MarylandHB 07762025 Regular SessionHouseWALLET

Maryland Medical Practice Act and Maryland Physician Assistants Act - Revisions

Sponsored By: Joseline A. Peña-Melnyk (Democratic)

Signed by Governor

Health OccupationsCertificationsCivil OffensesCommittees and CommissionsComptrollerContracts -see also- ProcurementDisciplineDisclosureEducation -see also- ContEd; DrvEd; HigherEd; etc.EthicsFines -see also- Penalties and SentencesGeneticsHealth -see also- COVID19; EnvHlth; MedCon; etc.Health Care Facilities -see also- Clinics; Hospices; etcHealth Occupations -see also- (specific health occupations)HearingsHospitals -see also- Clinics; State HospitalsInjuryInternational AffairsInternet -see also- Internet AccessInvestigations and Inquiries -see also- Crim Bckgrnd InvestJob Training -see also- Continuing Ed; Vocational RehabLanguage -see also- Communications; LiteracyLiabilityLicenses -see also- AB Lic; Certifications; DrLic; PermitsMedical MalpracticeMedical TreatmentsMeetings -see also- Hearings; Open GovernmentMental and Behavioral Health -see also- Aut; Cogn; Dev; etc.NoticesPatientsPenalties and Sentences -see also- Death PenaltyPhysician AssistantsPhysicians -see also- MedExmnrs; Pediatr; Psychiatrists etc.Public InformationRecords -see also- Land Records; Vital RecordsRehabilitationReportsRules and RegulationsSafety -see also- Occupational SafetyStandards and Best PracticesSubpoenasSubstance Abuse TreatmentTermination of EmploymentWork, Labor, and Employment -see also- JobTrn; Leave; etc.

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Bill Overview

Analyzed Economic Effects

43 provisions identified: 18 benefits, 13 costs, 12 mixed.

Federal health workers get state exemptions

Beginning October 1, 2025, federal physician assistants can practice without a Maryland license within their federal jobs. Federal sleep-study technologists are also exempt from state licensing requirements for that work. Federal athletic trainers and perfusionists are exempt from their professions’ Maryland rules while performing federal duties. Federal physicians can use titles such as “doctor” and “M.D.” within their federal practice. These exceptions do not cover work outside the federal job.

Loan repayment help for primary-care providers

Beginning October 1, 2025, Board fees provide $400,000 for loan repayment grants when the Governor’s budget includes less than $400,000. A related funding rule for fiscal year 2023 and later also requires that permanent program funding is not in place. Eligible providers include primary-care physicians, physician assistants, and medical residents specializing in primary care. Recipients must agree to serve at least two years as primary care physicians in a designated medically underserved area. The law does not set individual grant amounts. Remaining fees go to the Board of Physicians Fund; when the budget provides at least $400,000, no transfer occurs.

Some license penalties have lower caps

The Board’s maximum administrative penalty for three listed violations falls from $25,000 to $15,000. These include failing to provide all subpoenaed documents and dispensing drugs without proper authority under a valid dispensing permit. The lower cap also covers failing to complete a supplemental license compact application. The actual penalty can be below the cap.

Genetic counselors lose experience-based licensing path

Beginning October 1, 2025, genetic counselor applicants must be at least 18 and of good moral character. They must graduate from a Board-approved program, hold approved national certification, and complete a criminal history check. Additional Board education, training, or exam requirements also apply. The law removes the former experience-and-recommendations pathway for applications filed by December 31, 2024.

Naturopathic care requires physician collaboration

Naturopathic doctors need a license and a written collaboration and consultation agreement with a Maryland-licensed physician. Agreements identify the physician and provide for referrals and consultations; the naturopathic doctor must inform the named physician. Patients must sign consent acknowledging the limits of naturopathic practice. Doctors cannot practice without an active agreement, including when the named physician leaves or becomes unable to practice. Both parties must report an agreement’s end within 10 days; physicians or employers must report discipline-related terminations within 10 days.

Doctors face English tests with accommodations

Medical license applicants must show they can speak and write in English. Licensees facing disciplinary charges or action involving English communication must pass a Board-approved test of both skills. The Board must develop a testing procedure for people whose speech impairment prevents them from completing its standard oral test.

