EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0727*
HOUSE BILL 727
J2 3lr1582
CF SB 673
By: Delegate Kerr
Introduced and read first time: February 8, 2023
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Physician Assistants – Revisions 2
(Physician Assistant Modernization Act of 2023) 3
FOR the purpose of requiring that a physician assistant have a collaboration registration, 4
rather than a delegation agreement, in order to practice as a physician assistant; 5
altering the scope of practice of a physician assistant; altering the education required 6
for licensure as a physician assistant; authorizing physician assistants who are 7
employees of the federal government to perform acts, tasks, or functions as a 8
physician assistant during a certain disaster; providing certain immunity to certain 9
physician assistants; and generally relating to physician assistants. 10
BY repealing and reenacting, with amendments, 11
Article – Education 12
Section 7–402(c) and 18–802(a)(8) 13
Annotated Code of Maryland 14
(2022 Replacement Volume) 15
BY repealing and reenacting, without amendments, 16
Article – Education 17
Section 18–802(a)(1) 18
Annotated Code of Maryland 19
(2022 Replacement Volume) 20
BY repealing and reenacting, without amendments, 21
Article – Health – General 22
Section 4–201(a), 5–601(a), and 13–3301(a) 23
Annotated Code of Maryland 24
(2019 Replacement Volume and 2022 Supplement) 25
BY repealing and reenacting, with amendments, 26
Article – Health – General 27 2 HOUSE BILL 727
Section 4–201(s), 5–601(v), and 13–3301(d)(1)(v) 1
Annotated Code of Maryland 2
(2019 Replacement Volume and 2022 Supplement) 3
BY repealing and reenacting, with amendments, 4
Article – Health Occupations 5
Section 12–102(c)(2)(iv) and (v), 14–306(a) and (e)(3), 15–101, 15–102, 15–103, 6
15–202(b), 15–205(a), 15–301, 15–302, 15–302.2, 15–303, 15–306, 7
15–309(a), 15–310, 15–314(a)(43) through (45), 15–317, 15–401, and 8
15–402.1(a) 9
Annotated Code of Maryland 10
(2021 Replacement Volume and 2022 Supplement) 11
BY adding to 12
Article – Health Occupations 13
Section 12–102(c)(2)(vi) and 15–314(a)(41) 14
Annotated Code of Maryland 15
(2021 Replacement Volume and 2022 Supplement) 16
BY repealing and reenacting, without amendments, 17
Article – Health Occupations 18
Section 15–202(a)(1) and (2) 19
Annotated Code of Maryland 20
(2021 Replacement Volume and 2022 Supplement) 21
BY repealing 22
Article – Health Occupations 23
Section 15–302.1, 15–302.3, 15–313, and 15–314(a)(41) and (42) 24
Annotated Code of Maryland 25
(2021 Replacement Volume and 2022 Supplement) 26
BY repealing and reenacting, without amendments, 27
Article – Transportation 28
Section 13–616(a)(1) 29
Annotated Code of Maryland 30
(2020 Replacement Volume and 2022 Supplement) 31
BY repealing and reenacting, with amendments, 32
Article – Transportation 33
Section 13–616(a)(7) 34
Annotated Code of Maryland 35
(2020 Replacement Volume and 2022 Supplement) 36
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 37
That the Laws of Maryland read as follows: 38
Article – Education 39 HOUSE BILL 727 3
7–402. 1
(c) The physical examination required under subsection (b) of this section shall 2
be completed by: 3
(1) A licensed physician; 4
(2) A licensed physician assistant [with a delegation agreement approved 5
by the State Board of Physicians]; or 6
(3) A certified nurse practitioner. 7
18–802. 8
(a) (1) In this section the following words have the meanings indicated. 9
(8) “Physician assistant” means an individual [to whom duties are 10
delegated by a licensed physician under the rules and regulations of the State Board of 11
Physicians] LICENSED UNDER TITLE 15 OF THE HEALTH OCCUPATIONS ARTICLE TO 12
PRACTICE AS A PHYSIC IAN ASSISTANT. 13
Article – Health – General 14
4–201. 15
(a) In this subtitle the following words have the meanings indicated. 16
(s) “Physician assistant” means an individual who is licensed under Title 15 of 17
the Health Occupations Article to practice [medicine with physician supervision] AS A 18
PHYSICIAN ASSISTANT . 19
5–601. 20
(a) In this subtitle the following words have the meanings indicated. 21
(v) “Physician assistant” means an individual who is licensed under Title 15 of 22
the Health Occupations Article to practice [medicine with physician supervision] AS A 23
PHYSICIAN ASSISTANT . 24
13–3301. 25
(a) In this subtitle the following words have the meanings indicated. 26
(d) “Certifying provider” means an individual who: 27
4 HOUSE BILL 727
(1) (v) 1. Has an active, unrestricted license to practice as a 1
physician assistant issued by the State Board of Physicians under Title 15 of the Health 2
Occupations Article; AND 3
2. [Has an active delegation agreement with a primary 4
supervising physician who is a certifying provider; and 5
3.] Is in good standing with the State Board of Physicians; 6
Article – Health Occupations 7
12–102. 8
(c) (2) This title does not prohibit: 9
(iv) A licensed physician who complies with the requirements of item 10
(ii) of this paragraph from personally preparing and dispensing a prescription written by: 11
1. A physician assistant [in accordance with a delegation 12
agreement that] WHO complies with Title 15, Subtitle 3 of this article; or 13
2. A nurse practitioner who is authorized to practice under 14
Title 8, Subtitle 3 of this article and is working with the physician in the same office setting; 15
[or] 16
(v) A hospital–based clinic from dispensing prescriptions to its 17
patients; OR 18
(VI) A PHYSICIAN ASSISTANT FROM PERSONALLY PREPARING 19
AND DISPENSING A PRE SCRIPTION IN ACCORDA NCE WITH § 15–302.1 OF THIS 20
ARTICLE. 21
14–306. 22
(a) To the extent permitted by the rules, regulations, and orders of the Board, an 23
individual to whom duties are delegated by a licensed physician OR A PHYSI CIAN 24
ASSISTANT WHO HAS TH E APPROPRIATE EDUCAT ION, TRAINING, AND EXPERIENCE 25
TO PERFORM X–RAY DUTIES may perform those duties without a license as provided in 26
this section. 27
(e) Except as otherwise provided in this section, an individual may perform 28
X–ray duties without a license only if the duties: 29
(3) Are performed: 30
HOUSE BILL 727 5
(i) By an individual who is not employed primarily to perform 1
X–ray duties; 2
(ii) 1. In the medical office of the physician who delegates the 3
duties; [and] OR 4
2. IN THE SETTING IN WHICH THE PHYSICIAN ASSISTANT 5
PRACTICES AS A PHYSI CIAN ASSISTANT; AND 6
(iii) 1. By an individual who, before October 1, 2002, has: 7
A. Taken a course consisting of at least 30 hours of training 8
in performing X–ray procedures approved by the Maryland Radiological Society in 9
consultation with the Maryland Society of Radiologic Technologists; and 10
B. Successfully passed an examination based on that course 11
that has been approved by the Maryland Radiological Society in consultation with the 12
Maryland Society of Radiologic Technologists; or 13
2. By a licensed physician assistant [who has completed a 14
course that includes anterior–posterior and lateral radiographic studies of extremities on 15
at least 20 separate patients under the direct supervision of the delegating physician or 16
radiologist using a mini C–arm or similar low–level radiation machine to perform 17
nonfluoroscopic X–ray procedures, if the duties: 18
