WES MOORE, Governor Ch. 919
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Chapter 919
(Senate Bill 167)
AN ACT concerning
Physician Assistants – Revisions
(Physician Assistant Modernization Act of 2024)
FOR the purpose of requiring that a physician assistant have a collaboration agreement,
rather than a delegation agreement, in order to practice as a physician assistant;
altering the scope of practice of a physician assistant; altering the education required
for licensure as a physician assistant; authorizing physician assistants who are
employees of the federal government to perform acts, tasks, or functions as a
physician assistant during a certain disaster; requiring the State Board of
Physicians to review and update the list of advanced duties for physician assistants;
and generally relating to physician assistants.
BY repealing and reenacting, without amendments,
Article – Alcoholic Beverages and Cannabis
Section 36–101(a)
Annotated Code of Maryland
(2016 Volume and 2023 Supplement)
BY repealing and reenacting, with amendments,
Article – Alcoholic Beverages and Cannabis
Section 36–101(m)(1)(v)
Annotated Code of Maryland
(2016 Volume and 2023 Supplement)
BY repealing and reenacting, without amendments,
Article – Courts and Judicial Proceedings
Section 3–2A–01(a)
Annotated Code of Maryland
(2020 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, with amendments,
Article – Courts and Judicial Proceedings
Section 3–2A–01(f)
Annotated Code of Maryland
(2020 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, with amendments,
Article – Education
Section 7–402(c) and 18–802(a)(8)
Annotated Code of Maryland
(2022 Replacement Volume and 2023 Supplement) Ch. 919 2024 LAWS OF MARYLAND
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BY repealing and reenacting, without amendments,
Article – Education
Section 18–802(a)(1)
Annotated Code of Maryland
(2022 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, without amendments,
Article – Health – General
Section 4–201(a) and 5–601(a)
Annotated Code of Maryland
(2023 Replacement Volume)
BY repealing and reenacting, with amendments,
Article – Health – General
Section 4–201(s) and 5–601(v)
Annotated Code of Maryland
(2023 Replacement Volume)
BY repealing and reenacting, with amendments,
Article – Health Occupations
Section 12–102(c)(2)(iv), (v), and (vi) 12–102(a) and (c)(2)(iv), 14–306(a), 15–101,
15–103, 15–202(b), 15–205(a), 15–301, 15–302, 15–302.2, 15–303, 15–306,
15–309(a), 15–310, 15–314(a)(41), (43), (44), and (45), 15–317, 15–401, and
15–402.1(a)
Annotated Code of Maryland
(2021 Replacement Volume and 2023 Supplement)
BY adding to
Article – Health Occupations
Section 12–102(c)(2)(vii) and 15–314(a)(42)
Annotated Code of Maryland
(2021 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, without amendments,
Article – Health Occupations
Section 15–202(a)(1) and (2)
Annotated Code of Maryland
(2021 Replacement Volume and 2023 Supplement)
BY repealing
Article – Health Occupations
Section 15–302.1, 15–302.3, 15–313, and 15–314(a)(42)
Annotated Code of Maryland
(2021 Replacement Volume and 2023 Supplement)
WES MOORE, Governor Ch. 919
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BY adding to
Article – Health Occupations
Section 15–302.1, 15–309(c) and (d), and 15–314(a)(42), (43), and (44)
Annotated Code of Maryland
(2021 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, without amendments,
Article – Transportation
Section 13–616(a)(1)
Annotated Code of Maryland
(2020 Replacement Volume and 2023 Supplement)
BY repealing and reenacting, with amendments,
Article – Transportation
Section 13–616(a)(7)
Annotated Code of Maryland
(2020 Replacement Volume and 2023 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Alcoholic Beverages and Cannabis
36–101.
(a) In this title the following words have the meanings indicated.
(m) “Certifying provider” means an individual who:
(1) (v) 1. has an active, unrestricted license to practice as a
physician assistant issued by the State Board of Physicians under Title 15 of the Health
Occupations Article; AND
2. [has an active delegation agreement with a primary
supervising physician COLLABORATION AGREEM ENT WITH A PATIENT C ARE TEAM
PHYSICIAN who is a certifying provider; and
3.] is in good standing with the State Board of Physicians;
Article – Courts and Judicial Proceedings
3–2A–01.
(a) In this subtitle the following terms have the meanings indicated unless the
context of their use requires otherwise.
Ch. 919 2024 LAWS OF MARYLAND
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(f) (1) “Health care provider” means a hospital, a related institution as defined
in § 19–301 of the Health – General Article, a medical day care center, a hospice care
program, an assisted living program, a freestanding ambulatory care facility as defined in
§ 19–3B–01 of the Health – General Article, a physician, A PHYSICIAN ASSISTAN T, an
osteopath, an optometrist, a chiropractor, a registered or licensed practical nurse, a dentist,
a podiatrist, a psychologist, a licensed certified social worker–clinical, and a physical
therapist, licensed or authorized to provide one or more health care services in Maryland.
(2) “Health care provider” does not include any nursing institution
conducted by and for those who rely upon treatment by spiritual means through prayer
alone in accordance with the tenets and practices of a recognized church or religious
denomination.
Article – Education
7–402.
(c) The physical examination required under subsection (b) of this section shall
be completed by:
(1) A licensed physician;
(2) A licensed physician assistant [with a delegation agreement approved
by the State Board of Physicians WHO HAS AN ACTIVE CO LLABORATION AGREEMEN T];
or
(3) A certified nurse practitioner.
18–802.
(a) (1) In this section the following words have the meanings indicated.
(8) “Physician assistant” means an individual [to whom duties are
delegated by a licensed physician under the rules and regulations of the State Board of
Physicians] LICENSED UNDER TITLE 15 OF THE HEALTH OCCUPATIONS ARTICLE TO
PRACTICE AS A PHYSIC IAN ASSISTANT.
Article – Health – General
4–201.
(a) In this subtitle the following words have the meanings indicated.
WES MOORE, Governor Ch. 919
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(s) “Physician assistant” means an individual who is licensed under Title 15 of
the Health Occupations Article to practice [medicine with physician supervision] AS A
PHYSICIAN ASSISTANT .
5–601.
(a) In this subtitle the following words have the meanings indicated.
(v) “Physician assistant” means an individual who is licensed under Title 15 of
the Health Occupations Article to practice [medicine with physician supervision] AS A
PHYSICIAN ASSISTANT .
Article – Health Occupations
12–102.
(a) (1) In this section the following terms have the meanings indicated.
(2) “In the public interest” means the dispensing of drugs or devices by a
licensed dentist, physician, nurse or midwife, or podiatrist to a patient when a pharmacy
is not conveniently available to the patient.
(3) “Nurse or midwife” means an individual licensed or certified by the
Board of Nursing under Title 8 of this article.
(4) [“Personally] EXCEPT AS PROVIDED IN § 15–302.2 OF THIS
ARTICLE, “PERSONALLY preparing and dispensing” means that the licensed dentist,
physician, nurse or midwife, or podiatrist:
(i) Is physically present on the premises where the prescription is
filled; and
(ii) Performs a final check of the prescription before it is provided to
the patient.
(c) (2) This title does not prohibit:
(iv) A licensed physician who complies with the requirements of item
(ii) of this paragraph from personally preparing and dispensing a prescription written by:
1. A physician assistant [in accordance with a delegation
agreement that] WHO complies with Title 15, Subtitle 3 of this article; or
2. An advanced practice registered nurse with prescriptive
authority under Title 8 of this article and is working with the physician in the same office
setting; Ch. 919 2024 LAWS OF MARYLAND
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(v) A hospital–based clinic from dispensing prescriptions to its
patients; [or]
(vi) An individual licensed or certified under Title 8 of this article
from personally preparing and dispensing a drug or device as authorized under Title 8 of
this article; OR
(VII) A PHYSICIAN ASS ISTANT FROM PERSONAL LY PREPARING
AND DISPENSING A PRE SCRIPTION IN ACCORDA NCE WITH § 15–302.1 OF THIS
ARTICLE.
14–306.
(a) [To] EXCEPT AS PROVIDED IN SUBSECTIONS (E) AND (F) OF THIS
SECTION, TO the extent permitted by the rules, regulations, and orders of the Board, an
individual to whom duties are delegated by a licensed physician OR PHYSICIAN
ASSISTANT may perform those duties without a license as provided in this section.
15–101.
(a) In this title the following words have the meanings indicated.
[(b) “Alternate supervising physician” means one or more physicians designated
by the primary supervising physician to provide supervision of a physician assistant in
accordance with the delegation agreement on file with the Board.]
[(c)] (B) “Ambulatory surgical facility” means a facility:
(1) Accredited by:
(i) The American Association for Accreditation of Ambulatory
Surgical Facilities;
(ii) The Accreditation Association for Ambulatory Health Care; or
(iii) The Joint Commission on Accreditation of Healthcare
Organizations; or
(2) Certified to participate in the Medicare program, as enacted by Title
XVIII of the Social Security Act.
[(d)] (C) “Board” means the State Board of Physicians, established under §
14–201 of this article.
WES MOORE, Governor Ch. 919
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(D) (1) “COLLABORATION ” MEANS THE COMMUNICAT ION AND
DECISION–MAKING PROCESS AMONG HEALTH CARE PROVIDER S WHO ARE MEMBERS
OF A PATIENT CARE TE AM RELATED TO THE TR EATMENT OF A PATIENT THAT
INCLUDES THE DEGREE OF COOPER ATION NECESSARY TO P ROVIDE TREATMENT
AND CARE TO THE PATI ENT AND INCLUDES :
(I) COMMUNICATION OF DATA AND INFORMATION ABOU T THE
TREATMENT AND CARE O F A PATIENT, INCLUDING THE EXCHAN GE OF CLINICAL
OBSERVATIONS AND ASS ESSMENTS; AND
(II) DEVELOPMENT OF AN APP ROPRIATE PLAN OF CAR E,
INCLUDING:
1. DECISIONS REGARDING T HE HEALTH CARE
PROVIDED;
2. ACCESSING AND ASSESSM ENT OF APPROPRIATE
ADDITIONAL RESOURCES OR EXPERTISE; AND
3. ARRANGEMENT OF APPROP RIATE REFERRALS ,
TESTING, OR STUDIES.