Missed licensing notices avoid automatic penalties

Beginning October 1, 2025, failure to give notice required by section 14-505 no longer automatically triggers a civil penalty. A penalty remains possible, but it cannot exceed $100 per violation.

Health license applicants gain list privacy

Beginning October 1, 2025, the Board of Physicians cannot release lists of people applying for licenses. This protects applicant lists, not every record about an applicant. Other disclosures allowed by the law remain available.

Physician assistant teams gain simpler procedures

Beginning October 1, 2025, physician assistant teams document physician additions or removals immediately in their workplace collaboration agreement. This replaces the prior Board-notification process for those team changes. When the Board modifies advanced-duty approval because an assistant lacks required education, training, or experience, it must explain why in writing. Both the assistant and delegating team physician must receive that explanation, and the Board cannot block submission of an advanced-duty amendment.

Physician assistants get simpler practice notices

Beginning October 1, 2025, physician assistants can practice after notifying the Board of an executed collaboration agreement through its approved process. The notice no longer needs to list every patient care team physician. License applicants can also use education accredited by the Accreditation Review Commission on Education for the Physician Assistant or its predecessor.

Rehabilitation help reaches more health professionals

Beginning October 1, 2025, the Board of Physicians’ rehabilitation program covers impaired allied health professionals as well as physicians. It evaluates and helps professionals whom the Board directs to receive treatment and rehabilitation. The Board or a contracted nonprofit runs the program, using professional fee revenue.

Respiratory practitioners get narrower regulatory exposure

Beginning October 1, 2025, federal respiratory care practitioners receive the licensing exception only while working within their federal duties. Listed discipline grounds require willful rather than merely knowing conduct, including misrepresentation, unauthorized practice, false fees, and failure to report child abuse. The law separates immoral practice from unprofessional conduct and professional, physical, and mental incompetence into distinct grounds. Discipline remains subject to hearing requirements and approval by a majority of a disciplinary panel quorum.

Treatment can spare practitioners employer reports

Beginning October 1, 2025, employers can withhold otherwise-required impairment reports about physicians and respiratory care practitioners receiving qualifying substance-use treatment. Care must come through a Joint Commission-accredited program, a Department-certified program, or a practitioner competent to treat substance-use disorders. Employers must verify treatment continues through successful discharge, and the practitioner must have caused no injury while practicing. Employers must report known treatment noncompliance.

Federal health workers receive state exemptions

Beginning October 1, 2025, federal naturopathic doctors and genetic counselors are exempt from their respective Maryland professional rules. The exemptions apply only while they practice within the scope of their federal jobs. They do not cover work outside that federal employment.

Licensees get verification and address privacy

The Board must issue professional-standing certificates and license-status verifications for licensees to use in another jurisdiction. It must also keep a public list of current licensees. Licensees can provide a separate nonpublic address in addition to their public address. The Board cannot release that designated nonpublic address.

Faster medical reviews and facility warnings

Beginning October 1, 2025, contracted peer reviews are due in 60 days instead of 90. Requested extensions are limited to 20 days instead of 30; the Board can replace reviewers after 60 or 80 days. Facility disclosure rules extend across covered licensees, including complaints warranting disclosure, possible imminent patient threats, and claims with filed qualified-expert certificates. After formal discipline, the Board must notify relevant hospitals, health plans, and facilities within 10 days. It must send enforcement or monitoring reports within 10 days after receiving them.

Medical discipline targets unsafe and obstructive conduct

Beginning October 1, 2025, physician discipline separately addresses professional, physical, and mental incompetence. Physicians and physician assistants can face discipline for patterns of excessive or medically unnecessary care. Willfully failing to report suspected child abuse as required by law is also grounds for discipline. Covered testimony interference and willfully blocking information during investigations are disciplinary grounds. For physician assistants, testimony interference no longer needs to involve threats, force, or corrupt means.

Medical panels gain tools against unsafe practice

Beginning October 1, 2025, disciplinary panels can order unauthorized practitioners to stop or seek court orders against their practice. This includes practicing without a license or with an unauthorized person. Panels can also act against listed misconduct posing serious patient risks when evidence shows disciplinary grounds are more likely than not. Regulated people cannot surrender or let credentials lapse to avoid investigation or discipline while investigations or charges are pending. A panel can agree to accept a surrender.

