# Health Occupations (GHO)

## Title 14. Physicians

### Subtitle 1. Definitions; General Provisions

#### Section 14-101

(a) In this title the following words have the meanings indicated.

(a-1) "Advisory committee" means a committee appointed by the Board that includes members of a profession regulated under this title or Title 15 of this article and formed to:

  (1) Further the Board's regulation of applicants and licensees of the regulated profession;

  (2) Assist the Board in protecting the health, safety, and welfare of the public; and

  (3) Make recommendations about the regulated profession to the Board on request.

(a-2) "Allied health professional" means an individual licensed by the Board under Subtitle 5A, 5B, 5C, 5D, 5E, 5F, or 5G of this title or Title 15 of this article.

(a-3) "Alternative health system" has the meaning stated in Sec. 1-401 of this article.

(a-4) "Applicant" means, unless the context requires otherwise, an individual applying for initial licensure, renewal, or reinstatement as a physician or an allied health professional in the State.

(b) "Board" means the State Board of Physicians.

(c) "Board certified" means the physician is certified by a public or private board, including a multidisciplinary board, and the certifying board:

  (1) Is:

    (i) A member of the American Board of Medical Specialties;

    (ii) An American Osteopathic Association certifying board;

    (iii) The Royal College of Physicians and Surgeons of Canada; or

    (iv) The College of Family Physicians of Canada; or

  (2) Requires that, in order to be certified, the physician:

    (i) Complete a postgraduate training program that:

      (1) Provides complete training in the specialty or subspecialty; and

      (2) Is accredited by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association; and

    (ii) Be certified by:

      (1) The member board of the American Board of Medical Specialties;

      (2) The American Osteopathic Association in the training field;

      (3) The Royal College of Physicians and Surgeons of Canada; or

      (4) The College of Family Physicians of Canada.

(d) "Civil action" includes a health care malpractice claim under Title 3, Subtitle 2A of the Courts Article.

(d-1) "Compact physician" means a physician licensed under the Interstate Medical Licensure Compact established under Sec. 14-3A-01 of this title.

(e)

  (1) "Cosmetic surgical procedure" means the use of surgical services to reshape the structure of a human body in order to change the appearance of an individual.

  (2) Except as provided in paragraph (3) of this subsection, "cosmetic surgical procedure" does not include:

    (i) A procedure done under local anesthesia or mild sedation; or

    (ii) Liposuction that removes less than 1,000 cubic centimeters of aspirate.

  (3) "Cosmetic surgical procedure" includes any procedure under paragraph (2) of this subsection that, under the circumstances established by the Secretary in regulations adopted under Title 19, Subtitle 3C of the Health - General Article, is a cosmetic surgical procedure.

(e-1) "Disciplinary panel" means a disciplinary panel of the Board established under Sec. 14-401 of this title.

(e-2) "Employer" means a person that enters an arrangement for professional services, whether paid or unpaid or contractual or otherwise, with an individual licensed under this title or Title 15 of this article.

(f) "Hospital" has the meaning stated in Sec. 19-301 of the Health - General Article.

(g) "License" means, unless the context requires otherwise, a license issued by the Board to practice medicine or an allied health profession regulated by the Board.

(h) "Licensed physician" means, unless the context requires otherwise, a physician, including a doctor of osteopathy, who is licensed by the Board to practice medicine.

(i) "Licensee" means an individual to whom the Board issues a license, including an individual practicing medicine within or as a professional corporation or professional association.

(j) "MedChi" means the Maryland State Medical Society.

(k) "Mild sedation" means a drug-induced state during which:

  (1) A patient is able to respond to verbal commands;

  (2) A patient's ventilatory and cardiovascular functions are not affected; and

  (3) A patient's cognitive function and coordination may be impaired.

(l) "Perform acupuncture" means to stimulate a certain point or points on or near the surface of the human body by the insertion of needles to prevent or modify the perception of pain or to normalize physiological functions, including pain control, for the treatment of ailments or conditions of the body.

(m) "Physician" means an individual who practices medicine.

(n) "Physician assistant" means an individual licensed under Title 15 of this article to practice as a physician assistant.

(o)

  (1) "Practice medicine" means to engage, with or without compensation, in medical:

    (i) Diagnosis;

    (ii) Healing;

    (iii) Treatment; or

    (iv) Surgery.

  (2) "Practice medicine" includes doing, undertaking, professing to do, and attempting any of the following:

    (i) Diagnosing, healing, treating, preventing, prescribing for, or removing any physical, mental, or emotional ailment or supposed ailment of an individual:

      (1) By physical, mental, emotional, or other process that is exercised or invoked by the practitioner, the patient, or both; or

      (2) By appliance, test, drug, operation, or treatment;

    (ii) Ending of a human pregnancy; and

    (iii) Performing acupuncture as provided under Sec. 14-504 of this title.

  (3) "Practice medicine" does not include:

    (i) Selling any nonprescription drug or medicine;

    (ii) Practicing as an optician; or

    (iii) Performing a massage or other manipulation by hand, but by no other means.

(p) "Registered cardiovascular invasive specialist" means an individual who is credentialed by Cardiovascular Credentialing International or another credentialing body approved by the Board to assist in cardiac catheterization procedures in a hospital under the direct, in-person supervision of a licensed physician.

(q) "Rehabilitation Program" means the program of the Board or the nonprofit entity with which the Board contracts under Sec. 14-401.1(g) of this title that evaluates and provides assistance to impaired physicians and allied health professionals who are directed by the Board to receive treatment and rehabilitation for alcoholism, chemical dependency, or other physical, emotional, or mental conditions.

(r) "Related institution" has the meaning stated in Sec. 19-301 of the Health - General Article.

#### Section 14-102

(a) This title does not limit the right of:

  (1) An individual to practice a health occupation that the individual is authorized to practice under this article; or

  (2) A Christian Science practitioner, who is accredited by the First Church of Christ, Scientist, in Boston, Massachusetts, from:

    (i) Dealing with human ills in accordance with the tenets of Christian Science; and

    (ii) Charging for services.

(b) This title does not prohibit a licensed dentist or any other individual authorized to practice dentistry under Title 4 of this article, who has administered anesthesia regularly in hospitals in this State for at least 15 years before June 1, 1962, from practicing anesthesiology or administering anesthesia for medical purposes.

### Subtitle 2. State Board of Physicians

#### Section 14-201

There is a State Board of Physicians in the Department.

#### Section 14-202

(a)

  (1) The Board shall consist of 22 members appointed by the Governor with the advice of the Secretary and the advice and consent of the Senate.

  (2) Of the 22 members:

    (i) 11 shall be practicing licensed physicians, at least one of whom shall be a doctor of osteopathy, appointed as provided in subsections (d) and (e) of this section;

    (ii) 1 shall be a practicing licensed physician appointed at the Governor's discretion;

    (iii) 1 shall be a representative of the Department nominated by the Secretary;

    (iv) 1 shall be a licensed physician assistant appointed at the Governor's discretion as provided in subsections (f) and (g) of this section;

    (v) 2 shall be practicing licensed physicians with full-time faculty appointments appointed to serve as representatives of academic medical institutions in the State and of whom:

      (1) 1 shall be appointed from a list containing 3 names submitted by the Johns Hopkins University School of Medicine; and

      (2) 1 shall be appointed from a list containing 3 names submitted by the University of Maryland School of Medicine;

    (vi) 5 shall be consumer members; and

    (vii) 1 shall be a public member knowledgeable in risk management or quality assurance matters appointed from a list submitted by the Maryland Hospital Association.

(b)

  (1) Each consumer or public member of the Board:

    (i) Shall be a member of the general public;

    (ii) Shall be a resident of the State for at least 5 years;

    (iii) May not be or ever have been a physician or in training to become a physician;

    (iv) May not have a household member who is a physician or in training to become a physician;

    (v) May not have a household member who participates in a commercial or professional field related to medicine; and

    (vi) May not have had within 2 years before appointment a substantial financial interest in a person regulated by the Board.

  (2) A consumer member of the Board may not have a substantial personal, business, professional, or pecuniary connection with a medical field or with an institution of medical education or a health care facility.

(c) While serving as a member of the Board, each consumer member and the public member shall continue to meet the requirements of subsection (b) of this section.

(d)

  (1) For each vacancy of a practicing licensed physician appointed in accordance with subsection (a)(2)(i) of this section, the Board shall:

    (i) Notify all practicing licensed physicians and professional organizations representing at least 25 licensed physicians in the State of the vacancy;

    (ii) Provide information regarding the selection process as provided under subsection (a)(2)(i) of this section;

    (iii) Solicit nominations for the vacancy; and

    (iv) Forward to the Governor:

      (1) Valid nominations submitted by professional organizations representing at least 25 licensed physicians in the State; and

      (2) Valid petitions submitted by practicing licensed physicians.

  (2) The Board shall meet the requirements of paragraph (1) of this subsection within:

    (i) 4 months prior to an upcoming vacancy on the Board; or

    (ii) 2 months after a vacancy exists on the Board.

(e) For each vacancy of a practicing licensed physician appointed in accordance with subsection (a)(2)(i) of this section, the Governor:

  (1) May:

    (i) Reappoint a member who has not served for more than 2 consecutive full terms; or

    (ii) Appoint a practicing licensed physician in accordance with subsection (a)(2)(i) of this section from lists submitted by the Board as provided in subsection (d)(1)(iv) of this section; and

  (2) May not reappoint or appoint a practicing licensed physician from a particular medical specialty if there are two current members serving on the Board from the same medical specialty.

(f)

  (1) For the vacancy of a certified physician assistant appointed in accordance with subsection (a)(2)(iv) of this section, the Board shall:

    (i) Notify all practicing certified physician assistants and professional organizations representing at least 25 certified physician assistants in the State of the vacancy;

    (ii) Provide information regarding the selection process as provided under subsection (a)(2)(iv) of this section;

    (iii) Solicit nominations for the vacancy; and

    (iv) Forward to the Governor:

      (1) Valid nominations submitted by professional organizations representing at least 25 certified physician assistants in the State; and

      (2) Valid petitions submitted by practicing certified physician assistants supporting the appointment of the certified physician assistant to the Board that are signed by at least 25 practicing certified physician assistants in the State.

  (2) The Board shall meet the requirements of paragraph (1) of this subsection within:

    (i) 4 months prior to an upcoming vacancy on the Board; or

    (ii) 2 months after a vacancy exists on the Board.

(g) For each vacancy of a certified physician assistant appointed in accordance with subsection (a)(2)(iv) of this section, the Governor may:

  (1) Reappoint a member who has not served for more than two consecutive full terms; or

  (2) Appoint a certified physician assistant in accordance with subsection (a)(2)(iv) of this section from lists submitted by the Board as provided in subsection (f)(1)(iv) of this section.

(h) Before taking office, each appointee to the Board shall take the oath required by Article I, Sec. 9 of the Maryland Constitution.

(i)

  (1) The term of a member is 4 years.

  (2) The terms of members are staggered as required by the terms provided for members of the Board on August 1, 2003.

  (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

  (4) A member may not serve more than 2 consecutive full terms.

(j)

  (1) If a vacancy occurs as to a member, the Governor shall appoint a new member to serve only for the rest of the term and until a successor is appointed and qualifies.

  (2) To the extent practicable, the Governor shall fill any vacancy on the Board within 60 days of the date of the vacancy.

(k)

  (1) On the recommendation of the Board, the Secretary may remove any member of the Board for neglect of duty, misconduct, malfeasance, or misfeasance in office.

  (2) Upon the recommendation of the Secretary, the Governor may remove a member whom the Secretary finds to have been absent from 2 successive Board meetings without adequate reason.

  (3) The Governor may remove a member for incompetence or misconduct.

#### Section 14-203

(a)

  (1) The Governor shall appoint the chair of the Board.

  (2) The term of office of the chair is 2 years.

(b) From among its members, the Board shall elect any officers, other than the chair, that it considers necessary.

(c) The Board shall determine:

  (1) The manner of election of officers;

  (2) The term of office of each officer; and

  (3) The duties of each officer.

#### Section 14-204

(a) A majority of the members then serving on the Board is a quorum.

(b) The Board shall meet:

  (1) At the times and places that it determines; and

  (2) As requested by the Secretary.

(c) Each member of the Board is entitled to:

  (1) Compensation in accordance with the State budget; and

  (2) Reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.

(d)

  (1)

    (i) The Secretary may employ a staff for the Board in accordance with the State budget.

    (ii) The Secretary may designate one of the staff as an executive director.

  (2) The Secretary may set the compensation of an employee of the Board in a position that:

    (i) Is unique to the Board;

    (ii) Requires specific skills or experience to perform the duties of the position; and

    (iii) Does not require the employee to perform functions that are comparable to functions performed in other units of the Executive Branch of State government.

  (3) The Secretary of Budget and Management, in consultation with the Secretary, shall determine the positions for which the Secretary may set compensation under paragraph (2) of this subsection.

(e) To provide adequate assistance in the investigation, development, and prosecution of cases referred to the Board, the Board shall be assigned a sufficient number of:

  (1) Assistant Attorneys General by the Attorney General; and

  (2) Investigators and hearing officers by the Secretary.

