Maryland 2023 Regular Session

Maryland Senate Bill SB213 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	WES MOORE, Governor Ch. 327
2	1
3		-	– 1 –
4		-	Chapter 327
5		-	(Senate Bill 213)
6	2
7		-	AN ACT concerning
	3	+	EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTING 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	+	sb0213
8	9
9		-	Health Occupations – Clinical Nurse Specialists – Prescribing
	10	+	SENATE BILL 213
	11	+	J2 3lr2201
	12	+	HB 276/22 – HGO CF HB 278
	13	+	By: Senator Ellis
	14	+	Introduced and read first time: January 23, 2023
	15	+	Assigned to: Finance
	16	+	Committee Report: Favorable with amendments
	17	+	Senate action: Adopted
	18	+	Read second time: March 5, 2023
10	19
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.
	20	+	CHAPTER ______
19	21
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)
	22	+	AN ACT concerning 1
25	23
26		-	BY adding to
27		-	Article – Health Occupations
28		-	Section 8–514
29		-	Annotated Code of Maryland
30		-	(2021 Replacement Volume and 2022 Supplement)
	24	+	Health Occupations – Clinical Nurse Specialists – Prescribing 2
31	25
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)
	26	+	FOR the purpose of defining “clinical nurse specialist” and “practice as a clinical nurse 3
	27	+	specialist” for the purpose of authorizing clinical nurse specialists to prescribe drugs 4
	28	+	and durable medical equipment under regulations adopted by the State Board of 5
	29	+	Nursing; altering the definition of “authorized prescriber” for purposes of the 6
	30	+	Maryland Pharmacy Act to include clinical nurse specialists; authorizing a licensed 7
	31	+	physician to personally prepare and dispense a prescription written by a clinical 8
	32	+	nurse specialist; and generally relating to the prescription authority of clinical nurse 9
	33	+	specialists. 10
37	34
38		-	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
39		-	That the Laws of Maryland read as follows:
	35	+	BY repealing and reenacting, without amendments, 11
	36	+	Article – Health Occupations 12
	37	+	Section 8–101(a) and (b) 13
	38	+	Annotated Code of Maryland 14
	39	+	(2021 Replacement Volume and 2022 Supplement) 15
40	40
41		-	Article – Health Occupations
	41	+	BY adding to 16
	42	+	Article – Health Occupations 17
	43	+	Section 8–514 18
	44	+	Annotated Code of Maryland 19
	45	+	(2021 Replacement Volume and 2022 Supplement) 20
42	46
43		-	8–101.
	47	+	BY repealing and reenacting, with amendments, 21
	48	+	Article – Health Occupations 22 2 SENATE BILL 213
44	49
45		-	(a) In this title the following words have the meanings indicated.
46	50
47		-	(b) “Advanced practice registered nurse” means an individual who:
	51	+	Section 12–101(b) and 12–102(c)(2)(iv)2. 1
	52	+	Annotated Code of Maryland 2
	53	+	(2021 Replacement Volume and 2022 Supplement) 3
48	54
49		-	(1) (i) Is licensed by the Board to practice registered nursing; or Ch. 327 2023 LAWS OF MARYLAND
	55	+	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 4
	56	+	That the Laws of Maryland read as follows: 5
50	57
51		-	~~– 2~~ –
	58	+	Article – Health Occupations 6
52	59
53		-	(ii) Has a multistate licensure privilege to practice registered
54		-	nursing under the Nurse Licensure Compact; and
	60	+	8–101. 7
55	61
56		-	(2) ~~Is certified by~~ the ~~Board to practice as:~~
	62	+	(a) In this title the following words have the meanings indicated. 8
57	63
58		-	(i) A nurse ~~practitioner;~~
	64	+	(b) “Advanced practice registered nurse” means an individual who: 9
59	65
60		-	(ii) ~~A nurse anesthetist~~;
	66	+	(1) (i) Is licensed by the Board to practice registered nursing; or 10
61	67
62		-	(iii) A nurse midwife; or
	68	+	(ii) Has a multistate licensure privilege to practice registered 11
	69	+	nursing under the Nurse Licensure Compact; and 12
63	70
64		-	(iv) ~~A clinical nurse specialist.~~
	71	+	(2) Is certified by the Board to practice as: 13
65	72
66		-	~~8–514.~~
	73	+	(i) A nurse practitioner; 14
67	74
68		-	(A) (1) IN THIS SECTION THE FOL LOWING WORDS HAVE TH E MEANINGS
69		-	INDICATED.
