S T A T E O F N E W Y O R K
________________________________________________________________________
9293--A
I N A S S E M B L Y
February 14, 2012
___________
Introduced by M. of A. PRETLOW, LATIMER, CASTRO -- Multi-Sponsored by --
M. of A. RA, WALTER -- read once and referred to the Committee on
Higher Education -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
AN ACT to amend the education law, the public health law, and the civil
practice law and rules, in relation to the podiatric scope of practice
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Section 7001 of the education law, as amended by chapter
2 677 of the laws of 1996, is amended to read as follows:
3 S 7001. Definition of practice of podiatry. 1. The practice of the
4 profession of podiatry is defined as diagnosing, treating, operating and
5 prescribing for any disease, injury, deformity or other condition of the
6 foot, and may include performing physical evaluations in conjunction
7 with the provision of podiatric treatment. FOR THE PURPOSES OF WOUND
8 CARE HOWEVER, THE PRACTICE OF PODIATRY SHALL INCLUDE THE TREATMENT OF
9 SUCH WOUNDS IF THEY ARE CONTIGUOUS WITH WOUNDS RELATING, ORIGINATING OR
10 IN THE COURSE OF TREATMENT OF A WOUND ON THE FOOT WITHIN THE PODIATRIC
11 SCOPE OF PRACTICE. WOUND CARE SHALL NOT, HOWEVER, EXTEND BEYOND TO THE
12 LEVEL ENDING AT THE DISTAL TIBIAL TUBEROSITY. THE PRACTICE OF PODIATRY
13 MAY ALSO INCLUDE DIAGNOSING, TREATING, OPERATING AND PRESCRIBING FOR ANY
14 DISEASE, INJURY, DEFORMITY OR OTHER CONDITION OF THE ANKLE AND SOFT
15 TISSUE OF THE LEG BELOW THE TIBIAL TUBEROSITY IF THE PODIATRIST HAS
16 OBTAINED AN ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC STANDARD ANKLE
17 SURGERY OR ADVANCED ANKLE SURGERY IN ACCORDANCE WITH SECTION SEVEN THOU-
18 SAND NINE OF THIS ARTICLE. Podiatrists may treat traumatic open wound
19 fractures only in hospitals, as defined in article twenty-eight of the
20 public health law. FOR THE PURPOSES OF THIS ARTICLE, THE TERM "ANKLE"
21 SHALL BE DEFINED AS THE DISTAL METAPHYSIS AND EPIPHYSIS OF THE TIBIA AND
22 FIBULA, THE ARTICULAR CARTILAGE OF THE DISTAL TIBIA AND DISTAL FIBULA,
23 THE LIGAMENTS THAT CONNECT THE DISTAL METAPHYSIS AND EPIPHYSIS OF THE
24 TIBIA AND FIBULA AND TALUS, AND THE PORTIONS OF SKIN, SUBCUTANEOUS
