MD
Maryland House Bill HB278

Maryland 2023 Regular Session

Maryland House Bill HB278 Compare Versions

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1- WES MOORE, Governor Ch. 328
21
3-– 1 –
4-Chapter 328
5-(House Bill 278)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4+ [Brackets] indicate matter deleted from existing law.
5+ Underlining indicates amendments to bill.
6+ Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7+amendment.
8+ *hb0278*
89
9-Health Occupations – Clinical Nurse Specialists – Prescribing
10+HOUSE BILL 278
11+J2 3lr1706
12+SB 513/22 – EHE CF SB 213
13+By: Delegate Cullison Delegates Cullison, Alston, Bagnall, Bhandari, Chisholm,
14+Guzzone, Hutchinson, S. Johnson, Kaiser, Kerr, Kipke, R. Lewis, Lopez,
15+Martinez, M. Morgan, Pena–Melnyk, Reilly, Rosenberg, Szeliga, Taveras,
16+White, and Woods
17+Introduced and read first time: January 25, 2023
18+Assigned to: Health and Government Operations
19+Committee Report: Favorable with amendments
20+House action: Adopted
21+Read second time: March 1, 2023
1022
11-FOR the purpose of defining “clinical nurse specialist” and “practice as a clinical nurse
12-specialist” for the purpose of authorizing clinical nurse specialists to prescribe drugs
13-and durable medical equipment under regulations adopted by the State Board of
14-Nursing; altering the definition of “authorized prescriber” for purposes of the
15-Maryland Pharmacy Act to include clinical nurse specialists; authorizing a licensed
16-physician to personally prepare and dispense a prescription written by a clinical
17-nurse specialist; and generally relating to the prescription authority of clinical nurse
18-specialists.
23+CHAPTER ______
1924
20-BY repealing and reenacting, without amendments,
21- Article – Health Occupations
22-Section 8–101(a) and (b)
23- Annotated Code of Maryland
24- (2021 Replacement Volume and 2022 Supplement)
25+AN ACT concerning 1
2526
26-BY adding to
27- Article – Health Occupations
28-Section 8–514
29- Annotated Code of Maryland
30- (2021 Replacement Volume and 2022 Supplement)
27+Health Occupations – Clinical Nurse Specialists – Prescribing 2
3128
32-BY repealing and reenacting, with amendments,
33- Article – Health Occupations
34-Section 12–101(b) and 12–102(c)(2)(iv)2.
35- Annotated Code of Maryland
36- (2021 Replacement Volume and 2022 Supplement)
29+FOR the purpose of defining “clinical nurse specialist” and “practice as a clinical nurse 3
30+specialist” for the purpose of authorizing clinical nurse specialists to prescribe drugs 4
31+and durable medical equipment under regulations adopted by the State Board of 5
32+Nursing; altering the definition of “authorized prescriber” for purposes of the 6
33+Maryland Pharmacy Act to include clinical nurse specialists; authorizing a licensed 7
34+physician to personally prepare and dispense a prescription written by a clinical 8
35+nurse specialist; and generally relating to the prescription authority of clinical nurse 9
36+specialists. 10
3737
38- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
39-That the Laws of Maryland read as follows:
38+BY repealing and reenacting, without amendments, 11
39+ Article – Health Occupations 12
40+Section 8–101(a) and (b) 13
41+ Annotated Code of Maryland 14
42+ (2021 Replacement Volume and 2022 Supplement) 15
4043
41-Article – Health Occupations
44+BY adding to 16
45+ Article – Health Occupations 17
46+Section 8–514 18
47+ Annotated Code of Maryland 19
48+ (2021 Replacement Volume and 2022 Supplement) 20 2 HOUSE BILL 278
4249
43-8–101.
4450
45- (a) In this title the following words have the meanings indicated.
4651
47- (b) “Advanced practice registered nurse” means an individual who:
52+BY repealing and reenacting, with amendments, 1
53+ Article – Health Occupations 2
54+Section 12–101(b) and 12–102(c)(2)(iv)2. 3
55+ Annotated Code of Maryland 4
56+ (2021 Replacement Volume and 2022 Supplement) 5
4857
49- (1) (i) Is licensed by the Board to practice registered nursing; or Ch. 328 2023 LAWS OF MARYLAND
58+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 6
59+That the Laws of Maryland read as follows: 7
5060
51-– 2 –
61+Article – Health Occupations 8
5262
53- (ii) Has a multistate licensure privilege to practice registered
54-nursing under the Nurse Licensure Compact; and
63+8–101. 9
5564
56- (2) Is certified by the Board to practice as:
65+ (a) In this title the following words have the meanings indicated. 10
5766
58- (i) A nurse practitioner;
67+ (b) “Advanced practice registered nurse” means an individual who: 11
5968
60- (ii) A nurse anesthetist;
69+ (1) (i) Is licensed by the Board to practice registered nursing; or 12
6170
62- (iii) A nurse midwife; or
71+ (ii) Has a multistate licensure privilege to practice registered 13
72+nursing under the Nurse Licensure Compact; and 14
6373
64- (iv) A clinical nurse specialist.
