EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb0278*
HOUSE BILL 278
J2 3lr1706
SB 513/22 – EHE CF SB 213
By: Delegate Cullison Delegates Cullison, Alston, Bagnall, Bhandari, Chisholm,
Guzzone, Hutchinson, S. Johnson, Kaiser, Kerr, Kipke, R. Lewis, Lopez,
Martinez, M. Morgan, Pena–Melnyk, Reilly, Rosenberg, Szeliga, Taveras,
White, and Woods
Introduced and read first time: January 25, 2023
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 1, 2023
CHAPTER ______
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 2 HOUSE BILL 278
BY repealing and reenacting, with amendments, 1
Article – Health Occupations 2
Section 12–101(b) and 12–102(c)(2)(iv)2. 3
Annotated Code of Maryland 4
(2021 Replacement Volume and 2022 Supplement) 5
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 6
That the Laws of Maryland read as follows: 7
Article – Health Occupations 8
8–101. 9
(a) In this title the following words have the meanings indicated. 10
(b) “Advanced practice registered nurse” means an individual who: 11
(1) (i) Is licensed by the Board to practice registered nursing; or 12
(ii) Has a multistate licensure privilege to practice registered 13
nursing under the Nurse Licensure Compact; and 14
(2) Is certified by the Board to practice as: 15
(i) A nurse practitioner; 16
(ii) A nurse anesthetist; 17
(iii) A nurse midwife; or 18
(iv) A clinical nurse specialist. 19
8–514. 20
(A) (1) IN THIS SECTION THE FOLLOWIN G WORDS HAVE THE MEA NINGS 21
INDICATED. 22
(2) “CLINICAL NURSE SPECIA LIST” MEANS AN INDIVIDUAL WHO IS: 23
(I) 1. LICENSED IS LICENSED BY THE BOARD TO PRACTICE 24
REGISTERED NURSING ; OR 25
2. HAS A MULTISTATE LICE NSURE PRIVILEGE TO 26
PRACTICE REGISTERED NURSING U NDER THE NURSE LICENSURE COMPACT; AND 27
HOUSE BILL 278 3
(II) CERTIFIED IS CERTIFIED BY THE BOARD TO PRACTICE AS A 1
CLINICAL NURSE SPECI ALIST; AND 2
(III) AUTHORIZED TO PRESCRI BE DRUGS AND DURABLE 3
MEDICAL EQUIPMENT UN DER REGULATIONS ADOP TED BY THE BOARD. 4
(3) (I) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” MEANS TO: 5
1. PROVIDE DIRECT CARE T O PATIENTS WITH COMP LEX 6
NEEDS; 7
2. ACT AS A CONSULTANT T O ANOTHER HEALTH CAR E 8
PROVIDER AS NEEDED ; 9
3. CONDUCT HEALTH –RELATED RESEARCH ; AND 10
4. PROVIDE EDUCATION AND GUIDANCE FOR STAFF 11
NURSES. 12
(II) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” INCLUDES: 13
1. ORDERING, PERFORMING , AND INTERPRETING 14
LABORATORY TESTS ; 15
2. ORDERING DIAGNOSTIC T ESTS AND USING THE 16
FINDINGS OR RESULTS IN THE CARE OF PATIENTS ; 17
3. PRESCRIBING DRUGS AND DURABLE MEDICAL 18
EQUIPMENT AS PROVIDED UNDER PA RAGRAPH (2)(III) OF THIS SUBSECTION UNDER 19
REGULATIONS ADOPTED BY THE BOARD; 20
4. ORDERING HOME HEALTH AND HOSPICE CARE ; AND 21
5. INITIATING, MONITORING , AND ALTERING 22
APPROPRIATE THERAPIE S OR TREATMENTS . 23
(B) PRACTICE AS A CLINICA L NURSE SPECIALIST I S GOVERNED BY RULES 24
AND REGULATIONS THAT ARE ADOPTED UNDER § 8–205 OF THIS TITLE AND TH AT 25
CONCERN ADDITIONAL A CTS IN THE PRACTICE OF REGISTERED NURSIN G. 26
12–101. 27
(b) “Authorized prescriber” means any licensed dentist, licensed dental hygienist 28
with prescriptive authority under § 4–206.4 of this article, licensed physician, licensed 29
podiatrist, licensed veterinarian, advanced practice REGISTERED nurse with prescriptive 30 4 HOUSE BILL 278
authority under § 8–508 OR § 8–514 TITLE 8 of this article, licensed nurse anesthetist, or 1
other individual authorized by law to prescribe prescription or nonprescription drugs or 2
devices. 3
12–102. 4
(c) (2) This title does not prohibit: 5
(iv) A licensed physician who complies with the requirements of item 6
(ii) of this paragraph from personally preparing and dispensing a prescription written by: 7
2. [A nurse practitioner who is authorized to practice under 8
Title 8, Subtitle 3] AN ADVANCED P RACTICE REGISTERED N URSE WITH 9
PRESCRIPTIVE AUTHORI TY UNDER § 8–508 OR § 8–514 TITLE 8 of this article and is 10
working with the physician in the same office setting; or 11
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 12
October 1, 2023. 13
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.