(2) “COLLABORATION ” DOES NOT REQUIRE THE CONSTANT,
PHYSICAL PRESENCE OF A COLLABORATING PHYS ICIAN ON–SITE IN THE PRACTICE
SETTING, IF THE COLLABORATING PHYSICIAN IS ACCESSI BLE BY ELECTRONIC
MEANS.
(E) “COLLABORATION AGREEME NT” MEANS A DOCUMENT THAT :
(1) OUTLINES THE COLLABOR ATION BETWEEN A PHYS ICIAN
ASSISTANT AND:
(I) AN INDIVIDUAL PHYSICI AN; OR
(II) A GROUP OF PHYSICIANS ; AND
(2) IS DEVELOPED BY A PHY SICIAN ASSISTANT AND THE PHYSICIAN
OR GROUP OF PHYSICIA NS; AND
(3) IS SUBMITTED TO THE BOARD.
[(e)] (F) “Committee” means the Physician Assistant Advisory Committee.
Ch. 919 2024 LAWS OF MARYLAND
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[(f)] (G) “Controlled dangerous substances” has the meaning stated in § 5–101
of the Criminal Law Article.
[(g)] (H) “Correctional facility” includes a State or local correctional facility.
[(h) “Delegated medical acts” means activities that constitute the practice of
medicine delegated by a physician under Title 14 of this article.
(i) “Delegation agreement” means a document that is executed by a primary
supervising physician and a physician assistant containing the requirements of § 15–302
of this title.
(i–1)] (I) “Disciplinary panel” means a disciplinary panel of the Board
established under § 14–401 of this article.
(j) “Dispense” or “dispensing” has the meaning stated in § 12–101 of this article.
(k) “Drug sample” means a unit of a prescription drug that is intended to promote
the sale of the drug and is not intended for sale.
(l) “Hospital” means:
(1) A hospital as defined under § 19–301 of the Health – General Article;
(2) A comprehensive care facility that:
(i) Meets the requirements of a hospital–based skilled nursing
facility under federal law; and
(ii) Offers acute care in the same building; and
(3) An emergency room that is physically connected to a hospital or a
freestanding medical facility that is licensed under Title 19, Subtitle 3A of the Health –
General Article.
(m) “License” means a license issued by the Board to a physician assistant under
this title.
(n) “National certifying examination” means the Physician Assistant National
Certifying Examination administered by the National Commission on Certification of
Physician Assistants or its successor.
(O) “PATIENT CARE TEAM ” MEANS A MULTIDISCIPL INARY TEAM OF HEALTH
CARE PROVIDERS ACTIV ELY FUNCTIONING AS A UNIT IN CONSULTATION WITH THE
LEADERSHIP OF ONE OR MORE PATIENT CARE TEAM PHYSICIANS FOR THE PURPOSE WES MOORE, Governor Ch. 919
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OF PROVIDING AND DEL IVERING HEALTH CARE TO A PATIENT OR GROU P OF
PATIENTS.
(P) “PATIENT CARE TEAM PHY SICIAN” MEANS A LICENSED PHY SICIAN WHO
REGULARLY PRACTICES IN THE STATE AND WHO PROVIDE S CONSULTATION
LEADERSHIP IN THE CARE OF PATIE NTS AS PART OF A PA TIENT CARE TEAM .
[(o)] (Q) “Physician assistant” means an individual who is licensed under this
title to practice [medicine with physician supervision] AS A PHYSICIAN ASSIS TANT.
[(p)] (R) “Practice as a physician assistant” means the performance of medical
acts that are:
[(1) Delegated by a supervising physician to a physician assistant;
(2) Within the supervising physician’s scope of practice; and
(3) Appropriate to the physician assistant’s education, training, and
experience]
(1) AUTHORIZED UNDER A LICENSE ISSUED BY THE BOARD; AND
(2) AUTHORIZED UNDER THE PHYSICIAN ASSISTANT ’S
COLLABORATION AGREEM ENT.
[(q)] (S) “Prescriptive authority” means the authority [delegated by a primary
or alternate supervising physician to] OF a physician assistant to:
(1) Prescribe and administer controlled dangerous substances, prescription
drugs, medical devices, and the oral, written, or electronic ordering of medications; and
(2) Dispense as provided under [§ 15–302.2(b), (c), and (d)] § 15–302.1 of
this title.
[(r) “Primary supervising physician” means a physician who:
(1) Completes a delegation agreement that meets the requirements under
§§ 15–301(d) and (e) and 15–302 of this title and files a copy with the Board;
(2) Acts as the physician responsible to ensure that a physician assistant
practices medicine in accordance with this title and the regulations adopted under this title;
(3) Ensures that a physician assistant practices within the scope of practice
of the primary supervising physician or any designated alternate supervising physician;
and Ch. 919 2024 LAWS OF MARYLAND
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(4) Ensures that a list of alternate supervising physicians is maintained at
the practice setting.]
[(s)] (T) “Public health facility” means a site where clinical public health
services are rendered under the auspices of the Department, a local health department in
a county, or the Baltimore City Health Department.
[(t)] (U) “Starter dosage” means an amount of a drug sufficient to begin therapy:
(1) Of short duration of 72 hours or less; or
(2) Prior to obtaining a larger quantity of the drug to complete therapy.
[(u) (1) “Supervision” means the responsibility of a physician to exercise
on–site supervision or immediately available direction for physician assistants performing
delegated medical acts.
(2) “Supervision” includes physician oversight of and acceptance of direct
responsibility for the patient services and care rendered by a physician assistant, including
continuous availability to the physician assistant in person, through written instructions,
or by electronic means and by designation of one or more alternate supervising physicians.]
15–103.
(a) In this section, “alternative health care system” has the meaning stated in §
1–401 of this article.
(b) (1) Subject to paragraph (2) of this subsection, an employer of a physician
assistant shall report to the Board, on the form prescribed by the Board, any termination
of employment of the physician assistant if the cause of termination is related to a quality
of care issue.
(2) Subject to subsection (d) of this section, a [supervising physician]
PHYSICIAN OR GROUP O F PHYSICIANS THAT DE VELOPS A COLLABORATI ON
AGREEMENT WITH A PHY SICIAN ASSISTANT or an employer of a physician assistant shall
notify the Board within 10 days of the termination of employment of the physician assistant
for reasons that would be grounds for discipline under this title.
(3) A [supervising physician and a] PHYSICIAN OR GROUP O F
PHYSICIANS THAT DEVE LOPS A COLLABORATION AGREEMENT WITH A PHY SICIAN
ASSISTANT OR THE physician assistant shall notify the Board within 10 days of the
termination of the relationship under a [delegation agreement for any reason]
COLLABORATION AGREEMENT .
WES MOORE, Governor Ch. 919
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(c) Except as otherwise provided under subsections (b) and (d) of this section, a
hospital, a related institution, an alternative health care system, or an employer of a
physician assistant shall report to the Board any limitation, reduction, or other change of
the terms of employment of the physician assistant or any termination of employment of
the physician assistant for any reason that might be grounds for disciplinary action under
§ 15–314 of this title.
(d) A hospital, related institution, alternative health care system, or employer
that has reason to know that a physician assistant has committed an action or has a
condition that might be grounds for reprimand or probation of the physician assistant or
suspension or revocation of the license of the physician assistant under § 15–314 of this
title because the physician assistant is alcohol– or drug–impaired is not required to report
to the Board if:
(1) The hospital, related institution, alternative health care system, or
employer knows that the physician assistant is:
(i) In an alcohol or drug treatment program that is accredited by the
Joint Commission on the Accreditation of Healthcare Organizations or is certified by the
Department; or
(ii) Under the care of a health care practitioner who is competent
and capable of dealing with alcoholism and drug abuse;
(2) The hospital, related institution, alternative health care system, or
employer is able to verify that the physician assistant remains in the treatment program
until discharge; and
(3) The action or condition of the physician assistant has not caused injury
to any person while the physician assistant is practicing as a licensed physician assistant.
(e) (1) If the physician assistant enters, or is considering entering, an alcohol
or drug treatment program that is accredited by the Joint Commission on Accreditation of
Healthcare Organizations or that is certified by the Department, the physician assistant
shall notify the hospital, related institution, alternative health care system, or employer of
the physician assistant’s decision to enter the treatment program.
(2) If the physician assistant fails to provide the notice required under
paragraph (1) of this subsection, and the hospital, related institution, alternative health
care system, or employer learns that the physician assistant has entered a treatment
program, the hospital, related institution, alternative health care system, or employer shall
report to the Board that the physician assistant has entered a treatment program and has
failed to provide the required notice.
(3) If the physician assistant is found to be noncompliant with the
treatment program’s policies and procedures while in the treatment program, the Ch. 919 2024 LAWS OF MARYLAND
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treatment program shall notify the hospital, related institution, alternative health care
system, or employer of the physician assistant’s noncompliance.
(4) On receipt of the notification required under paragraph (3) of this
subsection, the hospital, related institution, alternative health care system, or employer of
the physician assistant shall report the physician assistant’s noncompliance to the Board.
(f) A person is not required under this section to make any report that would be
in violation of any federal or State law, rule, or regulation concerning the confidentiality of
alcohol– and drug–abuse patient records.
(g) The hospital, related institution, alternative health care system, or employer
shall submit the report within 10 days of any action described in this section.
