SB 475 — INS-CHIP COAL MINER CVG

h.(5) (3) It shall be certified in such filing by an officer of the company and a qualified actuary that the company’s rates are based on sound actuarial principles and are not inconsistent with the company’s experience.

EstablishThe rules,Secretary conditionsmay request any additional statistical data and proceduresother forpertinent reinsuringSB0475 risksEnrolled under- this5 Act.- LRB094 07024 LJB 37163 b information necessary to determine the manner the company used to set the filed rates and the reasonableness of those rates.

i.This data and information shall be made available, on a company-by-company basis, to the general public.

Employ(d) andIf fixafter a public hearing the compensationSecretary ofDirector employees.finds:

Such(1) employeesthat mayany berate, paidrating onplan aor warrantrating issuedsystem byviolates the Stateprovisions Treasurerof pursuantthis Section applicable to ait, payrollhe vouchershall certifiedmay byissue an order to the Boardcompany andwhich drawnhas bybeen the Comptrollersubject againstof appropriationsthe orhearing trustspecifying fundsin heldwhat byrespects such violation exists and, in that order, may adjust the Staterate Treasurer.stating when, within a reasonable period of time, the further use of such rate or rating system by such company in contracts of insurance made thereafter shall be prohibited;

j.(2) that the violation of any of the provisions of this Section applicable to it by any company which has been the subject of the hearing was wilful or that any company has repeatedly violated any provision of this Section, he may take either or both of the following actions:

Enter(A) intoSuspend intergovernmentalsuspend cooperationor agreementsrevoke, within otherwhole agencies or entitiesin ofpart, State government for the purposecertificate of sharingauthority the cost of providingsuch healthcompany carewith servicesrespect thatto are otherwise authorized by this Act for children who are both plan participants and eligible for financial assistance from the Divisionclass of Specializedinsurance Carewhich forhas Childrenbeen of the Universitysubject of Illinois.the hearing.

k.(B) Impose a penalty of up to $1,000 against the company for each violation.

EstablishEach conditionsday andduring procedures under which thea planviolation may,occurs ifconstitutes fundsa permit,separate discountviolation. or subsidize premium rates that SB0475 Engrossed - 3 - LRB094 07024 LJB 37163 b are paid directly by senior citizens, as defined by the Board, by unemployed or retired coal miners who are federally eligible and whose employer-provided health insurance coverage was terminated on September 28, 2004, and by other plan participants, who are retired or unemployed and meet other qualifications.

l.The burden is on the company to justify the rate or proposed rate at the public hearing.

Establish(e) andEvery maintaincompany thewriting Planmedical Fundliability authorizedinsurance in Sectionthis 3State shall offer to each of thisits Act,medical whichliability shallinsureds bethe dividedoption intoto separatemake accounts,premium payments in quarterly installments as follows:prescribed by and filed with the Secretary.

(1)This accountsoffer toshall fundbe theincluded administrative,in claim,the andinitial otheroffer expensesor ofin the Planfirst associatedpolicy withrenewal eligibleoccurring personsafter whothe qualifyeffective fordate Planof coveragethis underamendatory SectionAct 7 of thisthe Act,94th whichGeneral shallAssembly, consistbut of:no earlier than January 1, 2006.

(A)SB0475 premiumsEnrolled paid- on6 behalf- ofLRB094 covered07024 persons;LJB 37163 b (f) Every company writing medical liability insurance is encouraged, but not required, to offer the opportunity for participation in a plan offering deductibles to its medical liability insureds.

(B)Any appropriatedplan fundsto andoffer otherdeductibles revenuesshall collectedbe orfiled receivedwith by the Board;Department.

(C)(g) reservesEvery forcompany futurewriting lossesmedical maintainedliability byinsurance theis Board;encouraged, but not required, to offer their medical liability insureds a plan providing premium discounts for participation in risk management activities.

andAny (D)such interestplan earningsshall frombe investmentreported ofto the fundsDepartment. in the Plan Fund or any of its accounts other than the funds in the account established under item 2 of this subsection;

(2)(h) anA account,company towriting bemedical denominatedliability theinsurance federallyin eligibleIllinois individualsmust account,give to180 funddays’ thenotice administrative,before claim,the andcompany otherdiscontinues expenses of the Planwriting associated with federally eligible individuals who qualify for Plan coverage under Section 15 of thismedical Act,liability whichinsurance shallin consistIllinois. of:

(A) premiums paid on behalf of covered persons;

(B) assessments and other revenues collected or received by the Board;

(C) reserves for future losses maintained by the Board;

and (D) interest earnings from investment of the federally eligible individuals account funds;

and (E) grants provided pursuant to the federal Trade SB0475 Engrossed - 4 - LRB094 07024 LJB 37163 b Act of 2002;

and (3) such other accounts as may be appropriate.

m.

Charge and collect assessments paid by insurers pursuant to Section 12 of this Act and recover any assessments for, on behalf of, or against those insurers.

n.

Accept funds appropriated by law for the sole purpose of, in accordance with subsection k of this Section, discounting or subsidizing premium rates paid directly by unemployed or retired coal miners who are federally eligible individuals and whose employer-provided health insurance coverage was terminated on September 28, 2004.

93-33,79-1434.) eff.(215 ILCS 5/155.18a new) Sec.

6-23-03;155.18a.

93-34,Professional eff.Liability Insurance Resource Center.

6-23-03.)The (215Secretary ILCSof 105/7)Financial (fromand Ch.Professional Regulation shall establish a Professional Liability Insurance Resource Center on the Department’s Internet website containing the name, telephone number, and base rates of each licensed company providing medical liability insurance and the name, address, and telephone number of each producer who sells medical liability insurance and the name of each licensed company for which the producer sells medical liability insurance.

Each company and producer shall submit the information to the Department on or before September 30 of each year in order to be listed on the website.

Hyperlinks to company websites shall be included, if available.

The publication of the information on the Department’s website shall commence on January 1, 2006.

The Department shall update the information on the Professional Liability Insurance Resource Center at least annually.

(215 ILCS 5/155.19) (from Ch.

1307)767.19) Sec.

155.19.

All claims filed after December 31, 1976 with SB0475 Enrolled - 7 - LRB094 07024 LJB 37163 b any insurer and all suits filed after December 31, 1976 in any court in this State, alleging liability on the part of any physician, hospital or other health care provider for medically related injuries, shall be reported to the Secretary of Financial and Professional Regulation Director of Insurance in such form and under such terms and conditions as may be prescribed by the Secretary Director.

In addition, and notwithstanding any other provision of law to the contrary, any insurer, stop loss insurer, captive insurer, risk retention group, county risk retention trust, religious or charitable risk pooling trust, surplus line insurer, or other entity authorized or permitted by law to provide medical liability insurance in this State shall report to the Secretary, in such form and under such terms and conditions as may be prescribed by the Secretary, all claims filed after December 31, 2005 and all suits filed after December 31, 2005 in any court in this State alleging liability on the part of any physician, hospital, or health care provider for medically related injuries.

Each clerk of the circuit court shall provide to the Secretary such information as the Secretary may deem necessary to verify the accuracy and completeness of reports made to the Secretary under this Section.

The Secretary Director shall maintain complete and accurate records of all such claims and suits including their nature, amount, disposition (categorized by verdict, settlement, dismissal, or otherwise and including disposition of any post-trial motions and types of damages awarded, if any, including but not limited to economic damages and non-economic damages) and other information as he may deem useful or desirable in observing and reporting on health care provider liability trends in this State.

Records received by the Secretary under this Section shall be available to the general public;

however, the records made available to the general public shall not include the names or addresses of the parties to any claims or suits.

The Secretary Director shall release to appropriate disciplinary and licensing agencies any such data or information which may assist such agencies in SB0475 Enrolled - 8 - LRB094 07024 LJB 37163 b improving the quality of health care or which may be useful to such agencies for the purpose of professional discipline.

With due regard for appropriate maintenance of the confidentiality thereof, the Secretary Director shall may release, on an annual basis, from time to time to the Governor, the General Assembly and the general public statistical reports based on such data and information.

If the Secretary finds that any entity required to report information in its possession under this Section has violated any provision of this Section by filing late, incomplete, or inaccurate reports, the Secretary may fine the entity up to $1,000 for each offense.

Each day during which a violation occurs constitutes a separate offense.

The Secretary Director may promulgate such rules and regulations as may be necessary to carry out the provisions of this Section.

(Source:

P.A.

79-1434.) (215 ILCS 5/1204) (from Ch.

73, par.

1065.904) Sec.

1204.

(A) The Secretary Director shall promulgate rules and regulations which shall require each insurer licensed to write property or casualty insurance in the State and each syndicate doing business on the Illinois Insurance Exchange to record and report its loss and expense experience and other data as may be necessary to assess the relationship of insurance premiums and related income as compared to insurance costs and expenses.

The Secretary Director may designate one or more rate service organizations or advisory organizations to gather and compile such experience and data.