25 TISSUE, FACIA, MUSCLES, TENDONS, LIGAMENTS AND NERVES AT OR BELOW THE
26 LEVEL OF THE MYOTENDINOUS JUNCTION OF THE TRICEPS SURAE.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02760-07-2
A. 9293--A 2
1 2. The practice of podiatry shall not include treating any part of the
2 human body other than the foot, nor treating fractures of the malleoli
3 or cutting operations upon the malleoli UNLESS THE PODIATRIST OBTAINS AN
4 ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC STANDARD ANKLE SURGERY OR
5 PODIATRIC ADVANCED ANKLE SURGERY. PODIATRISTS WHO HAVE OBTAINED AN ISSU-
6 ANCE OF A PRIVILEGE TO PERFORM PODIATRIC STANDARD ANKLE SURGERY MAY
7 PERFORM SURGERY ON THE ANKLE WHICH MAY INCLUDE SOFT TISSUE AND OSSEOUS
8 PROCEDURES EXCEPT THOSE PROCEDURES SPECIFICALLY AUTHORIZED FOR PODIA-
9 TRISTS WHO HAVE OBTAINED AN ISSUANCE OF A PRIVILEGE FOR ADVANCED ANKLE
10 SURGERY. PODIATRISTS WHO HAVE OBTAINED AN ISSUANCE OF A PRIVILEGE TO
11 PERFORM PODIATRIC ADVANCED ANKLE SURGERY MAY PERFORM SURGERY ON THE
12 ANKLE WHICH MAY INCLUDE ANKLE FRACTURE FIXATION, ANKLE FUSION, ANKLE
13 ARTHROSCOPY, INSERTION OR REMOVAL OF EXTERNAL FIXATION PINS INTO OR FROM
14 THE TIBIAL DIAPHYSIS AT OR BELOW THE LEVEL OF THE MYOTENDINOUS JUNCTION
15 OF THE TRICEPS SURAE, AND INSERTION AND REMOVAL OF RETROGRADE TIBIOTALO-
16 CALCANNEAL INTRAMEDULLARY RODS AND LOCKING SCREWS UP TO THE LEVEL OF THE
17 MYOTENDINOUS JUNCTION OF THE TRICEPS SURAE, BUT DOES NOT INCLUDE THE
18 SURGICAL TREATMENT OF COMPLICATIONS WITHIN THE TIBIAL DIAPHYSIS RELATED
19 TO THE USE OF SUCH EXTERNAL FIXATION PINS. Podiatrists licensed to
20 practice, but not authorized to prescribe or administer narcotics prior
21 to the effective date of this subdivision, may do so only after certif-
22 ication by the department in accordance with the qualifications estab-
23 lished by the commissioner. The practice of podiatry shall include
24 administering only local anesthetics for therapeutic purposes as well as
25 for anesthesia and treatment under general anesthesia administered by
26 authorized persons. THE PRACTICE OF PODIATRY BY ANY LICENSEE SHALL NOT
27 INCLUDE PARTIAL OR TOTAL ANKLE REPLACEMENTS NOR THE TREATMENT OF PILON
28 FRACTURES.
29 S 2. The education law is amended by adding two new sections 7009 and
30 7010 to read as follows:
