THIRTEENTH CONGRESS OF THE REPUBLIC ) 
OF THE PHILIPPINES 
) 
5 OGT 27 
Second Regular Session 
1 
Introduced by Senator Miriam Defensor Santiago 
EXPLANATORY NOTE 
The movement of health care services away from traditional inpatient facilities to 
outpatient settings has escalated the volume of surgery and other invasive procedures being 
performed in the private offices and facilities. While the majority of these services are provided 
in a safe and effective manner, the complexity of services and procedures being performed in 
private practitioners’ offices is increasing at unprecedented levels. 
While surgery and other invasive and minor procedures performed in Philippine medical 
facilities, such as hospitals, diagnostic centers, and treatment centers, are regulated by the 
respective professional Boards (Board of Medicine, Board of Dentistry, etc.) to which the 
practitioner who performed the operation belongs, the same procedures performed in private 
medical or dental offices and clinics, cosmetic and facial care centers, spas, and others health 
facilities is not subject to similar regulatory standards, regardless of the scope or complexity of 
the procedure. The facility itself where the surgery is performed is not subject to the same 
regulation as hospitals, diagnostic centers, and treatment centers which must be licensed by the 
Department of Health. 
This bill seeks to correct the unregulated performance of surgery and other invasive 
procedures and minor procedures in a location other than a hospital, diagnostic center, and 
treatment center. Thus, the performance of such procedures should be restricted only to licensed 
practitioners, and the location where such procedure is to be performed only to licensed facilities. 


THIRTEENTH CONGRESS OF THE REPUBLIC 1 
OF THE PHILIPPINES 
Second Regular Session 
Introduced by Senator Miriam Defensor Santiago 
AN ACT 
TO REGULATE OFFICE-BASED INVASIVE PROCEDURES 
Be it enacted by the Senate and House of Representatives of the Philippines in Congress 
nssembled: 
SECTION 1. Short Title. - This Act shall be known as the “Regulation of Office-Based 
Surgical Procedures Act.” 
SECTION 2. Purpose. 
~ 
The purpose of this Act is to regulate the performance of 
surgery as well as cosmetic, dental and other invasive and minor procedures in private offices, 
clinics, and other cosmetic and facial care centers, spas, health facilities and other 
establishments. 
SECTION 3. De$nition of Terms. -For the purposes oftbis Act, the term 
(A)“office-based surgery” means surgical or other invasive procedure requiring 
anesthesia, analgesia or sedation including, but not limited to, cosmetic surgery 
including face lifts, nose lifts, chin lifts, tummy tucks, breast enlargement, and 
breast reduction; laser surgery; and tumescent and high-volume liposuction on 
any part of the body, which is performed by a practitioner in a location other than 
a hospital, diagnostic center, and treatment center which results in a patient stay 
of less than twenty-four (24) consecutive hours. 
(B)“minor procedures” are those that can be performed safely, requiring local or 
topical anesthesia with a minimum of discomfort, and where the likelihood of 
complications requiring hospitalization is minimal by current best practice 
experience. Such minor procedures include, but are not limited to, cosmetic 


tattooing, Box injections, collagen injections, and the injection of any foreign 
substance into any part of the body, 
(C) “practitioner’ means either a physician, dentist, nurse or other health care 
practitioner licensed by the Professional Regulation Commission (PRC), who are 
engaged in the performance of office-based and minor procedures, either in a 
primary, contributing or assisting capacity, and whose professional practice is 
subject to review by their respective professional Boards. 
(D)“unlicensed personnel” means the members of the staff and any other individuals 
employed by or affiliated with the practitioner, including contract. 
SECTION 4. Who can perform surgery and other invasive and minor procedures. - It 
shall be unlawful for any person who is not a licensed practitioner to perform any surgery or any 
invasive or minor procedure, or to contribute thereto by way of administering any anesthesia, 
analgesia, or in any way sedate the patient. It shall likewise be unlawful for any licensed 
practitioner to perform surgery or any invasive or minor procedure which he or she is not 
licensed to perform. 
SECTION 5. Duties of unlicensed personnel. - It shall be unlawful for any person, being 
unlicensed personnel of the practitioner, to perform any duty, task or responsibility that requires 
a license to perform. 
Duties that do not require professional licensure and are assigned to unlicensed personnel 
should be in accordance with their training, education and experience and under the direct 
supervision of a practitioner. 
SECTION 6. Where the surgery and other invasive and minor procedures can be 
performed. - It shall be unlawful to perform any surgery or other invasive or minor procedure in 
an office, clinic, center, facility or other establishment that does not conform to all the following 
requirements: 
(A)The premises in which the surgery is undertaken shall be licensed and registered 
under the Department of Health. 