The Secretary Director shall require each insurer licensed to write property or casualty insurance in this State and each syndicate doing business on the Illinois Insurance Exchange to submit a report, on a form furnished by the Secretary Director, showing its direct writings in this State and companywide.

(B) Such report required by subsection (A) of this Section may include, but not be limited to, the following specific SB0475 Enrolled - 9 - LRB094 07024 LJB 37163 b types of insurance written by such insurer:

(1) Political subdivision liability insurance reported separately in the following categories:

(a) municipalities;

(b) school districts;

(c) other political subdivisions;

(2) Public official liability insurance;

(3) Dram shop liability insurance;

(4) Day care center liability insurance;

(5) Labor, fraternal or religious organizations liability insurance;

(6) Errors and omissions liability insurance;

(7) Officers and directors liability insurance reported separately as follows:

(a) non-profit entities;

(b) for-profit entities;

(8) Products liability insurance;

(9) Medical malpractice insurance;

(10) Attorney malpractice insurance;

(11) Architects and engineers malpractice insurance;

and (12) Motor vehicle insurance reported separately for commercial and private passenger vehicles as follows:

(a) motor vehicle physical damage insurance;

(b) motor vehicle liability insurance.

(C) Such report may include, but need not be limited to the following data, both specific to this State and companywide, in the aggregate or by type of insurance for the previous year on a calendar year basis:

(1) Direct premiums written;

(2) Direct premiums earned;

(3) Number of policies;

(4) Net investment income, using appropriate estimates where necessary;

(5) Losses paid;

(6) Losses incurred;

SB0475 Enrolled - 10 - LRB094 07024 LJB 37163 b (7) Loss reserves:

(a) Losses unpaid on reported claims;

(b) Losses unpaid on incurred but not reported claims;

(8) Number of claims:

(a) Paid claims;

(b) Arising claims;

(9) Loss adjustment expenses:

(a) Allocated loss adjustment expenses;

(b) Unallocated loss adjustment expenses;

(10) Net underwriting gain or loss;

(11) Net operation gain or loss, including net investment income;

(12) Any other information requested by the Secretary Director.

(C-5) Additional information required from medical malpractice insurers.

(1) In addition to the other requirements of this Section, the following information shall be included in the report required by subsection (A) of this Section in such form and under such terms and conditions as may be prescribed by the Secretary:

(a) paid and incurred losses by county for each of the past 10 policy years;

(b) earned exposures by ISO code, policy type, and policy year by county for each of the past 10 years;

and (c) the following actuarial information:

(i) Base class and territory equivalent exposures by report year by relative accident year.

(ii) Cumulative loss array by accident year by calendar year of development.

This array will show frequency of claims in the following categories:

open, closed with indemnity (CWI), closed with expense (CWE), and closed no pay (CNP);

paid SB0475 Enrolled - 11 - LRB094 07024 LJB 37163 b severity in the following categories:

indemnity and allocated loss adjustment expenses (ALAE) on closed claims;

and indemnity and expense reserves on pending claims.

(iii) Cumulative loss array by report year by calendar year of development.

This array will show frequency of claims in the following categories:

open, closed with indemnity (CWI), closed with expense (CWE), and closed no pay (CNP);

paid severity in the following categories:

indemnity and allocated loss adjustment expenses (ALAE) on closed claims;

and indemnity and expense reserves on pending claims.

(iv) Maturity year and tail factors.

(v) Any expense, contingency ddr (death, disability, and retirement), commission, tax, and/or off-balance factors.

(2) The following information must also be annually provided to the Department:

(a) copies of the company’s reserve and surplus studies;

and (b) consulting actuarial report and data supporting the company’s rate filing.

(3) All information collected by the Secretary under paragraphs (1) and (2) shall be made available, on a company-by-company basis, to the General Assembly and the general public.

This provision shall supersede any other provision of State law that may otherwise protect such information from public disclosure as confidential.

(D) In addition to the information which may be requested under subsection (C), the Secretary Director may also request on a companywide, aggregate basis, Federal Income Tax recoverable, net realized capital gain or loss, net unrealized capital gain or loss, and all other expenses not requested in subsection (C) above.

(E) Violations - Suspensions - Revocations.

SB0475 Enrolled - 12 - LRB094 07024 LJB 37163 b (1) Any company or person subject to this Article, who willfully or repeatedly fails to observe or who otherwise violates any of the provisions of this Article or any rule or regulation promulgated by the Secretary Director under authority of this Article or any final order of the Secretary Director entered under the authority of this Article shall by civil penalty forfeit to the State of Illinois a sum not to exceed $2,000.

Each day during which a violation occurs constitutes a separate offense.

(2) No forfeiture liability under paragraph (1) of this subsection may attach unless a written notice of apparent liability has been issued by the Secretary Director and received by the respondent, or the Secretary Director sends written notice of apparent liability by registered or certified mail, return receipt requested, to the last known address of the respondent.

Any respondent so notified must be granted an opportunity to request a hearing within 10 days from receipt of notice, or to show in writing, why he should not be held liable.

A notice issued under this Section must set forth the date, facts and nature of the act or omission with which the respondent is charged and must specifically identify the particular provision of this Article, rule, regulation or order of which a violation is charged.

(3) No forfeiture liability under paragraph (1) of this subsection may attach for any violation occurring more than 2 years prior to the date of issuance of the notice of apparent liability and in no event may the total civil penalty forfeiture imposed for the acts or omissions set forth in any one notice of apparent liability exceed $100,000.

(4) All administrative hearings conducted pursuant to this Article are subject to 50 Ill.

Adm.

Code 2402 and all administrative hearings are subject to the Administrative Review Law.

(5) The civil penalty forfeitures provided for in this SB0475 Enrolled - 13 - LRB094 07024 LJB 37163 b Section are payable to the General Revenue Fund of the State of Illinois, and may be recovered in a civil suit in the name of the State of Illinois brought in the Circuit Court in Sangamon County or in the Circuit Court of the county where the respondent is domiciled or has its principal operating office.

(6) In any case where the Secretary Director issues a notice of apparent liability looking toward the imposition of a civil penalty forfeiture under this Section that fact may not be used in any other proceeding before the Secretary Director to the prejudice of the respondent to whom the notice was issued, unless (a) the civil penalty forfeiture has been paid, or (b) a court has ordered payment of the civil penalty forfeiture and that order has become final.

(7) When any person or company has a license or certificate of authority under this Code and knowingly fails or refuses to comply with a lawful order of the Secretary Director requiring compliance with this Article, entered after notice and hearing, within the period of time specified in the order, the Secretary Director may, in addition to any other penalty or authority provided, revoke or refuse to renew the license or certificate of authority of such person or company, or may suspend the license or certificate of authority of such person or company until compliance with such order has been obtained.

(8) When any person or company has a license or certificate of authority under this Code and knowingly fails or refuses to comply with any provisions of this Article, the Secretary Director may, after notice and hearing, in addition to any other penalty provided, revoke or refuse to renew the license or certificate of authority of such person or company, or may suspend the license or certificate of authority of such person or company, until compliance with such provision of this Article has been obtained.

SB0475 Enrolled - 14 - LRB094 07024 LJB 37163 b (9) No suspension or revocation under this Section may become effective until 5 days from the date that the notice of suspension or revocation has been personally delivered or delivered by registered or certified mail to the company or person.

A suspension or revocation under this Section is stayed upon the filing, by the company or person, of a petition for judicial review under the Administrative Review Law.

(Source:

P.A.

93-32, eff.

7-1-03.) Section 315.

The Medical Practice Act of 1987 is amended by changing Sections 7, 22, 23, 24, and 36 and adding Section 24.1 as follows:

(225 ILCS 60/7) (from Ch.

111, par.

4400-7) (Section scheduled to be repealed on January 1, 2007) Sec.

Eligibility.Medical Disciplinary Board.

a.(A) There is hereby created the Illinois State Medical Disciplinary Board (hereinafter referred to as the "Disciplinary Board").

ExceptThe asDisciplinary providedBoard inshall subsectionconsist (e) of this11 Section9 ormembers, into Sectionbe 15appointed ofby this Act, any person who is either a citizen of the UnitedGovernor Statesby or an alien lawfully admitted for permanent residence and whowith hasthe beenadvice for a period of at least 180 days and continuesconsent to be a resident of thisthe StateSenate. shall be eligible for Plan coverage under this Section if evidence is provided of:

(1)All Amembers noticeshall ofbe rejectionresidents orof refusalthe toState, issuenot substantiallymore similarthan individual6 health5 insuranceof coveragewhom forshall healthbe reasonsmembers byof athe healthsame insurancepolitical issuer;party.

orAll (2)members Ashall refusalbe byvoting amembers. health insurance issuer to issue individual health insurance coverage except at a rate exceeding the applicable Plan rate for which the person is responsible.