#### Section 14-205

(a) In addition to the powers and duties set forth in this title and in Title 15 of this article, the Board shall:

  (1) Enforce this title and Title 15 of this article;

  (2) Adopt regulations to carry out the provisions of this title and Title 15 of this article;

  (3) Establish policies for Board operations;

  (4) Maintain the rules, regulations, and policies of the Board so that the rules, regulations, and policies reflect the current practices of the Board;

  (5) Oversee:

    (i) The licensing requirements for physicians and the allied health professionals; and

    (ii) The issuance and renewal of licenses;

  (6) Maintain secure and complete records;

  (7) Review and preliminarily investigate complaints, including acknowledging receipt of complaints and informing complainants of the final disposition of complaints;

  (8) Develop and implement methods to:

    (i) Assess and improve licensee practices; and

    (ii) Ensure the ongoing competence of licensees;

  (9) Ensure that an opportunity for a hearing is provided to an individual, in accordance with law, before any action is taken against the individual;

  (10) Adjudicate nondisciplinary matters within the Board's jurisdiction;

  (11) Report on all disciplinary actions, license denials, and license surrenders;

  (12) Establish appropriate fees that are adequate to fund the effective regulation of physicians and allied health professionals;

  (13) Make recommendations that benefit the health, safety, and welfare of the public;

  (14) Provide ongoing education and training for Board members to ensure that the Board members can competently discharge their duties;

  (15) Direct educational outreach to and communicate with licensees and the public;

  (16) Develop and adopt a budget that reflects revenues and supports the costs associated with each allied health profession regulated by the Board;

  (17) Develop and approve an annual report and other required reports for submission to the Secretary, the Governor, the General Assembly, and the public;

  (18) Approve contracts as needed and within budgetary limits;

  (19) Appoint standing and ad hoc committees from among Board members as necessary;

  (20) Delegate to the executive director of the Board the authority to discharge Board or disciplinary panel duties, as deemed appropriate and necessary by the Board or disciplinary panel, and hold the executive director accountable to the Board; and

  (21) Appoint members of the disciplinary panels.

(b)

  (1) In addition to the powers set forth elsewhere in this title, the Board may:

    (i) Adopt regulations to regulate the performance of acupuncture, but only to the extent authorized by Sec. 14-504 of this title;

    (ii) After consulting with the State Board of Pharmacy, adopt rules and regulations regarding the dispensing of prescription drugs by a licensed physician;

    (iii) On receipt of a written and signed complaint, including a referral from the Commissioner of Labor and Industry, conduct an unannounced inspection of the office of a physician or acupuncturist, other than an office of a physician or acupuncturist in a hospital, related institution, freestanding medical facility, or a freestanding birthing center, to determine compliance at that office with the Centers for Disease Control and Prevention's guidelines on universal precautions; and

    (iv) Contract with others for the purchase of administrative and examination services to carry out the provisions of this title.

  (2) The Board or a disciplinary panel may investigate an alleged violation of this title and Title 15 of this article.

  (3) Subject to the Administrative Procedure Act and the hearing provisions of Sec. 14-405 of this title, a disciplinary panel may deny a license to an applicant or, if an applicant has failed to renew the applicant's license, refuse to renew or reinstate an applicant's license for:

    (i) Any of the reasons that are grounds for action under Sec. 14-404, Sec. 14-5A-17, Sec. 14-5B-14, Sec. 14-5C-17, Sec. 14-5D-14, Sec. 14-5E-16, Sec. 14-5F-18, or Sec. 14-5G-18 of this title, as applicable; or

    (ii) Failure to complete a criminal history records check in accordance with Sec. 14-308.1 of this title.

(c)

  (1) In addition to the duties set forth elsewhere in this title, the Board shall:

    (i) Issue, for use in other jurisdictions, a certificate of professional standing and a verification of license status to any licensee; and

    (ii) Keep a list of all pending license applicants.

  (2)

    (i) The Board shall keep a list of all licensees who are currently licensed.

    (ii) The list shall include each licensee's designated public address.

    (iii) A licensee's designated public address may be a post office box only if the licensee provides to the Board a nonpublic address, under paragraph (3) of this subsection, that is not a post office box.

    (iv) The list of current licensees is a public record.

  (3)

    (i) The Board shall collect a licensee's designated nonpublic address, if provided by the licensee, to facilitate communication between the licensee and the Board.

    (ii) The Board shall offer a licensee the opportunity to designate a nonpublic address, in addition to the licensee's public address, at the time of initial licensure and license renewal.

    (iii) A licensee shall designate an address where the Board may send the licensee mail.

    (iv) A licensee's designated nonpublic address is not a public record and may not be released by the Board.

(d) The Board may not release a list of applicants for licensure.

(e) Except as otherwise specified in statute, the Board may adopt regulations regarding advisory committees established under this title and Title 15 of this article governing:

  (1) The term of office for members;

  (2) The procedures for filling vacancies on an advisory committee;

  (3) The removal of members; and

  (4) The duties of each officer.

#### Section 14-205.1

On or before October 1 each year, the Board shall submit to the Governor, the Secretary, and, in accordance with Sec. 2-1257 of the State Government Article, the General Assembly an annual report that includes the following data calculated on a fiscal year basis:

(1) Relevant disciplinary indicators, including:

  (i) The number of new complaints investigated for physicians, allied health practitioners, and unlicensed individuals;

  (ii) The number of complaints that remain open as of June 30 of the immediately preceding fiscal year at the Board and at the Office of the Attorney General;

  (iii) The three most common grounds for complaints;

  (iv) The three most common sources of the complaints received;

  (v) The number and types of disciplinary actions taken by the Board;

  (vi) The total number of cases referred to peer review; and

  (vii) Of the cases referred to peer review:

    (1) The number of peer review cases that resulted in total disagreement;

    (2) The number of peer review cases that resulted in charges being issued; and

    (3) The number of peer review cases that resulted in closure or closure with an advisory letter;

(2) The number of cases not completed within 18 months by the Board and the reasons for the failure to complete the cases in 18 months; and

(3) For both physicians and allied health professionals:

  (i) The total number of all licensees;

  (ii) The number of initial, renewal, and reinstatement licenses issued;

  (iii) The number of positive and negative criminal history records checks results received;

  (iv) The number of individuals denied initial or renewal licensure due to positive criminal history records checks results; and

  (v) The number of individuals denied initial, renewal, or reinstatement licensure due to reasons other than a positive criminal history records check.

#### Section 14-205.2

The Board shall provide training on an as-needed basis to the personnel of the Office of Administrative Hearings in order to improve the quality and efficiency of the hearings in physician discipline cases.

#### Section 14-206

(a) Over the signature of an officer, the executive director, or the deputy director of the Board, the Board may issue subpoenas and administer oaths in connection with any investigation under this title and any hearings or proceedings before it.

(b) If, without lawful excuse, a person disobeys a subpoena from the Board or an order by the Board to take an oath or to testify or answer a question, then, on petition of the Board, a court of competent jurisdiction may punish the person as for contempt of court.

(c) If after due notice the individual against whom the action is contemplated fails or refuses to appear, nevertheless the Board may hear and determine the matter.

(d)

  (1) If the entry is necessary to carry out a duty under this title or Title 15 of this article, the Board's executive director or other duly authorized agent or investigator of the Board may enter at any reasonable hour:

    (i) A place of business of a licensee; or

    (ii) Public premises.

  (2) A person may not deny or interfere with an entry under this subsection.

  (3) A person who violates this subsection is guilty of a misdemeanor and on conviction is subject to a fine of $1,000.

(e) A disciplinary panel may issue a cease and desist order or obtain injunctive relief against an individual for:

  (1) Practicing a profession regulated under this title or Title 15 of this article without a license or with an unauthorized person;

  (2) Representing to the public, by title, description of services, methods, procedures, or otherwise, that the individual is authorized to practice:

    (i) Medicine in this State, in violation of Sec. 14-602 of this title;

    (ii) Respiratory care in this State, in violation of Sec. 14-5A-21 of this title;

    (iii) Radiation therapy, radiography, nuclear medicine technology, or radiation assistance in this State, in violation of Sec. 14-5B-18 of this title;

    (iv) Polysomnography in this State, in violation of Sec. 14-5C-21 of this title;

    (v) Athletic training in this State, in violation of Sec. 14-5D-17(3) of this title;

    (vi) Perfusion in this State, in violation of Sec. 14-5E-21 of this title;

    (vii) Naturopathic medicine in this State, in violation of Sec. 14-5F-30 of this title;

    (viii) Genetic counseling in this State, in violation of Sec. 14-5G-24 of this title;

    (ix) As a physician assistant in this State, in violation of Sec. 15-402 of this article; or

    (x) Limited X-ray machine operation in the State, in violation of Sec. 14-306.3 of this title; or

  (3) Taking any action:

    (i) For which a disciplinary panel determines there is a preponderance of evidence of grounds for discipline under Sec. 14-404, Sec. 14-5A-17, Sec. 14-5B-14, Sec. 14-5C-17, Sec. 14-5E-16, Sec. 14-5F-18, or Sec. 14-5G-18 of this title or Sec. 15-415 of this article; and

    (ii) That poses a serious risk to the health, safety, and welfare of a patient.

(f) The Board shall adopt regulations to carry out the provisions of this section, including hearing procedures and sanctions for noncompliance with a cease and desist order.

#### Section 14-206.1

(a) Based on a complaint received by the Board, the executive director of the Board may apply to a judge of the District Court or a circuit court for a search warrant to enter private premises where the Board or a disciplinary panel suspects that a person who is not licensed by the Board is practicing, attempting to practice, or offering to practice medicine.

(b) An application for a search warrant shall:

  (1) Be in writing;

  (2) Be verified by the applicant; and

  (3) Describe the premises to be searched and the nature, scope, and purpose of the search.

(c) A judge who receives an application for a search warrant may issue a warrant on a finding that:

  (1) The scope of the proposed search is reasonable;

  (2) The request for a search warrant is based on a complaint received by the Board; and

  (3) Obtaining consent to enter the premises may jeopardize the attempt to determine whether a person who is not licensed by the Board is practicing, attempting to practice, or offering to practice medicine.

(d)

  (1) A search warrant issued under this section shall specify the location of the premises to be searched.

  (2) A search conducted in accordance with a search warrant issued under this section may not exceed the limits specified in the warrant.

(e) A search warrant issued under this section shall be executed and returned to the issuing judge:

  (1) Within the period specified in the warrant, which may not exceed 30 days after the date of issuance; or

  (2) Within 15 days after the date of issuance, if no period is specified in the warrant.

#### Section 14-207

(a) There is a Board of Physicians Fund.

(b)

  (1) The Board may set reasonable fees for the issuance and renewal of licenses and its other services provided to applicants or licensees.

  (2) The fees charged shall be set to generate sufficient funds to approximate the cost of maintaining the Board, the license programs under this title and Title 15 of this article, and the other services it provides to applicants and licensees, including the cost of providing a rehabilitation program under Sec. 14-401.1(g) of this title.

  (3) Funds to cover the compensation and expenses of the Board members shall be generated by fees set under this section.

  (4) A fee collected under this section, this title, or Title 15 of this article shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board established under this title and Title 15 of this article for the practitioner type of the applicant or licensee from whom the fee was collected.

(c) The Board shall pay all fees collected under this title to the Comptroller of the State.

(d)

  (1) In fiscal year 2023 and each fiscal year thereafter, if the Department does not implement a permanent funding structure under Sec. 24-1702(b)(1) of the Health - General Article and the Governor does not include in the State budget at least $400,000 for the operation of the Maryland Loan Assistance Repayment Program for Physicians and Physician Assistants under Title 24, Subtitle 17 of the Health - General Article, as administered by the Department, the Comptroller shall distribute:

    (i) $400,000 of the fees received from the Board to the Department to be used to make grants under the Maryland Loan Assistance Repayment Program for Physicians and Physician Assistants under Title 24, Subtitle 17 of the Health - General Article to physicians and physician assistants engaged in primary care or to medical residents specializing in primary care who agree to practice for at least 2 years as primary care physicians in a geographic area of the State that has been designated by the Secretary as being medically underserved; and

    (ii) The balance of the fees to the Board of Physicians Fund.

  (2) If the Governor includes in the State budget at least the amount specified in paragraph (1) of this subsection for the operation of the Maryland Loan Assistance Repayment Program for Physicians and Physician Assistants under Title 24, Subtitle 17 of the Health - General Article, as administered by the Department, the Comptroller shall distribute the fees to the Board of Physicians Fund.

(e)

  (1)

    (i) The Fund shall be used exclusively to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by this title.

    (ii) For fiscal year 2027 only, $2,000,000 of the Fund balance may be used to support the programs in the Office of Population Health Improvement within the Department.

  (2)

    (i) The Fund is a continuing, nonlapsing fund, not subject to Sec. 7-302 of the State Finance and Procurement Article.

    (ii) Any unspent portions of the Fund may not be transferred or revert to the General Fund of the State, but shall remain in the Fund to be used for the purposes specified in this title.

  (3) Interest or other income earned on the investment of money in the Fund shall be paid into the Fund.

  (4) No other State money may be used to support the Fund.

(f) In addition to the requirements of subsection (e) of this section, the Board shall fund the budget of the Rehabilitation Program with fees set, collected, and distributed to the Fund under this title.

(g)

  (1) The chair of the Board or the designee of the chair shall administer the Fund.

  (2) Money in the Fund may be expended only for any lawful purpose authorized by this title.

(h) The Legislative Auditor shall audit the accounts and transactions of the Fund as provided in Sec. 2-1220 of the State Government Article.