(B) All equipment in the said facility shall be properly maintained and calibrated. 
(C)There shall be dated and documented procedures within the facility for the use of 
all surgical and clinical equipment. These must be reviewed annually. 
(D)All staff using surgical and clinical equipment shall have completed a training 
program in the safe clinical use of the said equipment, and have demonstrated and 
documented competence to personnel licensed by the Department of Health to 
conduct such training programs. 
(E) A backup power supply shall be available and readily accessible by the facility in 
case of power failure during a procedure. 
SECTION 7. Informution for patients. - There shall be made available to patients the 
following information: 
(A) A price list of procedures and should be explicit about what is and is not 
included in the quoted fees. Such price list should also give details about 
payments of deposits, their refund, and any penalty which may be incurred by 
cancellation. 
(B) A description of the procedure they wish to be performed on them which must be 
written in concise, plain non-technical language. Such information shall 
eligibility criteria for patients; treatment options including relative advantages 
and disadvantages; general and procedure-specific risks and complications 
associated with the procedure, their frequency, management course and possible 
outcomes; and statistical information regarding the probability of achieving the 
desired goal or probability of needing more than one procedure. 
(C) The qualifications of the practitioners, including the specific office-based 
surgical or invasive procedures and anesthesia services which each practitioner is 
qualified and competent to perform, and the licensure, accreditation, training and 
experience relevant to the procedure to be performed. For medical practitioners, 
board certification or completion of a training program qualified to lead to board 
certification; for other practitioners, certification that is appropriate and 


applicable for the practitioner. The practitioner should also include his or her 
professional misconduct and malpractice history. 
SECTION 8. Follow-up care. - The professional who performed the procedure shall be 
personally responsible for patient care. He or she must maintain an outpatient service, either at 
facility where procedure was undertaken, or elsewhere, such that the professional can provide 
appropriate follow-up care. The professional must ensure his or her availability for emergencies 
or arrange for appropriate cover if on leave. 
SECTION 9. Penalties. - The performance of any surgery or any invasive or minor 
procedure by other than a licensed practitioner shall be punishable by a penalty of imprisonment 
ranging fromprision mayor in its maximum term to reclusion temporal in its minimum term, or 
a fine ranging from Five Hundred Thousand Pesos (P 500,000) to One Million Pesos (R 
1 ,OOO,OOO), or both, at the discretion of the court, taking into consideration all attending 
circumstances, and the cancellation of the license to practice his or her profession. 
The performance of any surgery or any invasive or minor procedure by a licensed 
practitioner but who is not licensed to perform the procedure he or she did shall be punishable by 
a penalty of imprisonment ranging from prision mayor in its medium to prision mayor in its 
maximum term, or a fine ranging from Three Hundred Thousand Pesos (P 300,000) to Five 
Hundred Thousand Pesos (P 500,000), or both, at the discretion of the court, taking into 
consideration all attending circumstances, and the cancellation of the license to practice his or 
her procession. 
The performance o f  any duty, task or responsibility other than any surgery or any 
invasive or minor procedure that requires a license to perform by any unlicensed person shall be 
punishable by a penalty of imprisonment ranging from prision mayor in its minimum term to 
prision mayor in its medium term, or a fine ranging from One Hundred Thousand Pesos (P 
100,000) to Three Hundred Thousand Pesos (P 300,000), or both, at the discretion of the court, 
taking into consideration all attending circumstances. 
The owner, proprietor, or operator of any office, clinic, center, facility or other location 
that does not conform to all requirements in section six of this Act be punished by a penalty of 


imprisonment ranging from prision mayor in its medium term to prision mayor in its maximum 
term, or a fine ranging from Three Hundred Thousand Pesos (P 300,000) to Five Hundred 
Thousand Pesos (P 500,000), or both, at the discretion of the court, taking into consideration all 
attending circumstances, and the cancellation of the license to operation such an establishment. 
If the owner, proprietor or operator of the establishment above is a corporation, trust or firm, 
partnership, association or any other entity, the penalty of imprisonment shall be imposed on the 
entity's responsible officers, including, but not limited to, the president, vice-president, chief 
executive officer, general manager, managing director or partner directly responsible therefor. 
SECTION 10. Aggravating circumstances. - The penaIties described in section eight 
shall be imposed in the maximum if the violation of this act results in the following 
circumstances: 
(A) death of the patient; 
(B) insanity or psychological damage of the patient; and 
(C) permanent physical disfigurement or permanent disability of the patient. 
SECTION 11. Appropriations. - To carry out the provisions of this Act, such sum as may 
be necessary is hereby authorized to be appropriated from the National Treasury. Thereafter, the 
sum necessary for the continuous operation of the program shall be included in the annual 
appropriation of the Department of Health. 
SECTION 12. Separability Clause. - If any provision, or part hereof, is held invalid or 
unconstitutional, the remainder of the law or the provision shall remain valid and subsisting. 
SECTION 13. Repealing Clause. - Any law, presidential decree, issuance, executive 
order, letter of instruction, administrative order, rule or regulation contrary to or inconsistent 
with, the provisions of this Act is hereby repealed, modified or amended accordingly. 
SECTION 14. Effectivity Clause. - This Act shall take effect fifteen (15) days after its 
publication in at least two (2) newspapers of general circulation. 
Approved,