 direction of licensed advanced practice nurses or 24 supervision of licensed physician assistants and delegation 25 to other personnel under Section 54.5 of the Medical Practice 26 Act of 1987. 27 (g) Physician disciplinary actions. Nothing in this 28 Section shall be construed to limit or prohibit the governing 29 body of an employing entity or its medical staff, if any, 30 from taking disciplinary actions against a physician as 31 permitted by law. 32 (h) Physician review. Nothing in this Section shall be 33 construed to prohibit a hospital or hospital affiliate from 34 making a determination not to pay for a particular health SB933 Enrolled -5- LRB9205026LBmb 1 care service or to prohibit a medical group, independent 2 practice association, hospital medical staff, or hospital 3 governing body from enforcing reasonable peer review or 4 utilization review protocols or determining whether the 5 employed physician complied with those protocols. 6 (i) Review. Nothing in this Section may be used or 7 construed to establish that any activity of a hospital or 8 hospital affiliate is subject to review under the Illinois 9 Health Facilities Planning Act. 10 (j) Rules. The Department shall adopt any rules 11 necessary to implement this Section. 12 Section 99. Effective date. This Act takes effect on 13 September 30, 2001.