MarylandHB 03772026 Regular SessionHouseWALLET

Physician Assistants and Midwives - Parity With Other Health Care Practitioners

Sponsored By: Steve Johnson (Democratic)

Signed by Governor

Health OccupationsCommittee ChangesCommittees and CommissionsData -see also- Census; DemographicsDisabilitiesDisparityEmergencies -see also- PandemicsEthicsGood SamaritanHealth -see also- COVID19; EnvHlth; MedCon; etc.Health Care CommissionHealth Care Facilities -see also- Clinics; Hospices; etcHealth, 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.MidwivesNurse PractitionersNurses -see also- Nurse Practitioners; Nursing AssistantsParents and GuardiansPetitionsPhysician AssistantsPhysicians -see also- MedExmnrs; Pediatr; Psychiatrists etc.PovertyPregnancyReportsStudies -see also- Commitees & Commissions; ReportsTimeWork, Labor, and Employment -see also- JobTrn; Leave; etc.

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Bill Overview

Analyzed Economic Effects

10 provisions identified: 8 benefits, 0 costs, 2 mixed.

Physician assistants can support guardianship petitions

Beginning October 1, 2026, guardianship petitions can use competency certificates from one licensed physician and one licensed physician assistant. Both must have examined or evaluated the person. The certificates must be signed and verified; they do not decide the guardianship outcome.

Health plan members gain provider choices

Beginning October 1, 2026, required health maintenance organization standards give members more primary-care provider choices among available providers. Choices include physicians, physician assistants, certified nurse-midwives, licensed certified midwives, and certified nurse practitioners. The law does not require these plans to include certified nurse practitioners on their primary-care panels.

More access to emergency allergy medicine

Beginning October 1, 2026, physician assistants can prescribe and dispense emergency epinephrine and supplies to Emergency and Allergy Treatment Program certificate holders. Holders or their agents can give it for anaphylaxis, a severe allergic reaction, or a good-faith belief that it is occurring. This authority applies when physicians, physician assistants, registered nurse practitioners, and emergency medical services are not immediately available. The law bars lawsuits over physician assistants' good-faith acts or omissions in prescribing or dispensing to people certified by Maryland's Department of Health.

More clinicians can certify home-care needs

Beginning October 1, 2026, physician assistants can certify institutional-placement risk for people eligible for Attendant Care Program financial help. The certification shows that without community attendant care, the person risks placement in a nursing facility or similar licensed institution. Physicians and certified nurse practitioners can also certify this risk. Program-wide, at least 50% of recipients must work, actively seek work, or attend postsecondary education. Remaining recipients can include nursing-facility residents or people with a certified placement risk; the new signer option does not change underlying eligibility.

More clinicians can order pregnancy care

Beginning October 1, 2026, more clinicians can order infirmary admission for pregnant people in custody who need that care. They include physicians, physician assistants, nurse practitioners, certified nurse-midwives, and licensed certified midwives.

State covers qualifying emergency evaluation costs

Beginning October 1, 2026, Maryland's Department of Health pays specified emergency mental health evaluation costs for qualifying people. Coverage applies when the person cannot pay or lacks insurance covering the emergency charges. It includes initial consultant examinations by physician assistants or nurse practitioners and specified transport to emergency or admitting facilities. Payment is the actual cost or a reasonable rate, whichever is lower. Hospital payments follow rates set by the Health Services Cost Review Commission.

State workers gain sick-leave documentation options

Beginning October 1, 2026, Maryland state employees can use a physician assistant's certificate for extended paid sick leave. After 5 or more consecutive workdays, employees must give their immediate supervisor an original illness or disability certificate. Leave can cover the employee's illness or disability or that of an immediate family member. The physician assistant must be authorized to practice in a state and act within that authority.

Physician assistant staffing referrals leave licensing

Beginning October 1, 2026, physician assistants are excluded from the practitioner definition used in Maryland's health care staffing-agency licensing rules. Physicians are also excluded from that definition. Agencies must still be licensed before referring practitioners covered by those rules for temporary services.

Physician assistants join mental health admissions

Beginning October 1, 2026, physician assistants can examine people and petition for emergency mental health evaluations without immediate court review. Their signed petitions can lead police to take people to the nearest emergency facility. A physician and physician assistant can also certify a disabled person's capacity to choose voluntary admission. That process requires the official written application and personal examinations covering understanding, discharge requests, and ongoing assent. Signers cannot have a financial interest in the privately owned facility or be related to the person or guardian. By November 1, 2026, Maryland's Health Care Commission must report on emergency department stays for involuntary admissions, including overnight staffing concerns.

Physician assistants join treatment decision certifications

Beginning October 1, 2026, a physician assistant can serve as the second professional for specified treatment certifications. These cover inability to make informed treatment decisions and terminal or end-stage conditions, including decisions about life-sustaining treatment. This expands access to certification, but also expands who can certify that patients cannot make their own decisions. Incapacity certification requires personal examinations; one certifier must examine the patient within 2 hours before certification. Assessment costs count as treatment costs. For mental-illness certifications, the second professional cannot currently treat the person; a persistent vegetative state still requires two physicians.

Sponsors & Cosponsors

Sponsor

Steve Johnson
Democratic • House

Cosponsors

Tiffany T. Alston
Democratic • House
Heather Bagnall
Democratic • House
Bonnie Cullison
Democratic • House
Pam Lanman Guzzone
Democratic • House
Aaron M. Kaufman
Democratic • House
Nicholaus R. Kipke
Republican • House
Lesley J. Lopez
Democratic • House
Ashanti Martinez
Democratic • House
Samuel I. Rosenberg
Democratic • House
Kim Ross
Democratic • House
Deni Taveras
Democratic • House
Jennifer White Holland
Democratic • House
Teresa Woorman
Democratic • House

Roll Call Votes

All Roll Calls

Yes: 179 • No: 0

Senate vote • 4/6/2026

Third Reading Passed

Yes: 46 • No: 0

House vote • 3/12/2026