MarylandHB 10472026 Regular SessionHouseWALLET

State Board of Physicians - Delegation of Duties - Alterations

Sponsored By: Thomas S. Hutchinson (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 RehabLicenses -see also- AB Lic; Certifications; DrLic; PermitsMedical Equipment and DevicesMedical TechnologyPenalties 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

7 provisions identified: 3 benefits, 1 costs, 3 mixed.

Fines and discipline for X‑ray violations

Beginning Oct 1, 2026, the Board can fine a physician’s office up to $5,000 per violation if an unregistered person performs X‑rays. It can fine the individual up to $1,000 per violation. The office is responsible for making sure every X‑ray meets the law’s registration and supervision rules. A disciplinary panel can deny, suspend, revoke, or fine a registrant for fraud, incompetence, or other listed conduct. The panel may also order anyone to stop falsely claiming they are allowed to operate limited X‑ray machines.

PAs may X‑ray arms and legs

Beginning Oct 1, 2026, a physician assistant may take X‑rays of the extremities in a medical office. The PA must finish a course with radiographic studies of at least 20 separate patients. A collaborating physician or radiologist must directly supervise the X‑rays. The PA must use a mini C‑arm or similar low‑level device for nonfluoroscopic work and get Board approval as an advanced duty.

New registration for limited X‑ray operators

Beginning Oct 1, 2026, the state registers limited X‑ray machine operators. Work is limited to chest, spine, and arms or legs, and excludes fluoroscopy, mammography, and other advanced imaging. You must have at least 115 classroom hours, 480 clinical hours, five competencies per body part, at least 6 months of experience, and a passing ARRT or Board‑approved exam. You must work under on‑site supervision by a physician or radiographer. Registration lasts up to 3 years, requires a criminal background check, Board‑set fees, and 24 hours of continuing education every 2 years. A program director may attest for first‑year radiography students. If the Board once denied you a license, you cannot register.

Using 'physician' in job titles

Beginning Oct 1, 2026, unlicensed delegated staff acting under the listed delegation laws may use the word “physician” with another word in a job title, like “physician’s assistant.” They still may not claim to be licensed to practice medicine.

Stakeholder input and joint rulemaking

Beginning Oct 1, 2026, the Board must invite and consider proposals from people and health groups before setting rules on delegated duties. When a duty overlaps another licensed field, the Board must adopt the rule together with that board. If the boards cannot agree, the Secretary makes the final decision.

Delegated duties and supervised graduates

Beginning Oct 1, 2026, people may perform duties a physician or physician assistant delegates without a separate license when Board rules allow it. The law defines on‑site supervision. Supervised medical graduates may perform delegated duties under on‑site supervision, but only for up to 2 years. The delegating physician does not have to be physically present to finish a delegated duty, if allowed by Board regulation.

Fluoroscopy delegation in hospital cath labs

Beginning Oct 1, 2026, a doctor may delegate fluoroscopy tasks to a registered cardiovascular invasive specialist only during a cardiac catheterization in a hospital cath lab. The doctor must be there in person and direct each act. The specialist must meet Board training rules, and the hospital must verify and document that training. A disciplinary panel may fine a hospital up to $5,000 for each time it fails to follow these rules.

Sponsors & Cosponsors

Sponsor

Thomas S. Hutchinson
Republican • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 175 • No: 0

Senate vote • 4/8/2026

Third Reading Passed

Yes: 43 • No: 0 • Other: 2

House vote • 3/18/2026