A. Include only the X–ray procedures described in paragraph 19
(2)(iii) of this subsection; and 20
B. Are performed pursuant to a Board–approved delegation 21
agreement that includes a request to perform advanced duties under § 15–302(c)(2) of this 22
article] WHO HAS THE APPROPRI ATE EDUCATION , TRAINING, AND EXPERIENCE TO 23
PERFORM X–RAY DUTIES. 24
15–101. 25
(a) In this title the following words have the meanings indicated. 26
[(b) “Alternate supervising physician” means one or more physicians designated 27
by the primary supervising physician to provide supervision of a physician assistant in 28
accordance with the delegation agreement on file with the Board.] 29
[(c)] (B) “Ambulatory surgical facility” means a facility: 30
(1) Accredited by: 31
6 HOUSE BILL 727
(i) The American Association for Accreditation of Ambulatory 1
Surgical Facilities; 2
(ii) The Accreditation Association for Ambulatory Health Care; or 3
(iii) The Joint Commission on Accreditation of Healthcare 4
Organizations; or 5
(2) Certified to participate in the Medicare program, as enacted by Title 6
XVIII of the Social Security Act. 7
[(d)] (C) “Board” means the State Board of Physicians, established under § 8
14–201 of this article. 9
(D) “COLLABORATION REGISTR ATION” MEANS A DOCUMENT THA T: 10
(1) OUTLINES A COLLABORAT IVE RELATIONSHIP BET WEEN A 11
PHYSICIAN ASSISTANT AND: 12
(I) AN INDIVIDUAL PHYSICI AN; 13
(II) A GROUP OF PHYSICIANS ; OR 14
(III) A HEALTH CARE FACILITY OR ORGANIZATION THAT 15
EMPLOYS, CONTRACTS WITH , OR CREDENTIALS PHYSI CIANS; 16
(2) IS DEVELOPED BY A PHY SICIAN ASSISTANT AND A PERSON LISTED 17
IN ITEM (1) OF THIS SUBSECTION ; AND 18
(3) IS SUBMITTED TO THE BOARD. 19
(e) “Committee” means the Physician Assistant Advisory Committee. 20
(f) “Controlled dangerous substances” has the meaning stated in § 5–101 of the 21
Criminal Law Article. 22
(g) “Correctional facility” includes a State or local correctional facility. 23
[(h) “Delegated medical acts” means activities that constitute the practice of 24
medicine delegated by a physician under Title 14 of this article. 25
(i) “Delegation agreement” means a document that is executed by a primary 26
supervising physician and a physician assistant containing the requirements of § 15–302 27
of this title. 28
HOUSE BILL 727 7
(i–1)] (H) “Disciplinary panel” means a disciplinary panel of the Board 1
established under § 14–401 of this article. 2
[(j)] (I) “Dispense” or “dispensing” has the meaning stated in § 12–101 of this 3
article. 4
[(k)] (J) “Drug sample” means a unit of a prescription drug that is intended to 5
promote the sale of the drug and is not intended for sale. 6
[(l)] (K) “Hospital” means: 7
(1) A hospital as defined under § 19–301 of the Health – General Article; 8
(2) A comprehensive care facility that: 9
(i) Meets the requirements of a hospital–based skilled nursing 10
facility under federal law; and 11
(ii) Offers acute care in the same building; and 12
(3) An emergency room that is physically connected to a hospital or a 13
freestanding medical facility that is licensed under Title 19, Subtitle 3A of the Health – 14
General Article. 15
[(m)] (L) “License” means a license issued by the Board to a physician assistant 16
under this title. 17
[(n)] (M) “National certifying examination” means the Physician Assistant 18
National Certifying Examination administered by the National Commission on 19
Certification of Physician Assistants or its successor. 20
[(o)] (N) “Physician assistant” means an individual who is licensed under this 21
title to practice [medicine with physician supervision] AS A PHYSICIAN ASSIS TANT. 22
[(p)] (O) “Practice as a physician assistant” means the performance of medical 23
acts that are: 24
(1) [Delegated by a supervising physician to a physician assistant; 25
(2) Within the supervising physician’s scope of practice; and 26
(3)] Appropriate to the physician assistant’s education, training, and 27
experience; AND 28
(2) PERFORMED BY A PHYSIC IAN ASSISTANT WHO HA S SUBMITTED A 29
COLLABORATION REGISTRATION WITH TH E BOARD. 30 8 HOUSE BILL 727
[(q)] (P) “Prescriptive authority” means the authority [delegated by a primary 1
or alternate supervising physician to] OF a physician assistant to: 2
(1) Prescribe and administer controlled dangerous substances, prescription 3
drugs, medical devices, and the oral, written, or electronic ordering of medications; and 4
(2) Dispense as provided under [§ 15–302.2(b), (c), and (d)] § 15–302.1 of 5
this title. 6
[(r) “Primary supervising physician” means a physician who: 7
(1) Completes a delegation agreement that meets the requirements under 8
§§ 15–301(d) and (e) and 15–302 of this title and files a copy with the Board; 9
(2) Acts as the physician responsible to ensure that a physician assistant 10
practices medicine in accordance with this title and the regulations adopted under this title; 11
(3) Ensures that a physician assistant practices within the scope of practice 12
of the primary supervising physician or any designated alternate supervising physician; 13
and 14
(4) Ensures that a list of alternate supervising physicians is maintained at 15
the practice setting.] 16
[(s)] (Q) “Public health facility” means a site where clinical public health 17
services are rendered under the auspices of the Department, a local health department in 18
a county, or the Baltimore City Health Department. 19
[(t)] (R) “Starter dosage” means an amount of a drug sufficient to begin therapy: 20
(1) Of short duration of 72 hours or less; or 21
(2) Prior to obtaining a larger quantity of the drug to complete therapy. 22
[(u) (1) “Supervision” means the responsibility of a physician to exercise 23
on–site supervision or immediately available direction for physician assistants performing 24
delegated medical acts. 25
(2) “Supervision” includes physician oversight of and acceptance of direct 26
responsibility for the patient services and care rendered by a physician assistant, including 27
continuous availability to the physician assistant in person, through written instructions, 28
or by electronic means and by designation of one or more alternate supervising physicians.] 29
15–102. 30
HOUSE BILL 727 9
(a) A physician assistant may not practice within the scope of practice of any of 1
the following health occupations authorized under this article: 2
(1) Nursing; 3
(2) Optometry; OR 4
(3) Physical therapy[; or 5
(4) Psychology]. 6
(b) This title does not limit the right of an individual to practice a health 7
occupation that the individual is authorized to practice under this article. 8
15–103. 9
(a) In this section, “alternative health care system” has the meaning stated in § 10
1–401 of this article. 11
(b) (1) Subject to paragraph (2) of this subsection, an employer of a physician 12
assistant shall report to the Board, on the form prescribed by the Board, any termination 13
of employment of the physician assistant if the cause of termination is related to a quality 14
of care issue. 15
(2) Subject to subsection (d) of this section, a [supervising physician] 16
PERSON THAT DEVELOPS A COLLABORATION REGI STRATION WITH A PHYS ICIAN 17
ASSISTANT or an employer of a physician assistant shall notify the Board within 10 days 18