74+ (2) Is certified by the Board to practice as: 15
6575
66-8–514.
76+ (i) A nurse practitioner; 16
6777
68- (A) (1) IN THIS SECTION THE FOL LOWING WORDS HAVE TH E MEANINGS
69-INDICATED.
78+ (ii) A nurse anesthetist; 17
7079
71- (2) “CLINICAL NURSE SPECIA LIST” MEANS AN INDIVIDUAL WHO IS:
80+ (iii) A nurse midwife; or 18
7281
73- (I) 1. LICENSED IS LICENSED BY THE BOARD TO PRACTICE
74-REGISTERED NURSING ; OR
82+ (iv) A clinical nurse specialist. 19
7583
76- 2. HAS A MULTISTATE LICE NSURE PRIVILEGE TO
77-PRACTICE REGISTERED NURSING UNDER THE NURSE LICENSURE COMPACT; AND
84+8–514. 20
7885
79- (II) CERTIFIED IS CERTIFIED BY THE BOARD TO PRACTICE AS A
80-CLINICAL NURSE SPECI ALIST; AND
86+ (A) (1) IN THIS SECTION THE FOLLOWIN G WORDS HAVE THE MEA NINGS 21
87+INDICATED. 22
8188
82- (III) AUTHORIZED TO PRESCRI BE DRUGS AND DURABLE
83-MEDICAL EQUIPMENT UN DER REGULATIONS ADOP TED BY THE BOARD.
89+ (2) “CLINICAL NURSE SPECIA LIST” MEANS AN INDIVIDUAL WHO IS: 23
8490
85- (3) (I) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” MEANS TO:
91+ (I) 1. LICENSED IS LICENSED BY THE BOARD TO PRACTICE 24
92+REGISTERED NURSING ; OR 25
8693
87- 1. PROVIDE DIRECT CARE T O PATIENTS WITH COMP LEX
88-NEEDS;
94+ 2. HAS A MULTISTATE LICE NSURE PRIVILEGE TO 26
95+PRACTICE REGISTERED NURSING U NDER THE NURSE LICENSURE COMPACT; AND 27
96+ HOUSE BILL 278 3
8997
90- 2. ACT AS A CONSULTANT T O ANOTHER HEALTH CAR E
91-PROVIDER AS NEEDED ;
9298
93- 3. CONDUCT HEALTH –RELATED RESEARCH ; AND
94- WES MOORE, Governor Ch. 328
99+ (II) CERTIFIED IS CERTIFIED BY THE BOARD TO PRACTICE AS A 1
100+CLINICAL NURSE SPECI ALIST; AND 2
95101
96-– 3 –
97- 4. PROVIDE EDUCATION AND GUIDANCE FOR STAFF
98-NURSES.
102+ (III) AUTHORIZED TO PRESCRI BE DRUGS AND DURABLE 3
103+MEDICAL EQUIPMENT UN DER REGULATIONS ADOP TED BY THE BOARD. 4
99104
100- (II) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” INCLUDES:
105+ (3) (I) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” MEANS TO: 5
101106
102- 1. ORDERING, PERFORMING , AND INTERPRETING
103-LABORATORY TESTS ;
107+ 1. PROVIDE DIRECT CARE T O PATIENTS WITH COMP LEX 6
108+NEEDS; 7
104109
105- 2. ORDERING DIAGNOSTIC T ESTS AND USING THE
106-FINDINGS OR RESULTS IN THE CARE OF PATIE NTS;
110+ 2. ACT AS A CONSULTANT T O ANOTHER HEALTH CAR E 8
111+PROVIDER AS NEEDED ; 9
107112
108- 3. PRESCRIBING DRUGS AND DURABLE MEDICAL
109-EQUIPMENT AS PROVIDED UNDER PA RAGRAPH (2)(III) OF THIS SUBSECTION UNDER
110-REGULATIONS ADOPTED BY THE BOARD;
113+ 3. CONDUCT HEALTH –RELATED RESEARCH ; AND 10
111114
112- 4. ORDERING HOME HEALTH AND HOSPICE CARE ; AND
115+ 4. PROVIDE EDUCATION AND GUIDANCE FOR STAFF 11
116+NURSES. 12
113117
114- 5. INITIATING, MONITORING, AND ALTERING
115-APPROPRIATE THERAPIE S OR TREATMENTS .