AFive rejectionmembers orshall refusalbe byphysicians alicensed groupto healthpractice planmedicine orin healthall insuranceof issuerits offeringbranches onlyin stop-lossIllinois orpossessing excessthe degree of lossdoctor insuranceof ormedicine, contracts,and agreements,it orshall otherbe arrangementsthe forgoal reinsurancethat coverageat withleast respectone toof the applicantmembers shallpractice notin bethe sufficientfield evidenceof underneurosurgery, thisone subsection.of the members practice in the field of obstetrics and gynecology, and one of the members practice in the field of cardiology.

b.One member shall be a physician licensed to practice in Illinois possessing the degree of doctor of osteopathy or osteopathic medicine.

TheOne boardmember shall promulgatebe a listphysician oflicensed medicalto orpractice healthin conditionsIllinois forand whichpossessing athe persondegree who is either a citizen of thedoctor SB0475 Engrossed - 5 - LRB094 07024 LJB 37163 b United States or an alien lawfully admitted for permanent residence and a resident of thischiropractic. State would be eligible for Plan coverage without applying for health insurance coverage pursuant to subsection a.

Four members Two shall be members of thisthe Section.public, who shall not be engaged in any way, SB0475 Enrolled - 15 - LRB094 07024 LJB 37163 b directly or indirectly, as providers of health care.

PersonsThe who2 canpublic demonstratemembers the existence or history of any medical or health conditions on the list promulgated by the board shall notact beas requiredvoting tomembers. provide the evidence specified in subsection a.

One member shall be a physician licensed to practice in Illinois possessing the degree of thisdoctor Section.of osteopathy or osteopathic medicine.

TheOne listmember shall be effectivea onphysician thelicensed firstto daypractice ofin theIllinois operationand ofpossessing the Plandegree andof maydoctor beof amendedchiropractic. from time to time as appropriate.

c.(B) Members of the Disciplinary Board shall be appointed for terms of 4 years.

FamilyUpon membersthe expiration of the sameterm householdof whoany eachmember, aretheir coveredsuccessor personsshall arebe eligibleappointed for optionala familyterm coverageof under4 years by the Plan.Governor by and with the advice and consent of the Senate.

d.The Governor shall fill any vacancy for the remainder of the unexpired term by and with the advice and consent of the Senate.

ForUpon personsrecommendation qualifying for coverage in accordance with Section 7 of this Act, the boardBoard, shall,any ifmember it determines that such appropriations as are made pursuant to Section 12 of this Act are insufficient to allow the boardDisciplinary toBoard acceptmay allbe ofremoved by the eligibleGovernor persons which it projects will apply for enrollmentmisfeasance, undermalfeasance, theor Plan,wilful limitneglect orof closeduty, enrollmentafter tonotice, ensureand thata thepublic Planhearing, isunless notsuch over-subscribednotice and thathearing itshall hasbe sufficientexpressly resourceswaived toin meetwriting. its obligations to existing enrollees.

TheEach boardmember shall notserve limiton orthe closeDisciplinary enrollmentBoard foruntil federallytheir eligiblesuccessor individuals.is appointed and qualified.

e.No member of the Disciplinary Board shall serve more than 2 consecutive 4 year terms.

AIn personmaking appointments the Governor shall notattempt beto eligibleinsure forthat coveragethe undervarious social and geographic regions of the PlanState if:of Illinois are properly represented.

(1)In Hemaking orthe shedesignation hasof orpersons obtains other coverage under a group health plan or health insurance coverage substantially similar to oract betterfor thanthe aseveral Planprofessions policyrepresented ason anthe insuredDisciplinary orBoard, coveredthe dependentGovernor orshall wouldgive bedue eligibleconsideration to haverecommendations thatby coveragemembers ifof hethe orrespective sheprofessions electedand toby obtainorganizations it.therein.

Persons(C) otherwiseThe eligibleDisciplinary forBoard Planshall coverageannually may,elect however,one solely for the purpose of havingits coveragevoting formembers aas pre-existingchairperson condition,and maintainone otheras coveragevice onlychairperson. while satisfying any pre-existing condition waiting period under a Plan policy or a subsequent replacement policy of a Plan policy.

(1.1)No Hisofficer orshall herbe priorelected coverage under a group health SB0475 Engrossed - 6 - LRB094 07024 LJB 37163 b plan or health insurance coverage, provided or arranged by an employer of more than 10twice employeesin wassuccession discontinuedto for any reason without the entire group or plan being discontinued and not replaced, provided he or she remains an employee, or dependent thereof, of the same employer.office.

(2)Each Heofficer orshall sheserve isuntil atheir recipientsuccessor ofhas orbeen iselected approvedand toqualified. receive medical assistance, except that a person may continue to receive medical assistance through the medical assistance no grant program, but only while satisfying the requirements for a preexisting condition under Section 8, subsection f.

of(D) this(Blank). Act.

Payment(E) ofSix premiumsFour pursuantvoting tomembers this Act shall be allocable to the person’s spenddown for purposes of the medicalDisciplinary assistanceBoard, noat grantleast program,4 butof thatwhom personare physicians, shall notconstitute bea eligiblequorum. for any Plan benefits while that person remains eligible for medical assistance.

IfA theSB0475 personEnrolled continues- to16 receive- orLRB094 be07024 approvedLJB to37163 receiveb medicalvacancy assistancein through the medicalmembership assistanceof nothe grantDisciplinary programBoard atshall ornot afterimpair the timeright thatof requirements for a preexistingquorum conditionto areexercise satisfied,all the personrights shalland notperform beall eligiblethe forduties coverageof under the Plan.Disciplinary Board.

InAny thataction circumstance,taken coverageby the Disciplinary Board under thethis planAct shallmay terminatebe asauthorized ofby theresolution expirationat ofany theregular preexistingor conditionspecial limitationmeeting period.and each such resolution shall take effect immediately.

UnderThe allDisciplinary otherBoard circumstances, coverage under the Plan shall automaticallymeet terminateat asleast ofquarterly. the effective date of any medical assistance.

(3)The ExceptDisciplinary asBoard providedis inempowered Sectionto 15,adopt theall personrules hasand previouslyregulations participatednecessary in the Plan and voluntarilyincident terminatedto Plan coverage, unless 12 months have elapsed since the person’spowers latestgranted voluntaryto terminationit ofunder coverage.this Act.

(4)(F) TheEach personmember, failsand tomember-officer, payof the requiredDisciplinary premiumBoard undershall thereceive covereda person’sper termsdiem ofstipend enrollmentas and participation, in which event the liabilitySecretary Director of the PlanDepartment, shallhereinafter bereferred limited to benefitsas incurred under the PlanSecretary forDirector, theshall timedetermine. period for which premiums had been paid and the covered person remained eligible for Plan coverage.

SB0475 Engrossed - 7 - LRB094 07024 LJB 37163 b (5) The PlanSecretary hasDirector paidshall aalso totaldetermine ofthe $1,000,000per indiem benefitsstipend onthat behalfeach ofex-officio themember coveredshall person.receive.

(6)Each Themember personshall isbe apaid residenttheir ofnecessary aexpenses publicwhile institution.engaged in the performance of their duties.

(7)(G) The person’sSecretary premiumDirector isshall paidselect fora orChief reimbursedMedical underCoordinator anyand governmentnot sponsoredless programthan or2 bya anyDeputy governmentMedical agencyCoordinators orCoordinator healthwho careshall provider,not exceptbe asmembers an otherwise qualifying full-time employee, or dependent of such employee, of a government agency or health care provider, or, except when a person’s premium is paid by the U.S.Disciplinary Board.

TreasuryEach Departmentmedical pursuantcoordinator toshall thebe federala Tradephysician Actlicensed ofto 2002,practice ormedicine exceptin whenall the premium rate of anits unemployedbranches, orand retiredthe coalSecretary minerDirector whoshall isset atheir federallyrates eligibleof individualcompensation. whose employer-provided health insurance coverage was terminated on September 28, 2004 is discounted or subsidized with funds appropriated by law.

(8) The personSecretary hasDirector orshall laterassign receivesat otherleast benefitsone ormedical fundscoordinator fromto anya settlement,region judgement,composed or award resulting from any accident or injury, regardless of theCook dateCounty ofand thesuch accident or injury, or any other circumstancescounties creatingas a legal liability for damages due that person by a third party, whether the settlement,Secretary judgment,Director ormay awarddeem isappropriate, in the form of a contract, agreement, or trust on behalf of a minor or otherwise and whethersuch themedical settlement,coordinator judgment, or awardcoordinators isshall payablelocate totheir theoffice person, his or her dependent, estate, personal representative, or guardian in aChicago. lump sum or over time, so long as there continues to be benefits or assets remaining from those sources in an amount in excess of $100,000.

(9)The WithinSecretary theDirector 5shall yearsassign priorat toleast one the dateremaining amedical person’scoordinator Planto applicationa isregion receivedcomposed byof the Board,balance of counties in the person’sState, coverageand undersuch anymedical healthcoordinator careor benefitcoordinators programshall aslocate definedtheir office in 18Springfield. U.S.C.

