Maryland 2024 Regular Session

Maryland Senate Bill SB167 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	WES MOORE, Governor Ch. 919
2	1
3		-	– 1 –
4		-	Chapter 919
5		-	(Senate Bill 167)
6	2
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	+	sb0167
8	9
9		-	Physician Assistants – Revisions
10		-	(Physician Assistant Modernization Act of 2024)
	10	+	SENATE BILL 167
	11	+	J2 4lr1212
	12	+	SB 673/23 – FIN (PRE–FILED) CF HB 806
	13	+	By: Senator Carozza
	14	+	Requested: October 27, 2023
	15	+	Introduced and read first time: January 10, 2024
	16	+	Assigned to: Finance
	17	+	Committee Report: Favorable with amendments
	18	+	Senate action: Adopted
	19	+	Read second time: March 16, 2024
11	20
12		-	FOR the purpose of requiring that a physician assistant have a collaboration agreement,
13		-	rather than a delegation agreement, in order to practice as a physician assistant;
14		-	altering the scope of practice of a physician assistant; altering the education required
15		-	for licensure as a physician assistant; authorizing physician assistants who are
16		-	employees of the federal government to perform acts, tasks, or functions as a
17		-	physician assistant during a certain disaster; requiring the State Board of
18		-	Physicians to review and update the list of advanced duties for physician assistants;
19		-	and generally relating to physician assistants.
	21	+	CHAPTER ______
20	22
21		-	BY repealing and reenacting, without amendments,
22		-	Article – Alcoholic Beverages and Cannabis
23		-	Section 36–101(a)
24		-	Annotated Code of Maryland
25		-	(2016 Volume and 2023 Supplement)
	23	+	AN ACT concerning 1
26	24
27		-	BY repealing and reenacting, with amendments,
28		-	Article – Alcoholic Beverages and Cannabis
29		-	Section 36–101(m)(1)(v)
30		-	Annotated Code of Maryland
31		-	(2016 Volume and 2023 Supplement)
	25	+	Physician Assistants – Revisions 2
	26	+	(Physician Assistant Modernization Act of 2024) 3
32	27
33		-	BY repealing and reenacting, without amendments,
34		-	Article – Courts and Judicial Proceedings
35		-	Section 3–2A–01(a)
36		-	Annotated Code of Maryland
37		-	(2020 Replacement Volume and 2023 Supplement)
	28	+	FOR the purpose of requiring that a physician assistant have a collaboration agreement, 4
	29	+	rather than a delegation agreement, in order to practice as a physician assistant; 5
	30	+	altering the scope of practice of a physician assistant; altering the education required 6
	31	+	for licensure as a physician assistant; authorizing physician assistants who are 7
	32	+	employees of the federal government to perform acts, tasks, or functions as a 8
	33	+	physician assistant during a certain disaster; requiring the State Board of 9
	34	+	Physicians to review and update the list of advanced duties for physician assistants; 10
	35	+	and generally relating to physician assistants. 11
38	36
39		-	BY repealing and reenacting, ~~with~~ amendments,
40		-	Article – ~~Courts~~ and ~~Judicial Proceedings~~
41		-	Section 3–~~2A–01~~(f)
42		-	Annotated Code of Maryland
43		-	(~~2020 Replacement~~ Volume and 2023 Supplement)
	37	+	BY repealing and reenacting, without amendments, 12
	38	+	Article – Alcoholic Beverages and Cannabis 13
	39	+	Section 36–101(a) 14
	40	+	Annotated Code of Maryland 15
	41	+	(2016 Volume and 2023 Supplement) 16
44	42
45		-	BY repealing and reenacting, with amendments,
46		-	Article – Education
47		-	Section 7–402(c) and 18–802(a)(8)
48		-	Annotated Code of Maryland
49		-	(2022 Replacement Volume and 2023 Supplement) Ch. 919 2024 LAWS OF MARYLAND
	43	+	BY repealing and reenacting, with amendments, 17
	44	+	Article – Alcoholic Beverages and Cannabis 18
	45	+	Section 36–101(m)(1)(v) 19
	46	+	Annotated Code of Maryland 20
	47	+	(2016 Volume and 2023 Supplement) 21
	48	+	2 SENATE BILL 167
50	49
51		-	– 2 –
52	50
53		-	BY repealing and reenacting, without amendments,
54		-	Article – ~~Education~~
55		-	Section 18–~~802~~(a)~~(1)~~
56		-	Annotated Code of Maryland
57		-	(~~2022~~ Replacement Volume and 2023 Supplement)
	51	+	BY repealing and reenacting, without amendments, 1
	52	+	Article – Courts and Judicial Proceedings 2
	53	+	Section 3–2A–01(a) 3
	54	+	Annotated Code of Maryland 4
	55	+	(2020 Replacement Volume and 2023 Supplement) 5
58	56
59		-	BY repealing and reenacting, ~~without~~ amendments,
60		-	Article – ~~Health – General~~
61		-	Section 4–~~201~~(a) ~~and 5–601(a)~~
62		-	Annotated Code of Maryland
63		-	(~~2023~~ Replacement Volume)
	57	+	BY repealing and reenacting, with amendments, 6
	58	+	Article – Courts and Judicial Proceedings 7
	59	+	Section 3–2A–01(f) 8
	60	+	Annotated Code of Maryland 9
	61	+	(2020 Replacement Volume and 2023 Supplement) 10
64	62
65		-	BY repealing and reenacting, with amendments,
66		-	Article – ~~Health – General~~
67		-	Section 4–~~201~~(s) and 5–~~601~~(v)
68		-	Annotated Code of Maryland
69		-	(~~2023~~ Replacement Volume)
	63	+	BY repealing and reenacting, with amendments, 11
	64	+	Article – Education 12
	65	+	Section 7–402(c) and 18–802(a)(8) 13
	66	+	Annotated Code of Maryland 14
	67	+	(2022 Replacement Volume and 2023 Supplement) 15
70	68
71		-	BY repealing and reenacting, with amendments,
72		-	Article – Health Occupations
73		-	Section 12–102(c)(2)(iv), (v), and (vi) 12–102(a) and (c)(2)(iv), 14–306(a), 15–101,
74		-	15–103, 15–202(b), 15–205(a), 15–301, 15–302, 15–302.2, 15–303, 15–306,
75		-	15–309(a), 15–310, 15–314(a)(41), (43), (44), and (45), 15–317, 15–401, and
76		-	15–402.1(a)
77		-	Annotated Code of Maryland
78		-	(2021 Replacement Volume and 2023 Supplement)
	69	+	BY repealing and reenacting, without amendments, 16
	70	+	Article – Education 17
	71	+	Section 18–802(a)(1) 18
	72	+	Annotated Code of Maryland 19
	73	+	(2022 Replacement Volume and 2023 Supplement) 20
79	74
80		-	BY ~~adding to~~
81		-	Article – Health ~~Occupations~~
82		-	Section 12–~~102~~(~~c)(2)(vii~~) and 15–~~314~~(a)~~(42)~~
83		-	Annotated Code of Maryland
84		-	(~~2021~~ Replacement Volume ~~and 2023 Supplement~~)
	75	+	BY repealing and reenacting, without amendments, 21
	76	+	Article – Health – General 22
	77	+	Section 4–201(a) and 5–601(a) 23
	78	+	Annotated Code of Maryland 24
	79	+	(2023 Replacement Volume) 25
85	80
86		-	BY repealing and reenacting, ~~without~~ amendments,
87		-	Article – Health ~~Occupations~~
88		-	Section 15–~~202~~(~~a)(1~~) and (2)
89		-	Annotated Code of Maryland
90		-	(~~2021~~ Replacement Volume ~~and 2023 Supplement~~)
	81	+	BY repealing and reenacting, with amendments, 26
	82	+	Article – Health – General 27
	83	+	Section 4–201(s) and 5–601(v) 28
	84	+	Annotated Code of Maryland 29
	85	+	(2023 Replacement Volume) 30
91	86
92		-	BY repealing
93		-	Article – Health Occupations
94		-	Section 15–302.1, 15–302.3, 15–313, and 15–314(a)(42)
95		-	Annotated Code of Maryland
96		-	(2021 Replacement Volume and 2023 Supplement)
97		-	WES MOORE, Governor Ch. 919
	87	+	BY repealing and reenacting, with amendments, 31
	88	+	Article – Health Occupations 32
	89	+	Section 12–102(c)(2)(iv), (v), and (vi) 12–102(a) and (c)(2)(iv), 14–306(a), 15–101, 33
	90	+	15–103, 15–202(b), 15–205(a), 15–301, 15–302, 15–302.2, 15–303, 15–306, 34
	91	+	15–309(a), 15–310, 15–314(a)(41), (43), (44), and (45), 15–317, 15–401, and 35
	92	+	15–402.1(a) 36
	93	+	Annotated Code of Maryland 37
	94	+	(2021 Replacement Volume and 2023 Supplement) 38
98	95
99		-	– 3 –
100		-	BY adding to
101		-	Article – Health Occupations
102		-	Section 15–302.1, 15–309(c) and (d), and 15–314(a)(42), (43), and (44)
103		-	Annotated Code of Maryland
104		-	(2021 Replacement Volume and 2023 Supplement)
	96	+	BY adding to 39
	97	+	Article – Health Occupations 40 SENATE BILL 167 3
105	98
106		-	BY repealing and reenacting, without amendments,
107		-	Article – Transportation
108		-	Section 13–616(a)(1)
109		-	Annotated Code of Maryland
110		-	(2020 Replacement Volume and 2023 Supplement)
111	99
112		-	BY repealing and reenacting, with amendments,
113		-	Article – Transportation
114		-	Section 13–616(a)(7)
115		-	Annotated Code of Maryland
116		-	(2020 Replacement Volume and 2023 Supplement)
	100	+	Section 12–102(c)(2)(vii) and 15–314(a)(42) 1
	101	+	Annotated Code of Maryland 2
	102	+	(2021 Replacement Volume and 2023 Supplement) 3
117	103
118		-	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
119		-	That the Laws of Maryland read as follows:
	104	+	BY repealing and reenacting, without amendments, 4
	105	+	Article – Health Occupations 5
	106	+	Section 15–202(a)(1) and (2) 6
	107	+	Annotated Code of Maryland 7
	108	+	(2021 Replacement Volume and 2023 Supplement) 8
120	109
121		-	Article – Alcoholic Beverages and Cannabis
	110	+	BY repealing 9
	111	+	Article – Health Occupations 10
	112	+	Section 15–302.1, 15–302.3, 15–313, and 15–314(a)(42) 11
	113	+	Annotated Code of Maryland 12
	114	+	(2021 Replacement Volume and 2023 Supplement) 13
122	115
123		-	36–101.
	116	+	BY adding to 14
	117	+	Article – Health Occupations 15
	118	+	Section 15–302.1, 15–309(c) and (d), and 15–314(a)(42), (43), and (44) 16
	119	+	Annotated Code of Maryland 17
	120	+	(2021 Replacement Volume and 2023 Supplement) 18
124	121
125		-	(a) In this title the following words have the meanings indicated.
	122	+	BY repealing and reenacting, without amendments, 19
	123	+	Article – Transportation 20
	124	+	Section 13–616(a)(1) 21
	125	+	Annotated Code of Maryland 22
	126	+	(2020 Replacement Volume and 2023 Supplement) 23
126	127
127		-	(m) “Certifying provider” means an individual who:
	128	+	BY repealing and reenacting, with amendments, 24
	129	+	Article – Transportation 25
	130	+	Section 13–616(a)(7) 26
	131	+	Annotated Code of Maryland 27
	132	+	(2020 Replacement Volume and 2023 Supplement) 28
128	133
129		-	(1) (v) 1. has an active, unrestricted license to practice as a
130		-	physician assistant issued by the State Board of Physicians under Title 15 of the Health
131		-	Occupations Article; AND
	134	+	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 29
	135	+	That the Laws of Maryland read as follows: 30
132	136
133		-	2. [has an active delegation agreement with a primary
134		-	supervising physician COLLABORATION AGREEM ENT WITH A PATIENT C ARE TEAM
135		-	PHYSICIAN who is a certifying provider; and
	137	+	Article – Alcoholic Beverages and Cannabis 31
136	138
137		-	~~3.] is in good standing with the State Board of Physicians;~~
	139	+	36–101. 32
138	140
139		-	~~Article – Courts and Judicial Proceedings~~
	141	+	(a) In this title the following words have the meanings indicated. 33
140	142
141		-	3–2A–01.
	143	+	(m) “Certifying provider” means an individual who: 34
	144	+	4 SENATE BILL 167
142	145
143		-	(a) In this subtitle the following terms have the meanings indicated unless the
144		-	context of their use requires otherwise.
145		-	Ch. 919 2024 LAWS OF MARYLAND
146	146
147		-	– 4 –
148		-	(f) (1) “Health care provider” means a hospital, a related institution as defined
149		-	in § 19–301 of the Health – General Article, a medical day care center, a hospice care
150		-	program, an assisted living program, a freestanding ambulatory care facility as defined in
151		-	§ 19–3B–01 of the Health – General Article, a physician, A PHYSICIAN ASSISTAN T, an
152		-	osteopath, an optometrist, a chiropractor, a registered or licensed practical nurse, a dentist,
153		-	a podiatrist, a psychologist, a licensed certified social worker–clinical, and a physical
154		-	therapist, licensed or authorized to provide one or more health care services in Maryland.
	147	+	(1) (v) 1. has an active, unrestricted license to practice as a 1
	148	+	physician assistant issued by the State Board of Physicians under Title 15 of the Health 2
	149	+	Occupations Article; AND 3
155	150
156		-	(2) “Health care provider” does not include any nursing institution
157		-	conducted by and for those who rely upon treatment by spiritual means through prayer
158		-	alone in accordance with the tenets and practices of a recognized church or religious
159		-	denomination.
	151	+	2. [has an active delegation agreement with a primary 4
	152	+	supervising physician COLLABORATION AGREEM ENT WITH A PATIENT C ARE TEAM 5
	153	+	PHYSICIAN who is a certifying provider; and 6
160	154
161		-	~~Article – Education~~
	155	+	3.] is in good standing with the State Board of Physicians; 7
162	156
163		-	7–~~402.~~
	157	+	Article – Courts and Judicial Proceedings 8
164	158
165		-	(c) The physical examination required under subsection (b) of this section shall
166		-	be completed by:
	159	+	3–2A–01. 9
167	160
168		-	(1) A licensed physician;
	161	+	(a) In this subtitle the following terms have the meanings indicated unless the 10
	162	+	context of their use requires otherwise. 11
169	163
170		-	(2) A licensed physician assistant [with a delegation agreement approved
171		-	by the State Board of Physicians WHO HAS AN ACTIVE CO LLABORATION AGREEMEN T];
172		-	or
	164	+	(f) (1) “Health care provider” means a hospital, a related institution as defined 12
	165	+	in § 19–301 of the Health – General Article, a medical day care center, a hospice care 13
	166	+	program, an assisted living program, a freestanding ambulatory care facility as defined in 14
	167	+	§ 19–3B–01 of the Health – General Article, a physician, A PHYSICIAN ASSISTAN T, an 15
	168	+	osteopath, an optometrist, a chiropractor, a registered or licensed practical nurse, a dentist, 16
	169	+	a podiatrist, a psychologist, a licensed certified social worker–clinical, and a physical 17
	170	+	therapist, licensed or authorized to provide one or more health care services in Maryland. 18
173	171
174		-	(3) A certified nurse practitioner.
	172	+	(2) “Health care provider” does not include any nursing institution 19
	173	+	conducted by and for those who rely upon treatment by spiritual means through prayer 20
	174	+	alone in accordance with the tenets and practices of a recognized church or religious 21
	175	+	denomination. 22
175	176
176		-	18–~~802.~~
	177	+	Article – Education 23
177	178
178		-	~~(a) (1) In this section the following words have the meanings indicated~~.
	179	+	7–402. 24
179	180
180		-	(8) “Physician assistant” means an individual [to whom duties are
181		-	delegated by a licensed physician under the rules and regulations of the State Board of
182		-	Physicians] LICENSED UNDER TITLE 15 OF THE HEALTH OCCUPATIONS ARTICLE TO
183		-	PRACTICE AS A PHYSIC IAN ASSISTANT.
	181	+	(c) The physical examination required under subsection (b) of this section shall 25
	182	+	be completed by: 26
184	183
185		-	~~Article – Health – General~~
	184	+	(1) A licensed physician; 27
186	185
187		-	4–201.
	186	+	(2) A licensed physician assistant [with a delegation agreement approved 28
	187	+	by the State Board of Physicians WHO HAS AN ACTIVE CO LLABORATION AGREEMEN T]; 29
	188	+	or 30
188	189
189		-	(a) In this subtitle the following words have the meanings indicated.
190		-	WES MOORE, Governor Ch. 919
	190	+	(3) A certified nurse practitioner. 31
191	191
192		-	– 5 –
193		-	(s) “Physician assistant” means an individual who is licensed under Title 15 of
194		-	the Health Occupations Article to practice [medicine with physician supervision] AS A
195		-	PHYSICIAN ASSISTANT .
	192	+	18–802. 32 SENATE BILL 167 5
196	193
197		-	5–601.
198	194
199		-	(a) In this subtitle the following words have the meanings indicated.
200	195
201		-	(v) “Physician assistant” means an individual who is licensed under Title 15 of
202		-	the Health Occupations Article to practice [medicine with physician supervision] AS A
203		-	PHYSICIAN ASSISTANT .
	196	+	(a) (1) In this section the following words have the meanings indicated. 1
204	197
205		-	Article – Health Occupations
	198	+	(8) “Physician assistant” means an individual [to whom duties are 2
	199	+	delegated by a licensed physician under the rules and regulations of the State Board of 3
	200	+	Physicians] LICENSED UNDER TITLE 15 OF THE HEALTH OCCUPATIONS ARTICLE TO 4
	201	+	PRACTICE AS A PHYSIC IAN ASSISTANT. 5
206	202
207		-	12–~~102.~~
	203	+	Article – Health – General 6
208	204
209		-	~~(a) (1) In this section the following terms have the meanings indicated~~.
	205	+	4–201. 7
210	206
211		-	(2) “In the public interest” means the dispensing of drugs or devices by a
212		-	licensed dentist, physician, nurse or midwife, or podiatrist to a patient when a pharmacy
213		-	is not conveniently available to the patient.
	207	+	(a) In this subtitle the following words have the meanings indicated. 8
214	208
215		-	(3) “Nurse or midwife” means an individual licensed or certified by the
216		-	Board of Nursing under Title 8 of this article.
	209	+	(s) “Physician assistant” means an individual who is licensed under Title 15 of 9
	210	+	the Health Occupations Article to practice [medicine with physician supervision] AS A 10
	211	+	PHYSICIAN ASSISTANT . 11
217	212
218		-	(4) [“Personally] EXCEPT AS PROVIDED IN § 15–302.2 OF THIS
219		-	ARTICLE, “PERSONALLY preparing and dispensing” means that the licensed dentist,
220		-	physician, nurse or midwife, or podiatrist:
	213	+	5–601. 12
221	214
222		-	(i) Is physically present on the premises where the prescription is
223		-	filled; and
	215	+	(a) In this subtitle the following words have the meanings indicated. 13
224	216
225		-	(ii) Performs a final check of the prescription before it is provided to
226		-	the patient.
	217	+	(v) “Physician assistant” means an individual who is licensed under Title 15 of 14
	218	+	the Health Occupations Article to practice [medicine with physician supervision] AS A 15
	219	+	PHYSICIAN ASSISTANT . 16
227	220
228		-	~~(c) (2) This title does not prohibit:~~
	221	+	Article – Health Occupations 17
229	222
230		-	(iv) A licensed physician who complies with the requirements of item
231		-	(ii) of this paragraph from personally preparing and dispensing a prescription written by:
	223	+	12–102. 18
232	224
233		-	1. A physician assistant [in accordance with a delegation
234		-	agreement that] WHO complies with Title 15, Subtitle 3 of this article; or
	225	+	(a) (1) In this section the following terms have the meanings indicated. 19
235	226
236		-	2~~. An advanced practice registered nurse with prescriptive~~
237		-	~~authority under Title 8 of this article and is working with the~~ physician ~~in the same office~~
238		-	~~setting; Ch~~. ~~919 2024 LAWS OF MARYLAND~~
	227	+	(2) “In the public interest” means the dispensing of drugs or devices by a 20
	228	+	licensed dentist, physician, nurse or midwife, or podiatrist to a patient when a pharmacy 21
	229	+	is not conveniently available to the patient. 22
239	230
240		-	– 6 –
	231	+	(3) “Nurse or midwife” means an individual licensed or certified by the 23
	232	+	Board of Nursing under Title 8 of this article. 24
241	233
242		-	(v) A hospital–based clinic from dispensing prescriptions to its
243		-	patients; [or]
	234	+	(4) [“Personally] EXCEPT AS PROVIDED IN § 15–302.2 OF THIS 25
	235	+	ARTICLE, “PERSONALLY preparing and dispensing” means that the licensed dentist, 26
	236	+	physician, nurse or midwife, or podiatrist: 27
244	237
245		-	(vi) ~~An individual licensed or certified under Title 8 of this article~~
246		-	~~from personally preparing~~ and ~~dispensing a drug or device as authorized under Title 8 of~~
247		-	~~this article;~~ OR
	238	+	(i) Is physically present on the premises where the prescription is 28
	239	+	filled; and 29
	240	+	6 SENATE BILL 167
248	241
249		-	(VII) A PHYSICIAN ASS ISTANT FROM PERSONAL LY PREPARING
250		-	AND DISPENSING A PRE SCRIPTION IN ACCORDA NCE WITH § 15–302.1 OF THIS
251		-	ARTICLE.
252	242
253		-	14–306.
	243	+	(ii) Performs a final check of the prescription before it is provided to 1
	244	+	the patient. 2
254	245
255		-	(a) [To] EXCEPT AS PROVIDED IN SUBSECTIONS (E) AND (F) OF THIS
256		-	SECTION, TO the extent permitted by the rules, regulations, and orders of the Board, an
257		-	individual to whom duties are delegated by a licensed physician OR PHYSICIAN
258		-	ASSISTANT may perform those duties without a license as provided in this section.
	246	+	(c) (2) This title does not prohibit: 3
259	247
260		-	15–101.
	248	+	(iv) A licensed physician who complies with the requirements of item 4
	249	+	(ii) of this paragraph from personally preparing and dispensing a prescription written by: 5
261	250
262		-	(a) In this title the following words have the meanings indicated.
	251	+	1. A physician assistant [in accordance with a delegation 6
	252	+	agreement that] WHO complies with Title 15, Subtitle 3 of this article; or 7
263	253
264		-	~~[(b) “Alternate~~ ~~supervising physician”~~ ~~means one or more physicians designated~~
265		-	by the ~~primary supervising~~ physician ~~to provide supervision of a physician assistant~~ in
266		-	~~accordance with the delegation agreement on file with the Board.]~~
	254	+	2. An advanced practice registered nurse with prescriptive 8
	255	+	authority under Title 8 of this article and is working with the physician in the same office 9
	256	+	setting; 10
267	257
268		-	[(c)] (B) “Ambulatory surgical facility” means a facility:
	258	+	(v) A hospital–based clinic from dispensing prescriptions to its 11
	259	+	patients; [or] 12
269	260
270		-	(1) Accredited by:
	261	+	(vi) An individual licensed or certified under Title 8 of this article 13
	262	+	from personally preparing and dispensing a drug or device as authorized under Title 8 of 14
	263	+	this article; OR 15
271	264
272		-	(i) The American Association for Accreditation of Ambulatory
273		-	Surgical Facilities;
	265	+	(VII) A PHYSICIAN ASSISTANT FROM PERSONALLY PREP ARING 16
	266	+	AND DISPENSING A PRE SCRIPTION IN ACCORDANCE WITH § 15–302.1 OF THIS 17
	267	+	ARTICLE. 18
274	268
275		-	~~(ii) The Accreditation Association for Ambulatory Health Care; or~~
	269	+	14–306. 19
276	270
277		-	(iii) The Joint Commission on Accreditation of Healthcare
278		-	Organizations; or
	271	+	(a) [To] EXCEPT AS PROVIDED IN SUBSECTIONS (E) AND (F) OF THIS 20
	272	+	SECTION, TO the extent permitted by the rules, regulations, and orders of the Board, an 21
	273	+	individual to whom duties are delegated by a licensed physician OR PHYSICIAN 22
	274	+	ASSISTANT may perform those duties without a license as provided in this section. 23
279	275
280		-	(2) Certified to participate in the Medicare program, as enacted by Title
281		-	XVIII of the Social Security Act.
	276	+	15–101. 24
282	277
283		-	[(d)] (C) “Board” means the State Board of Physicians, established under §
284		-	14–201 of this article.
