# Maryland SB 0423: Maryland Medical Practice Act and Maryland Physician Assistants Act - Revisions Maryland SB 0423, Maryland Medical Practice Act and Maryland Physician Assistants Act - Revisions, is a 2025 Regular Session Senate bill sponsored by Pamela Beidle (Democratic); status signed, last action 2025-05-20 (Approved by the Governor - Chapter 675); PRIA reads it as touching household money (as of 2026-10-17). - Canonical: https://policyrisk.com/state-bill/MD-SB0423-2025RS - As of: 2026-10-17 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: Maryland SB 0423 - State: Maryland - Session: 2025 Regular Session - Title: Maryland Medical Practice Act and Maryland Physician Assistants Act - Revisions - Status: signed - Chamber: Senate - Introduced: 2025-01-21 - Last action: 2025-05-20, Approved by the Governor - Chapter 675 - Sponsor: Pamela Beidle (Democratic) - Cosponsors: 0 - Subjects: Health Occupations, Certifications, Civil Offenses, Committees and Commissions, Comptroller, Disclosure, Education -see also- ContEd; DrvEd; HigherEd; etc., Ethics, Fines -see also- Penalties and Sentences, Health -see also- COVID19; EnvHlth; MedCon; etc., Health Care Facilities -see also- Clinics; Hospices; etc, Health Occupations -see also- (specific health occupations), Hearings, Hospitals -see also- Clinics; State Hospitals, International Affairs, Internet -see also- Internet Access, Job Training -see also- Continuing Ed; Vocational Rehab, Language -see also- Communications; Literacy, Licenses -see also- AB Lic; Certifications; DrLic; Permits, Mental and Behavioral Health -see also- Aut; Cogn; Dev; etc., Notices, Penalties and Sentences -see also- Death Penalty, Physician Assistants, Physicians -see also- MedExmnrs; Pediatr; Psychiatrists etc., Public Information, Rehabilitation, Reports, Rules and Regulations, Safety -see also- Occupational Safety, Standards and Best Practices, Substance Abuse Treatment, Work, Labor, and Employment -see also- JobTrn; Leave; etc. - Touches household money: yes - Roll calls: 2 (182 yes, 0 no in all) - Economic provisions PRIA read: 42 ## Summary No summary available. ## Bill overview: provisions PRIA read - Backup loan repayment money for clinicians: benefit, medium. 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-b… - Federal naturopathic work gets limited exemption: benefit, low. 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: benefit, low. 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 natur… - Physician assistants gain delegated prescribing authority: benefit, low. 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 complianc… - Broader education options for physician assistants: benefit, low. 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… - Federal health workers get narrow exemptions: benefit, low. 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 outsid… - Fewer health practice violations are misdemeanors: benefit, low. 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 f… - Hospitals get more physician safety notices: benefit, low. 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… - Health advisory panels guide practice rules: benefit, low. 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 r… - Naturopathic doctors must maintain physician agreements: cost, medium. 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 B… - Clinicians face exams and surrender limits: cost, medium. 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 unde… - Compact doctors face license termination rules: cost, medium. 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. - Clinicians face discipline for obstructing oversight: cost, low. 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: cost, low. 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 grou… - Higher penalties for hiring unlicensed clinicians: cost, low. 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 an… - Higher penalties for physician assistant reports: cost, low. 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: cost, low. 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 s… - Stricter rules for medical oversight cooperation: cost, low. 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: cost, low. 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: cost, low. 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 re… - Employers face naturopathic practice hiring limits: cost, low. 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: cost, low. 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. Em… - Health licensees face shorter update deadlines: cost, low. 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. - New qualification rules for Maryland doctors: mixed, medium. 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 f… - Doctors face Board-set license renewal rules: mixed, low. 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 appli… - Health professionals get contact-update deadlines: mixed, low. 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: mixed, low. 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 physicia… - Physician assistants get simpler agreement paperwork: mixed, low. 