The Legislature appears poised to tighten statutes that regulate Brazilian butt lifts.
A Senate health care panel approved legislation (SB 1188) which modifies a 2023 law regarding the popular plastic surgery procedures and the physician's offices where the surgeries are performed. The bill is identical to HB 1561, which cleared a House health care spending panel last week.
Jacksonville health care lawyer Christopher Nuland said the physicians he represents support improving safety for the sought-after plastic surgery procedure. He noted that since the 2023 law was passed, there has been only one reported death stemming from a Brazilian butt lift.
But Nuland said as currently written, a requirement in the bill that all surgery centers re-register with the state according to a yet-to-be-published Department of Health (DOH) timeline would effectively close down the 724 surgery centers currently registered with DOH. That's because the 2023 law required that state surgery center inspections be done in person by DOH medical quality assurance (MQA) staff.
"As written the bill would say that those people who have been operating for years would be closed down until they could get re-inspected," he said. "I don't think that's what was intended. But that is a concern."
Nuland also flagged his concerns with a portion of SB 1188 that requires MQA staff to refer to the state Agency for Health Care Administration office surgery centers if there is a determination that the center would cause significant risk to the safety and health of patients and that they would be better served in a hospital or ambulatory surgical center.
"Also, the criteria that will be used ... allows a single inspector to say in the interest of 'public health.' That's the criteria. And while again, we appreciate the policy — we love the policy — that's not the type of legislation with which these offices can make a reasonable factual determination. We would ask that there be a definition of what an office surgery is. And these inspectors as part of the existing inspection program, go in to make sure that they are in fact an office surgery but to have clear standards."
While he opposed the bill Tuesday, Nuland told committee members "I'm pleased to report that we're working with the Senator's Office. We are working with staff. And despite our opposition today, we hope that we will be able to support a revised bill at the next committee stop."
The Florida Medical Association also opposed the bill but did not testify at the committee.
BBLs, or gluteal fat grafting, are the fastest-growing plastic surgery procedure in the nation. BBLs involve two steps: the liposuction of fat from the abdomen or back, and the injection of the purified fat into the subcutaneous layer of the buttocks, which is below the skin but above the gluteal muscle.
Florida law requires surgeons to register their offices with the DOH if they perform a liposuction procedure that removes more than 1,000 cubic centimeters of supernatant fat. The law also requires surgeons who perform BBLs to use ultrasounds for the part of the procedure where fat is injected back into the patient's body.
The 2023 law was meant to settle an ongoing regulatory dispute between surgeons and Florida's two state medical boards but, as written, provides wiggle room to surgeons who don't want to register their offices with the state.
SB 1188 changes the law to make clear that physicians are required to register their offices as surgery centers if 1,000 cubic centimeters of supernatant fat is removed, regardless of whether the removal is temporary or permanent.
The bill also tightens current law to make clear that a physician must register their office with the state if any liposuction is performed that requires the patient's body to be moved 180 degrees or more or if a gluteal fat grafting procedure is performed.
The financial penalties surgeons face for not registering their offices with the state also are altered under HB 1561 from a $5,000 fine per day to a $5,000 fine per violation.
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