285		-	WES MOORE, Governor Ch. 919
	278	+	(a) In this title the following words have the meanings indicated. 25
286	279
287		-	– 7 –
288		-	(D) (1) “COLLABORATION ” MEANS THE COMMUNICAT ION AND
289		-	DECISION–MAKING PROCESS AMONG HEALTH CARE PROVIDER S WHO ARE MEMBERS
290		-	OF A PATIENT CARE TE AM RELATED TO THE TR EATMENT OF A PATIENT THAT
291		-	INCLUDES THE DEGREE OF COOPER ATION NECESSARY TO P ROVIDE TREATMENT
292		-	AND CARE TO THE PATI ENT AND INCLUDES :
	280	+	[(b) “Alternate supervising physician” means one or more physicians designated 26
	281	+	by the primary supervising physician to provide supervision of a physician assistant in 27
	282	+	accordance with the delegation agreement on file with the Board.] 28
293	283
294		-	(I) COMMUNICATION OF DATA AND INFORMATION ABOU T THE
295		-	TREATMENT AND CARE O F A PATIENT, INCLUDING THE EXCHAN GE OF CLINICAL
296		-	OBSERVATIONS AND ASS ESSMENTS; AND
	284	+	[(c)] (B) “Ambulatory surgical facility” means a facility: 29
297	285
298		-	(II) ~~DEVELOPMENT OF AN APP ROPRIATE PLAN OF CAR E,~~
299		-	~~INCLUDING:~~
	286	+	(1) Accredited by: 30
	287	+	SENATE BILL 167 7
300	288
301		-	1. DECISIONS REGARDING T HE HEALTH CARE
302		-	PROVIDED;
303	289
304		-	~~2. ACCESSING AND ASSESSM ENT~~ OF ~~APPROPRIATE~~
305		-	~~ADDITIONAL RESOURCES OR EXPERTISE~~; ~~AND~~
	290	+	(i) The American Association for Accreditation of Ambulatory 1
	291	+	Surgical Facilities; 2
306	292
307		-	3. ARRANGEMENT OF APPROP RIATE REFERRALS ,
308		-	TESTING, OR STUDIES.
	293	+	(ii) The Accreditation Association for Ambulatory Health Care; or 3
309	294
310		-	(2) “COLLABORATION ” DOES NOT REQUIRE THE CONSTANT,
311		-	PHYSICAL PRESENCE OF A COLLABORATING PHYS ICIAN ON–SITE IN THE PRACTICE
312		-	SETTING, IF THE COLLABORATING PHYSICIAN IS ACCESSI BLE BY ELECTRONIC
313		-	MEANS.
	295	+	(iii) The Joint Commission on Accreditation of Healthcare 4
	296	+	Organizations; or 5
314	297
315		-	(E) “COLLABORATION AGREEME NT” MEANS A DOCUMENT THAT :
	298	+	(2) Certified to participate in the Medicare program, as enacted by Title 6
	299	+	XVIII of the Social Security Act. 7
316	300
317		-	(1) ~~OUTLINES~~ THE ~~COLLABOR ATION BETWEEN A PHYS ICIAN~~
318		-	~~ASSISTANT AND:~~
	301	+	[(d)] (C) “Board” means the State Board of Physicians, established under § 8
	302	+	14–201 of this article. 9
319	303
320		-	(I) AN INDIVIDUAL PHYSICI AN; OR
	304	+	(D) (1) “COLLABORATION ” MEANS THE COMMUNICAT ION AND 10
	305	+	DECISION–MAKING PROCESS AMONG HEALTH CARE PROVIDER S WHO ARE MEMBERS 11
	306	+	OF A PATIENT CARE TE AM RELATED TO THE TR EATMENT OF A PATIENT THAT 12
	307	+	INCLUDES THE DEGREE OF COOPERATION NECESSAR Y TO PROVIDE TREATME NT 13
	308	+	AND CARE TO THE PATI ENT AND INCLUDES : 14
321	309
322		-	(II) A GROUP OF PHYSICIANS ; AND
	310	+	(I) COMMUNICATION OF DATA AND INFORMATION ABOU T THE 15
	311	+	TREATMENT AND CARE O F A PATIENT, INCLUDING THE EXCHAN GE OF CLINICAL 16
	312	+	OBSERVATIONS AND ASS ESSMENTS; AND 17
323	313
324		-	(2) ~~IS DEVELOPED BY A PHY SICIAN ASSISTANT AND THE PHYSICIAN~~
325		-	~~OR GROUP OF PHYSICIA NS; AND~~
	314	+	(II) DEVELOPMENT OF AN APP ROPRIATE PLAN OF CAR E, 18
	315	+	INCLUDING: 19
326	316
327		-	(3) IS SUBMITTED TO THE BOARD.
	317	+	1. DECISIONS REGARDING T HE HEALTH CARE 20
	318	+	PROVIDED; 21
328	319
329		-	~~[(e)] (F) “Committee” means the Physician Assistant Advisory Committee~~.
330		-	~~Ch.~~ ~~919~~ ~~2024 LAWS OF MARYLAND~~
	320	+	2. ACCESSING AND ASSESSM ENT OF APPROPRIATE 22
	321	+	ADDITIONAL RESOURCES OR EXPERTISE; AND 23
331	322
332		-	– 8 –
333		-	[(f)] (G) “Controlled dangerous substances” has the meaning stated in § 5–101
334		-	of the Criminal Law Article.
	323	+	3. ARRANGEMENT OF APPROP RIATE REFERRALS , 24
	324	+	TESTING, OR STUDIES. 25
335	325
336		-	[(g)] (H) “Correctional facility” includes a State or local correctional facility.
	326	+	(2) “COLLABORATION ” DOES NOT REQUIRE THE CONSTANT, 26
	327	+	PHYSICAL PRESENCE OF A COLLABORATING PHYS ICIAN ON–SITE IN THE PRACTICE 27
	328	+	SETTING, IF THE COLLABORATING PHYSICIAN IS ACCESSI BLE BY ELECTRONIC 28
	329	+	MEANS. 29
337	330
338		-	[(h) “Delegated medical acts” means activities that constitute the practice of
339		-	medicine delegated by a physician under Title 14 of this article.
	331	+	(E) “COLLABORATION AGREEME NT” MEANS A DOCUMENT THA T: 30
340	332
341		-	(i) “Delegation agreement” means a document that is executed by a primary
342		-	supervising physician and a physician assistant containing the requirements of § 15–302
343		-	of this title.
	333	+	(1) OUTLINES THE COLLABOR ATION BETWEEN A PHYS ICIAN 31
	334	+	ASSISTANT AND: 32 8 SENATE BILL 167
344	335
345		-	(i–1)] (I) “Disciplinary panel” means a disciplinary panel of the Board
346		-	established under § 14–401 of this article.
347	336
348		-	(j) “Dispense” or “dispensing” has the meaning stated in § 12–101 of this article.
349	337
350		-	(k) “Drug sample” means a unit of a prescription drug that is intended to promote
351		-	the sale of the drug and is not intended for sale.
	338	+	(I) AN INDIVIDUAL PHYSICI AN; OR 1
352	339
353		-	(l) ~~“Hospital” means:~~
	340	+	(II) A GROUP OF PHYSICIANS ; AND 2
354	341
355		-	(1) A hospital as defined under § 19–301 of the Health – General Article;
	342	+	(2) IS DEVELOPED BY A PHY SICIAN ASSISTANT AND THE PHYSICIAN 3
	343	+	OR GROUP OF PHYSICIA NS; AND 4
356	344
357		-	(2) ~~A comprehensive care facility that:~~
	345	+	(3) IS SUBMITTED TO THE BOARD. 5
358	346
359		-	(i) Meets the requirements of a hospital–based skilled nursing
360		-	facility under federal law; and
	347	+	[(e)] (F) “Committee” means the Physician Assistant Advisory Committee. 6
361	348
362		-	(ii) Offers acute care in the same building; and
	349	+	[(f)] (G) “Controlled dangerous substances” has the meaning stated in § 5–101 7
	350	+	of the Criminal Law Article. 8
363	351
364		-	(3) An emergency room that is physically connected to a hospital or a
365		-	freestanding medical facility that is licensed under Title 19, Subtitle 3A of the Health –
366		-	General Article.
	352	+	[(g)] (H) “Correctional facility” includes a State or local correctional facility. 9
367	353
368		-	(m) “~~License~~” means ~~a license issued by~~ the ~~Board to a physician assistant under~~
369		-	this ~~title~~.
	354	+	[(h) “Delegated medical acts” means activities that constitute the practice of 10
	355	+	medicine delegated by a physician under Title 14 of this article. 11
370	356
371		-	(n) “~~National certifying examination~~” means ~~the Physician Assistant National~~
372		-	~~Certifying Examination administered by~~ the ~~National Commission on Certification~~ of
373		-	~~Physician Assistants or its successor~~.
	357	+	(i) “Delegation agreement” means a document that is executed by a primary 12
	358	+	supervising physician and a physician assistant containing the requirements of § 15–302 13
	359	+	of this title. 14
374	360
375		-	(O) “PATIENT CARE TEAM ” MEANS A MULTIDISCIPL INARY TEAM OF HEALTH
376		-	CARE PROVIDERS ACTIV ELY FUNCTIONING AS A UNIT IN CONSULTATION WITH THE
377		-	LEADERSHIP OF ONE OR MORE PATIENT CARE TEAM PHYSICIANS FOR THE PURPOSE WES MOORE, Governor Ch. 919
	361	+	(i–1)] (I) “Disciplinary panel” means a disciplinary panel of the Board 15
	362	+	established under § 14–401 of this article. 16
378	363
379		-	– 9 –
380		-	OF PROVIDING AND DEL IVERING HEALTH CARE TO A PATIENT OR GROU P OF
381		-	PATIENTS.
	364	+	(j) “Dispense” or “dispensing” has the meaning stated in § 12–101 of this article. 17
382	365
383		-	(P) “PATIENT CARE TEAM PHY SICIAN” MEANS A LICENSED PHY SICIAN WHO
384		-	REGULARLY PRACTICES IN THE STATE AND WHO PROVIDE S CONSULTATION
385		-	LEADERSHIP IN THE CARE OF PATIE NTS AS PART OF A PA TIENT CARE TEAM .
	366	+	(k) “Drug sample” means a unit of a prescription drug that is intended to promote 18
	367	+	the sale of the drug and is not intended for sale. 19
386	368
387		-	[(o)] (Q) “Physician assistant” means an individual who is licensed under this
388		-	title to practice [medicine with physician supervision] AS A PHYSICIAN ASSIS TANT.
	369	+	(l) “Hospital” means: 20
389	370
390		-	[(p)] (R) “Practice as a physician assistant” means the performance of medical
391		-	acts that are:
	371	+	(1) A hospital as defined under § 19–301 of the Health – General Article; 21
392	372
393		-	[(1) ~~Delegated by~~ a ~~supervising physician to a physician assistant;~~
	373	+	(2) A comprehensive care facility that: 22
394	374
395		-	(2) Within the supervising physician’s scope of practice; and
	375	+	(i) Meets the requirements of a hospital–based skilled nursing 23
	376	+	facility under federal law; and 24
396	377
397		-	(3) Appropriate to the physician assistant’s education, training, and
398		-	experience]
	378	+	(ii) Offers acute care in the same building; and 25
399	379
400		-	(1) AUTHORIZED UNDER A LICENSE ISSUED BY THE BOARD; AND
	380	+	(3) An emergency room that is physically connected to a hospital or a 26
	381	+	freestanding medical facility that is licensed under Title 19, Subtitle 3A of the Health – 27
	382	+	General Article. 28 SENATE BILL 167 9
401	383
402		-	(2) AUTHORIZED UNDER THE PHYSICIAN ASSISTANT ’S
403		-	COLLABORATION AGREEM ENT.
404	384
405		-	[(q)] (S) “Prescriptive authority” means the authority [delegated by a primary
406		-	or alternate supervising physician to] OF a physician assistant to:
407	385
408		-	(1) ~~Prescribe and administer controlled dangerous substances,~~ ~~prescription~~
409		-	~~drugs, medical devices,~~ ~~and the oral, written, or electronic ordering of medications; and~~
	386	+	(m) “License” means a license issued by the Board to a physician assistant under 1
	387	+	this title. 2
410	388
411		-	(2) Dispense as provided under [§ 15–302.2(b), (c), and (d)] § 15–302.1 of
412		-	this title.
	389	+	(n) “National certifying examination” means the Physician Assistant National 3
	390	+	Certifying Examination administered by the National Commission on Certification of 4
	391	+	Physician Assistants or its successor. 5
413	392
414		-	[(r) “Primary supervising physician” means a physician who:
	393	+	(O) “PATIENT CARE TEAM ” MEANS A MULTIDISCIPL INARY TEAM OF HEALTH 6
	394	+	CARE PROVIDERS ACTIV ELY FUNCTIONING AS A UNIT IN CONSULTATION WITH THE 7
	395	+	LEADERSHIP OF ONE OR MORE PATIENT CARE TEAM PHYSICIANS FOR THE PURPOSE 8
	396	+	OF PROVIDING AND DEL IVERING HEALTH CARE TO A PATIENT OR GROU P OF 9
	397	+	PATIENTS. 10
415	398
416		-	(1) Completes a delegation agreement that meets the requirements under
417		-	§§ 15–301(d) and (e) and 15–302 of this title and files a copy with the Board;
	399	+	(P) “PATIENT CARE TEAM PHY SICIAN” MEANS A LICENSED PHY SICIAN WHO 11
	400	+	REGULARLY PRACTICES IN THE STATE AND WHO PROVIDE S CONSULTATION 12
	401	+	LEADERSHIP IN THE CARE OF PATIE NTS AS PART OF A PAT IENT CARE TEAM . 13
418	402
419		-	(2) ~~Acts as the physician responsible to ensure that a~~ physician assistant
420		-	~~practices~~ medicine ~~in accordance~~ with ~~this title and the regulations adopted under this title;~~
	403	+	[(o)] (Q) “Physician assistant” means an individual who is licensed under this 14
	404	+	title to practice [medicine with physician supervision] AS A PHYSICIAN ASSIS TANT. 15
421	405
422		-	(3) Ensures that a physician assistant practices within the scope of practice
423		-	of the primary supervising physician or any designated alternate supervising physician;
424		-	and Ch. 919 2024 LAWS OF MARYLAND
	406	+	[(p)] (R) “Practice as a physician assistant” means the performance of medical 16
	407	+	acts that are: 17
425	408
426		-	~~– 10 –~~
	409	+	[(1) Delegated by a supervising physician to a physician assistant; 18
427	410
428		-	(4) Ensures that a list of alternate supervising physicians is maintained at
429		-	the practice setting.]
	411	+	(2) Within the supervising physician’s scope of practice; and 19
430	412
431		-	[(s)] (T) “Public health facility” means a site where clinical public health
432		-	services are rendered under the auspices of the Department, a local health department in
433		-	a county, or the Baltimore City Health Department.
	413	+	(3) Appropriate to the physician assistant’s education, training, and 20
	414	+	experience] 21
434	415
435		-	~~[(t)]~~ (U) ~~“Starter dosage” means an amount of~~ a ~~drug sufficient to begin therapy:~~
	416	+	(1) AUTHORIZED UNDER A LI CENSE ISSUED BY THE BOARD; AND 22
436	417
437		-	(1) Of short duration of 72 hours or less; or
	418	+	(2) AUTHORIZED UNDER THE PHYSICIAN ASSISTANT’S 23
	419	+	COLLABORATION AGREEM ENT. 24
438	420
439		-	(2) Prior to obtaining a larger quantity of the drug to complete therapy.
	421	+	[(q)] (S) “Prescriptive authority” means the authority [delegated by a primary 25
	422	+	or alternate supervising physician to] OF a physician assistant to: 26
440	423
441		-	[(u) (1) “Supervision” means the responsibility of a physician to exercise
442		-	on–site supervision or immediately available direction for physician assistants performing
443		-	delegated medical acts.
	424	+	(1) Prescribe and administer controlled dangerous substances, prescription 27
	425	+	drugs, medical devices, and the oral, written, or electronic ordering of medications; and 28
444	426
445		-	(2) “Supervision” includes physician oversight of and acceptance of direct
446		-	responsibility for the patient services and care rendered by a physician assistant, including
447		-	continuous availability to the physician assistant in person, through written instructions,
448		-	or by electronic means and by designation of one or more alternate supervising physicians.]
	427	+	(2) Dispense as provided under [§ 15–302.2(b), (c), and (d)] § 15–302.1 of 29
	428	+	this title. 30
	429	+	10 SENATE BILL 167
449	430
450		-	15–103.
451	431
452		-	(a) In this section, “alternative health care system” has the meaning stated in §
453		-	1–401 of this article.
	432	+	[(r) “Primary supervising physician” means a physician who: 1
454	433
455		-	(b) (1) Subject to paragraph (2) of this subsection, an employer of a physician
456		-	assistant shall report to the Board, on the form prescribed by the Board, any termination
457		-	of employment of the physician assistant if the cause of termination is related to a quality
458		-	of care issue.
	434	+	(1) Completes a delegation agreement that meets the requirements under 2
	435	+	§§ 15–301(d) and (e) and 15–302 of this title and files a copy with the Board; 3
459	436
460		-	(2) Subject to subsection (d) of this section, a [supervising physician]
461		-	PHYSICIAN OR GROUP O F PHYSICIANS THAT DE VELOPS A COLLABORATI ON
462		-	AGREEMENT WITH A PHY SICIAN ASSISTANT or an employer of a physician assistant shall
463		-	notify the Board within 10 days of the termination of employment of the physician assistant
464		-	for reasons that would be grounds for discipline under this title.
	437	+	(2) Acts as the physician responsible to ensure that a physician assistant 4
	438	+	practices medicine in accordance with this title and the regulations adopted under this title; 5
465	439
466		-	(3) A [supervising physician and a] PHYSICIAN OR GROUP O F
467		-	PHYSICIANS THAT DEVE LOPS A COLLABORATION AGREEMENT WITH A PHY SICIAN
468		-	ASSISTANT OR THE physician assistant shall notify the Board within 10 days of the
469		-	termination of the relationship under a [delegation agreement for any reason]
470		-	COLLABORATION AGREEMENT .
471		-	WES MOORE, Governor Ch. 919
	440	+	(3) Ensures that a physician assistant practices within the scope of practice 6
	441	+	of the primary supervising physician or any designated alternate supervising physician; 7
	442	+	and 8
472	443
473		-	– 11 –
474		-	(c) Except as otherwise provided under subsections (b) and (d) of this section, a
475		-	hospital, a related institution, an alternative health care system, or an employer of a
476		-	physician assistant shall report to the Board any limitation, reduction, or other change of
477		-	the terms of employment of the physician assistant or any termination of employment of
478		-	the physician assistant for any reason that might be grounds for disciplinary action under
479		-	§ 15–314 of this title.
	444	+	(4) Ensures that a list of alternate supervising physicians is maintained at 9
	445	+	the practice setting.] 10
480	446
481		-	(d) A hospital, related institution, alternative health care system, or employer
482		-	that has reason to know that a physician assistant has committed an action or has a
483		-	condition that might be grounds for reprimand or probation of the physician assistant or
484		-	suspension or revocation of the license of the physician assistant under § 15–314 of this
485		-	title because the physician assistant is alcohol– or drug–impaired is not required to report
486		-	to the Board if:
	447	+	[(s)] (T) “Public health facility” means a site where clinical public health 11
	448	+	services are rendered under the auspices of the Department, a local health department in 12
	449	+	a county, or the Baltimore City Health Department. 13
487	450
488		-	(1) The hospital, related institution, alternative health care system, or
489		-	employer knows that the physician assistant is:
	451	+	[(t)] (U) “Starter dosage” means an amount of a drug sufficient to begin therapy: 14
490	452
491		-	(i) In an alcohol or drug treatment program that is accredited by the
492		-	Joint Commission on the Accreditation of Healthcare Organizations or is certified by the
493		-	Department; or
	453	+	(1) Of short duration of 72 hours or less; or 15
494	454
495		-	(ii) Under the care of a health care practitioner who is competent
496		-	and capable of dealing with alcoholism and drug abuse;
	455	+	(2) Prior to obtaining a larger quantity of the drug to complete therapy. 16
497	456
498		-	(2) The ~~hospital, related institution,~~ ~~alternative health care system,~~ or
499		-	~~employer is able to verify that the~~ physician ~~assistant remains in the treatment program~~
500		-	~~until discharge;~~ ~~and~~
	457	+	[(u) (1) “Supervision” means the responsibility of a physician to exercise 17
	458	+	on–site supervision or immediately available direction for physician assistants performing 18
	459	+	delegated medical acts. 19
501	460
502		-	(3) The action or condition of the physician assistant has not caused injury
503		-	to any person while the physician assistant is practicing as a licensed physician assistant.
	461	+	(2) “Supervision” includes physician oversight of and acceptance of direct 20
	462	+	responsibility for the patient services and care rendered by a physician assistant, including 21
	463	+	continuous availability to the physician assistant in person, through written instructions, 22
	464	+	or by electronic means and by designation of one or more alternate supervising physicians.] 23
504	465
505		-	(e) (1) If the physician assistant enters, or is considering entering, an alcohol
506		-	or drug treatment program that is accredited by the Joint Commission on Accreditation of
507		-	Healthcare Organizations or that is certified by the Department, the physician assistant
508		-	shall notify the hospital, related institution, alternative health care system, or employer of
509		-	the physician assistant’s decision to enter the treatment program.
	466	+	15–103. 24
510	467
511		-	(2) If the physician assistant fails to provide the notice required under
512		-	paragraph (1) of this subsection, and the hospital, related institution, alternative health
513		-	care system, or employer learns that the physician assistant has entered a treatment
514		-	program, the hospital, related institution, alternative health care system, or employer shall
515		-	report to the Board that the physician assistant has entered a treatment program and has
516		-	failed to provide the required notice.
	468	+	(a) In this section, “alternative health care system” has the meaning stated in § 25
	469	+	1–401 of this article. 26
517	470
518		-	(3) If the physician assistant is found to be noncompliant with the
519		-	treatment program’s policies and procedures while in the treatment program, the Ch. 919 2024 LAWS OF MARYLAND
	471	+	(b) (1) Subject to paragraph (2) of this subsection, an employer of a physician 27
	472	+	assistant shall report to the Board, on the form prescribed by the Board, any termination 28
	473	+	of employment of the physician assistant if the cause of termination is related to a quality 29
	474	+	of care issue. 30
520	475
521		-	– 12 –
522		-	treatment program shall notify the hospital, related institution, alternative health care
523		-	system, or employer of the physician assistant’s noncompliance.
	476	+	(2) Subject to subsection (d) of this section, a [supervising physician] 31
	477	+	PHYSICIAN OR GROUP O F PHYSICIANS THAT DE VELOPS A COLLABORATI ON 32 SENATE BILL 167 11
524	478
525		-	(4) On receipt of the notification required under paragraph (3) of this
526		-	subsection, the hospital, related institution, alternative health care system, or employer of
527		-	the physician assistant shall report the physician assistant’s noncompliance to the Board.
528	479
529		-	~~(f)~~ A ~~person is not required under this section to make any report that would be~~
530		-	~~in violation~~ of ~~any federal or State law, rule, or regulation concerning~~ the ~~confidentiality of~~
531		-	~~alcohol– and drug–abuse patient records~~.
	480	+	AGREEMENT WITH A PHY SICIAN ASSISTANT or an employer of a physician assistant shall 1
	481	+	notify the Board within 10 days of the termination of employment of the physician assistant 2
	482	+	for reasons that would be grounds for discipline under this title. 3
532	483
533		-	(g) The hospital, related institution, alternative health care system, or employer
534		-	shall submit the report within 10 days of any action described in this section.
	484	+	(3) A [supervising physician and a] PHYSICIAN OR GROUP O F 4
	485	+	PHYSICIANS THAT DEVE LOPS A COLLABORATION AGREEMENT WITH A PHY SICIAN 5
	486	+	ASSISTANT OR THE physician assistant shall notify the Board within 10 days of the 6
	487	+	termination of the relationship under a [delegation agreement for any reason] 7
	488	+	COLLABORATION AGREEM ENT. 8
535	489
536		-	(h) A report under this section is not subject to subpoena or discovery in any civil
537		-	action other than a proceeding arising out of a hearing and decision of the Board or a
538		-	disciplinary panel under this title.
	490	+	(c) Except as otherwise provided under subsections (b) and (d) of this section, a 9
	491	+	hospital, a related institution, an alternative health care system, or an employer of a 10
	492	+	physician assistant shall report to the Board any limitation, reduction, or other change of 11
	493	+	the terms of employment of the physician assistant or any termination of employment of 12
	494	+	the physician assistant for any reason that might be grounds for disciplinary action under 13
	495	+	§ 15–314 of this title. 14
539	496
540		-	(i) (1) A disciplinary panel may impose a civil penalty of up to $1,000 for
541		-	failure to report under this section.
	497	+	(d) A hospital, related institution, alternative health care system, or employer 15
	498	+	that has reason to know that a physician assistant has committed an action or has a 16
	499	+	condition that might be grounds for reprimand or probation of the physician assistant or 17
	500	+	suspension or revocation of the license of the physician assistant under § 15–314 of this 18
	501	+	title because the physician assistant is alcohol– or drug–impaired is not required to report 19
	502	+	to the Board if: 20
542	503
543		-	(2) The ~~Board shall pay any fees collected under this subsection into the~~
544		-	~~General Fund of~~ the ~~State.~~
	504	+	(1) The hospital, related institution, alternative health care system, or 21
	505	+	employer knows that the physician assistant is: 22
545	506
546		-	(j) An employer shall make the report required under this section to the Board
547		-	within 5 days after the date of termination of employment.
