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MarylandSB 09152026 Regular SessionSenate

State Board of Physicians - Delegation of Duties - Alterations

Sponsored By: Johnny Mautz (Republican)

Signed by Governor

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Analyzed Economic Effects

5 provisions identified: 3 benefits, 0 costs, 2 mixed.

Fluoroscopy rules for cardiac labs

A physician may delegate fluoroscopy tasks during a cardiac catheterization to a registered cardiovascular invasive specialist in a hospital lab. The doctor must be physically present and personally direct each act. The specialist must meet Board‑set training and experience, and the hospital must verify and document it. Hospitals are responsible for compliance and can be fined up to $5,000 per noncompliant instance.

New path to limited X-ray jobs

The law creates a registration for Limited X‑ray Machine Operators. You may do only listed, nonfluoroscopic X‑rays of the chest, spine, arms, and legs under on‑site supervision by a physician or radiographer. To register, you need at least 6 months of clinical care, 150 hours of classroom training, 480 clinical hours, at least five competencies per body part, and a passing score on the ARRT limited exam or an approved test. You must pay Board‑set application and renewal fees, pass a criminal history check, and earn 24 hours of continuing education every 2 years; registrations last up to 3 years. The Board can deny, suspend, or revoke for listed violations, order false claims to stop, and fine a physician’s office up to $5,000 per violation and an individual up to $1,000 per violation for unregistered practice.

Physician assistants may take extremity X-rays

A physician assistant may take nonfluoroscopic X‑rays of the extremities in a medical office. The PA must complete a course with radiographic studies on at least 20 separate patients. The PA works under direct supervision, uses a mini C‑arm or similar low‑radiation device, and gets the duty approved by the Board as an advanced duty in the collaboration agreement.

Two-year role for supervised medical graduates

A supervised medical graduate (MD or DO who passed USMLE or COMLEX parts 1 and 2) may perform delegated duties under on‑site supervision. The delegating physician does not have to be in the room for each task if on‑site supervision rules are met. A person may serve in this role for no more than two years.

All changes start October 1, 2026

The law takes effect on October 1, 2026. The new registration, training, delegation, and enforcement rules apply starting that date.

Sponsors & Cosponsors

Sponsor

  • Johnny Mautz

    Republican • Senate

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 218 • No: 0

Senate vote • 4/9/2026

Third Reading Passed

Yes: 40 • No: 0 • Other: 3

House vote • 4/8/2026

Third Reading Passed

Yes: 133 • No: 0 • Other: 3

Senate vote • 3/19/2026

Third Reading Passed

Yes: 45 • No: 0

Actions Timeline

  1. Approved by the Governor - Chapter 214

    4/28/2026

  2. Passed Enrolled

    4/9/2026Senate

  3. Third Reading Passed (40-0)

    4/9/2026Senate

  4. Senate Concurs House Amendments

    4/9/2026Senate

  5. Third Reading Passed (133-0)

    4/8/2026House

  6. Second Reading Passed with Amendments

    4/3/2026House

  7. Favorable with Amendments {163120/1 Adopted

    4/3/2026House

  8. Favorable with Amendments Report by Health

    4/3/2026House

  9. Hearing 4/01 at 1:00 p.m.

    3/20/2026House

  10. Referred Health

    3/20/2026House

  11. Third Reading Passed (45-0)

    3/19/2026Senate

  12. Second Reading Passed with Amendments

    3/17/2026Senate

  13. Favorable with Amendments {993729/1 Adopted

    3/17/2026Senate

  14. Favorable with Amendments Report by Finance

    3/16/2026Senate

  15. Hearing 3/03 at 1:00 p.m.

    2/12/2026Senate

  16. First Reading Finance

    2/6/2026Senate

Bill Text

  • Enacted

    4/28/2026

    PDF

  • Enrolled

    4/9/2026

    PDF

  • Third Reading

    3/17/2026

    PDF

  • First Reading

    2/6/2026

    PDF

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