of the termination of employment of the physician assistant for reasons that would be 19
grounds for discipline under this title. 20
(3) A [supervising physician and a] PERSON THAT DEVELOPS A 21
COLLABORATION REGIST RATION WITH A PHYSICIAN ASS ISTANT OR THE physician 22
assistant shall notify the Board within [10] 30 days of the termination of the relationship 23
under a [delegation agreement for any reason] COLLABORATION REGIST RATION. 24
(c) Except as otherwise provided under subsections (b) and (d) of this section, a 25
hospital, a related institution, an alternative health care system, or an employer of a 26
physician assistant shall report to the Board any limitation, reduction, or other change of 27
the terms of employment of the physician assistant or any termination of employment of 28
the physician assistant for any reason that might be grounds for disciplinary action under 29
§ 15–314 of this title. 30
(d) A hospital, related institution, alternative health care system, or employer 31
that has [reason to know] ACTUAL KNOWLEDGE that a physician assistant has committed 32
an action or has a condition that might be grounds for reprimand or probation of the 33
physician assistant or suspension or revocation of the license of the physician assistant 34 10 HOUSE BILL 727
under § 15–314 of this title because the physician assistant is alcohol– or drug–impaired is 1
not required to report to the Board if: 2
(1) The hospital, related institution, alternative health care system, or 3
employer knows that the physician assistant is: 4
(i) In an alcohol or drug treatment program that is accredited by the 5
Joint Commission on the Accreditation of Healthcare Organizations or is certified by the 6
Department; or 7
(ii) Under the care of a health care practitioner who is competent 8
and capable of dealing with alcoholism and drug abuse; 9
(2) The hospital, related institution, alternative health care system, or 10
employer is able to verify that the physician assistant remains in the treatment program 11
until discharge; and 12
(3) The action or condition of the physician assistant has not caused injury 13
to any person while the physician assistant is practicing as a licensed physician assistant. 14
(e) (1) If the physician assistant enters, or is considering entering, an alcohol 15
or drug treatment program that is accredited by the Joint Commission on Accreditation of 16
Healthcare Organizations or that is certified by the Department, the physician assistant 17
shall notify the hospital, related institution, alternative health care system, or employer of 18
the physician assistant’s decision to enter the treatment program. 19
(2) If the physician assistant fails to provide the notice required under 20
paragraph (1) of this subsection, and the hospital, related institution, alternative health 21
care system, or employer learns that the physician assistant has entered a treatment 22
program, the hospital, related institution, alternative health care system, or employer shall 23
report to the Board that the physician assistant has entered a treatment program and has 24
failed to provide the required notice. 25
(3) If the physician assistant is found to be noncompliant with the 26
treatment program’s policies and procedures while in the treatment program, the 27
treatment program shall notify the hospital, related institution, alternative health care 28
system, or employer of the physician assistant’s noncompliance. 29
(4) On receipt of the notification required under paragraph (3) of this 30
subsection, the hospital, related institution, alternative health care system, or employer of 31
the physician assistant shall report the physician assistant’s noncompliance to the Board. 32
(f) A person is not required under this section to make any report that would be 33
in violation of any federal or State law, rule, or regulation concerning the confidentiality of 34
alcohol– and drug–abuse patient records. 35
HOUSE BILL 727 11
(g) The hospital, related institution, alternative health care system, or employer 1
shall submit the report within [10] 30 days of any action described in this section. 2
(h) A report under this section is not subject to subpoena or discovery in any civil 3
action other than a proceeding arising out of a hearing and decision of the Board or a 4
disciplinary panel under this title. 5
(i) (1) A disciplinary panel may impose a civil penalty of up to $1,000 for 6
failure to report under this section. 7
(2) The Board shall pay any fees collected under this subsection into the 8
General Fund of the State. 9
(j) An employer shall make the report required under this section to the Board 10
within [5] 14 days after the date of termination of employment. 11
(k) The Board shall adopt regulations to implement the provisions of this section. 12
15–202. 13
(a) (1) The Committee shall consist of 7 members appointed by the Board. 14
(2) Of the 7 Committee members: 15
(i) 3 shall be licensed physicians; 16
(ii) 3 shall be licensed physician assistants; and 17
(iii) 1 shall be a consumer. 18
(b) Of the three physician members of the Committee, two shall [be previously or 19
currently serving as supervising physicians of a physician assistant unde r a 20
Board–approved delegation agreement] HAVE DEVELOPED A COL LABORATION 21
REGISTRATION WITH A PHYSICIAN ASSISTANT . 22
15–205. 23
(a) In addition to the powers set forth elsewhere in this title, the Committee, on 24
its initiative or on the Board’s request, may: 25
(1) Recommend to the Board regulations for carrying out the provisions of 26
this title; 27
(2) Recommend to the Board approval, modification, or disapproval of an 28
application for licensure [or a delegation agreement]; 29
12 HOUSE BILL 727
(3) Report to the Board any conduct of a [supervising physician] PERSON 1
WHO DEVELOPS A COLLA BORATION REGISTRATIO N WITH A PHYSICIAN A SSISTANT or 2
a physician assistant that may be cause for disciplinary action under this title or under § 3
14–404 of this article; and 4
(4) Report to the Board any alleged unauthorized practice of a physician 5
assistant. 6
15–301. 7
(a) [Nothing in this] THIS title may NOT be construed to authorize a physician 8
assistant to practice [independent of a primary or alternate supervising physician] 9
INDEPENDENTLY . 10
(b) A license issued to a physician assistant shall limit the physician assistant’s 11
scope of practice to medical acts[: 12
(1) Delegated by the primary or alternate supervising physician; 13
(2) Appropriate] APPROPRIATE to the education, training, and experience 14
of the physician assistant[; 15
(3) Customary to the practice of the primary or alternate supervising 16
physician; and 17
(4) Consistent with the delegation agreement filed with the Board]. 18
(c) Patient services that may be provided by a physician assistant include: 19
[(1) (i) Taking complete, detailed, and accurate patient histories; and 20
(ii) Reviewing patient records to develop comprehensive medical 21
status reports; 22
(2) Performing physical examinations and recording all pertinent patient 23
data; 24
(3) Interpreting and evaluating patient data as authorized by the primary 25
or alternate supervising physician for the purpose of determining management and 26
treatment of patients; 27
