" " 
FIFTEENTH CONGRESS OF THE REPUBLIC 
) 
OF THE PHILIPPINES 
) 
First Regular Session 
) 
SENA1J;. 
S.No. 
~~50 
p.F,:nHC I', ~", G -
q 
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 
1 


practitioners, and the location where such procedure IS to be performed only to licensed 
facilities.! 
1 This bill was originally filed in the Thirteenth Congress, Second Regular Session. 
2 


1 
2 
FIFTEENTH CONGRESS OF THE REPUBLIC 
OF THE PHILIPPINES 
) 
) 
) 
First Regular Session 
SEN~.Tll 
S.No. 
~~50 
Introduced by Senator Miriam Defensor Santiago 
AN ACT 
10 
TO REGULATE OFFICE-BASED INVASIVE PROCEDURES 
f ,\1 , 
Be it enacted by the Senate and the House of Representatives of the Philippines in 
Congress assembled: 
3 
SECTION 1. Short Title. - This Act shall be known as the "Regulation of Office-Based 
4 
Surgical Procedures Act." 
5 
SECTION 2. Purpose. - The purpose of this Act is to regulate the perfonnance of surgery 
6 
as well as cosmetic, dental and other invasive and minor procedures in private offices, clinics, 
7 
and other cosmetic and facial care centers, spas, health facilities and other establishments. 
8 
SECTION 3. Definition of Terms. -For the purposes of this Act, the tenn: 
9 
(A) "Office-based surgery" means surgical or other invasive procedure requiring 
10 
anesthesia, analgesia or sedation including, but not limited to, cosmetic surgery including 
11 
face lifts, nose lifts, chin lifts, tummy tucks, breast augmentation, and breast reduction; 
12 
laser surgery; plastic, and reconstructive surgery; and tumescent and high-volume 
13 
liposuction on any part of the body, which is perfonned by a practitioner in a location 
14 
other than a hospital, diagnostic center, and treatment center which results in a patient 
15 
stay ofless than twenty-four (24) consecutive hours. 
16 
(B) "Minor procedures" are those that can be perfonned safely, requiring local or 
17 
topical anesthesia with a minimum of discomfort, and where the likelihood of 
, 
18 
compiications requiring hospitalization is minimal by current best practice experience. 
19 
Such minor procedures include, but are not limited to, cosmetic tattooing, Clostridium 
1 


I 
botulinum bacterium (Botox) injections, collagen injections, and the injection of any 
2 
foreign substance into any part of the body. 
3 
(C) "Practitioner' means either a physician, dentist, nurse or other health care 
4 
practitioner licensed by the Professional Regulation Commission (PRC), who is engaged 
5 
in the performance of office-based and minor procedures, either in a primary, 
6 
contributing or assisting capacity, and whose professional practice is subject to review by 
7 
their respective professional Boards. 
8 
(D) "Unlicensed personnel" means the members of the staff and any other 
9 
individuals employed by or affiliated with the practitioner, including contract. 
10 
SECTION 4. Who Can Perform Surgery and Other Invasive and Minor Procedures. - It 
II 
shall be unlawful for any person who is not a licensed practitioner to perform any surgery or any 
12 
invasive or minor procedure, or to contribute thereto by way of administering any anesthesia, 
13 
analgesia, or in any way sedate the patient. It shall likewise be unlawful for any licensed 
, 
14 
practitioner to perform surgery or any invasive or minor procedure which he or she is not 
15 
licensed to' perform. 
16 
SECTION 5. Duties of Unlicensed Personnel. -It shall be unlawful for any person, being 
17 
unlicensed personnel of the practitioner, to perform any duty, task or responsibility that requires 
18 
a license to perform. 
19 
Dnties that do not require professional licensure and are assigned to unlicensed personnel 
20 
should be in accordance with their training, education and experience and under the direct 
21 
supervision of a practitioner. 
22 
SECTION 6. Where the Surgery and Other Invasive and Minor Procedures Can Be 
23 
Performed. -It shall be unlawful to perform any surgery or other invasive or minor procedure in 
24 
an office, clinic, center, facility or other establishment that does not conform to all the following 
25 
reqnirements: 
2 


