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

10 provisions identified: 7 benefits, 0 costs, 3 mixed.

More certification options for attendant care

Beginning October 1, 2026, physician assistants can certify placement risk for eligible Attendant Care Program financial aid recipients. The certification must show risk of nursing facility or similar institutional placement without community attendant care. It supports a program eligibility condition. The law does not change the amount of aid.

More clinicians can order pregnancy infirmary care

Beginning October 1, 2026, more clinicians can order infirmary admission for pregnant people in custody who need this care. They include physicians, physician assistants, nurse practitioners, certified nurse-midwives, and licensed certified midwives. The law does not set a new payment or benefit amount.

More prescribers for emergency allergy medicine

Beginning October 1, 2026, physician assistants can prescribe and dispense emergency epinephrine and needed supplies to certificate holders. Holders must show their certificate to get a prescription. A holder or agent can give the medicine when listed health professionals and emergency services are not immediately available. The person must have, or be believed in good faith to have, a severe allergic reaction called anaphylaxis. Physician assistants receive civil liability protection for good-faith prescribing or dispensing to people certified by the Maryland Department of Health.

More primary care choices for plan members

Beginning October 1, 2026, health maintenance organizations must let members choose a primary care provider from those available through the plan. Eligible choices include physicians, physician assistants, certified nurse-midwives, licensed certified midwives, and certified nurse practitioners. The law does not require plans to offer every provider type or a provider unavailable to them.

Broader emergency evaluation and payment rules

Beginning October 1, 2026, a physician assistant who examined someone can petition for emergency mental health evaluation without prior court review. A signed, submitted petition requires officer transport to the nearest emergency facility; a court-endorsed petition does too within 5 days. Maryland must pay for a qualifying initial physician or physician assistant exam and specified transport when the person cannot pay or lacks insurance covering the charges. Payment is the lower of actual cost or a reasonable rate, except hospitals receive state-approved rates. This does not erase every possible patient charge.

Physician assistants gain treatment certification authority

Beginning October 1, 2026, a physician assistant can join the attending physician in certifying inability to make informed treatment decisions. This also covers specified terminal or end-stage condition certifications, based on personal exams; existing physician-only safeguards for stopping life-sustaining treatment remain. For inability to make informed decisions, one signer must examine the patient within 2 hours before certification. For mental illness treatment, the second signer cannot be involved in the patient's treatment. No second certification is required when the patient is unconscious or cannot communicate by any means.

More certification options for voluntary psychiatric admission

Beginning October 1, 2026, a physician and physician assistant can jointly certify a disabled person's capacity to seek voluntary psychiatric admission. They must certify that the person understands admission criteria and how to request discharge. The physician assistant must personally examine the person, who must submit a written application on the required form. A certificate cannot be used if a signer has a barred financial interest in the facility. It also cannot be used if a signer is related by blood or marriage to the person or guardian.

Workers gain another sick leave certifier

Beginning October 1, 2026, physician assistants can sign illness or disability certificates for employees covered by these sick leave payment rules. The certificate is required after 5 or more consecutive workdays of sick leave. Leave must 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. The law does not change the payment amount.

More clinician options for guardianship certificates

Beginning October 1, 2026, guardianship petitions for disabled people can use certificates from one licensed physician and one licensed physician assistant. The physician assistant must examine or evaluate the person. The certificates must be signed and verified. They provide evidence for the petition but do not decide the guardianship case.

Staffing agencies gain physician assistant licensing exemption

Beginning October 1, 2026, physician assistants are excluded from the health care practitioner definition used by these staffing agency rules. The license requirement for referring covered practitioners therefore does not apply to physician assistant referrals under this rule. This changes agency licensing, not the physician assistant's own authority to practice.

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: 2

Senate vote • 3/19/2026