(4) Initiating requests for or performing diagnostic procedures as indicated 28
by pertinent data and as authorized by the supervising physician; 29
(5) Providing instructions and guidance regarding medical care matters to 30
patients; 31 HOUSE BILL 727 13
(6) Assisting the primary or alternate supervising physician in the delivery 1
of services to patients who require medical care in the home and in health care institutions, 2
including: 3
(i) Recording patient progress notes; 4
(ii) Issuing diagnostic orders; and 5
(iii) Transcribing or executing specific orders at the direction of the 6
primary or alternate supervising physician; and 7
(7) Exercising prescriptive authority under a delegation agreement and in 8
accordance with § 15–302.2 of this subtitle] 9
(1) OBTAINING COMPREHENSI VE HEALTH HISTORIES ; 10
(2) PERFORMING PHYSICAL E XAMINATIONS ; 11
(3) EVALUATING, DIAGNOSING, MANAGING, AND PROVIDING 12
MEDICAL TREATMENT ; 13
(4) ORDERING, PERFORMING , AND INTERPRETING DIA GNOSTIC 14
STUDIES AND THERAPEU TIC PROCEDURES ; 15
(5) EXERCISING PRESCRIPTI VE AUTHORITY IN ACCO RDANCE WITH § 16
15–302.1 OF THIS SUBTITLE; 17
(6) INFORMING PATIENTS AB OUT HEALTH PROMOTION AND DISEASE 18
PREVENTION ; 19
(7) PROVIDING CONSULTATIO NS; 20
(8) WRITING MEDICAL ORDER S; 21
(9) PROVIDING SERVICES IN HEALTH CARE FACILITI ES, INCLUDING 22
HOSPITALS, NURSING FACILITIES , ASSISTED LIVING FACI LITIES, AND HOSPICE 23
FACILITIES; 24
(10) OBTAINING INFORMED CO NSENT; 25
(11) DELEGATING OR ASSIGNI NG THERAPEUTIC AND D IAGNOSTIC 26
MEASURES TO BE PERFO RMED BY LICENSED OR UNLICENSED PERSONNEL AND 27 14 HOUSE BILL 727
SUPERVISING LICENSED OR UNLICENSED PERSON NEL PERFORMING THERA PEUTIC 1
AND DIAGNOSTIC MEASURES ; 2
(12) CERTIFYING A PATIENT ’S HEALTH OR DISABILI TY AS REQUIRED 3
BY A FEDERAL, STATE, OR LOCAL PROGRAM ; AND 4
(13) AUTHENTICATING ANY DO CUMENT THAT A PHYSIC IAN MAY 5
AUTHENTICATE THROUGH SIGNATURE, CERTIFICATION , STAMP VERIFICATION , 6
AFFIDAVIT, OR ENDORSEMENT . 7
(d) (1) Except as otherwise provided in this title, an individual shall be 8
licensed by the Board before the individual may practice as a physician assistant. 9
(2) [Except as otherwise provided in this title, a physician may not 10
supervise a physician assistant in the performance of delegated medical acts without filing 11
a completed delegation agreement with the Board. 12
(3)] Except as otherwise provided in this title or in a medical emergency, a 13
physician assistant may not perform any medical act for which: 14
(i) The individual has not been licensed; and 15
(ii) [The medical acts have not been delegated by a primary or 16
alternate supervising physician] THE INDIVIDUAL HAS NO T RECEIVED APPROPRIA TE 17
EDUCATION, TRAINING, AND EXPERIENCE . 18
[(e) A physician assistant is the agent of the primary or alternate supervising 19
physician in the performance of all practice–related activities, including the oral, written, 20
or electronic ordering of diagnostic, therapeutic, and other medical services.] 21
(E) A PHYSICIAN ASSISTANT SHALL CONSULT AND COLLABORATE WITH OR 22
REFER AN INDIVIDUAL TO AN APPROPRIATE LI CENSED PHYSICIAN OR ANY OTHER 23
HEALTH CARE PROVIDER AS APPROPRIATE . 24
(F) A PHYSICIAN ASSISTANT WHO HAS NOT BEEN PRE VIOUSLY LICENSED BY 25
THE BOARD TO PRACTICE AS A PHYS ICIAN ASSISTANT OR L ICENSED, CERTIFIED, OR 26
REGISTERED AS A PHYS ICIAN ASSISTANT BY A NOTHER STATE REGULAT ORY 27
AUTHORITY SHALL BE M ENTORED BY A LICENSE D PHYSICIAN OR PHYSI CIANS WHO 28
ARE IDENTIFIED IN AN INITIAL COLLABORATIO N REGISTRATION TO CONSULT AND 29
COLLABORATE WITH THE PHYSICIAN ASSISTANT FOR AT LEAST 18 MONTHS AFTER 30
THE DATE AN INITIAL COLLABORATION REGIST RATION IS SUBMITTED TO THE 31
BOARD. 32
HOUSE BILL 727 15
[(f)] (G) Except as OTHERWISE provided in [subsection (g) of this section] THIS 1
TITLE, the following individuals may practice as a physician assistant without a license: 2
(1) A physician assistant student enrolled in a physician assistant 3
educational program that is accredited by the Accreditation Review Commission on 4
Education for the Physician Assistant or its successor and approved by the Board; or 5
(2) A physician assistant employed in the service of the federal government 6
while performing duties incident to that employment. 7
[(g) A physician may not delegate prescriptive authority to a physician assistant 8
student in a training program that is accredited by the Accreditation Review Commission 9
on Education for the Physician Assistant or its successor.] 10
(h) (1) If a medical act that is to be [delegated] PERFORMED BY A PHYSI CIAN 11
ASSISTANT under this section is a part of the practice of a health occupation that is 12
regulated under this article by another board, any rule or regulation concerning that 13
medical act shall be adopted jointly by the State Board of Physicians and the board that 14
regulates the other health occupation. 15
(2) If the two boards cannot agree on a proposed rule or regulation, the 16
proposal shall be submitted to the Secretary for a final decision. 17
15–302. 18
(a) A physician [may delegate medical acts to a physician assistant only after: 19
(1) A delegation agreement has been executed and filed with the Board; 20
and 21
(2) Any advanced duties have been authorized as required under 22
subsection (c) of this section] ASSISTANT MAY PRACTI CE AS A PHYSICIAN AS SISTANT 23
ONLY AFTER SUBMITTIN G A COLLABORATION RE GISTRATION TO THE BOARD. 24
(b) (1) [The delegation agreement] SUBJECT TO PARAGRAPH (2) OF THIS 25
SUBSECTION, A COLLABORATION REGI STRATION shall contain: 26
[(1)] (I) A description of the qualifications of the [primary supervising 27
physician] PERSON WHO DEVELOPED THE COLLABORATION RE GISTRATION WITH 28
THE PHYSICIAN ASSIST ANT and THE physician assistant; 29
[(2)] (II) A description of the settings in which the physician assistant will 30
practice; 31
[(3) A description of the continuous physician supervision mechanisms that 32
are reasonable and appropriate to the practice setting; 33 16 HOUSE BILL 727
(4) A description of the delegated medical acts that are within the primary 1
or alternate supervising physician’s scope of practice and require specialized education or 2
training that is consistent with accepted medical practice; 3
(5) An attestation that all medical acts to be delegated to the physician 4
assistant are within the scope of practice of the primary or alternate supervising physician 5
and appropriate to the physician assistant’s education, training, and level of competence; 6
(6) An attestation of continuous supervision of the physician assistant by 7
the primary supervising physician through the mechanisms described in the delegation 8
agreement; 9
(7) An attestation by the primary supervising physician of the physician’s 10
acceptance of responsibility for any care given by the physician assistant; 11
(8) A description prepared by the primary supervising physician of the 12
process by which the physician assistant’s practice is reviewed appropriate to the practice 13
setting and consistent with current standards of acceptable medical practice; 14
(9) An attestation by the primary supervising physician that the physician 15
will respond in a timely manner when contacted by the physician assistant; 16