#### Section 14-208

(a) The Board may impose an administrative penalty not exceeding $15,000 on a licensee for:

  (1) Failure to produce all documents in response to a Board subpoena;

  (2) Dispensing a drug without the proper authority from a valid dispensing permit; and

  (3) Failure to complete a supplemental application for a license compact.

(b) The Board shall adopt regulations establishing the administrative penalties listed in subsection (a) of this section.

(c) The Board shall pay any penalty collected under this section to the Board of Physicians Fund established under Sec. 14-207 of this subtitle.

### Subtitle 3

#### Section 14-301

Except as otherwise provided in this title, Sec. 13-516 of the Education Article, or Sec.Sec. 10-14A-03 and 10-14B-03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice medicine in this State.

#### Section 14-302

Subject to the rules, regulations, and orders of the Board, the following individuals may practice medicine without a license:

(1) A medical student or an individual in a postgraduate medical training program that is accredited by an accrediting organization recognized by the Board in regulations, while the individual is practicing medicine in the program and doing the assigned duties at any office of a licensed physician, hospital, clinic, or similar facility;

(2) A physician licensed by and residing in another jurisdiction, if the physician:

  (i) Is engaged in consultation with a physician licensed in the State about a particular patient and does not direct patient care;

  (ii)

    (1) Has an active, unrestricted license to practice medicine in the jurisdiction where the physician regularly engages in the practice of medicine;

    (2) Is employed by or has a written agreement with an athletic team or a sports team based outside the State;

    (3) Is designated as the team physician by the athletic or sports team to provide medical care to the team's members, band members, cheerleading squad, mascot, coaches, and other staff who travel to a specified sporting event taking place in the State;

    (4) While in the State, provides medical care only to individuals listed in item 3 of this item;

    (5) Does not provide medical care in the State for more than 45 days in a calendar year; and

    (6) Does not engage in the practice of medicine at a hospital, related institution, or other health care facility, including an acute care facility, located within the State; or

  (iii) Is engaged in clinical training or participates in training or teaching of a skill or procedure in a hospital if:

    (1) The skill or procedure:

    (A) Is advanced beyond those skills or procedures normally taught or exercised in the hospital and in standard medical education or training;

    (B) Could not be otherwise conveniently taught or demonstrated in standard medical education or training in that hospital; and

    (C) Is likely to benefit Maryland patients in this instance;

    (2) The demonstration of all skills or procedures by the physician does not exceed 14 days total in the calendar year;

    (3) A licensed physician who practices at a hospital in the State will be responsible for the medical care provided by that visiting physician to patients in the State;

    (4) The visiting physician has no history of any medical disciplinary action in any other state, territory, nation, or any branch of the uniformed services or the U.S. Department of Veterans Affairs, and has no significant detrimental malpractice history;

    (5) The physician is covered by malpractice insurance in the jurisdiction in which the physician practices; and

    (6) The hospital ensures that the patients will be protected by adequate malpractice insurance;

(3) A physician employed in the service of the federal government while practicing within the scope of the employment;

(4) A physician who resides in and is authorized to practice medicine by any state adjoining this State for the purpose of prescribing home health services to a patient who resides in this State, if the physician:

  (i) Does not have an office or other regularly appointed place in this State to meet patients; and

  (ii) Has performed an in-person physical examination of the patient within the jurisdictional boundaries of the adjoining state in which the prescribing physician is authorized to practice medicine; and

(5) An individual while under the supervision of a licensed physician who has specialty training in psychiatry, and whose specialty training in psychiatry has been approved by the Board, if the individual submits an application to the Board on or before October 1, 1993, and either:

  (i)

    (1) Has a master's degree from an accredited college or university; and

    (2) Has completed a graduate program accepted by the Board in a behavioral science that includes 1,000 hours of supervised clinical psychotherapy experience; or

  (ii)

    (1) Has a baccalaureate degree from an accredited college or university; and

    (2) Has 4,000 hours of supervised clinical experience that is approved by the Board.

#### Section 14-306

(a) To the extent authorized by the rules, regulations, and orders of the Board, an individual to whom duties are delegated by a licensed physician or physician assistant may perform those duties without a license as provided in this section.

(b) The individuals to whom duties may be delegated under this section include any individual authorized to practice any other health occupation regulated under this article or Sec. 13-516 of the Education Article.

(c)

  (1) The Board shall adopt rules and regulations to delineate the scope of this section.

  (2) Before the Board adopts any rule or regulation under this section, the Board shall invite and consider proposals from any individual or health group that could be affected by the rule or regulation.

(d)

  (1) If a duty that is to be delegated under this section is a part of the practice of a health occupation that is regulated under this article by another board, any rule or regulation concerning that duty shall be adopted jointly by the Board of Physicians and the board that regulates the other health occupation.

  (2) If the two boards cannot agree on a proposed rule or regulation, the proposal shall be submitted to the Secretary for a final decision.

#### Section 14-306.1

(a) In accordance with regulations adopted by the Board, a licensed physician may delegate duties to a registered cardiovascular invasive specialist assisting in the physician's performance of fluoroscopy if:

  (1) The delegated duties are limited to a cardiac catheterization procedure performed in a hospital cardiac catheterization laboratory;

  (2) The physician is physically present and personally directs each act performed by the registered cardiovascular invasive specialist;

  (3) The registered cardiovascular invasive specialist has completed the training and education and has the experience required by regulations adopted by the Board; and

  (4) The hospital in which the cardiac catheterization laboratory is located has verified and documented that the registered cardiovascular invasive specialist has completed the training and education and has the experience required by regulations adopted by the Board.

(b) The hospital in which the cardiac catheterization laboratory is located and the physician delegating duties to a registered cardiovascular invasive specialist under this section are responsible for ensuring that all requirements of this section are met for each procedure.

(c) A disciplinary panel may impose a civil penalty of up to $5,000 for each instance of a hospital's failure to comply with the requirements of this section.

#### Section 14-306.2

(a)

  (1) In this section the following words have the meanings indicated.

  (2) "On-site supervision" means oversight exercised by a delegating physician who is:

    (i) Personally treating the patient;

    (ii) In the same medical office as the patient and the supervised medical graduate; and

    (iii) Immediately available to provide assistance and guidance to the supervised medical graduate for the duration of the completion of a delegated duty.

  (3) "Supervised medical graduate" means an individual who:

    (i) Has a degree of:

      (1) Doctor of medicine from a medical school that is accredited by an accrediting organization that the Board recognizes in its regulations; or

      (2) Doctor of osteopathy from a school of osteopathy in the United States, its territories or possessions, Puerto Rico, or Canada that has standards for graduation equivalent to those established by the American Osteopathic Association; and

    (ii) Has passed parts 1 and 2 of:

      (1) The United States Medical Licensing Examination; or

      (2) The Comprehensive Osteopathic Medical Licensing Examination of the United States.

(b) Subject to subsection (c) of this section and in accordance with regulations adopted by the Board, a supervised medical graduate may perform delegated duties under on-site supervision.

(c) An individual may not practice as a supervised medical graduate for a period of more than 2 years.

(d) For the purposes of this section, a delegating physician is not required to be in the presence of a patient and a supervised medical graduate during the completion of a delegated duty.

#### Section 14-306.3

(a) In accordance with regulations adopted by the Board, an individual may perform X-ray duties as a limited X-ray machine operator registered with the Board under this section without a license if the X-ray procedures:

  (1) Do not include:

    (i) Computerized or noncomputerized tomography;

    (ii) Fluoroscopy;

    (iii) Invasive radiology;

    (iv) Mammography;

    (v) Nuclear medicine;

    (vi) Radiation therapy; or

    (vii) Xerography;

  (2) Are limited to X-ray procedures of:

    (i) The chest;

    (ii) The spine, including:

      (1) The cervical spine;

      (2) The lumbar spine;

      (3) The sacroiliac joints;

      (4) The sacrum and coccyx; and

      (5) The thoracic spine;

    (iii) Lower extremities, including:

      (1) Toes;

      (2) The foot;

      (3) The ankle;

      (4) The calcaneus;

      (5) The tibia and fibula;

      (6) The knee and patella; and

      (7) The femur; and

    (iv) Upper extremities, including:

      (1) Fingers;

      (2) The hand;

      (3) The wrist;

      (4) The forearm;

      (5) The elbow;

      (6) The humerus;

      (7) The shoulder;

      (8) The clavicle;

      (9) Acromioclavicular joints; and

      (10) The scapula;

  (3) Are performed under the supervision of a licensed physician or radiographer who is on-site or able to provide immediately available direction; and

  (4) Are performed by an individual who has registered with the Board and attests:

    (i) To the successful completion of at least 6 months of clinical care experience;

    (ii) To the successful completion of:

      (1) A limited X-ray educational program; or

      (2) The first year of an accredited radiologic technologist program in good standing with the Board;

    (iii) To the successful completion of at least 115 hours of didactic training delivered by a radiologic technologist certified by the American Registry of Radiologic Technologists providing instruction in radiographic anatomy, procedures, and pathology, digital image acquisition and display, fundamentals, ethics, and laws of health care, human anatomy and physiology, image production and analysis, imaging equipment and radiation production, medical terminology, and patient care;

    (iv) To the successful completion of at least 480 hours of clinical training;

    (v) To the successful completion of a minimum of five competencies in each body part listed under subsection (a)(2) of this section under the direct supervision of a radiologic technologist certified by the American Registry of Radiologic Technologists; and

    (vi) To the successful achievement of a passing score, as determined by the Board, on the American Registry of Radiologic Technologists examination for limited scope of practice in radiography or an alternative examination approved by the Board.

(b) If the applicant completed the first year of an accredited radiologic technologist educational program, the program director of the educational program shall provide an attestation directly to the Board stating that the applicant meets or exceeds the requirements of subsection (a)(4)(i), (ii)2, (iii), (iv), (v), and (vi) of this section.

(c) An individual seeking registration under this section shall:

  (1) Apply for registration on a form supplied by the Board;

  (2) Pay the registration fee established by the Board; and

  (3) Complete any other requirements established by the Board.

(d) If an individual was denied a license by the Board, the individual is not eligible for registration under this section.

(e) An individual registered under this section shall complete at least 24 hours of approved continuing education credits earned during the 2-year period immediately preceding the expiration of a registration.

(f)

  (1) The term of a registration may not exceed 3 years.

  (2) A registration shall expire on a date established by the Board.

  (3) To renew a registration, the registrant must:

    (i) Apply for renewal on a form supplied by the Board;

    (ii) Pay the renewal fee established by the Board; and

    (iii) Complete any other requirements established by the Board.

(g) An applicant for registration shall complete a criminal history records check in accordance with Sec. 14-308.1 of this subtitle.

(h)

  (1) The Board shall set reasonable fees for the issuance and renewal of registrations and other services provided.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the registration program and other services provided to registrants under this section.

(i) In accordance with regulations adopted by the Board, a physician's office that employs an individual authorized to perform X-ray duties without a license under this section is responsible for ensuring that all requirements of this section are met for each X-ray examination performed.

(j) If an unregistered individual performs X-ray duties without meeting the requirements of this section, the Board may impose a civil penalty of up to:

  (1) $5,000 for each violation on the physician's office where the violation occurred; and

  (2) $1,000 for each violation on the individual who committed the violation.

#### Section 14-306.4

(a) Subject to the hearing provisions of Sec. 14-405 of this title, a disciplinary panel, on the affirmative vote of a majority of the quorum of the disciplinary panel, may deny a registration to practice as a limited X-ray machine operator to any applicant, reprimand any limited X-ray machine operator registrant, place any registrant on probation, or suspend or revoke a registration, if the applicant or registrant:

  (1) Fraudulently or deceptively obtains or attempts to obtain a registration for the applicant, registrant, or for another;

  (2) Fraudulently or deceptively uses a registration;

  (3) Is guilty of:

    (i) Immoral conduct in the practice of limited X-ray machine operation; or

    (ii) Unprofessional conduct in the practice of limited X-ray machine operation;

  (4) Is:

    (i) Professionally incompetent;

    (ii) Physically incompetent; or

    (iii) Mentally incompetent;

  (5) Abandons a patient;

  (6) Is habitually intoxicated;

  (7) Is addicted to or habitually abuses any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article;

  (8) Provides professional services while:

    (i) Under the influence of alcohol; or

    (ii) Using any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article or any other drug that is in excess of therapeutic amounts or without valid medical indication;

  (9) Promotes the sale of services, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

  (10) Willfully makes or files a false report or record in the practice of limited X-ray machine operation;

  (11) Willfully fails to file or record any report as required under law, willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record a report;

  (12) Breaches patient confidentiality;

  (13) Pays or agrees to pay any sum or provide any form of remuneration or material benefit to any person for bringing or referring a patient or accepts or agrees to accept any sum or any form of remuneration or material benefit from an individual for bringing or referring a patient;

  (14) Willfully makes a misrepresentation while practicing limited X-ray machine operation;

  (15) Willfully practices limited X-ray machine operation with an unauthorized individual or aids an unauthorized individual in the practice of limited X-ray machine operation;

  (16) Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine;

  (17) Is disciplined by a licensing or disciplinary authority or is convicted or disciplined by a court of any state or country or is disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (18) Fails to meet appropriate standards for the delivery of quality limited X-ray machine operation care performed in any outpatient surgical facility, office, hospital or related institution, or any other location in this State;

  (19) Willfully submits false statements to collect fees for which services are not provided;

  (20)

    (i) Has been subject to investigation or disciplinary action by a disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under the Board's disciplinary statutes; and

    (ii) Has:

      (1) Surrendered the license, registration, certification, or permit issued by the State or country; or

      (2) Allowed the license, registration, certification, or permit issued by the State or country to expire or lapse;

  (21) Willfully fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

  (22) Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes;

  (23) Practices or attempts to practice beyond the authorized scope of practice;

  (24) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

  (25) Practices or attempts to practice a limited X-ray machine operation procedure or uses limited X-ray machine operation equipment if the applicant or registrant has not received an education, an internship, training, or experience in the performance of the procedure or the use of the equipment;

  (26) Fails to cooperate with a lawful investigation conducted by the Board or a disciplinary panel;

  (27) Fails to practice under the supervision of a licensed physician or licensed radiographer or violates a supervisory order of a supervising physician or supervising radiographer; or

  (28) Fails to complete a criminal history records check under Sec. 14-308.1 of this subtitle.