118+ (II) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” INCLUDES: 13
116119
117- (B) PRACTICE AS A CLINICA L NURSE SPECIALIST I S GOVERNED BY RULES
118-AND REGULATIONS THAT ARE ADOPTED UNDER § 8–205 OF THIS TITLE AND TH AT
119-CONCERN ADDITIONAL A CTS IN THE PRACTICE OF REGISTERED NURSIN G.
120+ 1. ORDERING, PERFORMING , AND INTERPRETING 14
121+LABORATORY TESTS ; 15
120122
121-12–101.
123+ 2. ORDERING DIAGNOSTIC T ESTS AND USING THE 16
124+FINDINGS OR RESULTS IN THE CARE OF PATIENTS ; 17
122125
123- (b) “Authorized prescriber” means any licensed dentist, licensed dental hygienist
124-with prescriptive authority under § 4–206.4 of this article, licensed physician, licensed
125-podiatrist, licensed veterinarian, advanced practice REGISTERED nurse with prescriptive
126-authority under § 8–508 OR § 8–514 TITLE 8 of this article, licensed nurse anesthetist, or
127-other individual authorized by law to prescribe prescription or nonprescription drugs or
128-devices.
126+ 3. PRESCRIBING DRUGS AND DURABLE MEDICAL 18
127+EQUIPMENT AS PROVIDED UNDER PA RAGRAPH (2)(III) OF THIS SUBSECTION UNDER 19
128+REGULATIONS ADOPTED BY THE BOARD; 20
129129
130-12–102.
130+ 4. ORDERING HOME HEALTH AND HOSPICE CARE ; AND 21
131131
132- (c) (2) This title does not prohibit:
132+ 5. INITIATING, MONITORING , AND ALTERING 22
133+APPROPRIATE THERAPIE S OR TREATMENTS . 23
133134
134- (iv) A licensed physician who complies with the requirements of item
135-(ii) of this paragraph from personally preparing and dispensing a prescription written by:
135+ (B) PRACTICE AS A CLINICA L NURSE SPECIALIST I S GOVERNED BY RULES 24
136+AND REGULATIONS THAT ARE ADOPTED UNDER § 8–205 OF THIS TITLE AND TH AT 25
137+CONCERN ADDITIONAL A CTS IN THE PRACTICE OF REGISTERED NURSIN G. 26
136138
137- 2. [A nurse practitioner who is authorized to practice under
138-Title 8, Subtitle 3] AN ADVANCED PRACTICE REGISTERED NURSE WIT H
139-PRESCRIPTIVE AUTHORI TY UNDER § 8–508 OR § 8–514 TITLE 8 of this article and is
140-working with the physician in the same office setting; or
141- Ch. 328 2023 LAWS OF MARYLAND
139+12–101. 27
142140
143-– 4 –
144- SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
145-October 1, 2023.
141+ (b) “Authorized prescriber” means any licensed dentist, licensed dental hygienist 28
142+with prescriptive authority under § 4–206.4 of this article, licensed physician, licensed 29
143+podiatrist, licensed veterinarian, advanced practice REGISTERED nurse with prescriptive 30 4 HOUSE BILL 278
146144
147-Approved by the Governor, May 3, 2023.
145+
146+authority under § 8–508 OR § 8–514 TITLE 8 of this article, licensed nurse anesthetist, or 1
147+other individual authorized by law to prescribe prescription or nonprescription drugs or 2
148+devices. 3
149+
150+12–102. 4
151+
152+ (c) (2) This title does not prohibit: 5
153+
154+ (iv) A licensed physician who complies with the requirements of item 6
155+(ii) of this paragraph from personally preparing and dispensing a prescription written by: 7
156+
157+ 2. [A nurse practitioner who is authorized to practice under 8
158+Title 8, Subtitle 3] AN ADVANCED P RACTICE REGISTERED N URSE WITH 9
159+PRESCRIPTIVE AUTHORI TY UNDER § 8–508 OR § 8–514 TITLE 8 of this article and is 10
160+working with the physician in the same office setting; or 11
161+
162+ SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 12
163+October 1, 2023. 13
164+
165+
166+
167+
168+Approved:
169+________________________________________________________________________________
170+ Governor.
171+________________________________________________________________________________
172+ Speaker of the House of Delegates.
173+________________________________________________________________________________
174+ President of the Senate.