§ 230-D — Office-based surgery

§ 230-d. Office-based surgery. 1. The following words or phrases, as\nused in this section shall have the following meanings:\n (a) "Accredited status" means the full accreditation by\nnationally-recognized accrediting agency(ies) determined by the\ncommissioner.\n (b) "Adverse event" means (i) patient death within thirty days; (ii)\nunplanned transfer to a hospital or emergency department visit within\nseventy-two hours of office-based surgery for reasons related to the\noffice-based surgery encounter; (iii) unscheduled hospital admission or\nassignment to observation services, within seventy-two hours of the\noffice-based surgery, for longer than twenty-four hours; or (iv) any\nother serious or life-threatening event.\n (c) "Deep sedation" means a drug-induced depression of consciousness\nduring which (i) the patient cannot be easily aroused but responds\npurposefully following repeated painful stimulation; (ii) the patient's\nability to maintain independent ventilatory function may be impaired;\n(iii) the patient may require assistance in maintaining a patent airway\nand spontaneous ventilation may be inadequate; and (iv) the patient's\ncardiovascular function is usually maintained without assistance.\n (d) "General anesthesia" means a drug-induced depression of\nconsciousness during which (i) the patient is not arousable, even by\npainful stimulation; (ii) the patient's ability to maintain independent\nventilatory function is often impaired; (iii) the patient, in many\ncases, often requires assistance in maintaining a patent airway and\npositive pressure ventilation may be required because of depressed\nspontaneous ventilation or drug-induced depression of neuromuscular\nfunction; and (iv) the patient's cardiovascular function may be\nimpaired.\n (e) "Moderate sedation" means a drug-induced depression of\nconsciousness during which (i) the patient responds purposefully to\nverbal commands, either alone or accompanied by light tactile\nstimulation; (ii) no interventions are required to maintain a patent\nairway; (iii) spontaneous ventilation is adequate; and (iv) the\npatient's cardiovascular function is usually maintained without\nassistance.\n (f) "Minimal sedation" means a drug-induced state during which (i)\npatients respond normally to verbal commands; (ii) cognitive function\nand coordination may be impaired; and (iii) ventilatory and\ncardiovascular functions are unaffected.\n (g) "Minor procedures" means (i) procedures that can be performed\nsafely with a minimum of discomfort where the likelihood of\ncomplications requiring hospitalization is minimal; (ii) procedures\nperformed with local or topical anesthesia; or (iii) liposuction with\nremoval of less than 500 cc of fat under unsupplemented local\nanesthesia.\n (h) "Office-based surgery" means any surgical or other invasive\nprocedure, requiring general anesthesia, moderate sedation, or deep\nsedation, and any liposuction procedure, where such surgical or other\ninvasive procedure or liposuction is performed by a licensee in a\nlocation other than a hospital, as such term is defined in article\ntwenty-eight of this chapter, excluding minor procedures and procedures\nrequiring minimal sedation.\n (i) "Licensee" shall mean an individual licensed or otherwise\nauthorized under article one hundred thirty-one, one hundred\nthirty-one-B, individuals who have obtained an issuance of a privilege\nto perform podiatric standard or advanced ankle surgery pursuant to\nsubdivisions one and two of section seven thousand nine of the education\nlaw.\n 2. Licensee practices in which office-based surgery is performed shall\nobtain and maintain full accredited status.\n 3. A licensee may only perform office-based surgery in a setting that\nhas obtained and maintains full accredited status.\n 4. (a) Licensees shall report adverse events to the department's\npatient safety center within three business days of the occurrence of\nsuch adverse event. Licensees shall also report any suspected health\ncare disease transmission originating in their practices to the patient\nsafety center within three business days of becoming aware of such\nsuspected transmission. For purposes of this section, health care\ndisease transmission shall mean the transmission of a reportable\ncommunicable disease that is blood borne from a health care professional\nto a patient or between patients as a result of improper infection\ncontrol practices by the health care professional.\n (b) The department may also require licensees to report additional\ndata such as procedural information as needed for the interpretation of\nadverse events.\n (c) The data reported under this subdivision shall be subject to all\nconfidentiality provisions provided by section twenty-nine hundred\nninety-eight-e of this chapter.\n 5. The commissioner shall make, adopt, promulgate and enforce such\nrules and regulations, as he or she may deem appropriate, to effectuate\nthe purposes of this section. Where any rule or regulation under this\nsection would affect the scope of practice of a health care practitioner\nlicensed, registered or certified under title eight of the education law\nother than those licensed under articles one hundred thirty-one or one\nhundred thirty-one-B of the education law, the rule or regulation shall\nbe made with the concurrence of the commissioner of education.\n