(b) Except as otherwise provided in the Administrative Procedure Act, before the Board or a disciplinary panel takes any action under subsection (a) of this section, the Board or a disciplinary panel shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board or the disciplinary panel in accordance with the hearing requirements of Sec. 14-405 of this title.

(c)

  (1) On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a registration if the registrant is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

  (2) After completion of the appellate process, if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a registration on the certification by the Office of the Attorney General.

(d) If, after a hearing under Sec. 14-405 of this title, a disciplinary panel finds that there are grounds under subsection (a) of this section to suspend or revoke a registration, to reprimand a registrant, or to place a registrant on probation, the disciplinary panel may impose a fine subject to the Board's regulations in addition to suspending or revoking the license, reprimanding the registrant, or placing the registrant on probation.

(e) In addition to any sanction authorized under this section, a disciplinary panel may require a registrant to comply with specified terms and conditions determined by the disciplinary panel.

#### Section 14-307

(a) To qualify for a license, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall be of good moral character.

(c) The applicant shall be at least 18 years old.

(d) Except as provided in Sec. 14-308 of this subtitle, the applicant shall:

  (1)

    (i) Have a degree of doctor of medicine from a medical school that is accredited by an accrediting organization that the Board recognizes in its regulations; and

    (ii) Submit evidence acceptable to the Board of successful completion of 1 year of training in a postgraduate medical training program that is accredited by an accrediting organization that the Board recognizes in its regulations; or

  (2)

    (i) Have a degree of doctor of osteopathy from a school of osteopathy in the United States, its territories or possessions, Puerto Rico, or Canada that has standards for graduation equivalent to those established by the American Osteopathic Association; and

    (ii) Submit evidence acceptable to the Board of successful completion of 1 year of training in a postgraduate medical training program accredited by an accrediting organization that the Board recognizes in its regulations.

(e) Except as otherwise provided in this subtitle, the applicant shall meet any education, certification, training, or examination requirements established by the Board.

(f) The applicant shall meet any other qualifications that the Board establishes in its regulations for license applicants.

(g) An otherwise qualified applicant who passes the examination after having failed the examination or any part of the examination 3 or more times may qualify for a license only if the applicant:

  (1) Has successfully completed 2 or more years of a residency or fellowship accredited by the Accreditation Council on Graduate Medical Education or the American Osteopathic Association;

  (2)

    (i) Has a minimum of 5 years of clinical practice of medicine:

      (1) In the United States or in Canada;

      (2) With at least 3 of the 5 years having occurred within 5 years of the date of the application; and

      (3) That occurred under a full unrestricted license to practice medicine; and

    (ii) Has no disciplinary action pending and has had no disciplinary action taken against the applicant that would be grounds for discipline under Sec. 14-404 of this title; or

  (3) Is board certified.

(h)

  (1) The Board shall require as part of its examination or licensing procedures that an applicant for a license to practice medicine demonstrate an oral and written competency in the English language.

  (2) Graduation from a recognized English-speaking undergraduate school or high school, including General Education Development (GED), after at least 3 years of enrollment, or from a recognized English-speaking professional school is acceptable as proof of proficiency in the oral and written communication of the English language under this section.

  (3) By regulation, the Board shall develop a procedure for testing individuals who because of their speech impairment are unable to complete satisfactorily a Board approved standardized test of oral competency.

  (4) If any disciplinary charges or action that involves a problem with the oral and written communication of the English language are brought against a licensee under this title, the Board shall require the licensee to take and pass a Board approved standardized test of oral and written competency.

(i) The applicant shall complete a criminal history records check in accordance with Sec. 14-308.1 of this subtitle.

(j)

  (1) The Board shall license an applicant to practice medicine if:

    (i) The applicant:

      (1) Became licensed or certified as a physician in another jurisdiction under requirements that the Board determines are substantially equivalent to the licensing requirements of this title;

      (2) Is in good standing under the laws of the other jurisdiction;

      (3) Submits an application to the Board on a form that the Board requires; and

      (4) Pays to the Board an application fee set by the Board; and

    (ii) The jurisdiction in which the applicant is licensed or certified offers a similar reciprocal licensing process for individuals licensed to practice medicine by the Board.

  (2) The Board shall adopt regulations to implement this subsection.

#### Section 14-308

(a)

  (1) In this section the following terms have the meanings indicated.

  (2) "Fifth pathway program" means a program that the Board approves in its regulations for a student who:

    (i) Has studied medicine at an international medical school;

    (ii) Was a United States citizen when the student enrolled in the international medical school; and

    (iii) Has completed all of the formal requirements for graduation from the international medical school, except for any social service or postgraduate requirements.

  (3) "International medical school" means a medical school located outside of the United States, its territories or possessions, Puerto Rico, or Canada.

(b) An applicant for a license is exempt from the educational requirements of Sec. 14-307 of this subtitle, if the applicant:

  (1) Has studied medicine at an international medical school;

  (2) Is certified by the Educational Commission for Foreign Medical Graduates or by its successor as approved by the Board;

  (3) Passes a qualifying examination for international medical school graduates required by the Board;

  (4) Meets any other qualifications for international medical school graduates that the Board establishes in its regulation for licensing of applicants;

  (5) Submits acceptable evidence to the Board of the requirements set in the Board's regulations; and

  (6) Meets one of the following requirements:

    (i) The applicant graduated from any international medical school and submits evidence acceptable to the Board of successful completion of 2 years of training in a postgraduate medical education program accredited by an accrediting organization recognized by the Board; or

    (ii) The applicant successfully completed a fifth pathway program and submits evidence acceptable to the Board that the applicant:

      (1) Has a document issued by the international medical school certifying that the applicant completed all of the formal requirements of that school for the study of medicine, except for the postgraduate or social service components as required by the international country or its medical school;

      (2) Has successfully completed a fifth pathway program; and

      (3) Has successfully completed 2 years of training in a postgraduate medical education program following completion of a Board approved fifth pathway program.

#### Section 14-308.1

(a) In this section, "Central Repository" means the Criminal Justice Information System Central Repository of the Department of Public Safety and Correctional Services.

(b) An applicant, a licensee, or a certificate holder shall apply to the Central Repository for a State and national criminal history records check.

(c) As part of the application required under subsection (b) of this section, an individual shall submit to the Central Repository:

  (1) Two complete sets of legible fingerprints taken on forms approved by the Director of the Central Repository and the Director of the Federal Bureau of Investigation;

  (2) The fee authorized under Sec. 10-221(b)(7) of the Criminal Procedure Article for access to State criminal history records; and

  (3) The mandatory processing fee required by the Federal Bureau of Investigation for a national criminal history records check.

(d) In accordance with Sec.Sec. 10-201 through 10-229 of the Criminal Procedure Article, the Central Repository shall forward to the Board and to the individual the criminal history record information of the individual.

(e) If criminal history record information is reported to the Central Repository after the date of the initial criminal history records check, the Central Repository shall provide to the Board and the individual a revised printed statement of the individual's State criminal history record.

(f) Information obtained from the Central Repository under this section:

  (1) Is confidential;

  (2) May not be redisseminated; and

  (3) May be used only for the licensing purpose authorized by this title.

(g) The subject of a criminal history records check under this section may contest the contents of the printed statement issued by the Central Repository as provided in Sec. 10-223 of the Criminal Procedure Article.

#### Section 14-309

To apply for a license, an applicant shall:

(1) Complete a criminal history records check in accordance with Sec. 14-308.1 of this subtitle;

(2) Submit an application to the Board on the form that the Board requires; and

(3) Pay to the Board the application fee set by the Board.

#### Section 14-311

(a) An applicant who otherwise qualifies for a license under this title is entitled to sit for an examination as provided under this section or any regulations adopted to carry out this section.

(b) An applicant shall:

  (1) Attain on the federation licensing examination or the United States Medical Licensing Examination a passing score as set by the Board under its rules and regulations; or

  (2) Hold a certificate of proficiency and professional standing of:

    (i) The National Board of Medical Examiners;

    (ii) The board of medical examiners of this State or any other state that was issued before January 1, 1985;

    (iii) The National Board of Examiners for Osteopathic Physicians and Surgeons, if the certificate is issued after January 1, 1971; or

    (iv) The Licentiate of the Medical Council of Canada.

#### Section 14-312

On request of the Board, a physician who reports to the Board that the physician maintains medical professional liability insurance for purposes of the public individual profile maintained by the Board under Sec. 14-411.1(b) of this title shall provide the Board with verification or other documentation that the physician maintains the insurance within 25 business days after the physician receives a request from the Board.

#### Section 14-313

(a) Subject to subsection (b) of this section, the Board shall issue a license to any applicant who meets the requirements of this title.

(b)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 14-308.1 of this subtitle, in determining whether to issue a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 14-308.1 of this subtitle has not been received.

#### Section 14-313.1

(a) Within 30 days after receiving a request from the Board, a compact physician shall provide to the Board verification, on a form provided by the Board, that the compact physician satisfies the requirements for licensure under this subtitle.

(b) Refusal by a compact physician to provide the verification requested under subsection (a) of this section may not be considered a basis for denial of a license under the Interstate Medical Licensure Compact established under Sec. 14-3A-01 of this title.

#### Section 14-314

(a) Except as otherwise provided in this title, a license authorizes the licensee to practice medicine while the license is effective.

(b) A licensee may practice medicine using only the name in which the license is issued.

#### Section 14-315

(a) The Board shall issue a license free of charge to any physician who:

  (1) Provides medical services to patients for which the physician receives no personal remuneration;

  (2) Is not engaged in the private practice of medicine; and

  (3) Otherwise qualifies for a license under this title.

(b) Except as provided in subsection (c) of this section, each license issued under this section expires on a date set by the Board and may be renewed for a term set by the Board.

(c)

  (1) If, at any time, a physician licensed under this section ceases to meet the requirements of subsection (a)(1) or (2) of this section, the licensee shall notify the Board of the status change.

  (2) On receipt of this notice, the Board shall charge the physician the license fee otherwise required under this subtitle.

#### Section 14-316

(a)

  (1) This subsection does not apply to a physician who is on inactive status under Sec. 14-320 of this subtitle or emeritus status under Sec. 14-320.1 of this subtitle.

  (2) The term of a license issued by the Board may not exceed 3 years.

  (3) A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.

(b)

  (1) Subject to paragraph (2) of this subsection, at least 1 month before the license expires, the Board shall send to the licensee, by electronic or first-class mail to the last known electronic or physical address of the licensee a renewal notice that states:

    (i) The date on which the current license expires;

    (ii) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and

    (iii) The amount of the renewal fee.

  (2) If the Board chooses to send renewal notices exclusively by electronic mail under paragraph (1) of this subsection, the Board shall send a renewal notice by first-class mail to a licensee on request of the licensee.

(c)

  (1) Before the license expires, the licensee periodically may renew it for an additional term, if the licensee:

    (i) Otherwise is entitled to be licensed;

    (ii) Is of good moral character;

    (iii) Pays to the Board a renewal fee set by the Board;

    (iv) Submits to the Board:

      (1) A renewal application on the form that the Board requires; and

      (2) Satisfactory evidence of compliance with any continuing education or competency requirements set under this section for license renewal; and

    (v) Meets any additional license renewal requirements established by the Board.

  (2) Within 30 days after a license renewal under Section 7 of the Interstate Medical Licensure Compact established under Sec. 14-3A-01 of this title, a compact physician shall submit to the Board the information required under paragraph (1)(iv) of this subsection.

(d)

  (1) In addition to any other qualifications and requirements established by the Board, the Board may establish continuing education or competency requirements as a condition to the renewal of licenses under this section.

  (2) In establishing these requirements, the Board shall evaluate existing methods, devices, and programs in use among the various medical specialties and other recognized medical groups.

  (3) The Board shall adopt regulations that allow a licensee seeking renewal to receive up to 5 continuing education credits per renewal period for providing uncompensated, voluntary medical services during each renewal period.

  (4) The Board may not establish or enforce these requirements if they would so reduce the number of physicians in a community as to jeopardize the availability of adequate medical care in that community.

  (5) The Board may not establish a continuing education requirement that every licensee complete a specific course or program as a condition to the renewal of a license under this section.

  (6) A disciplinary panel may impose a civil penalty of up to $100 per continuing medical education credit in lieu of a sanction under Sec. 14-404 of this title, for a first offense, for the failure of a licensee to obtain the continuing medical education credits required by the Board.

(e) The Board shall renew the license of each licensee who meets the requirements of this section.

(f)

  (1) A licensee shall notify the Board in writing of a change in name or address within 30 days after the change.