24,Each including any public or private plan or contract under which any medical benefit,coordinator item,shall orbe servicethe ischief provided,enforcement wasofficer terminated as a result of anythis actAct orin practicehis that constitutes fraud under State or federalher lawtheir orassigned asregion aand resultshall ofserve anat intentionalthe misrepresentationwill of SB0475the EngrossedDisciplinary -Board. 8 - LRB094 07024 LJB 37163 b material fact;

orThe ifSecretary thatDirector personshall knowinglyemploy, andin willfullyconformity obtainedwith orthe attemptedPersonnel toCode, obtain,not orless fraudulentlythan aidedone orfull attemptedtime toinvestigator aidfor anySB0475 otherEnrolled person- in17 obtaining,- anyLRB094 coverage07024 orLJB benefits37163 underb theevery Plan2,500 to5000 whichphysicians thatlicensed personin wasthe notState. entitled.

f.Each investigator shall be a college graduate with at least 2 years’ investigative experience or one year advanced medical education.

TheUpon boardthe orwritten request of the administratorDisciplinary Board, the Secretary Director shall requireemploy, verificationin ofconformity residencywith andthe mayPersonnel requireCode, anysuch additionalother informationprofessional, ortechnical, documentation,investigative, orand statementsclerical underhelp, oath,either whenon necessarya tofull determineor residencypart-time uponbasis initialas applicationthe andDisciplinary Board deems necessary for the entireproper termperformance of theits policy.duties.

g.(H) Upon the specific request of the Disciplinary Board, signed by either the chairman, vice chairman, or a medical coordinator of the Disciplinary Board, the Department of Human Services or the Department of State Police shall make available any and all information that they have in their possession regarding a particular case then under investigation by the Disciplinary Board.

Coverage(I) shallMembers ceaseof (i) on the dateDisciplinary aBoard personshall isbe noimmune longerfrom asuit residentin ofany Illinois,action (ii)based on the date a person requests coverage to end, (iii) upon theany deathdisciplinary ofproceedings the covered person, (iv) on the date State law requires cancellation of the policy, or (v)other atacts theperformed Plan’sin option,good 30faith daysas aftermembers the Plan makes any inquiry concerning a person’s eligibility or place of residence to which the personDisciplinary doesBoard. not reply.

h.(J) The Disciplinary Board may compile and establish a statewide roster of physicians and other medical professionals, including the several medical specialties, of such physicians and medical professionals, who have agreed to serve from time to time as advisors to the medical coordinators.

ExceptSuch underadvisors theshall conditionsassist set forth in subsection g of this Section, the coveragemedical ofcoordinators anyor person who ceases to meet the eligibilityDisciplinary requirementsBoard ofin thistheir Sectioninvestigations shalland beparticipation terminatedin atcomplaints theagainst endphysicians. of the current policy period for which the necessary premiums have been paid.

Such advisors shall serve under contract and shall be reimbursed at a reasonable rate for the services provided, plus reasonable expenses incurred.

While serving in this capacity, the advisor, for any act undertaken in good faith and in the conduct of their duties under this Section, shall be immune from civil suit.

93-33,93-138, eff.

6-23-03;7-10-03.) SB0475 Enrolled - 18 - LRB094 07024 LJB 37163 b (225 ILCS 60/22) (from Ch.

93-34,111, eff.par.

6-23-03.)4400-22) (215(Section ILCSscheduled 105/15)to be repealed on January 1, 2007) Sec.

15.22.

AlternativeDisciplinary portableaction. coverage for federally eligible individuals.

(a)(A) NotwithstandingThe Department may revoke, suspend, place on probationary status, refuse to renew, or take any other disciplinary action as the requirementsDepartment may deem proper with regard to the license or visiting professor permit of subsectionany a.person issued under this Act to practice medicine, or to treat human ailments without the use of drugs and without operative surgery upon any of the following grounds:

of(1) SectionPerformance 7of andan exceptelective asabortion otherwise provided in this Section, any federallyplace, eligiblelocale, individualfacility, foror whominstitution aother Planthan: application, and such enclosures and supporting documentation as the Board may require, is received by the Board within 90 days after the termination of prior creditable coverage shall qualify to enroll in the Plan under the portability provisions of this Section.

A(a) federallya eligiblefacility personlicensed who has been certified as SB0475 Engrossed - 9 - LRB094 07024 LJB 37163 b eligible pursuant to the federalAmbulatory TradeSurgical ActTreatment ofCenter 2002Act; and whose Plan application and enclosures and supporting documentation as the Board may require is received by the Board within 63 days after the termination of previous creditable coverage shall qualify to enroll in the Plan under the portability provisions of this Section.

(b) Anyan federallyinstitution eligiblelicensed individual seeking Plan coverage under this Section must submit with his or her application evidence, including acceptable written certification of previous creditable coverage, that will establish to the Board’sHospital satisfaction,Licensing thatAct; he or she meets all of the requirements to be a federally eligible individual and is currently and permanently residing in this State (as of the date his or her application was received by the Board).

or (c) Exceptan asambulatory otherwisesurgical providedtreatment incenter thisor Section,hospitalization aor periodcare offacility creditablemaintained coverageby shallthe notState beor counted,any withagency respectthereof, towhere qualifyingsuch andepartment applicantor foragency Planhas coverageauthority as a federally eligible individual under thislaw Section,to ifestablish after such period and beforeenforce thestandards application for Plan coverage was received by the Board,ambulatory theresurgical wastreatment atcenters, leasthospitalization, aor 90care dayfacilities period during all of which the individual was not covered under anyits creditablemanagement coverage.and control;

Foror a(d) federallyambulatory eligiblesurgical persontreatment whocenters, hashospitalization beenor certifiedcare asfacilities eligiblemaintained pursuant to the federal Trade Act of 2002, a period of creditable coverage shall not be counted, with respect to qualifying an applicant for Plan coverage as a federally eligible individual under this Section, if after such period and before the application for Plan coverage was received by the Board,Federal thereGovernment; was at least a 63 day period during all of which the individual was not covered under any creditable coverage.

(d)or Any(e) federallyambulatory eligiblesurgical individualtreatment whocenters, thehospitalization Boardor determinescare qualifiesfacilities formaintained Planby coverageany underuniversity this Section shall be offered his or hercollege choiceestablished ofunder enrollingthe inlaws one of alternative portability health benefit plans which the Board is authorized under this SectionState toand establishsupported forprincipally theseby federallypublic eligiblefunds SB0475raised Engrossedby -taxation. 10 - LRB094 07024 LJB 37163 b individuals and their dependents.

(e)(2) ThePerformance Board shall offer a choice of healthan careabortion coveragesprocedure consistentin witha majorwilful medicaland coveragewanton undermanner theon alternativea healthwoman benefitwho planswas authorizednot bypregnant thisat Sectionthe totime everythe federallyabortion eligibleprocedure individual.was performed.

(3) The coveragesconviction toof bea offeredfelony underin thethis plans,or theany scheduleother jurisdiction, except as otherwise provided in subsection B SB0475 Enrolled - 19 - LRB094 07024 LJB 37163 b of benefits,this deductibles,Section, co-payments,whether exclusions,or andnot otherrelated limitationsto shallpractice beunder approvedthis byAct, or the Board.entry of a guilty or nolo contendere plea to a felony charge.

One(4) optionalGross formnegligence of coverage shall be comparable to comprehensive health insurance coverage offered in thepractice individualunder market in this StateAct. or a standard option of coverage available under the group or individual health insurance laws of the State.

The(5) standardEngaging benefitin plandishonorable, thatunethical isor authorizedunprofessional byconduct Sectionof 8a ofcharacter thislikely Actto maydeceive, bedefraud usedor forharm thisthe purpose.public.

The(6) BoardObtaining mayany alsofee offerby afraud, preferreddeceit, provideror optionmisrepresentation. and such other options as the Board determines may be appropriate for these federally eligible individuals who qualify for Plan coverage pursuant to this Section.

(f)(7) NotwithstandingHabitual theor requirementsexcessive use or abuse of subsectiondrugs f.defined in law as controlled substances, of alcohol, or of any other substances which results in the inability to practice with reasonable judgment, skill or safety.

of(8) SectionPracticing 8,under anya planfalse coverageor, thatexcept isas issuedprovided toby federallylaw, eligiblean individualsassumed whoname. qualify for the Plan pursuant to the portability provisions of this Section shall not be subject to any preexisting conditions exclusion, waiting period, or other similar limitation on coverage.

(g)(9) FederallyFraud eligibleor individualsmisrepresentation whoin qualifyapplying andfor, enrollor inprocuring, thea Planlicense pursuantunder to this SectionAct shallor be required to pay such premium rates as the Board shall establish and approve in accordanceconnection with theapplying requirementsfor renewal of Sectiona 7.1license ofunder this Act.

