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92_SB0933ham002
LRB9205026LBgcam06
1 AMENDMENT TO SENATE BILL 933
2 AMENDMENT NO. . Amend Senate Bill 933, AS AMENDED,
3 by replacing everything after the enacting clause with the
4 following:
5 "Section 5. The Hospital Licensing Act is amended by
6 adding Section 10.8 as follows:
7 (210 ILCS 85/10.8 new)
8 Sec. 10.8. Requirements for employment of physicians.
9 (a) Physician employment by hospitals and hospital
10 affiliates. Employing entities may employ physicians to
11 practice medicine in all of its branches provided that the
12 following requirements are met:
13 (1) The employed physician is a member of the
14 medical staff of either the hospital or hospital
15 affiliate. If a hospital affiliate decides to have a
16 medical staff, its medical staff shall be organized in
17 accordance with written bylaws where the affiliate
18 medical staff is responsible for making recommendations
19 to the governing body of the affiliate regarding all
20 quality assurance activities and safeguarding
21 professional autonomy. The affiliate medical staff
22 bylaws may not be unilaterally changed by the governing
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1 body of the affiliate. Nothing in this Section requires
2 hospital affiliates to have a medical staff.
3 (2) Independent physicians, who are not employed by
4 an employing entity, periodically review the quality of
5 the medical services provided by the employed physician
6 to continuously improve patient care.
7 (3) The employing entity and the employed physician
8 sign a statement acknowledging that the employer shall
9 not unreasonably exercise control, direct, or interfere
10 with the employed physician's exercise and execution of
11 his or her professional judgment in a manner that
12 adversely affects the employed physician's ability to
13 provide quality care to patients. This signed statement
14 shall take the form of a provision in the physician's
15 employment contract or a separate signed document from
16 the employing entity to the employed physician. This
17 statement shall state: "As the employer of a physician,
18 (employer's name) shall not unreasonably exercise
19 control, direct, or interfere with the employed
20 physician's exercise and execution of his or her
21 professional judgment in a manner that adversely affects
22 the employed physician's ability to provide quality care
23 to patients."
24 (4) The employing entity shall establish a mutually
25 agreed upon independent review process with criteria
26 under which an employed physician may seek review of the
27 alleged violation of this Section by physicians who are
28 not employed by the employing entity. The affiliate may
29 arrange with the hospital medical staff to conduct these
30 reviews. The independent physicians shall make findings
31 and recommendations to the employing entity and the
32 employed physician within 30 days of the conclusion of
33 the gathering of the relevant information.
34 (b) Definitions. For the purpose of this Section:
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1 "Employing entity" means a hospital licensed under the
2 Hospital Licensing Act or a hospital affiliate.
3 "Employed physician" means a physician who receives an
4 IRS W-2 form, or any successor federal income tax form, from
5 an employing entity.
6 "Hospital" means a hospital licensed under the Hospital
7 Licensing Act, except county hospitals as defined in
8 subsection (c) of Section 15-1 of the Public Aid Code.
9 "Hospital affiliate" means a corporation, partnership,
10 joint venture, limited liability company, or similar
11 organization, other than a hospital, that is devoted
12 primarily to the provision, management, or support of health
13 care services and that directly or indirectly controls, is
14 controlled by, or is under common control of the hospital.
15 "Control" means having at least an equal or a majority
16 ownership or membership interest. A hospital affiliate shall
17 be 100% owned or controlled by any combination of hospitals,
18 their parent corporations, or physicians licensed to practice
19 medicine in all its branches in Illinois. "Hospital
20 affiliate" does not include a health maintenance organization
21 regulated under the Health Maintenance Organization Act.
22 "Physician" means an individual licensed to practice
23 medicine in all its branches in Illinois.
24 "Professional judgment" means the exercise of a
25 physician's independent clinical judgment in providing
26 medically appropriate diagnoses, care, and treatment to a
27 particular patient at a particular time. Situations in which
28 an employing entity does not interfere with an employed
29 physician's professional judgment include, without
30 limitation, the following:
31 (1) practice restrictions based upon peer review of
32 the physician's clinical practice to assess quality of
33 care and utilization of resources in accordance with
34 applicable bylaws;
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1 (2) supervision of physicians by appropriately
2 licensed medical directors, medical school faculty,
3 department chairpersons or directors, or supervising
4 physicians;
5 (3) written statements of ethical or religious
6 directives; and
7 (4) reasonable referral restrictions that do not,
8 in the reasonable professional judgment of the physician,
9 adversely affect the health or welfare of the patient.
10 (c) Private enforcement. An employed physician aggrieved
11 by a violation of this Act may seek to obtain an injunction
12 or reinstatement of employment with the employing entity as
13 the court may deem appropriate. Nothing in this Section
14 limits or abrogates any common law cause of action. Nothing
15 in this Section shall be deemed to alter the law of
16 negligence.
17 (d) Department enforcement. The Department may enforce
18 the provisions of this Section, but nothing in this Section
19 shall require or permit the Department to license, certify,
20 or otherwise investigate the activities of a hospital
21 affiliate not otherwise required to be licensed by the
22 Department.
23 (e) Retaliation prohibited. No employing entity shall
24 retaliate against any employed physician for requesting a
25 hearing or review under this Section. No action may be
26 taken that affects the ability of a physician to practice
27 during this review, except in circumstances where the medical
28 staff bylaws authorize summary suspension.
29 (f) Physician collaboration. No employing entity shall
30 adopt or enforce, either formally or informally, any
31 policy, rule, regulation, or practice inconsistent with the
32 provision of adequate collaboration, including medical
33 direction of licensed advanced practice nurses or
34 supervision of licensed physician assistants and delegation
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1 to other personnel under Section 54.5 of the Medical Practice
2 Act of 1987.
3 (g) Physician disciplinary actions. Nothing in this
4 Section shall be construed to limit or prohibit the governing
5 body of an employing entity or its medical staff, if any,
6 from taking disciplinary actions against a physician as
7 permitted by law.
8 (h) Physician review. Nothing in this Section shall be
9 construed to prohibit a hospital or hospital affiliate from
10 making a determination not to pay for a particular health
11 care service or to prohibit a medical group, independent
12 practice association, hospital medical staff, or hospital
13 governing body from enforcing reasonable peer review or
14 utilization review protocols or determining whether the
15 employed physician complied with those protocols.
16 (i) Review. Nothing in this Section may be used or
17 construed to establish that any activity of a hospital or
18 hospital affiliate is subject to review under the Illinois
19 Health Facilities Planning Act.
20 (j) Rules. The Department shall adopt any rules
21 necessary to implement this Section.
22 Section 99. Effective date. This Act takes effect on
23 September 30, 2001.".