31 S 7009. PODIATRIC ANKLE SURGERY PRIVILEGES. 1. FOR ISSUANCE OF A PRIV-
32 ILEGE TO PERFORM PODIATRIC STANDARD ANKLE SURGERY, AS THAT TERM IS USED
33 IN SUBDIVISION TWO OF SECTION SEVEN THOUSAND ONE OF THIS ARTICLE, THE
34 APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS:
35 A. APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT;
36 B. LICENSE: BE LICENSED AS A PODIATRIST IN THE STATE;
37 C. TRAINING AND CERTIFICATION: EITHER:
38 (I) HAVE GRADUATED ON OR AFTER JUNE FIRST, TWO THOUSAND SIX FROM A
39 THREE-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
40 ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, AND BE
41 CERTIFIED IN RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY BY A NATIONAL
42 CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE
43 DEPARTMENT; OR
44 (II) HAVE GRADUATED ON OR AFTER JUNE FIRST, TWO THOUSAND SIX FROM A
45 THREE-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
46 ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, BE
47 BOARD QUALIFIED BUT NOT YET CERTIFIED IN RECONSTRUCTIVE REARFOOT AND
48 ANKLE SURGERY BY A NATIONAL CERTIFYING BOARD HAVING CERTIFICATION STAND-
49 ARDS ACCEPTABLE TO THE DEPARTMENT, AND PROVIDE DOCUMENTATION THAT HE OR
50 SHE HAS ACCEPTABLE TRAINING AND EXPERIENCE IN STANDARD OR ADVANCE
51 MIDFOOT, REARFOOT AND ANKLE PROCEDURES THAT HAS BEEN APPROVED BY THE
52 DEPARTMENT; OR
53 (III) HAVE GRADUATED BEFORE JUNE FIRST, TWO THOUSAND SIX FROM A
54 TWO-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
55 ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, BE
56 CERTIFIED IN RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY BY A NATIONAL
A. 9293--A 3
1 CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE
2 DEPARTMENT, AND PROVIDE DOCUMENTATION THAT HE OR SHE HAS ACCEPTABLE
3 TRAINING AND EXPERIENCE IN STANDARD OR ADVANCED MIDFOOT, REARFOOT AND
4 ANKLE PROCEDURES THAT HAS BEEN APPROVED BY THE DEPARTMENT;
5 D. FEES: PAY A FEE TO THE DEPARTMENT OF TWO HUNDRED TWENTY DOLLARS FOR
6 THE ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC STANDARD ANKLE SURGERY.
7 2. FOR ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC ADVANCED ANKLE
8 SURGERY, AS THAT TERM IS USED IN SUBDIVISION TWO OF SECTION SEVEN THOU-
9 SAND ONE OF THIS ARTICLE, THE APPLICANT SHALL FULFILL THE FOLLOWING
10 REQUIREMENTS:
11 A. APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT;
12 B. LICENSE: BE LICENSED AS A PODIATRIST IN THE STATE;
13 C. EXPERIENCE AND CERTIFICATION: EITHER:
14 (I) HAVE GRADUATED ON OR AFTER JUNE FIRST, TWO THOUSAND SIX FROM A
15 THREE-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
16 ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, BE
17 CERTIFIED IN RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY BY A NATIONAL
18 CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE
19 DEPARTMENT, AND PROVIDE DOCUMENTATION THAT HE OR SHE HAS ACCEPTABLE
20 TRAINING AND EXPERIENCE IN ADVANCED MIDFOOT, REARFOOT AND ANKLE PROCE-
21 DURES THAT HAS BEEN APPROVED BY THE DEPARTMENT; OR
22 (II) HAVE GRADUATED BEFORE JUNE FIRST, TWO THOUSAND SIX FROM A
23 TWO-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
24 ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, BE
25 CERTIFIED IN RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY, BY A NATIONAL