	507	+	(i) In an alcohol or drug treatment program that is accredited by the 23
	508	+	Joint Commission on the Accreditation of Healthcare Organizations or is certified by the 24
	509	+	Department; or 25
548	510
549		-	(k) The Board shall adopt regulations to implement the provisions of this section.
	511	+	(ii) Under the care of a health care practitioner who is competent 26
	512	+	and capable of dealing with alcoholism and drug abuse; 27
550	513
551		-	15–202.
	514	+	(2) The hospital, related institution, alternative health care system, or 28
	515	+	employer is able to verify that the physician assistant remains in the treatment program 29
	516	+	until discharge; and 30
552	517
553		-	(a) (1) The Committee shall consist of 7 members appointed by the Board.
	518	+	(3) The action or condition of the physician assistant has not caused injury 31
	519	+	to any person while the physician assistant is practicing as a licensed physician assistant. 32
554	520
555		-	(2) Of the 7 Committee members:
	521	+	(e) (1) If the physician assistant enters, or is considering entering, an alcohol 33
	522	+	or drug treatment program that is accredited by the Joint Commission on Accreditation of 34
	523	+	Healthcare Organizations or that is certified by the Department, the physician assistant 35
	524	+	shall notify the hospital, related institution, alternative health care system, or employer of 36
	525	+	the physician assistant’s decision to enter the treatment program. 37 12 SENATE BILL 167
556	526
557		-	(i) 3 shall be licensed physicians;
558	527
559		-	(ii) 3 shall be licensed physician assistants; and
560	528
561		-	(iii) 1 shall be a consumer.
	529	+	(2) If the physician assistant fails to provide the notice required under 1
	530	+	paragraph (1) of this subsection, and the hospital, related institution, alternative health 2
	531	+	care system, or employer learns that the physician assistant has entered a treatment 3
	532	+	program, the hospital, related institution, alternative health care system, or employer shall 4
	533	+	report to the Board that the physician assistant has entered a treatment program and has 5
	534	+	failed to provide the required notice. 6
562	535
563		-	(b) Of the three physician members of the Committee, two shall [be previously or
564		-	currently serving as supervising physicians of a physician assistant under a
565		-	Board–approved delegation agreement] HAVE DEVELOPED A COL LABORATION
566		-	CURRENTLY SERVING AS A PATIENT CARE TEAM PHYSICIAN UNDER A
567		-	COLLABORATION AGREEMENT WITH A PHY SICIAN ASSISTANT . WES MOORE, Governor Ch. 919
	536	+	(3) If the physician assistant is found to be noncompliant with the 7
	537	+	treatment program’s policies and procedures while in the treatment program, the 8
	538	+	treatment program shall notify the hospital, related institution, alternative health care 9
	539	+	system, or employer of the physician assistant’s noncompliance. 10
568	540
569		-	– 13 –
	541	+	(4) On receipt of the notification required under paragraph (3) of this 11
	542	+	subsection, the hospital, related institution, alternative health care system, or employer of 12
	543	+	the physician assistant shall report the physician assistant’s noncompliance to the Board. 13
570	544
571		-	15–205.
	545	+	(f) A person is not required under this section to make any report that would be 14
	546	+	in violation of any federal or State law, rule, or regulation concerning the confidentiality of 15
	547	+	alcohol– and drug–abuse patient records. 16
572	548
573		-	(a) ~~In addition to~~ the ~~powers set forth elsewhere in this title~~, ~~the Committee~~, on
574		-	~~its initiative or on~~ the ~~Board’s request,~~ ~~may:~~
	549	+	(g) The hospital, related institution, alternative health care system, or employer 17
	550	+	shall submit the report within 10 days of any action described in this section. 18
575	551
576		-	(1) Recommend to the Board regulations for carrying out the provisions of
577		-	this title;
	552	+	(h) A report under this section is not subject to subpoena or discovery in any civil 19
	553	+	action other than a proceeding arising out of a hearing and decision of the Board or a 20
	554	+	disciplinary panel under this title. 21
578	555
579		-	(2) ~~Recommend~~ to ~~the Board approval,~~ ~~modification, or disapproval of an~~
580		-	~~application for licensure [or~~ ~~a delegation agreement];~~
	556	+	(i) (1) A disciplinary panel may impose a civil penalty of up to $1,000 for 22
	557	+	failure to report under this section. 23
581	558
582		-	(3) Report to the Board any conduct of a [supervising physician]
583		-	PHYSICIAN OR GROUP O F PHYSICIANS WHO DEVELOPS A COLLA BORATION
584		-	AGREEMENT WITH A PHY SICIAN ASSISTANT or a physician assistant that may be cause
585		-	for disciplinary action under this title or under § 14–404 of this article; and
	559	+	(2) The Board shall pay any fees collected under this subsection into the 24
	560	+	General Fund of the State. 25
586	561
587		-	(4) Report to the Board ~~any alleged unauthorized practice of a physician~~
588		-	~~assistant~~.
	562	+	(j) An employer shall make the report required under this section to the Board 26
	563	+	within 5 days after the date of termination of employment. 27
589	564
590		-	~~15–301~~.
	565	+	(k) The Board shall adopt regulations to implement the provisions of this section. 28
591	566
592		-	(a) [Nothing in this] THIS title may NOT be construed to authorize a physician
593		-	assistant to practice [independent of a primary or alternate supervising physician]
594		-	INDEPENDENTLY .
	567	+	15–202. 29
595	568
596		-	(b) A license issued to a physician assistant shall limit the physician assistant’s
597		-	scope of practice to medical acts:
	569	+	(a) (1) The Committee shall consist of 7 members appointed by the Board. 30
598	570
599		-	[(1) ~~Delegated by~~ the ~~primary or alternate supervising physician;]~~
	571	+	(2) Of the 7 Committee members: 31
600	572
601		-	~~[(2)]~~ (1) ~~Appropriate to the education,~~ ~~training, and experience of the~~
602		-	~~physician assistant;~~
	573	+	(i) 3 shall be licensed physicians; 32
	574	+	SENATE BILL 167 13
603	575
604		-	[(3)] (2) Customary to the practice of the [primary or alternate
605		-	supervising] physician; and
606	576
607		-	(2) CUSTOMARY TO THE PRAC TICE OF A PATIENT CA RE TEAM
608		-	PHYSICIAN; AND
	577	+	(ii) 3 shall be licensed physician assistants; and 1
609	578
610		-	[(4)] (3) Consistent with the [delegation] COLLABORATION agreement
611		-	filed with the Board.
	579	+	(iii) 1 shall be a consumer. 2
612	580
613		-	(3) IN A MANNER CONSISTENT WITH THE COLLABORATI ON
614		-	AGREEMENT . Ch. 919 2024 LAWS OF MARYLAND
	581	+	(b) Of the three physician members of the Committee, two shall [be previously or 3
	582	+	currently serving as supervising physicians of a physician assistant under a 4
	583	+	Board–approved delegation agreement] HAVE DEVELOPED A COL LABORATION 5
	584	+	CURRENTLY SERVING AS A PATIENT CA RE TEAM PHYSICIAN UN DER A 6
	585	+	COLLABORATION AGREEMENT WITH A PHY SICIAN ASSISTANT . 7
615	586
616		-	– ~~14 –~~
	587	+	15–205. 8
617	588
618		-	(c) ~~Patient services that may be provided by a physician assistant UNDER A~~
619		-	~~COLLABORATION AGREEM ENT include~~:
	589	+	(a) In addition to the powers set forth elsewhere in this title, the Committee, on 9
	590	+	its initiative or on the Board’s request, may: 10
620	591
621		-	[(1) (i) Taking complete, detailed, and accurate patient histories; and
	592	+	(1) Recommend to the Board regulations for carrying out the provisions of 11
	593	+	this title; 12
622	594
623		-	(ii) ~~Reviewing patient records~~ to ~~develop comprehensive medical~~
624		-	~~status reports~~;
	595	+	(2) Recommend to the Board approval, modification, or disapproval of an 13
	596	+	application for licensure [or a delegation agreement]; 14
625	597
626		-	(2) Performing physical examinations and recording all pertinent patient
627		-	data;
	598	+	(3) Report to the Board any conduct of a [supervising physician] 15
	599	+	PHYSICIAN OR GROUP OF PHY SICIANS WHO DEVELOPS A COLLA BORATION 16
	600	+	AGREEMENT WITH A PHY SICIAN ASSISTANT or a physician assistant that may be cause 17
	601	+	for disciplinary action under this title or under § 14–404 of this article; and 18
628	602
629		-	(3) Interpreting and evaluating patient data as authorized by the primary
630		-	or alternate supervising physician for the purpose of determining management and
631		-	treatment of patients;
	603	+	(4) Report to the Board any alleged unauthorized practice of a physician 19
	604	+	assistant. 20
632	605
633		-	(4) Initiating requests for or performing diagnostic procedures as indicated
634		-	by pertinent data and as authorized by the supervising physician;
	606	+	15–301. 21
635	607
636		-	(5) Providing instructions and guidance regarding medical care matters to
637		-	patients;
	608	+	(a) [Nothing in this] THIS title may NOT be construed to authorize a physician 22
	609	+	assistant to practice [independent of a primary or alternate supervising physician] 23
	610	+	INDEPENDENTLY . 24
638	611
639		-	(6) Assisting the primary or alternate supervising physician in the delivery
640		-	of services to patients who require medical care in the home and in health care institutions,
641		-	including:
	612	+	(b) A license issued to a physician assistant shall limit the physician assistant’s 25
	613	+	scope of practice to medical acts: 26
642	614
643		-	(i) ~~Recording patient progress notes~~;
	615	+	[(1) Delegated by the primary or alternate supervising physician;] 27
644	616
645		-	(ii) Issuing diagnostic orders; and
	617	+	[(2)] (1) Appropriate to the education, training, and experience of the 28
	618	+	physician assistant; 29
646	619
647		-	(iii) Transcribing or executing specific orders at the direction of the
648		-	primary or alternate supervising physician; and
	620	+	[(3)] (2) Customary to the practice of the [primary or alternate 30
	621	+	supervising] physician; and 31
	622	+	14 SENATE BILL 167
649	623
650		-	(7) Exercising prescriptive authority under a delegation agreement and in
651		-	accordance with § 15–302.2 of this subtitle.]
652	624
653		-	(1) OBTAINING COMPREHENSI VE HEALTH HISTORIES ;
	625	+	(2) CUSTOMARY TO THE PRAC TICE OF A PATIENT CA RE TEAM 1
	626	+	PHYSICIAN; AND 2
654	627
655		-	(2) PERFORMING PHYSICAL E XAMINATIONS ;
	628	+	[(4)] (3) Consistent with the [delegation] COLLABORATION agreement 3
	629	+	filed with the Board. 4
656	630
657		-	(3) ~~EVALUATING, DIAGNOSING,~~ ~~MANAGING, AND PROVIDING~~
658		-	~~MEDICAL TREATMENT ;~~
	631	+	(3) IN A MANNER CONSISTEN T WITH THE COLLABORA TION 5
	632	+	AGREEMENT . 6
659	633
660		-	(4) ~~ORDERING, PERFORMING , AND INTERPRETING DIA GNOSTIC~~
661		-	~~STUDIES, THERAPEUTIC PROCEDUR ES,~~ ~~AND LABORATORY TESTS ; WES MOORE, Governor Ch. 919~~
	634	+	(c) Patient services that may be provided by a physician assistant UNDER A 7
	635	+	COLLABORATION AGREEM ENT include: 8
662	636
663		-	~~– 15 –~~
	637	+	[(1) (i) Taking complete, detailed, and accurate patient histories; and 9
664	638
665		-	(5) ~~ORDERING DIAGNOSTIC T ESTS AND USING THE F INDINGS OR~~
666		-	~~RESULTS IN THE CARE OF PATIENTS~~;
	639	+	(ii) Reviewing patient records to develop comprehensive medical 10
	640	+	status reports; 11
667	641
668		-	(4) INTERPRETING AND EVAL UATING PATIENT DATA AS AUTHORIZED
669		-	BY A PATIENT CARE TE AM PHYSICIAN FOR THE PURPOSE OF DETERMINI NG
670		-	MANAGEMENT AND TREAT MENT OF PATIENTS ;
	642	+	(2) Performing physical examinations and recording all pertinent patient 12
	643	+	data; 13
671	644
672		-	(5) ~~INITIATING REQUESTS F OR OR PERFORMING DIA GNOSTIC~~
673		-	~~PROCEDURES AS INDICA TED BY PERTINENT DAT A~~ AND ~~AS AUTHORIZED BY A~~
674		-	~~PATIENT CARE TEAM PH YSICIAN~~;
	645	+	(3) Interpreting and evaluating patient data as authorized by the primary 14
	646	+	or alternate supervising physician for the purpose of determining management and 15
	647	+	treatment of patients; 16
675	648
676		-	(6) ~~EXERCISING PRESCRIPTI VE AUTHORITY IN ACCO RDANCE WITH §~~
677		-	~~15–302.1 15–302.2 OF THIS SUBTITLE~~;
	649	+	(4) Initiating requests for or performing diagnostic procedures as indicated 17
	650	+	by pertinent data and as authorized by the supervising physician; 18
678	651
679		-	(7) ~~INFORMING PATIENTS AB OUT HEALTH PROMOTION~~ AND ~~DISEASE~~
680		-	~~PREVENTION~~ ;
	652	+	(5) Providing instructions and guidance regarding medical care matters to 19
	653	+	patients; 20
681	654
682		-	(8) PROVIDING CONSULTATIO NS;
	655	+	(6) Assisting the primary or alternate supervising physician in the delivery 21
	656	+	of services to patients who require medical care in the home and in health care institutions, 22
	657	+	including: 23
683	658
684		-	(9) ~~WRITING MEDICAL ORDER S~~;
	659	+	(i) Recording patient progress notes; 24
685	660
686		-	(10) PROVIDING SERVICES IN HEALTH CARE FACILITI ES, INCLUDING
687		-	HOSPITALS, NURSING FACILITIES , ASSISTED LIVING FACI LITIES, AND HOSPICE
688		-	FACILITIES;
	661	+	(ii) Issuing diagnostic orders; and 25
689	662
690		-	(11) (10) OBTAINING INFORMED CO NSENT;
	663	+	(iii) Transcribing or executing specific orders at the direction of the 26
	664	+	primary or alternate supervising physician; and 27
691	665
692		-	(12) DELEGATING OR ASSIGNI NG THERAPEUTIC AND DIAG NOSTIC
693		-	MEASURES TO BE PERFO RMED BY LICENSED OR UNLICENSED PERSONNEL AND
694		-	SUPERVISING LICENSED OR UNLICENSED PERSON NEL PERFORMING THERA PEUTIC
695		-	AND DIAGNOSTIC MEASU RES;
	666	+	(7) Exercising prescriptive authority under a delegation agreement and in 28
	667	+	accordance with § 15–302.2 of this subtitle.] 29
696	668
697		-	(11) DELEGATING MEDICAL AC TS TO LICENSED OR UN LICENSED
698		-	PERSONNEL AS AUTHORIZED UNDER § 14–306 OF THIS ARTICLE IF T HE PHYSICIAN
699		-	ASSISTANT HAS AT LEA ST 7,000 HOURS OF CLINICAL PR ACTICE EXPERIENCE ; AND
	669	+	(1) OBTAINING COMPREHENSI VE HEALTH HISTORIES ; 30
	670	+	SENATE BILL 167 15
700	671
701		-	(13) (12) CERTIFYING A PATIENT ’S HEALTH OR DISABILI TY AS
702		-	REQUIRED BY A FEDERA L, STATE, OR LOCAL PROGRAM ; AND
703	672
704		-	(14) AUTHENTICATING ANY DO CUMENT THAT A PHYSIC IAN MAY
705		-	AUTHENTICATE THROUGH SIGNATURE, CERTIFICATION , STAMP VERIFICATION ,
706		-	AFFIDAVIT, OR ENDORSEMENT .
707		-	Ch. 919 2024 LAWS OF MARYLAND
	673	+	(2) PERFORMING PHYSICAL E XAMINATIONS ; 1
708	674
709		-	– 16 –
710		-	(d) (1) Except as otherwise provided in this title, an individual shall be
711		-	licensed by the Board before the individual may practice as a physician assistant.
	675	+	(3) EVALUATING, DIAGNOSING, MANAGING, AND PROVIDING 2
	676	+	MEDICAL TREAT MENT; 3
712	677
713		-	(2) Except as otherwise provided in this title, a physician may not
714		-	[supervise] ENTER INTO A COLLABO RATION COLLABORATE WITH a physician assistant
715		-	in the performance of [delegated] medical acts without filing NOTIFYING THE BOARD OF
716		-	a completed [delegation] COLLABORATION agreement with the Board.
	678	+	(4) ORDERING, PERFORMING , AND INTERPRETING DIA GNOSTIC 4
	679	+	STUDIES, THERAPEUTIC PROCEDUR ES, AND LABORATORY TESTS ; 5
717	680
718		-	(3) ~~Except as otherwise provided in this title~~ or ~~in a medical emergency, a~~
719		-	~~physician assistant may not perform any medical act for which:~~
	681	+	(5) ORDERING DIAGNOSTIC T ESTS AND USING THE F INDINGS OR 6
	682	+	RESULTS IN THE CARE OF PATIENTS; 7
720	683
721		-	(i) The FOR WHICH THE individual has not been licensed; and
	684	+	(4) INTERPRETING AND EVAL UATING PATIENT DATA AS AUTHORIZED 8
	685	+	BY A PATIENT CARE TE AM PHYSICIAN FOR THE PURPOSE OF DETERMINI NG 9
	686	+	MANAGEMENT AND TREAT MENT OF PATIENTS ; 10
722	687
723		-	(ii) ~~[The medical acts have not been delegated by a primary~~ or
724		-	~~alternate supervising physician]~~ ~~THE INDIVIDUAL HAS NO T RECEIVED APPROPRIA TE~~
725		-	~~EDUCATION, TRAINING,~~ ~~AND EXPERIENCE~~
	688	+	(5) INITIATING REQUESTS F OR OR PERFORMING DIA GNOSTIC 11
	689	+	PROCEDURES AS INDICA TED BY PERTINENT DAT A AND AS AUTHORIZED BY A 12
	690	+	PATIENT CARE TEAM PH YSICIAN; 13
726	691
727		-	(II) ~~THAT HAS NOT BEEN DEL EGATED~~ IN ~~A MANNER~~
728		-	~~CONSISTENT WITH THE COLLABORATION AGREEM ENT~~;
	692	+	(6) EXERCISING PRESCRIPTI VE AUTHORITY IN ACCO RDANCE WITH § 14
	693	+	15–302.1 15–302.2 OF THIS SUBTITLE; 15
729	694
730		-	(~~III~~) ~~THAT IS NOT APPROPRIA TE TO THE EDUCATION , TRAINING,~~
731		-	~~AND EXPERIENCE OF TH E PHYSICIAN ASSISTAN T~~; ~~AND~~
	695	+	(7) INFORMING PATIENTS ABOUT HE ALTH PROMOTION AND D ISEASE 16
	696	+	PREVENTION ; 17
732	697
733		-	(IV) THAT IS NOT CUSTOMARY TO THE PRACTICE OF A PATIENT
734		-	CARE TEAM PHYSICIAN L ISTED ON THE COLLABO RATION AGREEMENT .
	698	+	(8) PROVIDING CONSULTATIO NS; 18
735	699
736		-	[(e) A physician assistant is the agent of the primary or alternate supervising
737		-	physician in the performance of all practice–related activities, including the oral, written,
738		-	or electronic ordering of diagnostic, therapeutic, and other medical services.]
	700	+	(9) WRITING MEDICAL ORDER S; 19
739	701
740		-	(E) ~~A PHYSICIAN ASSISTANT SHALL CONSULT AND CO LLABORATE WITH OR~~
741		-	~~REFER AN INDIVIDUAL TO AN APPROPRIATE LI CENSED PHYSICIAN OR ANY OTHER~~
742		-	~~HEALTH CARE PROVIDER AS APPROPRIATE .~~
	702	+	(10) PROVIDING SERVICES IN HEALTH CARE FACILITI ES, INCLUDING 20
	703	+	HOSPITALS, NURSING FACILITIES , ASSISTED LIVING FACI LITIES, AND HOSPICE 21
	704	+	FACILITIES; 22
743	705
744		-	(F) A PHYSICIAN ASSISTANT WHO HAS NO T BEEN PREVIOUSLY LI CENSED BY
745		-	THE BOARD TO PRACTICE AS A PHYSICIAN ASSISTAN T OR LICENSED, CERTIFIED, OR
746		-	REGISTERED AS A PHYS ICIAN ASSISTANT BY A NOTHER STATE REGULAT ORY
747		-	AUTHORITY SHALL BE M ENTORED BY A LICENSE D PHYSICIAN OR PHYSI CIANS WHO
748		-	ARE IDENTIFIED IN AN INITIAL COLLABORATIO N AGREEMENT TO CONSU LT AND
749		-	COLLABORATE WITH THE PHYSICIAN ASSISTANT FOR AT LEAST 18 MONTHS AFTER
750		-	THE DATE AN INITIAL COLLABORATION AGREEM ENT IS SUBMITTED TO THE BOARD.
	706	+	(11) (10) OBTAINING INFORMED CO NSENT; 23
751	707
752		-	[(f)] (G) Except as OTHERWISE provided in [subsection (g) of this section] THIS
753		-	TITLE, the following individuals may practice as a physician assistant without a license: WES MOORE, Governor Ch. 919
	708	+	(12) DELEGATING OR ASSIGNI NG THERAPEUTIC AND D IAGNOSTIC 24
	709	+	MEASURES TO BE PERFO RMED BY LICENSED OR UNLICENSED PERSONNEL AND 25
	710	+	SUPERVISING LICENSED OR UNLICENSED PERSON NEL PERFORMING THERA PEUTIC 26
	711	+	AND DIAGNO STIC MEASURES ; 27
754	712
755		-	– 17 –
	713	+	(11) DELEGATING MEDICAL AC TS TO LICENSED OR UN LICENSED 28
	714	+	PERSONNEL AS AUTHORI ZED UNDER § 14–306 OF THIS ARTICLE IF T HE PHYSICIAN 29
	715	+	ASSISTANT HAS AT LEA ST 7,000 HOURS OF CLINICAL PR ACTICE EXPERIENCE ; AND 30
	716	+	16 SENATE BILL 167
756	717
757		-	(1) A physician assistant student enrolled in a physician assistant
758		-	educational program that is accredited by the Accreditation Review Commission on
759		-	Education for the Physician Assistant or its successor and approved by the Board; or
760	718
761		-	(2) A ~~physician assistant employed in the service of the federal government~~
762		-	~~while performing duties incident to that employment.~~
	719	+	(13) (12) CERTIFYING A PATIENT ’S HEALTH OR DISABILITY AS 1
	720	+	REQUIRED BY A FEDERA L, STATE, OR LOCAL PROGRAM ; AND 2
763	721
764		-	[(g) A ~~physician~~ may ~~not delegate prescriptive authority to a physician assistant~~
765		-	~~student in a training program that is accredited by the Accreditation Review Commission~~
766		-	~~on Education for the Physician Assistant~~ or ~~its successor~~.]
	722	+	(14) AUTHENTICATING ANY DO CUMENT THAT A PHYSIC IAN MAY 3
	723	+	AUTHENTICATE THROUGH SIGNATURE, CERTIFICATION , STAMP VERIFICATION , 4
	724	+	AFFIDAVIT, OR ENDORSEMENT . 5
767	725
768		-	(h) (G) (1) If a medical act that is to be [delegated] PERFORMED BY A
769		-	PHYSICIAN ASSISTANT under this section is a part of the practice of a health occupation
770		-	that is regulated under this article by another board, any rule or regulation concerning that
771		-	medical act shall be adopted jointly by the State Board of Physicians and the board that
772		-	regulates the other health occupation.
	726	+	(d) (1) Except as otherwise provided in this title, an individual shall be 6
	727	+	licensed by the Board before the individual may practice as a physician assistant. 7
773	728
774		-	(2) If the two boards cannot agree on a proposed rule or regulation, the
775		-	proposal shall be submitted to the Secretary for a final decision.
	729	+	(2) Except as otherwise provided in this title, a physician may not 8
	730	+	[supervise] ENTER INTO A COLLABO RATION COLLABORATE WITH a physician assistant 9
	731	+	in the performance of [delegated] medical acts without filing NOTIFYING THE BOARD OF 10
	732	+	a completed [delegation] COLLABORATION agreement with the Board. 11
776	733
777		-	15–302.