  (2) A licensee who fails to comply with paragraph (1) of this subsection is subject to an administrative penalty of $100.

(g)

  (1) Beginning October 1, 2016, the Board shall require a criminal history records check in accordance with Sec. 14-308.1 of this subtitle for:

    (i) Renewal applicants as determined by regulations adopted by the Board; and

    (ii) Each former licensee who files for reinstatement under Sec. 14-317 of this subtitle.

  (2) On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with Sec. 14-308.1 of this subtitle, in determining whether disciplinary action should be taken, based on the criminal record information, against a licensee who renewed or reinstated a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.

  (3) The Board may renew or reinstate a license only if the licensee or applicant attests that the licensee or applicant has submitted to a criminal history records check under Sec. 14-308.1 of this subtitle.

#### Section 14-317

The Board shall reinstate the license of a physician who has failed to renew the license for any reason, is on inactive status under Sec. 14-320 of this subtitle, or is on emeritus status under Sec. 14-320.1 of this subtitle if the physician:

(1) Meets the renewal requirements of Sec. 14-316 of this subtitle;

(2) Submits a reinstatement application on the form that the Board requires;

(3) Pays to the Board a reinstatement fee set by the Board;

(4) Submits to the Board satisfactory evidence of compliance with the qualifications and requirements established under this title for license reinstatements; and

(5) Meets any additional license reinstatement requirements established by the Board.

#### Section 14-318

(a) If an applicant is qualified as a postgraduate teacher, the Board may:

  (1) Waive the examination requirements of this subtitle for the applicant; and

  (2) Issue to the applicant a limited license to practice medicine for postgraduate teaching.

(b) Each limited license issued under this section expires on the first anniversary of its effective date.

#### Section 14-319

(a) The Board may:

  (1) License an applicant by virtue of the conceded eminence and authority of the applicant in the profession if the applicant:

    (i) Is recommended to the Board by:

      (1) The dean of a school of medicine in the State; or

      (2) The Director of the National Institutes of Health;

    (ii) Is to receive an appointment at the institution making the recommendation under item (i) of this paragraph; and

    (iii) Meets any other requirement the Board may adopt by regulation under this section;

  (2) Define by regulation the term "conceded eminence and authority in the profession" and, for this purpose, shall consider such criteria as:

    (i) Academic appointments;

    (ii) Length of time in the profession;

    (iii) Scholarly publications; and

    (iv) Professional accomplishments;

  (3) Adopt regulations concerning the further qualifications of an applicant for licensure, including conditions of employment, application procedures, and fees under this section;

  (4) Allow an exception to the general education and examination requirements of Sec. 14-307(d) and (e) of this subtitle, but may not permit waiver of the requirements of Sec. 14-307(a) through (c) of this subtitle;

  (5) Qualify, restrict, or otherwise limit a license granted under this section; and

  (6) Require a 6-month probationary period during which the medical services performed by the applicant granted a license under this section are supervised by another licensed physician.

(b) Upon judicial review, a determination by the Board under this section shall be accorded the maximum deference permitted by law.

#### Section 14-320

(a) The Board may place a licensee on inactive status, if the licensee submits to the Board:

  (1) An application for inactive status on the form required by the Board; and

  (2) The inactive status fee set by the Board.

(b) A licensee on inactive status is exempt from the continuing education requirements under Sec. 14-316(d) of this subtitle.

#### Section 14-320.1

(a) The Board may place a licensee on emeritus status, if the licensee submits to the Board:

  (1) An application for emeritus status on the form required by the Board; and

  (2) The emeritus status fee set by the Board.

(b) The Board shall place a licensee on emeritus status if the individual:

  (1) Has an active, unrestricted license to practice medicine under this subtitle;

  (2) Is not under investigation by the Board for a violation of this title;

  (3) Has practiced medicine in this State for at least 10 years;

  (4) Has not been the subject of disciplinary action in a jurisdiction where the individual is licensed that resulted in the revocation or suspension of the individual's license; and

  (5) Attests that the individual is retired and is no longer actively practicing medicine in this State.

(c) A licensee on emeritus status is exempt from the continuing education requirements under Sec. 14-316(d) of this subtitle.

#### Section 14-322

Notwithstanding any other law, the Board may not require as a qualification to obtain a license or as a condition to renew a license:

(1) Certification by a nationally recognized accrediting organization that specializes in a specific area of medicine; or

(2) Maintenance of certification by a nationally recognized accrediting organization that specializes in a specific area of medicine that includes continuous reexamination to measure core competencies in the practice of medicine as a requirement for maintaining certification.

### Subtitle 3A. Interstate Medical Licensure Compact

#### Section 14-3A-01

The Interstate Medical Licensure Compact is enacted into law and entered into with all other states legally joining in it in the form substantially as it appears in this section as follows:

SECTION 1. PURPOSE

In order to strengthen access to health care, and in recognition of the advances in the delivery of health care, the member states of the Interstate Medical Licensure Compact have allied in common purpose to develop a comprehensive process that complements the existing licensing and regulatory authority of state medical boards, and provides a streamlined process that allows physicians to become licensed in multiple states, thereby enhancing the portability of a medical license and ensuring the safety of patients. The Compact creates another pathway for licensure and does not otherwise change a state's existing Medical Practice Act. The Compact also adopts the prevailing standard for licensure and affirms that the practice of medicine occurs where the patient is located at the time of the physician-patient encounter, and therefore requires the physician to be under the jurisdiction of the state medical board where the patient is located. State medical boards that participate in the Compact retain the jurisdiction to impose an adverse action against a license to practice medicine in that state issued to a physician through the procedures in the Compact.

SECTION 2. DEFINITIONS

In this Compact:

(a) "Bylaws" means those bylaws established by the Interstate Commission pursuant to Section 11 for its governance, or for directing and controlling its actions and conduct.

(b) "Commissioner" means the voting representative appointed by each member board pursuant to Section 11.

(c) "Conviction" means a finding by a court that an individual is guilty of a criminal offense through adjudication, or entry of a plea of guilt or no contest to the charge by the offender. Evidence of an entry of a conviction of a criminal offense by the court shall be considered final for purposes of disciplinary action by a member board.

(d) "Expedited License" means a full and unrestricted medical license granted by a member state to an eligible physician through the process set forth in the Compact.

(e) "Interstate Commission" means the Interstate Commission created pursuant to Section 11.

(f) "License" means authorization by a state for a physician to engage in the practice of medicine, which would be unlawful without the authorization.

(g) "Medical Practice Act" means the laws and regulations governing the practice of allopathic and osteopathic medicine within a member state.

(h) "Member Board" means a state agency in a member state that acts in the sovereign interests of the state by protecting the public through licensure, regulation, and education of physicians as directed by the state government.

(i) "Member State" means a state that has enacted the Compact.

(j) "Offense" means a felony, gross misdemeanor, or crime of moral turpitude.

(k) "Physician" means any person who:

  (1) Is a graduate of a medical school accredited by the Liaison Committee on Medical Education, the Commission on Osteopathic College Accreditation, or a medical school listed in the International Medical Education Directory or its equivalent;

  (2) Passed each component of the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within three attempts, or any of its predecessor examinations accepted by a state medical board as an equivalent examination for licensure purposes;

  (3) Successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association;

  (4) Possesses a full and unrestricted license to engage in the practice of medicine issued by a member board;

  (5) Has never been convicted of or received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;

  (6) Has never held a license authorizing the practice of medicine subjected to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to nonpayment of fees related to a license;

  (7) Has never had a controlled substance license or permit suspended or revoked by a state or the United States Drug Enforcement Administration; and

  (8) Is not under active investigation by a licensing agency or law enforcement authority in any state, federal, or foreign jurisdiction.

(l) "Practice of Medicine" means the clinical prevention, diagnosis, or treatment of human disease, injury, or condition requiring a physician to obtain and maintain a license in compliance with the Medical Practice Act of a member state.

(m) "Rule" means a written statement by the Interstate Commission promulgated pursuant to Section 12 that is of general applicability, implements, interprets, or prescribes a policy or provision of the Compact, or an organizational, procedural, or practice requirement of the Interstate Commission, and has the force and effect of statutory law in a member state, and includes the amendment, repeal, or suspension of an existing rule.

(n) "State" means any state, commonwealth, district, or territory of the United States.

(o) "State of Principal License" means a member state where a physician holds a license to practice medicine and that has been designated as such by the physician for purposes of registration and participation in the Compact.

SECTION 3. ELIGIBILITY

(a)

  (1) In order to receive an initial expedited license under the terms and provisions of the Compact, a physician must:

    (i) Meet the eligibility requirements as defined in Section 2(k); and

    (ii) Hold specialty certification or a time-unlimited specialty certificate recognized by the American Board of Medical Specialties or the American Osteopathic Association's Bureau of Osteopathic Specialists.

  (2) A physician is not required to maintain specialty certification described under paragraph (1)(ii) of this subsection in order to renew an expedited license under Section 6.

(b) A physician who does not meet the requirements of Section 2(k) may obtain a license to practice medicine in a member state if the individual complies with all laws and requirements, other than the Compact, relating to the issuance of a license to practice medicine in that state.

SECTION 4. DESIGNATION OF STATE OF PRINCIPAL LICENSE

(a) A physician shall designate a member state as the state of principal license for purposes of registration for expedited licensure through the Compact if the physician possesses a full and unrestricted license to practice medicine in that state, and the state is:

  (1) The state of primary residence for the physician;

  (2) The state where at least 25% of the practice of medicine occurs;

  (3) The location of the physician's employer; or

  (4) If no state qualifies under items (1), (2), or (3), the state designated as state of residence for purpose of federal income tax.

(b) A physician may redesignate a member state as state of principal license at any time, as long as the state meets the requirements in subsection (a).

(c) The Interstate Commission is authorized to develop rules to facilitate redesignation of another member state as the state of principal license.

SECTION 5. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE

(a) A physician seeking licensure through the Compact shall file an application for an expedited license with the member board of the state selected by the physician as the state of principal license.

(b)

  (1) On receipt of an application for an expedited license, the member board within the state selected as the state of principal license shall evaluate whether the physician is eligible for expedited licensure and issue a letter of qualification, verifying or denying the physician's eligibility, to the Interstate Commission.

  (2) Static qualifications, which include verification of medical education, graduate medical education, results of any medical or licensing examination, and other qualifications as determined by the Interstate Commission through rule, may not be subject to additional primary source verification where already primary source verified by the state of principal license.

  (3)

    (i) The member board within the state selected as the state of principal license shall, in the course of verifying eligibility, require the applicant to obtain a criminal background check as required under Sec. 14-308.1 of this title, including the use of the results of fingerprint or other biometric data checks compliant with the requirements of the Federal Bureau of Investigation, with the exception of federal employees who have suitability determination in accordance with U.S. C.F.R. Sec. 731.202.

    (ii) The member board may not disclose to the Interstate Commission any information received from the Federal Bureau of Investigation that is provided in a background check of an applicant performed under this paragraph.

  (4) An appeal on the determination of eligibility shall be made to the member state, if an appeal is allowed under the laws of that state, where the application was filed and shall be subject to the law of that state.

(c) On verification in subsection (b), physicians eligible for an expedited license shall complete the registration process established by the Interstate Commission to receive a license in a member state selected pursuant to subsection (a), including the payment of any applicable fees.

(d) After receiving verification of eligibility under subsection (b) and any fees under subsection (c), a member board shall issue an expedited license to the physician. This license shall authorize the physician to practice medicine in the issuing state consistent with the Medical Practice Act and all applicable laws and regulations of the issuing member board and member state.

(e) An expedited license shall be valid for a period consistent with the licensure period in the member state and in the same manner as required for other physicians holding a full and unrestricted license within the member state.

(f) An expedited license obtained through the Compact shall be terminated if a physician fails to maintain a license in the state of principal license for a nondisciplinary reason, without redesignation of a new state of principal license.

(g) The Interstate Commission is authorized to develop rules regarding the application process, including payment of any applicable fees, and the issuance of an expedited license.

SECTION 6. FEES FOR EXPEDITED LICENSURE

(a) A member state issuing an expedited license authorizing the practice of medicine in that state may impose a fee for a license issued or renewed through the Compact.

(b) The Interstate Commission is authorized to develop rules regarding fees for expedited licenses.

SECTION 7. RENEWAL AND CONTINUED PARTICIPATION

(a) A physician seeking to renew an expedited license granted in a member state shall complete a renewal process with the Interstate Commission if the physician:

  (1) Maintains a full and unrestricted license in a state of principal license;

  (2) Has not been convicted of or received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;

  (3) Has not had a license authorizing the practice of medicine subject to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to nonpayment of fees related to a license; and

  (4) Has not had a controlled substance license or permit suspended or revoked by a state or the United States Drug Enforcement Administration.

(b) Physicians shall comply with all continuing professional development or continuing medical education requirements for renewal of a license issued by a member state and shall attest to the member board about the physician's compliance.

(c) The Interstate Commission shall collect any renewal fees charged for the renewal of a license and distribute the fees to the applicable member board.

(d) On receipt of any renewal fees collected in subsection (c), a member board shall renew the physician's license.

(e) Physician information collected by the Interstate Commission during the renewal process will be distributed to all member boards.

(f) The Interstate Commission is authorized to develop rules to address renewal of licenses obtained through the Compact.

SECTION 8. COORDINATED INFORMATION SYSTEM

(a) The Interstate Commission shall establish a database of all physicians licensed, or who have applied for licensure, under Section 5.

