S T A T E O F N E W Y O R K
________________________________________________________________________
7800
I N S E N A T E
June 19, 2012
___________
Introduced by Sen. LIBOUS -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
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:
Section 1. Section 7001 of the education law, as amended by chapter
677 of the laws of 1996, is amended to read as follows:
S 7001. Definition of practice of podiatry. 1. The practice of the
profession of podiatry is defined as diagnosing, treating, operating and
prescribing for any disease, injury, deformity or other condition of the
foot, and may include performing physical evaluations in conjunction
with the provision of podiatric treatment. FOR THE PURPOSES OF WOUND
CARE HOWEVER, THE PRACTICE OF PODIATRY SHALL INCLUDE THE TREATMENT OF
SUCH WOUNDS IF THEY ARE CONTIGUOUS WITH WOUNDS RELATING, ORIGINATING OR
IN THE COURSE OF TREATMENT OF A WOUND ON THE FOOT WITHIN THE PODIATRIC
SCOPE OF PRACTICE. WOUND CARE SHALL NOT, HOWEVER, EXTEND BEYOND TO THE
LEVEL ENDING AT THE DISTAL TIBIAL TUBEROSITY. THE PRACTICE OF PODIATRY
MAY ALSO INCLUDE DIAGNOSING, TREATING, OPERATING AND PRESCRIBING FOR ANY
DISEASE, INJURY, DEFORMITY OR OTHER CONDITION OF THE ANKLE AND SOFT
TISSUE OF THE LEG BELOW THE TIBIAL TUBEROSITY IF THE PODIATRIST HAS
OBTAINED AN ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC STANDARD ANKLE
SURGERY OR ADVANCED ANKLE SURGERY IN ACCORDANCE WITH SECTION SEVEN THOU-
SAND NINE OF THIS ARTICLE. Podiatrists may treat traumatic open wound
fractures only in hospitals, as defined in article twenty-eight of the
public health law. FOR THE PURPOSES OF THIS ARTICLE, THE TERM "ANKLE"
SHALL BE DEFINED AS THE DISTAL METAPHYSIS AND EPIPHYSIS OF THE TIBIA AND
FIBULA, THE ARTICULAR CARTILAGE OF THE DISTAL TIBIA AND DISTAL FIBULA,
THE LIGAMENTS THAT CONNECT THE DISTAL METAPHYSIS AND EPIPHYSIS OF THE
TIBIA AND FIBULA AND TALUS, AND THE PORTIONS OF SKIN, SUBCUTANEOUS
TISSUE, FACIA, MUSCLES, TENDONS, LIGAMENTS AND NERVES AT OR BELOW THE
LEVEL OF THE MYOTENDINOUS JUNCTION OF THE TRICEPS SURAE.
2. The practice of podiatry shall not include treating any part of the
human body other than the foot, nor treating fractures of the malleoli
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD16059-08-2
S. 7800 2
or cutting operations upon the malleoli UNLESS THE PODIATRIST OBTAINS AN
ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC STANDARD ANKLE SURGERY OR
PODIATRIC ADVANCED ANKLE SURGERY. PODIATRISTS WHO HAVE OBTAINED AN ISSU-
ANCE OF A PRIVILEGE TO PERFORM PODIATRIC STANDARD ANKLE SURGERY MAY
PERFORM SURGERY ON THE ANKLE WHICH MAY INCLUDE SOFT TISSUE AND OSSEOUS
PROCEDURES EXCEPT THOSE PROCEDURES SPECIFICALLY AUTHORIZED FOR PODIA-
TRISTS WHO HAVE OBTAINED AN ISSUANCE OF A PRIVILEGE FOR ADVANCED ANKLE
SURGERY. PODIATRISTS WHO HAVE OBTAINED AN ISSUANCE OF A PRIVILEGE TO
PERFORM PODIATRIC ADVANCED ANKLE SURGERY MAY PERFORM SURGERY ON THE
ANKLE WHICH MAY INCLUDE ANKLE FRACTURE FIXATION, ANKLE FUSION, ANKLE
ARTHROSCOPY, INSERTION OR REMOVAL OF EXTERNAL FIXATION PINS INTO OR FROM
THE TIBIAL DIAPHYSIS AT OR BELOW THE LEVEL OF THE MYOTENDINOUS JUNCTION
OF THE TRICEPS SURAE, AND INSERTION AND REMOVAL OF RETROGRADE TIBIOTALO-
CALCANNEAL INTRAMEDULLARY RODS AND LOCKING SCREWS UP TO THE LEVEL OF THE
MYOTENDINOUS JUNCTION OF THE TRICEPS SURAE, BUT DOES NOT INCLUDE THE
SURGICAL TREATMENT OF COMPLICATIONS WITHIN THE TIBIAL DIAPHYSIS RELATED
TO THE USE OF SUCH EXTERNAL FIXATION PINS. Podiatrists licensed to
practice, but not authorized to prescribe or administer narcotics prior
to the effective date of this subdivision, may do so only after certif-
ication by the department in accordance with the qualifications estab-
lished by the commissioner. The practice of podiatry shall include
administering only local anesthetics for therapeutic purposes as well as
for anesthesia and treatment under general anesthesia administered by
authorized persons. THE PRACTICE OF PODIATRY BY ANY LICENSEE SHALL NOT
INCLUDE PARTIAL OR TOTAL ANKLE REPLACEMENTS NOR THE TREATMENT OF PILON
FRACTURES.