(h) A report under this section is not subject to subpoena or discovery in any civil
action other than a proceeding arising out of a hearing and decision of the Board or a
disciplinary panel under this title.
(i) (1) A disciplinary panel may impose a civil penalty of up to $1,000 for
failure to report under this section.
(2) The Board shall pay any fees collected under this subsection into the
General Fund of the State.
(j) An employer shall make the report required under this section to the Board
within 5 days after the date of termination of employment.
(k) The Board shall adopt regulations to implement the provisions of this section.
15–202.
(a) (1) The Committee shall consist of 7 members appointed by the Board.
(2) Of the 7 Committee members:
(i) 3 shall be licensed physicians;
(ii) 3 shall be licensed physician assistants; and
(iii) 1 shall be a consumer.
(b) Of the three physician members of the Committee, two shall [be previously or
currently serving as supervising physicians of a physician assistant under a
Board–approved delegation agreement] HAVE DEVELOPED A COL LABORATION
CURRENTLY SERVING AS A PATIENT CARE TEAM PHYSICIAN UNDER A
COLLABORATION AGREEMENT WITH A PHY SICIAN ASSISTANT . WES MOORE, Governor Ch. 919
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15–205.
(a) In addition to the powers set forth elsewhere in this title, the Committee, on
its initiative or on the Board’s request, may:
(1) Recommend to the Board regulations for carrying out the provisions of
this title;
(2) Recommend to the Board approval, modification, or disapproval of an
application for licensure [or a delegation agreement];
(3) Report to the Board any conduct of a [supervising physician]
PHYSICIAN OR GROUP O F PHYSICIANS WHO DEVELOPS A COLLA BORATION
AGREEMENT WITH A PHY SICIAN ASSISTANT or a physician assistant that may be cause
for disciplinary action under this title or under § 14–404 of this article; and
(4) Report to the Board any alleged unauthorized practice of a physician
assistant.
15–301.
(a) [Nothing in this] THIS title may NOT be construed to authorize a physician
assistant to practice [independent of a primary or alternate supervising physician]
INDEPENDENTLY .
(b) A license issued to a physician assistant shall limit the physician assistant’s
scope of practice to medical acts:
[(1) Delegated by the primary or alternate supervising physician;]
[(2)] (1) Appropriate to the education, training, and experience of the
physician assistant;
[(3)] (2) Customary to the practice of the [primary or alternate
supervising] physician; and
(2) CUSTOMARY TO THE PRAC TICE OF A PATIENT CA RE TEAM
PHYSICIAN; AND
[(4)] (3) Consistent with the [delegation] COLLABORATION agreement
filed with the Board.
(3) IN A MANNER CONSISTENT WITH THE COLLABORATI ON
AGREEMENT . Ch. 919 2024 LAWS OF MARYLAND
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(c) Patient services that may be provided by a physician assistant UNDER A
COLLABORATION AGREEM ENT include:
[(1) (i) Taking complete, detailed, and accurate patient histories; and
(ii) Reviewing patient records to develop comprehensive medical
status reports;
(2) Performing physical examinations and recording all pertinent patient
data;
(3) Interpreting and evaluating patient data as authorized by the primary
or alternate supervising physician for the purpose of determining management and
treatment of patients;
(4) Initiating requests for or performing diagnostic procedures as indicated
by pertinent data and as authorized by the supervising physician;
(5) Providing instructions and guidance regarding medical care matters to
patients;
(6) Assisting the primary or alternate supervising physician in the delivery
of services to patients who require medical care in the home and in health care institutions,
including:
(i) Recording patient progress notes;
(ii) Issuing diagnostic orders; and
(iii) Transcribing or executing specific orders at the direction of the
primary or alternate supervising physician; and
(7) Exercising prescriptive authority under a delegation agreement and in
accordance with § 15–302.2 of this subtitle.]
(1) OBTAINING COMPREHENSI VE HEALTH HISTORIES ;
(2) PERFORMING PHYSICAL E XAMINATIONS ;
(3) EVALUATING, DIAGNOSING, MANAGING, AND PROVIDING
MEDICAL TREATMENT ;
(4) ORDERING, PERFORMING , AND INTERPRETING DIA GNOSTIC
STUDIES, THERAPEUTIC PROCEDUR ES, AND LABORATORY TESTS ; WES MOORE, Governor Ch. 919
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(5) ORDERING DIAGNOSTIC T ESTS AND USING THE F INDINGS OR
RESULTS IN THE CARE OF PATIENTS;
(4) INTERPRETING AND EVAL UATING PATIENT DATA AS AUTHORIZED
BY A PATIENT CARE TE AM PHYSICIAN FOR THE PURPOSE OF DETERMINI NG
MANAGEMENT AND TREAT MENT OF PATIENTS ;
(5) INITIATING REQUESTS F OR OR PERFORMING DIA GNOSTIC
PROCEDURES AS INDICA TED BY PERTINENT DAT A AND AS AUTHORIZED BY A
PATIENT CARE TEAM PH YSICIAN;
(6) EXERCISING PRESCRIPTI VE AUTHORITY IN ACCO RDANCE WITH §
15–302.1 15–302.2 OF THIS SUBTITLE;
(7) INFORMING PATIENTS AB OUT HEALTH PROMOTION AND DISEASE
PREVENTION ;
(8) PROVIDING CONSULTATIO NS;
(9) WRITING MEDICAL ORDER S;
(10) PROVIDING SERVICES IN HEALTH CARE FACILITI ES, INCLUDING
HOSPITALS, NURSING FACILITIES , ASSISTED LIVING FACI LITIES, AND HOSPICE
FACILITIES;
(11) (10) OBTAINING INFORMED CO NSENT;
(12) DELEGATING OR ASSIGNI NG THERAPEUTIC AND DIAG NOSTIC
MEASURES TO BE PERFO RMED BY LICENSED OR UNLICENSED PERSONNEL AND
SUPERVISING LICENSED OR UNLICENSED PERSON NEL PERFORMING THERA PEUTIC
AND DIAGNOSTIC MEASU RES;
(11) DELEGATING MEDICAL AC TS TO LICENSED OR UN LICENSED
PERSONNEL AS AUTHORIZED UNDER § 14–306 OF THIS ARTICLE IF T HE PHYSICIAN
ASSISTANT HAS AT LEA ST 7,000 HOURS OF CLINICAL PR ACTICE EXPERIENCE ; AND
(13) (12) CERTIFYING A PATIENT ’S HEALTH OR DISABILI TY AS
REQUIRED BY A FEDERA L, STATE, OR LOCAL PROGRAM ; AND
(14) AUTHENTICATING ANY DO CUMENT THAT A PHYSIC IAN MAY
AUTHENTICATE THROUGH SIGNATURE, CERTIFICATION , STAMP VERIFICATION ,
AFFIDAVIT, OR ENDORSEMENT .
Ch. 919 2024 LAWS OF MARYLAND
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(d) (1) Except as otherwise provided in this title, an individual shall be
licensed by the Board before the individual may practice as a physician assistant.
(2) Except as otherwise provided in this title, a physician may not
[supervise] ENTER INTO A COLLABO RATION COLLABORATE WITH a physician assistant
in the performance of [delegated] medical acts without filing NOTIFYING THE BOARD OF
a completed [delegation] COLLABORATION agreement with the Board.
(3) Except as otherwise provided in this title or in a medical emergency, a
physician assistant may not perform any medical act for which:
(i) The FOR WHICH THE individual has not been licensed; and
(ii) [The medical acts have not been delegated by a primary or
alternate supervising physician] THE INDIVIDUAL HAS NO T RECEIVED APPROPRIA TE
EDUCATION, TRAINING, AND EXPERIENCE
(II) THAT HAS NOT BEEN DEL EGATED IN A MANNER
CONSISTENT WITH THE COLLABORATION AGREEM ENT;
(III) THAT IS NOT APPROPRIA TE TO THE EDUCATION , TRAINING,
AND EXPERIENCE OF TH E PHYSICIAN ASSISTAN T; AND
(IV) THAT IS NOT CUSTOMARY TO THE PRACTICE OF A PATIENT
CARE TEAM PHYSICIAN L ISTED ON THE COLLABO RATION AGREEMENT .
[(e) A physician assistant is the agent of the primary or alternate supervising
physician in the performance of all practice–related activities, including the oral, written,
or electronic ordering of diagnostic, therapeutic, and other medical services.]
(E) A PHYSICIAN ASSISTANT SHALL CONSULT AND CO LLABORATE WITH OR
REFER AN INDIVIDUAL TO AN APPROPRIATE LI CENSED PHYSICIAN OR ANY OTHER
HEALTH CARE PROVIDER AS APPROPRIATE .
(F) A PHYSICIAN ASSISTANT WHO HAS NO T BEEN PREVIOUSLY LI CENSED BY
THE BOARD TO PRACTICE AS A PHYSICIAN ASSISTAN T OR LICENSED, CERTIFIED, OR
REGISTERED AS A PHYS ICIAN ASSISTANT BY A NOTHER STATE REGULAT ORY
AUTHORITY SHALL BE M ENTORED BY A LICENSE D PHYSICIAN OR PHYSI CIANS WHO
ARE IDENTIFIED IN AN INITIAL COLLABORATIO N AGREEMENT TO CONSU LT AND
COLLABORATE WITH THE PHYSICIAN ASSISTANT FOR AT LEAST 18 MONTHS AFTER
THE DATE AN INITIAL COLLABORATION AGREEM ENT IS SUBMITTED TO THE BOARD.
[(f)] (G) Except as OTHERWISE provided in [subsection (g) of this section] THIS
TITLE, the following individuals may practice as a physician assistant without a license: WES MOORE, Governor Ch. 919
– 17 –
(1) A physician assistant student enrolled in a physician assistant
educational program that is accredited by the Accreditation Review Commission on
Education for the Physician Assistant or its successor and approved by the Board; or
(2) A physician assistant employed in the service of the federal government
while performing duties incident to that employment.