	734	+	(3) Except as otherwise provided in this title or in a medical emergency, a 12
	735	+	physician assistant may not perform any medical act for which: 13
778	736
779		-	(a) ~~A physician [may~~ ~~delegate medical acts to a physician assistant only after:~~
	737	+	(i) The FOR WHICH THE individual has not been licensed; and 14
780	738
781		-	(1) A delegation agreement has been executed and filed with the Board;
782		-	and
	739	+	(ii) [The medical acts have not been delegated by a primary or 15
	740	+	alternate supervising physician] THE INDIVIDUAL HAS NO T RECEIVED APPROPRIA TE 16
	741	+	EDUCATION, TRAINING, AND EXPERIENCE 17
783	742
784		-	(2) Any advanced duties have been authorized as required under
785		-	subsection (c) of this section] ASSISTANT MAY PRACTI CE AS A PHYSICIAN AS SISTANT
786		-	ONLY AFTER SUBMITTING A COLLABO RATION AGREEMENT TO THE BOARD
787		-	PROVIDING NOTICE TO THE BOARD, IN A MANNER APPROVED BY THE BOARD, OF:
	743	+	(II) THAT HAS NOT BEEN DEL EGATED IN A MANNER 18
	744	+	CONSISTENT WITH THE COLLABORATION AGREEM ENT; 19
788	745
789		-	(1) THE EXECUTED COLLABOR ATION AGREEMENT ; AND
	746	+	(III) THAT IS NOT APPROPRIA TE TO THE EDUCATION , TRAINING, 20
	747	+	AND EXPERIENCE OF TH E PHYSICIAN ASSISTAN T; AND 21
790	748
791		-	(2) ~~EACH PATIEN T CARE TEAM PHYSICIA N LISTED ON~~ THE
792		-	~~COLLABORATION AGREEM ENT~~.
	749	+	(IV) THAT IS NOT CUSTOMARY TO THE PRACTICE OF A PATIENT 22
	750	+	CARE TEAM PHYSICIAN LISTED ON THE COLLAB ORATION AGREEMENT . 23
793	751
794		-	(b) (1) [The delegation agreement] SUBJECT TO PARAGRAPH (2) OF THIS
795		-	SUBSECTION, A A COLLABORATION AGREEM ENT shall contain:
	752	+	[(e) A physician assistant is the agent of the primary or alternate supervising 24
	753	+	physician in the performance of all practice–related activities, including the oral, written, 25
	754	+	or electronic ordering of diagnostic, therapeutic, and other medical services.] 26
796	755
797		-	[(1)] (I) A description of the qualifications of the [primary supervising
798		-	physician and] PHYSICIAN ASSISTANT AND THE PHYSICIAN OR GROUP O F PHYSICIANS
799		-	WHO DEVELOPED THE CO LLABORATION AGREEMEN T WITH THE physician assistant;
800		-	Ch. 919 2024 LAWS OF MARYLAND
	756	+	(E) A PHYSICIAN ASSISTANT SHALL CONSULT AND CO LLABORATE WITH O R 27
	757	+	REFER AN INDIVIDUAL TO AN APPROPRIATE LI CENSED PHYSICIAN OR ANY OTHER 28
	758	+	HEALTH CARE PROVIDER AS APPROPRIATE . 29
801	759
802		-	– 18 –
803		-	(II) ANY PRACTICE SPECIALT Y OF THE PHYSICIAN O R GROUP OF
804		-	PHYSICIANS; AND
	760	+	(F) A PHYSICIAN ASSISTANT WHO HAS NOT BEEN PRE VIOUSLY LICENSED BY 30
	761	+	THE BOARD TO PRACTICE AS A PHYSICIAN ASSISTAN T OR LICENSED, CERTIFIED, OR 31
	762	+	REGISTERED AS A PHYS ICIAN ASSISTANT BY A NOTHER STATE REGULAT ORY 32
	763	+	AUTHORITY SHALL BE M ENTORED BY A LICENSE D PHYSICIAN OR PHYSI CIANS WHO 33 SENATE BILL 167 17
805	764
806		-	[(2)] (III) A description of the settings in which the physician assistant will
807		-	practice[;
808	765
809		-	(3) A description of the continuous physician supervision mechanisms that
810		-	are reasonable and appropriate to the practice setting;
	766	+	ARE IDENTIFIED IN AN INITIAL COLLABORATIO N AGREEMENT TO CONSU LT AND 1
	767	+	COLLABORATE WITH THE PHYSICIAN ASSISTANT FOR AT LEAST 18 MONTHS AFTER 2
	768	+	THE DATE AN INITIAL COLLABORATION AGREEM ENT IS SUBMITTED TO THE BOARD. 3
811	769
812		-	(4) A description of the delegated medical acts that are within the primary
813		-	or alternate supervising physician’s scope of practice and require specialized education or
814		-	training that is consistent with accepted medical practice;
	770	+	[(f)] (G) Except as OTHERWISE provided in [subsection (g) of this section] THIS 4
	771	+	TITLE, the following individuals may practice as a physician assistant without a license: 5
815	772
816		-	(5) ~~An attestation that all medical acts to be delegated to the~~ physician
817		-	~~assistant are within~~ the ~~scope of practice of the primary or alternate supervising physician~~
818		-	~~and appropriate to~~ the physician assistant~~’s education,~~ ~~training,~~ and ~~level of competence~~;
	773	+	(1) A physician assistant student enrolled in a physician assistant 6
	774	+	educational program that is accredited by the Accreditation Review Commission on 7
	775	+	Education for the Physician Assistant or its successor and approved by the Board; or 8
819	776
820		-	(6) An attestation of continuous supervision of the physician assistant by
821		-	the primary supervising physician through the mechanisms described in the delegation
822		-	agreement;
	777	+	(2) A physician assistant employed in the service of the federal government 9
	778	+	while performing duties incident to that employment. 10
823	779
824		-	(7) An attestation by the primary supervising physician of the physician’s
825		-	acceptance of responsibility for any care given by the physician assistant;
	780	+	[(g) A physician may not delegate prescriptive authority to a physician assistant 11
	781	+	student in a training program that is accredited by the Accreditation Review Commission 12
	782	+	on Education for the Physician Assistant or its successor.] 13
826	783
827		-	(8) A description prepared by the primary supervising physician of the
828		-	process by which the physician assistant’s practice is reviewed appropriate to the practice
829		-	setting and consistent with current standards of acceptable medical practice;
	784	+	(h) (G) (1) If a medical act that is to be [delegated] PERFORMED BY A 14
	785	+	PHYSICIAN ASSISTANT under this section is a part of the practice of a health occupation 15
	786	+	that is regulated under this article by another board, any rule or regulation concerning that 16
	787	+	medical act shall be adopted jointly by the State Board of Physicians and the board that 17
	788	+	regulates the other health occupation. 18
830	789
831		-	(9) ~~An attestation by~~ the ~~primary supervising physician that~~ the ~~physician~~
832		-	~~will respond in~~ a ~~timely manner when contacted by the physician assistant;~~
	790	+	(2) If the two boards cannot agree on a proposed rule or regulation, the 19
	791	+	proposal shall be submitted to the Secretary for a final decision. 20
833	792
834		-	(10) The following statement: “The primary supervising physician and the
835		-	physician assistant attest that:
	793	+	15–302. 21
836	794
837		-	(i) They will establish a plan for the types of cases that require a
838		-	physician plan of care or require that the patient initially or periodically be seen by the
839		-	supervising physician; and
	795	+	(a) A physician [may delegate medical acts to a physician assistant only after: 22
840	796
841		-	(ii) The ~~patient will be provided access to the supervising physician~~
842		-	~~on request”;~~ and
	797	+	(1) A delegation agreement has been executed and filed with the Board; 23
	798	+	and 24
843	799
844		-	(11) Any other information deemed necessary by the Board to carry out the
845		-	provisions of this subtitle].
846		-	WES MOORE, Governor Ch. 919
	800	+	(2) Any advanced duties have been authorized as required under 25
	801	+	subsection (c) of this section] ASSISTANT MAY PRACTI CE AS A PHYSICIAN AS SISTANT 26
	802	+	ONLY AFTER SUBMITTING A COLLABO RATION AGREEMENT TO THE BOARD 27
	803	+	PROVIDING NOTICE TO THE BOARD, IN A MANNER APPROVED BY THE BOARD, OF: 28
847	804
848		-	– 19 –
849		-	(2) IF A PHYSICIAN ASSIST ANT WHO SUBMITS AN I NITIAL
850		-	COLLABORATION AGREEM ENT TO THE BOARD HAS NOT BEEN PR EVIOUSLY
851		-	LICENSED BY THE BOARD TO PRACTICE AS A PHYSICIAN ASSISTAN T OR LICENSED,
852		-	CERTIFIED, OR REGISTERED AS A P HYSICIAN ASSISTANT B Y ANOTHER STATE
853		-	REGULATORY AUTHORITY , THE INITIAL COLLABOR ATION AGREEMENT SHAL L
854		-	IDENTIFY A LICENSED PHYSICIAN OR PHYSICI ANS WHO WILL CONSULT AND
855		-	COLLABORATE WITH THE PHYSICIAN ASSISTANT FOR AT LEAST 18 MONTHS AFTER
856		-	THE DATE THE INITIAL COLLABORATION AGREEM ENT IS SUBMITTED TO THE BOARD.
	805	+	(1) THE EXECUTED COLLABOR ATION AGREEMENT ; AND 29
857	806
858		-	(3) (2) A COLLABORATION AGREEM ENT MAY INCLUDE PROV ISIONS
859		-	LIMITING THE PHYSICI AN ASSISTANT’S SCOPE OF PRACTICE, SPECIFYING OFFICE
860		-	PROCEDURES , OR OTHERWISE DETAILI NG THE PRACTICE OF T HE PHYSICIAN
861		-	ASSISTANT AS AGREED BY THE PHYSICIAN OR GROUP OF PHYSICIANS AND THE
862		-	PHYSICIAN ASSISTANT .
	807	+	(2) EACH PATIENT CARE TEA M PHYSICIAN LISTED O N THE 30
	808	+	COLLABORATION AGREEM ENT. 31
	809	+	18 SENATE BILL 167
863	810
864		-	(c) (1) The Board may not require [prior] approval of a [delegation agreement
865		-	that includes advanced duties, if an advanced duty will be performed in a hospital or
866		-	ambulatory surgical facility, provided that:
867	811
868		-	(i) A physician, with credentials that have been reviewed by the
869		-	hospital or ambulatory surgical facility as a condition of employment, as an independent
870		-	contractor, or as a member of the medical staff, supervises the physician assistant;
	812	+	(b) (1) [The delegation agreement] SUBJECT TO PARAGRAPH (2) OF THIS 1
	813	+	SUBSECTION, A A COLLABORATION AGREEM ENT shall contain: 2
871	814
872		-	(ii) The ~~physician assistant has credentials that have been reviewed~~
873		-	by the ~~hospital~~ or ~~ambulatory surgical facility as a condition of employment, as an~~
874		-	~~independent contractor, or as a member of~~ the ~~medical staff~~; ~~and~~
	815	+	[(1)] (I) A description of the qualifications of the [primary supervising 3
	816	+	physician and] PHYSICIAN ASSISTANT AND THE PHYSICIAN OR GROUP O F PHYSICIANS 4
	817	+	WHO DEVELOPED THE CO LLABORATION AGREEMEN T WITH THE physician assistant; 5
875	818
876		-	(iii) Each advanced duty to be delegated to the physician assistant is
877		-	reviewed and approved within a process approved by the governing body of the health care
878		-	facility before the physician assistant performs the advanced duties] COLLABORATION
879		-	AGREEMENT .
	819	+	(II) ANY PRACTICE SPECIALT Y OF THE PHYSICIAN O R GROUP OF 6
	820	+	PHYSICIANS; AND 7
880	821
881		-	[(2) (i) In any setting that does not meet the requirements of paragraph
882		-	(1) of this subsection, a primary supervising physician shall obtain the Board’s approval of
883		-	a delegation agreement that includes advanced duties, before the physician assistant
884		-	performs the advanced duties.
	822	+	[(2)] (III) A description of the settings in which the physician assistant will 8
	823	+	practice[; 9
885	824
886		-	(ii) 1. Before a physician assistant may perform X–ray duties
887		-	authorized under § 14–306(e) of this article in the medical office of the physician delegating
888		-	the duties, a primary supervising physician shall obtain the Board’s approval of a
889		-	delegation agreement that includes advanced duties in accordance with subsubparagraph
890		-	2 of this subparagraph.
891		-	Ch. 919 2024 LAWS OF MARYLAND
	825	+	(3) A description of the continuous physician supervision mechanisms that 10
	826	+	are reasonable and appropriate to the practice setting; 11
892	827
893		-	– 20 –
894		-	2. The advanced duties set forth in a delegation agreement
895		-	under this subparagraph shall be limited to nonfluoroscopic X–ray procedures of the
896		-	extremities, anterior–posterior and lateral, not including the head.]
	828	+	(4) A description of the delegated medical acts that are within the primary 12
	829	+	or alternate supervising physician’s scope of practice and require specialized education or 13
	830	+	training that is consistent with accepted medical practice; 14
897	831
898		-	[(3)] (2) [Notwithstanding paragraph (1) of this subsection, a primary
899		-	supervising physician shall obtain the Board’s approval of a delegation agreement before]
900		-	A PHYSICIAN ASSISTANT SHALL SUBMIT TO THE BOARD A COLLABORATION
901		-	AGREEMENT THAT CONTA INS ANESTHESIA DUTIE S BEFORE the physician assistant
902		-	may administer, monitor, or maintain general anesthesia or neuroaxial anesthesia,
903		-	including spinal and epidural techniques, under the agreement.
	832	+	(5) An attestation that all medical acts to be delegated to the physician 15
	833	+	assistant are within the scope of practice of the primary or alternate supervising physician 16
	834	+	and appropriate to the physician assistant’s education, training, and level of competence; 17
904	835
905		-	[(d) For a delegation agreement containing advanced duties that require Board
906		-	approval, the Committee shall review the delegation agreement and recommend to the
907		-	Board that the delegation agreement be approved, rejected, or modified to ensure
908		-	conformance with the requirements of this title.
	836	+	(6) An attestation of continuous supervision of the physician assistant by 18
	837	+	the primary supervising physician through the mechanisms described in the delegation 19
	838	+	agreement; 20
909	839
910		-	(e) ~~The Committee may conduct a personal interview of~~ the primary supervising
911		-	~~physician and~~ the physician assistant.
	840	+	(7) An attestation by the primary supervising physician of the physician’s 21
	841	+	acceptance of responsibility for any care given by the physician assistant; 22
912	842
913		-	(f) ~~(1) On review~~ of the ~~Committee’s recommendation regarding a primary~~
914		-	~~supervising~~ physician’s ~~request~~ to ~~delegate advanced duties as described in a delegation~~
915		-	~~agreement, the Board:~~
	843	+	(8) A description prepared by the primary supervising physician of the 23
	844	+	process by which the physician assistant’s practice is reviewed appropriate to the practice 24
	845	+	setting and consistent with current standards of acceptable medical practice; 25
916	846
917		-	(i) May approve the delegation agreement; or
	847	+	(9) An attestation by the primary supervising physician that the physician 26
	848	+	will respond in a timely manner when contacted by the physician assistant; 27
918	849
919		-	(ii) 1. If the physician assistant does not meet the applicable
920		-	education, training, and experience requirements to perform the specified delegated acts,
921		-	may modify or disapprove the delegation agreement; and
	850	+	(10) The following statement: “The primary supervising physician and the 28
	851	+	physician assistant attest that: 29
922	852
923		-	2. If the Board takes an action under item 1 of this item:
	853	+	(i) They will establish a plan for the types of cases that require a 30
	854	+	physician plan of care or require that the patient initially or periodically be seen by the 31
	855	+	supervising physician; and 32
	856	+	SENATE BILL 167 19
924	857
925		-	A. Shall notify the primary supervising physician and the
926		-	physician assistant in writing of the particular elements of the proposed delegation
927		-	agreement that were the cause for the modification or disapproval; and
928	858
929		-	~~B. May not restrict~~ the ~~submission of an amendment~~ to the
930		-	~~delegation agreement.~~
	859	+	(ii) The patient will be provided access to the supervising physician 1
	860	+	on request”; and 2
931	861
932		-	(2) To the extent practicable, the Board shall approve a delegation
933		-	agreement or take other action authorized under this subsection within 90 days after
934		-	receiving a completed delegation agreement including any information from the physician
935		-	assistant and primary supervising physician necessary to approve or take action.]
	862	+	(11) Any other information deemed necessary by the Board to carry out the 3
	863	+	provisions of this subtitle]. 4
936	864
937		-	[(g)] (D) If the Board determines that a [primary or alternate supervising
938		-	physician] PHYSICIAN OR GROUP O F PHYSICIANS THAT DE VELOPS A WES MOORE, Governor Ch. 919
	865	+	(2) IF A PHYSICIAN ASSISTANT WHO SUBMITS AN INITI AL 5
	866	+	COLLABORATION AGREEM ENT TO THE BOARD HAS NOT BEEN PR EVIOUSLY 6
	867	+	LICENSED BY THE BOARD TO PRACTICE AS A PHYSICIAN ASSISTAN T OR LICENSED, 7
	868	+	CERTIFIED, OR REGISTERED AS A P HYSICIAN ASSISTANT B Y ANOTHER STATE 8
	869	+	REGULATORY AU THORITY, THE INITIAL COLLABOR ATION AGREEMENT SHAL L 9
	870	+	IDENTIFY A LICENSED PHYSICIAN OR PHYSICI ANS WHO WILL CONSULT AND 10
	871	+	COLLABORATE WITH THE PHYSICIAN ASSISTANT FOR AT LEAST 18 MONTHS AFTER 11
	872	+	THE DATE THE INITIAL COLLABORATION AGREEM ENT IS SUBMITTED TO THE BOARD. 12
939	873
940		-	– 21 –
941		-	COLLABORATION AGREEM ENT WITH A PHYSICIAN ASSISTANT or A physician assistant
942		-	is practicing in a manner inconsistent with the requirements of this title or Title 14 of this
943		-	article, the Board on its own initiative or on the recommendation of the Committee may
944		-	demand modification of the practice[, withdraw the approval of the delegation agreement,]
945		-	or refer the matter to a disciplinary panel for the purpose of taking other disciplinary action
946		-	under § 14–404 OF THIS ARTICLE or § 15–314 of this [article] SUBTITLE.
	874	+	(3) (2) A COLLABORATION AGREEM ENT MAY INCLUDE PROV ISIONS 13
	875	+	LIMITING THE PHYSICI AN ASSISTANT’S SCOPE OF PRACTICE , SPECIFYING OFFICE 14
	876	+	PROCEDURES , OR OTHERWISE DETAILI NG THE PRACTICE OF T HE PHYSICIAN 15
	877	+	ASSISTANT AS AGREED BY THE PHYSICIAN OR GROUP OF PHYSICI ANS AND THE 16
	878	+	PHYSICIAN ASSISTANT . 17
947	879
948		-	[(h)] (E) [A primary supervising physician may not delegate medical acts under
949		-	a delegation agreement to more than four physician assistants at any one time, except in
950		-	a] A PHYSICIAN OR GROUP O F PHYSICIANS MAY NOT ENTER INTO A COLLABORATION
951		-	AGREEMENT THAT ALLOW S FOR COLLABORATION OF MORE THAN EIGHT P HYSICIAN
952		-	ASSISTANTS FOR EACH PHYSICIAN IN THE AGR EEMENT AT ONE TIME , EXCEPT IN A
953		-	hospital or in the following nonhospital settings:
	880	+	(c) (1) The Board may not require [prior] approval of a [delegation agreement 18
	881	+	that includes advanced duties, if an advanced duty will be performed in a hospital or 19
	882	+	ambulatory surgical facility, provided that: 20
954	883
955		-	(1) A correctional facility;
	884	+	(i) A physician, with credentials that have been reviewed by the 21
	885	+	hospital or ambulatory surgical facility as a condition of employment, as an independent 22
	886	+	contractor, or as a member of the medical staff, supervises the physician assistant; 23
956	887
957		-	(2) A detention center; or
	888	+	(ii) The physician assistant has credentials that have been reviewed 24
	889	+	by the hospital or ambulatory surgical facility as a condition of employment, as an 25
	890	+	independent contractor, or as a member of the medical staff; and 26
958	891
959		-	(3) A public health facility.
	892	+	(iii) Each advanced duty to be delegated to the physician assistant is 27
	893	+	reviewed and approved within a process approved by the governing body of the health care 28
	894	+	facility before the physician assistant performs the advanced duties] COLLABORATION 29
	895	+	AGREEMENT . 30
960	896
961		-	[(i)] (F) A person may not coerce another person to enter into a [delegation]
962		-	COLLABORATION agreement under this subtitle.
	897	+	[(2) (i) In any setting that does not meet the requirements of paragraph 31
	898	+	(1) of this subsection, a primary supervising physician shall obtain the Board’s approval of 32
	899	+	a delegation agreement that includes advanced duties, before the physician assistant 33
	900	+	performs the advanced duties. 34
963	901
964		-	[(j) A physician may supervise a physician assistant:
	902	+	(ii) 1. Before a physician assistant may perform X–ray duties 35
	903	+	authorized under § 14–306(e) of this article in the medical office of the physician delegating 36 20 SENATE BILL 167
965	904
966		-	(1) As a primary supervising physician in accordance with a delegation
967		-	agreement approved by the Board under this subtitle; or
968	905
969		-	(2) As an alternate supervising physician if:
	906	+	the duties, a primary supervising physician shall obtain the Board’s approval of a 1
	907	+	delegation agreement that includes advanced duties in accordance with subsubparagraph 2
	908	+	2 of this subparagraph. 3
970	909
971		-	(i) The alternate supervising physician supervises in accordance
972		-	with a delegation agreement filed with the Board;
	910	+	2. The advanced duties set forth in a delegation agreement 4
	911	+	under this subparagraph shall be limited to nonfluoroscopic X–ray procedures of the 5
	912	+	extremities, anterior–posterior and lateral, not including the head.] 6
973	913
974		-	(ii) The alternate supervising physician supervises no more than
975		-	four physician assistants at any one time, except in a hospital, correctional facility,
976		-	detention center, or public health facility;
	914	+	[(3)] (2) [Notwithstanding paragraph (1) of this subsection, a primary 7
	915	+	supervising physician shall obtain the Board’s approval of a delegation agreement before] 8
	916	+	A PHYSICIAN ASSISTANT SHALL SUBMIT TO THE BOARD A COLLABORATION 9
	917	+	AGREEMENT THAT CONTA INS ANESTHESIA DUTIE S BEFORE the physician assistant 10
	918	+	may administer, monitor, or maintain general anesthesia or neuroaxial anesthesia, 11
	919	+	including spinal and epidural techniques, under the agreement. 12
977	920
978		-	(iii) The alternate supervising physician’s period of supervision, in
979		-	the temporary absence of the primary supervising physician, does not exceed:
	921	+	[(d) For a delegation agreement containing advanced duties that require Board 13
	922	+	approval, the Committee shall review the delegation agreement and recommend to the 14
	923	+	Board that the delegation agreement be approved, rejected, or modified to ensure 15
	924	+	conformance with the requirements of this title. 16
980	925
981		-	1. The ~~period~~ of ~~time specified in~~ the ~~delegation agreement;~~
982		-	and
	926	+	(e) The Committee may conduct a personal interview of the primary supervising 17
	927	+	physician and the physician assistant. 18
983	928
984		-	2. A period of 45 consecutive days at any one time; and
	929	+	(f) (1) On review of the Committee’s recommendation regarding a primary 19
	930	+	supervising physician’s request to delegate advanced duties as described in a delegation 20
	931	+	agreement, the Board: 21
985	932
986		-	(iv) The ~~physician assistant performs only those medical acts that: Ch. 919 2024 LAWS OF MARYLAND~~
	933	+	(i) May approve the delegation agreement; or 22
987	934
988		-	– 22 –
	935	+	(ii) 1. If the physician assistant does not meet the applicable 23
	936	+	education, training, and experience requirements to perform the specified delegated acts, 24
	937	+	may modify or disapprove the delegation agreement; and 25
989	938
990		-	1. Have been delegated under the delegation agreement filed
991		-	with the Board; and
	939	+	2. If the Board takes an action under item 1 of this item: 26
992	940
993		-	2. Are within the scope of practice of the primary supervising
994		-	physician and alternate supervising physician.]
	941	+	A. Shall notify the primary supervising physician and the 27
	942	+	physician assistant in writing of the particular elements of the proposed delegation 28
	943	+	agreement that were the cause for the modification or disapproval; and 29
995	944
996		-	[(k)] (G) Subject to the notice required under § 15–103 of this title, a physician
997		-	assistant may terminate a [delegation agreement filed with the Board under ]
998		-	COLLABORATION AGREEM ENT DEVELOPED IN ACC ORDANCE WITH this subtitle at any
999		-	time.
	945	+	B. May not restrict the submission of an amendment to the 30
	946	+	delegation agreement. 31
1000	947
1001		-	[(l)] (H) (1) In the event of the sudden departure, incapacity, or death of [the
1002		-	primary supervising physician of a physician assistant] A PATIENT CARE TEAM
1003		-	PHYSICIAN, or change in license status that results in [the primary supervising physician]
1004		-	A PATIENT CARE TEAM PHYSICIAN being unable to legally practice medicine, [an
1005		-	alternate supervising physician designated under subsection (b) of this section may
1006		-	supervise the physician assistant for not longer than 15 days following the event] THE
1007		-	COLLABORATION AGR EEMENT SHALL REMAIN ACTIVE AND VALID UND ER THE
1008		-	SUPERVISION OF THE R EMAINING LISTED PATI ENT CARE TEAM PHYSIC IANS.
