MarylandSB 04232025 Regular SessionSenateWALLET

Maryland Medical Practice Act and Maryland Physician Assistants Act - Revisions

Sponsored By: Pamela Beidle (Democratic)

Signed by Governor

Health OccupationsCertificationsCivil OffensesCommittees and CommissionsComptrollerDisclosureEducation -see also- ContEd; DrvEd; HigherEd; etc.EthicsFines -see also- Penalties and SentencesHealth -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 HospitalsInternational AffairsInternet -see also- Internet AccessJob Training -see also- Continuing Ed; Vocational RehabLanguage -see also- Communications; LiteracyLicenses -see also- AB Lic; Certifications; DrLic; PermitsMental and Behavioral Health -see also- Aut; Cogn; Dev; etc.NoticesPenalties and Sentences -see also- Death PenaltyPhysician AssistantsPhysicians -see also- MedExmnrs; Pediatr; Psychiatrists etc.Public InformationRehabilitationReportsRules and RegulationsSafety -see also- Occupational SafetyStandards and Best PracticesSubstance Abuse TreatmentWork, Labor, and Employment -see also- JobTrn; Leave; etc.

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Bill Overview

Analyzed Economic Effects

42 provisions identified: 9 benefits, 14 costs, 19 mixed.

Backup loan repayment money for clinicians

The law directs $400,000 in Board fees to clinician loan repayment when the Governor budgets less than $400,000 for the program. The fiscal year 2023-onward rule also requires that the Department has not established permanent program funding. Beginning October 1, 2025, the law provides the budget-based transfer, with remaining fees going to the Board Fund. When the budget provides at least $400,000, fees stay with the Fund instead. Eligible recipients include primary care physicians, physician assistants, and medical residents specializing in primary care. The stated service pledge requires at least two years practicing as a primary care physician in a designated medically underserved area.

Naturopathic doctors must maintain physician agreements

Naturopathic doctors must maintain a collaboration and consultation agreement with a Maryland-licensed physician throughout practice. It must provide referrals and consultation as needed, plus signed patient consent acknowledging the legal limits of naturopathic practice. Doctors must attest on a Board form and notify the named physician. Practice must stop whenever the agreement ends or the physician becomes unavailable or ineligible, until a new agreement is in place. Both parties must report termination within 10 days; physicians or employers must also report discipline-related firings within 10 days.

Clinicians face exams and surrender limits

During licensing reviews or investigations, the Board or a disciplinary panel can order appropriate exams for covered applicants and licensees. An unreasonable refusal is initial evidence of inability to practice competently, unless the refusal was beyond the person's control. Regulated people under investigation or facing charges cannot surrender their license, certification, or registration, or let it lapse. A disciplinary panel can agree to accept a surrender.

Compact doctors face license termination rules

A doctor's expedited interstate compact license ends when two conditions apply. The doctor fails to maintain the principal-state license for a nondisciplinary reason and does not designate a new principal state. The doctor loses authority to practice under that expedited license.

New qualification rules for Maryland doctors

Medical-license applicants must show spoken and written English skills and meet Board-set education, certification, training, or exam requirements. Graduation from a recognized English-speaking school after 3 years, or an English-speaking professional school, proves both English skills. Licensees facing English communication charges must pass a Board-approved test of both skills. Supervised medical graduates can qualify by passing parts 1 and 2 of either the United States or osteopathic medical licensing exams. Board-certification rules remove separate Board approval of certifiers and recognize listed bodies or an alternative combining accredited specialty training with specified American or Canadian certification.

Federal naturopathic work gets limited exemption

Naturopathic doctors employed in federal service receive an exemption from the specified state provision while working within that job’s scope. The exemption does not cover practice outside their federal employment.

Lower penalties and hearing costs for clinicians

The maximum administrative penalty drops from $25,000 to $15,000 for three specified licensing violations. These involve missing subpoenaed documents, dispensing drugs without proper permit authority, or an incomplete license-compact supplemental application. People found in violation after a naturopathic hearing no longer face the statutory requirement to pay hearing costs. Failure to give a required burn-treatment notice carries a discretionary penalty of up to $100, rather than automatic liability.

Physician assistants gain delegated prescribing authority

Beginning October 1, 2025, team physicians can delegate prescribing, dispensing, or administering controlled substances, prescription drugs, or medical devices to qualified physician assistants. The collaboration agreement must state the authority and include required promises about legal compliance, medical records, and prescription information. Assistants need either a national certification exam passed within 2 years or 8 Category 1 pharmacology education hours within 2 years. They also need a bachelor's degree or equivalent, or 2 years of physician assistant work experience.

Broader education options for physician assistants

Beginning October 1, 2025, Maryland recognizes more qualifying education for physician assistant licenses. Applicants can satisfy the education requirement through programs accredited by the Accreditation Review Commission on Education for the Physician Assistant or its predecessor. This addresses the education requirement, not all requirements for a license.

