Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H2203 Compare Versions

Only one version of the bill is available at this time.

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1	1	1 of 1
2	2	HOUSE DOCKET, NO. 210 FILED ON: 1/11/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 2203
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Hannah Kane and Carole A. Fiola
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to informed consent for concurrent surgical procedures.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Hannah Kane11th Worcester1/10/2023Carole A. Fiola6th Bristol1/24/2023Kimberly N. Ferguson1st Worcester1/26/2023David Allen Robertson19th Middlesex2/6/2023William M. Straus10th Bristol2/6/2023David Paul Linsky5th Middlesex2/7/2023Paul McMurtry11th Norfolk2/15/2023 1 of 6
16	16	HOUSE DOCKET, NO. 210 FILED ON: 1/11/2023
17	17	HOUSE . . . . . . . . . . . . . . . No. 2203
18	18	By Representatives Kane of Shrewsbury and Fiola of Fall River, a petition (accompanied by bill,
19	19	House, No. 2203) of Hannah Kane, Carole A. Fiola and others relative to informed consent for
20	20	concurrent surgical procedures. Public Health.
21	21	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE HOUSE, NO. 2328 OF 2021-2022.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Third General Court
26	26	(2023-2024)
27	27	_______________
28	28	An Act relative to informed consent for concurrent surgical procedures.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 SECTION 1. Section 70E of chapter 111 of the General Laws, as appearing in the 2016
32	32	2Official Edition, is hereby amended by inserting after the first paragraph the following
33	33	3paragraph:-
34	34	4 As used in this section, the terms “Attending physician”, “Concurrent surgical
35	35	5procedure”, “Elective surgical procedure”, “Emergency surgical procedure”, and “Secondary
36	36	6emergency surgical procedure” shall have the same meanings as defined in section 70i.
37	37	7 SECTION 2. Said section 70E of said chapter 111, as so appearing, is hereby further
38	38	8amended by striking out, in line 105, the word “and”. 2 of 6
39	39	9 SECTION 3. The fifth paragraph of said section 70E of said chapter 111, as so
40	40	10appearing, is hereby amended by striking out clause(o) and inserting in place thereof the
41	41	11following 2 clauses:-
42	42	12 (o) if the patient is a female rape victim of childbearing age, to receive medically and
43	43	13factually accurate written information prepared by the commissioner of public health about
44	44	14emergency contraception; to be promptly offered emergency contraception; and to be provided
45	45	15with emergency contraception upon request; and
46	46	16 (p) to refuse to undergo a concurrent surgical procedure, except in cases of an emergency
47	47	17surgical procedure.
48	48	18 SECTION 4. The sixth paragraph of said section 70E of said chapter 111, as so
49	49	19appearing, is hereby amended by striking out clause (h) and inserting in place thereof the
50	50	20following 3 clauses:-
51	51	21 (h) in the case of a patient suffering from any form of breast cancer, to complete
52	52	22information on all alternative treatments which are medically viable;
53	53	23 (i) in the case of a patient scheduled for an elective concurrent surgical procedure, to
54	54	24written notice and informed consent of such concurrent scheduling, and a detailed account of the
55	55	25attending physician’s participation in the surgical procedure, at least 14 days prior to the surgical
56	56	26procedure pursuant to section 70i; and
57	57	27 (j) in the case of a patient scheduled for a secondary emergency concurrent surgical
58	58	28procedure, to written notice and informed consent of such concurrent scheduling, and a detailed 3 of 6
59	59	29account of the attending physician’s participation in the surgical procedure, at least 48 hours
60	60	30prior to the surgical procedure pursuant to section 70i.
61	61	31 SECTION 5. Said chapter 111 is hereby further amended by inserting after section 70H
62	62	32the following section:-
63	63	33 Section 70I. (a) As used in this section, the following words shall have the following
64	64	34meanings:
65	65	35 “Attending physician”, the physician licensed under sections 2 through 9B of chapter
66	66	36112, who has been credentialed by the facility to independently perform the patient’s procedure
67	67	37and to supervise physician trainees or physician extenders.
68	68	38 “Concurrent surgical procedure”, any surgical procedure during which the attending
69	69	39physician is scheduled to leave the operating room at any point between incision and skin closure
70	70	40of the procedure to participate in the performance or supervision of a different surgical procedure
71	71	41on a different patient in a different operating room, where critical portions of the operations are
72	72	42performed concurrently.