(10) The following statement: “The primary supervising physician and the 17
physician assistant attest that: 18
(i) They will establish a plan for the types of cases that require a 19
physician plan of care or require that the patient initially or periodically be seen by the 20
supervising physician; and 21
(ii) The patient will be provided access to the supervising physician 22
on request”; and 23
(11) Any other information deemed necessary by the Board to carry out the 24
provisions of this subtitle] 25
(III) AN ATTESTATION BY THE PHYSICIAN ASSISTANT THAT THE 26
PHYSICIAN ASSISTANT WILL CONSULT AND COLLABORATE WITH OR REFER AN 27
INDIVIDUAL TO AN APP ROPRIATE LICENSED PH YSICIAN OR ANY OTHER HEALTH 28
CARE PROVIDER , AS APPROPRIATE ; AND 29
(IV) AN ATTESTATION BY THE PERS ON THAT DEVELOPED TH E 30
COLLABORATION REGIST RATION WITH THE PHYS ICIAN ASSISTANT THAT THE 31
PERSON WILL ENSURE T HAT A PHYSICIAN WILL RESPOND IN A TIMELY MANNER 32
WHEN CONTACTED BY TH E PHYSICIAN ASSISTAN T. 33
HOUSE BILL 727 17
(2) IF A PHYSICIAN ASSIST ANT WHO SU BMITS AN INITIAL 1
COLLABORATION REGIST RATION TO THE BOARD HAS NOT BEEN PR EVIOUSLY 2
LICENSED BY THE BOARD TO PRACTICE AS A PHYSICIAN ASSISTAN T OR LICENSED, 3
CERTIFIED, OR REGISTERED AS A P HYSICIAN ASSISTANT B Y ANOTHER STATE 4
REGULATORY AUTHORITY , THE INITIAL CO LLABORATION REGISTRA TION SHALL 5
IDENTIFY A LICENSED PHYSICIAN OR PHYSICI ANS WHO WILL CONSULT AND 6
COLLABORATE WITH THE PHYSICIAN ASSISTANT FOR AT LEAST 18 MONTHS AFTER 7
THE DATE THE INITIAL COLLABORATION REGIST RATION IS SUBMITTED TO THE 8
BOARD. 9
(c) [(1)] The Board may not require [prior] approval of a [delegation agreement 10
that includes advanced duties, if an advanced duty will be performed in a hospital or 11
ambulatory surgical facility, provided that: 12
(i) A physician, with credentials that have been reviewed by the 13
hospital or ambulatory surgical facility as a condition of employment, as an independent 14
contractor, or as a member of the medical staff, supervises the physician assistant; 15
(ii) The physician assistant has credentials that have been reviewed 16
by the hospital or ambulatory surgical facility as a condition of employment, as an 17
independent contractor, or as a member of the medical staff; and 18
(iii) Each advanced duty to be delegated to the physician assistant is 19
reviewed and approved within a process approved by the governing body of the health care 20
facility before the physician assistant performs the advanced duties] COLLABORATION 21
REGISTRATION . 22
[(2) (i) In any setting that does not meet the requirements of paragraph 23
(1) of this subsection, a primary supervising physician shall obtain the Board’s approval of 24
a delegation agreement that includes advanced duties, before the physician assistant 25
performs the advanced duties. 26
(ii) 1. Before a physician assistant may perform X–ray duties 27
authorized under § 14–306(e) of this article in the medical office of the physician delegating 28
the duties, a primary supervising physician shall obtain the Board’s approval of a 29
delegation agreement that includes advanced duties in accordance with subsubparagraph 30
2 of this subparagraph. 31
2. The advanced duties set forth in a delegation agreement 32
under this subparagraph shall be limited to nonfluoroscopic X–ray procedures of the 33
extremities, anterior–posterior and lateral, not including the head. 34
(3) Notwithstanding paragraph (1) of this subsection, a primary 35
supervising physician shall obtain the Board’s approval of a delegation agreement before 36
the physician assistant may administer, monitor, or maintain general anesthesia or 37
neuroaxial anesthesia, including spinal and epidural techniques, under the agreement. 38 18 HOUSE BILL 727
(d) For a delegation agreement containing advanced duties that require Board 1
approval, the Committee shall review the delegation agreement and recommend to the 2
Board that the delegation agreement be approved, rejected, or modified to ensure 3
conformance with the requirements of this title. 4
(e) The Committee may conduct a personal interview of the primary supervising 5
physician and the physician assistant. 6
(f) (1) On review of the Committee’s recommendation regarding a primary 7
supervising physician’s request to delegate advanced duties as described in a delegation 8
agreement, the Board: 9
(i) May approve the delegation agreement; or 10
(ii) 1. If the physician assistant does not meet the applicable 11
education, training, and experience requirements to perform the specified delegated acts, 12
may modify or disapprove the delegation agreement; and 13
2. If the Board takes an action under item 1 of this item: 14
A. Shall notify the primary supervising physician and the 15
physician assistant in writing of the particular elements of the proposed delegation 16
agreement that were the cause for the modification or disapproval; and 17
B. May not restrict the submission of an amendment to the 18
delegation agreement. 19
(2) To the extent practicable, the Board shall approve a delegation 20
agreement or take other action authorized under this subsection within 90 days after 21
receiving a completed delegation agreement including any information from the physician 22
assistant and primary supervising physician necessary to approve or take action.] 23
[(g)] (D) If the Board determines that a [primary or alternate supervising 24
physician] PERSON THAT DEVELOPS A COLLABORATION REGI STRATION WITH A 25
PHYSICIAN ASSISTANT or A physician assistant is practicing in a manner inconsistent 26
with the requirements of this title or Title 14 of this article, the Board on its own initiative 27
or on the recommendation of the Committee may demand modification of the practice[, 28
withdraw the approval of the delegation agreement,] or refer the matter to a disciplinary 29
panel for the purpose of taking other disciplinary action under § 14–404 or § 15–314 of this 30
article. 31
[(h) A primary supervising physician may not delegate medical acts under a 32
delegation agreement to more than four physician assistants at any one time, except in a 33
hospital or in the following nonhospital settings: 34
HOUSE BILL 727 19
(1) A correctional facility; 1
(2) A detention center; or 2
(3) A public health facility. 3
(i) A person may not coerce another person to enter into a delegation agreement 4
under this subtitle. 5
(j) A physician may supervise a physician assistant: 6
(1) As a primary supervising physician in accordance with a delegation 7
agreement approved by the Board under this subtitle; or 8
(2) As an alternate supervising physician if: 9
(i) The alternate supervising physician supervises in accordance 10
with a delegation agreement filed with the Board; 11
(ii) The alternate supervising physician supervises no more than 12
four physician assistants at any one time, except in a hospital, correctional facility, 13
detention center, or public health facility; 14
(iii) The alternate supervising physician’s period of supervision, in 15
the temporary absence of the primary supervising physician, does not exceed: 16
1. The period of time specified in the delegation agreement; 17
and 18
2. A period of 45 consecutive days at any one time; and 19
