EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0278*
HOUSE BILL 278
J2 3lr1706
SB 513/22 – EHE CF SB 213
By: Delegate Cullison
Introduced and read first time: January 25, 2023
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Health Occupations – Clinical Nurse Specialists – Prescribing 2
FOR the purpose of defining “clinical nurse specialist” and “practice as a clinical nurse 3
specialist” for the purpose of authorizing clinical nurse specialists to prescribe drugs 4
and durable medical equipment under regulations adopted by the State Board of 5
Nursing; altering the definition of “authorized prescriber” for purposes of the 6
Maryland Pharmacy Act to include clinical nurse specialists; authorizing a licensed 7
physician to personally prepare and dispense a prescription written by a clinical 8
nurse specialist; and generally relating to the prescription authority of clinical nurse 9
specialists. 10
BY repealing and reenacting, without amendments, 11
Article – Health Occupations 12
Section 8–101(a) and (b) 13
Annotated Code of Maryland 14
(2021 Replacement Volume and 2022 Supplement) 15
BY adding to 16
Article – Health Occupations 17
Section 8–514 18
Annotated Code of Maryland 19
(2021 Replacement Volume and 2022 Supplement) 20
BY repealing and reenacting, with amendments, 21
Article – Health Occupations 22
Section 12–101(b) and 12–102(c)(2)(iv)2. 23
Annotated Code of Maryland 24
(2021 Replacement Volume and 2022 Supplement) 25
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 26
That the Laws of Maryland read as follows: 27 2 HOUSE BILL 278
Article – Health Occupations 1
8–101. 2
(a) In this title the following words have the meanings indicated. 3
(b) “Advanced practice registered nurse” means an individual who: 4
(1) (i) Is licensed by the Board to practice registered nursing; or 5
(ii) Has a multistate licensure privilege to practice registered 6
nursing under the Nurse Licensure Compact; and 7
(2) Is certified by the Board to practice as: 8
(i) A nurse practitioner; 9
(ii) A nurse anesthetist; 10
(iii) A nurse midwife; or 11
(iv) A clinical nurse specialist. 12
8–514. 13
(A) (1) IN THIS SECTION THE FOL LOWING WORDS HAVE TH E MEANINGS 14
INDICATED. 15
(2) “CLINICAL NURSE SPECIA LIST” MEANS AN INDIVIDUAL WHO IS: 16
(I) LICENSED BY THE BOARD TO PRACTICE REG ISTERED 17
NURSING; 18
(II) CERTIFIED BY THE BOARD TO PRACTICE AS A CLINICAL 19
NURSE SPEC IALIST; AND 20
(III) AUTHORIZED TO PRESCRI BE DRUGS AND DURABLE 21
MEDICAL EQUIPMENT UN DER REGULATIONS ADOP TED BY THE BOARD. 22
(3) (I) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” MEANS TO: 23
1. PROVIDE DIRECT CARE T O PATIENTS WITH COMP LEX 24
NEEDS; 25
HOUSE BILL 278 3
2. ACT AS A CONSULTANT T O ANOTHER HEALTH CAR E 1
PROVIDER AS NEEDED ; 2
3. CONDUCT HEALTH –RELATED RESEARCH ; AND 3
4. PROVIDE EDUCATION AND GUIDANCE FOR STAFF 4
NURSES. 5
(II) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” INCLUDES: 6
1. ORDERING, PERFORMIN G, AND INTERPRETING 7
LABORATORY TESTS ; 8
2. ORDERING DIAGNOSTIC T ESTS AND USING THE 9
FINDINGS OR RESULTS IN THE CARE OF PATIE NTS; 10
3. PRESCRIBING DRUGS AND DURABLE MEDICAL 11
EQUIPMENT AS PROVIDE D UNDER PARAGRAPH (2)(III) OF THIS SUBSECTION ; 12
4. ORDERING HOME HEALTH AND HOSPICE CARE ; AND 13
5. INITIATING, MONITORING , AND ALTERING 14
APPROPRIATE THERAPIE S OR TREATMENTS . 15
(B) PRACTICE AS A CLINICA L NURSE SPECIALIST I S GOVERNED BY RULES 16
AND REGULATIONS THAT ARE ADOPTED UNDER § 8–205 OF THIS TITLE AND TH AT 17
CONCERN ADDITIONAL A CTS IN THE PRACTICE OF REGISTERED NURSIN G. 18
12–101. 19
(b) “Authorized prescriber” means any licensed dentist, licensed dental hygienist 20
with prescriptive authority under § 4–206.4 of this article, licensed physician, licensed 21
podiatrist, licensed veterinarian, advanced practice REGISTERED nurse with prescriptive 22
authority under § 8–508 OR § 8–514 of this article, licensed nurse anesthetist, or other 23
individual authorized by law to prescribe prescription or nonprescription drugs or devices. 24
12–102. 25
(c) (2) This title does not prohibit: 26
(iv) A licensed physician who complies with the requirements of item 27
(ii) of this paragraph from personally preparing and dispensing a prescription written by: 28
2. [A nurse practitioner who is authorized to practice under 29
Title 8, Subtitle 3] AN ADVANCED PRACTICE REGISTERED NURSE WITH 30 4 HOUSE BILL 278
PRESCRIPTIVE AUTHORI TY UNDER § 8–508 OR § 8–514 of this article and is working 1
with the physician in the same office setting; or 2
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 3
October 1, 2023. 4