Federally(10) eligibleMaking individualsa whofalse qualifyor andmisleading enrollstatement inregarding thetheir Planskill andor arethe unemployedefficacy or retiredvalue coalof minersthe whosemedicine, employer-providedtreatment, healthor insuranceremedy coverageprescribed wasby terminatedthem onat Septembertheir 28,direction 2004in shallthe betreatment requiredof toany paydisease the discounted or subsidizedother premiumcondition ratesof that the Boardbody hasor establishedmind. and approved in accordance with subsection k of Section 4 of this Act.

(h)(11) AAllowing federallyanother eligibleperson individualor whoorganization qualifies and enrolls in the Plan pursuant to thisuse Sectiontheir mustlicense, satisfyprocured onunder an SB0475 Engrossed - 11 - LRB094 07024 LJB 37163 b ongoing basis all of the other eligibility requirements of this ActAct, to thepractice. extent not inconsistent with the federal Health Insurance Portability and Accountability Act of 1996 in order to maintain continued eligibility for coverage under the Plan.

(12) Disciplinary action of another state or jurisdiction against a license or other authorization to practice as a medical doctor, doctor of osteopathy, doctor of osteopathic medicine or doctor of chiropractic, a certified copy of the record of the action taken by the other state or jurisdiction being prima facie evidence thereof.

(13) Violation of any provision of this Act or of the Medical Practice Act prior to the repeal of that Act, or violation of the rules, or a final administrative action of the Secretary Director, after consideration of the SB0475 Enrolled - 20 - LRB094 07024 LJB 37163 b recommendation of the Disciplinary Board.

(14) Dividing with anyone other than physicians with whom the licensee practices in a partnership, Professional Association, limited liability company, or Medical or Professional Corporation any fee, commission, rebate or other form of compensation for any professional services not actually and personally rendered.

Nothing contained in this subsection prohibits persons holding valid and current licenses under this Act from practicing medicine in partnership under a partnership agreement, including a limited liability partnership, in a limited liability company under the Limited Liability Company Act, in a corporation authorized by the Medical Corporation Act, as an association authorized by the Professional Association Act, or in a corporation under the Professional Corporation Act or from pooling, sharing, dividing or apportioning the fees and monies received by them or by the partnership, corporation or association in accordance with the partnership agreement or the policies of the Board of Directors of the corporation or association.

Nothing contained in this subsection prohibits 2 or more corporations authorized by the Medical Corporation Act, from forming a partnership or joint venture of such corporations, and providing medical, surgical and scientific research and knowledge by employees of these corporations if such employees are licensed under this Act, or from pooling, sharing, dividing, or apportioning the fees and monies received by the partnership or joint venture in accordance with the partnership or joint venture agreement.

Nothing contained in this subsection shall abrogate the right of 2 or more persons, holding valid and current licenses under this Act, to each receive adequate compensation for concurrently rendering professional services to a patient and divide a fee;

provided, the patient has full knowledge of the division, and, provided, that the division is made in proportion to the services SB0475 Enrolled - 21 - LRB094 07024 LJB 37163 b performed and responsibility assumed by each.

(15) A finding by the Medical Disciplinary Board that the registrant after having his or her license placed on probationary status or subjected to conditions or restrictions violated the terms of the probation or failed to comply with such terms or conditions.

(16) Abandonment of a patient.

(17) Prescribing, selling, administering, distributing, giving or self-administering any drug classified as a controlled substance (designated product) or narcotic for other than medically accepted therapeutic purposes.

(18) Promotion of the sale of drugs, devices, appliances or goods provided for a patient in such manner as to exploit the patient for financial gain of the physician.

(19) Offering, undertaking or agreeing to cure or treat disease by a secret method, procedure, treatment or medicine, or the treating, operating or prescribing for any human condition by a method, means or procedure which the licensee refuses to divulge upon demand of the Department.

(20) Immoral conduct in the commission of any act including, but not limited to, commission of an act of sexual misconduct related to the licensee’s practice.

(21) Wilfully making or filing false records or reports in his or her practice as a physician, including, but not limited to, false records to support claims against the medical assistance program of the Department of Public Aid under the Illinois Public Aid Code.

(22) Wilful omission to file or record, or wilfully impeding the filing or recording, or inducing another person to omit to file or record, medical reports as required by law, or wilfully failing to report an instance of suspected abuse or neglect as required by law.

(23) Being named as a perpetrator in an indicated report by the Department of Children and Family Services SB0475 Enrolled - 22 - LRB094 07024 LJB 37163 b under the Abused and Neglected Child Reporting Act, and upon proof by clear and convincing evidence that the licensee has caused a child to be an abused child or neglected child as defined in the Abused and Neglected Child Reporting Act.

(24) Solicitation of professional patronage by any corporation, agents or persons, or profiting from those representing themselves to be agents of the licensee.

(25) Gross and wilful and continued overcharging for professional services, including filing false statements for collection of fees for which services are not rendered, including, but not limited to, filing such false statements for collection of monies for services not rendered from the medical assistance program of the Department of Public Aid under the Illinois Public Aid Code.

(26) A pattern of practice or other behavior which demonstrates incapacity or incompetence to practice under this Act.

(27) Mental illness or disability which results in the inability to practice under this Act with reasonable judgment, skill or safety.

(28) Physical illness, including, but not limited to, deterioration through the aging process, or loss of motor skill which results in a physician’s inability to practice under this Act with reasonable judgment, skill or safety.

(29) Cheating on or attempt to subvert the licensing examinations administered under this Act.

(30) Wilfully or negligently violating the confidentiality between physician and patient except as required by law.

(31) The use of any false, fraudulent, or deceptive statement in any document connected with practice under this Act.

(32) Aiding and abetting an individual not licensed under this Act in the practice of a profession licensed under this Act.

SB0475 Enrolled - 23 - LRB094 07024 LJB 37163 b (33) Violating state or federal laws or regulations relating to controlled substances, legend drugs, or ephedra, as defined in the Ephedra Prohibition Act.

(34) Failure to report to the Department any adverse final action taken against them by another licensing jurisdiction (any other state or any territory of the United States or any foreign state or country), by any peer review body, by any health care institution, by any professional society or association related to practice under this Act, by any governmental agency, by any law enforcement agency, or by any court for acts or conduct similar to acts or conduct which would constitute grounds for action as defined in this Section.

(35) Failure to report to the Department surrender of a license or authorization to practice as a medical doctor, a doctor of osteopathy, a doctor of osteopathic medicine, or doctor of chiropractic in another state or jurisdiction, or surrender of membership on any medical staff or in any medical or professional association or society, while under disciplinary investigation by any of those authorities or bodies, for acts or conduct similar to acts or conduct which would constitute grounds for action as defined in this Section.

(36) Failure to report to the Department any adverse judgment, settlement, or award arising from a liability claim related to acts or conduct similar to acts or conduct which would constitute grounds for action as defined in this Section.

(37) Failure to transfer copies of medical records as required by law.

(38) Failure to furnish the Department, its investigators or representatives, relevant information, legally requested by the Department after consultation with the Chief Medical Coordinator or the Deputy Medical Coordinator.

(39) Violating the Health Care Worker Self-Referral SB0475 Enrolled - 24 - LRB094 07024 LJB 37163 b Act.

(40) Willful failure to provide notice when notice is required under the Parental Notice of Abortion Act of 1995.

(41) Failure to establish and maintain records of patient care and treatment as required by this law.

(42) Entering into an excessive number of written collaborative agreements with licensed advanced practice nurses resulting in an inability to adequately collaborate and provide medical direction.

(43) Repeated failure to adequately collaborate with or provide medical direction to a licensed advanced practice nurse.

Except for actions involving the ground numbered (26), all All proceedings to suspend, revoke, place on probationary status, or take any other disciplinary action as the Department may deem proper, with regard to a license on any of the foregoing grounds, must be commenced within 5 3 years next after receipt by the Department of a complaint alleging the commission of or notice of the conviction order for any of the acts described herein.

Except for the grounds numbered (8), (9), (26), and (29), no action shall be commenced more than 10 5 years after the date of the incident or act alleged to have violated this Section.

For actions involving the ground numbered (26), a pattern of practice or other behavior includes all incidents alleged to be part of the pattern of practice or other behavior that occurred or a report pursuant to Section 23 of this Act received within the 10-year period preceding the filing of the complaint.

In the event of the settlement of any claim or cause of action in favor of the claimant or the reduction to final judgment of any civil action in favor of the plaintiff, such claim, cause of action or civil action being grounded on the allegation that a person licensed under this Act was negligent in providing care, the Department shall have an additional period of 2 years one year from the date of notification to the Department under Section 23 of this Act of such settlement or final judgment in which to investigate and SB0475 Enrolled - 25 - LRB094 07024 LJB 37163 b commence formal disciplinary proceedings under Section 36 of this Act, except as otherwise provided by law.

The time during which the holder of the license was outside the State of Illinois shall not be included within any period of time limiting the commencement of disciplinary action by the Department.