	75	+	(ii) A nurse anesthetist; 15
70	76
71		-	(2) ~~“CLINICAL~~ NURSE ~~SPECIA LIST”~~ ~~MEANS AN INDIVIDUAL WHO IS:~~
	77	+	(iii) A nurse midwife; or 16
72	78
73		-	(I) 1. LICENSED IS LICENSED BY THE BOARD TO PRACTICE
74		-	REGISTERED NURSING ; OR
	79	+	(iv) A clinical nurse specialist. 17
75	80
76		-	2. HAS A MULTISTATE LICE NSURE PRIVILEGE TO
77		-	PRACTICE REGISTERED NURSING UNDER THE NURSE LICENSURE COMPACT; AND
	81	+	8–514. 18
78	82
79		-	(II) ~~CERTIFIED IS CERTIFIED BY~~ THE ~~BOARD TO PRACTICE AS A~~
80		-	~~CLINICAL NURSE SPECI ALIST; AND~~
	83	+	(A) (1) IN THIS SECTION THE FOLLOWIN G WORDS HAVE THE MEA NINGS 19
	84	+	INDICATED. 20
81	85
82		-	(III) AUTHORIZED TO PRESCRI BE DRUGS AND DURABLE
83		-	MEDICAL EQUIPMENT UN DER REGULATIONS ADOP TED BY THE BOARD.
	86	+	(2) “CLINICAL NURSE SPECIA LIST” MEANS AN INDIVIDUAL WHO IS: 21
84	87
85		-	(3) (I) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” MEANS TO:
	88	+	(I) 1. LICENSED IS LICENSED BY THE BOARD TO PRACTICE 22
	89	+	REGISTERED NURSING ; OR 23
86	90
87		-	1. ~~PROVIDE DIRECT CARE T O PATIENTS WITH COMP LEX~~
88		-	~~NEEDS~~;
	91	+	2. HAS A MULTISTATE LICE NSURE PRIVILEGE TO 24
	92	+	PRACTICE REGISTERED NURSING U NDER THE NURSE LICENSURE COMPACT; AND 25
89	93
90		-	2. ACT AS A CONSULTANT T O ANOTHER HEALTH CAR E
91		-	PROVIDER AS NEEDED ;
	94	+	(II) CERTIFIED IS CERTIFIED BY THE BOARD TO PRACTICE AS A 26
	95	+	CLINICAL NURSE SPECI ALIST; AND 27
	96	+	SENATE BILL 213 3
92	97
93		-	3. CONDUCT HEALTH –RELATED RESEARCH ; AND
94		-	WES MOORE, Governor Ch. 327
95	98
96		-	– 3 –
97		-	4. PROVIDE EDUCATION AND GUIDANCE FOR STAFF
98		-	NURSES.
	99	+	(III) AUTHORIZED TO PRESCRI BE DRUGS AND DURABLE 1
	100	+	MEDICAL EQUIPMENT UN DER REGULATIONS ADOP TED BY THE BOARD. 2
99	101
100		-	(II) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” ~~INCLUDES~~:
	102	+	(3) (I) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” MEANS TO: 3
101	103
102		-	1. ~~ORDERING, PERFORMING , AND INTERPRETING~~
103		-	~~LABORATORY TESTS~~ ;
	104	+	1. PROVIDE DIRECT CARE T O PATIENTS WITH COMP LEX 4
	105	+	NEEDS; 5
104	106
105		-	2. ~~ORDERING DIAGNOSTIC~~ T ~~ESTS AND USING THE~~
106		-	~~FINDINGS OR RESULTS IN THE CARE OF PATIE NTS~~;
	107	+	2. ACT AS A CONSULTANT T O ANOTHER HEALTH CAR E 6
	108	+	PROVIDER AS NEEDED ; 7
107	109
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;
	110	+	3. CONDUCT HEALTH –RELATED RESEARCH ; AND 8
111	111
112		-	4. ORDERING HOME HEALTH AND HOSPICE CARE ; AND
	112	+	4. PROVIDE EDUCATION AND GUIDANCE FOR STAFF 9
	113	+	NURSES. 10
113	114
114		-	5. INITIATING, MONITORING, AND ALTERING
115		-	APPROPRIATE THERAPIE S OR TREATMENTS .