(b) Notwithstanding any other provision of law, member boards shall report to the Interstate Commission any public action or complaints against a licensed physician who has applied or received an expedited license through the Compact.

(c) Member boards shall report disciplinary or investigatory information determined as necessary and proper by rule of the Interstate Commission.

(d) Member boards may report any nonpublic complaint, disciplinary, or investigatory information not required by subsection (c) to the Interstate Commission.

(e) Member boards shall share complaint or disciplinary information about a physician on request of another member board.

(f) All information provided to the Interstate Commission or distributed by member boards shall be confidential, filed under seal, and used only for investigatory or disciplinary matters.

(g) The Interstate Commission is authorized to develop rules for mandated or discretionary sharing of information by member boards.

SECTION 9. JOINT INVESTIGATIONS

(a) Licensure and disciplinary records of physicians are deemed investigative.

(b) In addition to the authority granted to a member board by its respective Medical Practice Act or other applicable state law, a member board may participate with other member boards in joint investigations of physicians licensed by the member boards.

(c) A subpoena issued by a member state shall be enforceable in other member states.

(d) Member boards may share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.

(e) Any member state may investigate actual or alleged violations of the statutes authorizing the practice of medicine in any other member state in which a physician holds a license to practice medicine.

SECTION 10. DISCIPLINARY ACTIONS

(a) Any disciplinary action taken by any member board against a physician licensed through the Compact shall be deemed unprofessional conduct that may be subject to discipline by other member boards, in addition to any violation of the Medical Practice Act or regulations in that state.

(b) If a license granted to a physician by the member board in the state of principal license is revoked, surrendered or relinquished in lieu of discipline, or suspended, then all licenses issued to the physician by member boards shall automatically be placed, without further action necessary by any member board, on the same status. If the member board in the state of principal license subsequently reinstates the physician's license, a license issued to the physician by any other member board shall remain encumbered until that respective member board takes action to reinstate the license in a manner consistent with the Medical Practice Act of that state.

(c) If disciplinary action is taken against a physician by a member board not in the state of principal license, any other member board may deem the action conclusive as to matter of law and fact decided, and:

  (1) Impose the same or lesser sanction(s) against the physician so long as such sanctions are consistent with the Medical Practice Act of that state; or

  (2) Pursue separate disciplinary action against the physician under its respective Medical Practice Act, regardless of the action taken in other member states.

(d) If a license granted to a physician by a member board is revoked, surrendered or relinquished in lieu of discipline, or suspended, then any license(s) issued to the physician by any other member board(s) shall be suspended, automatically and immediately without further action necessary by the other member board(s), for ninety (90) days on entry of the order by the disciplining board, to permit the member board(s) to investigate the basis for the action under the Medical Practice Act of that state. A member board shall waive the automatic suspension of the license it issued unless the member board:

  (1) Finds that the public health, safety, or welfare imperatively requires emergency action; and

  (2) Promptly gives the licensee:

    (i) Written notice of the suspension, the finding, and the reasons that support the finding; and

    (ii) An opportunity to be heard.

    SECTION 11. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION

(a) The member states hereby create the "Interstate Medical Licensure Compact Commission".

(b) The purpose of the Interstate Commission is the administration of the Interstate Medical Licensure Compact, which is a discretionary state function.

(c) The Interstate Commission shall be a body corporate and joint agency of the member states and shall have all the responsibilities, powers, and duties set forth in the Compact, and such additional powers as may be conferred on it by a subsequent concurrent action of the respective legislatures of the member states in accordance with the terms of the Compact.

(d) The Interstate Commission shall consist of two voting representatives appointed by each member state who shall serve as Commissioners. In states where allopathic and osteopathic physicians are regulated by separate member boards, or if the licensing and disciplinary authority is split between multiple member boards within a member state, the member state shall appoint one representative from each member board. A Commissioner shall be:

  (1) An allopathic or osteopathic physician appointed to a member board;

  (2) An executive director, executive secretary, or similar executive of a member board; or

  (3) A member of the public appointed to a member board.

(e) The Interstate Commission shall meet at least once each calendar year. A portion of this meeting shall be a business meeting to address such matters as may properly come before the Commission, including the election of officers. The chairperson may call additional meetings and shall call for a meeting on the request of a majority of the member states.

(f) The bylaws may provide for meetings of the Interstate Commission to be conducted by telecommunication or electronic communication.

(g) Each Commissioner participating at a meeting of the Interstate Commission is entitled to one vote. A majority of Commissioners shall constitute a quorum for the transaction of business, unless a larger quorum is required by the bylaws of the Interstate Commission. A Commissioner shall not delegate a vote to another Commissioner. In the absence of its Commissioner, a member state may delegate voting authority for a specified meeting to another person from that state who shall meet the requirements of subsection (d).

(h) The Interstate Commission shall provide public notice of all meetings and all meetings shall be open to the public. The Interstate Commission may close a meeting, in full or in portion, where it determines by a two-thirds vote of the Commissioners present that an open meeting would be likely to:

  (1) Relate solely to the internal personnel practices and procedures of the Interstate Commission;

  (2) Discuss matters specifically exempted from disclosure by federal statute;

  (3) Discuss trade secrets or commercial or financial information that is privileged or confidential;

  (4) Involve accusing a person of a crime, or formally censuring a person;

  (5) Discuss information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;

  (6) Discuss investigative records compiled for law enforcement purposes; or

  (7) Specifically relate to the participation in a civil action or other legal proceeding.

(i) The Interstate Commission shall keep minutes that shall fully describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, including record of any roll call votes.

(j) The Interstate Commission shall make its information and official records, to the extent not otherwise designated in the Compact or by its rules, available to the public for inspection.

(k) The Interstate Commission shall establish an executive committee, which shall include officers, members, and others as determined by the bylaws. The executive committee shall have the power to act on behalf of the Interstate Commission, with the exception of rulemaking, during periods when the Interstate Commission is not in session. When acting on behalf of the Interstate Commission, the executive committee shall oversee the administration of the Compact including enforcement and compliance with the provisions of the Compact, its bylaws and rules, and other such duties as necessary.

(l) The Interstate Commission may establish other committees for governance and administration of the Compact.

SECTION 12. POWERS AND DUTIES OF THE INTERSTATE COMMISSION

The Interstate Commission shall have the duty and power to:

  (1) Oversee and maintain the administration of the Compact;

  (2) Promulgate rules that shall be binding to the extent and in the manner provided for in the Compact;

  (3) Issue, on the request of a member state or member board, advisory opinions concerning the meaning or interpretation of the Compact, its bylaws, rules, and actions;

  (4) Enforce compliance with Compact provisions, the rules promulgated by the Interstate Commission, and the bylaws, using all necessary and proper means, including but not limited to the use of judicial process;

  (5) Establish and appoint committees including, but not limited to, an executive committee as required by Section 11, which shall have the power to act on behalf of the Interstate Commission in carrying out its powers and duties;

  (6) Pay, or provide for the payment of the expenses related to the establishment, organization, and ongoing activities of the Interstate Commission;

  (7) Establish and maintain one or more offices;

  (8) Borrow, accept, hire, or contract for services of personnel;

  (9) Purchase and maintain insurance and bonds;

  (10) Employ an executive director who shall have such powers to employ, select or appoint employees, agents, or consultants, and to determine their qualifications, define their duties, and fix their compensation;

  (11) Establish personnel policies and programs relating to conflicts of interest, rates of compensation, and qualifications of personnel;

  (12) Accept donations and grants of money, equipment, supplies, materials and services, and to receive, utilize, and dispose of it in a manner consistent with the conflict of interest policies established by the Interstate Commission;

  (13) Lease, purchase, accept contributions or donations of, or otherwise to own, hold, improve or use, any property, real, personal, or mixed;

  (14) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;

  (15) Establish a budget and make expenditures;

  (16) Adopt a seal and bylaws governing the management and operation of the Interstate Commission;

  (17) Report annually to the legislatures and governors of the member states concerning the activities of the Interstate Commission during the preceding year. Such reports shall also include reports of financial audits and any recommendations that may have been adopted by the Interstate Commission;

  (18) Coordinate education, training, and public awareness regarding the Compact, its implementation, and its operation;

  (19) Maintain records in accordance with the bylaws;

  (20) Seek and obtain trademarks, copyrights, and patents; and

  (21) Perform such functions as may be necessary or appropriate to achieve the purposes of the Compact.

  SECTION 13. FINANCE POWERS

(a) The Interstate Commission may levy on and collect an annual assessment from each member state to cover the cost of the operations and activities of the Interstate Commission and its staff. The total assessment must be sufficient to cover the annual budget approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated on a formula to be determined by the Interstate Commission, which shall promulgate a rule binding on all member states.

(b) The Interstate Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same.

(c) The Interstate Commission shall not pledge the credit of any of the member states, except by, and with the authority of, the member state.

(d) The Interstate Commission shall be subject to a yearly financial audit conducted by a certified or licensed public accountant and the report of the audit shall be included in the annual report of the Interstate Commission.

SECTION 14. ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION

(a) The Interstate Commission shall, by a majority of Commissioners present and voting, adopt bylaws to govern its conduct as may be necessary or appropriate to carry out the purposes of the Compact within twelve (12) months of the first Interstate Commission meeting.

(b) The Interstate Commission shall elect or appoint annually from among its Commissioners a chairperson, a vice-chairperson, and a treasurer, each of whom shall have such authority and duties as may be specified in the bylaws. The chairperson, or in the chairperson's absence or disability, the vice-chairperson, shall preside at all meetings of the Interstate Commission.

(c) Officers selected in subsection (b) shall serve without remuneration from the Interstate Commission.

(d)

  (1) The officers and employees of the Interstate Commission shall be immune from suit and liability, either personally or in their official capacity, for a claim for damage to or loss of property or personal injury or other civil liability caused or arising out of, or relating to, an actual or alleged act, error, or omission that occurred, or that such person had a reasonable basis for believing occurred, within the scope of Interstate Commission employment, duties, or responsibilities; provided that such person shall not be protected from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person.

  (2) The liability of the executive director and employees of the Interstate Commission or representatives of the Interstate Commission, acting within the scope of such person's employment or duties for acts, errors, or omissions occurring within such person's state, may not exceed the limits of liability set forth under the constitution and laws of that state for state officials, employees, and agents. The Interstate Commission is considered to be an instrumentality of the states for the purposes of any such action. Nothing in this subsection shall be construed to protect such person from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person.

  (3) The Interstate Commission shall defend the executive director, its employees, and subject to the approval of the attorney general or other appropriate legal counsel of the member state represented by an Interstate Commission representative, shall defend such Interstate Commission representative in any civil action seeking to impose liability arising out of an actual or alleged act, error, or omission that occurred within the scope of Interstate Commission employment, duties, or responsibilities, or that the defendant had a reasonable basis for believing occurred within the scope of Interstate Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such person.

  (4) To the extent not covered by the state involved, member state, or the Interstate Commission, the representatives or employees of the Interstate Commission shall be held harmless in the amount of a settlement or judgment, including attorney's fees and costs, obtained against such persons arising out of an actual or alleged act, error, or omission that occurred within the scope of Interstate Commission employment, duties, or responsibilities, or that such persons had a reasonable basis for believing occurred within the scope of Interstate Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such persons.

  SECTION 15. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION

(a) The Interstate Commission shall promulgate reasonable rules in order to effectively and efficiently achieve the purposes of the Compact. Notwithstanding the foregoing, in the event the Interstate Commission exercises its rulemaking authority in a manner that is beyond the scope of the purposes of the Compact, or the powers granted hereunder, then such an action by the Interstate Commission shall be invalid and have no force or effect.

(b) Rules deemed appropriate for the operations of the Interstate Commission shall be made pursuant to a rulemaking process that substantially conforms to the "Model State Administrative Procedure Act" of 2010, and subsequent amendments thereto.

(c) Not later than thirty (30) days after a rule is promulgated, any person may file a petition for judicial review of the rule in the United States District Court for the District of Columbia or the federal district where the Interstate Commission has its principal offices, provided that the filing of such a petition shall not stay or otherwise prevent the rule from becoming effective unless the court finds that the petitioner has a substantial likelihood of success. The court shall give deference to the actions of the Interstate Commission consistent with applicable law and shall not find the rule to be unlawful if the rule represents a reasonable exercise of the authority granted to the Interstate Commission.

SECTION 16. OVERSIGHT OF INTERSTATE COMPACT

(a) The executive, legislative, and judicial branches of state government in each member state shall enforce the Compact and shall take all actions necessary and appropriate to effectuate the Compact's purposes and intent. The provisions of the Compact and the rules promulgated hereunder shall have standing as statutory law but shall not override existing state authority to regulate the practice of medicine.

(b) All courts shall take judicial notice of the Compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of the Compact that may affect the powers, responsibilities, or actions of the Interstate Commission.

(c) The Interstate Commission shall be entitled to receive all service of process in any such proceeding, and shall have standing to intervene in the proceeding for all purposes. Failure to provide service of process to the Interstate Commission shall render a judgment or an order void as to the Interstate Commission, the Compact, or promulgated rules.

SECTION 17. ENFORCEMENT OF INTERSTATE COMPACT

(a) The Interstate Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of the Compact.