[(g) A physician may not delegate prescriptive authority to a physician assistant
student in a training program that is accredited by the Accreditation Review Commission
on Education for the Physician Assistant or its successor.]
(h) (G) (1) If a medical act that is to be [delegated] PERFORMED BY A
PHYSICIAN ASSISTANT under this section is a part of the practice of a health occupation
that is regulated under this article by another board, any rule or regulation concerning that
medical act shall be adopted jointly by the State Board of Physicians and the board that
regulates the other health occupation.
(2) If the two boards cannot agree on a proposed rule or regulation, the
proposal shall be submitted to the Secretary for a final decision.
15–302.
(a) A physician [may delegate medical acts to a physician assistant only after:
(1) A delegation agreement has been executed and filed with the Board;
and
(2) Any advanced duties have been authorized as required under
subsection (c) of this section] ASSISTANT MAY PRACTI CE AS A PHYSICIAN AS SISTANT
ONLY AFTER SUBMITTING A COLLABO RATION AGREEMENT TO THE BOARD
PROVIDING NOTICE TO THE BOARD, IN A MANNER APPROVED BY THE BOARD, OF:
(1) THE EXECUTED COLLABOR ATION AGREEMENT ; AND
(2) EACH PATIEN T CARE TEAM PHYSICIA N LISTED ON THE
COLLABORATION AGREEM ENT.
(b) (1) [The delegation agreement] SUBJECT TO PARAGRAPH (2) OF THIS
SUBSECTION, A A COLLABORATION AGREEM ENT shall contain:
[(1)] (I) A description of the qualifications of the [primary supervising
physician and] PHYSICIAN ASSISTANT AND THE PHYSICIAN OR GROUP O F PHYSICIANS
WHO DEVELOPED THE CO LLABORATION AGREEMEN T WITH THE physician assistant;
Ch. 919 2024 LAWS OF MARYLAND
– 18 –
(II) ANY PRACTICE SPECIALT Y OF THE PHYSICIAN O R GROUP OF
PHYSICIANS; AND
[(2)] (III) A description of the settings in which the physician assistant will
practice[;
(3) A description of the continuous physician supervision mechanisms that
are reasonable and appropriate to the practice setting;
(4) A description of the delegated medical acts that are within the primary
or alternate supervising physician’s scope of practice and require specialized education or
training that is consistent with accepted medical practice;
(5) An attestation that all medical acts to be delegated to the physician
assistant are within the scope of practice of the primary or alternate supervising physician
and appropriate to the physician assistant’s education, training, and level of competence;
(6) An attestation of continuous supervision of the physician assistant by
the primary supervising physician through the mechanisms described in the delegation
agreement;
(7) An attestation by the primary supervising physician of the physician’s
acceptance of responsibility for any care given by the physician assistant;
(8) A description prepared by the primary supervising physician of the
process by which the physician assistant’s practice is reviewed appropriate to the practice
setting and consistent with current standards of acceptable medical practice;
(9) An attestation by the primary supervising physician that the physician
will respond in a timely manner when contacted by the physician assistant;
(10) The following statement: “The primary supervising physician and the
physician assistant attest that:
(i) They will establish a plan for the types of cases that require a
physician plan of care or require that the patient initially or periodically be seen by the
supervising physician; and
(ii) The patient will be provided access to the supervising physician
on request”; and
(11) Any other information deemed necessary by the Board to carry out the
provisions of this subtitle].
WES MOORE, Governor Ch. 919
– 19 –
(2) IF A PHYSICIAN ASSIST ANT WHO SUBMITS AN I NITIAL
COLLABORATION AGREEM ENT TO THE BOARD HAS NOT BEEN PR EVIOUSLY
LICENSED BY THE BOARD TO PRACTICE AS A PHYSICIAN ASSISTAN T OR LICENSED,
CERTIFIED, OR REGISTERED AS A P HYSICIAN ASSISTANT B Y ANOTHER STATE
REGULATORY AUTHORITY , THE INITIAL COLLABOR ATION AGREEMENT SHAL L
IDENTIFY A LICENSED PHYSICIAN OR PHYSICI ANS WHO WILL CONSULT AND
COLLABORATE WITH THE PHYSICIAN ASSISTANT FOR AT LEAST 18 MONTHS AFTER
THE DATE THE INITIAL COLLABORATION AGREEM ENT IS SUBMITTED TO THE BOARD.
(3) (2) A COLLABORATION AGREEM ENT MAY INCLUDE PROV ISIONS
LIMITING THE PHYSICI AN ASSISTANT’S SCOPE OF PRACTICE, SPECIFYING OFFICE
PROCEDURES , OR OTHERWISE DETAILI NG THE PRACTICE OF T HE PHYSICIAN
ASSISTANT AS AGREED BY THE PHYSICIAN OR GROUP OF PHYSICIANS AND THE
PHYSICIAN ASSISTANT .
(c) (1) The Board may not require [prior] approval of a [delegation agreement
that includes advanced duties, if an advanced duty will be performed in a hospital or
ambulatory surgical facility, provided that:
(i) A physician, with credentials that have been reviewed by the
hospital or ambulatory surgical facility as a condition of employment, as an independent
contractor, or as a member of the medical staff, supervises the physician assistant;
(ii) The physician assistant has credentials that have been reviewed
by the hospital or ambulatory surgical facility as a condition of employment, as an
independent contractor, or as a member of the medical staff; and
(iii) Each advanced duty to be delegated to the physician assistant is
reviewed and approved within a process approved by the governing body of the health care
facility before the physician assistant performs the advanced duties] COLLABORATION
AGREEMENT .
[(2) (i) In any setting that does not meet the requirements of paragraph
(1) of this subsection, a primary supervising physician shall obtain the Board’s approval of
a delegation agreement that includes advanced duties, before the physician assistant
performs the advanced duties.
(ii) 1. Before a physician assistant may perform X–ray duties
authorized under § 14–306(e) of this article in the medical office of the physician delegating
the duties, a primary supervising physician shall obtain the Board’s approval of a
delegation agreement that includes advanced duties in accordance with subsubparagraph
2 of this subparagraph.
Ch. 919 2024 LAWS OF MARYLAND
– 20 –
2. The advanced duties set forth in a delegation agreement
under this subparagraph shall be limited to nonfluoroscopic X–ray procedures of the
extremities, anterior–posterior and lateral, not including the head.]
[(3)] (2) [Notwithstanding paragraph (1) of this subsection, a primary
supervising physician shall obtain the Board’s approval of a delegation agreement before]
A PHYSICIAN ASSISTANT SHALL SUBMIT TO THE BOARD A COLLABORATION
AGREEMENT THAT CONTA INS ANESTHESIA DUTIE S BEFORE the physician assistant
may administer, monitor, or maintain general anesthesia or neuroaxial anesthesia,
including spinal and epidural techniques, under the agreement.
[(d) For a delegation agreement containing advanced duties that require Board
approval, the Committee shall review the delegation agreement and recommend to the
Board that the delegation agreement be approved, rejected, or modified to ensure
conformance with the requirements of this title.
(e) The Committee may conduct a personal interview of the primary supervising
physician and the physician assistant.
(f) (1) On review of the Committee’s recommendation regarding a primary
supervising physician’s request to delegate advanced duties as described in a delegation
agreement, the Board:
(i) May approve the delegation agreement; or
(ii) 1. If the physician assistant does not meet the applicable
education, training, and experience requirements to perform the specified delegated acts,
may modify or disapprove the delegation agreement; and
2. If the Board takes an action under item 1 of this item:
A. Shall notify the primary supervising physician and the
physician assistant in writing of the particular elements of the proposed delegation
agreement that were the cause for the modification or disapproval; and
B. May not restrict the submission of an amendment to the
delegation agreement.
(2) To the extent practicable, the Board shall approve a delegation
agreement or take other action authorized under this subsection within 90 days after
receiving a completed delegation agreement including any information from the physician
assistant and primary supervising physician necessary to approve or take action.]
[(g)] (D) If the Board determines that a [primary or alternate supervising
physician] PHYSICIAN OR GROUP O F PHYSICIANS THAT DE VELOPS A WES MOORE, Governor Ch. 919
– 21 –
COLLABORATION AGREEM ENT WITH A PHYSICIAN ASSISTANT or A physician assistant
is practicing in a manner inconsistent with the requirements of this title or Title 14 of this
article, the Board on its own initiative or on the recommendation of the Committee may
demand modification of the practice[, withdraw the approval of the delegation agreement,]
or refer the matter to a disciplinary panel for the purpose of taking other disciplinary action
under § 14–404 OF THIS ARTICLE or § 15–314 of this [article] SUBTITLE.
[(h)] (E) [A primary supervising physician may not delegate medical acts under
a delegation agreement to more than four physician assistants at any one time, except in
a] A PHYSICIAN OR GROUP O F PHYSICIANS MAY NOT ENTER INTO A COLLABORATION
AGREEMENT THAT ALLOW S FOR COLLABORATION OF MORE THAN EIGHT P HYSICIAN
ASSISTANTS FOR EACH PHYSICIAN IN THE AGR EEMENT AT ONE TIME , EXCEPT IN A
hospital or in the following nonhospital settings:
(1) A correctional facility;
(2) A detention center; or
(3) A public health facility.
[(i)] (F) A person may not coerce another person to enter into a [delegation]
COLLABORATION agreement under this subtitle.