1 
(C) 
The qualifications of the practitioners, including the specific office-based 
2 
surgical or invasive procedures and anesthesia services which each practitioner is 
3 
qualified and competent to perform, and the licensure, accreditation, training and 
4 
experience relevant to the procedure to be performed. For medical practitioners, 
5 
board certification or completion of a training program qualified to lead to board 
6 
celiification; for other practitioners, celiification that is appropriate and applicable 
7 
for misconduct and malpractice history. 
8 
SECTION 8. Follow-up Cure. - The professional who performed the procedure shall be 
9 
personally responsible for patient care. He or she must maintain an outpatient service, either at 
10 
facility where procedure was undertaken, or elsewhere, such that the professional can provide 
II 
appropriate follow-up care. The professional must ensure his or her availability for emergencies 
, 
12 
or arrange for appropriate cover if on leave. 
13 
SECTION 9. Penalties. - The performance of any surgery or any invasive or minor 
14 
procedure by other than a licensed practitioner shall be punishable by a penalty of imprisonment 
15 
ranging from prision mayor in its maximum term to reclusion temporal in its minimum term, or 
16 
a fine ranging from Five Hundred Thousand' Pesos (P500,000.00) to One Million 
17 
Pesos(PI,OOO,OOO.OO), or both, at the discretion of the court, taking into consideration all 
18 
attending circumstances, and the cancellation of the license to practice his or her profession. 
19 
The performance of any surgery or any invasive or minor procedure by a licensed 
20 
practitioner but who is not licensed to perform the procedure he or she did shall be punishable by 
21 
a penalty of imprisonment ranging from prision mayor in its medium to prision mayor in its 
22 
maximum term, or a fine ranging from Three Hundred Thousand Pesos (p300,000.00) to Five 
23 
Hundred Thousand Pesos (P5000,000.00), or both, at the discretion of the court, taking into 
24 
consideration all attending circumstances, and the cancellation of the license to practice his or 
25 
her procession. 
26 
The performance of any duty, task or responsibility other than any surgery or any 
27 
invasive or minor procedure that requires a license to perform by any unlicensed person shall be 
28 
punishable by a penalty of imprisonment ranging from prision mayor in its minimum term to 
4 


1 
prision mayor m its medium term, or a fine rangmg from One Hundred Thousand Pesos 
2 
(PIOO,OOO.OO) to Three Hundred Thousand Pesos (P300,OOO.OO), or both, at the discretion of the 
3 
court, taking into consideration all attending circumstances. 
4 
The owner, proprietor, or operator of any office, clinic, center, facility or other location 
5 
that does not conform to all requirements in section six of this Act be punished by a penalty of 
6 
imprisonment ranging from prision mayor in its mecii"um term to prision mayor in its maximum 
7 
term, or a fine ranging from Three Hundred Thousand Pesos (P300,OOo.OO) to Five Hundred 
8 
Thousand Pesos (P500,000.00), or both, at the discretion of the court, taking into consideration 
9 
all attending circumstances, and the cancellation of the license to operation such an 
10 
establishment. If the owner, proprietor or operator of the establishment above is a corporation, 
11 
trust or firm, partnership, association or any other entity, the penalty of imprisonment shall be 
12 
imposed on the entity's responsible officers, including, but not limited to, the president, vice 
13 
president, chief executive officer, general manager, managing director or partner directly 
14 
responsible therefor. 
15 
SECTION 10. Aggravating Circumstances. - The penalties described in section eight 
16 
shall be imposed in the maximum if the violation of this act results in the following 
17 
circumstances: 
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(A) Death of the patient or the contraction of some incurable disease; 
19 
(B) Insanity or psychological damage of the patient; and 
20 
: (C) Permanent physical disfigurement or permanent disability of the patient. 
21 
SECTION II. Appropriations. -To carry out the provisions of this Act, such sum as may 
22 
be necessary is hereby authorized to be appropriated from the National Treasury. Thereafter, the 
23 
sum necessary for the continuous operation of the program shall be included in the annual 
24 
appropriation of the Department of Health. 
25 
SECTION 12 Separability Clause. - If any provision or part hereof, is held invalid or 
26 
unconstitutional, the remainder of the law or the provision shall remain valid and subsisting. 
5 


I 
SECTION 13. Repealing Clause. - Any law, presidential decree, issuance, executive 
2 
order, letter of instmction, administrative order, mle or regulation contrary to or inconsistent 
3 
with, the provisions of this Act is hereby repealed, modified or amended accordingly. 
4 
SECTION 14. Effectivity Clause. - This Act shall take effect fifteen (15) days after its 
5 
pUblication in at least two (2) newspapers of general circulation. 
Approved, 
iptml06july201O 
6