	948	+	(2) To the extent practicable, the Board shall approve a delegation 32
	949	+	agreement or take other action authorized under this subsection within 90 days after 33
	950	+	receiving a completed delegation agreement including any information from the physician 34
	951	+	assistant and primary supervising physician necessary to approve or take action.] 35 SENATE BILL 167 21
1009	952
1010		-	(2) If there is no [designated alternate supervising physician] REMAINING
1011		-	PATIENT CARE TEAM PH YSICIAN LISTED ON TH E COLLABORATION AGRE EMENT or
1012		-	the [designated alternate supervising physician] REMAINING PATIENT CA RE TEAM
1013		-	PHYSICIAN does not agree to supervise the physician assistant, the physician assistant
1014		-	may not practice until the physician assistant receives approval of a new [delegation]
1015		-	COLLABORATION agreement under [§ 15–302.1 of] this subtitle.
1016	953
1017		-	[(3) An alternate supervising physician or other licensed physician may
1018		-	assume the role of primary supervising physician by submitting a new delegation
1019		-	agreement to the Board for approval under subsection (b) of this section.
1020	954
1021		-	(4) The Board may terminate a delegation agreement if:
	955	+	[(g)] (D) If the Board determines that a [primary or alternate supervising 1
	956	+	physician] PHYSICIAN OR GROUP O F PHYSICIANS THAT DE VELOPS A 2
	957	+	COLLABORATION AGREEM ENT WITH A PHYSICIAN ASSISTANT or A physician assistant 3
	958	+	is practicing in a manner inconsistent with the requirements of this title or Title 14 of this 4
	959	+	article, the Board on its own initiative or on the recommendation of the Committee may 5
	960	+	demand modification of the practice[, withdraw the approval of the delegation agreement,] 6
	961	+	or refer the matter to a disciplinary panel for the purpose of taking other disciplinary action 7
	962	+	under § 14–404 OF THIS ARTICLE or § 15–314 of this [article] SUBTITLE. 8
1022	963
1023		-	(i) The physician assistant has a change in license status that
1024		-	results in the physician assistant being unable to legally practice as a physician assistant;
	964	+	[(h)] (E) [A primary supervising physician may not delegate medical acts under 9
	965	+	a delegation agreement to more than four physician assistants at any one time, except in 10
	966	+	a] A PHYSICIAN OR GROUP O F PHYSICIANS MAY NOT ENTER INTO A COLLABO RATION 11
	967	+	AGREEMENT THAT ALLOW S FOR COLLABORATION OF MORE THAN EIGHT P HYSICIAN 12
	968	+	ASSISTANTS FOR EACH PHYSICIAN IN THE AGR EEMENT AT ONE TIME , EXCEPT IN A 13
	969	+	hospital or in the following nonhospital settings: 14
1025	970
1026		-	(ii) At least 15 days have elapsed since an event listed under
1027		-	paragraph (1) of this subsection if there is an alternate supervising physician designated
1028		-	under subsection (b) of this section; or
	971	+	(1) A correctional facility; 15
1029	972
1030		-	(iii) Immediately after an event listed under paragraph (1) of this
1031		-	subsection if there is no alternate supervising physician designated under subsection (b) of
1032		-	this section.] WES MOORE, Governor Ch. 919
	973	+	(2) A detention center; or 16
1033	974
1034		-	~~– 23 –~~
	975	+	(3) A public health facility. 17
1035	976
1036		-	(I) THE BOARD SHALL NOTIFY TH E PHYSICIAN ASSISTAN T AND PHYSICIAN
1037		-	OR GROUP OF PHYSICIA NS WHO HAVE ENTERED INTO A COLLABORATION
1038		-	AGREEMENT WITH A PHY SICIAN ASSISTANT IMM EDIATELY IF:
	977	+	[(i)] (F) A person may not coerce another person to enter into a [delegation] 18
	978	+	COLLABORATION agreement under this subtitle. 19
1039	979
1040		-	(1) THE PHYSICIAN ASSISTA NT HAS A CHANGE IN L ICENSE
1041		-	STATUS THAT RESULTS IN THE PHYSICIAN ASS ISTANT BEING UNABLE TO LEGALLY
1042		-	PRACTICE AS A PHYSIC IAN ASSISTANT; OR
	980	+	[(j) A physician may supervise a physician assistant: 20
1043	981
1044		-	(2) ~~AN EVENT DESCRIBED~~ IN ~~SUBSECTION (H) OF THIS SECTION~~
1045		-	~~OCCURS.~~
	982	+	(1) As a primary supervising physician in accordance with a delegation 21
	983	+	agreement approved by the Board under this subtitle; or 22
1046	984
1047		-	[(m)] (J) A physician assistant whose [delegation] COLLABORATION agreement
1048		-	is terminated may not practice as a physician assistant until the physician assistant
1049		-	[receives preliminary approval of a new delegation agreement under § 15–302.1 of this
1050		-	subtitle] SUBMITS A NEW COLLAB ORATION AGREEMENT TO THE BOARD.
	985	+	(2) As an alternate supervising physician if: 23
1051	986
1052		-	[(n) Individual members of the Board are not civilly liable for actions regarding
1053		-	the approval, modification, or disapproval of a delegation agreement described in this
1054		-	section.
	987	+	(i) The alternate supervising physician supervises in accordance 24
	988	+	with a delegation agreement filed with the Board; 25
1055	989
1056		-	(o) A physician assistant may practice in accordance with a delegation agreement
1057		-	filed with the Board under this subtitle.]
	990	+	(ii) The alternate supervising physician supervises no more than 26
	991	+	four physician assistants at any one time, except in a hospital, correctional facility, 27
	992	+	detention center, or public health facility; 28
1058	993
1059		-	(C) IF THE BOARD DETERMINES THAT A PATIENT CARE TEAM PHYSICIAN OR
1060		-	PHYSICIAN ASSISTANT IS PRACTICING IN A M ANNER INCONSISTENT W ITH THE
1061		-	REQUIREMENTS OF THIS TITLE OR TITLE 14 OF THIS ARTICLE, THE BOARD ON ITS
1062		-	OWN INITIATIVE OR ON THE RECOMMENDATION O F THE COMMITTEE MAY DEMAND
1063		-	MODIFICATION OF THE PRACTICE, WITHDRAW THE APPROVA L OF AN ADVANCED
1064		-	DUTY REGARDLESS OF W HETHER THE ADVANCED DUTY REQUIRES PRIOR APPROVAL
1065		-	UNDER THIS SECTION , OR REFER THE MATTER TO A DISCIPLINARY PA NEL FOR THE
1066		-	PURPOSE OF TAKING OT HER DISCIPLIN ARY ACTION UNDER § 14–404 OF THIS
1067		-	ARTICLE OR § 15–314 OF THIS SUBTITLE.
	994	+	(iii) The alternate supervising physician’s period of supervision, in 29
	995	+	the temporary absence of the primary supervising physician, does not exceed: 30
1068	996
1069		-	(D) (1) EXCEPT AS PROVIDED UN DER PARAGRAPH (2) OF THIS
1070		-	SUBSECTION, A PATIENT CARE TEAM PHYSICIAN MAY NOT DE LEGATE MEDICAL ACTS
1071		-	UNDER A COLLABORATIO N AGREEMENT TO MORE THAN EIGHT PHY SICIAN
1072		-	ASSISTANTS AT ANY ON E TIME.
	997	+	1. The period of time specified in the delegation agreement; 31
	998	+	and 32
	999	+	22 SENATE BILL 167
1073	1000
1074		-	(2) A PATIENT CARE TEAM PH YSICIAN MAY DELEGATE MEDICAL ACTS
1075		-	UNDER A COLLABORATIO N AGREEMENT TO MORE THAN EIGHT PHYSICIAN
1076		-	ASSISTANTS IN:
1077	1001
1078		-	~~(I)~~ A ~~HOSPITAL; Ch. 919 2024 LAWS~~ OF ~~MARYLAND~~
	1002	+	2. A period of 45 consecutive days at any one time; and 1
1079	1003
1080		-	~~– 24 –~~
	1004	+	(iv) The physician assistant performs only those medical acts that: 2
1081	1005
1082		-	(II) A CORRECTIONAL FACILIT Y;
	1006	+	1. Have been delegated under the delegation agreement filed 3
	1007	+	with the Board; and 4
1083	1008
1084		-	(III) A DETENTION CENTER; OR
	1009	+	2. Are within the scope of practice of the primary supervising 5
	1010	+	physician and alternate supervising physician.] 6
1085	1011
1086		-	(IV) A PUBLIC HEALTH FACILI TY.
	1012	+	[(k)] (G) Subject to the notice required under § 15–103 of this title, a physician 7
	1013	+	assistant may terminate a [delegation agreement filed with the Board under] 8
	1014	+	COLLABORATION AGREEM ENT DEVELOPED IN ACC ORDANCE WITH this subtitle at any 9
	1015	+	time. 10
1087	1016
1088		-	(E) A PERSON MAY NOT COERC E ANOTHER PERSON TO ENTER INTO A
1089		-	COLLABORATION AGREEM ENT UNDER THIS SUBTI TLE.
	1017	+	[(l)] (H) (1) In the event of the sudden departure, incapacity, or death of [the 11
	1018	+	primary supervising physician of a physician assistant] A PATIENT CARE TEAM 12
	1019	+	PHYSICIAN, or change in license status that results in [the primary supervising physician] 13
	1020	+	A PATIENT CARE TEAM PHYSICIAN being unable to legally practice medicine, [an 14
	1021	+	alternate supervising physician designated under subsection (b) of this section may 15
	1022	+	supervise the physician assistant for not longer than 15 days following the event] THE 16
	1023	+	COLLABORATION AGREEM ENT SHALL REMAIN ACT IVE AND VALID UNDER THE 17
	1024	+	SUPERVISION OF THE R EMAINING LISTED PATI ENT CARE TEAM PHYSIC IANS. 18
1090	1025
1091		-	(F) SUBJECT TO THE NOTICE REQUIRED UNDER § 15–103 OF THIS TITLE, A
1092		-	PHYSICIAN ASSISTANT MAY TERMINATE A COLL ABORATION AGREEMENT UNDER
1093		-	THIS SUBTITLE AT ANY TIME.
	1026	+	(2) If there is no [designated alternate supervising physician] REMAINING 19
	1027	+	PATIENT CARE TEAM PH YSICIAN LISTED ON TH E COLLABORATION AGRE EMENT or 20
	1028	+	the [designated alternate supervising physician] REMAINING PATIENT CA RE TEAM 21
	1029	+	PHYSICIAN does not agree to supervise the physician assistant, the physician assistant 22
	1030	+	may not practice until the physician assistant receives approval of a new [delegation] 23
	1031	+	COLLABORATION agreement under [§ 15–302.1 of] this subtitle. 24
1094	1032
1095		-	(G) (1) IN THE EVENT OF A SUD DEN DEPARTURE , INCAPACITY, OR DEATH
1096		-	OF A PATIENT CARE TE AM PHYSICIAN , OR CHANGE IN LICENSE STATUS THAT
1097		-	RESULTS IN A PATIENT CARE TEAM PHYSICIAN BEING UNABLE TO LEGA LLY
1098		-	PRACTICE MEDICINE , THE COLLABORATION AG REEMENT WILL REMAIN ACTIVE AND
1099		-	VALID UNDER THE SUPE RVISION OF ANY REMAI NING LISTED PATIENT CARE TEAM
1100		-	PHYSICIANS.
	1033	+	[(3) An alternate supervising physician or other licensed physician may 25
	1034	+	assume the role of primary supervising physician by submitting a new delegation 26
	1035	+	agreement to the Board for approval under subsection (b) of this section. 27
1101	1036
1102		-	(2) IF THERE IS NO REMAIN ING PATIENT CARE TEA M PHYSICIAN
1103		-	LISTED ON THE COLLAB ORATION AGREEMENT , THE PHYSICIAN ASSIST ANT MAY NOT
1104		-	PRACTICE UNTIL THE P HYSICIAN ASSISTANT H AS EXECUTED A NEW
1105		-	COLLABORATION AGREEM ENT AND, IF APPLICABLE , HAS BOARD APPROVAL TO
1106		-	PERFORM ANY ADVANCED DUTI ES DELEGATED TO THE PHYSICIAN ASSISTANT
1107		-	UNDER THE NEW COLLAB ORATION AGREEMENT .
	1037	+	(4) The Board may terminate a delegation agreement if: 28
1108	1038
1109		-	(3) THE BOARD MAY TERMINATE A COLLABORATION AGREEM ENT IF:
	1039	+	(i) The physician assistant has a change in license status that 29
	1040	+	results in the physician assistant being unable to legally practice as a physician assistant; 30
1110	1041
1111		-	(I) THE PHYSICIAN ASSISTA NT HAS A CHANGE IN L ICENSE
1112		-	STATUS THAT RESULTS IN THE PHYSICIAN A SSISTANT BEING UNABL E TO LEGALLY
1113		-	PRACTICE AS A PHYSIC IAN ASSISTANT; OR
	1042	+	(ii) At least 15 days have elapsed since an event listed under 31
	1043	+	paragraph (1) of this subsection if there is an alternate supervising physician designated 32
	1044	+	under subsection (b) of this section; or 33
	1045	+	SENATE BILL 167 23
1114	1046
1115		-	(II) IMMEDIATELY AFTER AN EVENT LISTED UNDER
1116		-	PARAGRAPH (1) OF THIS SUBSECTION I F THERE IS NO REMAIN ING PATIENT CARE
1117		-	TEAM PHYSICIAN LISTE D IN THE COLLABORATI ON AGREEMENT .
1118	1047
1119		-	(H) A PHYSICIAN ASSISTANT WH OSE COLLABORATION AG REEMENT IS
1120		-	TERMINATED MAY NOT P RACTICE AS A PHYSICI AN ASSISTANT UNTIL T HE PHYSICIAN
1121		-	ASSISTANT EXECUTES A NEW COLLABORATION AG REEMENT UNDER THIS S ECTION.
1122		-	WES MOORE, Governor Ch. 919
	1048	+	(iii) Immediately after an event listed under paragraph (1) of this 1
	1049	+	subsection if there is no alternate supervising physician designated under subsection (b) of 2
	1050	+	this section.] 3
1123	1051
1124		-	~~– 25 –~~
1125		-	~~(I)~~ A ~~PHYSICIAN ASSISTANT MAY PRACTICE IN ACCO RDANCE WITH A~~
1126		-	~~COLLABORATION AGREEME NT UNDER THIS SUBTIT LE.~~
	1052	+	(I) THE BOARD SHALL NOTIFY TH E PHYSICIAN ASSISTAN T AND PHYSICIAN 4
	1053	+	OR GROUP OF PHYSICIA NS WHO HAVE ENTERED INTO A COLLABORATION 5
	1054	+	AGREEMENT WITH A PHY SICIAN ASSISTANT IMM EDIATELY IF: 6
1127	1055
1128		-	(J) A PATIENT CARE TEAM PH YSICIAN MAY BE ADDED OR REMOVED FROM
1129		-	A COLLABORATION AGRE EMENT BY PROVIDING N OTIFICATION TO THE BOARD.
	1056	+	(1) THE PHYSICIAN ASSISTA NT HAS A CHANGE IN LICENSE 7
	1057	+	STATUS THAT RESULTS IN THE PHYSICIAN ASS ISTANT BEING UNABLE TO LEGALLY 8
	1058	+	PRACTICE AS A PHYSIC IAN ASSISTANT; OR 9
1130	1059
1131		-	(K) ~~THE BOARD MAY MODIFY A CO LLABORATION AGREEMEN T IF IT FINDS~~
1132		-	~~THAT:~~
	1060	+	(2) AN EVENT DESCRIBED IN SUBSECTION (H) OF THIS SECTION 10
	1061	+	OCCURS. 11
1133	1062
1134		-	(1) THE COLLABORATION AGR EEMENT DOES NOT MEET THE
1135		-	REQUIREMENTS OF THIS SUBTITLE; OR
	1063	+	[(m)] (J) A physician assistant whose [delegation] COLLABORATION agreement 12
	1064	+	is terminated may not practice as a physician assistant until the physician assistant 13
	1065	+	[receives preliminary approval of a new delegation agreement under § 15–302.1 of this 14
	1066	+	subtitle] SUBMITS A NEW COLLAB ORATION AGREEMENT TO THE BOARD. 15
1136	1067
1137		-	(2) THE PHYSICIAN ASSISTA NT IS UNABLE TO PERF ORM THE
1138		-	DELEGATED DUTIES SAF ELY.
	1068	+	[(n) Individual members of the Board are not civilly liable for actions regarding 16
	1069	+	the approval, modification, or disapproval of a delegation agreement described in this 17
	1070	+	section. 18
1139	1071
1140		-	(L) A ~~COLLABORATION AGREEM ENT SHALL BE MAINTAI NED AT THE~~
1141		-	~~PRACTICE SETTING AND MADE AVAILABLE TO TH E~~ BOARD ~~ON REQUEST~~ .
	1072	+	(o) A physician assistant may practice in accordance with a delegation agreement 19
	1073	+	filed with the Board under this subtitle.] 20
1142	1074
1143		-	(M) A LICENSED PHYSICIAN A SSISTANT WHO FAILS T O COMPLY WITH THE
1144		-	COLLABORATION AGREEM ENT REQUIREMENTS IS SUBJECT TO AN ADMINI STRATIVE
1145		-	PENALTY AS ESTABLISHED IN REGULATIONS .
	1075	+	(C) IF THE BOARD DETERMINES THAT A PATIENT CARE TEAM PHYSICIAN OR 21
	1076	+	PHYSICIAN ASSISTANT IS PRACTICING IN A M ANNER INCONSISTENT W ITH THE 22
	1077	+	REQUIREMENTS OF THIS TITLE OR TITLE 14 OF THIS ARTICLE, THE BOARD ON ITS 23
	1078	+	OWN INITIATIVE OR ON THE RECO MMENDATION OF THE COMMITTEE MAY DEMAND 24
	1079	+	MODIFICATION OF THE PRACTICE, WITHDRAW THE APPROVA L OF AN ADVANCED 25
	1080	+	DUTY REGARDLESS OF W HETHER THE ADVANCED DUTY REQUIRES PRIOR APPROVAL 26
	1081	+	UNDER THIS SECTION , OR REFER THE MATTER TO A DISCIPLINARY PA NEL FOR THE 27
	1082	+	PURPOSE OF TAKING OT HER DISCIPLINARY ACT ION UNDER § 14–404 OF THIS 28
	1083	+	ARTICLE OR § 15–314 OF THIS SUBTITLE. 29
1146	1084
1147		-	[15–302.1.
	1085	+	(D) (1) EXCEPT AS PROVIDED UN DER PARAGRAPH (2) OF THIS 30
	1086	+	SUBSECTION, A PATIENT CARE TEAM PHYSICIAN MAY NOT DE LEGATE MEDICAL ACTS 31
	1087	+	UNDER A CO LLABORATION AGREEMEN T TO MORE THAN EIGHT PHYSICIAN 32
	1088	+	ASSISTANTS AT ANY ON E TIME. 33
	1089	+	24 SENATE BILL 167
1148	1090
1149		-	(a) If a delegation agreement does not include advanced duties or the advanced
1150		-	duties have been approved under § 15–302(c)(1) of this subtitle, a physician assistant may
1151		-	assume the duties under a delegation agreement on the date that the Board acknowledges
1152		-	receipt of the completed delegation agreement.
1153	1091
1154		-	(b) In this section, “pending” means that a delegation agreement that includes
1155		-	delegation of advanced duties in a setting that does not meet the requirements under §
1156		-	15–302(c)(1) of this subtitle has been executed and submitted to the Board for its approval,
1157		-	but:
	1092	+	(2) A PATIENT CARE TEAM PH YSICIAN MAY DELEGATE MEDICAL ACTS 1
	1093	+	UNDER A COLLABORATIO N AGREEMENT TO MORE THAN EIGHT PHYSICIAN 2
	1094	+	ASSISTANTS IN: 3
1158	1095
1159		-	(1) ~~The Committee has not made~~ a ~~recommendation to the Board~~; or
	1096	+	(I) A HOSPITAL; 4
1160	1097
1161		-	(2) The Board has not made a final decision regarding the delegation
1162		-	agreement.
	1098	+	(II) A CORRECTIONAL FACILITY ; 5
1163	1099
1164		-	(c) Subject to subsection (d) of this section, if a delegation agreement is pending,
1165		-	on receipt of a temporary practice letter from the staff of the Board, a physician assistant
1166		-	may perform the advanced duty if:
	1100	+	(III) A DETENTION CENTER ; OR 6
1167	1101
1168		-	(1) The primary supervising physician has been previously approved to
1169		-	supervise one or more physician assistants in the performance of the advanced duty; and Ch. 919 2024 LAWS OF MARYLAND
	1102	+	(IV) A PUBLIC HEALTH FACILI TY. 7
1170	1103
1171		-	– 26 –
	1104	+	(E) A PERSON MAY NOT COERC E ANOTHER PERSON TO ENTER INTO A 8
	1105	+	COLLABORATION AGREEM ENT UNDER THIS SUBTI TLE. 9
1172	1106
1173		-	(2) The physician assistant has been previously approved by the Board to
1174		-	perform the advanced duty.
	1107	+	(F) SUBJECT TO THE NOTICE REQUIRED UNDER § 15–103 OF THIS TITLE, A 10
	1108	+	PHYSICIAN ASSISTANT MAY TERMINATE A COLL ABORATION AGREEMENT UNDER 11
	1109	+	THIS SUBTITLE AT ANY TIME. 12
1175	1110
1176		-	(d) If the Committee recommends a denial of the pending delegation agreement
1177		-	or the Board denies the pending delegation agreement, on notice to the primary supervising
1178		-	physician and the physician assistant, the physician assistant may no longer perform the
1179		-	advanced duty that has not received the approval of the Board.
	1111	+	(G) (1) IN THE EVENT OF A SUD DEN DEPARTURE , INCAPACITY, OR DEATH 13
	1112	+	OF A PATIENT CARE TE AM PHYSICIAN, OR CHANGE IN LICENSE STATUS THAT 14
	1113	+	RESULTS IN A PATIENT CARE TEAM PHYSICIAN BEING UNABLE TO LEGA LLY 15
	1114	+	PRACTICE MEDICINE , THE COLLABORATION AG REEMENT WILL REMAIN ACTIVE AND 16
	1115	+	VALID UNDER THE SUPE RVISION OF ANY REMAI NING LISTED PATIENT CARE TEAM 17
	1116	+	PHYSICIANS. 18
1180	1117
1181		-	(e) The Board may disapprove any delegation agreement if it believes that:
	1118	+	(2) IF THERE IS NO REMAIN ING PATIENT CARE TEA M PHYSICIAN 19
	1119	+	LISTED ON THE COLLAB ORATION AGREEMENT , THE PHYSICIAN ASSIST ANT MAY NOT 20
	1120	+	PRACTICE UNTIL THE P HYSICIAN ASSISTANT H AS EXECUTED A NEW 21
	1121	+	COLLABORATION AGREEM ENT AND, IF APPLICABLE , HAS BOARD APPROVAL TO 22
	1122	+	PERFORM ANY ADVANCED DUTIES DELEGATED TO THE PHYSICIAN ASSIST ANT 23
	1123	+	UNDER THE NEW COLLAB ORATION AGREEMENT . 24
1182	1124
1183		-	(1) The ~~agreement does not meet the requirements of this subtitle;~~ or
	1125	+	(3) THE BOARD MAY TERMINATE A COLLABORATION AGREEM ENT IF: 25
1184	1126
1185		-	(2) The physician assistant is unable to perform safely the delegated
1186		-	duties.
	1127	+	(I) THE PHYSICIAN ASSISTA NT HAS A CHANGE IN L ICENSE 26
	1128	+	STATUS THAT RESULTS IN THE PHYSICIAN ASSISTANT BE ING UNABLE TO LEGALL Y 27
	1129	+	PRACTICE AS A PHYSIC IAN ASSISTANT; OR 28
1187	1130
1188		-	(f) If the Board disapproves a delegation agreement or the delegation of any
1189		-	function under an agreement, the Board shall provide the primary supervising physician
1190		-	and the physician assistant with written notice of the disapproval.
	1131	+	(II) IMMEDIATELY AFTER AN EVENT LISTED UNDER 29
	1132	+	PARAGRAPH (1) OF THIS SUBSECTION I F THERE IS NO REMAIN ING PATIENT CARE 30
	1133	+	TEAM PHYSICIAN LISTE D IN THE COLLABORATI ON AGREEMENT . 31
	1134	+	SENATE BILL 167 25
1191	1135
1192		-	(g) A physician assistant who receives notice that the Board has disapproved a
1193		-	delegation agreement or an advanced function under the delegation agreement shall
1194		-	immediately cease to practice under the agreement or to perform the disapproved function.]
1195	1136
1196		-	15–302.1.