[(j) A physician may supervise a physician assistant:
(1) As a primary supervising physician in accordance with a delegation
agreement approved by the Board under this subtitle; or
(2) As an alternate supervising physician if:
(i) The alternate supervising physician supervises in accordance
with a delegation agreement filed with the Board;
(ii) The alternate supervising physician supervises no more than
four physician assistants at any one time, except in a hospital, correctional facility,
detention center, or public health facility;
(iii) The alternate supervising physician’s period of supervision, in
the temporary absence of the primary supervising physician, does not exceed:
1. The period of time specified in the delegation agreement;
and
2. A period of 45 consecutive days at any one time; and
(iv) The physician assistant performs only those medical acts that: Ch. 919 2024 LAWS OF MARYLAND
– 22 –
1. Have been delegated under the delegation agreement filed
with the Board; and
2. Are within the scope of practice of the primary supervising
physician and alternate supervising physician.]
[(k)] (G) Subject to the notice required under § 15–103 of this title, a physician
assistant may terminate a [delegation agreement filed with the Board under ]
COLLABORATION AGREEM ENT DEVELOPED IN ACC ORDANCE WITH this subtitle at any
time.
[(l)] (H) (1) In the event of the sudden departure, incapacity, or death of [the
primary supervising physician of a physician assistant] A PATIENT CARE TEAM
PHYSICIAN, or change in license status that results in [the primary supervising physician]
A PATIENT CARE TEAM PHYSICIAN being unable to legally practice medicine, [an
alternate supervising physician designated under subsection (b) of this section may
supervise the physician assistant for not longer than 15 days following the event] THE
COLLABORATION AGR EEMENT SHALL REMAIN ACTIVE AND VALID UND ER THE
SUPERVISION OF THE R EMAINING LISTED PATI ENT CARE TEAM PHYSIC IANS.
(2) If there is no [designated alternate supervising physician] REMAINING
PATIENT CARE TEAM PH YSICIAN LISTED ON TH E COLLABORATION AGRE EMENT or
the [designated alternate supervising physician] REMAINING PATIENT CA RE TEAM
PHYSICIAN does not agree to supervise the physician assistant, the physician assistant
may not practice until the physician assistant receives approval of a new [delegation]
COLLABORATION agreement under [§ 15–302.1 of] this subtitle.
[(3) An alternate supervising physician or other licensed physician may
assume the role of primary supervising physician by submitting a new delegation
agreement to the Board for approval under subsection (b) of this section.
(4) The Board may terminate a delegation agreement if:
(i) The physician assistant has a change in license status that
results in the physician assistant being unable to legally practice as a physician assistant;
(ii) At least 15 days have elapsed since an event listed under
paragraph (1) of this subsection if there is an alternate supervising physician designated
under subsection (b) of this section; or
(iii) Immediately after an event listed under paragraph (1) of this
subsection if there is no alternate supervising physician designated under subsection (b) of
this section.] WES MOORE, Governor Ch. 919
– 23 –
(I) THE BOARD SHALL NOTIFY TH E PHYSICIAN ASSISTAN T AND PHYSICIAN
OR GROUP OF PHYSICIA NS WHO HAVE ENTERED INTO A COLLABORATION
AGREEMENT WITH A PHY SICIAN ASSISTANT IMM EDIATELY IF:
(1) THE PHYSICIAN ASSISTA NT HAS A CHANGE IN L ICENSE
STATUS THAT RESULTS IN THE PHYSICIAN ASS ISTANT BEING UNABLE TO LEGALLY
PRACTICE AS A PHYSIC IAN ASSISTANT; OR
(2) AN EVENT DESCRIBED IN SUBSECTION (H) OF THIS SECTION
OCCURS.
[(m)] (J) A physician assistant whose [delegation] COLLABORATION agreement
is terminated may not practice as a physician assistant until the physician assistant
[receives preliminary approval of a new delegation agreement under § 15–302.1 of this
subtitle] SUBMITS A NEW COLLAB ORATION AGREEMENT TO THE BOARD.
[(n) Individual members of the Board are not civilly liable for actions regarding
the approval, modification, or disapproval of a delegation agreement described in this
section.
(o) A physician assistant may practice in accordance with a delegation agreement
filed with the Board under this subtitle.]
(C) IF THE BOARD DETERMINES THAT A PATIENT CARE TEAM PHYSICIAN OR
PHYSICIAN ASSISTANT IS PRACTICING IN A M ANNER INCONSISTENT W ITH THE
REQUIREMENTS OF THIS TITLE OR TITLE 14 OF THIS ARTICLE, THE BOARD ON ITS
OWN INITIATIVE OR ON THE RECOMMENDATION O F THE COMMITTEE MAY DEMAND
MODIFICATION OF THE PRACTICE, WITHDRAW THE APPROVA L OF AN ADVANCED
DUTY REGARDLESS OF W HETHER THE ADVANCED DUTY REQUIRES PRIOR APPROVAL
UNDER THIS SECTION , OR REFER THE MATTER TO A DISCIPLINARY PA NEL FOR THE
PURPOSE OF TAKING OT HER DISCIPLIN ARY ACTION UNDER § 14–404 OF THIS
ARTICLE OR § 15–314 OF THIS SUBTITLE.
(D) (1) EXCEPT AS PROVIDED UN DER PARAGRAPH (2) OF THIS
SUBSECTION, A PATIENT CARE TEAM PHYSICIAN MAY NOT DE LEGATE MEDICAL ACTS
UNDER A COLLABORATIO N AGREEMENT TO MORE THAN EIGHT PHY SICIAN
ASSISTANTS AT ANY ON E TIME.
(2) A PATIENT CARE TEAM PH YSICIAN MAY DELEGATE MEDICAL ACTS
UNDER A COLLABORATIO N AGREEMENT TO MORE THAN EIGHT PHYSICIAN
ASSISTANTS IN:
(I) A HOSPITAL; Ch. 919 2024 LAWS OF MARYLAND
– 24 –
(II) A CORRECTIONAL FACILIT Y;
(III) A DETENTION CENTER; OR
(IV) A PUBLIC HEALTH FACILI TY.
(E) A PERSON MAY NOT COERC E ANOTHER PERSON TO ENTER INTO A
COLLABORATION AGREEM ENT UNDER THIS SUBTI TLE.
(F) SUBJECT TO THE NOTICE REQUIRED UNDER § 15–103 OF THIS TITLE, A
PHYSICIAN ASSISTANT MAY TERMINATE A COLL ABORATION AGREEMENT UNDER
THIS SUBTITLE AT ANY TIME.
(G) (1) IN THE EVENT OF A SUD DEN DEPARTURE , INCAPACITY, OR DEATH
OF A PATIENT CARE TE AM PHYSICIAN , OR CHANGE IN LICENSE STATUS THAT
RESULTS IN A PATIENT CARE TEAM PHYSICIAN BEING UNABLE TO LEGA LLY
PRACTICE MEDICINE , THE COLLABORATION AG REEMENT WILL REMAIN ACTIVE AND
VALID UNDER THE SUPE RVISION OF ANY REMAI NING LISTED PATIENT CARE TEAM
PHYSICIANS.
(2) IF THERE IS NO REMAIN ING PATIENT CARE TEA M PHYSICIAN
LISTED ON THE COLLAB ORATION AGREEMENT , THE PHYSICIAN ASSIST ANT MAY NOT
PRACTICE UNTIL THE P HYSICIAN ASSISTANT H AS EXECUTED A NEW
COLLABORATION AGREEM ENT AND, IF APPLICABLE , HAS BOARD APPROVAL TO
PERFORM ANY ADVANCED DUTI ES DELEGATED TO THE PHYSICIAN ASSISTANT
UNDER THE NEW COLLAB ORATION AGREEMENT .
(3) THE BOARD MAY TERMINATE A COLLABORATION AGREEM ENT IF:
(I) THE PHYSICIAN ASSISTA NT HAS A CHANGE IN L ICENSE
STATUS THAT RESULTS IN THE PHYSICIAN A SSISTANT BEING UNABL E TO LEGALLY
PRACTICE AS A PHYSIC IAN ASSISTANT; OR
(II) IMMEDIATELY AFTER AN EVENT LISTED UNDER
PARAGRAPH (1) OF THIS SUBSECTION I F THERE IS NO REMAIN ING PATIENT CARE
TEAM PHYSICIAN LISTE D IN THE COLLABORATI ON AGREEMENT .
(H) A PHYSICIAN ASSISTANT WH OSE COLLABORATION AG REEMENT IS
TERMINATED MAY NOT P RACTICE AS A PHYSICI AN ASSISTANT UNTIL T HE PHYSICIAN
ASSISTANT EXECUTES A NEW COLLABORATION AG REEMENT UNDER THIS S ECTION.
WES MOORE, Governor Ch. 919
– 25 –
(I) A PHYSICIAN ASSISTANT MAY PRACTICE IN ACCO RDANCE WITH A
COLLABORATION AGREEME NT UNDER THIS SUBTIT LE.
(J) A PATIENT CARE TEAM PH YSICIAN MAY BE ADDED OR REMOVED FROM
A COLLABORATION AGRE EMENT BY PROVIDING N OTIFICATION TO THE BOARD.
(K) THE BOARD MAY MODIFY A CO LLABORATION AGREEMEN T IF IT FINDS
THAT:
(1) THE COLLABORATION AGR EEMENT DOES NOT MEET THE
REQUIREMENTS OF THIS SUBTITLE; OR
(2) THE PHYSICIAN ASSISTA NT IS UNABLE TO PERF ORM THE
DELEGATED DUTIES SAF ELY.
(L) A COLLABORATION AGREEM ENT SHALL BE MAINTAI NED AT THE
PRACTICE SETTING AND MADE AVAILABLE TO TH E BOARD ON REQUEST .
(M) A LICENSED PHYSICIAN A SSISTANT WHO FAILS T O COMPLY WITH THE
COLLABORATION AGREEM ENT REQUIREMENTS IS SUBJECT TO AN ADMINI STRATIVE
PENALTY AS ESTABLISHED IN REGULATIONS .
[15–302.1.