The entry of an order or judgment by any circuit court establishing that any person holding a license under this Act is a person in need of mental treatment operates as a suspension of that license.

That person may resume their practice only upon the entry of a Departmental order based upon a finding by the Medical Disciplinary Board that they have been determined to be recovered from mental illness by the court and upon the Disciplinary Board’s recommendation that they be permitted to resume their practice.

The Department may refuse to issue or take disciplinary action concerning the license of any person who fails to file a return, or to pay the tax, penalty or interest shown in a filed return, or to pay any final assessment of tax, penalty or interest, as required by any tax Act administered by the Illinois Department of Revenue, until such time as the requirements of any such tax Act are satisfied as determined by the Illinois Department of Revenue.

The Department, upon the recommendation of the Disciplinary Board, shall adopt rules which set forth standards to be used in determining:

(a) when a person will be deemed sufficiently rehabilitated to warrant the public trust;

(b) what constitutes dishonorable, unethical or unprofessional conduct of a character likely to deceive, defraud, or harm the public;

(c) what constitutes immoral conduct in the commission of any act, including, but not limited to, commission of an act of sexual misconduct related to the licensee’s practice;

and (d) what constitutes gross negligence in the practice SB0475 Enrolled - 26 - LRB094 07024 LJB 37163 b of medicine.

However, no such rule shall be admissible into evidence in any civil action except for review of a licensing or other disciplinary action under this Act.

In enforcing this Section, the Medical Disciplinary Board, upon a showing of a possible violation, may compel any individual licensed to practice under this Act, or who has applied for licensure or a permit pursuant to this Act, to submit to a mental or physical examination, or both, as required by and at the expense of the Department.

The examining physician or physicians shall be those specifically designated by the Disciplinary Board.

The Medical Disciplinary Board or the Department may order the examining physician to present testimony concerning this mental or physical examination of the licensee or applicant.

No information shall be excluded by reason of any common law or statutory privilege relating to communication between the licensee or applicant and the examining physician.

The individual to be examined may have, at his or her own expense, another physician of his or her choice present during all aspects of the examination.

Failure of any individual to submit to mental or physical examination, when directed, shall be grounds for suspension of his or her license until such time as the individual submits to the examination if the Disciplinary Board finds, after notice and hearing, that the refusal to submit to the examination was without reasonable cause.

If the Disciplinary Board finds a physician unable to practice because of the reasons set forth in this Section, the Disciplinary Board shall require such physician to submit to care, counseling, or treatment by physicians approved or designated by the Disciplinary Board, as a condition for continued, reinstated, or renewed licensure to practice.

Any physician, whose license was granted pursuant to Sections 9, 17, or 19 of this Act, or, continued, reinstated, renewed, disciplined or supervised, subject to such terms, conditions or restrictions who shall fail to comply with such terms, conditions or restrictions, or to complete a required program SB0475 Enrolled - 27 - LRB094 07024 LJB 37163 b of care, counseling, or treatment, as determined by the Chief Medical Coordinator or Deputy Medical Coordinators, shall be referred to the Secretary Director for a determination as to whether the licensee shall have their license suspended immediately, pending a hearing by the Disciplinary Board.

In instances in which the Secretary Director immediately suspends a license under this Section, a hearing upon such person’s license must be convened by the Disciplinary Board within 15 days after such suspension and completed without appreciable delay.

The Disciplinary Board shall have the authority to review the subject physician’s record of treatment and counseling regarding the impairment, to the extent permitted by applicable federal statutes and regulations safeguarding the confidentiality of medical records.

An individual licensed under this Act, affected under this Section, shall be afforded an opportunity to demonstrate to the Disciplinary Board that they can resume practice in compliance with acceptable and prevailing standards under the provisions of their license.

The Department may promulgate rules for the imposition of fines in disciplinary cases, not to exceed $10,000 $5,000 for each violation of this Act.

Fines may be imposed in conjunction with other forms of disciplinary action, but shall not be the exclusive disposition of any disciplinary action arising out of conduct resulting in death or injury to a patient.

Any funds collected from such fines shall be deposited in the Medical Disciplinary Fund.

(B) The Department shall revoke the license or visiting permit of any person issued under this Act to practice medicine or to treat human ailments without the use of drugs and without operative surgery, who has been convicted a second time of committing any felony under the Illinois Controlled Substances Act, or who has been convicted a second time of committing a Class 1 felony under Sections 8A-3 and 8A-6 of the Illinois Public Aid Code.

A person whose license or visiting permit is revoked under this subsection B of Section 22 of this Act shall SB0475 Enrolled - 28 - LRB094 07024 LJB 37163 b be prohibited from practicing medicine or treating human ailments without the use of drugs and without operative surgery.

(C) The Medical Disciplinary Board shall recommend to the Department civil penalties and any other appropriate discipline in disciplinary cases when the Board finds that a physician willfully performed an abortion with actual knowledge that the person upon whom the abortion has been performed is a minor or an incompetent person without notice as required under the Parental Notice of Abortion Act of 1995.

Upon the Board’s recommendation, the Department shall impose, for the first violation, a civil penalty of $1,000 and for a second or subsequent violation, a civil penalty of $5,000.

92-153,89-18, eff.

7-25-01;6-1-95;

93-33,89-201, eff.

6-23-03;1-1-96;

93-34,89-626, eff.

6-23-03;8-9-96;

93-622,89-702, eff.

12-18-03.)7-1-97; Section 99.

90-742, eff.

8-13-98.) (225 ILCS 60/23) (from Ch.

111, par.

4400-23) (Section scheduled to be repealed on January 1, 2007) Sec.

23.

Reports relating to professional conduct and capacity.

(A) Entities required to report.

(1) Health care institutions.

The chief administrator or executive officer of any health care institution licensed by the Illinois Department of Public Health shall report to the Disciplinary Board when any person’s clinical privileges are terminated or are restricted based on a final determination, in accordance with that institution’s by-laws or rules and regulations, that a person has either committed an act or acts which may directly threaten patient care, and not of an administrative nature, or that a person may be mentally or physically disabled in such a manner as to endanger patients under that person’s care.

Such officer also shall report if a person accepts voluntary termination or restriction of clinical privileges in lieu of formal action based upon conduct related directly to patient care and not of an SB0475 Enrolled - 29 - LRB094 07024 LJB 37163 b administrative nature, or in lieu of formal action seeking to determine whether a person may be mentally or physically disabled in such a manner as to endanger patients under that person’s care.

The Medical Disciplinary Board shall, by rule, provide for the reporting to it of all instances in which a person, licensed under this Act, who is impaired by reason of age, drug or alcohol abuse or physical or mental impairment, is under supervision and, where appropriate, is in a program of rehabilitation.

Such reports shall be strictly confidential and may be reviewed and considered only by the members of the Disciplinary Board, or by authorized staff as provided by rules of the Disciplinary Board.

Provisions shall be made for the periodic report of the status of any such person not less than twice annually in order that the Disciplinary Board shall have current information upon which to determine the status of any such person.

Such initial and periodic reports of impaired physicians shall not be considered records within the meaning of The State Records Act and shall be disposed of, following a determination by the Disciplinary Board that such reports are no longer required, in a manner and at such time as the Disciplinary Board shall determine by rule.

The filing of such reports shall be construed as the filing of a report for purposes of subsection (C) of this Section.

(2) Professional associations.

The President or chief executive officer of any association or society, of persons licensed under this Act, operating within this State shall report to the Disciplinary Board when the association or society renders a final determination that a person has committed unprofessional conduct related directly to patient care or that a person may be mentally or physically disabled in such a manner as to endanger patients under that person’s care.

(3) Professional liability insurers.

Every insurance company which offers policies of professional liability SB0475 Enrolled - 30 - LRB094 07024 LJB 37163 b insurance to persons licensed under this Act, or any other entity which seeks to indemnify the professional liability of a person licensed under this Act, shall report to the Disciplinary Board the settlement of any claim or cause of action, or final judgment rendered in any cause of action, which alleged negligence in the furnishing of medical care by such licensed person when such settlement or final judgment is in favor of the plaintiff.

(4) State’s Attorneys.

The State’s Attorney of each county shall report to the Disciplinary Board all instances in which a person licensed under this Act is convicted or otherwise found guilty of the commission of any felony.

The State’s Attorney of each county may report to the Disciplinary Board through a verified complaint any instance in which the State’s Attorney believes that a physician has willfully violated the notice requirements of the Parental Notice of Abortion Act of 1995.

(5) State agencies.

All agencies, boards, commissions, departments, or other instrumentalities of the government of the State of Illinois shall report to the Disciplinary Board any instance arising in connection with the operations of such agency, including the administration of any law by such agency, in which a person licensed under this Act has either committed an act or acts which may be a violation of this Act or which may constitute unprofessional conduct related directly to patient care or which indicates that a person licensed under this Act may be mentally or physically disabled in such a manner as to endanger patients under that person’s care.

