N.Y. Public Health Law § 230-d: Office-based surgery

§ 230-d. Office-based surgery. 1. The following words or phrases, as

used in this section shall have the following meanings:

(a) "Accredited status" means the full accreditation by

nationally-recognized accrediting agency(ies) determined by the

commissioner.

(b) "Adverse event" means (i) patient death within thirty days; (ii)

unplanned transfer to a hospital or emergency department visit within

seventy-two hours of office-based surgery for reasons related to the

office-based surgery encounter; (iii) unscheduled hospital admission or

assignment to observation services, within seventy-two hours of the

office-based surgery, for longer than twenty-four hours; or (iv) any

other serious or life-threatening event.

(c) "Deep sedation" means a drug-induced depression of consciousness

during which (i) the patient cannot be easily aroused but responds

purposefully following repeated painful stimulation; (ii) the patient's

ability to maintain independent ventilatory function may be impaired;

(iii) the patient may require assistance in maintaining a patent airway

and spontaneous ventilation may be inadequate; and (iv) the patient's

cardiovascular function is usually maintained without assistance.

(d) "General anesthesia" means a drug-induced depression of

consciousness during which (i) the patient is not arousable, even by

painful stimulation; (ii) the patient's ability to maintain independent

ventilatory function is often impaired; (iii) the patient, in many

cases, often requires assistance in maintaining a patent airway and

positive pressure ventilation may be required because of depressed

spontaneous ventilation or drug-induced depression of neuromuscular

function; and (iv) the patient's cardiovascular function may be

impaired.

(e) "Moderate sedation" means a drug-induced depression of

consciousness during which (i) the patient responds purposefully to

verbal commands, either alone or accompanied by light tactile

stimulation; (ii) no interventions are required to maintain a patent

airway; (iii) spontaneous ventilation is adequate; and (iv) the

patient's cardiovascular function is usually maintained without

assistance.

(f) "Minimal sedation" means a drug-induced state during which (i)

patients respond normally to verbal commands; (ii) cognitive function

and coordination may be impaired; and (iii) ventilatory and

cardiovascular functions are unaffected.

(g) "Minor procedures" means (i) procedures that can be performed

safely with a minimum of discomfort where the likelihood of

complications requiring hospitalization is minimal; (ii) procedures

performed with local or topical anesthesia; or (iii) liposuction with

removal of less than 500 cc of fat under unsupplemented local

anesthesia.

(h) "Office-based surgery" means any surgical or other invasive

procedure, requiring general anesthesia, moderate sedation, or deep

sedation, and any liposuction procedure, where such surgical or other

invasive procedure or liposuction is performed by a licensee in a

location other than a hospital, as such term is defined in article

twenty-eight of this chapter, excluding minor procedures and procedures

requiring minimal sedation.

(i) "Licensee" shall mean an individual licensed or otherwise

authorized under article one hundred thirty-one, one hundred

thirty-one-B, individuals who have obtained an issuance of a privilege

to perform podiatric standard or advanced ankle surgery pursuant to

subdivisions one and two of section seven thousand nine of the education

law.

2. Licensee practices in which office-based surgery is performed shall

obtain and maintain full accredited status.

3. A licensee may only perform office-based surgery in a setting that

has obtained and maintains full accredited status.

4. (a) Licensees shall report adverse events to the department's

patient safety center within three business days of the occurrence of

such adverse event. Licensees shall also report any suspected health

care disease transmission originating in their practices to the patient

safety center within three business days of becoming aware of such

suspected transmission. For purposes of this section, health care

disease transmission shall mean the transmission of a reportable

communicable disease that is blood borne from a health care professional

to a patient or between patients as a result of improper infection

control practices by the health care professional.

(b) The department may also require licensees to report additional

data such as procedural information as needed for the interpretation of

adverse events.

(c) The data reported under this subdivision shall be subject to all

confidentiality provisions provided by section twenty-nine hundred

ninety-eight-e of this chapter.

5. The commissioner shall make, adopt, promulgate and enforce such

rules and regulations, as he or she may deem appropriate, to effectuate

the purposes of this section. Where any rule or regulation under this

section would affect the scope of practice of a health care practitioner

licensed, registered or certified under title eight of the education law

other than those licensed under articles one hundred thirty-one or one

hundred thirty-one-B of the education law, the rule or regulation shall

be made with the concurrence of the commissioner of education.