(iv) The physician assistant performs only those medical acts that: 20
1. Have been delegated under the delegation agreement filed 21
with the Board; and 22
2. Are within the scope of practice of the primary supervising 23
physician and alternate supervising physician.] 24
[(k)] (E) Subject to the notice required under § 15–103 of this title, a physician 25
assistant may terminate a [delegation agreement filed with the Board under] 26
COLLABORATION REGIST RATION DEVELOPED IN ACCORDANCE WITH this subtitle at 27
any time. 28
[(l) (1) In the event of the sudden departure, incapacity, or death of the 29
primary supervising physician of a physician assistant, or change in license status that 30
results in the primary supervising physician being unable to legally practice medicine, an 31 20 HOUSE BILL 727
alternate supervising physician designated under subsection (b) of this section may 1
supervise the physician assistant for not longer than 15 days following the event. 2
(2) If there is no designated alternate supervising physician or the 3
designated alternate supervising physician does not agree to supervise the physician 4
assistant, the physician assistant may not practice until the physician assistant receives 5
approval of a new delegation agreement under § 15–302.1 of this subtitle. 6
(3) An alternate supervising physician or other licensed physician may 7
assume the role of primary supervising physician by submitting a new delegation 8
agreement to the Board for approval under subsection (b) of this section. 9
(4) The Board may terminate a delegation agreement if: 10
(i) The physician assistant has a change in license status that 11
results in the physician assistant being unable to legally practice as a physician assistant; 12
(ii) At least 15 days have elapsed since an event listed under 13
paragraph (1) of this subsection if there is an alternate supervising physician designated 14
under subsection (b) of this section; or 15
(iii) Immediately after an event listed under paragraph (1) of this 16
subsection if there is no alternate supervising physician designated under subsection (b) of 17
this section.] 18
[(m)] (F) A physician assistant whose [delegation agreement] COLLABORATION 19
REGISTRATION is terminated may not practice as a physician assistant until the physician 20
assistant [receives preliminary approval of a new delegation agreement under § 15–302.1 21
of this subtitle] SUBMITS A NEW COLLAB ORATION REGISTRATION TO THE BOARD. 22
[(n) Individual members of the Board are not civilly liable for actions regarding 23
the approval, modification, or disapproval of a delegation agreement described in this 24
section. 25
(o) A physician assistant may practice in accordance with a delegation agreement 26
filed with the Board under this subtitle.] 27
[15–302.1. 28
(a) If a delegation agreement does not include advanced duties or the advanced 29
duties have been approved under § 15–302(c)(1) of this subtitle, a physician assistant may 30
assume the duties under a delegation agreement on the date that the Board acknowledges 31
receipt of the completed delegation agreement. 32
(b) In this section, “pending” means that a delegation agreement that includes 33
delegation of advanced duties in a setting that does not meet the requirements under § 34 HOUSE BILL 727 21
15–302(c)(1) of this subtitle has been executed and submitted to the Board for its approval, 1
but: 2
(1) The Committee has not made a recommendation to the Board; or 3
(2) The Board has not made a final decision regarding the delegation 4
agreement. 5
(c) Subject to subsection (d) of this section, if a delegation agreement is pending, 6
on receipt of a temporary practice letter from the staff of the Board, a physician assistant 7
may perform the advanced duty if: 8
(1) The primary supervising physician has been previously approved to 9
supervise one or more physician assistants in the performance of the advanced duty; and 10
(2) The physician assistant has been previously approved by the Board to 11
perform the advanced duty. 12
(d) If the Committee recommends a denial of the pending delegation agreement 13
or the Board denies the pending delegation agreement, on notice to the primary supervising 14
physician and the physician assistant, the physician assistant may no longer perform the 15
advanced duty that has not received the approval of the Board. 16
(e) The Board may disapprove any delegation agreement if it believes that: 17
(1) The agreement does not meet the requirements of this subtitle; or 18
(2) The physician assistant is unable to perform safely the delegated 19
duties. 20
(f) If the Board disapproves a delegation agreement or the delegation of any 21
function under an agreement, the Board shall provide the primary supervising physician 22
and the physician assistant with written notice of the disapproval. 23
(g) A physician assistant who receives notice that the Board has disapproved a 24
delegation agreement or an advanced function under the delegation agreement shall 25
immediately cease to practice under the agreement or to perform the disapproved function.] 26
[15–302.2.] 15–302.1. 27
[(a) A primary supervising physician may not delegate prescribing, dispensing, 28
and administering of controlled dangerous substances, prescription drugs, or medical 29
devices unless the primary supervising physician and physician assistant include in the 30
delegation agreement: 31
(1) A notice of intent to delegate prescribing and, if applicable, dispensing 32
of controlled dangerous substances, prescription drugs, or medical devices; 33 22 HOUSE BILL 727
(2) An attestation that all prescribing and, if applicable, dispensing 1
activities of the physician assistant will comply with applicable federal and State 2
regulations; 3
(3) An attestation that all medical charts or records will contain a notation 4
of any prescriptions written or dispensed by a physician assistant in accordance with this 5
section; 6
(4) An attestation that all prescriptions written or dispensed under this 7
section will include the physician assistant’s name and the supervising physician’s name, 8
business address, and business telephone number legibly written or printed; 9
(5) An attestation that the physician assistant has: 10
(i) Passed the physician assistant national certification exam 11
administered by the National Commission on the Certification of Physician Assistants 12
within the previous 2 years; or 13
(ii) Successfully completed 8 category 1 hours of pharmacology 14
education within the previous 2 years; and 15
(6) An attestation that the physician assistant has: 16
(i) A bachelor’s degree or its equivalent; or 17
(ii) Successfully completed 2 years of work experience as a physician 18
assistant. 19
(b) (1) A primary supervising physician may not delegate the prescribing or 20
dispensing of substances that are identified as Schedule I controlled dangerous substances 21
under § 5–402 of the Criminal Law Article. 22
(2) A primary supervising physician may delegate the prescribing or 23
dispensing of substances that are identified as Schedules II through V controlled dangerous 24
substances under § 5–402 of the Criminal Law Article, including legend drugs as defined 25
under § 503(b) of the Federal Food, Drug, and Cosmetic Act. 26
