11/09/2023

State Medical Board Advances Podiatry Rules

The State Medical Board of Ohio (SMBO) unanimously voted to advance two important administrative rules relating to the podiatry scope of practice as part of a multi-step rule review process.

SMBO proposed no changes to rules that define foot and outline requirements for podiatrists to perform surgery on the ankle joint. The rules were filed on November 9 with the Common Sense Initiative (CSI), a state body that seeks to ensure regulations are transparent, responsible, fair, and consistent.

The move from SMBO comes after the agency called for public comments from physicians and interested parties. OHFAMA submitted a letter on November 3 urging SMBO to maintain the current rules. No other individuals or organizations submitted comments to SMBO.

Next Steps in the Five-Year Rule Review Process
Following SMBO approval, the podiatry rules will be filed with CSI and the Board will invite interested parties to submit comments.

If there is any opposition to the rules, CSI may call interested parties together to discuss provisions, after which the agency has an opportunity to revise the rule. CSI recommends either that the proposed rule be further amended or be filed in its present form to complete the rule-making process.

The rule is then filed with the Joint Committee on Agency Rule Review (JCARR), a legislative committee composed of members of the Ohio House of Representatives and the Ohio Senate. JCARR jurisdiction lasts for 65 days, during which time SMBO and JCARR must hold a public hearing on the rules.

After the JCARR jurisdiction ends, SMBO can officially adopt the proposed rule and assign an effective date.

Podiatry Scope of Practice
Ohio Revised Code (ORC) and Ohio Administrative Code (OAC) have long recognized podiatric physicians and surgeons are uniquely qualified among medical professionals to diagnose and treat the foot, ankle, and related structures in the lower leg due to the depth and breadth of their education and training. 

Chapter 4731, ORC, defines (in part) the practice of podiatric medicine and surgery as consisting of the “medical, mechanical, and surgical treatment of ailments of the foot, the muscles and tendons of the leg governing the functions of the foot; and superficial lesions of the hand other than those associated with trauma.”

The Board, using rulemaking authority granted to it by the Ohio General Assembly, created Rule 4731-20-01, OAC, which defines “foot” as follows:

“Foot,” as used in section 4731.51 of ORC, means the terminal appendage of the lower extremity, and includes the ankle joint which consists of the tibial plafond, its posterolateral border (posterior malleolus), the medial malleolus, distal fibula (lateral malleolus) and the talus.

The Board further promulgated Rule 4731-20-02, OAC, to formally empower podiatrists to perform surgery on the ankle joint provided they hold privileges from a college of podiatric medicine, hospital, or ambulatory surgical center and can demonstrate adequate education, training, and experience needed to conform to minimal standards of care of similar practitioners.

Both Rule 4731-20-01, OAC, and Rule 4731-20-02, OAC, have been in place since 1997.

OHFAMA will continue to monitor comments submitted by other parties, submit comments to CSI, and participate in the upcoming public hearings to express our support for continuing the rules.

Please contact OHFAMA Executive Director Mike Mathy if have any questions about the rules or the rule-review process.