(a) If a delegation agreement does not include advanced duties or the advanced
duties have been approved under § 15–302(c)(1) of this subtitle, a physician assistant may
assume the duties under a delegation agreement on the date that the Board acknowledges
receipt of the completed delegation agreement.
(b) In this section, “pending” means that a delegation agreement that includes
delegation of advanced duties in a setting that does not meet the requirements under §
15–302(c)(1) of this subtitle has been executed and submitted to the Board for its approval,
but:
(1) The Committee has not made a recommendation to the Board; or
(2) The Board has not made a final decision regarding the delegation
agreement.
(c) Subject to subsection (d) of this section, if a delegation agreement is pending,
on receipt of a temporary practice letter from the staff of the Board, a physician assistant
may perform the advanced duty if:
(1) The primary supervising physician has been previously approved to
supervise one or more physician assistants in the performance of the advanced duty; and Ch. 919 2024 LAWS OF MARYLAND
– 26 –
(2) The physician assistant has been previously approved by the Board to
perform the advanced duty.
(d) If the Committee recommends a denial of the pending delegation agreement
or the Board denies the pending delegation agreement, on notice to the primary supervising
physician and the physician assistant, the physician assistant may no longer perform the
advanced duty that has not received the approval of the Board.
(e) The Board may disapprove any delegation agreement if it believes that:
(1) The agreement does not meet the requirements of this subtitle; or
(2) The physician assistant is unable to perform safely the delegated
duties.
(f) If the Board disapproves a delegation agreement or the delegation of any
function under an agreement, the Board shall provide the primary supervising physician
and the physician assistant with written notice of the disapproval.
(g) A physician assistant who receives notice that the Board has disapproved a
delegation agreement or an advanced function under the delegation agreement shall
immediately cease to practice under the agreement or to perform the disapproved function.]
15–302.1.
(A) IN THIS SECTION, “EXEMPT FACILITY ” MEANS:
(1) A HOSPITAL;
(2) AN AMBULATORY SURGICA L FACILITY;
(3) A FEDERALLY QUALIFIED HEALTH CENTER ; OR
(4) ANOTHER PRACTICE SETT ING LISTED ON A HOSP ITAL
DELINEATION OF PRIVI LEGES DOCUMENT .
(B) EXCEPT AS PROVIDED IN SUBSECTION (E) OF THIS SECTION , A
PHYSICIAN ASSISTANT MAY PERFORM ADVANCED DUTIES WITHOUT BOARD
APPROVAL IF THE ADVA NCED DUTY WILL BE PE RFORMED IN AN EXEMPT FACILITY
AND:
(1) THE PHYSICIAN ASSISTA NT IS SUPERVISED BY A PHYSICIAN WI TH
CREDENTIALS THAT HAV E BEEN REVIEWED BY T HE EXEMPT FACILITY A S A WES MOORE, Governor Ch. 919
– 27 –
CONDITION OF EMPLOYM ENT AS AN INDEPENDEN T CONTRACTOR OR AS A MEMBER
OF THE MEDICAL STAFF ;
(2) THE PHYSICIAN ASSISTA NT HAS CREDENTIALS T HAT HAVE BEEN
REVIEWED BY THE EXEM PT FACILITY AS A CONDITION OF EMPLOYM ENT AS AN
INDEPENDENT CONTRACT OR OR AS A MEMBER OF THE MEDICAL STAFF ; AND
(3) THE ADVANCED DUTY TO BE DELEGATED TO THE PHYSICIAN
ASSISTANT IS REVIEWE D AND APPROVED IN A PROCESS APPROVED BY THE EXEMPT
FACILITY BEFORE THE PHYSICIAN ASSISTANT PERFORMS THE ADVANCE D DUTY.
(C) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION A ND
SUBSECTION (D) OF THIS SECTION AND EXCEPT AS PROVIDED I N SUBSECTION (E) OF
THIS SECTION, A PHYSICIAN ASSISTAN T MAY PERFORM ADVANC ED DUTIES IN A
PRACTICE SETTING THA T IS NOT AN EXEMPT F ACILITY ONLY AFTER T HE PHYSICIAN
ASSISTANT OBTAINS BOARD APPROVAL OF THE ADVANCED DUTY UNDER THE
COLLABORATION AGREEM ENT.
(2) (I) SUBJECT TO SUBPARAGRA PH (II) OF THIS PARAGRAPH , A
PHYSICIAN ASSISTANT MAY PERFORM X–RAY DUTIES AUTHORIZE D UNDER §
14–306(E) OF THIS ARTICLE IN T HE MEDICAL OFFICE OF A PATIENT CARE TEAM
PHYSICIAN ONLY AFTER THE PHYSICIAN ASSISTANT OBTAINS BOARD APPROVAL OF
THE X–RAY DUTY UNDER THE C OLLABORATION AGREEME NT.
(II) A COLLABORATION AGREEM ENT MAY AUTHORIZE TH E
DELEGATION OF X–RAY DUTIES LIMITED T O NONFLUOROSCOPIC X–RAY
PROCEDURES OF THE EX TREMITIES, ANTERIOR–POSTERIOR AND LATERA L, NOT
INCLUDING THE HEAD .
(D) A PHYSICIAN ASSISTANT MAY NOT PERFORM THE MEDICAL ACTS OF
ADMINISTERING GENERA L ANESTHESIA OR NEUR OAXIAL ANESTHESIA , INCLUDING
SPINAL, EPIDURAL, AND IMAGE GUIDED INT ERVENTIONAL SPINE PR OCEDURES.
(E) A PHYSICIAN ASSISTANT MAY PERFORM AN ADVAN CED DUTY IN
COLLABORATION WITH A PATIENT CARE TEAM PH YSICIAN WITHOUT PRIO R
APPROVAL OF THE BOARD IF:
(1) THE BOARD HAS PREVIOUSLY APPROVED THE PHYSICI AN
ASSISTANT TO PERFORM THE ADVANCED DUTY IN COLLABORATION WITH A PATIENT
CARE TEAM PHYSICIAN ; OR
(2) THE PHYSICIAN ASSISTA NT HAS AT LEAST 7,000 HOURS OF
CLINICAL PRACTICE EX PERIENCE.
Ch. 919 2024 LAWS OF MARYLAND
– 28 –
(F) IF AN ADVANCED DUTY R EQUIRES BOARD APPROVAL , THE COMMITTEE:
(1) SHALL REVIEW THE COLL ABORATION AGREEMENT ;
(2) MAY CONDUCT A PERSONA L INTERVIEW OF THE P HYSICIAN
ASSISTANT AND PATIEN T CARE TEAM PHYSICIA NS; AND
(3) MAY RECOMMEND TO THE BOARD THAT THE COLLAB ORATION
AGREEMENT BE MODIFIE D TO ENSURE CONFORMA NCE WITH THE REQUIRE MENTS
OF THIS TITLE.
(G) (1) ON REVIEW OF THE COMMITTEE’S RECOMMENDATIONS
REGARDING THE REQUES T OF A PATIENT CARE TEAM PHYSICIAN TO DE LEGATE
ADVANCED DUTIES AS D ESCRIBED IN A COLLAB ORATION AGREEMENT , THE BOARD
MAY MODIFY THE PERFO RMANCE OF ADVANCED D UTIES UNDER A COLLAB ORATION
AGREEME NT IF THE PHYSICIAN ASSISTANT DOES NOT M EET THE APPLICABLE
EDUCATION, TRAINING, AND EXPERIENCE REQUI REMENTS TO PERFORM T HE
SPECIFIED ADVANCED D UTIES.
(2) IF THE BOARD MAKES A MODIFIC ATION UNDER PARAGRAP H (1)
OF THIS SUBSECTION , THE BOARD:
(I) SHALL NOTIFY EACH PAT IENT CARE TEAM PHYSI CIAN
LISTED IN THE COLLAB ORATION AGREEMENT AN D THE PHYSICIAN ASSI STANT IN
WRITING OF THE PARTI CULAR ELEMENTS OF TH E ADVANCED DUTY APPR OVAL
REQUEST THAT WERE TH E CAUSE FOR THE MODI FICATION; AND
(II) MAY NOT RESTR ICT THE SUBMISSION O F AN AMENDMENT
TO THE ADVANCED DUTY .
(H) DOCUMENTATION DEMONST RATING A PHYSICIAN A SSISTANT’S
AUTHORITY TO PERFORM AN ADVANCED DUTY UND ER THIS SECTION SHAL L BE
MAINTAINED AT THE FA CILITY IN WHICH THE PHYSICIAN ASSISTANT IS PERFORMING
THE ADVANCED DUTY .
(I) INDIVIDUAL MEMBERS OF THE BOARD ARE NOT CIVILLY LIABLE FOR
ACTIONS REGARDING TH E APPROVAL , MODIFICATION , OR DISAPPROVAL OF AN
ADVANCED DUTY UNDER THE COLLABORATION AG REEMENT DESCRIBED IN THIS
SECTION.
[15–302.2.] 15–302.1.