Federal health workers get narrow exemptions

Federally employed sleep technologists are exempt from the specified Maryland licensing requirements while working within their federal jobs. Federally employed perfusionists also receive an exemption from the specified state rule for work within those jobs. Neither exemption covers practice outside federal employment.

Fewer health practice violations are misdemeanors

The law removes one statutory section from the misdemeanor coverage for radiation-related professions and another for genetic counseling. Conduct covered only by those removed sections no longer triggers these misdemeanor provisions. Covered radiation-related violations still carry up to a $1,000 fine, one year in jail, or both upon conviction.

Hospitals get more physician safety notices

The Board must alert connected hospitals, health plans, and care facilities about specified physician complaints, safety concerns, and formal actions. Notice triggers include a possible imminent patient-safety threat and qualifying malpractice claims supported by an expert's certificate. A facility's discipline committee can request competency information in writing when the Board has a qualifying complaint or report. The Board must send later enforcement or monitoring reports within 10 days after receiving them.

Health advisory panels guide practice rules

Respiratory-care and radiation-profession advisory committees must keep meeting records and recommend rules, including updates responding to statutory changes. They can advise the Board or disciplinary panels when asked. The respiratory committee has three respiratory practitioners, three doctors representing thoracic surgery, pulmonary medicine, and anesthesiology, and one consumer. All members must live in Maryland; licensed members must be in good standing, and the consumer must meet professional-interest and financial-interest restrictions. Members can serve no more than two consecutive full terms, and four members make a quorum.

Clinicians face discipline for obstructing oversight

Medical licensees face discipline for willfully blocking, preventing, or delaying information from reaching the Board or a disciplinary panel during investigations. Beginning October 1, 2025, physician assistants also face discipline for willfully making a misrepresentation to a disciplinary panel.

Genetic counselors face tighter professional rules

Genetic counselor applicants must show certification from a Board-approved national organization, alongside required education, background checks, and other Board requirements. The law removes the experience-and-recommendation route for applications submitted by December 31, 2024. Disciplinary grounds include unprofessional or immoral practice, professional, physical, or mental incompetence, and patterns of excessive or medically unnecessary treatment. Several grounds require willful conduct, including misrepresentation, unauthorized practice or delegation, false fee statements, and failure to report suspected child abuse. Discipline remains subject to statutory hearing protections.

Higher penalties for hiring unlicensed clinicians

Employers generally cannot hire people to practice medicine, genetic counseling, or physician assistant care without required licenses. The medical-practice penalty cap rises from $5,000 to $10,000, with collections going to the Board Fund. Genetic counseling penalties rise from $1,000 to $5,000 and also cover prohibited employment or supervision by licensed physicians and genetic counselors. Beginning October 1, 2025, the physician assistant employment penalty cap rises from $1,000 to $5,000. Exceptions elsewhere in the medical-practice and genetic counseling laws remain available.

Higher penalties for physician assistant reports

Knowingly failing to make a required physician assistant report carries a civil penalty of up to $5,000, up from $1,000. Employers also face up to $5,000 for each bad-faith report. Collected penalties go to Maryland's General Fund.

Less malpractice information covered by disclosure

The Board's website must explain how to request whether a licensee meets the malpractice-settlement disclosure threshold. That threshold covers three or more reported settlements in the most recent five years, each worth at least $1 million. The dollar threshold rises from $150,000, narrowing the settlements covered by this disclosure rule.

Stricter rules for medical oversight cooperation

A person convicted of blocking or interfering with authorized Board entry faces a $1,000 fine. This replaces the previous maximum fine of $100. The Board can also discipline a medical licensee who knowingly misrepresents facts to a disciplinary panel.

Cardiac specialists face hospital supervision limits

Registered cardiovascular invasive specialists can assist with cardiac catheterization only in hospitals under a licensed physician's direct, in-person supervision. They must hold credentials from Cardiovascular Credentialing International or another Board-approved organization.

Employers cannot hire unlicensed health practitioners

Employers cannot hire unlicensed people to practice respiratory care, covered radiation professions, sleep testing, or perfusion, unless a statutory exception applies. Physicians also cannot employ or supervise unlicensed perfusion practitioners, subject to those exceptions. Violations involving respiratory care, radiation professions, or perfusion can bring civil penalties up to $5,000. Perfusion penalties go to Maryland’s General Fund.

Employers face naturopathic practice hiring limits

Physicians and employers cannot employ someone practicing naturopathic medicine without a license or the required collaboration and consultation agreement. Exceptions provided elsewhere in the naturopathic medicine law still apply.