(3) A primary supervising physician may not delegate the prescribing or 27
dispensing of controlled dangerous substances to a physician assistant unless the physician 28
assistant has a valid: 29
(i) State controlled dangerous substance registration; and 30
(ii) Federal Drug Enforcement Agency (DEA) registration.] 31
HOUSE BILL 727 23
(A) IN THIS SECTION, “PERSONALLY PREPARE A ND DISPENSE” MEANS THAT 1
A PHYSICIAN ASSISTAN T: 2
(1) IS PHYSICALL Y PRESENT ON THE PRE MISES WHERE A 3
PRESCRIPTION IS FILL ED; AND 4
(2) PERFORMS A FINAL CHEC K OF THE PRESCRIPTIO N BEFORE IT IS 5
PROVIDED TO THE PATI ENT. 6
(B) A PHYSICIAN ASSISTANT MAY PRESCRIBE , DISPENSE, ORDER, OR 7
ADMINISTER: 8
(1) SUBJECT TO SUBSECTION (C)(2) OF THIS SECTION , DRUGS AND 9
SUBSTANCES THAT ARE IDENTIFIED AS SCHEDULES II THROUGH V CONTROLLED 10
DANGEROUS SUBSTANCES UNDER §§ 5–403 THROUGH 5–406 OF THE CRIMINAL LAW 11
ARTICLE, INCLUDING LEGEND DRU GS AS DEFINED UNDER § 503(B) OF THE 12
FEDERAL FOOD, DRUG, AND COSMETIC ACT; 13
(2) MEDICAL DEVICES ; AND 14
(3) DURABLE MEDICAL EQUIP MENT. 15
(C) (1) A PHYSICIAN ASSISTANT MAY NOT PRESCRIBE OR DISPENSE 16
SUBSTANCES THAT ARE IDENTIFIED AS SCHEDULE I CONTROLLED DANGEROUS 17
SUBSTANCES UNDER § 5–402 OF THE CRIMINAL LAW ARTICLE. 18
(2) A PHYSICIAN ASSISTANT MAY NOT PRESCRIBE OR DISPENSE 19
CONTROLLED DANGEROUS SUBSTANCES UNLESS TH E PHYSICIAN ASSISTAN T HAS A 20
VALID: 21
(I) STATE CONTROLLED DANG EROUS SUBSTANCE 22
REGISTRATION ; AND 23
(II) FEDERAL DRUG ENFORCEMENT AGENCY (DEA) 24
REGISTRATION. 25
[(c)] (D) (1) A physician assistant personally may prepare and dispense [a 26
drug that the physician assistant is authorized to prescribe under a delegation agreement 27
if]: 28
[(1) Except as otherwise provided under § 12–102(g) of this article, the 29
supervising physician possesses a dispensing permit; and 30
(2) The physician assistant dispenses drugs only within: 31 24 HOUSE BILL 727
(i) The supervising physician’s scope of practice; and 1
(ii) The scope of the delegation agreement] 2
(I) A STARTER DOSAGE OF ANY DRUG THAT THE PH YSICIAN 3
ASSISTANT IS AUTHORI ZED TO PRESCRIBE TO A PATIENT OF THE PHY SICIAN 4
ASSISTANT IF: 5
1. THE STARTER DOSAGE CO MPLIES WITH THE 6
LABELING REQUIREMENT S OF § 12–505 OF THIS ARTICLE; 7
2. NO CHARGE IS MADE FOR THE STARTER DOSAGE ; AND 8
3. THE PHYSICIAN ASSISTA NT ENTERS AN APPROPR IATE 9
RECORD IN THE PATIEN T’S MEDICAL RECORD ; OR 10
(II) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , ANY 11
DRUG THAT A PHYSICIA N ASSISTANT MAY PRES CRIBE TO THE EXTENT AUTHORIZED 12
BY LAW IN THE COURSE OF TREATING A PATIENT A T: 13
1. A MEDICAL FACILITY OR CLINIC THAT SPECIALI ZES IN 14
THE TREATMENT OF MED ICAL CASES REIMBURSA BLE THROUGH WORKERS ’ 15
COMPENSATION INSURAN CE; 16
2. A MEDICAL FACILITY OR CLINIC THAT IS OPERA TED 17
ON A NONPROFIT BASIS ; 18
3. A HEALTH CENTER THAT OPERAT ES ON A CAMPUS OF 19
AN INSTITUTION OF HI GHER EDUCATION ; 20
4. A PUBLIC HEALTH FACILI TY, A MEDICAL FACILITY 21
UNDER CONTRACT WITH A STATE OR LOCAL HEALTH DEPARTMENT , OR A FACILITY 22
FUNDED WITH PUBLIC F UNDS; OR 23
5. A NONPROFIT HOSPITAL O R A NONPROFIT HOSPIT AL 24
OUTPATIENT FACILITY AS AUTHORIZED UNDER THE POLICIES ESTABLI SHED BY THE 25
HOSPITAL. 26
(2) A PHYSICIAN ASSISTANT WHO PERSONALLY PREPA RES AND 27
DISPENSES A DRUG IN THE COURSE OF TREATI NG A PATIENT AS AUTH ORIZED UNDER 28
THIS SUBSECTION SHAL L: 29
HOUSE BILL 727 25
(I) COMPLY WITH THE LABEL ING REQUIREMENTS OF § 12–505 1
OF THIS ARTICLE; 2
(II) RECORD THE DISPENSING OF THE PRESCRIPTION DRUG ON 3
THE PATIENT’S CHART; 4
(III) ALLOW THE OFFICE OF CONTROLLED SUBSTANCES 5
ADMINISTRATION TO ENT ER AND INSPECT THE P HYSICIAN ASSISTANT’S OFFICE AT 6
ALL REASONABLE HOURS ; AND 7
(IV) EXCEPT FOR STARTER DO SAGES OR SAMPLES DIS PENSED 8
WITHOUT CHARGE , PROVIDE THE PATIENT WITH A WRITTEN PRESC RIPTION, 9
MAINTAIN PRESCRIPTIO N FILES, AND MAINTAIN A SEPAR ATE FILE FOR SCHEDULE 10
II PRESCRIPTIONS FOR A PERIOD O F AT LEAST 5 YEARS. 11
[(d)] (E) A physician assistant who personally dispenses a drug in the course of 12
treating a patient as authorized under subsections (b) and [(c)] (D) of this section shall 13
comply with the requirements under Titles 12 and 14 of this article and applicable federal 14
law and regulations. 15
[(e) Before a physician assistant may renew a license for an additional 2–year 16
term under § 15–307 of this subtitle, the physician assistant shall submit evidence to the 17
Board of successful completion of 8 category 1 hours of pharmacology education within the 18
previous 2 years.] 19
(F) A PRESCRIPTION DISPENS ED UNDER THIS SECTIO N SHALL INCLUDE 20
THE PHYSICIAN ASSIST ANT’S: 21
(1) NAME; 22
(2) BUSINESS ADDRESS ; AND 23
(3) BUSINESS TELEPHONE NUMBER. 24
(G) A PHYSICIAN ASSISTANT STUDENT IN A TRAININ G PROGRAM THAT IS 25
ACCREDITED BY THE ACCREDITATION REVIEW COMMISSION ON EDUCATION FOR 26
THE PHYSICIAN ASSISTANT MAY NOT EXE RCISE PRESCRIPTIVE A UTHORITY. 27
[15–302.3. 28
(a) On a quarterly basis, the Board shall provide to the Board of Pharmacy a list 29
of physician assistants whose delegation agreements include the delegation of prescriptive 30
authority. 31
26 HOUSE BILL 727
(b) The list required under subsection (a) of this section shall specify whether 1
each physician assistant has been delegated the authority to prescribe controlled dangerous 2
substances, prescription drugs, or medical devices. 3
(c) If a primary supervising physician who has delegated authority to exercise 4
prescriptive authority to a physician assistant subsequently restricts or removes the 5
delegation, the primary supervising physician shall notify the Board of the restriction or 6
removal within 5 business days.] 7
15–303. 8
(a) To qualify for a license, an applicant shall: 9
(1) Complete a criminal history records check in accordance with § 10
14–308.1 of this article; 11
(2) Be of good moral character; 12
(3) Demonstrate oral and written competency in the English language as 13
required by the Board; 14
(4) Be at least 18 years old; [and] 15
(5) [(i) Be a graduate of a physician assistant training program 16
approved by the Board; or 17
(ii) Have passed the physician assistant national certifying 18
examination administered by the National Commission on Certification of Physician 19
Assistants prior to 1986, maintained all continuing education and recertification 20
requirements, and been in continuous practice since passage of the examination] EXCEPT 21
AS PROVIDED IN SUBSE CTION (B) OF THIS SECTION , HAVE SUCCESSFULLY 22
COMPLETED AN EDUCATI ONAL PROGRAM FOR PHY SICIAN ASSISTANTS AC CREDITED 23
BY: 24
(I) THE ACCREDITATION REVIEW COMMISSION ON 25
EDUCATION FOR THE PHYSICIAN ASSISTANT; OR 26
(II) IF COMPLETED BEFORE 2001: 27
1. THE COMMITTEE ON ALLIED HEALTH EDUCATION 28
AND ACCREDITATION ; OR 29
2. THE COMMISSION ON ACCREDITATION OF ALLIED 30
HEALTH EDUCATION PROGRAMS; AND 31
HOUSE BILL 727 27
(6) HAVE PASSED THE PHYSICIAN ASSISTANT NATIONAL 1
CERTIFYING EXAMINATION ADMINISTE RED BY THE NATIONAL COMMISSION ON 2
CERTIFICATION OF PHYSICIAN ASSISTANTS. 3
[(b) Except as otherwise provided in this title, the applicant shall pass a national 4
certifying examination approved by the Board.] 5
(B) THE BOARD MAY GRANT A LIC ENSE TO AN APPLICANT WHO DOES NOT 6
