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FOURTEENTH CONGRESS OF THE REPUBLIC) 
OF THE PHILIPPINES 
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First Regular Session 
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SENATE 
S.No. 1734 
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 other health 
facilities are 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.* 
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* This bill was originally filed during the Thirteenth Congress, Second Regular Session 


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FOURTEENTH CONGRESS OF THE REPUBLIC) 
OF THE PHILIPPINES 
) 
1 
First 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 
assem bled: 
SECTION 1. Short Title. - This Act shall be known as the "Regulation of Office-Based 
Surgical Procedures Act of 2007.'' 
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. Definition ofTerms. -For the purposes of this 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 augmentation, and 
breast reduction; laser surgery; plastic and reconstructive 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, Clostridium botulinum 
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bacterium (Botox) injections, collagen injections, and the injection of any foreign 
substance into ahy 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 is 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 Peusonnel. -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. 


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(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)AIl staff using surgical and clinical equipment shall have completed a training 
program in the safe clinical use o f  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. Information 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 infomation 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 
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misconduct and malpractice history. 
the practitioner. The practitioner should also include his or her professional 
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SECTION 8. Follow-up Cure. - 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 from prision mayor in its maximum term to reclusion temporal in its minimum term, or 
a fine ranging from Five Hundred Thousand Pesos (P500,OOO.OO) to One Million Pesos 
(Pl,OOO,OOO.OO), 
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 fi-om prision mayor in its medium to prision mayor in its 
maximum term, or a fine ranging fi-om Three Hundred Thousand Pesos (F'300,OOO.OO) to Five 
Hundred Thousand Pesos (PSOO,OOO.OO), 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 of 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 
(PlO0,OOO.OO) to Three Hundred Thousand Pesos (P300,000.00), 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 
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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 (P300,OOO.OO) to Five Hundred 
Thousand Pesos (P500,000.00), 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 penalties 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 or the contraction of some incurable disease; 
(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 
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with, the provisions of this Act is hereby repealed, modified or amended accordingly. 
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SECTION 14. Effectivitj Clause. - This Act shall take effect fifteen (15) days after its 
publication in at least two (2) newspapers of general circulation. 
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Approved, 
Irgs 
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