Section 15-301 - Scope of practice; required certification; practice without certificate. - Maryland Statutes

§ 15-301. Scope of practice; required certification; practice without certificate.
 

(a)  Independent practice not authorized.- Nothing in this title may be construed to authorize a physician assistant to practice independent of a primary or alternate supervising physician. 

(b)  License limitations.- 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) Appropriate to the education, training, and experience of the physician assistant; 

(3) Customary to the practice of the primary or alternate supervising physician; and 

(4) Consistent with the delegation agreement filed with the Board. 

(c)  Permitted patient services.- Patient services that may be provided by a physician assistant 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. 

(d)  Requirements.-  

(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 a physician assistant in the performance of delegated medical acts without filing a completed delegation 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 individual has not been licensed; and 

(ii) The medical acts have not been delegated by a primary or alternate supervising physician. 

(e)  Agency.- 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. 

(f)  Exemptions from certification.- Except as provided in subsection (g) of this section, the following individuals may practice as a physician assistant without a license: 

(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)  Limitations on prescription/medication delegation.- 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)  Dual regulatory authority.-  

(1) If a medical act that is to be delegated 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. 

(i)  Patient access to supervising physician.- Notwithstanding the provisions of this section, a patient being treated regularly for a life-threatening, chronic, degenerative, or disabling condition shall be seen initially by the supervising physician and as frequently as the patient's condition requires, but no less than within every five appointments or within 180 days, whichever occurs first. 
 

[1986, ch. 759; 1988, ch. 109, § 1; 1990, ch. 6, § 11; 1991, ch. 118; 1997, ch. 540; 1999, ch. 655; 2002, ch. 374; 2003, ch. 252, § 10; 2005, ch. 25, § 13; 2006, ch. 540, § 2; 2010, chs. 273, 274.]