Patients get public provider discipline notices

The Board must post when it files charges against a licensee or issues an initial license denial. Profiles must explain that charges are not a final finding of guilt. Each naturopathic licensee gets an online profile with a public address, specified charges, and the last 10 years of discipline. These profiles include known out-of-state discipline and convictions or pleas involving moral turpitude that support discipline. The Board must allow correction requests and add charge or final-action information within 10 days.

Health advisory committees get defined duties

Beginning October 1, 2025, naturopathic medicine, genetic counseling, and physician assistant committees must recommend regulations and legal changes. They must also keep meeting records and can advise the Board on professional practice. The physician assistant committee must recommend licensing decisions and decisions about advanced duties under collaboration agreements. It must also report specified conduct that may warrant discipline.

Radiation advisers must recommend practice rules

Beginning October 1, 2025, the radiation professions advisory committee must develop and recommend regulations and keep meeting records. Its work covers radiation therapy, radiography, nuclear medicine technology, and radiology assistance, including related statutory changes. The Board or a disciplinary panel can request its advice on practice and covered licensees.

Medical professionals face updated license deadlines

Beginning October 1, 2025, the Board sets covered physician license expiration and renewal terms, replacing the fixed two-year schedule. Physicians renewing must remain eligible and of good moral character, apply, pay the fee, and show education or competency compliance. The Board can add renewal requirements. Medical licensees, physician assistants, and covered radiation professionals must report name or address changes in writing within 30 days. This replaces 60-day deadlines for assistants and radiation professionals; medical licensees face a $100 penalty for missing their deadline.

Physician assistants must document prescribing qualifications

Beginning October 1, 2025, physicians can delegate prescribing, dispensing, or administering authority only with required collaboration-agreement terms and attestations. This covers controlled substances, prescription drugs, and medical devices. The assistant needs a bachelor’s degree or equivalent, or two years of physician assistant work experience. The assistant must also have passed the national certification exam within two years or completed eight Category 1 pharmacology hours within two years.

Physicians must maintain compact license eligibility

Beginning October 1, 2025, an expedited interstate compact license ends if a physician fails to maintain their principal-state license for nondisciplinary reasons. Termination applies when the physician also fails to designate a new principal state.

Employers face limits on unlicensed healthcare work

Beginning October 1, 2025, employers cannot hire unlicensed radiation, sleep-testing, perfusion, or genetic counseling practitioners unless a legal exception applies. Physicians also face perfusion employment and supervision limits; physicians and genetic counselors face similar genetic counseling limits. Athletic training employment requires a license or an approved evaluation and treatment protocol. Naturopathic employment rules require a license and the required collaboration and consultation agreement, subject to legal exceptions. Covered radiation, athletic training, perfusion, naturopathic, and genetic counseling violations can bring civil penalties up to $5,000; perfusion penalties go to the General Fund.

Patients face narrower malpractice settlement notices

The Board’s public malpractice notice raises its settlement threshold from $150,000 to $1 million. The notice tells people they can contact the Board about a licensee’s settlement history. The inquiry covers three or more reported settlements meeting that threshold during the most recent five years. Smaller settlements no longer meet this notice’s threshold.

Health reporting violations bring higher fines

Physician reporting violations carry up to $10,000 for knowing failure to report, up from $5,000. Bad-faith employer reports under those rules can bring up to $10,000 per incident. Another covered reporting rule raises the knowing-failure maximum from $1,000 to $5,000 and allows $5,000 per bad-faith employer report. Sleep-study reporting violations also carry up to $5,000 for knowing failure and $5,000 per bad-faith employer report. Fines under these latter two reporting rules go to the General Fund.

Medical employers face ten-day reporting deadlines

Beginning October 1, 2025, employers must report covered actions involving physicians or respiratory care practitioners within 10 days. Covered actions affect privileges, employment, or practice and relate to possible discipline, misconduct, unsafe practice, or danger to patients. Physician reports also cover requests to resign. Reports must describe the action, reasons, relevant patient-record references, and investigation steps. Employers must promptly supply additional information the Board requests.