Health employers must report safety-related actions

Employers must report specified job or practice restrictions involving doctors, respiratory care practitioners, radiation-related professionals, and athletic trainers. Reports cover actions tied to possible discipline, unprofessional conduct, unsafe practice, or danger to patients or the public. Employers must explain the action, reasons, and investigation, and promptly supply additional information requested by the Board. Reports are due within 10 days; athletic-trainer reports can receive an extension for good cause. Athletic-trainer reporting must also respect laws protecting substance-use treatment records.

Health licensees face shorter update deadlines

Licensed respiratory care practitioners must report name or address changes to the Board in writing within 30 days, down from 60. Radiation therapists, radiographers, nuclear medicine technologists, and radiologist assistants also must provide written updates within 30 days.

Doctors face Board-set license renewal rules

The Board sets medical-license expiration dates and renewal terms, replacing the fixed two-year schedule. Doctors renewing licenses must apply, pay fees, and meet education or competency rules and any added Board requirements. Restoring a lapsed, inactive, or emeritus license also requires an application, fees, proof of qualifications, and any added Board requirements. For exams ordered under this authority, the Board pays for current licensees and applicants it has never licensed. Reinstatement applicants pay their own exam costs; the law sets no dollar amount.

Health professionals get contact-update deadlines

Doctors, sleep technologists, athletic trainers, perfusionists, and naturopathic doctors must report name or address changes in writing within 30 days. Athletic trainers and perfusionists previously had only 10 days. Medical licensees who miss the 30-day deadline face a $100 administrative penalty.

Federal clinicians get limited licensing exemptions

Beginning October 1, 2025, federally employed physician assistants can practice in Maryland without a state license within their federal duties. The law limits the federal physician licensing exemption to work within federal employment. The exception allowing federal workers to use covered physician-related titles also applies only within their federal duties. These exceptions do not cover outside practice.

Physician assistants get simpler agreement paperwork

Beginning October 1, 2025, physician assistants must notify the Board of a signed collaboration agreement before practicing, without listing every team physician. Adding or removing team physicians requires immediate documentation in the agreement at the assistant's primary workplace, not separate Board notice. When the Board modifies an advanced-duty request for insufficient education, training, or experience, it must explain why in writing. Both the assistant and delegating physician receive that explanation. Assistants must report name or address changes in writing within 30 days, down from 60 days.

Doctors and assistants face broader discipline

Doctors and physician assistants face discipline for patterns of excessive or medically unnecessary treatment and willfully failing to report suspected child abuse. For physician assistants, these replace gross-overuse language and remove the separate requirement that child-abuse nonreporting also be knowing. Both groups face discipline for trying to make someone withhold or change testimony in Board, panel, or covered administrative proceedings. That conduct no longer needs threats, force, or corrupt means. Physician assistants also face discipline for willfully blocking or delaying investigative information, without requiring threats, force, or corrupt means.

Employer reporting rules for health practitioners

Employers must report specified work restrictions, firings, and resignation requests involving respiratory, sleep, and naturopathic practitioners when discipline or safety concerns arise. Sleep reports must include reasons, relevant patient records, and investigation steps within 10 days, with extensions for good cause. Those reports cannot violate substance use treatment-record privacy laws. Naturopathic employers must explain their actions and investigations, identify relevant patient records, and promptly answer Board requests. Respiratory reports have immunity and confidentiality protections, and the Board can enforce reporting with subpoenas. Respiratory, radiation-related, and naturopathic reporting rules allow penalties up to $5,000 for knowing failures or each bad-faith employer report; radiation-related and naturopathic penalties go to the General Fund.

Genetic counselor employers must report concerns

Genetic counselor employers must report specified restrictions, employment actions, and requested resignations tied to discipline or safety concerns within 10 days. Reports must describe the action, reasons, and investigative steps; the Board can extend deadlines for good cause and issue subpoenas. A treatment exception requires qualifying care, verified continued participation, and no injury while practicing; known treatment noncompliance must be reported. Substance-use record confidentiality laws still limit required disclosures, and reports receive legal protections. Knowingly failing to report can bring a civil penalty up to $5,000; bad-faith reports can bring up to $5,000 per incident.

Medical applicant lists can become public

The Board can release lists of medical-license applicants because the law removes the prior prohibition. This permits public access but removes that specific disclosure protection for applicants. The Board is not required to publish a list.

Medical Board reshapes clinician oversight powers

The law broadens allied-health and applicant definitions and gives the Board and both disciplinary panels oversight of physician assistant violations. Panels can deny, refuse to renew, or refuse to reinstate covered licenses for disciplinary grounds or incomplete required background checks. Authorized officials can enter licensee businesses or public premises at reasonable hours when necessary for Board duties; people cannot block entry. Panels can seek orders stopping specified unauthorized practice, or conduct supported by a preponderance of evidence that poses serious patient risks. The law removes separate physician assistant investigation and inspection provisions, including their entry-interference misdemeanor fine of up to $100.

