Substitute House Bill No. 5196 Public Act No. 24-112 AN ACT EXPANDING THE PODIATRIC SCOPE OF PRACTICE. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Subsection (c) of section 20-54 of the general statutes is repealed and the following is substituted in lieu thereof (Effective October 1, 2024): (c) A licensed podiatrist may independently engage in the surgical treatment of the ankle, including the surgical treatment of the anatomical structures of the ankle, as well as the administration and prescription of drugs incidental thereto, and the surgical treatment of manifestations of systemic diseases as they appear on the ankle, after the podiatrist provides documentation to the Department of Public Health of the following: (1) (A) Graduation on or after June 1, 2006, from a three-year residency program in podiatric medicine and surgery that was accredited by the Council on Podiatric Medical Education, or its successor organization, at the time of graduation, and (B) current board certification or qualification in reconstructive rearfoot ankle surgery by the American Board of Foot and Ankle Surgery, or its successor organization; or (2) (A) graduation prior to June 1, 2006, from a residency program in podiatric medicine and surgery that was at least two years in length and accredited at the time of graduation by said council, and (B) current board certification or qualification in Substitute House Bill No. 5196 Public Act No. 24-112 2 of 3 reconstructive rearfoot ankle surgery by the American Board of Foot and Ankle Surgery, or its successor organization. For purposes of this section, "surgical treatment of the ankle" includes all soft tissue and osseous procedures, including 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 tibiotalocalcaneal intramedullary rods and locking screws up to the level of the myotendinous junction of the triceps [surea] surae and Chopart joint-level amputation, but does not include the surgical treatment of complications within the tibial diaphysis related to the use of external fixation pins, the performance of total ankle replacements or the treatment of tibial pilon fractures. Sec. 2. (NEW) (Effective from passage) (a) The cochairpersons of the joint standing committee of the General Assembly having cognizance of matters relating to public health shall convene a panel comprised of two representatives each from an organization representing podiatrists in the state and an organization representing orthopedic physicians in the state to develop, not later than August 1, 2024, a protocol for permitting licensed podiatrists who have provided documentation to the Department of Public Health of meeting the requirements set forth in subdivision (1) or (2) of subsection (c) of section 20-54 of the general statutes, as amended by this act, to perform total ankle replacement surgery. The protocol shall consist of a description of the experience, skill and training requirements for performance of such surgery and the procedure for assessing whether a podiatrist has the requisite experience, skill and training. Not later September 1, 2024, the panel shall submit a report, in accordance with the provisions of section 11-4a of the general statutes, regarding the panel's protocol to the joint standing committee of the General Assembly having cognizance of matters relating to public health and the Commissioner of Public Health. Not later than October 1, 2024, the commissioner shall post such Substitute House Bill No. 5196 Public Act No. 24-112 3 of 3 protocol on the Department of Public Health's Internet web site. (b) On and after October 1, 2024, a licensed podiatrist who has provided documentation to the Department of Public Health of meeting the requirements set forth in subdivision (1) or (2) of subsection (c) of section 20-54 of the general statutes, as amended by this act, may apply to a hospital in the state for privileges to perform total ankle replacement surgery at such hospital. A hospital may, at a minimum, utilize the protocol developed pursuant to subsection (a) of this section to assess whether a podiatrist has the requisite experience, skill and training to perform total ankle replacement surgery at such hospital. (c) A podiatrist who has been approved by a hospital for privileges to perform total ankle replacement surgery pursuant to subsection (b) of this section may perform such surgery at such hospital. (d) Nothing in this section shall be construed to require a hospital to grant a podiatrist privileges to perform total ankle replacement surgery at the hospital.