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Doctor and/or Dentist Offices

This document provides useful information health care in an office setting.

	
		

Overview

A health care practitioner's authority to perform health services in an office setting is established by that practitioner's license to practice his or her profession according the NYS Education Law. The care delivered in such offices is expected to meet prevailing standards of care for the licensed profession set forth by the NYS Department of Health.

To view applicable New York State's Codes, Rules and Regulations (NYCRR) for medical facilities, see the link below.

Under the U.S. Controlled Substances Act of 1970, all health care professionals wanting to dispense, administer, or prescribe controlled drugs must register with the Drug Enforcement Administration. For information and guidelines, contact the U.S. Department of Justice, Drug Enforcement Administration, Diversion Control Program or visit their website. The processing and issuing of a DEA registration takes about four to six weeks.

New York also has requirements and guidelines that health care practitioners need to follow regarding the dispensing, administering and prescribing of controlled substances as well as the use and disposal of hypodermic syringes and needles. Visit the NYS Department of Health, Bureau of Narcotic Enforcement website for regulatory requirements.

NYS Public Health Law, Article 2, Section 230-d requires a practice that performs office-based surgical or other invasive procedures using moderate sedation, deep sedation or under general anesthesia to the patient in order to perform the procedure or liposuction of greater than 500cc's of fat to become accredited on or before July 14, 2009. A physician, physician assistant or specialist assistant, who wishes to perform procedures in an office setting, must perform the office-based surgery or other invasive procedure in an office that is accredited. Some examples of office-based surgical or invasive procedures are endoscopy and colonoscopy, bronchoscopy, rhinoplasty, augmentation or reduction mammoplasty, and herniorrhaphy.

The NYS Department of Health has designated three accrediting agencies. The practice is required to have completed the process and received its Certificate of Accreditation on or prior to July 14, 2009 by one of these designated accrediting agencies. For a list of accrediting agencies approved by the NYS Department of Health, see the link below.

A practice or facility that is licensed through the NYS Public Health Law, Article 28 is not required to follow this law. Examples of an Article 28 facility may include: a hospital, an urgent care center, an ambulatory care center or a diagnostic and treatment center.

This law does not cover procedures performed by dentists and podiatrists who are not regulated by the NYS Department of Health. The NYS Education Department has guidelines for office-based surgery and conscious sedation that applies to dentists and podiatrist who are not regulated by the NYS Department of Health. To view these guidelines, see the links below.

NYS Public Health Law, Article 2, Section 230-d and Article 29-D, Section 2998-e requires office-based surgeries performed by physicians, physician assistants, specialist assistants and dentists who are dually licensed as physicians to report adverse events, which are related to or may be related to an office-base surgery procedure. A physician, physician assistant, or specialist assistance who believes that a patient complaint, complication, condition, emergency room visit, hospital admission or death that may be related to an office-based surgery must report the event to the NYS Health Department's Patient Safety Center within one business day of the occurrence of the adverse event. For further information and forms to report an adverse event, visit the NYS Department of Health's website.

Physicians, osteopaths, dentists, midwives, nurse practitioners or podiatrist who perform laboratory tests or procedures, personally or through his or her employees, solely as an addition to the treatment of his or her own patients, are consider physician office laboratories (POL) and may be exempt from holding a clinical laboratory permit. For a determination, contact the NYS Health Department, Physician Office Laboratory Evaluation Program, at the Wadsworth Center.

The NYS Department of Health has guidelines to help medical facilities comply with the NYS Public Health Law that governs the management of regulated medical waste. For detailed information on regulated medical waste, contact the NYS Department of Health, Bureau of Hospital and Primary Care Services or visit their website.

The NYS Department of Environmental Conservation regulates the storage, transportation and disposal of regulated medical waste, including oversight of facilities such as private medical practices. For information on the management of regulated medical wastes, contact the Department of Environmental Conservation, Division of Materials Management or visit their website.

The NYS Department of Environmental Conservation has prepared two booklets for health care facilities and pollution prevention measures that may be useful. These are Environmental Self-Assessment for Health Care Facilities and A Pollution Prevention Guide to Reducing Mercury Emissions from Health Care Facility Incinerators. To view a PDF version of these booklets see the links below.

NYS Environmental Conservation Law, requires all dentists to recycle mercury and mercury amalgam waste generated in their practices. The law also requires dentists to use encapsulated mercury and prohibits, in the practice of dentistry, the use or possession of elemental mercury not in capsules. Dental facilities are required to install amalgam separators that remove waste amalgam from the dental facilities' wastewater. The law requires that all amalgam capsule waste be recycled. Dental practices that continue to utilize dental amalgam must use single-use amalgam capsules. For more information on recycling mercury, contact the NYS Department of Environmental Conservation or visit their website.

For information on Medicaid, contact the NYS Department of Health or see the link below.

An insurance expert can help determine professional liability insurance requirements for health care practitioners. In deciding how much insurance coverage to purchase, you should base your decision on your specialty and the risk it entails, practice location, how much of your own assets you are willing to risk, and requirements imposed by parties with whom you have a contractual relationship.

For information about infection control requirements, contact the U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), Regional Office or visit their website.

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