Maryland Health Occupations Section 15-302

      (a)      Subject to the provisions of subsection (i) of this section, the Board may authorize a physician to delegate medical acts to a physician assistant only after:

            (1)      A delegation agreement has been executed and submitted to the Committee for review to ensure the delegation agreement contains the requirements of this subtitle; and

            (2)      The Board has reviewed and approved a favorable recommendation by the Committee that the requirements of this subtitle have been met.

      (b)      The delegation agreement shall contain:

            (1)      A description of the qualifications of the supervising physician and physician assistant;

            (2)      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 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 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 supervising physician through the mechanisms described in the delegation agreement;

            (7)      An attestation by the supervising physician of the physician's acceptance of responsibility for any care given by the physician assistant;

            (8)      An attestation by the supervising physician that the physician will respond in a timely manner when contacted by the physician assistant; and

            (9)      Any other information deemed necessary by the Board or Committee to carry out the provisions of this subtitle.

      (c)      (1)      The delegation agreement shall be submitted with the application fee established by the Board and the supervising physician and physician assistant shall comply with all other requirements established by the Board in accordance with this title.

            (2)      The Board shall set the application fee so as to produce funds to approximate the cost of reviewing and approving delegation agreements and any other related services provided.

      (d)      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 supervising physician and the physician assistant.

      (f)      On review of the Committee's recommendation regarding a supervising physician's request to delegate medical acts as described in a delegation agreement, the Board:

            (1)      May approve the delegation agreement; or

            (2)      (i)      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

                  (ii)      If the Board takes an action under item (i) of this item:

                        1.      Shall notify the 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

                        2.      May not restrict the submission of an amendment to the delegation agreement.

      (g)      If the Board determines that a supervising physician or 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 take other disciplinary action under § 14-404 or § 15-314 of this article.

      (h)      (1)      A delegation agreement approved under this subtitle may be reviewed as a component of the certificate renewal process established under § 15-307 of this subtitle.

            (2)      A delegation agreement shall expire when a physician assistant's certificate expires.

      (i)      The Board may not authorize a physician to delegate medical acts under a delegation agreement to more than two physician assistants at any 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.

      (j)      A person may not coerce another person to enter into a delegation agreement under this subtitle.

      (k)      A physician may supervise a physician assistant:

            (1)      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 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:

                        1.      Have been delegated under the delegation agreement filed with the Board; and

                        2.      Are within the scope of practice of the alternate supervising physician.

      (l)      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.