(B) Mandatory reporting.

All reports required by items (34), (35), and (36) of subsection (A) of Section 22 and by Section 23 shall be submitted to the Disciplinary Board in a timely fashion.

The reports shall be filed in writing within 60 days after a determination that a report is required under this Act.

All reports shall contain the following information:

(1) The name, address and telephone number of the SB0475 Enrolled - 31 - LRB094 07024 LJB 37163 b person making the report.

(2) The name, address and telephone number of the person who is the subject of the report.

(3) The name and date of birth or other means of identification of any patient or patients whose treatment is a subject of the report, if available, or other means of identification if such information is not available, identification of the hospital or other healthcare facility where the care at issue in the report was rendered, provided, however, no medical records may be revealed without the written consent of the patient or patients.

(4) A brief description of the facts which gave rise to the issuance of the report, including the dates of any occurrences deemed to necessitate the filing of the report.

(5) If court action is involved, the identity of the court in which the action is filed, along with the docket number and date of filing of the action.

(6) Any further pertinent information which the reporting party deems to be an aid in the evaluation of the report.

The Department shall have the right to inform patients of the right to provide written consent for the Department to obtain copies of hospital and medical records.

The Disciplinary Board or Department may also exercise the power under Section 38 of this Act to subpoena copies of hospital or medical records in mandatory report cases alleging death or permanent bodily injury when consent to obtain records is not provided by a patient or legal representative.

Appropriate rules shall be adopted by the Department with the approval of the Disciplinary Board.

When the Department has received written reports concerning incidents required to be reported in items (34), (35), and (36) of subsection (A) of Section 22, the licensee’s failure to report the incident to the Department under those items shall not be the sole grounds for disciplinary action.

SB0475 Enrolled - 32 - LRB094 07024 LJB 37163 b Nothing contained in this Section shall act to in any way, waive or modify the confidentiality of medical reports and committee reports to the extent provided by law.

Any information reported or disclosed shall be kept for the confidential use of the Disciplinary Board, the Medical Coordinators, the Disciplinary Board’s attorneys, the medical investigative staff, and authorized clerical staff, as provided in this Act, and shall be afforded the same status as is provided information concerning medical studies in Part 21 of Article VIII of the Code of Civil Procedure, except that the Department may disclose information and documents to a federal, State, or local law enforcement agency pursuant to a subpoena in an ongoing criminal investigation.

Furthermore, information and documents disclosed to a federal, State, or local law enforcement agency may be used by that agency only for the investigation and prosecution of a criminal offense.

(C) Immunity from prosecution.

Any individual or organization acting in good faith, and not in a wilful and wanton manner, in complying with this Act by providing any report or other information to the Disciplinary Board or a peer review committee, or assisting in the investigation or preparation of such information, or by voluntarily reporting to the Disciplinary Board or a peer review committee information regarding alleged errors or negligence by a person licensed under this Act, or by participating in proceedings of the Disciplinary Board or a peer review committee, or by serving as a member of the Disciplinary Board or a peer review committee, shall not, as a result of such actions, be subject to criminal prosecution or civil damages.

(D) Indemnification.

Members of the Disciplinary Board, the Medical Coordinators, the Disciplinary Board’s attorneys, the medical investigative staff, physicians retained under contract to assist and advise the medical coordinators in the investigation, and authorized clerical staff shall be indemnified by the State for any actions occurring within the scope of services on the Disciplinary Board, done in good faith SB0475 Enrolled - 33 - LRB094 07024 LJB 37163 b and not wilful and wanton in nature.

The Attorney General shall defend all such actions unless he or she determines either that there would be a conflict of interest in such representation or that the actions complained of were not in good faith or were wilful and wanton.

Should the Attorney General decline representation, the member shall have the right to employ counsel of his or her choice, whose fees shall be provided by the State, after approval by the Attorney General, unless there is a determination by a court that the member’s actions were not in good faith or were wilful and wanton.

The member must notify the Attorney General within 7 days of receipt of notice of the initiation of any action involving services of the Disciplinary Board.

Failure to so notify the Attorney General shall constitute an absolute waiver of the right to a defense and indemnification.

The Attorney General shall determine within 7 days after receiving such notice, whether he or she will undertake to represent the member.

(E) Deliberations of Disciplinary Board.

Upon the receipt of any report called for by this Act, other than those reports of impaired persons licensed under this Act required pursuant to the rules of the Disciplinary Board, the Disciplinary Board shall notify in writing, by certified mail, the person who is the subject of the report.

Such notification shall be made within 30 days of receipt by the Disciplinary Board of the report.

The notification shall include a written notice setting forth the person’s right to examine the report.

Included in such notification shall be the address at which the file is maintained, the name of the custodian of the reports, and the telephone number at which the custodian may be reached.

The person who is the subject of the report shall submit a written statement responding, clarifying, adding to, or proposing the amending of the report previously filed.

The person who is the subject of the report shall also submit with the written SB0475 Enrolled - 34 - LRB094 07024 LJB 37163 b statement any medical records related to the report.

The statement and accompanying medical records shall become a permanent part of the file and must be received by the Disciplinary Board no more than 30 60 days after the date on which the person was notified by the Disciplinary Board of the existence of the original report.

The Disciplinary Board shall review all reports received by it, together with any supporting information and responding statements submitted by persons who are the subject of reports.

The review by the Disciplinary Board shall be in a timely manner but in no event, shall the Disciplinary Board’s initial review of the material contained in each disciplinary file be less than 61 days nor more than 180 days after the receipt of the initial report by the Disciplinary Board.

When the Disciplinary Board makes its initial review of the materials contained within its disciplinary files, the Disciplinary Board shall, in writing, make a determination as to whether there are sufficient facts to warrant further investigation or action.

Failure to make such determination within the time provided shall be deemed to be a determination that there are not sufficient facts to warrant further investigation or action.

Should the Disciplinary Board find that there are not sufficient facts to warrant further investigation, or action, the report shall be accepted for filing and the matter shall be deemed closed and so reported to the Secretary Director.

The Secretary Director shall then have 30 days to accept the Medical Disciplinary Board’s decision or request further investigation.

The Secretary Director shall inform the Board in writing of the decision to request further investigation, including the specific reasons for the decision.

The individual or entity filing the original report or complaint and the person who is the subject of the report or complaint shall be notified in writing by the Secretary Director of any final action on their report or complaint.

(F) Summary reports.

The Disciplinary Board shall prepare, SB0475 Enrolled - 35 - LRB094 07024 LJB 37163 b on a timely basis, but in no event less than one every other month, a summary report of final actions taken upon disciplinary files maintained by the Disciplinary Board.

The summary reports shall be sent by the Disciplinary Board to every health care facility licensed by the Illinois Department of Public Health, every professional association and society of persons licensed under this Act functioning on a statewide basis in this State, the American Medical Association, the American Osteopathic Association, the American Chiropractic Association, all insurers providing professional liability insurance to persons licensed under this Act in the State of Illinois, the Federation of State Medical Licensing Boards, and the Illinois Pharmacists Association.

(G) Any violation of this Section shall be a Class A misdemeanor.

(H) If any such person violates the provisions of this Section an action may be brought in the name of the People of the State of Illinois, through the Attorney General of the State of Illinois, for an order enjoining such violation or for an order enforcing compliance with this Section.

Upon filing of a verified petition in such court, the court may issue a temporary restraining order without notice or bond and may preliminarily or permanently enjoin such violation, and if it is established that such person has violated or is violating the injunction, the court may punish the offender for contempt of court.

Proceedings under this paragraph shall be in addition to, and not in lieu of, all other remedies and penalties provided for by this Section.

(Source:

P.A.

89-18, eff.

6-1-95;

89-702, eff.

7-1-97;

90-699, eff.

1-1-99.) (225 ILCS 60/24) (from Ch.

111, par.

4400-24) (Section scheduled to be repealed on January 1, 2007) Sec.

24.

Report of violations;

medical associations.

Any physician licensed under this Act, the Illinois State Medical Society, the Illinois Association of Osteopathic Physicians SB0475 Enrolled - 36 - LRB094 07024 LJB 37163 b and Surgeons, the Illinois Chiropractic Society, the Illinois Prairie State Chiropractic Association, or any component societies of any of these 4 groups, and any other person, may report to the Disciplinary Board any information the physician, association, society, or person may have that appears to show that a physician is or may be in violation of any of the provisions of Section 22 of this Act.

The Department may enter into agreements with the Illinois State Medical Society, the Illinois Association of Osteopathic Physicians and Surgeons, the Illinois Prairie State Chiropractic Association, or the Illinois Chiropractic Society to allow these organizations to assist the Disciplinary Board in the review of alleged violations of this Act.

Subject to the approval of the Department, any organization party to such an agreement may subcontract with other individuals or organizations to assist in review.