(b) The Interstate Commission may, by majority vote of the Commissioners, initiate legal action in the United States District Court for the District of Columbia, or, at the discretion of the Interstate Commission, in the federal district where the Interstate Commission has its principal offices, to enforce compliance with the provisions of the Compact, and its promulgated rules and bylaws, against a member state in default. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation including reasonable attorney's fees.

(c) The remedies herein shall not be the exclusive remedies of the Interstate Commission. The Interstate Commission may avail itself of any other remedies available under state law or the regulation of a profession.

SECTION 18. DEFAULT PROCEDURES

(a) The grounds for default include, but are not limited to, failure of a member state to perform such obligations or responsibilities imposed on it by the Compact, or the rules and bylaws of the Interstate Commission promulgated under the Compact.

(b) If the Interstate Commission determines that a member state has defaulted in the performance of its obligations or responsibilities under the Compact, or the bylaws or promulgated rules, the Interstate Commission shall:

  (1) Provide written notice to the defaulting state and other member states, of the nature of the default, the means of curing the default, and any action taken by the Interstate Commission. The Interstate Commission shall specify the conditions by which the defaulting state must cure its default; and

  (2) Provide remedial training and specific technical assistance regarding the default.

(c) If the defaulting state fails to cure the default, the defaulting state shall be terminated from the Compact on an affirmative vote of a majority of the Commissioners and all rights, privileges, and benefits conferred by the Compact shall terminate on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of the default.

(d) Termination of membership in the Compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to terminate shall be given by the Interstate Commission to the governor, the majority and minority leaders of the defaulting state's legislature, and each of the member states.

(e) The Interstate Commission shall establish rules and procedures to address licenses and physicians that are materially impacted by the termination of a member state, or the withdrawal of a member state.

(f) The member state that has been terminated is responsible for all dues, obligations, and liabilities incurred through the effective date of termination including obligations, the performance of which extends beyond the effective date of termination.

(g) The Interstate Commission may not bear any costs relating to any state that has been found to be in default or that has been terminated from the Compact, unless otherwise mutually agreed on in writing between the Interstate Commission and the defaulting state.

(h) The defaulting state may appeal the action of the Interstate Commission by petitioning the United States District Court for the District of Columbia or the federal district where the Interstate Commission has its principal offices. The prevailing party shall be awarded all costs of such litigation including reasonable attorney's fees.

SECTION 19. DISPUTE RESOLUTION

(a) The Interstate Commission shall attempt, on the request of a member state, to resolve disputes that are subject to the Compact and that may arise among member states or member boards.

(b) The Interstate Commission shall promulgate rules providing for both mediation and binding dispute resolution as appropriate.

SECTION 20. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT

(a) Any state is eligible to become a member state of the Compact.

(b) The Compact shall become effective and binding on legislative enactment of the Compact into law by no less than seven (7) states. Thereafter, it shall become effective and binding on a state on enactment of the Compact into law by that state.

(c) The governors of nonmember states, or their designees, shall be invited to participate in the activities of the Interstate Commission on a nonvoting basis prior to adoption of the Compact by all states.

(d) The Interstate Commission may propose amendments to the Compact for enactment by the member states. No amendment shall become effective and binding on the Interstate Commission and the member states unless and until it is enacted into law by unanimous consent of the member states.

SECTION 21. WITHDRAWAL

(a) Once effective, the Compact shall continue in force and remain binding on each and every member state; provided that a member state may withdraw from the Compact by specifically repealing the statute that enacted the Compact into law.

(b) Withdrawal from the Compact shall be by the enactment of a statute repealing the same, but may not take effect until one (1) year after the effective date of such statute and until written notice of the withdrawal has been given by the withdrawing state to the governor of each other member state.

(c) The withdrawing state shall immediately notify the chairperson of the Interstate Commission in writing on the introduction of legislation repealing the Compact in the withdrawing state.

(d) The Interstate Commission shall notify the other member states of the withdrawing state's intent to withdraw within sixty (60) days of its receipt of notice provided under subsection (c).

(e) The withdrawing state is responsible for all dues, obligations, and liabilities incurred through the effective date of withdrawal, including obligations, the performance of which extend beyond the effective date of withdrawal.

(f) Reinstatement following withdrawal of a member state shall occur on the withdrawing state reenacting the Compact or on such later date as determined by the Interstate Commission.

(g) The Interstate Commission is authorized to develop rules to address the impact of the withdrawal of a member state on licenses granted in other member states to physicians who designated the withdrawing member state as the state of principal license.

SECTION 22. DISSOLUTION

(a) The Compact shall dissolve effective on the date of the withdrawal or default of the member state that reduces the membership in the Compact to one (1) member state.

(b) On the dissolution of the Compact, the Compact becomes null and void and shall be of no further force or effect, and the business and affairs of the Interstate Commission shall be concluded and surplus funds shall be distributed in accordance with the bylaws.

SECTION 23. SEVERABILITY AND CONSTRUCTION

(a) The provisions of the Compact shall be severable, and if any phrase, clause, sentence, or provision is deemed unenforceable, the remaining provisions of the Compact shall be enforceable.

(b) The provisions of the Compact shall be liberally construed to effectuate its purposes.

(c) Nothing in the Compact shall be construed to prohibit the applicability of other interstate compacts to which the states are members.

SECTION 24. BINDING EFFECT OF COMPACT AND OTHER LAWS

(a) Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the Compact.

(b) All laws in a member state in conflict with the Compact are superseded to the extent of the conflict.

(c) All lawful actions of the Interstate Commission, including all rules and bylaws promulgated by the Commission, are binding on the member states.

(d) All agreements between the Interstate Commission and the member states are binding in accordance with their terms.

(e) In the event any provision of the Compact exceeds the constitutional limits imposed on the legislature of any member state, such provision shall be ineffective to the extent of the conflict with the constitutional provision in question in that member state.

#### Section 14-3A-02

(a)

  (1) The Board shall set fees for the issuance and renewal of licenses under the Interstate Medical Licensure Compact established under Sec. 14-3A-01 of this subtitle.

  (2) The fees charged to a compact physician under paragraph (1) of this subsection shall be set so as to produce funds adequate to cover the cost of maintaining the licensure program.

(b) Any annual assessment levied by the Interstate Commission under Section 13(a) of the Interstate Medical Licensure Compact established under Sec. 14-3A-01 of this subtitle shall be funded through an additional surcharge on:

  (1) Each compact physician licensed under Section 3 of the Interstate Medical Licensure Compact established under Sec. 14-3A-01 of this subtitle; and

  (2) Physicians who designate Maryland as the physician's state of principal license under Section 4 of the Interstate Medical Licensure Compact established under Sec. 14-3A-01 of this subtitle.

### Subtitle 4. Disciplinary Actions

#### Section 14-401

(a) There are two disciplinary panels responsible for resolving allegations of violations of this title and Title 15 of this article.

(b)

  (1) The chair of the Board shall assign each member of the Board to one of the disciplinary panels established under subsection (a) of this section.

  (2) Each disciplinary panel shall consist of 11 Board members.

  (3) Of the 11 members on a disciplinary panel:

    (i) 6 shall be practicing licensed physicians;

    (ii) 1 shall be a practicing licensed physician with a full-time faculty appointment;

    (iii) 1 shall be a representative of the Department or a licensed physician assistant; and

    (iv) 3 shall be members of the public.

  (4) The chair of the Board may serve as an ex-officio member of the disciplinary panel to which the chair was not assigned as a member under paragraph (1) of this subsection.

  (5) The chair of the Board shall select a member of each disciplinary panel to be the chair of the disciplinary panel.

  (6) A quorum of a disciplinary panel consists of 7 members.

#### Section 14-401.1

(a)

  (1) The Board shall perform any necessary preliminary investigation regarding an allegation of grounds for disciplinary or other action brought to the Board's attention before the allegation is assigned to a disciplinary panel.

  (2)

    (i) After the completion of any necessary preliminary investigation under paragraph (1) of this subsection, a complaint shall be assigned to a disciplinary panel.

    (ii) Subject to the provisions of this section, a disciplinary panel:

      (1) Shall determine the final disposition of a complaint against a physician or an allied health professional; and

      (2) Has the independent authority to make a determination regarding the final disposition of a complaint.

    (iii) The Board may not vote to approve or disapprove any action taken by a disciplinary panel, including the final disposition of a complaint.

  (3) A disciplinary panel that is assigned a complaint under paragraph (2)(i) of this subsection may:

    (i) Conduct any additional investigation into a complaint that is deemed necessary to determine whether a violation of this title or Title 15 of this article has occurred; and

    (ii) Enter into a consent order with a physician or an allied health professional after conducting a meeting between the disciplinary panel and the physician or allied health professional to discuss any proposed disposition of the complaint.

  (4) A disciplinary panel that is assigned a complaint against an allied health professional under paragraph (2)(i) of this subsection shall consult with the chair of the appropriate allied health advisory committee, or the chair's designee, before taking disciplinary action against the allied health professional.

  (5)

    (i) If a complaint proceeds to a hearing under Sec. 14-405 of this subtitle, Sec. 14-5A-17, Sec. 14-5B-14, Sec. 14-5C-17, Sec. 14-5D-15, Sec. 14-5E-16, Sec. 14-5F-21, or Sec. 14-5G-18 of this title, or Sec. 15-315 of this article, the chair of the disciplinary panel that was assigned the complaint under paragraph (2)(i) of this subsection shall refer the complaint to the Office of Administrative Hearings.

    (ii) If the disciplinary panel rescinds its referral of the complaint to the Office of Administrative Hearings, the complaint will return to the original disciplinary panel that was assigned the complaint under paragraph (2)(i) of this subsection.

    (iii) After an evidentiary hearing at the Office of Administrative Hearings, the chair of the original disciplinary panel that was assigned the complaint under paragraph (2)(i) of this subsection shall refer the complaint to the other disciplinary panel for further action.

    (iv) After an evidentiary hearing at the Office of Administrative Hearings, the original disciplinary panel that was assigned the complaint under paragraph (2)(i) of this subsection, or any of its members, may not:

      (1) Continue to handle the complaint;

      (2) Participate in any disciplinary proceedings regarding the complaint; or

      (3) Determine the final disposition of the complaint.

(b) If an allegation of grounds for disciplinary or other action is made by a patient or a family member of a patient based on Sec. 14-404(a)(22) of this subtitle and a full investigation results from that allegation, the full investigation shall include an offer of an interview with the patient or a family member of the patient who was present on or about the time that the incident that gave rise to the allegation occurred.

(c)

  (1) Except as otherwise provided in this subsection, after being assigned a complaint under subsection (a) of this section, the disciplinary panel may:

    (i) Refer an allegation for further investigation to the entity that has contracted with the Board under subsection (e) of this section; or

    (ii) Take any appropriate and immediate action as necessary.

  (2)

    (i) If, after being assigned a complaint and completing the preliminary investigation, the disciplinary panel finds that the licensee may have violated Sec. 14-404(a)(22) of this subtitle, the disciplinary panel shall refer the allegation to the entity or entities that have contracted with the Board under subsection (e) of this section for further investigation and physician peer review within the involved medical specialty or specialties.

    (ii) A disciplinary panel shall obtain two peer review reports from the entity or individual with whom the Board contracted under subsection (e) of this section for each allegation the disciplinary panel refers for peer review.

  (3) If, after being assigned a complaint, the disciplinary panel determines that an allegation involving fees for professional or ancillary services does not constitute grounds for disciplinary or other action, the disciplinary panel shall offer the complainant and the licensee an opportunity to mediate the dispute.

(d) County medical societies shall refer to the Board all complaints that set forth allegations of grounds for disciplinary action under Sec. 14-404 of this subtitle.

(e)

  (1) In accordance with subsection (f) of this section, the Board shall enter into a written contract with an entity or individual for confidential physician peer review of allegations based on Sec. 14-404(a)(22) of this subtitle.

  (2) A peer reviewer shall:

    (i) Be board certified;

    (ii) Have special qualifications to judge the matter at hand;

    (iii) Have received a specified amount of medical experience and training;

    (iv) Have no formal actions against the peer reviewer's own license;

    (v) Receive training in peer review;

    (vi) Have a standard format for peer review reports; and

    (vii) To the extent practicable, be licensed and engaged in the practice of medicine in the State.

  (3) The Board may consult with the appropriate specialty health care provider societies in the State to obtain a list of physicians qualified to provide peer review services.

  (4) For purposes of peer review, the Board may use sole source procurement under Sec. 13-107 of the State Finance and Procurement Article.

  (5) The hearing of charges may not be stayed or challenged because of the selection of peer reviewers under this subsection before the filing of charges.

(f)

  (1) The entity or individual peer reviewer with which the Board contracts under subsection (e) of this section shall have 60 days for completion of peer review.

  (2) The entity or individual peer reviewer may apply to the Board for an extension of up to 20 days to the time limit imposed under paragraph (1) of this subsection.

  (3) If an extension is not granted, and 60 days have elapsed, the Board may contract with any other entity or individual who meets the requirements of subsection (e)(2) of this section for the services of peer review.

  (4) If an extension has been granted, and 80 days have elapsed, the Board may contract with any other entity or individual who meets the requirements of subsection (e)(2) of this section for the services of peer review.

(g) The Board shall issue a request for proposals and enter into a written contract with a nonprofit entity to provide rehabilitation services for physicians or other allied health professionals directed by the Board to receive rehabilitation services.

(h)

  (1) To facilitate the investigation and prosecution of disciplinary matters and the mediation of fee disputes coming before it, the Board may contract with an entity or entities for the purchase of investigatory, mediation, and related services.