26 CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE
27 DEPARTMENT, AND PROVIDE DOCUMENTATION THAT HE OR SHE HAS ACCEPTABLE
28 TRAINING AND EXPERIENCE IN ADVANCED MIDFOOT, REARFOOT AND ANKLE PROCE-
29 DURES THAT HAS BEEN APPROVED BY THE DEPARTMENT.
30 D. FEES: PAY A FEE TO THE DEPARTMENT OF TWO HUNDRED TWENTY DOLLARS FOR
31 THE ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC ADVANCED ANKLE SURGERY.
32 3. DURATION AND REGISTRATION OF PRIVILEGES. A PRIVILEGE ISSUED UNDER
33 THIS SECTION SHALL BE VALID FOR THE LIFE OF THE HOLDER, UNLESS REVOKED,
34 ANNULLED, OR SUSPENDED BY THE BOARD OF REGENTS. SUCH A PRIVILEGE SHALL
35 BE SUBJECT TO THE SAME OVERSIGHT AND DISCIPLINARY PROVISIONS AS LICENSES
36 ISSUED UNDER THIS TITLE. THE HOLDER OF A PRIVILEGE ISSUED UNDER THIS
37 SECTION SHALL REGISTER WITH THE DEPARTMENT AS A PRIVILEGE HOLDER IN THE
38 SAME MANNER AND SUBJECT TO THE SAME PROVISIONS AS REQUIRED OF A LICENSEE
39 PURSUANT TO SECTION SIX THOUSAND FIVE HUNDRED TWO OF THIS TITLE,
40 PROVIDED THAT, AT THE TIME OF EACH REGISTRATION, THE PRIVILEGE HOLDER
41 SHALL CERTIFY THAT HE OR SHE CONTINUES TO MEET THE REQUIREMENTS FOR THE
42 PRIVILEGE SET FORTH IN THIS SECTION. THE FEE FOR SUCH REGISTRATION SHALL
43 BE TWO HUNDRED TEN DOLLARS. THE REGISTRATION PERIOD FOR A PRIVILEGE
44 HOLDER SHALL BE COTERMINOUS WITH HIS OR HER REGISTRATION AS A PODIA-
45 TRIST.
46 S 7010. ANKLE SURGERY LIMITED PERMITS. A LIMITED PERMIT TO PERFORM
47 PODIATRIC STANDARD ANKLE SURGERY, AS DESCRIBED IN SUBDIVISION TWO OF
48 SECTION SEVEN THOUSAND ONE OF THIS ARTICLE, MAY BE ISSUED BY THE DEPART-
49 MENT TO A PODIATRIST WHO IS LICENSED PURSUANT TO THIS ARTICLE AND WHO
50 HAS MET THE RESIDENCY AND BOARD QUALIFICATION/CERTIFICATION REQUIREMENTS
51 SET FORTH IN SUBDIVISION ONE OF SECTION SEVEN THOUSAND NINE OF THIS
52 ARTICLE IN ORDER TO AUTHORIZE SUCH PODIATRIST TO OBTAIN THE TRAINING AND
53 EXPERIENCE REQUIRED FOR THE ISSUANCE OF A PODIATRIC STANDARD ANKLE
54 SURGERY PRIVILEGE PURSUANT TO SUBDIVISION ONE OF SECTION SEVEN THOUSAND
55 NINE OF THIS ARTICLE. SUCH PERMITS SHALL AUTHORIZE THE PERFORMANCE OF
56 PODIATRIC STANDARD ANKLE SURGERY ONLY UNDER THE DIRECT PERSONAL SUPER-
A. 9293--A 4
1 VISION OF A LICENSED PODIATRIST HOLDING A PODIATRIC STANDARD ANKLE
2 SURGERY PRIVILEGE OR A PODIATRIC ADVANCED ANKLE SURGERY PRIVILEGE ISSUED
3 PURSUANT TO SECTION SEVEN THOUSAND NINE OF THIS ARTICLE OR OF A PHYSI-
4 CIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THIS TITLE
5 AND CERTIFIED IN ORTHOPEDIC SURGERY BY A NATIONAL CERTIFYING BOARD
6 HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE DEPARTMENT.
7 2. A LIMITED PERMIT TO PERFORM PODIATRIC ADVANCED ANKLE SURGERY, AS
8 DESCRIBED IN SUBDIVISION TWO OF SECTION SEVEN THOUSAND ONE OF THIS ARTI-
9 CLE, MAY BE ISSUED BY THE DEPARTMENT TO A PODIATRIST WHO IS LICENSED
10 PURSUANT TO THIS ARTICLE AND WHO HAS MET THE RESIDENCY AND BOARD CERTIF-
11 ICATION REQUIREMENTS SET FORTH IN SUBDIVISION TWO OF SECTION SEVEN THOU-
12 SAND NINE OF THIS ARTICLE IN ORDER TO AUTHORIZE SUCH PODIATRIST TO
13 OBTAIN THE TRAINING AND EXPERIENCE REQUIRED FOR THE ISSUANCE OF A PODIA-
14 TRIC ADVANCED ANKLE SURGERY PRIVILEGE PURSUANT TO SUBDIVISION TWO OF
15 SECTION SEVEN THOUSAND NINE OF THIS ARTICLE. SUCH PERMITS SHALL AUTHOR-
16 IZE THE PERFORMANCE OF PODIATRIC ADVANCED ANKLE SURGERY ONLY UNDER THE