Medical oversight carries stronger enforcement

Willfully giving false information to a disciplinary panel is grounds for professional discipline, including for physician assistants beginning October 1, 2025. A conviction for blocking authorized Board entry carries a $1,000 misdemeanor fine, replacing a maximum fine of $100. Entry must be necessary for a Board duty under the medical or physician assistant laws. It must occur at a reasonable hour at a licensee’s business or on public premises.

Perfusionist employers face stronger reporting rules

Employers must report specified actions against licensed perfusionists when the reasons may support discipline. These include practice restrictions, involuntary terminations, and resignation requests tied to conduct or an investigation. The maximum penalty for knowingly failing to report rises from $1,000 to $5,000. Bad-faith employer reports can bring fines up to $5,000 per incident. Collected fines go to Maryland’s General Fund.

Tougher hiring rules for medical employers

Beginning October 1, 2025, employers generally cannot employ unlicensed physician assistants, expanding the ban beyond previously listed facilities and systems. Licensed physicians also cannot employ assistants who lack a license or have not given required Board notice. Employers cannot hire people to practice medicine without licenses unless a legal exception applies. The maximum civil penalty for that medical-practice violation rises from $5,000 to $10,000, payable to the Board of Physicians Fund.

Unlawful health employment brings higher fines

Employers and physicians cannot employ or supervise unlicensed respiratory care practitioners unless a statutory exception applies. The maximum civil fine rises from $1,000 to $5,000, and the prohibition extends to employers generally. Beginning October 1, 2025, the maximum fine for violating physician assistant employment restrictions also rises from $1,000 to $5,000. A panel can separately impose up to $5,000 for violations of § 14-5C-22. Those separate fines go to the Board of Physicians Fund.

Updated requirements for sleep-testing professionals

Beginning October 1, 2025, licensed sleep technologists must report name or address changes in writing within 30 days. The law repeals an old education waiver tied to meeting licensing requirements by September 30, 2013, including its extension process. All seven Polysomnography Advisory Committee members must live in Maryland. The committee must recommend regulations and legal changes, keep meeting records, and may advise the Board or disciplinary panels when asked.

Medical applicants get revised entry rules

Beginning October 1, 2025, supervised medical graduates can qualify by passing Parts 1 and 2 of either specified licensing exam. The exams are the United States Medical Licensing Examination and the Comprehensive Osteopathic Medical Licensing Examination of the United States. Medical applicants must meet Board-set education, certification, training, or exam requirements, rather than only Board-set exam requirements. The law also expands covered practitioner definitions to physician assistants and genetic counselors. Unless context requires otherwise, “applicant” includes people seeking initial licenses, renewals, or reinstatement.

Medical licensing fees must track costs

Beginning October 1, 2025, the Board of Physicians can set reasonable licensing and service fees to cover its costs. Fee revenue must cover documented direct and indirect duties related to the payer’s practitioner type. The law sets no new fee amount.

Returning physicians face reinstatement requirements

Beginning October 1, 2025, physicians returning from lapsed, inactive, or emeritus status must apply, pay, and meet renewal and reinstatement requirements. The Board can add reinstatement requirements. Applicants seeking reinstatement pay for Board-ordered exams; the Board pays for current licensees and applicants never previously licensed by it. A disciplinary panel can reinstate a physician license surrendered or revoked for more than one year. The physician must meet Board reinstatement requirements and complete a criminal history check.

Health employers face reporting duties and protections

Beginning October 1, 2025, employers must report covered safety-related restrictions, job actions, and resignation requests involving specified licensed health professionals. These rules cover radiation, sleep-testing, athletic training, perfusion, naturopathic medicine, and genetic counseling. Reports are due within 10 days and must explain the action, reasons, and investigation; employers must provide requested details. The Board can extend sleep-testing, athletic trainer, and perfusionist deadlines for good cause. Employers can withhold substance-related impairment reports when qualifying treatment continues through successful discharge and the professional caused no injury while practicing. Known treatment-program noncompliance must still be reported; sleep-testing and genetic counseling rules also address entry into treatment without required notice. Reports generally receive confidentiality protections, and applicable substance-use patient-record privacy laws can excuse reporting. For radiation, athletic training, naturopathic medicine, and genetic counseling, knowing failure to report can bring penalties up to $5,000. Bad-faith reports can also bring penalties up to $5,000, including per incident where specified. Radiation and athletic trainer reporting penalties go to Maryland’s General Fund.