S 2. The education law is amended by adding two new sections 7009 and
7010 to read as follows:
S 7009. PODIATRIC ANKLE SURGERY PRIVILEGES. 1. FOR ISSUANCE OF A PRIV-
ILEGE TO PERFORM PODIATRIC STANDARD ANKLE SURGERY, AS THAT TERM IS USED
IN SUBDIVISION TWO OF SECTION SEVEN THOUSAND ONE OF THIS ARTICLE, THE
APPLICANT SHALL FULFILL THE FOLLOWING REQUIREMENTS:
A. APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT;
B. LICENSE: BE LICENSED AS A PODIATRIST IN THE STATE;
C. TRAINING AND CERTIFICATION: EITHER:
(I) HAVE GRADUATED ON OR AFTER JUNE FIRST, TWO THOUSAND SIX FROM A
THREE-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, AND BE
CERTIFIED IN RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY BY A NATIONAL
CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE
DEPARTMENT; OR
(II) HAVE GRADUATED ON OR AFTER JUNE FIRST, TWO THOUSAND SIX FROM A
THREE-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, BE
BOARD QUALIFIED BUT NOT YET CERTIFIED IN RECONSTRUCTIVE REARFOOT AND
ANKLE SURGERY BY A NATIONAL CERTIFYING BOARD HAVING CERTIFICATION STAND-
ARDS ACCEPTABLE TO THE DEPARTMENT, AND PROVIDE DOCUMENTATION THAT HE OR
SHE HAS ACCEPTABLE TRAINING AND EXPERIENCE IN STANDARD OR ADVANCE
MIDFOOT, REARFOOT AND ANKLE PROCEDURES THAT HAS BEEN APPROVED BY THE
DEPARTMENT; OR
(III) HAVE GRADUATED BEFORE JUNE FIRST, TWO THOUSAND SIX FROM A
TWO-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, BE
CERTIFIED IN RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY BY A NATIONAL
CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE
DEPARTMENT, AND PROVIDE DOCUMENTATION THAT HE OR SHE HAS ACCEPTABLE
S. 7800 3
TRAINING AND EXPERIENCE IN STANDARD OR ADVANCED MIDFOOT, REARFOOT AND
ANKLE PROCEDURES THAT HAS BEEN APPROVED BY THE DEPARTMENT;
D. FEES: PAY A FEE TO THE DEPARTMENT OF TWO HUNDRED TWENTY DOLLARS FOR
THE ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC STANDARD ANKLE SURGERY.
2. FOR ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC ADVANCED ANKLE
SURGERY, AS THAT TERM IS USED IN SUBDIVISION TWO OF SECTION SEVEN THOU-
SAND ONE OF THIS ARTICLE, THE APPLICANT SHALL FULFILL THE FOLLOWING
REQUIREMENTS:
A. APPLICATION: FILE AN APPLICATION WITH THE DEPARTMENT;
B. LICENSE: BE LICENSED AS A PODIATRIST IN THE STATE;
C. EXPERIENCE AND CERTIFICATION: EITHER:
(I) HAVE GRADUATED ON OR AFTER JUNE FIRST, TWO THOUSAND SIX FROM A
THREE-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, BE
CERTIFIED IN RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY BY A NATIONAL
CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE
DEPARTMENT, AND PROVIDE DOCUMENTATION THAT HE OR SHE HAS ACCEPTABLE
TRAINING AND EXPERIENCE IN ADVANCED MIDFOOT, REARFOOT AND ANKLE PROCE-
DURES THAT HAS BEEN APPROVED BY THE DEPARTMENT; OR
(II) HAVE GRADUATED BEFORE JUNE FIRST, TWO THOUSAND SIX FROM A
TWO-YEAR RESIDENCY PROGRAM IN PODIATRIC MEDICINE AND SURGERY THAT WAS
ACCREDITED BY AN ACCREDITING AGENCY ACCEPTABLE TO THE DEPARTMENT, BE
CERTIFIED IN RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY, BY A NATIONAL
CERTIFYING BOARD HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE
DEPARTMENT, AND PROVIDE DOCUMENTATION THAT HE OR SHE HAS ACCEPTABLE
TRAINING AND EXPERIENCE IN ADVANCED MIDFOOT, REARFOOT AND ANKLE PROCE-
DURES THAT HAS BEEN APPROVED BY THE DEPARTMENT.