	1137	+	(H) A PHYSICIAN ASSISTANT WHOSE COLLABORATION AGREEMENT IS 1
	1138	+	TERMINATED MAY NOT P RACTICE AS A PHYSICI AN ASSISTANT UNTIL T HE PHYSICIAN 2
	1139	+	ASSISTANT EXECUTES A NEW COLLABORATION AG REEMENT UNDER THIS S ECTION. 3
1197	1140
1198		-	(A) IN THIS SECTION, “EXEMPT FACILITY ” MEANS:
	1141	+	(I) A PHYSICIAN ASSISTANT MAY PRACTICE IN ACCO RDANCE WITH A 4
	1142	+	COLLABORATION AGREEM ENT UNDER THIS SUBTI TLE. 5
1199	1143
1200		-	(1) A HOSPITAL;
	1144	+	(J) A PATIENT CARE TEAM PH YSICIAN MAY BE ADDED OR REMOVED FROM 6
	1145	+	A COLLABORATION AGRE EMENT BY PROVIDING N OTIFICATION TO THE BOARD. 7
1201	1146
1202		-	(2) AN AMBULATORY SURGICA L FACILITY;
	1147	+	(K) THE BOARD MAY MODIFY A CO LLABORATION AGREEMEN T IF IT FINDS 8
	1148	+	THAT: 9
1203	1149
1204		-	(3) A FEDERALLY QUALIFIED HEALTH CENTER ; OR
	1150	+	(1) THE COLLABORATION AGR EEMENT DOES NOT MEET THE 10
	1151	+	REQUIREMENTS OF THIS SUBTITLE; OR 11
1205	1152
1206		-	(4) ~~ANOTHER PRACTICE SETT ING LISTED ON A HOSP~~ ~~ITAL~~
1207		-	~~DELINEATION OF PRIVI LEGES DOCUMENT~~ .
	1153	+	(2) THE PHYSICIAN ASSISTA NT IS UNABLE TO PERF ORM THE 12
	1154	+	DELEGATED DUTIES SAF ELY. 13
1208	1155
1209		-	(B) EXCEPT AS PROVIDED IN SUBSECTION (E) OF THIS SECTION , A
1210		-	PHYSICIAN ASSISTANT MAY PERFORM ADVANCED DUTIES WITHOUT BOARD
1211		-	APPROVAL IF THE ADVA NCED DUTY WILL BE PE RFORMED IN AN EXEMPT FACILITY
1212		-	AND:
	1156	+	(L) A COLLABORATION AGREEM ENT SHALL BE MAINTAI NED AT THE 14
	1157	+	PRACTICE SETTING AND MADE AVAILABLE TO TH E BOARD ON REQUEST . 15
1213	1158
1214		-	(1) THE PHYSICIAN ASSISTA NT IS SUPERVISED BY A PHYSICIAN WI TH
1215		-	CREDENTIALS THAT HAV E BEEN REVIEWED BY T HE EXEMPT FACILITY A S A WES MOORE, Governor Ch. 919
	1159	+	(M) A LICENSED PHYSICIAN A SSISTANT WHO FAILS T O COMPLY WITH THE 16
	1160	+	COLLABORATION AGREEM ENT REQUIREMENTS IS SUBJECT TO AN ADMINI STRATIVE 17
	1161	+	PENALTY AS ESTABLISHED IN REGULATIONS . 18
1216	1162
1217		-	– 27 –
1218		-	CONDITION OF EMPLOYM ENT AS AN INDEPENDEN T CONTRACTOR OR AS A MEMBER
1219		-	OF THE MEDICAL STAFF ;
	1163	+	[15–302.1. 19
1220	1164
1221		-	(2) THE PHYSICIAN ASSISTA NT HAS CREDENTIALS T HAT HAVE BEEN
1222		-	REVIEWED BY THE EXEM PT FACILITY AS A CONDITION OF EMPLOYM ENT AS AN
1223		-	INDEPENDENT CONTRACT OR OR AS A MEMBER OF THE MEDICAL STAFF ; AND
	1165	+	(a) If a delegation agreement does not include advanced duties or the advanced 20
	1166	+	duties have been approved under § 15–302(c)(1) of this subtitle, a physician assistant may 21
	1167	+	assume the duties under a delegation agreement on the date that the Board acknowledges 22
	1168	+	receipt of the completed delegation agreement. 23
1224	1169
1225		-	(3) THE ADVANCED DUTY TO BE DELEGATED TO THE PHYSICIAN
1226		-	ASSISTANT IS REVIEWE D AND APPROVED IN A PROCESS APPROVED BY THE EXEMPT
1227		-	FACILITY BEFORE THE PHYSICIAN ASSISTANT PERFORMS THE ADVANCE D DUTY.
	1170	+	(b) In this section, “pending” means that a delegation agreement that includes 24
	1171	+	delegation of advanced duties in a setting that does not meet the requirements under § 25
	1172	+	15–302(c)(1) of this subtitle has been executed and submitted to the Board for its approval, 26
	1173	+	but: 27
1228	1174
1229		-	(C) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION A ND
1230		-	SUBSECTION (D) OF THIS SECTION AND EXCEPT AS PROVIDED I N SUBSECTION (E) OF
1231		-	THIS SECTION, A PHYSICIAN ASSISTAN T MAY PERFORM ADVANC ED DUTIES IN A
1232		-	PRACTICE SETTING THA T IS NOT AN EXEMPT F ACILITY ONLY AFTER T HE PHYSICIAN
1233		-	ASSISTANT OBTAINS BOARD APPROVAL OF THE ADVANCED DUTY UNDER THE
1234		-	COLLABORATION AGREEM ENT.
	1175	+	(1) The Committee has not made a recommendation to the Board; or 28
1235	1176
1236		-	(2) (I) SUBJECT TO SUBPARAGRA PH (II) OF THIS PARAGRAPH , A
1237		-	PHYSICIAN ASSISTANT MAY PERFORM X–RAY DUTIES AUTHORIZE D UNDER §
1238		-	14–306(E) OF THIS ARTICLE IN T HE MEDICAL OFFICE OF A PATIENT CARE TEAM
1239		-	PHYSICIAN ONLY AFTER THE PHYSICIAN ASSISTANT OBTAINS BOARD APPROVAL OF
1240		-	THE X–RAY DUTY UNDER THE C OLLABORATION AGREEME NT.
	1177	+	(2) The Board has not made a final decision regarding the delegation 29
	1178	+	agreement. 30
	1179	+	26 SENATE BILL 167
1241	1180
1242		-	(II) A COLLABORATION AGREEM ENT MAY AUTHORIZE TH E
1243		-	DELEGATION OF X–RAY DUTIES LIMITED T O NONFLUOROSCOPIC X–RAY
1244		-	PROCEDURES OF THE EX TREMITIES, ANTERIOR–POSTERIOR AND LATERA L, NOT
1245		-	INCLUDING THE HEAD .
1246	1181
1247		-	(D) A ~~PHYSICIAN ASSISTANT MAY NOT PERFORM THE MEDICAL ACTS OF~~
1248		-	~~ADMINISTERING GENERA L ANESTHESIA OR NEUR OAXIAL ANESTHESIA~~ , ~~INCLUDING~~
1249		-	~~SPINAL, EPIDURAL,~~ ~~AND IMAGE GUIDED INT ERVENTIONAL SPINE PR OCEDURES.~~
	1182	+	(c) Subject to subsection (d) of this section, if a delegation agreement is pending, 1
	1183	+	on receipt of a temporary practice letter from the staff of the Board, a physician assistant 2
	1184	+	may perform the advanced duty if: 3
1250	1185
1251		-	(E) A PHYSICIAN ASSISTANT MAY PERFORM AN ADVAN CED DUTY IN
1252		-	COLLABORATION WITH A PATIENT CARE TEAM PH YSICIAN WITHOUT PRIO R
1253		-	APPROVAL OF THE BOARD IF:
	1186	+	(1) The primary supervising physician has been previously approved to 4
	1187	+	supervise one or more physician assistants in the performance of the advanced duty; and 5
1254	1188
1255		-	(1) THE BOARD HAS PREVIOUSLY APPROVED THE PHYSICI AN
1256		-	ASSISTANT TO PERFORM THE ADVANCED DUTY IN COLLABORATION WITH A PATIENT
1257		-	CARE TEAM PHYSICIAN ; OR
	1189	+	(2) The physician assistant has been previously approved by the Board to 6
	1190	+	perform the advanced duty. 7
1258	1191
1259		-	(2) THE PHYSICIAN ASSISTA NT HAS AT LEAST 7,000 HOURS OF
1260		-	CLINICAL PRACTICE EX PERIENCE.
1261		-	Ch. 919 2024 LAWS OF MARYLAND
	1192	+	(d) If the Committee recommends a denial of the pending delegation agreement 8
	1193	+	or the Board denies the pending delegation agreement, on notice to the primary supervising 9
	1194	+	physician and the physician assistant, the physician assistant may no longer perform the 10
	1195	+	advanced duty that has not received the approval of the Board. 11
1262	1196
1263		-	– 28 –
1264		-	(F) IF AN ADVANCED DUTY R EQUIRES BOARD APPROVAL , THE COMMITTEE:
	1197	+	(e) The Board may disapprove any delegation agreement if it believes that: 12
1265	1198
1266		-	(1) ~~SHALL REVIEW~~ THE ~~COLL ABORATION AGREEMENT~~ ;
	1199	+	(1) The agreement does not meet the requirements of this subtitle; or 13
1267	1200
1268		-	(2) ~~MAY CONDUCT A PERSONA L INTERVIEW OF~~ THE ~~P HYSICIAN~~
1269		-	~~ASSISTANT AND PATIEN T CARE TEAM PHYSICIA NS; AND~~
	1201	+	(2) The physician assistant is unable to perform safely the delegated 14
	1202	+	duties. 15
1270	1203
1271		-	(3) ~~MAY RECOMMEND TO~~ THE BOARD ~~THAT~~ THE ~~COLLAB ORATION~~
1272		-	AGREEMENT ~~BE MODIFIE D TO ENSURE CONFORMA NCE WITH~~ THE ~~REQUIRE MENTS~~
1273		-	OF ~~THIS TITLE~~.
	1204	+	(f) If the Board disapproves a delegation agreement or the delegation of any 16
	1205	+	function under an agreement, the Board shall provide the primary supervising physician 17
	1206	+	and the physician assistant with written notice of the disapproval. 18
1274	1207
1275		-	(G) (1) ON REVIEW OF THE COMMITTEE’S RECOMMENDATIONS
1276		-	REGARDING THE REQUES T OF A PATIENT CARE TEAM PHYSICIAN TO DE LEGATE
1277		-	ADVANCED DUTIES AS D ESCRIBED IN A COLLAB ORATION AGREEMENT , THE BOARD
1278		-	MAY MODIFY THE PERFO RMANCE OF ADVANCED D UTIES UNDER A COLLAB ORATION
1279		-	AGREEME NT IF THE PHYSICIAN ASSISTANT DOES NOT M EET THE APPLICABLE
1280		-	EDUCATION, TRAINING, AND EXPERIENCE REQUI REMENTS TO PERFORM T HE
1281		-	SPECIFIED ADVANCED D UTIES.
	1208	+	(g) A physician assistant who receives notice that the Board has disapproved a 19
	1209	+	delegation agreement or an advanced function under the delegation agreement shall 20
	1210	+	immediately cease to practice under the agreement or to perform the disapproved function.] 21
1282	1211
1283		-	(2) IF THE BOARD MAKES A MODIFIC ATION UNDER PARAGRAP H (1)
1284		-	OF THIS SUBSECTION , THE BOARD:
	1212	+	15–302.1. 22
1285	1213
1286		-	(I) SHALL NOTIFY EACH PAT IENT CARE TEAM PHYSI CIAN
1287		-	LISTED IN THE COLLAB ORATION AGREEMENT AN D THE PHYSICIAN ASSI STANT IN
1288		-	WRITING OF THE PARTI CULAR ELEMENTS OF TH E ADVANCED DUTY APPR OVAL
1289		-	REQUEST THAT WERE TH E CAUSE FOR THE MODI FICATION; AND
	1214	+	(A) IN THIS SECTION, “EXEMPT FACILITY ” MEANS: 23
1290	1215
1291		-	(II) MAY NOT RESTR ICT THE SUBMISSION O F AN AMENDMENT
1292		-	TO THE ADVANCED DUTY .
	1216	+	(1) A HOSPITAL; 24
1293	1217
1294		-	(H) DOCUMENTATION DEMONST RATING A PHYSICIAN A SSISTANT’S
1295		-	AUTHORITY TO PERFORM AN ADVANCED DUTY UND ER THIS SECTION SHAL L BE
1296		-	MAINTAINED AT THE FA CILITY IN WHICH THE PHYSICIAN ASSISTANT IS PERFORMING
1297		-	THE ADVANCED DUTY .
	1218	+	(2) AN AMBULATORY SURGICA L FACILITY; 25
1298	1219
1299		-	(I) INDIVIDUAL MEMBERS OF THE BOARD ARE NOT CIVILLY LIABLE FOR
1300		-	ACTIONS REGARDING TH E APPROVAL , MODIFICATION , OR DISAPPROVAL OF AN
1301		-	ADVANCED DUTY UNDER THE COLLABORATION AG REEMENT DESCRIBED IN THIS
1302		-	SECTION.
	1220	+	(3) A FEDERALLY QUALIFIED HEALTH CENTER ; OR 26
1303	1221
1304		-	~~[15–302.2.] 15–302.1.~~
1305		-	~~WES MOORE, Governor Ch~~. ~~919~~
	1222	+	(4) ANOTHER PRACTICE SETT ING LISTED ON A HOSP ITAL 27
	1223	+	DELINEATION OF PRIVI LEGES DOCUMENT . 28
1306	1224
1307		-	– 29 –
1308		-	[(a) A primary supervising PATIENT CARE TEAM physician may not delegate
1309		-	prescribing, dispensing, and administering of controlled dangerous substances,
1310		-	prescription drugs, or medical devices unless the primary supervising physician and
1311		-	physician assistant include in the delegation COLLABORATION agreement:
	1225	+	(B) EXCEPT AS PROVIDED IN SUBSECTION (E) OF THIS SECTION , A 29
	1226	+	PHYSICIAN ASSISTANT MAY PERFORM ADVANCED DUTIES WITHOUT BOARD 30 SENATE BILL 167 27
1312	1227
1313		-	(1) A notice of intent to delegate prescribing and, if applicable, dispensing
1314	1228
1315		-	(1) THE AUTHORITY OF THE PHYSICIAN ASSISTANT TO PRESCRIBE
1316		-	AND, IF APPLICABLE, DISPENSE of controlled dangerous substances, prescription drugs,
1317		-	or medical devices;
	1229	+	APPROVAL IF THE ADVA NCED DUTY WILL BE PE RFORMED IN AN EXEMPT FACILITY 1
	1230	+	AND: 2
1318	1231
1319		-	(2) An attestation that all prescribing and, if applicable, dispensing
1320		-	activities of the physician assistant will comply with applicable federal and State LAW AND
1321		-	regulations;
	1232	+	(1) THE PHYSICIAN ASSISTA NT IS SUPERVISED BY A PHYSICIAN WI TH 3
	1233	+	CREDENTIALS THAT HAV E BEEN REVIEWED BY T HE EXEMPT FACILITY A S A 4
	1234	+	CONDITION OF EMPLOYM ENT AS AN INDEPENDEN T CONTRACTOR OR AS A MEMBER 5
	1235	+	OF THE MEDICAL STAFF ; 6
1322	1236
1323		-	(3) ~~An attestation that all medical charts or records will contain a notation~~
1324		-	~~of any prescriptions written or dispensed~~ by a ~~physician assistant in accordance with this~~
1325		-	~~section~~;
	1237	+	(2) THE PHYSICIAN ASSISTA NT HAS CREDENTIALS T HAT HAVE BEEN 7
	1238	+	REVIEWED BY THE EXEM PT FACILITY AS A CONDITION OF EMPLOYM ENT AS AN 8
	1239	+	INDEPENDENT CONTRACT OR OR AS A MEMBER OF THE MEDICAL STAFF ; AND 9
1326	1240
1327		-	(4) An attestation that all prescriptions written or dispensed under this
1328		-	section will include the physician assistant’s name and the supervising PATIENT CARE
1329		-	TEAM physician’s name, business address, and business telephone number legibly written
1330		-	or printed;
	1241	+	(3) THE ADVANCED DUTY TO BE DELEGATED TO THE PHYSICIAN 10
	1242	+	ASSISTANT IS REVIEWE D AND APPROVED IN A PROCESS APPROVED BY THE EXEMPT 11
	1243	+	FACILITY BEFORE THE PHYSICIAN ASSISTANT PERFORMS THE ADVANCED DUTY . 12
1331	1244
1332		-	(5) AN ATTESTATION THAT A LL PRESCRIPTIONS WRI TTEN UNDER
1333		-	THIS SECTION WILL IN CLUDE THE PHYSICIAN ASSISTANT’S NAME, BUSINESS
1334		-	ADDRESS, AND BUSINESS TELEPHO NE NUMBER LEGIBLY WR ITTEN OR PRINTED ;
	1245	+	(C) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION A ND 13
	1246	+	SUBSECTION (D) OF THIS SECTION AND EXCEPT AS PROVIDED I N SUBSECTION (E) OF 14
	1247	+	THIS SECTION, A PHYSICIAN ASSISTAN T MAY PERFORM ADVANC ED DUTIES IN A 15
	1248	+	PRACTICE SETTING THAT IS NOT AN EXEMP T FACILITY ONLY AFTE R THE PHYSICIAN 16
	1249	+	ASSISTANT OBTAINS BOARD APPROVAL OF THE ADVANCED DUTY UNDER THE 17
	1250	+	COLLABORATION AGREEM ENT. 18
1335	1251
1336		-	(5) (6) An attestation that the physician assistant has:
	1252	+	(2) (I) SUBJECT TO SUBPARAGRA PH (II) OF THIS PARAGRAPH , A 19
	1253	+	PHYSICIAN ASSISTANT MAY PERFORM X–RAY DUTIES AUTH ORIZED UNDER § 20
	1254	+	14–306(E) OF THIS ARTICLE IN T HE MEDICAL OFFICE OF A PATIENT CARE TEAM 21
	1255	+	PHYSICIAN ONLY AFTER THE PHYSICIAN ASSIST ANT OBTAINS BOARD APPROVAL OF 22
	1256	+	THE X–RAY DUTY UNDER THE C OLLABORATION AGREEME NT. 23
1337	1257
1338		-	(i) Passed the physician assistant national certification exam
1339		-	administered by the National Commission on the Certification of Physician Assistants
1340		-	within the previous 2 years; or
	1258	+	(II) A COLLABORATION AGREEM ENT MAY AUTHORIZE THE 24
	1259	+	DELEGATION OF X–RAY DUTIES LIMITED T O NONFLUOROSCOPIC X–RAY 25
	1260	+	PROCEDURES OF THE EX TREMITIES, ANTERIOR–POSTERIOR AND LATERA L, NOT 26
	1261	+	INCLUDING THE HEAD . 27
1341	1262
1342		-	(ii) Successfully completed 8 category 1 hours of pharmacology
1343		-	education within the previous 2 years; and
	1263	+	(D) A PHYSICIAN ASSISTANT MAY NOT PERFORM THE MEDICAL ACTS OF 28
	1264	+	ADMINISTERING GENERA L ANESTHESIA OR NEUR OAXIAL ANESTHESIA , INCLUDING 29
	1265	+	SPINAL, EPIDURAL, AND IMAGE GUIDED INT ERVENTIONAL SPINE PR OCEDURES. 30
1344	1266
1345		-	(6) (7) An attestation that the physician assistant has:
	1267	+	(E) A PHYSICIAN ASSISTANT MAY PERFORM AN ADVAN CED DUTY IN 31
	1268	+	COLLABORATION WITH A PATIENT CARE TEAM PH YSICIAN WITHOUT PRIO R 32
	1269	+	APPROVAL OF THE BOARD IF: 33
	1270	+	28 SENATE BILL 167
1346	1271
1347		-	(i) A bachelor’s degree or its equivalent; or
1348	1272
1349		-	(ii) ~~Successfully completed 2 years of work experience as a physician~~
1350		-	assistant.
1351		-	~~Ch.~~ ~~919~~ ~~2024 LAWS OF MARYLAND~~
	1273	+	(1) THE BOARD HAS PREVIOUSLY APPROVED THE PHYSICI AN 1
	1274	+	ASSISTANT TO PERFORM THE ADVANCED DUTY IN COLLABORATION WITH A PATIENT 2
	1275	+	CARE TEAM PHYSICIAN ; OR 3
1352	1276
1353		-	– 30 –
1354		-	(b) (1) A primary supervising PATIENT CARE TEAM physician may not
1355		-	delegate the prescribing or dispensing of substances that are identified as Schedule I
1356		-	controlled dangerous substances under § 5–402 of the Criminal Law Article.
	1277	+	(2) THE PHYSICIAN ASSISTANT HAS AT LEAST 7,000 HOURS OF 4
	1278	+	CLINICAL PRACTICE EX PERIENCE. 5
1357	1279
1358		-	(2) A primary supervising PATIENT CARE TEAM physician may delegate
1359		-	the prescribing or dispensing of substances that are identified as Schedules II through V
1360		-	controlled dangerous substances under § 5–402 of the Criminal Law Article, including
1361		-	legend drugs as defined under § 503(b) of the Federal Food, Drug, and Cosmetic Act.
	1280	+	(F) IF AN ADVANCED DUTY R EQUIRES BOARD APPROVAL , THE COMMITTEE: 6
1362	1281
1363		-	(3) A primary supervising PATIENT CARE TEAM physician may not
1364		-	delegate the prescribing or dispensing of controlled dangerous substances to a physician
1365		-	assistant unless the physician assistant has a valid:
	1282	+	(1) SHALL REVIEW THE COLL ABORATION AGREEMENT ; 7
1366	1283
1367		-	(i) State controlled dangerous substance registration; and
	1284	+	(2) MAY CONDUCT A PERSONA L INTERVIEW OF THE P HYSICIAN 8
	1285	+	ASSISTANT AND PATIENT CAR E TEAM PHYSICIANS ; AND 9
1368	1286
1369		-	(ii) Federal Drug Enforcement Agency (DEA) registration.]
	1287	+	(3) MAY RECOMMEND TO THE BOARD THAT THE COLLAB ORATION 10
	1288	+	AGREEMENT BE MODIFIE D TO ENSURE CONFORMA NCE WITH THE REQUIRE MENTS 11
	1289	+	OF THIS TITLE. 12
1370	1290
1371		-	(A) IN THIS SECTION, “PERSONALLY PREPARE A ND DISPENSE” MEANS THAT
1372		-	A PHYSICIAN ASSISTAN T:
	1291	+	(G) (1) ON REVIEW OF THE COMMITTEE’S RECOMMENDATIONS 13
	1292	+	REGARDING THE REQUE ST OF A PATIENT CARE TEAM PHYSICIAN TO DE LEGATE 14
	1293	+	ADVANCED DUTIES AS D ESCRIBED IN A COLLAB ORATION AGREEMENT , THE BOARD 15
	1294	+	MAY MODIFY THE PERFO RMANCE OF ADVANCED D UTIES UNDER A COLLAB ORATION 16
	1295	+	AGREEMENT IF THE PHY SICIAN ASSISTANT DOE S NOT MEET THE APPLI CABLE 17
	1296	+	EDUCATION, TRAINING, AND EXPERIENCE REQUI REMENTS TO PERFORM T HE 18
	1297	+	SPECIFIED ADVANCED D UTIES. 19
1373	1298
1374		-	(1) ~~IS PHYSICALLY PRESENT ON THE PREMISES WHER E A~~
1375		-	~~PRESCRIPTION IS FILL ED;~~ ~~AND~~
	1299	+	(2) IF THE BOARD MAKES A MODIFIC ATION UNDER PARAGRAP H (1) 20
	1300	+	OF THIS SUBSECTION , THE BOARD: 21
1376	1301
1377		-	(2) PERFORMS A FINAL CHEC K OF THE PRESCRIPTIO N BEFORE IT IS
1378		-	PROVIDED TO THE PATIENT.