MEET THE EDUCATIONAL REQUIREMENTS UNDER S UBSECTION (A) OF THIS SECTION 7
IF THE APPLICANT HAS PASSED THE PHYSICIAN ASSISTANT NATIONAL CERTIFYING 8
EXAMINATION ADMINISTE RED BY THE NATIONAL COMMISSION ON CERTIFICATION 9
OF PHYSICIAN ASSISTANTS. 10
(c) An applicant who graduates from [a physician assistant training program] AN 11
ACCREDITED EDUCATION AL PROGRAM FOR PHYSI CIAN ASSISTANTS UNDE R THIS 12
SECTION after October 1, 2003 shall have a bachelor’s degree or its equivalent. 13
15–306. 14
A license authorizes the licensee to practice as a physician assistant [under a 15
delegation agreement] while the license is effective. 16
15–309. 17
(a) Each licensee shall keep a license and [delegation agreement] 18
COLLABORATION REGIST RATION for inspection at the primary place of business of the 19
licensee. 20
15–310. 21
(a) In reviewing an application for licensure or in investigating an allegation 22
brought under § 15–314 of this subtitle, the Committee may request the Board to direct, or 23
the Board on its own initiative may direct, the physician assistant to submit to an 24
appropriate examination. 25
(b) In return for the privilege given to the physician assistant to [perform 26
delegated medical acts] PRACTICE AS A PHYSIC IAN ASSISTANT in the State, the 27
physician assistant is deemed to have: 28
(1) Consented to submit to an examination under this section, if requested 29
by the Board in writing; and 30
(2) Waived any claim of privilege as to the testimony or examination 31
reports. 32
28 HOUSE BILL 727
(c) The unreasonable failure or refusal of the licensed physician assistant or 1
applicant to submit to an examination is prima facie evidence of the licensed physician 2
assistant’s inability to [perform delegated medical acts] PRACTICE AS A PHYSIC IAN 3
ASSISTANT and is cause for denial of the application or immediate suspension of the 4
license. 5
(d) The Board shall pay the costs of any examination made under this section. 6
[15–313. 7
(a) (1) Except as otherwise provided under § 10–226 of the State Government 8
Article, before the Board takes any action to reject or modify a delegation agreement or 9
advanced duty, the Board shall give the licensee the opportunity for a hearing before the 10
Board. 11
(2) The Board shall give notice and hold the hearing under Title 10, 12
Subtitle 2 of the State Government Article. 13
(3) The Board may administer oaths in connection with any proceeding 14
under this section. 15
(4) At least 14 days before the hearing, the hearing notice shall be sent to 16
the last known address of the applicant or licensee. 17
(b) Any licensee aggrieved under this subtitle by a final decision of the Board 18
rejecting or modifying a delegation agreement or advanced duty may petition for judicial 19
review as allowed by the Administrative Procedure Act.] 20
15–314. 21
(a) Subject to the hearing provisions of § 15–315 of this subtitle, a disciplinary 22
panel, on the affirmative vote of a majority of the quorum, may reprimand any physician 23
assistant, place any physician assistant on probation, or suspend or revoke a license if the 24
physician assistant: 25
[(41) Performs delegated medical acts beyond the scope of the delegation 26
agreement filed with the Board or after notification from the Board that an advanced duty 27
has been disapproved; 28
(42) Performs delegated medical acts without the supervision of a 29
physician;] 30
(41) PRACTICES AS A PHYSIC IAN ASSISTANT WITHOU T FIRST 31
SUBMITTING A COLLABO RATION REGISTRATION TO THE BOARD; 32
HOUSE BILL 727 29
[(43)] (42) Fails to complete a criminal history records check under § 1
14–308.1 of this article; 2
[(44)] (43) Fails to comply with the requirements of the Prescription Drug 3
Monitoring Program in Title 21, Subtitle 2A of the Health – General Article; or 4
[(45)] (44) Fails to comply with any State or federal law pertaining to the 5
practice as a physician assistant. 6
15–317. 7
(a) A physician assistant WHO IS LICENSED in this State or in any other state 8
OR WHO IS AN EMPLOYE E OF THE FEDERAL GOV ERNMENT is authorized to perform 9
acts, tasks, or functions as a physician assistant [under the supervision of a physician 10
licensed to practice medicine in the State] during a disaster as defined by the Governor, 11
within a county in which a state of disaster has been declared, or counties contiguous to a 12
county in which a state of disaster has been declared. 13
(b) The physician assistant shall notify the Board in writing of the names, 14
practice locations, and telephone numbers for the physician assistant [and each primary 15
supervising physician] within 30 days [of] AFTER the first performance of medical acts, 16
tasks, or functions as a physician assistant during the disaster. 17
(c) A team of physicians and physician assistants or physician assistants 18
practicing under this section may not be required to maintain on–site documentation 19
describing [supervisory arrangements] COLLABORATION REGIST RATIONS as otherwise 20
required under this title. 21
(D) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , A 22
PHYSICIAN ASSISTANT WHO RESPONDS DURING A DISASTER MAY NOT B E LIABLE 23
FOR CIVIL DAMAGES FO R INJURIES THAT RESU LT FROM ACTS OR OMIS SIONS WITHIN 24
AN ACT, A TASK, OR A FUNCTION. 25
(2) THE IMMUNITY GRANTED UNDER PARAGRAPH (1) OF THIS 26
SUBSECTION DOES NOT APPLY TO ANY ACT THA T IS COMMITTED NEGLI GENTLY. 27
15–401. 28
[(a)] Except as otherwise provided in this title, a person may not practice, attempt 29
to practice, or offer to practice as a physician assistant in the State unless the person has 30
[a]: 31
(1) A license issued by the Board TO PRACTICE AS A PHY SICIAN 32
ASSISTANT; AND 33
30 HOUSE BILL 727
(2) SUBMITTED A COLLABORA TION REGISTRATION TO THE BOARD. 1
[(b) Except as otherwise provided in this title, a person may not perform, attempt 2
to perform, or offer to perform any delegated medical act beyond the scope of the license 3
and which is consistent with a delegation agreement filed with the Board.] 4
15–402.1. 5
(a) Except as otherwise provided in this subtitle, a licensed physician may not 6
employ [or supervise] an individual practicing as a physician assistant who does not have 7
a license OR WHO HAS N OT SUBMITTED A COLLA BORATION REGISTRATIO N TO THE 8
BOARD. 9
Article – Transportation 10
13–616. 11
(a) (1) In this subtitle the following words have the meanings indicated. 12
(7) “Licensed physician assistant” means an individual who is licensed 13
under Title 15 of the Health Occupations Article to practice [medicine with physician 14
supervision] AS A PHYSICIAN ASSIS TANT. 15
SECTION 2. AND BE IT FURTHER ENACTED, That: 16
(a) A physician assistant authorized to practice under a delegation agreement on 17
October 1, 2023, may continue to practice as a physician assistant under the delegation 18
agreement. 19
(b) The delegation agreement in effect on October 1, 2023, shall be treated the 20
same as collaboration registration required under § 15–302 of the Health Occupations 21
Article, as enacted by Section 1 of this Act, until an initial collaboration registration is 22
submitted to the State Board of Physicians by the physician assistant. 23
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 24
October 1, 2023. 25