WES MOORE, Governor Ch. 919
– 29 –
[(a) A primary supervising PATIENT CARE TEAM physician may not delegate
prescribing, dispensing, and administering of controlled dangerous substances,
prescription drugs, or medical devices unless the primary supervising physician and
physician assistant include in the delegation COLLABORATION agreement:
(1) A notice of intent to delegate prescribing and, if applicable, dispensing
(1) THE AUTHORITY OF THE PHYSICIAN ASSISTANT TO PRESCRIBE
AND, IF APPLICABLE, DISPENSE of controlled dangerous substances, prescription drugs,
or medical devices;
(2) An attestation that all prescribing and, if applicable, dispensing
activities of the physician assistant will comply with applicable federal and State LAW AND
regulations;
(3) An attestation that all medical charts or records will contain a notation
of any prescriptions written or dispensed by a physician assistant in accordance with this
section;
(4) An attestation that all prescriptions written or dispensed under this
section will include the physician assistant’s name and the supervising PATIENT CARE
TEAM physician’s name, business address, and business telephone number legibly written
or printed;
(5) AN ATTESTATION THAT A LL PRESCRIPTIONS WRI TTEN UNDER
THIS SECTION WILL IN CLUDE THE PHYSICIAN ASSISTANT’S NAME, BUSINESS
ADDRESS, AND BUSINESS TELEPHO NE NUMBER LEGIBLY WR ITTEN OR PRINTED ;
(5) (6) An attestation that the physician assistant has:
(i) Passed the physician assistant national certification exam
administered by the National Commission on the Certification of Physician Assistants
within the previous 2 years; or
(ii) Successfully completed 8 category 1 hours of pharmacology
education within the previous 2 years; and
(6) (7) An attestation that the physician assistant has:
(i) A bachelor’s degree or its equivalent; or
(ii) Successfully completed 2 years of work experience as a physician
assistant.
Ch. 919 2024 LAWS OF MARYLAND
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(b) (1) A primary supervising PATIENT CARE TEAM physician may not
delegate the prescribing or dispensing of substances that are identified as Schedule I
controlled dangerous substances under § 5–402 of the Criminal Law Article.
(2) A primary supervising PATIENT CARE TEAM physician may delegate
the prescribing or dispensing of substances that are identified as Schedules II through V
controlled dangerous substances under § 5–402 of the Criminal Law Article, including
legend drugs as defined under § 503(b) of the Federal Food, Drug, and Cosmetic Act.
(3) A primary supervising PATIENT CARE TEAM physician may not
delegate the prescribing or dispensing of controlled dangerous substances to a physician
assistant unless the physician assistant has a valid:
(i) State controlled dangerous substance registration; and
(ii) Federal Drug Enforcement Agency (DEA) registration.]
(A) IN THIS SECTION, “PERSONALLY PREPARE A ND DISPENSE” MEANS THAT
A PHYSICIAN ASSISTAN T:
(1) IS PHYSICALLY PRESENT ON THE PREMISES WHER E A
PRESCRIPTION IS FILL ED; AND
(2) PERFORMS A FINAL CHEC K OF THE PRESCRIPTIO N BEFORE IT IS
PROVIDED TO THE PATIENT.
(B) SUBJECT TO THE COLLAB ORATION AGREEMENT SU BMITTED UNDER §
15–302 OF THIS SUBTITLE , A PHYSICIAN ASSISTAN T MAY PRESCRIBE , PROCURE,
DISPENSE, ORDER, OR ADMINISTER :
(1) SUBJECT TO SUBSECTION (C)(2) OF THIS SECTION , DRUGS AND
SUBSTANCES THAT ARE IDENTIFIED AS SCHEDULES II THROUGH V CONTROLLED
DANGEROUS SUBSTANCES UNDER §§ 5–403 THROUGH 5–406 OF THE CRIMINAL LAW
ARTICLE, INCLUDING LEGEND DRU GS AS DEFINED UNDER § 503(B) OF THE
FEDERAL FOOD, DRUG, AND COSMETIC ACT;
(2) MEDICAL DEVICES ; AND
(3) DURABLE MEDICAL EQUIP MENT.
(C) (1) A PHYSICIAN ASSISTANT MAY NOT PRESCRIBE OR DISPENSE
SUBSTANCES THAT ARE IDENTIFIED AS SCHEDULE I CONTROLLED DANGEROUS
SUBSTANCES UNDER § 5–402 OF THE CRIMINAL LAW ARTICLE.
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(2) A PHYSICIAN ASSISTANT MAY NOT PRESCRIBE OR DISPENS E
CONTROLLED DANGEROUS SUBSTANCES UNLESS TH E PHYSICIAN ASSISTAN T HAS A
VALID:
(I) STATE CONTROLLED DANG EROUS SUBSTANCE
REGISTRATION ; AND
(II) FEDERAL DRUG ENFORCEMENT AGENCY (DEA)
REGISTRATION .
[(c)] (D) (C) (1) A PATIENT CARE TEAM PHYSICIAN MAY A UTHORIZE A
physician assistant TO personally may prepare and dispense [a drug that the physician
assistant is authorized to prescribe under a delegation COLLABORATION agreement if]:
[(1) (I) Except as otherwise provided under § 12–102(g) of this article,
the supervising PATIENT CARE TEAM physician possesses a dispensing permit; and
(2) (II) The physician assistant dispenses drugs only within:
(i) 1. The supervising PATIENT CARE TEAM physician’s scope
of practice; and
(ii) 2. The scope of the delegation COLLABORATION
agreement.]
(2) A PATIENT CARE TEAM PH YSICIAN MAY DELEGATE ANY
DISPENSING DUTIES , INCLUDING THE PERFOR MANCE OF THE FINAL C HECK OF
PRESCRIPTIONS AS REQ UIRED UNDER § 12–102(A)(4)(II) OF THIS ARTICLE.
(D) IF A PATIENT CARE TEAM PHYSICIAN WHO HAS DE LEGATED AUTHORITY
TO EXERCISE PRESCRIP TIVE AUTHORITY TO A PHYSICIAN ASSISTANT
SUBSEQUENTLY RESTRIC TS OR REMOVES THE DE LEGATION, THE PATIENT CARE
TEAM PHYSICIAN SHALL NOTIFY THE BOARD OF THE RESTRICT ION OR REMOVAL
WITHIN 5 BUSINESS DAYS.
(I) A STARTER DOSAGE OF AN Y DRUG THAT THE PHYS ICIAN
ASSISTANT IS AUTHORI ZED TO PRESCRIBE TO A PATIENT OF THE PHY SICIAN
ASSISTANT IF:
1. THE STARTER DOSAGE CO MPLIES WITH THE
LABELING REQUIREMENT S OF § 12–505 OF THIS ARTICLE;
2. NO CHARGE IS MADE FOR THE STARTER DOSAGE ; AND
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3. THE PHYSICIAN ASSISTA NT ENTERS AN APPROPR IATE
RECORD IN THE PATIEN T’S MEDICAL RECORD ; OR
(II) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , ANY
DRUG THAT A PHYSICIA N ASSISTANT MAY PRES CRIBE TO THE EXTENT AUTHORIZE D
BY LAW IN THE COURSE OF TREATING A PATIEN T AT:
1. A MEDICAL FACILITY OR CLINIC THAT SPECIALI ZES IN
THE TREATMENT OF MED ICAL CASES REIMBURSA BLE THROUGH WORKERS ’
COMPENSATION INSURAN CE;
2. A MEDICAL FACILITY OR CLINIC THAT IS OPERATED
ON A NONPROFIT BASIS ;
3. A HEALTH CENTER THAT O PERATES ON A CAMPUS OF
AN INSTITUTION OF HI GHER EDUCATION ;
4. A PUBLIC HEALTH FACILI TY, A MEDICAL FACILITY
UNDER CONTRACT WITH A STATE OR LOCAL HEALTH DEPARTMENT , OR A FACILITY
FUNDED WITH PUBLIC FUNDS; OR
5. A NONPROFIT HOSPITAL O R A NONPROFIT HOSPIT AL
OUTPATIENT FACILITY AS AUTHORIZED UNDER THE POLICIES ESTABLI SHED BY THE
HOSPITAL.
(2) A PHYSICIAN ASSISTANT WHO PERSONALLY PREPA RES AND
DISPENSES A DRUG IN THE COURSE OF TREATI NG A PATIENT AS AUTHORIZE D UNDER
THIS SUBSECTION SHAL L:
(I) COMPLY WITH THE LABEL ING REQUIREMENTS OF § 12–505
OF THIS ARTICLE;
(II) RECORD THE DISPENSING OF THE PRESCRIPTION DRUG ON
THE PATIENT’S CHART;
(III) ALLOW THE OFFICE OF CONTROLLED SUBSTANCES
ADMINISTRATION TO ENT ER AND INSPECT THE O FFICE IN WHICH THE P HYSICIAN
ASSISTANT PRACTICES AT ALL REASONABLE HO URS; AND
(IV) EXCEPT FOR STARTER DO SAGES OR SAMPLES DIS PENSED
WITHOUT CHARGE , PROVIDE THE PATIENT WITH A WRITTEN PRESC RIPTION,
MAINTAIN PRESCRIPTION F ILES, AND MAINTAIN A SEPAR ATE FILE FOR SCHEDULE
II PRESCRIPTIONS FOR A PERIOD OF AT LEAST 5 YEARS. WES MOORE, Governor Ch. 919
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[(d)] (E) A physician assistant who personally dispenses a drug in the course of
treating a patient as authorized under subsections (b) and [(c)] (D) of this section shall
comply with the requirements under Titles 12 and 14 of this article and applicable federal
law and regulations.
[(e) Before a physician assistant may renew a license for an additional 2–year
term under § 15–307 of this subtitle, the physician assistant shall submit evidence to the
Board of successful completion of 8 category 1 hours of pharmacology education within the
previous 2 years.]
(F) A PRESCRIPTION DISPENS ED UNDER THIS SECTIO N SHALL INCLUDE
THE PHYSICIAN ASSIST ANT’S:
(1) NAME;
(2) BUSINESS ADDRESS ; AND
(3) BUSINESS TELEPHONE NU MBER.
(G) A PHYSICIAN ASSISTANT STUDENT IN A TRAIN ING PROGRAM THAT IS
ACCREDITED BY THE ACCREDITATION REVIEW COMMISSION ON EDUCATION FOR
THE PHYSICIAN ASSISTANT MAY NOT EXE RCISE PRESCRIPTIVE A UTHORITY.
[15–302.3.
(a) On a quarterly basis, the Board shall provide to the Board of Pharmacy a list
of physician assistants whose delegation agreements include the delegation of prescriptive
authority.