D. FEES: PAY A FEE TO THE DEPARTMENT OF TWO HUNDRED TWENTY DOLLARS FOR
THE ISSUANCE OF A PRIVILEGE TO PERFORM PODIATRIC ADVANCED ANKLE SURGERY.
3. DURATION AND REGISTRATION OF PRIVILEGES. A PRIVILEGE ISSUED UNDER
THIS SECTION SHALL BE VALID FOR THE LIFE OF THE HOLDER, UNLESS REVOKED,
ANNULLED, OR SUSPENDED BY THE BOARD OF REGENTS. SUCH A PRIVILEGE SHALL
BE SUBJECT TO THE SAME OVERSIGHT AND DISCIPLINARY PROVISIONS AS LICENSES
ISSUED UNDER THIS TITLE. THE HOLDER OF A PRIVILEGE ISSUED UNDER THIS
SECTION SHALL REGISTER WITH THE DEPARTMENT AS A PRIVILEGE HOLDER IN THE
SAME MANNER AND SUBJECT TO THE SAME PROVISIONS AS REQUIRED OF A LICENSEE
PURSUANT TO SECTION SIX THOUSAND FIVE HUNDRED TWO OF THIS TITLE,
PROVIDED THAT, AT THE TIME OF EACH REGISTRATION, THE PRIVILEGE HOLDER
SHALL CERTIFY THAT HE OR SHE CONTINUES TO MEET THE REQUIREMENTS FOR THE
PRIVILEGE SET FORTH IN THIS SECTION. THE FEE FOR SUCH REGISTRATION SHALL
BE TWO HUNDRED TEN DOLLARS. THE REGISTRATION PERIOD FOR A PRIVILEGE
HOLDER SHALL BE COTERMINOUS WITH HIS OR HER REGISTRATION AS A PODIA-
TRIST.
S 7010. ANKLE SURGERY LIMITED PERMITS. A LIMITED PERMIT TO PERFORM
PODIATRIC STANDARD ANKLE SURGERY, AS DESCRIBED IN SUBDIVISION TWO OF
SECTION SEVEN THOUSAND ONE OF THIS ARTICLE, MAY BE ISSUED BY THE DEPART-
MENT TO A PODIATRIST WHO IS LICENSED PURSUANT TO THIS ARTICLE AND WHO
HAS MET THE RESIDENCY AND BOARD QUALIFICATION/CERTIFICATION REQUIREMENTS
SET FORTH IN SUBDIVISION ONE OF SECTION SEVEN THOUSAND NINE OF THIS
ARTICLE IN ORDER TO AUTHORIZE SUCH PODIATRIST TO OBTAIN THE TRAINING AND
EXPERIENCE REQUIRED FOR THE ISSUANCE OF A PODIATRIC STANDARD ANKLE
SURGERY PRIVILEGE PURSUANT TO SUBDIVISION ONE OF SECTION SEVEN THOUSAND
NINE OF THIS ARTICLE. SUCH PERMITS SHALL AUTHORIZE THE PERFORMANCE OF
PODIATRIC STANDARD ANKLE SURGERY ONLY UNDER THE DIRECT PERSONAL SUPER-
VISION OF A LICENSED PODIATRIST HOLDING A PODIATRIC STANDARD ANKLE
SURGERY PRIVILEGE OR A PODIATRIC ADVANCED ANKLE SURGERY PRIVILEGE ISSUED
S. 7800 4
PURSUANT TO SECTION SEVEN THOUSAND NINE OF THIS ARTICLE OR OF A PHYSI-
CIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THIS TITLE
AND CERTIFIED IN ORTHOPEDIC SURGERY BY A NATIONAL CERTIFYING BOARD
HAVING CERTIFICATION STANDARDS ACCEPTABLE TO THE DEPARTMENT.