	1302	+	(I) SHALL NOTIFY EACH PAT IENT CARE TEAM PHYSI CIAN 22
	1303	+	LISTED IN THE COLLAB ORATION AGREEMENT AND THE PHYSICIAN ASSIST ANT IN 23
	1304	+	WRITING OF THE PARTI CULAR ELEMENTS OF TH E ADVANCED DUTY APPR OVAL 24
	1305	+	REQUEST THAT WERE TH E CAUSE FOR THE MODI FICATION; AND 25
1379	1306
1380		-	(B) SUBJECT TO THE COLLAB ORATION AGREEMENT SU BMITTED UNDER §
1381		-	15–302 OF THIS SUBTITLE , A PHYSICIAN ASSISTAN T MAY PRESCRIBE , PROCURE,
1382		-	DISPENSE, ORDER, OR ADMINISTER :
	1307	+	(II) MAY NOT RESTRICT THE SUBMISSION OF AN AME NDMENT 26
	1308	+	TO THE ADVANCED DUTY . 27
1383	1309
1384		-	(1) SUBJECT TO SUBSECTION (C)(2) OF THIS SECTION , DRUGS AND
1385		-	SUBSTANCES THAT ARE IDENTIFIED AS SCHEDULES II THROUGH V CONTROLLED
1386		-	DANGEROUS SUBSTANCES UNDER §§ 5–403 THROUGH 5–406 OF THE CRIMINAL LAW
1387		-	ARTICLE, INCLUDING LEGEND DRU GS AS DEFINED UNDER § 503(B) OF THE
1388		-	FEDERAL FOOD, DRUG, AND COSMETIC ACT;
	1310	+	(H) DOCUMENTATION DEMONSTRATI NG A PHYSICIAN ASSIS TANT’S 28
	1311	+	AUTHORITY TO PERFORM AN ADVANCED DUTY UND ER THIS SECTION SHAL L BE 29
	1312	+	MAINTAINED AT THE FA CILITY IN WHICH THE PHYSICIAN ASSISTANT IS PERFORMING 30
	1313	+	THE ADVANCED DUTY . 31
1389	1314
1390		-	(2) MEDICAL DEVICES ; AND
	1315	+	(I) INDIVIDUAL MEMBERS OF THE BOARD ARE NOT CIVI LLY LIABLE FOR 32
	1316	+	ACTIONS REGARDING TH E APPROVAL , MODIFICATION , OR DISAPPROVAL OF AN 33 SENATE BILL 167 29
1391	1317
1392		-	(3) DURABLE MEDICAL EQUIP MENT.
1393	1318
1394		-	(C) (1) A PHYSICIAN ASSISTANT MAY NOT PRESCRIBE OR DISPENSE
1395		-	SUBSTANCES THAT ARE IDENTIFIED AS SCHEDULE I CONTROLLED DANGEROUS
1396		-	SUBSTANCES UNDER § 5–402 OF THE CRIMINAL LAW ARTICLE.
1397		-	WES MOORE, Governor Ch. 919
	1319	+	ADVANCED DUTY UNDER THE COLLABORATION AG REEMENT DESCRIBED IN THIS 1
	1320	+	SECTION. 2
1398	1321
1399		-	– 31 –
1400		-	(2) A PHYSICIAN ASSISTANT MAY NOT PRESCRIBE OR DISPENS E
1401		-	CONTROLLED DANGEROUS SUBSTANCES UNLESS TH E PHYSICIAN ASSISTAN T HAS A
1402		-	VALID:
	1322	+	[15–302.2.] 15–302.1. 3
1403	1323
1404		-	(I) STATE CONTROLLED DANG EROUS SUBSTANCE
1405		-	REGISTRATION ; AND
	1324	+	[(a) A primary supervising PATIENT CARE TEAM physician may not delegate 4
	1325	+	prescribing, dispensing, and administering of controlled dangerous substances, 5
	1326	+	prescription drugs, or medical devices unless the primary supervising physician and 6
	1327	+	physician assistant include in the delegation COLLABORATION agreement: 7
1406	1328
1407		-	(II) FEDERAL DRUG ENFORCEMENT AGENCY (DEA)
1408		-	REGISTRATION .
	1329	+	(1) A notice of intent to delegate prescribing and, if applicable, dispensing 8
1409	1330
1410		-	~~[(c)] (D) (C)~~ (1) ~~A PATIENT CARE TEAM~~ PHYSICIAN ~~MAY A UTHORIZE A~~
1411		-	~~physician assistant TO personally may prepare and~~ dispense ~~[a drug that the physician~~
1412		-	~~assistant is authorized to prescribe under a delegation COLLABORATION agreement if]:~~
	1331	+	(1) THE AUTHORITY OF THE PHYSICIAN ASSISTANT TO PRESCRIBE 9
	1332	+	AND, IF APPLICABLE, DISPENSE of controlled dangerous substances, prescription drugs, 10
	1333	+	or medical devices; 11
1413	1334
1414		-	[(1) (I) Except as otherwise provided under § 12–102(g) of this article,
1415		-	the supervising PATIENT CARE TEAM physician possesses a dispensing permit; and
	1335	+	(2) An attestation that all prescribing and, if applicable, dispensing 12
	1336	+	activities of the physician assistant will comply with applicable federal and State LAW AND 13
	1337	+	regulations; 14
1416	1338
1417		-	(2) (II) The physician assistant dispenses drugs only within:
	1339	+	(3) An attestation that all medical charts or records will contain a notation 15
	1340	+	of any prescriptions written or dispensed by a physician assistant in accordance with this 16
	1341	+	section; 17
1418	1342
1419		-	(i) 1. The supervising PATIENT CARE TEAM physician’s scope
1420		-	of practice; and
	1343	+	(4) An attestation that all prescriptions written or dispensed under this 18
	1344	+	section will include the physician assistant’s name and the supervising PATIENT CARE 19
	1345	+	TEAM physician’s name, business address, and business telephone number legibly written 20
	1346	+	or printed; 21
1421	1347
1422		-	(ii) 2. The scope of the delegation COLLABORATION
1423		-	agreement.]
	1348	+	(5) AN ATTESTATION THAT A LL PRESCRIPTIONS WRI TTEN UNDER 22
	1349	+	THIS SECTION WILL IN CLUDE THE PHYSICIAN ASSISTANT’S NAME, BUSINESS 23
	1350	+	ADDRESS, AND BUSINESS TELEPHONE NUMBER LEGIBLY WRITTEN OR P RINTED; 24
1424	1351
1425		-	(2) A PATIENT CARE TEAM PH YSICIAN MAY DELEGATE ANY
1426		-	DISPENSING DUTIES , INCLUDING THE PERFOR MANCE OF THE FINAL C HECK OF
1427		-	PRESCRIPTIONS AS REQ UIRED UNDER § 12–102(A)(4)(II) OF THIS ARTICLE.
	1352	+	(5) (6) An attestation that the physician assistant has: 25
1428	1353
1429		-	(D) IF A PATIENT CARE TEAM PHYSICIAN WHO HAS DE LEGATED AUTHORITY
1430		-	TO EXERCISE PRESCRIP TIVE AUTHORITY TO A PHYSICIAN ASSISTANT
1431		-	SUBSEQUENTLY RESTRIC TS OR REMOVES THE DE LEGATION, THE PATIENT CARE
1432		-	TEAM PHYSICIAN SHALL NOTIFY THE BOARD OF THE RESTRICT ION OR REMOVAL
1433		-	WITHIN 5 BUSINESS DAYS.
	1354	+	(i) Passed the physician assistant national certification exam 26
	1355	+	administered by the National Commission on the Certification of Physician Assistants 27
	1356	+	within the previous 2 years; or 28
1434	1357
1435		-	(I) A STARTER DOSAGE OF AN Y DRUG THAT THE PHYS ICIAN
1436		-	ASSISTANT IS AUTHORI ZED TO PRESCRIBE TO A PATIENT OF THE PHY SICIAN
1437		-	ASSISTANT IF:
	1358	+	(ii) Successfully completed 8 category 1 hours of pharmacology 29
	1359	+	education within the previous 2 years; and 30
1438	1360
1439		-	1. THE STARTER DOSAGE CO MPLIES WITH THE
1440		-	LABELING REQUIREMENT S OF § 12–505 OF THIS ARTICLE;
	1361	+	(6) (7) An attestation that the physician assistant has: 31
1441	1362
1442		-	~~2. NO CHARGE IS MADE FOR THE STARTER DOSAGE~~ ; ~~AND~~
1443		-	~~Ch. 919~~ ~~2024 LAWS OF MARYLAND~~
	1363	+	(i) A bachelor’s degree or its equivalent; or 32
	1364	+	30 SENATE BILL 167
1444	1365
1445		-	– 32 –
1446		-	3. THE PHYSICIAN ASSISTA NT ENTERS AN APPROPR IATE
1447		-	RECORD IN THE PATIEN T’S MEDICAL RECORD ; OR
1448	1366
1449		-	(II) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , ANY
1450		-	DRUG THAT A PHYSICIA N ASSISTANT MAY PRES CRIBE TO THE EXTENT AUTHORIZE D
1451		-	BY LAW IN THE COURSE OF TREATING A PATIEN T AT:
	1367	+	(ii) Successfully completed 2 years of work experience as a physician 1
	1368	+	assistant. 2
1452	1369
1453		-	1. A ~~MEDICAL FACILITY OR CLINIC THAT SPECIALI ZES IN~~
1454		-	THE ~~TREATMENT~~ OF ~~MED ICAL CASES REIMBURSA BLE THROUGH WORKERS ’~~
1455		-	~~COMPENSATION INSURAN CE;~~
	1370	+	(b) (1) A primary supervising PATIENT CARE TEAM physician may not 3
	1371	+	delegate the prescribing or dispensing of substances that are identified as Schedule I 4
	1372	+	controlled dangerous substances under § 5–402 of the Criminal Law Article. 5
1456	1373
1457		-	2. A MEDICAL FACILITY OR CLINIC THAT IS OPERATED
1458		-	ON A NONPROFIT BASIS ;
	1374	+	(2) A primary supervising PATIENT CARE TEAM physician may delegate 6
	1375	+	the prescribing or dispensing of substances that are identified as Schedules II through V 7
	1376	+	controlled dangerous substances under § 5–402 of the Criminal Law Article, including 8
	1377	+	legend drugs as defined under § 503(b) of the Federal Food, Drug, and Cosmetic Act. 9
1459	1378
1460		-	3. A HEALTH CENTER THAT O PERATES ON A CAMPUS OF
1461		-	AN INSTITUTION OF HI GHER EDUCATION ;
	1379	+	(3) A primary supervising PATIENT CARE TEAM physician may not 10
	1380	+	delegate the prescribing or dispensing of controlled dangerous substances to a physician 11
	1381	+	assistant unless the physician assistant has a valid: 12
1462	1382
1463		-	4. A PUBLIC HEALTH FACILI TY, A MEDICAL FACILITY
1464		-	UNDER CONTRACT WITH A STATE OR LOCAL HEALTH DEPARTMENT , OR A FACILITY
1465		-	FUNDED WITH PUBLIC FUNDS; OR
	1383	+	(i) State controlled dangerous substance registration; and 13
1466	1384
1467		-	5. A NONPROFIT HOSPITAL O R A NONPROFIT HOSPIT AL
1468		-	OUTPATIENT FACILITY AS AUTHORIZED UNDER THE POLICIES ESTABLI SHED BY THE
1469		-	HOSPITAL.
	1385	+	(ii) Federal Drug Enforcement Agency (DEA) registration.] 14
1470	1386
1471		-	(2) A PHYSICIAN ASSISTANT WHO PERSONALLY PREPA RES AND
1472		-	DISPENSES A DRUG IN THE COURSE OF TREATI NG A PATIENT AS AUTHORIZE D UNDER
1473		-	THIS SUBSECTION SHAL L:
	1387	+	(A) IN THIS SECTION, “PERSONALLY PREPARE A ND DISPENSE” MEANS THAT 15
	1388	+	A PHYSICIAN ASSISTAN T: 16
1474	1389
1475		-	(I) ~~COMPLY WITH~~ THE ~~LABEL ING REQUIREMENTS OF § 12–505~~
1476		-	~~OF THIS ARTICLE~~;
	1390	+	(1) IS PHYSICALLY PRESENT ON THE PREMISES WHER E A 17
	1391	+	PRESCRIPTION IS FILL ED; AND 18
1477	1392
1478		-	(II) ~~RECORD THE DISPENSING~~ OF THE ~~PRESCRIPTION DRUG ON~~
1479		-	THE ~~PATIENT’S CHART;~~
	1393	+	(2) PERFORMS A FINAL CHEC K OF THE PRESCRIPTIO N BEFORE IT IS 19
	1394	+	PROVIDED TO THE PATI ENT. 20
1480	1395
1481		-	(~~III~~) ~~ALLOW~~ THE ~~OFFICE OF CONTROLLED SUBSTANCES~~
1482		-	~~ADMINISTRATION TO ENT ER AND INSPECT THE O FFICE IN WHICH THE P HYSICIAN~~
1483		-	~~ASSISTANT PRACTICES AT ALL REASONABLE HO URS; AND~~
	1396	+	(B) SUBJECT TO THE COLLAB ORATION AGREEMENT SU BMITTED UNDER § 21
	1397	+	15–302 OF THIS SUBTITLE , A PHYSICIAN ASSISTAN T MAY PRESCRIBE , PROCURE, 22
	1398	+	DISPENSE, ORDER, OR ADMINISTER : 23
1484	1399
1485		-	(IV) EXCEPT FOR STARTER DO SAGES OR SAMPLES DIS PENSED
1486		-	WITHOUT CHARGE , PROVIDE THE PATIENT WITH A WRITTEN PRESC RIPTION,
1487		-	MAINTAIN PRESCRIPTION F ILES, AND MAINTAIN A SEPAR ATE FILE FOR SCHEDULE
1488		-	II PRESCRIPTIONS FOR A PERIOD OF AT LEAST 5 YEARS. WES MOORE, Governor Ch. 919
	1400	+	(1) SUBJECT TO SUBSECTION (C)(2) OF THIS SECTION , DRUGS AND 24
	1401	+	SUBSTANCES THAT ARE IDENTIFIED AS SCHEDULES II THROUGH V CONTROLLED 25
	1402	+	DANGEROUS SUBSTANCES UNDER §§ 5–403 THROUGH 5–406 OF THE CRIMINAL LAW 26
	1403	+	ARTICLE, INCLUDING LEGEND DRU GS AS DEFINED UNDER § 503(B) OF THE 27
	1404	+	FEDERAL FOOD, DRUG, AND COSMETIC ACT; 28
1489	1405
1490		-	~~– 33 –~~
	1406	+	(2) MEDICAL DEVICES ; AND 29
1491	1407
1492		-	[(d)] (E) A physician assistant who personally dispenses a drug in the course of
1493		-	treating a patient as authorized under subsections (b) and [(c)] (D) of this section shall
1494		-	comply with the requirements under Titles 12 and 14 of this article and applicable federal
1495		-	law and regulations.
	1408	+	(3) DURABLE MEDICAL EQUIP MENT. 30
	1409	+	SENATE BILL 167 31
1496	1410
1497		-	[(e) Before a physician assistant may renew a license for an additional 2–year
1498		-	term under § 15–307 of this subtitle, the physician assistant shall submit evidence to the
1499		-	Board of successful completion of 8 category 1 hours of pharmacology education within the
1500		-	previous 2 years.]
1501	1411
1502		-	(F) A PRESCRIPTION DISPENS ED UNDER THIS SECTIO N SHALL INCLUDE
1503		-	THE PHYSICIAN ASSIST ANT’S:
	1412	+	(C) (1) A PHYSICIAN ASSISTANT MAY NOT PRESCRIBE OR DISPENSE 1
	1413	+	SUBSTANCES THAT ARE IDENTIFIED AS SCHEDULE I CONTROLLED DANGEROUS 2
	1414	+	SUBSTANCES UNDER § 5–402 OF THE CRIMINAL LAW ARTICLE. 3
1504	1415
1505		-	(1) NAME;
	1416	+	(2) A PHYSICIAN ASSISTANT MAY NOT PRESCRIBE OR DISPENSE 4
	1417	+	CONTROLLED DANGEROUS SUBSTANCES UNLESS TH E PHYSICIAN ASSISTAN T HAS A 5
	1418	+	VALID: 6
1506	1419
1507		-	(2) BUSINESS ADDRESS ; AND
	1420	+	(I) STATE CONTROLLED DANG EROUS SUBSTANCE 7
	1421	+	REGISTRATION ; AND 8
1508	1422
1509		-	(3) BUSINESS TELEPHONE NU MBER.
	1423	+	(II) FEDERAL DRUG ENFORCEMENT AGENCY (DEA) 9
	1424	+	REGISTRATION . 10
1510	1425
1511		-	(G) A ~~PHYSICIAN ASSISTANT STUDENT IN~~ A ~~TRAIN ING PROGRAM THAT IS~~
1512		-	~~ACCREDITED BY~~ THE ~~ACCREDITATION REVIEW COMMISSION ON EDUCATION FOR~~
1513		-	~~THE PHYSICIAN~~ ASSISTANT ~~MAY NOT EXE RCISE PRESCRIPTIVE~~ A ~~UTHORITY.~~
	1426	+	[(c)] (D) (C) (1) A PATIENT CARE TEAM PH YSICIAN MAY AUTHORIZ E A 11
	1427	+	physician assistant TO personally may prepare and dispense [a drug that the physician 12
	1428	+	assistant is authorized to prescribe under a delegation COLLABORATION agreement if]: 13
1514	1429
1515		-	[15–302.3.
	1430	+	[(1) (I) Except as otherwise provided under § 12–102(g) of this article, 14
	1431	+	the supervising PATIENT CARE TEAM physician possesses a dispensing permit; and 15
1516	1432
1517		-	(a) On a quarterly basis, the Board shall provide to the Board of Pharmacy a list
1518		-	of physician assistants whose delegation agreements include the delegation of prescriptive
1519		-	authority.
	1433	+	(2) (II) The physician assistant dispenses drugs only within: 16
1520	1434
1521		-	(b) The list required under subsection (a) of this section shall specify whether
1522		-	each physician assistant has been delegated the authority to prescribe controlled dangerous
1523		-	substances, prescription drugs, or medical devices.
	1435	+	(i) 1. The supervising PATIENT CARE TEAM physician’s scope 17
	1436	+	of practice; and 18
1524	1437
1525		-	(c) If a primary supervising physician who has delegated authority to exercise
1526		-	prescriptive authority to a physician assistant subsequently restricts or removes the
1527		-	delegation, the primary supervising physician shall notify the Board of the restriction or
1528		-	removal within 5 business days.]
	1438	+	(ii) 2. The scope of the delegation COLLABORATION 19
	1439	+	agreement.] 20
1529	1440
1530		-	15–303.
	1441	+	(2) A PATIENT CARE TEAM PH YSICIAN MAY DELEGATE ANY 21
	1442	+	DISPENSING DUTIES , INCLUDING THE PERFOR MANCE OF THE FINAL CHECK OF 22
	1443	+	PRESCRIPTIONS AS REQ UIRED UNDER § 12–102(A)(4)(II) OF THIS ARTICLE. 23
1531	1444
1532		-	(a) To qualify for a license, an applicant shall:
	1445	+	(D) IF A PATIENT CARE TEA M PHYSICIAN WHO HAS DELEGATED AUTHORITY 24
	1446	+	TO EXERCISE PRESCRIP TIVE AUTHORITY TO A PHYSICIAN ASSISTANT 25
	1447	+	SUBSEQUENTLY RESTRIC TS OR REMOVES THE DE LEGATION, THE PATIENT CARE 26
	1448	+	TEAM PHYSICIAN SHALL NOTIFY THE BOARD OF THE RESTRICT ION OR REMOVAL 27
	1449	+	WITHIN 5 BUSINESS DAYS. 28
1533	1450
1534		-	(1) Complete a criminal history records check in accordance with §
1535		-	14–308.1 of this article; Ch. 919 2024 LAWS OF MARYLAND
	1451	+	(I) A STARTER DOSAGE OF AN Y DRUG THAT THE PHYS ICIAN 29
	1452	+	ASSISTANT IS AUTHORI ZED TO PRESCRIBE TO A PATIENT OF THE PHY SICIAN 30
	1453	+	ASSISTANT IF: 31
	1454	+	32 SENATE BILL 167
1536	1455
1537		-	– 34 –
1538	1456
1539		-	(2) Be of good moral character;
	1457	+	1. THE STARTER DOSAGE COMPL IES WITH THE 1
	1458	+	LABELING REQUIREMENT S OF § 12–505 OF THIS ARTICLE; 2
1540	1459
1541		-	(3) Demonstrate oral and written competency in the English language as
1542		-	required by the Board;
	1460	+	2. NO CHARGE IS MADE FOR THE STARTER DOSAGE ; AND 3
1543	1461
1544		-	(4) Be at least 18 years old; [and]
	1462	+	3. THE PHYSICIAN ASSISTA NT ENTERS AN APPROPR IATE 4
	1463	+	RECORD IN THE PATIEN T’S MEDICAL RECORD ; OR 5
1545	1464
1546		-	(5) [(i) Be a graduate of a physician assistant training program
1547		-	approved by the Board; or
	1465	+	(II) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , ANY 6
	1466	+	DRUG THAT A PHYSICIA N ASSISTANT MAY PRES CRIBE TO THE EXTENT AUTHORIZED 7
	1467	+	BY LAW IN THE COURSE OF TREATING A PATIEN T AT: 8
1548	1468
1549		-	(ii) Have passed the physician assistant national certifying
1550		-	examination administered by the National Commission on Certification of Physician
1551		-	Assistants prior to 1986, maintained all continuing education and recertification
1552		-	requirements, and been in continuous practice since passage of the examination] EXCEPT
1553		-	AS PROVIDED IN SUBSE CTION (B) OF THIS SECTION , HAVE SUCCESSFULLY
1554		-	COMPLETED AN EDUCATI ONAL PROGRAM FOR PHY SICIAN ASSISTANTS AC CREDITED
1555		-	BY:
	1469	+	1. A MEDICAL FACILITY OR CLINIC THAT SPECIALI ZES IN 9
	1470	+	THE TREATMENT OF MED ICAL CASES REIMBURSA BLE THROUGH WORKERS ’ 10
	1471	+	COMPENSATION INSURAN CE; 11
1556	1472
1557		-	~~(I) THE ACCREDITATION REVIEW COMMISSION ON~~
1558		-	~~EDUCATION FOR THE PHYSICIAN ASSISTANT~~; OR
	1473	+	2. A MEDICAL FACILITY OR CLINIC THAT IS OPERA TED 12
	1474	+	ON A NONPROFIT BASIS ; 13
1559	1475
1560		-	(II) IF COMPLETED BEFORE 2001:
	1476	+	3. A HEALTH CENTER THAT O PERATES ON A CAMPUS OF 14
	1477	+	AN INSTITUTION OF HI GHER EDUCATION ; 15
1561	1478
1562		-	1. THE COMMITTEE ON ALLIED HEALTH EDUCATION
1563		-	AND ACCREDITATION ; OR
	1479	+	4. A PUBLIC HEALTH FACILI TY, A MEDICAL FACIL ITY 16
	1480	+	UNDER CONTRACT WITH A STATE OR LOCAL HEALTH DEPARTMENT , OR A FACILITY 17
	1481	+	FUNDED WITH PUBLIC F UNDS; OR 18
1564	1482
1565		-	2. THE COMMISSION ON ACCREDITATION OF ALLIED
1566		-	HEALTH EDUCATION PROGRAMS; AND
	1483	+	5. A NONPROFIT HOSPITAL O R A NONPROFIT HOSPIT AL 19
	1484	+	OUTPATIENT FACILITY AS AUTHORIZED UNDER THE POLICIES ESTABLI SHED BY THE 20
	1485	+	HOSPITAL. 21
1567	1486
1568		-	(6) ~~HAVE PASSED T HE~~ PHYSICIAN ASSISTANT ~~NATIONAL~~
1569		-	~~CERTIFYING EXAMINATION ADMINISTE RED BY~~ THE ~~NATIONAL COMMISSION ON~~
1570		-	~~CERTIFICATION OF PHYSICIAN ASSISTANTS.~~
	1487	+	(2) A PHYSICIAN ASSISTANT WHO PERSON ALLY PREPARES AND 22
	1488	+	DISPENSES A DRUG IN THE COURSE OF TREATI NG A PATIENT AS AUTH ORIZED UNDER 23
	1489	+	THIS SUBSECTION SHAL L: 24
1571	1490
1572		-	[(b) ~~Except as otherwise provided in this title,~~ the ~~applicant shall pass a national~~
1573		-	~~certifying examination approved by the Board.]~~
	1491	+	(I) COMPLY WITH THE LABEL ING REQUIREMENTS OF § 12–505 25
	1492	+	OF THIS ARTICLE; 26
1574	1493
1575		-	[(c)] (B) An applicant who graduates from [a physician assistant training
1576		-	program] AN ACCREDITED EDUCAT IONAL PROGRAM FOR PH YSICIAN ASSISTANTS
1577		-	UNDER THIS SECTION after October 1, 2003, shall have a bachelor’s degree or its
1578		-	equivalent.
	1494	+	(II) RECORD THE DISPENSING OF THE PRESCRIP TION DRUG ON 27
	1495	+	THE PATIENT’S CHART; 28
1579	1496
1580		-	15–306.
1581		-	WES MOORE, Governor Ch. 919
	1497	+	(III) ALLOW THE OFFICE OF CONTROLLED SUBSTANCES 29
	1498	+	ADMINISTRATION TO ENT ER AND INSPECT THE O FFICE IN WHICH THE P HYSICIAN 30
	1499	+	ASSISTANT PRACTICES AT ALL REASONABLE HO URS; AND 31
	1500	+	SENATE BILL 167 33
1582	1501
1583		-	– 35 –
1584		-	A license authorizes the licensee to practice as a physician assistant [under a
1585		-	delegation agreement] while the license is effective.
1586	1502
1587		-	15–309.