(b) The list required under subsection (a) of this section shall specify whether
each physician assistant has been delegated the authority to prescribe controlled dangerous
substances, prescription drugs, or medical devices.
(c) If a primary supervising physician who has delegated authority to exercise
prescriptive authority to a physician assistant subsequently restricts or removes the
delegation, the primary supervising physician shall notify the Board of the restriction or
removal within 5 business days.]
15–303.
(a) To qualify for a license, an applicant shall:
(1) Complete a criminal history records check in accordance with §
14–308.1 of this article; Ch. 919 2024 LAWS OF MARYLAND
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(2) Be of good moral character;
(3) Demonstrate oral and written competency in the English language as
required by the Board;
(4) Be at least 18 years old; [and]
(5) [(i) Be a graduate of a physician assistant training program
approved by the Board; or
(ii) Have passed the physician assistant national certifying
examination administered by the National Commission on Certification of Physician
Assistants prior to 1986, maintained all continuing education and recertification
requirements, and been in continuous practice since passage of the examination] EXCEPT
AS PROVIDED IN SUBSE CTION (B) OF THIS SECTION , HAVE SUCCESSFULLY
COMPLETED AN EDUCATI ONAL PROGRAM FOR PHY SICIAN ASSISTANTS AC CREDITED
BY:
(I) THE ACCREDITATION REVIEW COMMISSION ON
EDUCATION FOR THE PHYSICIAN ASSISTANT; OR
(II) IF COMPLETED BEFORE 2001:
1. THE COMMITTEE ON ALLIED HEALTH EDUCATION
AND ACCREDITATION ; OR
2. THE COMMISSION ON ACCREDITATION OF ALLIED
HEALTH EDUCATION PROGRAMS; AND
(6) HAVE PASSED T HE PHYSICIAN ASSISTANT NATIONAL
CERTIFYING EXAMINATION ADMINISTE RED BY THE NATIONAL COMMISSION ON
CERTIFICATION OF PHYSICIAN ASSISTANTS.
[(b) Except as otherwise provided in this title, the applicant shall pass a national
certifying examination approved by the Board.]
[(c)] (B) An applicant who graduates from [a physician assistant training
program] AN ACCREDITED EDUCAT IONAL PROGRAM FOR PH YSICIAN ASSISTANTS
UNDER THIS SECTION after October 1, 2003, shall have a bachelor’s degree or its
equivalent.
15–306.
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A license authorizes the licensee to practice as a physician assistant [under a
delegation agreement] while the license is effective.
15–309.
(a) Each licensee shall keep a license and [delegation] COLLABORATION
agreement for inspection at the primary place of business of the licensee.
(C) THE BOARD MAY AUDIT AND R EVIEW COLLABORATION AGREEMENTS
KEPT BY THE LICENSEE AT THE PRIMARY PLACE OF BUSINESS OF THE L ICENSEE AT
ANY TIME.
(D) A PHYSICIAN ASSISTANT WHO FAILS TO PRODUCE A COLLABORATION
AGREEMENT TO THE BOARD ON REQUEST IS S UBJECT TO AN ADMINIS TRATIVE
PENALTY AS ESTABLISH ED IN REGULATIONS .
15–310.
(a) In reviewing an application for licensure or in investigating an allegation
brought under § 15–314 of this subtitle, the Committee may request the Board to direct, or
the Board on its own initiative may direct, the physician assistant to submit to an
appropriate examination.
(b) In return for the privilege given to the physician assistant to [perform
delegated medical acts] PRACTICE AS A PHY SICIAN ASSISTANT in the State, the
physician assistant is deemed to have:
(1) Consented to submit to an examination under this section, if requested
by the Board in writing; and
(2) Waived any claim of privilege as to the testimony or examination
reports.
(c) The unreasonable failure or refusal of the licensed physician assistant or
applicant to submit to an examination is prima facie evidence of the licensed physician
assistant’s inability to [perform delegated medical acts] PRACTICE AS A PHYSIC IAN
ASSISTANT and is cause for denial of the application or immediate suspension of the
license.
(d) The Board shall pay the costs of any examination made under this section.
[15–313.
(a) (1) Except as otherwise provided under § 10–226 of the State Government
Article, before the Board takes any action to reject or modify a delegation agreement or Ch. 919 2024 LAWS OF MARYLAND
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advanced duty, the Board shall give the licensee the opportunity for a hearing before the
Board.
(2) The Board shall give notice and hold the hearing under Title 10,
Subtitle 2 of the State Government Article.
(3) The Board may administer oaths in connection with any proceeding
under this section.
(4) At least 14 days before the hearing, the hearing notice shall be sent to
the last known address of the applicant or licensee.
(b) Any licensee aggrieved under this subtitle by a final decision of the Board
rejecting or modifying a delegation agreement or advanced duty may petition for judicial
review as allowed by the Administrative Procedure Act.]
15–314.
(a) Subject to the hearing provisions of § 15–315 of this subtitle, a disciplinary
panel, on the affirmative vote of a majority of the quorum, may reprimand any physician
assistant, place any physician assistant on probation, or suspend or revoke a license if the
physician assistant:
(41) Performs [delegated] medical acts beyond the scope of the [delegation]
COLLABORATION agreement filed with the Board [or after notification from the Board
that an advanced duty has been disapproved] IN A MANNER THAT IS NOT CONSISTENT
WITH THE COLLABORATI ON AGREEMENT ;
[(42) Performs delegated medical acts without the supervision of a
physician;]
(42) PERFORMS MEDICAL ACTS WHICH ARE OUTSIDE TH E EDUCATION,
TRAINING, AND EXPERIENCE OF TH E PHYSICIAN ASSISTAN T;
(43) PERFORMS MEDICAL ACTS THAT ARE NOT CUSTOMA RY TO THE
PRACTICE OF THE PATI ENT CARE TEAM PHYSIC IANS LISTED ON THE
COLLABORATION AGREEM ENT;
(42) (44) PRACTICES AS A PHYSIC IAN ASSISTANT WITHOU T FIRST
SUBMITTING A COLLABO RATION AGREEMENT TO THE BOARD; PROVIDING NOTICE
TO THE BOARD AS REQUIRED UND ER § 15–302(A) OF THIS SUBTITLE;
[(43)] (45) Fails to complete a criminal history records check under §
14–308.1 of this article;
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[(44)] (46) Fails to comply with the requirements of the Prescription Drug
Monitoring Program under Title 21, Subtitle 2A of the Health – General Article; or
[(45)] (47) Fails to comply with any State or federal law pertaining to the
practice as a physician assistant.
15–317.
(a) A physician assistant WHO IS LICENSED in this State or in any other state
OR WHO IS AN EMPLOYE E OF THE FEDERAL GOV ERNMENT is authorized to perform
acts, tasks, or functions as a physician assistant [under the supervision of a physician
licensed to practice medicine in the State] during a disaster as defined by the Governor,
within a county in which a state of disaster has been declared, or counties contiguous to a
county in which a state of disaster has been declared.
(b) The physician assistant shall notify the Board in writing of the names,
practice locations, and telephone numbers for the physician assistant [and each primary
supervising physician] within 30 days [of] AFTER the first performance of medical acts,
tasks, or functions as a physician assistant during the disaster.
(c) A team of physicians and physician assistants or physician assistants
practicing under this section may not be required to maintain on–site documentation
describing [supervisory arrangements] COLLABORATION AGREEM ENTS as otherwise
required under this title.
15–401.
[(a)] Except as otherwise provided in this title, a person may not practice, attempt
to practice, or offer to practice as a physician assistant in the State unless the person has
[a]:
(1) A license issued by the Board TO PRACTICE AS A PHY SICIAN
ASSISTANT; AND
(2) SUBMITTED A COLLABORA TION AGREEMENT TO TH E BOARD.
(2) PROVIDED NOTICE TO TH E BOARD AS REQUIRED UND ER §
15–302(A) OF THIS TITLE.
[(b) Except as otherwise provided in this title, a person may not perform, attempt
to perform, or offer to perform any delegated medical act beyond the scope of the license
and which is consistent with a delegation agreement filed with the Board.]
15–402.1.
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(a) Except as otherwise provided in this subtitle, a licensed physician may not
employ [or supervise] an individual practicing as a physician assistant who does not have
a license OR WHO HAS NOT SUBMITTED A COLLABOR ATION AGREEMENT TO T HE
BOARD PROVIDED NOTICE TO T HE BOARD AS REQUIRED UND ER § 15–302(A) OF
THIS TITLE.
Article – Transportation
13–616.
(a) (1) In this subtitle the following words have the meanings indicated.
(7) “Licensed physician assistant” means an individual who is licensed
under Title 15 of the Health Occupations Article to practice [medicine with physician
supervision] AS A PHYSICIAN ASSISTANT.
SECTION 2. AND BE IT FURTHER ENACTED, That:
(a) A physician assistant authorized to practice under a delegation agreement on
October 1, 2024, may continue to practice as a physician assistant under the delegation
agreement.
(b) The delegation agreement in effect on October 1, 2024, shall be treated the
same as the collaboration agreement required under § 15–302 of the Health Occupations
Article, as enacted by Section 1 of this Act, until an initial collaboration agreement is
submitted to the State Board of Physicians by the physician assistant the physician
assistant has provided notice to the State Board of Physicians as required under §
15–302(a) of the Health Occupations Article, as enacted under Section 1 of this Act.
SECTION 3. AND BE IT FURTHER ENACTED, That, on or before January 1, 2025,
the State Board of Physicians, with representatives from the Maryland Academy of
Physician Assistants, the Physician Assistant Education Association, and physician
assistant education programs in the State, shall review and update the list of advanced
duties for physician assistants.
SECTION 3. 4. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2024.
Approved by the Governor, May 16, 2024.