Any physician, association, society, or person participating in good faith in the making of a report, under this Act or participating in or assisting with an investigation or review under this Act Section shall have immunity from any civil, criminal, or other liability that might result by reason of those actions.

The medical information in the custody of an entity under contract with the Department participating in an investigation or review shall be privileged and confidential to the same extent as are information and reports under the provisions of Part 21 of Article VIII of the Code of Civil Procedure.

Upon request by the Department after a mandatory report has been filed with the Department, an attorney for any party seeking to recover damages for injuries or death by reason of medical, hospital, or other healing art malpractice shall provide patient records related to the physician involved in the disciplinary proceeding to the Department within 30 days of the Department’s request for use by the Department in any disciplinary matter under this Act.

An attorney who provides patient records to the Department in accordance with this SB0475 Enrolled - 37 - LRB094 07024 LJB 37163 b requirement shall not be deemed to have violated any attorney-client privilege.

Notwithstanding any other provision of law, consent by a patient shall not be required for the provision of patient records in accordance with this requirement.

For the purpose of any civil or criminal proceedings, the good faith of any physician, association, society or person shall be presumed.

The Disciplinary Board may request the Illinois State Medical Society, the Illinois Association of Osteopathic Physicians and Surgeons, the Illinois Prairie State Chiropractic Association, or the Illinois Chiropractic Society to assist the Disciplinary Board in preparing for or conducting any medical competency examination as the Board may deem appropriate.

(Source:

P.A.

88-324.) (225 ILCS 60/24.1 new) Sec.

24.1.

Physician profile.

(a) This Section may be cited as the Patients’ Right to Know Law.

(b) The Department shall make available to the public a profile of each physician.

The Department shall make this information available through an Internet web site and, if requested, in writing.

The physician profile shall contain the following information:

(1) the full name of the physician;

(2) a description of any criminal convictions for felonies and Class A misdemeanors, as determined by the Department, within the most recent 5 years.

For the purposes of this Section, a person shall be deemed to be convicted of a crime if he or she pleaded guilty or if he was found or adjudged guilty by a court of competent jurisdiction;

(3) a description of any final Department disciplinary actions within the most recent 5 years;

(4) a description of any final disciplinary actions by SB0475 Enrolled - 38 - LRB094 07024 LJB 37163 b licensing boards in other states within the most recent 5 years;

(5) a description of revocation or involuntary restriction of hospital privileges for reasons related to competence or character that have been taken by the hospital’s governing body or any other official of the hospital after procedural due process has been afforded, or the resignation from or nonrenewal of medical staff membership or the restriction of privileges at a hospital taken in lieu of or in settlement of a pending disciplinary case related to competence or character in that hospital.

Only cases which have occurred within the most recent 5 years shall be disclosed by the Department to the public;

(6) all medical malpractice court judgments and all medical malpractice arbitration awards in which a payment was awarded to a complaining party during the most recent 5 years and all settlements of medical malpractice claims in which a payment was made to a complaining party within the most recent 5 years.

A medical malpractice judgment or award that has been appealed shall be identified prominently as "Under Appeal" on the profile within 20 days of formal written notice to the Department.

Information concerning all settlements shall be accompanied by the following statement:

"Settlement of a claim may occur for a variety of reasons which do not necessarily reflect negatively on the professional competence or conduct of the physician.

A payment in settlement of a medical malpractice action or claim should not be construed as creating a presumption that medical malpractice has occurred." Nothing in this subdivision (6) shall be construed to limit or prevent the Disciplinary Board from providing further explanatory information regarding the significance of categories in which settlements are reported.

Pending malpractice claims shall not be disclosed by the Department to the public.

Nothing in this subdivision (6) shall be construed to prevent the Disciplinary Board from SB0475 Enrolled - 39 - LRB094 07024 LJB 37163 b investigating and the Department from disciplining a physician on the basis of medical malpractice claims that are pending;

(7) names of medical schools attended, dates of attendance, and date of graduation;

(8) graduate medical education;

(9) specialty board certification.

The toll-free number of the American Board of Medical Specialties shall be included to verify current board certification status;

(10) number of years in practice and locations;

(11) names of the hospitals where the physician has privileges;

(12) appointments to medical school faculties and indication as to whether a physician has a responsibility for graduate medical education within the most recent 5 years;

(13) information regarding publications in peer-reviewed medical literature within the most recent 5 years;

(14) information regarding professional or community service activities and awards;

(15) the location of the physician’s primary practice setting;

(16) identification of any translating services that may be available at the physician’s primary practice location;

(17) an indication of whether the physician participates in the Medicaid program.

(c) The Disciplinary Board shall provide individual physicians with a copy of their profiles prior to release to the public.

A physician shall be provided 60 days to correct factual inaccuracies that appear in such profile.

(d) A physician may elect to have his or her profile omit certain information provided pursuant to subdivisions (12) through (14) of subsection (b) concerning academic appointments and teaching responsibilities, publication in SB0475 Enrolled - 40 - LRB094 07024 LJB 37163 b peer-reviewed journals and professional and community service awards.

In collecting information for such profiles and in disseminating the same, the Disciplinary Board shall inform physicians that they may choose not to provide such information required pursuant to subdivisions (12) through (14) of subsection (b).

(e) The Department shall promulgate such rules as it deems necessary to accomplish the requirements of this Section.

(225 ILCS 60/36) (from Ch.

111, par.

4400-36) (Section scheduled to be repealed on January 1, 2007) Sec.

36.

Upon the motion of either the Department or the Disciplinary Board or upon the verified complaint in writing of any person setting forth facts which, if proven, would constitute grounds for suspension or revocation under Section 22 of this Act, the Department shall investigate the actions of any person, so accused, who holds or represents that they hold a license.

Such person is hereinafter called the accused.

The Department shall, before suspending, revoking, placing on probationary status, or taking any other disciplinary action as the Department may deem proper with regard to any license at least 30 days prior to the date set for the hearing, notify the accused in writing of any charges made and the time and place for a hearing of the charges before the Disciplinary Board, direct them to file their written answer thereto to the Disciplinary Board under oath within 20 days after the service on them of such notice and inform them that if they fail to file such answer default will be taken against them and their license may be suspended, revoked, placed on probationary status, or have other disciplinary action, including limiting the scope, nature or extent of their practice, as the Department may deem proper taken with regard thereto.

Where a physician has been found, upon complaint and investigation of the Department, and after hearing, to have performed an abortion procedure in a wilful and wanton manner upon a woman who was not pregnant at the time such abortion SB0475 Enrolled - 41 - LRB094 07024 LJB 37163 b procedure was performed, the Department shall automatically revoke the license of such physician to practice medicine in Illinois.

Such written notice and any notice in such proceedings thereafter may be served by delivery of the same, personally, to the accused person, or by mailing the same by registered or certified mail to the address last theretofore specified by the accused in their last notification to the Department.

All information gathered by the Department during its investigation including information subpoenaed under Section 23 or 38 of this Act and the investigative file shall be kept for the confidential use of the Secretary Director, Disciplinary Board, the Medical Coordinators, persons employed by contract to advise the Medical Coordinator or the Department, the Disciplinary Board’s attorneys, the medical investigative staff, and authorized clerical staff, as provided in this Act and shall be afforded the same status as is provided information concerning medical studies in Part 21 of Article VIII of the Code of Civil Procedure, except that the Department may disclose information and documents to a federal, State, or local law enforcement agency pursuant to a subpoena in an ongoing criminal investigation.

Furthermore, information and documents disclosed to a federal, State, or local law enforcement agency may be used by that agency only for the investigation and prosecution of a criminal offense.

(Source:

P.A.

90-699, eff.

1-1-99.) Section 320.

The Clerks of Courts Act is amended by adding Section 27.10 as follows:

(705 ILCS 105/27.10 new) Sec.

27.10.

Secretary of Financial and Professional Regulation.

Each clerk of the circuit court shall provide to the Secretary of Financial and Professional Regulation such information as the Secretary of Financial and Professional Regulation requests under Section 155.19 of the Illinois SB0475 Enrolled - 42 - LRB094 07024 LJB 37163 b Insurance Code.

Section 330.

The Code of Civil Procedure is amended by reenacting and changing Sections 2-622 and 8-2501, by changing Section 8-1901, and by adding Sections 2-1704.5 and 2-1706.5 as follows:

(735 ILCS 5/2-622) (from Ch.

110, par.

2-622) (Text of Section WITHOUT the changes made by P.A.

89-7, which has been held unconstitutional) Sec.

2-622.

Healing art malpractice.

(a) In any action, whether in tort, contract or otherwise, in which the plaintiff seeks damages for injuries or death by reason of medical, hospital, or other healing art malpractice, the plaintiff’s attorney or the plaintiff, if the plaintiff is proceeding pro se, shall file an affidavit, attached to the original and all copies of the complaint, declaring one of the following:

1.

That the affiant has consulted and reviewed the facts of the case with a health professional who the affiant reasonably believes:

(i) is knowledgeable in the relevant issues involved in the particular action;