SB0140sam002 97TH GENERAL ASSEMBLY

Sen. Iris Y. Martinez

Filed: 3/14/2011

09700SB0140sam002 LRB097 05330 CEL 52926 a

AMENDMENT TO SENATE BILL 140

AMENDMENT NO. ______. Amend Senate Bill 140 by replacing everything after the enacting clause with the following:

"Section 1. Short title. This Act may be cited as the Interventional Surgical Pain Procedures for Chronic Pain Act.

Section 5. Definitions. For the purposes of this Act:

"Chronic pain" means a pain state that is subacute, persistent, and intractable. This does not include procedures for post-surgical pain, labor pain, pain related to child birth, or treatment of pain seen in the emergency room setting.

"Department" means the Department of Financial and Professional Regulation.

"Interventional surgical pain procedures" means diagnostic or therapeutic techniques to treat chronic pain. These procedures are surgical and may require the use of imaging guidance and involve any of the following for the treatment of chronic pain only:

(1) The cranial nerves and their branches (such as occipital, supra-orbital, and temporal), including destruction by chemical or other modalities.

(2) The facets joints of the cervical, thoracic, lumbar region and surrounding nerve branches, including destruction, ablation, or denervation, aspiration of cysts of small and large joints, and injection of contrast material with the use of image guidance.

(3) Cervical, thoracic, or lumbar sympathetic ganglion, visceral plexuses, or nerve blocks.

(4) Epidural injections in the cervical, thoracic, lumbar, caudal, either both interlaminar and transforaminal, with and without the use of image guidance.

(5) Intrathecal surgical placement of percutaneous or tunneled intrathecal catheters or pumps and subcutaneous port placement not including procedures to refill these pumps.

(6) Injections into sacroiliac joint with and without the use of image guidance. This excludes injections into muscle and trigger point injections.

(7) Provocative or analgesic discography, intradiscal electrothermal therapy, or other intradiscal procedures in which drugs, gases, biologic materials, or prosthesis are placed or injected into the intervertebral disc.

(8) Injection, destruction, or ablation of peripheral nerves including intercostals and radiofrequency ablation or chemical destruction of any nerve or nerve groups or nerve plexus.

(9) Spinal cord or peripheral nerve stimulator placement.

(10) Spinal augmentation procedures such as vertebroplasty, kyphoplasty, sacroplasty, or other bone augmentation procedures.

Section 10. Prohibited practices and penalties. A person shall not practice or offer to practice interventional surgical pain procedures for pain medicine in this State unless the person is a physician licensed to practice medicine in all its branches. A physician may be assisted in these procedures by a physician licensed to practice medicine in all its branches, advanced practice registered nurse, physician assistant, registered nurse, surgical assistant, or surgical technician. Interventional surgical pain procedures as stated in this Act may not be delegated. Any person who violates this Section commits a Class A misdemeanor and is subject to the injunction, punishment, and enforcement provisions set forth in Section 3.5 of the Medical Practice Act of 1987.

Section 15. Rulemaking authority. The Department may adopt rules, in consultation with the Medical Licensing Board, as necessary to implement this Act.

Section 20. Applicability. This Act does not prevent the following:

(1) The performance of non-interventional pain procedures by a licensed advanced practice nurse, licensed physician assistant, licensed acupuncturist, licensed podiatrist, licensed hospice and palliative care provider, or licensed physical therapist in accordance with the law.

(2) The performance of nonsurgical pain care and treatment authorized by the statutory scope of practice for other licensed health care workers or delegated by a physician licensed under the Medical Practice Act of 1987.

(3) Nothing in this Act shall be construed to prohibit a licensed chiropractic physician from utilizing procedures within the scope of practice of a chiropractic physician, as defined in the Medical Practice Act of 1987.

Section 99. Effective date. This Act takes effect July 1, 2011.".