	1503	+	(IV) EXCEPT FOR STARTER DO SAGES OR SAMPLES DIS PENSED 1
	1504	+	WITHOUT CHARGE , PROVIDE THE PATIENT WITH A WRITTEN PRESC RIPTION, 2
	1505	+	MAINTAIN PRESCRIPTIO N FILES, AND MAINTAIN A SEPAR ATE FILE FOR SCHEDULE 3
	1506	+	II PRESCRIPTIONS FOR A PERIOD OF AT LEAST 5 YEARS. 4
1588	1507
1589		-	(a) Each licensee shall keep a license and [delegation] COLLABORATION
1590		-	agreement for inspection at the primary place of business of the licensee.
	1508	+	[(d)] (E) A physician assistant who personally dispenses a drug in the course of 5
	1509	+	treating a patient as authorized under subsections (b) and [(c)] (D) of this section shall 6
	1510	+	comply with the requirements under Titles 12 and 14 of this article and applicable federal 7
	1511	+	law and regulations. 8
1591	1512
1592		-	(C) THE BOARD MAY AUDIT AND R EVIEW COLLABORATION AGREEMENTS
1593		-	KEPT BY THE LICENSEE AT THE PRIMARY PLACE OF BUSINESS OF THE L ICENSEE AT
1594		-	ANY TIME.
	1513	+	[(e) Before a physician assistant may renew a license for an additional 2–year 9
	1514	+	term under § 15–307 of this subtitle, the physician assistant shall submit evidence to the 10
	1515	+	Board of successful completion of 8 category 1 hours of pharmacology education within the 11
	1516	+	previous 2 years.] 12
1595	1517
1596		-	(D) A PHYSICIAN ASSISTANT WHO FAILS TO PRODUCE A COLLABORATION
1597		-	AGREEMENT TO THE BOARD ON REQUEST IS S UBJECT TO AN ADMINIS TRATIVE
1598		-	PENALTY AS ESTABLISH ED IN REGULATIONS .
	1518	+	(F) A PRESCRIPTION DISPENS ED UNDER THIS SECTIO N SHALL INCLUDE 13
	1519	+	THE PHYSICIAN ASSIST ANT’S: 14
1599	1520
1600		-	15~~–310.~~
	1521	+	(1) NAME; 15
1601	1522
1602		-	(a) In reviewing an application for licensure or in investigating an allegation
1603		-	brought under § 15–314 of this subtitle, the Committee may request the Board to direct, or
1604		-	the Board on its own initiative may direct, the physician assistant to submit to an
1605		-	appropriate examination.
	1523	+	(2) BUSINESS ADDRESS ; AND 16
1606	1524
1607		-	(b) In return for the privilege given to the physician assistant to [perform
1608		-	delegated medical acts] PRACTICE AS A PHY SICIAN ASSISTANT in the State, the
1609		-	physician assistant is deemed to have:
	1525	+	(3) BUSINESS TELEPHONE NU MBER. 17
1610	1526
1611		-	(1) Consented to submit to an examination under this section, if requested
1612		-	by the Board in writing; and
	1527	+	(G) A PHYSICIAN ASSISTANT STUDENT IN A TRAINING PROGRAM THA T IS 18
	1528	+	ACCREDITED BY THE ACCREDITATION REVIEW COMMISSION ON EDUCATION FOR 19
	1529	+	THE PHYSICIAN ASSISTANT MAY NOT EXE RCISE PRESCRIPTIVE A UTHORITY. 20
1613	1530
1614		-	(2) Waived any claim of privilege as to the testimony or examination
1615		-	reports.
	1531	+	[15–302.3. 21
1616	1532
1617		-	(c) The unreasonable failure or refusal of the licensed physician assistant or
1618		-	applicant to submit to an examination is prima facie evidence of the licensed physician
1619		-	assistant’s inability to [perform delegated medical acts] PRACTICE AS A PHYSIC IAN
1620		-	ASSISTANT and is cause for denial of the application or immediate suspension of the
1621		-	license.
	1533	+	(a) On a quarterly basis, the Board shall provide to the Board of Pharmacy a list 22
	1534	+	of physician assistants whose delegation agreements include the delegation of prescriptive 23
	1535	+	authority. 24
1622	1536
1623		-	(d) The Board shall pay the costs of any examination made under this section.
	1537	+	(b) The list required under subsection (a) of this section shall specify whether 25
	1538	+	each physician assistant has been delegated the authority to prescribe controlled dangerous 26
	1539	+	substances, prescription drugs, or medical devices. 27
1624	1540
1625		-	[15–313.
	1541	+	(c) If a primary supervising physician who has delegated authority to exercise 28
	1542	+	prescriptive authority to a physician assistant subsequently restricts or removes the 29
	1543	+	delegation, the primary supervising physician shall notify the Board of the restriction or 30
	1544	+	removal within 5 business days.] 31
1626	1545
1627		-	~~(a) (1) Except as otherwise provided under § 10–226 of the State Government~~
1628		-	~~Article, before the Board takes any action to reject or modify a delegation agreement or Ch. 919~~ ~~2024 LAWS OF MARYLAND~~
	1546	+	15–303. 32
	1547	+	34 SENATE BILL 167
1629	1548
1630		-	– 36 –
1631		-	advanced duty, the Board shall give the licensee the opportunity for a hearing before the
1632		-	Board.
1633	1549
1634		-	(2) The Board shall give notice and hold the hearing under Title 10,
1635		-	Subtitle 2 of the State Government Article.
	1550	+	(a) To qualify for a license, an applicant shall: 1
1636	1551
1637		-	(3) ~~The Board may administer oaths~~ in ~~connection~~ with ~~any proceeding~~
1638		-	~~under~~ this ~~section.~~
	1552	+	(1) Complete a criminal history records check in accordance with § 2
	1553	+	14–308.1 of this article; 3
1639	1554
1640		-	(4) At least 14 days before the hearing, the hearing notice shall be sent to
1641		-	the last known address of the applicant or licensee.
	1555	+	(2) Be of good moral character; 4
1642	1556
1643		-	(b) Any licensee aggrieved under this subtitle by a final decision of the Board
1644		-	rejecting or modifying a delegation agreement or advanced duty may petition for judicial
1645		-	review as allowed by the Administrative Procedure Act.]
	1557	+	(3) Demonstrate oral and written competency in the English language as 5
	1558	+	required by the Board; 6
1646	1559
1647		-	~~15–314.~~
	1560	+	(4) Be at least 18 years old; [and] 7
1648	1561
1649		-	(a) Subject to the hearing provisions of § 15–315 of this subtitle, a disciplinary
1650		-	panel, on the affirmative vote of a majority of the quorum, may reprimand any physician
1651		-	assistant, place any physician assistant on probation, or suspend or revoke a license if the
1652		-	physician assistant:
	1562	+	(5) [(i) Be a graduate of a physician assistant training program 8
	1563	+	approved by the Board; or 9
1653	1564
1654		-	(41) Performs [delegated] medical acts beyond the scope of the [delegation]
1655		-	COLLABORATION agreement filed with the Board [or after notification from the Board
1656		-	that an advanced duty has been disapproved] IN A MANNER THAT IS NOT CONSISTENT
1657		-	WITH THE COLLABORATI ON AGREEMENT ;
	1565	+	(ii) Have passed the physician assistant national certifying 10
	1566	+	examination administered by the National Commission on Certification of Physician 11
	1567	+	Assistants prior to 1986, maintained all continuing education and recertification 12
	1568	+	requirements, and been in continuous practice since passage of the examination] EXCEPT 13
	1569	+	AS PROVIDED IN SUBSE CTION (B) OF THIS SECTION , HAVE SUCCESSFULLY 14
	1570	+	COMPLETED AN EDUCATI ONAL PROGRAM FOR PHY SICIAN ASSISTANTS AC CREDITED 15
	1571	+	BY: 16
1658	1572
1659		-	[(42) ~~Performs delegated medical acts without~~ the ~~supervision of a~~
1660		-	physician;]
	1573	+	(I) THE ACCREDITATION REVIEW COMMISSION ON 17
	1574	+	EDUCATION FOR THE PHYSICIAN ASSISTANT; OR 18
1661	1575
1662		-	(42) PERFORMS MEDICAL ACTS WHICH ARE OUTSIDE TH E EDUCATION,
1663		-	TRAINING, AND EXPERIENCE OF TH E PHYSICIAN ASSISTAN T;
	1576	+	(II) IF COMPLETED BEFORE 2001: 19
1664	1577
1665		-	(43) PERFORMS MEDICAL ACTS THAT ARE NOT CUSTOMA RY TO THE
1666		-	PRACTICE OF THE PATI ENT CARE TEAM PHYSIC IANS LISTED ON THE
1667		-	COLLABORATION AGREEM ENT;
	1578	+	1. THE COMMITTEE ON ALLIED HEALTH EDUCATION 20
	1579	+	AND ACCREDITATION ; OR 21
1668	1580
1669		-	(42) (44) PRACTICES AS A PHYSIC IAN ASSISTANT WITHOU T FIRST
1670		-	SUBMITTING A COLLABO RATION AGREEMENT TO THE BOARD; PROVIDING NOTICE
1671		-	TO THE BOARD AS REQUIRED UND ER § 15–302(A) OF THIS SUBTITLE;
	1581	+	2. THE COMMISSION ON ACCREDITATION OF ALLIED 22
	1582	+	HEALTH EDUCATION PROGRAMS; AND 23
1672	1583
1673		-	~~[(43)]~~ (45) ~~Fails to complete a criminal history records check under §~~
1674		-	~~14–308.1 of this article;~~
1675		-	~~WES MOORE, Governor Ch~~. ~~919~~
	1584	+	(6) HAVE PASSED TH E PHYSICIAN ASSISTANT NATIONAL 24
	1585	+	CERTIFYING EXAMINATION ADMINISTE RED BY THE NATIONAL COMMISSION ON 25
	1586	+	CERTIFICATION OF PHYSICIAN ASSISTANTS. 26
1676	1587
1677		-	– 37 –
1678		-	[(44)] (46) Fails to comply with the requirements of the Prescription Drug
1679		-	Monitoring Program under Title 21, Subtitle 2A of the Health – General Article; or
	1588	+	[(b) Except as otherwise provided in this title, the applicant shall pass a national 27
	1589	+	certifying examination approved by the Board.] 28
1680	1590
1681		-	[(45)] (47) Fails to comply with any State or federal law pertaining to the
1682		-	practice as a physician assistant.
	1591	+	[(c)] (B) An applicant who graduates from [a physician assistant training 29
	1592	+	program] AN ACCREDITED EDUCAT IONAL PROGRAM FOR PH YSICIAN ASSISTANTS 30
	1593	+	UNDER THIS SECTION after October 1, 2003, shall have a bachelor’s degree or its 31
	1594	+	equivalent. 32 SENATE BILL 167 35
1683	1595
1684		-	15–317.
1685	1596
1686		-	(a) A physician assistant WHO IS LICENSED in this State or in any other state
1687		-	OR WHO IS AN EMPLOYE E OF THE FEDERAL GOV ERNMENT is authorized to perform
1688		-	acts, tasks, or functions as a physician assistant [under the supervision of a physician
1689		-	licensed to practice medicine in the State] during a disaster as defined by the Governor,
1690		-	within a county in which a state of disaster has been declared, or counties contiguous to a
1691		-	county in which a state of disaster has been declared.
1692	1597
1693		-	(b) The physician assistant shall notify the Board in writing of the names,
1694		-	practice locations, and telephone numbers for the physician assistant [and each primary
1695		-	supervising physician] within 30 days [of] AFTER the first performance of medical acts,
1696		-	tasks, or functions as a physician assistant during the disaster.
	1598	+	15–306. 1
1697	1599
1698		-	(c) A team of physicians and physician assistants or physician assistants
1699		-	practicing under this section may not be required to maintain on–site documentation
1700		-	describing [supervisory arrangements] COLLABORATION AGREEM ENTS as otherwise
1701		-	required under this title.
	1600	+	A license authorizes the licensee to practice as a physician assistant [under a 2
	1601	+	delegation agreement] while the license is effective. 3
1702	1602
1703		-	15–~~401~~.
	1603	+	15–309. 4
1704	1604
1705		-	[(a)] Except as otherwise provided in this title, a person may not practice, attempt
1706		-	to practice, or offer to practice as a physician assistant in the State unless the person has
1707		-	[a]:
	1605	+	(a) Each licensee shall keep a license and [delegation] COLLABORATION 5
	1606	+	agreement for inspection at the primary place of business of the licensee. 6
1708	1607
1709		-	(1) A license issued by the Board TO PRACTICE AS A PHY SICIAN
1710		-	ASSISTANT; AND
	1608	+	(C) THE BOARD MAY AUDIT AND R EVIEW COLLABORATION AGREEMENTS 7
	1609	+	KEPT BY THE LICENSEE AT THE PRIMARY PLACE OF BUSINESS OF THE L ICENSEE AT 8
	1610	+	ANY TIME. 9
1711	1611
1712		-	(2) SUBMITTED A COLLABORA TION AGREEMENT TO TH E BOARD.
	1612	+	(D) A PHYSICIAN ASSISTANT WHO FAILS TO PRODUCE A COLL ABORATION 10
	1613	+	AGREEMENT TO THE BOARD ON REQUEST IS S UBJECT TO AN ADMINIS TRATIVE 11
	1614	+	PENALTY AS ESTABLISH ED IN REGULATIONS . 12
1713	1615
1714		-	(2) PROVIDED NOTICE TO TH E BOARD AS REQUIRED UND ER §
1715		-	15–302(A) OF THIS TITLE.
	1616	+	15–310. 13
1716	1617
1717		-	[(b) Except as otherwise provided in this title, a person may not perform, attempt
1718		-	to perform, or offer to perform any delegated medical act beyond the scope of the license
1719		-	and which is consistent with a delegation agreement filed with the Board.]
	1618	+	(a) In reviewing an application for licensure or in investigating an allegation 14
	1619	+	brought under § 15–314 of this subtitle, the Committee may request the Board to direct, or 15
	1620	+	the Board on its own initiative may direct, the physician assistant to submit to an 16
	1621	+	appropriate examination. 17
1720	1622
1721		-	15–402.1.
1722		-	Ch. 919 2024 LAWS OF MARYLAND
	1623	+	(b) In return for the privilege given to the physician assistant to [perform 18
	1624	+	delegated medical acts] PRACTICE AS A PHYSIC IAN ASSISTANT in the State, the 19
	1625	+	physician assistant is deemed to have: 20
1723	1626
1724		-	– 38 –
1725		-	(a) Except as otherwise provided in this subtitle, a licensed physician may not
1726		-	employ [or supervise] an individual practicing as a physician assistant who does not have
1727		-	a license OR WHO HAS NOT SUBMITTED A COLLABOR ATION AGREEMENT TO T HE
1728		-	BOARD PROVIDED NOTICE TO T HE BOARD AS REQUIRED UND ER § 15–302(A) OF
1729		-	THIS TITLE.
	1627	+	(1) Consented to submit to an examination under this section, if requested 21
	1628	+	by the Board in writing; and 22
1730	1629
1731		-	Article – Transportation
	1630	+	(2) Waived any claim of privilege as to the testimony or examination 23
	1631	+	reports. 24
1732	1632
1733		-	13–616.
	1633	+	(c) The unreasonable failure or refusal of the licensed physician assistant or 25
	1634	+	applicant to submit to an examination is prima facie evidence of the licensed physician 26
	1635	+	assistant’s inability to [perform delegated medical acts] PRACTICE AS A PHYSIC IAN 27
	1636	+	ASSISTANT and is cause for denial of the application or immediate suspension of the 28
	1637	+	license. 29
1734	1638
1735		-	(a) ~~(1) In~~ this ~~subtitle the following words have the meanings indicated~~.
	1639	+	(d) The Board shall pay the costs of any examination made under this section. 30
1736	1640
1737		-	(7) “Licensed physician assistant” means an individual who is licensed
1738		-	under Title 15 of the Health Occupations Article to practice [medicine with physician
1739		-	supervision] AS A PHYSICIAN ASSISTANT.
	1641	+	[15–313. 31
	1642	+	36 SENATE BILL 167
1740	1643
1741		-	SECTION 2. AND BE IT FURTHER ENACTED, That:
1742	1644
1743		-	(a) A physician assistant authorized to practice under a delegation agreement on
1744		-	October 1, 2024, may continue to practice as a physician assistant under the delegation
1745		-	agreement.
	1645	+	(a) (1) Except as otherwise provided under § 10–226 of the State Government 1
	1646	+	Article, before the Board takes any action to reject or modify a delegation agreement or 2
	1647	+	advanced duty, the Board shall give the licensee the opportunity for a hearing before the 3
	1648	+	Board. 4
1746	1649
1747		-	(b) The delegation agreement in effect on October 1, 2024, shall be treated the
1748		-	same as the collaboration agreement required under § 15–302 of the Health Occupations
1749		-	Article, as enacted by Section 1 of this Act, until an initial collaboration agreement is
1750		-	submitted to the State Board of Physicians by the physician assistant the physician
1751		-	assistant has provided notice to the State Board of Physicians as required under §
1752		-	15–302(a) of the Health Occupations Article, as enacted under Section 1 of this Act.
	1650	+	(2) The Board shall give notice and hold the hearing under Title 10, 5
	1651	+	Subtitle 2 of the State Government Article. 6
1753	1652
1754		-	SECTION 3. AND BE IT FURTHER ENACTED, That, on or before January 1, 2025,
1755		-	the State Board of Physicians, with representatives from the Maryland Academy of
1756		-	Physician Assistants, the Physician Assistant Education Association, and physician
1757		-	assistant education programs in the State, shall review and update the list of advanced
1758		-	duties for physician assistants.
	1653	+	(3) The Board may administer oaths in connection with any proceeding 7
	1654	+	under this section. 8
1759	1655
1760		-	~~SECTION 3.~~ ~~4. AND~~ BE ~~IT FURTHER ENACTED,~~ ~~That this Act shall take effect~~
1761		-	~~October 1,~~ ~~2024~~.
	1656	+	(4) At least 14 days before the hearing, the hearing notice shall be sent to 9
	1657	+	the last known address of the applicant or licensee. 10
1762	1658
1763		-	Approved by the Governor, May 16, 2024.
	1659	+	(b) Any licensee aggrieved under this subtitle by a final decision of the Board 11
	1660	+	rejecting or modifying a delegation agreement or advanced duty may petition for judicial 12
	1661	+	review as allowed by the Administrative Procedure Act.] 13
	1662	+
	1663	+	15–314. 14
	1664	+
	1665	+	(a) Subject to the hearing provisions of § 15–315 of this subtitle, a disciplinary 15
	1666	+	panel, on the affirmative vote of a majority of the quorum, may reprimand any physician 16
	1667	+	assistant, place any physician assistant on probation, or suspend or revoke a license if the 17
	1668	+	physician assistant: 18
	1669	+
	1670	+	(41) Performs [delegated] medical acts beyond the scope of the [delegation] 19
	1671	+	COLLABORATION agreement filed with the Board [or after notification from the Board 20
	1672	+	that an advanced duty has been disapproved] IN A MANNER THAT IS NOT CONSISTENT 21
	1673	+	WITH THE COLLABORATI ON AGREEMENT ; 22
	1674	+
	1675	+	[(42) Performs delegated medical acts without the supervision of a 23
	1676	+	physician;] 24
	1677	+
	1678	+	(42) PERFORMS MEDICAL ACTS WHICH ARE OUTSIDE TH E EDUCATION, 25
	1679	+	TRAINING, AND EXPERIENCE OF TH E PHYSICIAN ASSISTAN T; 26
	1680	+
	1681	+	(43) PERFORMS MEDICAL ACTS THAT ARE NOT CUSTOMA RY TO THE 27
	1682	+	PRACTICE OF THE PATI ENT CARE TEAM PHYSIC IANS LISTED ON THE 28
	1683	+	COLLABORATION AGREEM ENT; 29
	1684	+
	1685	+	(42) (44) PRACTICES AS A PHYSIC IAN ASSISTANT WITHOU T FIRST 30
	1686	+	SUBMITTING A COLLABO RATION AGREEMENT TO THE BOARD; PROVIDING NOTICE 31
	1687	+	TO THE BOARD AS REQUIRED UND ER § 15–302(A) OF THIS SUBTITLE; 32
	1688	+
	1689	+	[(43)] (45) Fails to complete a criminal history records check under § 33
	1690	+	14–308.1 of this article; 34 SENATE BILL 167 37
	1691	+
	1692	+
	1693	+
	1694	+	[(44)] (46) Fails to comply with the requirements of the Prescription Drug 1
	1695	+	Monitoring Program under Title 21, Subtitle 2A of the Health – General Article; or 2
	1696	+
	1697	+	[(45)] (47) Fails to comply with any State or federal law pertaining to the 3
	1698	+	practice as a physician assistant. 4
	1699	+
	1700	+	15–317. 5
	1701	+
	1702	+	(a) A physician assistant WHO IS LICENSED in this State or in any other state 6
	1703	+	OR WHO IS AN EMPLOYE E OF THE FEDERAL GOV ERNMENT is authorized to perform 7
	1704	+	acts, tasks, or functions as a physician assistant [under the supervision of a physician 8
	1705	+	licensed to practice medicine in the State] during a disaster as defined by the Governor, 9
	1706	+	within a county in which a state of disaster has been declared, or counties contiguous to a 10
	1707	+	county in which a state of disaster has been declared. 11
	1708	+
	1709	+	(b) The physician assistant shall notify the Board in writing of the names, 12
	1710	+	practice locations, and telephone numbers for the physician assistant [and each primary 13
	1711	+	supervising physician] within 30 days [of] AFTER the first performance of medical acts, 14
	1712	+	tasks, or functions as a physician assistant during the disaster. 15
	1713	+
	1714	+	(c) A team of physicians and physician assistants or physician assistants 16
	1715	+	practicing under this section may not be required to maintain on–site documentation 17
	1716	+	describing [supervisory arrangements] COLLABORATION AGREEM ENTS as otherwise 18
	1717	+	required under this title. 19
	1718	+
	1719	+	15–401. 20
	1720	+
	1721	+	[(a)] Except as otherwise provided in this title, a person may not practice, attempt 21
	1722	+	to practice, or offer to practice as a physician assistant in the State unless the person has 22
	1723	+	[a]: 23
	1724	+
	1725	+	(1) A license issued by the Board TO PRACTICE AS A PHY SICIAN 24
	1726	+	ASSISTANT; AND 25
	1727	+
	1728	+	(2) SUBMITTED A COLLABORA TION AGREEMENT TO TH E BOARD. 26
	1729	+
	1730	+	(2) PROVIDED NOTICE TO TH E BOARD AS REQUIRED UND ER § 27
	1731	+	15–302(A) OF THIS TITLE. 28
	1732	+
	1733	+	[(b) Except as otherwise provided in this title, a person may not perform, attempt 29
	1734	+	to perform, or offer to perform any delegated medical act beyond the scope of the license 30
	1735	+	and which is consistent with a delegation agreement filed with the Board.] 31
	1736	+
	1737	+	15–402.1. 32 38 SENATE BILL 167
	1738	+
	1739	+
	1740	+
	1741	+	(a) Except as otherwise provided in this subtitle, a licensed physician may not 1
	1742	+	employ [or supervise] an individual practicing as a physician assistant who does not have 2
	1743	+	a license OR WHO HAS NOT SUBMITTED A COLLABOR ATION AGREEMENT TO T HE 3
	1744	+	BOARD PROVIDED NOTICE TO T HE BOARD AS REQUIRED UND ER § 15–302(A) OF 4
	1745	+	THIS TITLE. 5
	1746	+
	1747	+	Article – Transportation 6
	1748	+
	1749	+	13–616. 7
	1750	+
	1751	+	(a) (1) In this subtitle the following words have the meanings indicated. 8
	1752	+
	1753	+	(7) “Licensed physician assistant” means an individual who is licensed 9
	1754	+	under Title 15 of the Health Occupations Article to practice [medicine with physician 10
	1755	+	supervision] AS A PHYSICIAN ASSISTANT. 11
	1756	+
	1757	+	SECTION 2. AND BE IT FURTHER ENACTED, That: 12
	1758	+
	1759	+	(a) A physician assistant authorized to practice under a delegation agreement on 13
	1760	+	October 1, 2024, may continue to practice as a physician assistant under the delegation 14
	1761	+	agreement. 15
	1762	+
	1763	+	(b) The delegation agreement in effect on October 1, 2024, shall be treated the 16
	1764	+	same as the collaboration agreement required under § 15–302 of the Health Occupations 17
	1765	+	Article, as enacted by Section 1 of this Act, until an initial collaboration agreement is 18
	1766	+	submitted to the State Board of Physicians by the physician assistant the physician 19
	1767	+	assistant has provided notice to the State Board of Physicians as required under § 20
	1768	+	15–302(a) of the Health Occupations Article, as enacted under Section 1 of this Act. 21
	1769	+
	1770	+	SECTION 3. AND BE IT FURTHER ENACTED, That, on or before January 1, 2025, 22
	1771	+	the State Board of Physicians, with representatives from the Maryland Academy of 23
	1772	+	Physician Assistants, the Physician Assistant Education Association, and physician 24
	1773	+	assistant education programs in the State, shall review and update the list of advanced 25
	1774	+	duties for physician assistants. 26
	1775	+
	1776	+	SECTION 3. 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 27
	1777	+	October 1, 2024. 28