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Bill to increase oversight of cosmetic surgery centers making la


Legislation clears House with a week remaining for Senate action

April 01, 2013|By Scott Dance, The Baltimore Sun

A bill to give health regulators more oversight of facilities like the now-closed Monarch Medspa in Timonium is making a late surge in the General Assembly after weeks of discussions among state and industry officials.

The House of Delegates unanimously passed the legislation Monday afternoon. It needs to clear the Senate, including an extra procedural step, within the next week. The legislative session draws to a close April 8.

If passed, the law would close a regulatory gap that does not allow state health officials to proactively inspect and oversee plastic surgery centers. While doctors working in the facilities are licensed, the centers themselves are not. But health officials argue they should be, given the risk involved in many cosmetic surgery procedures.

That risk was demonstrated, they said, when a Lochearn woman died after a liposuction procedure at the Timonium medical spa. She and two other patients who were treated at the spa contracted severe infections, prompting state health officials to close the facility in September.

Regulators and industry stakeholders began talks over possible increased oversight of medical spas just after the closure was announced. The state health department and Del. Kirill Reznik, a Montgomery County Democrat, each introduced bills addressing the concern early in the legislative session, which began in January. But the legislation was held up by disagreements over the approach.

There were concerns from dermatologists, for example, that expanding the definition of cosmetic surgery procedures in state law and regulations would mean they could end up needing to license their office as a cosmetic surgery center. Under state law that pertains to the Board of Physicians, doctors can remove 1,000 cubic centimeters of fat or less from patients in their offices, but must go to a surgery center for any larger amount, for example.

As a compromise, legislation passed by the House would not change that legal definition. Instead, it would give state health officials the authority to adjust regulations of plastic surgery procedures if they found that any in particular pose substantial health and safety risks.

"We think this is a step in the right direction," said Gene Ransom, executive director of MedChi, the state medical society. "This clearly addresses the issue where people are doing things that should be done in a hospital or ambulatory care center."

The approach leaves any future regulation of the facilities up in the air, but one lawmaker who helped guide the compromise said that helped satisfy industry groups. A similar approach was taken with oversight of abortion clinics in 2012, and led health officials last month to close three clinics, including one in Baltimore where a patient died.

"We have a lot of confidence that [state health officials] will look at what needs to be done, and not do more than what needs to be done to keep the citizens of Maryland safe," said Del. Shane Pendergrass, a Howard County Democrat.

Many plastic surgery centers in Maryland are not required to be licensed as ambulatory surgical centers because they bill patients directly, rather than billing insurance companies or government insurance programs. Part of the legal definition of regulated surgical centers involves how patients are billed.

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