Narrower health misdemeanors, added radiation fines

Beginning October 1, 2025, the law narrows misdemeanor coverage in radiation, sleep-testing, and genetic counseling law. The stated misdemeanor rules no longer cover the separate employment bans for unlicensed sleep technologists and genetic counselors. Those employment bans remain in place. Radiation violations under section 14-5B-18 can also bring a civil fine up to $5,000, paid to the Board of Physicians Fund.

Physician assistant oversight requirements are removed

Beginning October 1, 2025, team physicians no longer must report prescribing-authority restrictions or removal within five business days under this provision. The law removes this section’s authority for certain physician assistant investigations, unannounced office inspections, and entry for investigations or audits. It also removes the related ban on blocking entry and its misdemeanor penalty. These changes reduce reporting and enforcement burdens, but also remove the oversight tools granted by this section.

Physician reports stay private with exceptions

Reports under the physician and physician assistant reporting rules are privileged and closed to public inspection. They are generally protected from subpoenas and discovery in civil cases. This protects report confidentiality but limits access for the public and people bringing civil claims. An exception applies to proceedings arising from a Board or disciplinary panel hearing and decision.

Revised discipline rules for health professionals

Beginning October 1, 2025, the law revises discipline rules for radiation, sleep-testing, athletic training, perfusion, naturopathic medicine, and genetic counseling professionals. Grounds include immoral or unprofessional conduct and professional, physical, or mental inability to practice competently. Several violations require willful conduct, including specified false statements, unauthorized practice, and failure to report suspected child abuse. Genetic counselors also face discipline for a pattern of excessive or medically unnecessary care. The Board’s investigation authority extends to physician assistant law. Panels can deny or refuse to renew or reinstate genetic counseling licenses, subject to required hearing procedures and voting rules.

Physician assistant employers face reporting deadlines

Beginning October 1, 2025, employers must report covered physician assistant work restrictions tied to discipline, misconduct, unsafe practice, or patient danger. Reports must explain the action, reasons, and investigation steps; deadlines generally are 10 days, or five days after employment termination. Separate discipline-related termination notices are due within 10 days; collaboration endings require immediate updates to the agreement kept at the primary workplace. A treatment exception requires qualifying care, verified participation through successful discharge, and no injury during practice; known treatment noncompliance must be reported. The Board can extend deadlines for good cause, and reports are not required when they violate applicable confidentiality law.

Respiratory employers face protected reporting duties

Employers must report specified restrictions, terminations, or resignation requests involving respiratory care practitioners when reasons may support discipline. This duty belongs to employers, not practitioners. The Board can subpoena records and extend reporting deadlines for good cause; reports are privileged and generally protected from public inspection and civil discovery. Knowing failure to report can bring up to $5,000; bad-faith employer reports can bring up to $5,000 per incident. Fines go to the General Fund, and reports are not required when they violate substance-use treatment record confidentiality laws.

Sponsors & Cosponsors

Sponsor

Joseline A. Peña-Melnyk
Democratic • House

Cosponsors

Tiffany T. Alston
Democratic • House
Heather Bagnall
Democratic • House
Harry Bhandari
Democratic • House
Brian Chisholm
Republican • House
Bonnie Cullison
Democratic • House
Pam Lanman Guzzone
Democratic • House
Terri L. Hill
Democratic • House
Thomas S. Hutchinson
Republican • House
Anne R. Kaiser
Democratic • House
Kenneth Kerr
Democratic • House
Nicholaus R. Kipke
Republican • House
Lesley J. Lopez
Democratic • House
Matthew Morgan
Republican • House
Ashanti Martinez
Democratic • House
Teresa E. Reilly
Republican • House
Samuel I. Rosenberg
Democratic • House
Kim Ross
Democratic • House
Steve Johnson
Democratic • House
Kathy Szeliga
Republican • House
Deni Taveras
Democratic • House
Jennifer White Holland
Democratic • House
Jamila J. Woods
Democratic • House
Teresa Woorman
Democratic • House

Roll Call Votes

All Roll Calls

Yes: 182 • No: 1

Senate vote • 4/2/2025

Third Reading Passed

Yes: 46 • No: 0 • Other: 1

House vote • 3/17/2025