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… - Doctors and assistants face broader discipline: mixed, low. 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… - Employer reporting rules for health practitioners: mixed, low. 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 exte… - Genetic counselor employers must report concerns: mixed, low. 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.… - Medical applicant lists can become public: mixed, low. 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: mixed, low. 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. Authori… - Perfusionist reports include a treatment exception: mixed, low. 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… - Physician assistant employers face reporting deadlines: mixed, low. 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 gr… - Private reports carry physician reporting penalties: mixed, low. 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… - Public licensing records with privacy protections: mixed, low. 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 w… - Sleep and athletic reports gain safeguards: mixed, low. 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… - Health professionals face revised discipline standards: mixed, low. 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, includin… - Health reports gain privacy and enforcement: mixed, low. 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 protect… - Treatment limits reports about impaired clinicians: mixed, low. 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 f… - Clinician fees support oversight and rehabilitation: mixed, low. 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 professi… ## Sponsors and cosponsors - Sponsor: Pamela Beidle (Democratic), Senate ## Roll call votes | Date | Chamber | Motion | Result | Yes | No | Other | | --- | --- | --- | --- | --- | --- | --- | | 2025-04-07 | House | Third Reading Passed | pass | 138 | 0 | 2 | | 2025-03-17 | Senate | Third Reading Passed | pass | 44 | 0 | | ## Actions (13) - 2025-05-20: Approved by the Governor - Chapter 675 - 2025-04-07: Returned Passed (Senate) - 2025-04-07: Third Reading Passed (138-0) (House) - 2025-04-02: Favorable Adopted Second Reading Passed (House) - 2025-04-02: Favorable Report by Health and Government Operations (House) - 2025-03-18: Hearing 4/01 at 1:00 p.m. (House) - 2025-03-17: Referred Health and Government Operations (House) - 2025-03-17: Third Reading Passed (44-0) (Senate) - 2025-03-14: Second Reading Passed with Amendments (Senate) - 2025-03-14: Favorable with Amendments {813224/1 Adopted (Senate) - 2025-03-14: Favorable with Amendments Report by Finance (Senate) - 2025-01-22: Hearing 2/04 at 1:00 p.m. (Senate) - 2025-01-21: First Reading Finance (Senate) ## Bill text - Enacted, 2025-05-20: [PDF](https://mgaleg.maryland.gov/2025RS/Chapters_noln/CH_675_sb0423t.pdf) - Third Reading, 2025-03-14: [PDF](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0423t.pdf) - First Reading, 2025-01-21: [PDF](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0423f.pdf) ## Related bills - HB 0384: Maryland Disability Service Animal Program - Established (vetoed) - SB 0227: Workers' Compensation - Payment From Uninsured Employers' Fund - Revisions (vetoed) - HB 0482: Occupational Licensing and Certification - Criminal History - Predetermination Review Process (vetoed) - SB 0157: Maryland Disability Service Animal Program - Established (vetoed) - HB 1294: Commercial Law - Credit Regulation - Earned Wage Access and Credit Modernization (became law) - HB 0228: Maryland Veterans Trust – Assistance to Members of the Maryland National Guard (signed) ## Sources - [Enacted (PDF)](https://mgaleg.maryland.gov/2025RS/Chapters_noln/CH_675_sb0423t.pdf) - [Third Reading (PDF)](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0423t.pdf) - [First Reading (PDF)](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0423f.pdf) ## Related - [HB 0384: Maryland Disability Service Animal Program - Established](https://policyrisk.com/state-bill/MD-HB0384-2025RS) - [SB 0227: Workers' Compensation - Payment From Uninsured Employers' Fund - Revisions](https://policyrisk.com/state-bill/MD-SB0227-2025RS) - [HB 0482: Occupational Licensing and Certification - Criminal History - Predetermination…](https://policyrisk.com/state-bill/MD-HB0482-2025RS) - [SB 0157: Maryland Disability Service Animal Program - Established](https://policyrisk.com/state-bill/MD-SB0157-2025RS) - [HB 1294: Commercial Law - Credit Regulation - Earned Wage Access and Credit Modernization](https://policyrisk.com/state-bill/MD-HB1294-2025RS) - [HB 0228: Maryland Veterans Trust – Assistance to Members of the Maryland National Guard](https://policyrisk.com/state-bill/MD-HB0228-2025RS) - [Maryland bills](https://policyrisk.com/states/maryland/bills) - [Maryland state hub](https://policyrisk.com/states/maryland) - [All state legislation](https://policyrisk.com/state-bills) Source: PRIA, https://policyrisk.com/state-bill/MD-SB0423-2025RS (as of 2026-10-17).