	115	+	(II) “PRACTICE AS A CLINICA L NURSE SPECIALIST ” INCLUDES: 11
116	116
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.
	117	+	1. ORDERING, PERFORMING , AND INTERPRETING 12
	118	+	LABORATORY TESTS ; 13
120	119
121		-	12–101.
	120	+	2. ORDERING DIAGNOSTIC T ESTS AND USING THE 14
	121	+	FINDINGS OR RESULTS IN THE CARE OF PATIENTS ; 15
122	122
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.
	123	+	3. PRESCRIBING DRUGS AND DURABLE MEDICAL 16
	124	+	EQUIPMENT AS PROVIDED UNDER PA RAGRAPH (2)(III) OF THIS SUBSECTION UNDER 17
	125	+	REGULATIONS ADOPTED BY THE BOARD; 18
129	126
130		-	~~12–102~~.
	127	+	4. ORDERING HOME HEALTH AND HOSPICE CARE ; AND 19
131	128
132		-	(c) (2) This title does not prohibit:
	129	+	5. INITIATING, MONITORING , AND ALTERING 20
	130	+	APPROPRIATE THERAPIE S OR TREATMENTS . 21
133	131
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:
	132	+	(B) PRACTICE AS A CLINICA L NURSE SPECIALIST I S GOVERNED BY RULES 22
	133	+	AND REGULATIONS THAT ARE ADOPTED UNDER § 8–205 OF THIS TITLE AND TH AT 23
	134	+	CONCERN ADDITIONAL A CTS IN THE PRACTICE OF REGISTERED NURSIN G. 24
136	135
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. 327 2023 LAWS OF MARYLAND
	136	+	12–101. 25
142	137
143		-	– 4 –
144		-	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
145		-	October 1, 2023.
	138	+	(b) “Authorized prescriber” means any licensed dentist, licensed dental hygienist 26
	139	+	with prescriptive authority under § 4–206.4 of this article, licensed physician, licensed 27
	140	+	podiatrist, licensed veterinarian, advanced practice REGISTERED nurse with prescriptive 28
	141	+	authority under § 8–508 OR § 8–514 TITLE 8 of this article, licensed nurse anesthetist, or 29
	142	+	other individual authorized by law to prescribe prescription or nonprescription drugs or 30
	143	+	devices. 31 4 SENATE BILL 213
146	144
147		-	Approved by the Governor, May 3, 2023.
	145	+
	146	+
	147	+	12–102. 1
	148	+
	149	+	(c) (2) This title does not prohibit: 2
	150	+
	151	+	(iv) A licensed physician who complies with the requirements of item 3
	152	+	(ii) of this paragraph from personally preparing and dispensing a prescription written by: 4
	153	+
	154	+	2. [A nurse practitioner who is authorized to practice under 5
	155	+	Title 8, Subtitle 3] AN ADVANCED PRACTICE REGISTERED NURSE WIT H 6
	156	+	PRESCRIPTIVE AUTHORI TY UNDER § 8–508 OR § 8–514 TITLE 8 of this article and is 7
	157	+	working with the physician in the same office setting; or 8
	158	+
	159	+	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 9
	160	+	October 1, 2023. 10
	161	+
	162	+
	163	+
	164	+
	165	+
	166	+	Approved:
	167	+	________________________________________________________________________________
	168	+	Governor.
	169	+	________________________________________________________________________________
	170	+	President of the Senate.
	171	+	________________________________________________________________________________
	172	+	Speaker of the House of Delegates.