EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTING 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.
*sb0213*
SENATE BILL 213
J2 3lr2201
HB 276/22 – HGO CF HB 278
By: Senator Ellis
Introduced and read first time: January 23, 2023
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 5, 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
BY repealing and reenacting, with amendments, 21
Article – Health Occupations 22 2 SENATE BILL 213
Section 12–101(b) and 12–102(c)(2)(iv)2. 1
Annotated Code of Maryland 2
(2021 Replacement Volume and 2022 Supplement) 3
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 4
That the Laws of Maryland read as follows: 5
Article – Health Occupations 6
8–101. 7
(a) In this title the following words have the meanings indicated. 8
(b) “Advanced practice registered nurse” means an individual who: 9
(1) (i) Is licensed by the Board to practice registered nursing; or 10
(ii) Has a multistate licensure privilege to practice registered 11
nursing under the Nurse Licensure Compact; and 12
(2) Is certified by the Board to practice as: 13
(i) A nurse practitioner; 14
(ii) A nurse anesthetist; 15
(iii) A nurse midwife; or 16
(iv) A clinical nurse specialist. 17
8–514. 18
(A) (1) IN THIS SECTION THE FOLLOWIN G WORDS HAVE THE MEA NINGS 19
INDICATED. 20
(2) “CLINICAL NURSE SPECIA LIST” MEANS AN INDIVIDUAL WHO IS: 21
(I) 1. LICENSED IS LICENSED BY THE BOARD TO PRACTICE 22
REGISTERED NURSING ; OR 23
2. HAS A MULTISTATE LICE NSURE PRIVILEGE TO 24
PRACTICE REGISTERED NURSING U NDER THE NURSE LICENSURE COMPACT; AND 25
(II) CERTIFIED IS CERTIFIED BY THE BOARD TO PRACTICE AS A 26
CLINICAL NURSE SPECI ALIST; AND 27
SENATE BILL 213 3
(III) AUTHORIZED TO PRESCRI BE DRUGS AND DURABLE 1
MEDICAL EQUIPMENT UN DER REGULATIONS ADOP TED BY THE BOARD. 2
(3) (I) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” MEANS TO: 3
1. PROVIDE DIRECT CARE T O PATIENTS WITH COMP LEX 4
NEEDS; 5
2. ACT AS A CONSULTANT T O ANOTHER HEALTH CAR E 6
PROVIDER AS NEEDED ; 7
3. CONDUCT HEALTH –RELATED RESEARCH ; AND 8
4. PROVIDE EDUCATION AND GUIDANCE FOR STAFF 9
NURSES. 10
(II) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” INCLUDES: 11
1. ORDERING, PERFORMING , AND INTERPRETING 12
LABORATORY TESTS ; 13
2. ORDERING DIAGNOSTIC T ESTS AND USING THE 14
FINDINGS OR RESULTS IN THE CARE OF PATIENTS ; 15
3. PRESCRIBING DRUGS AND DURABLE MEDICAL 16
EQUIPMENT AS PROVIDED UNDER PA RAGRAPH (2)(III) OF THIS SUBSECTION UNDER 17
REGULATIONS ADOPTED BY THE BOARD; 18
4. ORDERING HOME HEALTH AND HOSPICE CARE ; AND 19
5. INITIATING, MONITORING , AND ALTERING 20
APPROPRIATE THERAPIE S OR TREATMENTS . 21
(B) PRACTICE AS A CLINICA L NURSE SPECIALIST I S GOVERNED BY RULES 22
AND REGULATIONS THAT ARE ADOPTED UNDER § 8–205 OF THIS TITLE AND TH AT 23
CONCERN ADDITIONAL A CTS IN THE PRACTICE OF REGISTERED NURSIN G. 24
12–101. 25
(b) “Authorized prescriber” means any licensed dentist, licensed dental hygienist 26
with prescriptive authority under § 4–206.4 of this article, licensed physician, licensed 27
podiatrist, licensed veterinarian, advanced practice REGISTERED nurse with prescriptive 28
authority under § 8–508 OR § 8–514 TITLE 8 of this article, licensed nurse anesthetist, or 29
other individual authorized by law to prescribe prescription or nonprescription drugs or 30
devices. 31 4 SENATE BILL 213
12–102. 1
(c) (2) This title does not prohibit: 2
(iv) A licensed physician who complies with the requirements of item 3
(ii) of this paragraph from personally preparing and dispensing a prescription written by: 4
2. [A nurse practitioner who is authorized to practice under 5
Title 8, Subtitle 3] AN ADVANCED PRACTICE REGISTERED NURSE WIT H 6
PRESCRIPTIVE AUTHORI TY UNDER § 8–508 OR § 8–514 TITLE 8 of this article and is 7
working with the physician in the same office setting; or 8
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 9
October 1, 2023. 10
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.