Resources and Legislation — For Patients and Professionals
CSPS Legislative Alert
Proposed: Vote Expected Shortly
Governor Malloy has proposed a new Cosmetic
Surgery Tax within his tax proposal bill-SB 1007.
The actual language included in the bill is:(NEW) (OO) Services in connection with a cosmetic medical procedure. For purposes of this subparagraph, "cosmetic medical procedure" means any medical procedure performed on an individual that is directed at improving the individual's appearance and that does not meaningfully promote the proper function of the body or prevent or treat illness or disease. "Cosmetic medical procedure" includes, but is not limited, to cosmetic surgery, hair ransplants, cosmetic injections, cosmetic soft tissue fillers, dermabrasion and chemical peel, laser hair removal, laser skin resurfacing, laser treatment of leg veins, and sclerotherapy. "Cosmetic medical procedure" does not include reconstructive surgery. "Reconstructive surgery" includes any surgery performed on abnormal structures caused by or related to congenital defects, developmental abnormalities, trauma, infection, tumors or disease, including procedures to improve function or give a more normal appearance.
Patient Flyer on Cosmetic Tax
CSPS testifies against Cosmetic Tax
Drs. Beam and Felcie testified against the proposal before the Finance, Revenue and Bonding Committee. Both doctors did an excellent job representing the interests of the society and the patients of CT. Their testimony outlined several strong arguments against the bill, including HIPAA concerns, surgical flight and the failure in New Jersey to raise the needed tax revenue. Please see their testimony below.
When contacting legislators:
- It is important to remain calm and polite when contacting legislators to express your opposition to the cosmetic surgery tax proposal in HB 1007.
- Tell them you are a constituent and/or small business owner in the district.
Let them know that:
- New Jersey passed a similar bill and now the primary sponsor, Assemblyman Joe Cryan, Chair of the NJ Democratic Party, is leading the effort to repeal it.
- No other states have passed the proposal; in fact, several have defeated it.
- In fact, procedures in New Jersey declined, bringing in less revenue than expected from the tax and resulting in lower income tax revenue being collected from the surgeons.
- The majority of patients receiving cosmetic surgery – 91% – are tax-paying, working women.
- According to a 2004 study, 60% of patients planning cosmetic surgery had incomes between $30,000 and $90,000 while 40% of that group had incomes between $30,000 and $60,000.
- Clearly, this proposal is discriminatory towards women.
- Taxing medical procedures is bad public policy and sets a dangerous precedent. What’s next – cataract surgery, elective orthopedic procedures, or bariatric surgery?
- There are a number of procedures that will fall into a grey zone that are not clearly cosmetic or reconstructive. This is a serious problem in New Jersey and the Department of Revenue is now making determinations about medical necessity.
- Patients considering plastic surgery will take their business out of state to New York and Massachusetts to avoid paying the tax.
- The tax will adversely affect the recruitment and retention of qualified plastic surgeons in Connecticut – the same doctors that provide needed care in the hospital setting.
Call your own Senator and Representative today at:
House Democrats: 1-800-842-1902
Senate Democrats: 1-800-842-1420
House Republicans: 1-800-842-8267
Senate Republicans: 1-800-842-1421
You can also go to the state website at www.ct.gov, click Legislative at the top and then House and Senate on the left to find your legislator.
The American Board of Plastic Surgery is one of the 24 specialty boards recognized by the American Board of Medical Specialties (ABMS). It is the only ABMS Board that certifies physicians in the entire specialty of plastic surgery.
By choosing a plastic surgeon certified by the American Board of Plastic Surgery, patients can rest assured that their surgeon has graduated from an accredited medical school and has completed at least five years of additional training as a resident surgeon. This includes a minimum three-year residency in an accredited general surgery program and a minimum two-year residency in plastic surgery. To become certified, the doctor must then successfully complete comprehensive written and oral exams. Board certification is a voluntary process.
Certification by a specialty board attests to 1) completion of a prescribed set of education and training requirements in a specialty of medicine beyond the minimum requirements for licensure, and 2) passage of a series of examinations that test the fund of knowledge in that specialty. Most specialties now also call for periodic recertification, which generally requires completion of specified continuing education and successful completion of a further examination testing the applicant’s fund of knowledge in that specialty. Many health care organizations and health plans now demand certification in order to provide services in the relevant specialty area. Board-certified physicians govern boards in the relevant specialty.
Plastic/Reconstructive Surgery Statistics
- In 2005, 15.6 million plastic/reconstructive procedures were performed – 2 million more than were performed in 2000.
- 5.4 million procedures were reconstructive while 10.2 million were cosmetic.
- The 5.4 million reconstructive cases recorded were 13% fewer than in 2000.
- Tumor removal was by far the most popular reconstructive procedure in 2005, with 3.9 million cases. Nearly 75% of all cases involved tumor removal.
- The next most popular procedure was laceration repair, which made up 6% of all cases.
- Breast reductions were 35% more popular in 2005, a total of 114,000 cases.
- There were 32% fewer animal bite repairs in 2005 – a total of 29,000 cases, the largest drop among all reconstructive procedures.
- 9 million (88%) cosmetic surgery patients were female in 2005, a 42% overall increase since 2000. The other 1.2 million (12%) were men, a 44% overall increase over the same time period.
- 3.8 million BOTOX® injections were performed in 2005, making this the most popular cosmetic procedure of the year.
- BOTOX® injections increased most in popularity with both genders, though the increase was larger among women (409%) than men (233%).
- 333,000 procedures were performed on patients aged 18 or younger
- 1.5 million patients (15%) were 19-34
- 4.7 million patients (46%) were 35-50
- 2.9 million patients (29%) were 51-64
- 718,000 patients (7%) were over 65
Choosing a Plastic/Reconstructive Surgeon
The most important stage of the plastic surgery process is choosing the right surgeon. When patients choose surgeons they are comfortable with, they are much more likely to be happy with the results of their procedure. Choosing a surgeon should be an involved process with several important steps.
An excellent way to start is by asking for recommendations from friends, relatives, or co-workers who have undergone a similar procedure. Another good option is to ask for a referral from a medical health professional – either a personal acquaintance or a primary care physician.
Any high-quality surgeon should be happy to provide detailed information on their past performance, including before-and-after pictures and testimonials. Patients should consult a number of surgeons before selecting the one they think is best for their case.
The most important indicator of a surgeon’s ability is his or her level of experience and past performance. The more successful procedures of a given type that a doctor has performed, the better he or she will be able to deal with the particulars of a new case. Board certification by the American Society of Plastic Surgeons or another similar organization is a good indicator of the quality of care a surgeon will provide. It is important to remember, however, that practical experience and procedure-specific expertise are the qualities that truly distinguish the best surgeons.
Another key to achieving satisfactory results is to be active in the decision-making process. A good surgeon should ask patients what they want, and should clearly and confidently answer questions. He or she should provide all the relevant information, including risks, alternatives, and fees, and then leave the final decision to the patient. Ultimately, the right surgeon will make the patient feel comfortable, confident, and well-informed. If patients know what to expect, they are much more likely to be satisfied with the results of plastic surgery.
Connecticut state law now requires that all licensed physicians and surgeons undergo a minimum of 50 hours of continuing medical education every two years. This policy is in effect for all license renewals beginning on October 1, 2007.
Qualifying continuing medical education (CME) courses include those offered or approved by the American Medical Association, the American Osteopathic Association, the Connecticut Hospital Association, the Connecticut State Medical Society, county medical societies or equivalent organizations in other jurisdictions, educational offerings sponsored by a health care institution, and courses offered either by a regionally accredited academic institution or a state or local health department.