17 DIRECT PERSONAL SUPERVISION OF A LICENSED PODIATRIST HOLDING A PODIATRIC
18 ADVANCED ANKLE SURGERY PRIVILEGE ISSUED PURSUANT TO SUBDIVISION TWO OF
19 SECTION SEVEN THOUSAND NINE OF THIS ARTICLE OR OF A PHYSICIAN LICENSED
20 PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THIS TITLE AND CERTIFIED
21 IN ORTHOPEDIC SURGERY BY A NATIONAL CERTIFYING BOARD HAVING CERTIF-
22 ICATION STANDARDS ACCEPTABLE TO THE DEPARTMENT.
23 3. FOR THE PURPOSES OF THIS SECTION, DIRECT PERSONAL SUPERVISION MEANS
24 SUPERVISION OF PROCEDURES BASED ON INSTRUCTIONS GIVEN DIRECTLY BY THE
25 SUPERVISING PODIATRIST OR PHYSICIAN WHO REMAINS IN THE IMMEDIATE AREA
26 WHERE THE PROCEDURES ARE BEING PERFORMED, AUTHORIZES THE PROCEDURES AND
27 EVALUATES THE PROCEDURES PERFORMED BY THE HOLDER OF THE LIMITED PERMIT.
28 4. THE HOLDER OF A LIMITED PERMIT ISSUED PURSUANT TO THIS SECTION
29 SHALL PERFORM PODIATRIC ANKLE SURGERY ONLY IN A HOSPITAL OR HEALTH
30 FACILITY LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH
31 LAW AND APPROPRIATELY AUTHORIZED TO PROVIDE SUCH SURGERY.
32 5. LIMITED PERMITS SHALL BE ISSUED FOR A PERIOD OF ONE YEAR, AND MAY
33 BE RENEWED FOR ADDITIONAL ONE YEAR PERIODS WHEN NECESSARY TO PERMIT THE
34 COMPLETION OF THE TRAINING AND EXPERIENCE REQUIRED TO OBTAIN A PODIATRIC
35 STANDARD ANKLE SURGERY PRIVILEGE OR PODIATRIC ADVANCED ANKLE SURGERY
36 PRIVILEGE, AS APPLICABLE, PROVIDED THAT NO PERMIT MAY BE RENEWED MORE
37 THAN FOUR TIMES FOR EACH SUCH PRIVILEGE.
38 6. THE FEE FOR A LIMITED PERMIT SHALL BE ONE HUNDRED FIVE DOLLARS AND
39 THE FEE FOR A RENEWAL SHALL BE FIFTY DOLLARS.
40 S 3. Paragraph (i) of subdivision 1 of section 230-d of the public
41 health law, as added by chapter 365 of the laws of 2007, is amended to
42 read as follows:
43 (i) "Licensee" shall mean an individual licensed or otherwise author-
44 ized under [articles] ARTICLE one hundred thirty-one [or], one hundred
45 thirty-one-B, INDIVIDUALS WHO HAVE OBTAINED AN ISSUANCE OF A PRIVILEGE
46 TO PERFORM PODIATRIC STANDARD OR ADVANCED ANKLE SURGERY PURSUANT TO
47 SUBDIVISIONS ONE AND TWO OF SECTION SEVEN THOUSAND NINE of the education
48 law.
49 S 4. Section 2995-d of the public health law is amended by adding a
50 new subdivision 4-a to read as follows:
51 4-A. IN COOPERATION WITH THE EDUCATION DEPARTMENT, ESTABLISH A HEALTH
52 CARE PRACTITIONER DATABASE RELATING TO PODIATRISTS. SUCH DATABASE SHALL
53 INCLUDE INFORMATION SIMILAR TO THE PHYSICIAN PROFILES ESTABLISHED PURSU-
54 ANT TO SECTION TWENTY-NINE HUNDRED NINETY-FIVE-A OF THIS TITLE. THE
55 DATABASE SHALL BE CAPABLE OF PRESENTING RELEVANT MEDICAL AND TREATMENT
A. 9293--A 5
1 INFORMATION IN A FORMAT THAT IS EASILY UNDERSTOOD BY AND MADE AVAILABLE
2 TO THE GENERAL PUBLIC.
3 S 5. Paragraph 1 of subdivision (d) of section 3101 of the civil prac-
4 tice law and rules is amended by adding a new subparagraph (iv) to read
5 as follows:
6 (IV) IN AN ACTION FOR PODIATRIC MEDICAL MALPRACTICE, A PHYSICIAN MAY
7 BE CALLED AS AN EXPERT WITNESS AT TRIAL.
8 S 6. This act shall take effect eighteen months after it shall have
9 become a law. Effective immediately, the addition, amendment and/or
10 repeal of any rule or regulation necessary for the implementation of the
11 provisions of this act on its effective date is authorized to be made on
12 or before such effective date.