Perfusionist reports include a treatment exception

Employers must report specified restrictions, firings, and resignation requests involving perfusionists when conduct, competence, or safety concerns arise. Reports must explain the action and investigation, answer Board requests promptly, and respect substance use record privacy laws. An exception covers substance impairment treated through an accredited or certified program, or a practitioner competent in substance use care. The employer must verify participation through successful discharge, and the condition or conduct must have caused no injury during practice. Employers must report known treatment noncompliance.

Physician assistant employers face reporting deadlines

Employers must report specified physician assistant employment or privilege actions tied to discipline or safety concerns, generally within 10 days. Reports after termination are due within 5 days and must describe the action, reasons, and investigative steps. Collaborating physicians, physician groups, and employers must report disciplinary terminations within 10 days; collaboration terminations require immediate agreement documentation. The Board can extend deadlines for good cause and use subpoenas. Substance-impairment reporting is excused during accredited or state-certified treatment, or care by a capable practitioner, when participation is verified through successful discharge and no practice-related injury occurred; known noncompliance must be reported.

Private reports carry physician reporting penalties

Physician employer reports are private and generally protected from public inspection, civil subpoenas, and discovery. An exception allows access in proceedings arising from a Board or disciplinary-panel hearing and decision. A panel can impose up to $10,000 for knowingly failing to make a required physician report. Employers face up to $10,000 for each bad-faith report, and collected penalties go to Maryland's General Fund.

Public licensing records with privacy protections

The Board must keep a public licensee list and give licensees proof of standing and license status. Applicant lists and designated nonpublic addresses remain private. The Board must post physician charges and initial license denials on its website. Each naturopathic licensee gets a public profile with specified discipline and conviction information, a disclaimer, and written-copy and correction options. Required information about charges and final actions must be added to those profiles within 10 days.

Sleep and athletic reports gain safeguards

Sleep-testing and athletic trainer reports are privileged and generally protected from public inspection, subpoenas, and discovery in civil cases. An exception covers proceedings arising from a Board or disciplinary-panel hearing and decision. People providing required athletic trainer information receive statutory immunity, and the Board can enforce that reporting section through subpoenas. Panels can impose up to $5,000 for knowingly failing to report, or $5,000 per incident for bad-faith employer reports. Collected penalties go to Maryland's General Fund.

Health professionals face revised discipline standards

The law revises discipline standards for respiratory, radiation, sleep-testing, athletic-training, perfusion, and naturopathic professionals. Grounds distinguish immoral or unprofessional conduct and professional, physical, or mental incompetence. Listed violations require willful conduct, including failure to report suspected child abuse. For several covered professions, that standard also applies to misrepresentation, unauthorized-practice involvement, or false fee statements; sleep-testing and perfusion rules also address delegation to unlicensed people. Applicable hearing and panel-voting protections remain in place.

Health reports gain privacy and enforcement

Covered radiation-profession, naturopathic, and physician-assistant reports are generally private and shielded from civil subpoenas and discovery, except proceedings arising from Board hearings and decisions. Naturopathic and physician-assistant reporting also preserves substance-use-record protections and provides statutory immunity to people supplying information. Naturopathic reports are due within 10 days, with good-cause extensions, and the Board can enforce reporting through subpoenas. Separate reporting rules set a 10-day deadline and allow up to $5,000 for knowing nonreporting or $5,000 per bad-faith employer report; penalties go to the General Fund. The Governor, Secretary, Auditor, and their employees cannot disclose personal information from legally confidential records.

Treatment limits reports about impaired clinicians

Employers can skip otherwise required substance-impairment reports for doctors, respiratory practitioners, radiation-related professionals, sleep technologists, athletic trainers, and naturopathic doctors. The clinician must receive qualifying accredited or Department-certified treatment, or care from a practitioner qualified to treat substance use disorders. Continued treatment through successful discharge must be verifiable, and the clinician’s condition or actions must not have caused injury while practicing. Employers must report known treatment noncompliance. For sleep technologists, employers must also report specified failures to notify them about treatment.

Clinician fees support oversight and rehabilitation

The Board sets reasonable license, renewal, and service fees to approximate its costs; the law sets no new fee amount. Collected fees must cover documented direct and indirect Board costs for the practitioner type that paid them. The rehabilitation program now covers impaired allied health professionals as well as physicians directed by the Board to receive treatment. The Board must fund that program through fees paid into the Board of Physicians Fund.

Sponsors & Cosponsors

Sponsor

Pamela Beidle
Democratic • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 182 • No: 0

House vote • 4/7/2025

Third Reading Passed

Yes: 138 • No: 0 • Other: 2

Senate vote • 3/17/2025