73	73	43 “Elective surgical procedure”, a surgical procedure that is scheduled at least 14 days in
74	74	44advance, that is not urgent in nature and is not an emergency procedure.
75	75	45 “Emergency surgical procedure”, an urgent surgical procedure that must be performed
76	76	46immediately upon the patient’s arrival at the facility, and is not scheduled in advance.
77	77	47 “Facility”, any hospital, institution for the care of unwed mothers, clinic, infirmary
78	78	48maintained in a town, convalescent or nursing home, rest home, or charitable home for the aged,
79	79	49licensed or subject to licensing by the department; any state hospital operated by the department; 4 of 6
80	80	50any “facility” as defined in section 3 of chapter 111B; any private, county or municipal facility,
81	81	51department or ward which is licensed or subject to licensing by the department of mental health
82	82	52pursuant to section 19 of chapter 19; or by the department of developmental services pursuant to
83	83	53section 15 of chapter 19B; any “facility” as defined in section 1 of chapter 123; the Soldiers
84	84	54Home in Holyoke, the Soldiers’ Home in Massachusetts; and any facility set forth in section 1 of
85	85	55chapter 19 or section 1 of chapter 19B.
86	86	56 “Overlapping surgical procedure”, a surgical procedure during which the attending
87	87	57physician is scheduled to leave the operating room at any point between incision and skin closure
88	88	58of the procedure to participate in the performance or supervision of a different surgical procedure
89	89	59on a different patient in a different operating room at the same time, where critical portions of the
90	90	60operations are not performed concurrently.
91	91	61 “Physician”, a person licensed to practice medicine under sections 2 through 9B of
92	92	62chapter 112.
93	93	63 “Physician Extender”, a person who is participating in the patient’s procedure who is
94	94	64under the direct supervision of the attending physician. A physician extender may be a resident, a
95	95	65fellow, a physician assistant, an advanced practice registered nurse or other person authorized by
96	96	66the facility to participate in the procedure, and who is directly supervised by the attending
97	97	67physician.
98	98	68 “Secondary emergency surgical procedure”, a surgical procedure that is scheduled at least
99	99	6948 hours in advance, but is still more urgent in nature than an elective surgical procedure.
100	100	70 “Staggered surgical procedure”, a surgical procedure during which the attending
101	101	71physician performs different surgical procedures on different patients in different operating 5 of 6
102	102	72rooms, one procedure directly after another, where no portions of the operations are performed
103	103	73concurrently.
104	104	74 (b) At least 14 days before the attending physician operates on a patient scheduled for an
105	105	75elective concurrent surgical procedure, and at least 48 hours before the attending physician
106	106	76operates on a patient scheduled for a secondary emergency concurrent surgical procedure, the
107	107	77attending physician shall inform the patient, in writing, of the concurrent scheduling and the
108	108	78involvement of the attending physician in the patient’s procedure, and shall obtain written
109	109	79informed consent from the patient prior to performing such procedure; provided, that the
110	110	80attending physician shall provide to the patient, in writing, a detailed description of what specific
111	111	81steps of the surgery said physician will and will not be performing, including, but not limited to
112	112	82critical surgical steps. The department shall develop a standardized written summary and
113	113	83consent form for use in obtaining informed consent for concurrent surgical procedures. This
114	114	84summary and consent form shall be written in a manner designed to permit a person unfamiliar
115	115	85with medical terminology to understand its purpose and content and shall inform the patient that
116	116	86they are scheduled to undergo a concurrent surgical procedure. The department shall update the
117	117	87form as necessary, and distribute such forms to each facility in the commonwealth in which the
118	118	88department knows or has reason to know concurrent surgical procedures are performed.
119	119	89 (c) The attending physician shall include in the patient’s medical record written
120	120	90documentation of the attending physician’s presence or absence during the surgical procedure. If
121	121	91the attending physician was absent for any part of the surgical procedure, the medical record
122	122	92shall accurately reflect the time of the absence or absences and who was the attending physician
123	123	93during the absence, if any. 6 of 6
124	124	94 (d) Any facility that performs concurrent surgical procedures shall publish, on their
125	125	95website, notice that said facility performs concurrent surgical procedures, and shall publish such
126	126	96notice on the individual webpages of each physician who performs concurrent surgeries at said
127	127	97facility.
128	128	98 SECTION 6. The department of public health shall promulgate rules and regulations
129	129	99necessary to implement this act.