§ 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.