2. A LIMITED PERMIT TO PERFORM PODIATRIC ADVANCED ANKLE SURGERY, AS
DESCRIBED IN SUBDIVISION TWO OF SECTION SEVEN THOUSAND ONE OF THIS ARTI-
CLE, MAY BE ISSUED BY THE DEPARTMENT TO A PODIATRIST WHO IS LICENSED
PURSUANT TO THIS ARTICLE AND WHO HAS MET THE RESIDENCY AND BOARD CERTIF-
ICATION REQUIREMENTS SET FORTH IN SUBDIVISION TWO OF SECTION SEVEN THOU-
SAND NINE OF THIS ARTICLE IN ORDER TO AUTHORIZE SUCH PODIATRIST TO
OBTAIN THE TRAINING AND EXPERIENCE REQUIRED FOR THE ISSUANCE OF A PODIA-
TRIC ADVANCED ANKLE SURGERY PRIVILEGE PURSUANT TO SUBDIVISION TWO OF
SECTION SEVEN THOUSAND NINE OF THIS ARTICLE. SUCH PERMITS SHALL AUTHOR-
IZE THE PERFORMANCE OF PODIATRIC ADVANCED ANKLE SURGERY ONLY UNDER THE
DIRECT PERSONAL SUPERVISION OF A LICENSED PODIATRIST HOLDING A PODIATRIC
ADVANCED ANKLE SURGERY PRIVILEGE ISSUED PURSUANT TO SUBDIVISION TWO OF
SECTION SEVEN THOUSAND NINE OF THIS ARTICLE OR OF A PHYSICIAN LICENSED
PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THIS TITLE AND CERTIFIED
IN ORTHOPEDIC SURGERY BY A NATIONAL CERTIFYING BOARD HAVING CERTIF-
ICATION STANDARDS ACCEPTABLE TO THE DEPARTMENT.
3. FOR THE PURPOSES OF THIS SECTION, DIRECT PERSONAL SUPERVISION MEANS
SUPERVISION OF PROCEDURES BASED ON INSTRUCTIONS GIVEN DIRECTLY BY THE
SUPERVISING PODIATRIST OR PHYSICIAN WHO REMAINS IN THE IMMEDIATE AREA
WHERE THE PROCEDURES ARE BEING PERFORMED, AUTHORIZES THE PROCEDURES AND
EVALUATES THE PROCEDURES PERFORMED BY THE HOLDER OF THE LIMITED PERMIT.
4. THE HOLDER OF A LIMITED PERMIT ISSUED PURSUANT TO THIS SECTION
SHALL PERFORM PODIATRIC ANKLE SURGERY ONLY IN A HOSPITAL OR HEALTH
FACILITY LICENSED PURSUANT TO ARTICLE TWENTY-EIGHT OF THE PUBLIC HEALTH
LAW AND APPROPRIATELY AUTHORIZED TO PROVIDE SUCH SURGERY.
5. LIMITED PERMITS SHALL BE ISSUED FOR A PERIOD OF ONE YEAR, AND MAY
BE RENEWED FOR ADDITIONAL ONE YEAR PERIODS WHEN NECESSARY TO PERMIT THE
COMPLETION OF THE TRAINING AND EXPERIENCE REQUIRED TO OBTAIN A PODIATRIC
STANDARD ANKLE SURGERY PRIVILEGE OR PODIATRIC ADVANCED ANKLE SURGERY
PRIVILEGE, AS APPLICABLE, PROVIDED THAT NO PERMIT MAY BE RENEWED MORE
THAN FOUR TIMES FOR EACH SUCH PRIVILEGE.
6. THE FEE FOR A LIMITED PERMIT SHALL BE ONE HUNDRED FIVE DOLLARS AND
THE FEE FOR A RENEWAL SHALL BE FIFTY DOLLARS.
S 3. Paragraph (i) of subdivision 1 of section 230-d of the public
health law, as added by chapter 365 of the laws of 2007, is amended to
read as follows:
(i) "Licensee" shall mean an individual licensed or otherwise author-
ized under [articles] ARTICLE one hundred thirty-one [or], 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.
S 4. Section 2995-d of the public health law is amended by adding a
new subdivision 4-a to read as follows:
4-A. IN COOPERATION WITH THE EDUCATION DEPARTMENT, ESTABLISH A HEALTH
CARE PRACTITIONER DATABASE RELATING TO PODIATRISTS. SUCH DATABASE SHALL
INCLUDE INFORMATION SIMILAR TO THE PHYSICIAN PROFILES ESTABLISHED PURSU-
ANT TO SECTION TWENTY-NINE HUNDRED NINETY-FIVE-A OF THIS TITLE. THE
DATABASE SHALL BE CAPABLE OF PRESENTING RELEVANT MEDICAL AND TREATMENT
INFORMATION IN A FORMAT THAT IS EASILY UNDERSTOOD BY AND MADE AVAILABLE
TO THE GENERAL PUBLIC.
S. 7800 5
S 5. Paragraph 1 of subdivision (d) of section 3101 of the civil prac-
tice law and rules is amended by adding a new subparagraph (iv) to read
as follows:
(IV) IN AN ACTION FOR PODIATRIC MEDICAL MALPRACTICE, A PHYSICIAN MAY
BE CALLED AS AN EXPERT WITNESS AT TRIAL.
S 6. This act shall take effect eighteen months after it shall have
become a law. Effective immediately, the addition, amendment and/or
repeal of any rule or regulation necessary for the implementation of the
provisions of this act on its effective date is authorized to be made on
or before such effective date.