Florida Senate - 2023 SB 412 By Senator Garcia 36-00934-23 2023412__ 1 A bill to be entitled 2 An act relating to gluteal fat grafting procedures; 3 amending ss. 458.328 and 459.0138, F.S.; requiring 4 physicians performing gluteal fat grafting procedures 5 in an office surgery setting to adhere to specified 6 standards of practice; authorizing the Board of 7 Medicine and the Board of Osteopathic Medicine, 8 respectively, to adopt certain rules; providing an 9 effective date. 10 11 Be It Enacted by the Legislature of the State of Florida: 12 13 Section 1. Present subsection (2) of section 458.328, 14 Florida Statutes, is redesignated as subsection (3), and a new 15 subsection (2) is added to that section, to read: 16 458.328 Office surgeries.— 17 (2) GLUTEAL FAT GRAFTING PROCEDURES.— 18 (a) Physicians performing gluteal fat grafting procedures 19 in an office surgery setting shall adhere to standards of 20 practice prescribed under this subsection. The board may adopt 21 rules to prescribe additional requirements for the safe 22 performance of gluteal fat grafting procedures, provided such 23 rules do not conflict with this subsection. 24 (b) An office in which a physician performs gluteal fat 25 grafting procedures must at all times maintain a ratio of one 26 physician to one patient during all phases of the procedure, 27 beginning with the administration of anesthesia to the patient 28 and concluding with the extubation of the patient. A physician 29 is not limited in the number of gluteal fat grafting procedures 30 that he or she may safely perform in accordance with the 31 applicable standard of care and as prescribed in this 32 subsection. However, a physician may not begin or otherwise 33 engage in more than one gluteal fat grafting procedure, or begin 34 or otherwise engage in a gluteal fat grafting procedure and any 35 other procedure, with more than one patient at a time. 36 (c) Any duties delegated during a gluteal fat grafting 37 procedure must be performed under the direct supervision of the 38 physician performing the procedure. Gluteal fat injections must 39 be performed by the physician performing the procedure and may 40 not be delegated. 41 (d) Only the physician performing the gluteal fat grafting 42 procedure may inject gluteal fat into the patient. The gluteal 43 fat may be injected only into the subcutaneous space of the 44 patient and may not cross the fascia overlying the gluteal 45 muscle. Intramuscular and submuscular fat injections are 46 prohibited. 47 (e) When the physician performing a gluteal fat grafting 48 procedure injects gluteal fat into the subcutaneous space of the 49 patient, the physician must use ultrasound guidance during the 50 placement and navigation of a cannula to ensure that the fat is 51 placed into the subcutaneous space of the patient above the 52 fascia overlying the gluteal muscle. Ultrasound guidance is not 53 required for other portions of the procedure. 54 Section 2. Present subsection (2) of section 459.0138, 55 Florida Statutes, is redesignated as subsection (3), and a new 56 subsection (2) is added to that section, to read: 57 459.0138 Office surgeries.— 58 (2) GLUTEAL FAT GRAFTING PROCEDURES.— 59 (a) Physicians performing gluteal fat grafting procedures 60 in an office surgery setting shall adhere to standards of 61 practice prescribed under this subsection. The board may adopt 62 rules to prescribe additional requirements for the safe 63 performance of gluteal fat grafting procedures, provided such 64 rules do not conflict with this subsection. 65 (b) An office in which a physician performs gluteal fat 66 grafting procedures must at all times maintain a ratio of one 67 physician to one patient during all phases of the procedure, 68 beginning with the administration of anesthesia to the patient 69 and concluding with the extubation of the patient. A physician 70 is not limited in the number of gluteal fat grafting procedures 71 that he or she may safely perform in accordance with the 72 applicable standard of care and as prescribed in this 73 subsection. However, a physician may not begin or otherwise 74 engage in more than one gluteal fat grafting procedure, or begin 75 or otherwise engage in a gluteal fat grafting procedure and any 76 other procedure, with more than one patient at a time. 77 (c) Any duties delegated during a gluteal fat grafting 78 procedure must be performed under the direct supervision of the 79 physician performing the procedure. Gluteal fat injections must 80 be performed by the physician performing the procedure and may 81 not be delegated. 82 (d) Only the physician performing the gluteal fat grafting 83 procedure may inject gluteal fat into the patient. The gluteal 84 fat may be injected only into the subcutaneous space of the 85 patient and may not cross the fascia overlying the gluteal 86 muscle. Intramuscular and submuscular fat injections are 87 prohibited. 88 (e) When the physician performing a gluteal fat grafting 89 procedure injects gluteal fat into the subcutaneous space of the 90 patient, the physician must use ultrasound guidance during the 91 placement and navigation of a cannula to ensure that the fat is 92 placed into the subcutaneous space of the patient above the 93 fascia overlying the gluteal muscle. Ultrasound guidance is not 94 required for other portions of the procedure. 95 Section 3. This act shall take effect July 1, 2023.