All Roll Calls
Yes: 218 • No: 0
MarylandSB 09152026 Regular SessionSenateWALLET
State Board of Physicians - Delegation of Duties - Alterations
Sponsored By: Johnny Mautz (Republican)
Signed by Governor
Health OccupationsApplicants and ApplicationsCommittees and CommissionsContinuing EducationCrimes and Punishments -see also- Penalties and Sentnc; etc.Criminal Background InvestigationsDisciplineEducation -see also- ContEd; DrvEd; HigherEd; etc.EthicsFees -see also- Attys' Fees; Devt Fees & TaxesFormsFraud -see also- ForgeryHealth Occupations -see also- (specific health occupations)HearingsHospitals -see also- Clinics; State HospitalsJob Training -see also- Continuing Ed; Vocational RehabLaboratoriesLicenses -see also- AB Lic; Certifications; DrLic; PermitsManagers and SupervisorsMedical Equipment and DevicesMedical TechnologyPatientsPenalties and Sentences -see also- Death PenaltyPhysician AssistantsPhysicians -see also- MedExmnrs; Pediatr; Psychiatrists etc.PleasPrivacyRadiationRecords -see also- Land Records; Vital RecordsRegistration -see also- Motor Vehicle RegistrationRevenue and Taxes -see also- (specific tax)Rules and RegulationsSubstance AbuseWork, Labor, and Employment -see also- JobTrn; Leave; etc.
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 4 benefits, 1 costs, 1 mixed.
New registration for limited X-ray operators
The law creates a registration for limited X-ray operators. You may do only nonfluoroscopic chest, listed spine parts, and listed upper and lower extremity X-rays. No CT, fluoroscopy, invasive radiology, mammography, nuclear medicine, radiation therapy, or xerography. You must work under on-site or immediately available supervision by a licensed physician or radiographer. You need at least 6 months of clinical care experience, 115 classroom hours taught by an ARRT-certified technologist (or equivalent), 480 clinical hours, and five competencies per listed body part. You must pass the ARRT limited-scope exam or a Board-approved alternative and complete a criminal background check. Registration lasts up to 3 years. You need 24 hours of continuing education every 2 years to renew.
Physician assistants may do extremity X-rays
A physician assistant may perform nonfluoroscopic extremity X-rays in a patient care team physician’s office. The PA must finish a course that includes radiographic studies on at least 20 separate patients. A collaborating physician or a radiologist must directly supervise the X-rays. The PA must use a mini C-arm or a similar low-level machine and get Board approval as an advanced duty in the collaboration agreement. This applies starting October 1, 2026.
Clearer delegation rules and titles
When Board rules allow, a person may perform duties delegated by a licensed physician or physician assistant without a separate license. Staff who work under the state’s delegation statutes may use titles with the word “physician” plus another word, like “physician’s assistant” or “physician’s aide.” All parts of this law take effect October 1, 2026.
Supervised medical graduates may practice
If you hold an MD or DO and passed parts 1 and 2 of the USMLE or COMLEX, you can work as a supervised medical graduate. You may perform delegated duties under on-site supervision per Board rules. You can be in this role for up to 2 years. The physician does not need to be in the room when rules allow. This begins October 1, 2026.
Fines and discipline for X-ray work
If an unregistered person performs X-ray work, the Board can fine the physician’s office up to $5,000 per violation and the person up to $1,000 per violation. The Board may deny, suspend, revoke, reprimand, fine, or put a registrant on probation for fraud, incompetence, substance issues, working beyond scope, or not completing the background check. Most actions require a hearing. The Board can also order people to stop falsely claiming they are allowed to do limited X-rays and seek a court injunction. These rules apply starting October 1, 2026.
Cardiovascular invasive specialists may assist fluoroscopy
A doctor may delegate fluoroscopy-related tasks to a registered cardiovascular invasive specialist during cardiac catheterization in a hospital cath lab. The doctor must be physically present and direct each act. The specialist must meet Board training and experience rules, and the hospital must verify and document qualifications. A hospital that fails to follow these rules can be fined up to $5,000 per instance. This starts on October 1, 2026.
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Sponsors & Cosponsors
Sponsor
Johnny Mautz
Republican • Senate
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 4/9/2026
Third Reading Passed
Yes: 40 • No: 0 • Other: 4
House vote • 4/8/2026
Third Reading Passed
Yes: 133 • No: 0 • Other: 5
Senate vote • 3/19/2026
Third Reading Passed
Yes: 45 • No: 0 • Other: 2
Actions Timeline
Approved by the Governor - Chapter 214
4/28/2026Passed Enrolled
4/9/2026SenateThird Reading Passed (40-0)
4/9/2026SenateSenate Concurs House Amendments
4/9/2026SenateThird Reading Passed (133-0)
4/8/2026HouseSecond Reading Passed with Amendments
4/3/2026HouseFavorable with Amendments {163120/1 Adopted
4/3/2026HouseFavorable with Amendments Report by Health
4/3/2026HouseHearing 4/01 at 1:00 p.m.
3/20/2026HouseReferred Health
3/20/2026HouseThird Reading Passed (45-0)
3/19/2026SenateSecond Reading Passed with Amendments
3/17/2026SenateFavorable with Amendments {993729/1 Adopted
3/17/2026SenateFavorable with Amendments Report by Finance
3/16/2026SenateHearing 3/03 at 1:00 p.m.
2/12/2026SenateFirst Reading Finance
2/6/2026Senate
Bill Text
Enrolled
4/9/2026
Third Reading
3/17/2026
First Reading
2/6/2026
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