The Alabama Board of Medical Examiners has proposed significant changes to regulations surrounding office-based surgeries in Alabama, according to an article by law firm Burr & Forman published in JD Supra March 24.
Here are 10 things to know about the proposed changes:
1. If passed, the new rules would repeal and replace existing regulations that were created in 2003 as a joint effort between the Board of Medical Examiners and an “ad hoc committee representing various medical and surgical specialties,” according to the preamble to the current rules.
2. Current requirements for in-office use of anesthesia employ “permissive language,” according to the report, establishing guidelines that physicians “should” follow in administering anesthesia to patients in physician office settings.
3. The proposed rules set more stringent prerequisites for performing office-based surgeries by adopting stricter language, such as changing uses of the word “should” to “shall.”
4. If adopted, compliance with the new rules will be required by Jan. 1, 2026.
5. Physician offices would be required to obtain accreditation or certification by a board-approved entity in order to perform any surgical procedure under moderate sedation, deep sedation or general anesthesia, liposuction using infiltration methods, any procedure using propofol, any procedure involving a major upper- or lower-extremity nerve block, or involves an MRI or other imaging studies under moderate or deep sedation or general anesthesia.
6. Every physician performing office-based surgeries and procedures would be required to have completed training in those specific surgeries and procedures. The proposed rule states that adequate training includes the completion of an accredited residency, fellowship or specialty board certification. Physicians who wanted to provide a new office-based surgical procedure would be required to conduct specific training for all personnel involved in the care of patients receiving that procedure, under the proposed rule.
8. Physician offices would be required to implement and maintain quality-assurance programs and conduct peer review activities.
9. Physicians would be required to ensure there is qualified call coverage at all times by a physician responsible for the emergency care of a physician’s patients during their absence. Physicians would also be required to maintain onsite emergency plans and age-appropriate supplies and equipment to react in an emergency.
10. Physicians would be required to establish inclusionary and exclusionary written criteria for patient selection, according to the proposed rule. Additionally, the board would require physicians to submit procedure-specific patient selection criteria at the time of registration and any time a physician begins performing a new procedure in-office.
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