MarylandSB 03262026 Regular SessionSenateWALLET

Physician Assistants and Midwives - Parity With Other Health Care Practitioners (Physician Assistant Parity Act of 2026)

Sponsored By: Clarence K. Lam (Democratic)

Signed by Governor

Health OccupationsCommittee ChangesCommittees and CommissionsDisabilitiesDisparityEmergency Medical Services -see also- Ambul; RescSqdEmergencies -see also- PandemicsEthicsGood SamaritanHealth -see also- COVID19; EnvHlth; MedCon; etc.Health Care CommissionHealth, Department ofHealth Maintenance Organizations -see also- Manage Care OrgsHealth Occupations -see also- (specific health occupations)ImmunizationIncarcerated IndividualsMedical Equipment and DevicesMedical TreatmentsMental and Behavioral Health -see also- Aut; Cogn; Dev; etc.MidwivesParents and GuardiansPetitionsPhysician AssistantsPovertyPregnancyReportsStudies -see also- Commitees & Commissions; ReportsTimeWork, Labor, and Employment -see also- JobTrn; Leave; etc.

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Bill Overview

Analyzed Economic Effects

8 provisions identified: 7 benefits, 1 costs, 0 mixed.

Easier in-home care approval for seniors

Beginning 2026-10-01, an attending physician assistant can certify that a person is at risk of going to a nursing facility. That certification can make the person eligible for attendant care services to remain at home. This helps seniors and caregivers get in-home help sooner.

Faster capacity and guardianship decisions by PAs

Beginning 2026-10-01, a physician assistant can be the second medical signer that says a patient is incapable for treatment decisions. The second signer must examine the patient within two hours, unless the patient is unconscious or cannot communicate. For guardianship cases, a PA can provide the non-physician competency certificate after examining the person. This speeds urgent care and court paperwork for families.

Faster mental health help; first exam paid

Beginning 2026-10-01, physician assistants can examine and sign papers for mental health admissions, file emergency petitions, and do exams that identify a mental disorder. A PA’s certificate must be based on a personal exam and cannot be used if the PA has a financial interest or is related to the person. When a PA certifies someone and placement elsewhere is not possible, a state facility must receive and evaluate the person within 12 hours. If the person cannot pay or lacks insurance, the Department pays for the first exam by a doctor, PA, or nurse practitioner and for transport, including to an admitting facility. Hospitals are paid at state-approved Health Services Cost Review Commission rates.

Faster epinephrine access at youth camps

Beginning 2026-10-01, physician assistants can authorize, prescribe, and dispense emergency-use epinephrine to certificate holders at youth camps. In an emergency when a clinician or EMS is not right there, a certified person can give epinephrine. PAs who act in good faith are protected from lawsuits when they prescribe or dispense epinephrine to certified people.

HMO members can pick a PA

Beginning 2026-10-01, HMO members must be given a chance to pick a primary provider from the plan’s network. Your choice can include a physician assistant, certified nurse-midwife, licensed certified midwife, or nurse practitioner, when available in the HMO. The law does not force plans to list midwives as primary care providers.

Quicker infirmary care for pregnant inmates

Beginning 2026-10-01, a physician assistant can order infirmary admission for a pregnant incarcerated person who needs that level of care. This helps pregnant people in custody get on-site care faster.

State workers can use PA sick notes

Beginning 2026-10-01, state employees can use a physician assistant’s signed medical certificate to verify sick leave of five or more straight workdays. Supervisors must accept PA notes for the employee’s illness or an immediate family member’s illness. This helps workers keep paid leave during longer illnesses.

Staffing agency rules exclude PAs

Beginning 2026-10-01, the state’s staffing‑agency law defines “health care practitioner” to exclude physician assistants. This changes which staffing‑agency rules and oversight apply to PAs.

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Sponsors & Cosponsors

Sponsor

Clarence K. Lam
Democratic • Senate

Cosponsors

Pamela Beidle
Democratic • Senate
Mary Beth Carozza
Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 181 • No: 0

House vote • 4/7/2026

Third Reading Passed

Yes: 136 • No: 0 • Other: 3

Senate vote • 3/19/2026

Third Reading Passed

Yes: 45 • No: 0 • Other: 2

Actions Timeline

Approved by the Governor - Chapter 222
4/28/2026
Returned Passed
4/8/2026Senate
Third Reading Passed (136-0)
4/7/2026House
Favorable Adopted Second Reading Passed
4/3/2026House
Favorable Report by Health
4/3/2026House
Hearing 4/01 at 1:00 p.m.
3/20/2026House
Referred Health
3/20/2026House
Third Reading Passed (45-0)
3/19/2026Senate
Second Reading Passed with Amendments
3/17/2026Senate
Favorable with Amendments {683022/1 Adopted
3/17/2026Senate
Favorable with Amendments Report by Finance
3/16/2026Senate
Hearing 2/10 at 1:00 p.m.
1/27/2026Senate
First Reading Finance
1/22/2026Senate

Bill Text

Third Reading
3/17/2026
PDF
First Reading
1/22/2026
PDF

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