  (2) Services that may be contracted for under this subsection include the services of:

    (i) Investigators;

    (ii) Attorneys;

    (iii) Accountants;

    (iv) Expert witnesses;

    (v) Consultants; and

    (vi) Mediators.

(i) The Board or a disciplinary panel may issue subpoenas and administer oaths in connection with any investigation under this section and any hearing or proceeding before it.

(j)

  (1) It is the intent of this section that the disposition of every complaint against a licensee that sets forth allegations of grounds for disciplinary action filed with the Board shall be completed as expeditiously as possible and, in any event, within 18 months after the complaint was received by the Board.

  (2) If a disciplinary panel is unable to complete the disposition of a complaint within 1 year, the Board shall include in the record of that complaint a detailed explanation of the reason for the delay.

(k) A disciplinary panel, in conducting a meeting with a physician or allied health professional to discuss the proposed disposition of a complaint, shall provide an opportunity to appear before the disciplinary panel to both the licensee who has been charged and the individual who has filed the complaint against the licensee giving rise to the charge.

#### Section 14-402

(a) In reviewing an application for licensure or in investigating an allegation brought against a licensed physician or any allied health professional regulated by the Board under this title or Title 15 of this article, the Rehabilitation Program may request the Board to direct, or the Board or a disciplinary panel on its own initiative may direct, the licensed physician or any allied health professional regulated by the Board under this title or Title 15 of this article to submit to an appropriate examination.

(b) In return for the privilege given by the State issuing a license, certification, or registration, the licensed, certified, or registered individual is deemed to have:

  (1) Consented to submit to an examination under this section, if requested by the Board in writing; and

  (2) Waived any claim of privilege as to the testimony or examination reports.

(c) The unreasonable failure or refusal of the applicant or licensee to submit to an examination is prima facie evidence of the applicant's or licensee's inability to practice medicine or the respective discipline competently, unless the Board or disciplinary panel finds that the failure or refusal was beyond the control of the applicant or licensee.

(d) The Board shall pay the costs of any examination made under this section for:

  (1) A licensee; or

  (2) An applicant who was not previously licensed by the Board.

(e) An applicant for reinstatement shall pay the cost of any examination directed by the Board under this section.

(f) The Rehabilitation Program is subject to audit by the Legislative Auditor as provided in Sec. 2-1220 of the State Government Article.

#### Section 14-403

(a) Unless a disciplinary panel agrees to accept the surrender of a license, certification, or registration of an individual the Board regulates, the individual may not surrender the license, certification, or registration nor may the license, certification, or registration lapse by operation of law for purposes of investigation or discipline while the individual is under investigation or while charges are pending.

(b) A disciplinary panel may set conditions on its agreement to accept surrender of a license, certification, or registration.

#### Section 14-404

(a) Subject to the hearing provisions of Sec. 14-405 of this subtitle, a disciplinary panel, on the affirmative vote of a majority of the quorum of the disciplinary panel, may reprimand any licensee, place any licensee on probation, or suspend or revoke a license if the licensee:

  (1) Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or licensee or for another;

  (2) Fraudulently or deceptively uses a license;

  (3) Is guilty of:

    (i) Immoral conduct in the practice of medicine; or

    (ii) Unprofessional conduct in the practice of medicine;

  (4) Is:

    (i) Professionally incompetent;

    (ii) Physically incompetent; or

    (iii) Mentally incompetent;

  (5) Solicits or advertises in violation of Sec. 14-503 of this title;

  (6) Abandons a patient;

  (7) Habitually is intoxicated;

  (8) Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article;

  (9) Provides professional services:

    (i) While under the influence of alcohol; or

    (ii) While using any narcotic or controlled dangerous substance, as defined in Sec. 5-101 of the Criminal Law Article, or other drug that is in excess of therapeutic amounts or without valid medical indication;

  (10) Promotes the sale of drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

  (11) Willfully makes or files a false report or record in the practice of medicine;

  (12) Willfully fails to file or record any medical report as required under law, willfully impedes or obstructs the filing or recording of the report, or induces another to fail to file or record the report;

  (13) On proper request, and in accordance with the provisions of Title 4, Subtitle 3 of the Health - General Article, fails to provide details of a patient's medical record to the patient, another physician, or hospital;

  (14) Solicits professional patronage through an agent or other person or profits from the acts of a person who is represented as an agent of the physician;

  (15) Pays or agrees to pay any sum to any person for bringing or referring a patient or accepts or agrees to accept any sum from any person for bringing or referring a patient;

  (16) Agrees with a clinical or bioanalytical laboratory to make payments to the laboratory for a test or test series for a patient, unless the licensed physician discloses on the bill to the patient or third-party payor:

    (i) The name of the laboratory;

    (ii) The amount paid to the laboratory for the test or test series; and

    (iii) The amount of procurement or processing charge of the licensed physician, if any, for each specimen taken;

  (17) Makes a willful misrepresentation in treatment;

  (18) Practices medicine with an unauthorized person or aids an unauthorized person in the practice of medicine;

  (19) Establishes a pattern of excessive or medically unnecessary procedures or treatment;

  (20) Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine;

  (21) Is disciplined by a licensing or disciplinary authority or convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (22) Fails to meet appropriate standards as determined by appropriate peer review for the delivery of quality medical and surgical care performed in an outpatient surgical facility, office, hospital, or any other location in this State;

  (23) Willfully submits false statements to collect fees for which services are not provided;

  (24) Was subject to investigation or disciplinary action by a licensing or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under this section and the licensee:

    (i) Surrendered the license issued by the state or country to the state or country; or

    (ii) Allowed the license issued by the state or country to expire or lapse;

  (25) Willfully fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

  (26) Fails to educate a patient being treated for breast cancer of alternative methods of treatment as required by Sec. 20-113 of the Health - General Article;

  (27) Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes;

  (28) Fails to comply with the provisions of Sec. 12-102 of this article;

  (29) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

  (30) Except as to an association that has remained in continuous existence since July 1, 1963:

    (i) Associates with a pharmacist as a partner or co-owner of a pharmacy for the purpose of operating a pharmacy;

    (ii) Employs a pharmacist for the purpose of operating a pharmacy; or

    (iii) Contracts with a pharmacist for the purpose of operating a pharmacy;

  (31) Except in an emergency life-threatening situation where it is not feasible or practicable, fails to comply with the Centers for Disease Control and Prevention's guidelines on universal precautions;

  (32) Fails to display the notice required under Sec. 14-415 of this subtitle;

  (33) Fails to cooperate with a lawful investigation conducted by the Board or a disciplinary panel;

  (34) Is convicted of insurance fraud as defined in Sec. 27-801 of the Insurance Article;

  (35) Is in breach of a service obligation resulting from the applicant's or licensee's receipt of State or federal funding for the licensee's medical education;

  (36) Willfully makes a false representation when seeking or making application for licensure or any other application related to the practice of medicine;

  (37) Intimidates or influences, or attempts to intimidate or influence, for the purpose of causing any person to withhold or change testimony in hearings or proceedings before the Board or a disciplinary panel or those otherwise delegated to the Office of Administrative Hearings;

  (38) Willfully hinders, prevents, or otherwise delays any person from making information available to the Board or a disciplinary panel in furtherance of any investigation of the Board or a disciplinary panel;

  (39) Intentionally misrepresents credentials for the purpose of testifying or rendering an expert opinion in hearings or proceedings before the Board or a disciplinary panel or those otherwise delegated to the Office of Administrative Hearings;

  (40) Fails to keep adequate medical records as determined by appropriate peer review;

  (41) Performs a cosmetic surgical procedure in an office or a facility that is not:

    (i) Accredited by:

      (1) The American Association for Accreditation of Ambulatory Surgical Facilities;

      (2) The Accreditation Association for Ambulatory Health Care; or

      (3) The Joint Commission on the Accreditation of Healthcare Organizations; or

    (ii) Certified to participate in the Medicare program, as enacted by Title XVIII of the Social Security Act;

  (42) Fails to complete a criminal history records check under Sec. 14-308.1 of this title;

  (43) Except for the licensure process described under Subtitle 3A of this title, violates any provision of this title, any rule or regulation adopted by the Board, or any State or federal law pertaining to the practice of medicine;

  (44) Fails to meet the qualifications for licensure under Subtitle 3 of this title;

  (45) Fails to comply with Sec. 1-223 of this article;

  (46) Fails to comply with the requirements of the Prescription Drug Monitoring Program under Title 21, Subtitle 2A of the Health - General Article; or

  (47) Willfully makes a misrepresentation to a disciplinary panel.

(b)

  (1) On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a license if the licensee is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

  (2) After completion of the appellate process if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a license on the certification by the Office of the Attorney General.

(c)

  (1) Except as provided in paragraph (2) of this subsection, a disciplinary panel may not reprimand, place on probation, or suspend or revoke a license of a licensee for providing a patient with a written statement, medical records, or testimony that, in the licensee's professional opinion, the patient is likely to receive therapeutic or palliative relief from cannabis.

  (2) Nothing in this subsection shall be deemed to release a licensee from the duty to exercise a professional standard of care when evaluating a patient's medical condition.

(d)

  (1) If, after a hearing under Sec. 14-405 of this subtitle, a disciplinary panel finds that there are grounds under subsection (a) of this section to suspend or revoke a license, to reprimand a licensee, or to place a licensee on probation, the disciplinary panel may impose a fine subject to the Board's regulations in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

  (2) The Board shall pay any fines collected under this section into the General Fund of the State.

(e) In addition to any sanction authorized under this section, a disciplinary panel may require a licensee to comply with specified terms and conditions determined by the disciplinary panel.

#### Section 14-405

(a) Except as otherwise provided in the Administrative Procedure Act, before the Board or a disciplinary panel takes any action under Sec. 14-404(a) of this subtitle or Sec. 14-205(b)(3), Sec. 14-5A-17(a), Sec. 14-5B-14(a), Sec. 14-5C-17(a), Sec. 14-5D-14(a), Sec. 14-5E-16(a), Sec. 14-5F-18, or Sec. 14-5G-18(a) of this title, it shall give the individual against whom the action is contemplated an opportunity for a hearing before a hearing officer.

(b)

  (1) The hearing officer shall give notice and hold the hearing in accordance with the Administrative Procedure Act.

  (2) Factual findings shall be supported by a preponderance of the evidence.

(c) The individual may be represented at the hearing by counsel.

(d) If after due notice the individual against whom the action is contemplated fails or refuses to appear, nevertheless the hearing officer may hear and refer the matter to the Board or a disciplinary panel for disposition.

(e) After performing any necessary hearing under this section, the hearing officer shall refer proposed factual findings to the Board or a disciplinary panel for the Board's or disciplinary panel's disposition.

(f) The Board may adopt regulations to govern the taking of depositions and discovery in the hearing of charges.

(g) The hearing of charges may not be stayed or challenged by any procedural defects alleged to have occurred prior to the filing of charges.

#### Section 14-406

(a) Following the filing of charges, if a majority of the quorum of a disciplinary panel finds that there are grounds for action under Sec. 14-404 of this subtitle, the disciplinary panel shall pass an order in accordance with the Administrative Procedure Act.

(b) After the charges are filed, if a disciplinary panel finds, on an affirmative vote of a majority of its quorum, that there are no grounds for action under Sec. 14-404 of this subtitle, the disciplinary panel:

  (1) Immediately shall dismiss the charges and exonerate the licensee;

  (2)

    (i) Except as provided in item (ii) of this item, shall expunge all records of the charges 3 years after the charges are dismissed; or

    (ii) If the physician executes a document releasing the Board from any liability related to the charges, shall immediately expunge all records of the charges; and

  (3) May not take any further action on the charges.

#### Section 14-407

(a) An order of suspension or revocation is effective, in accordance with its terms and conditions, as soon as a disciplinary panel files it under this title.

(b) The Board shall keep a copy of the order of suspension or revocation as a permanent record.

#### Section 14-408

(a) Any person aggrieved by a final decision of the Board or a disciplinary panel in a contested case, as defined in the Administrative Procedure Act, may take a direct judicial appeal as provided in the Administrative Procedure Act.

(b) An order of the Board or a disciplinary panel may not be stayed pending review.

(c) The Board may appeal from any decision that reverses or modifies an order of the Board or a disciplinary panel.

#### Section 14-409

(a)

  (1) Except as provided in subsection (b) of this section, a disciplinary panel may reinstate the license of an individual whose license has been surrendered or revoked under this title only in accordance with:

    (i) The terms and conditions of the order of revocation or letter of surrender;

    (ii) An order of reinstatement issued by the disciplinary panel; or

    (iii) A final judgment in any proceeding for review.

  (2) If a license is surrendered or revoked for a period of more than 1 year, a disciplinary panel may reinstate the license after 1 year if the licensee:

    (i) Meets the requirements for reinstatement as established by the Board; and

    (ii) Completes a criminal history records check in accordance with Sec. 14-308.1 of this title.

(b) An individual whose license has been surrendered or revoked under this title and who seeks reinstatement shall meet the continuing medical education requirements established for the renewal of licenses as if the individual were licensed during the period of surrender or revocation.

(c) If an order of revocation is based on Sec. 14-404(b) of this subtitle, and the conviction or plea subsequently is overturned at any stage of an appeal or other postconviction proceeding, the revocation ends when the conviction or plea is overturned.

#### Section 14-410

(a) Except by the express stipulation and consent of all parties to a proceeding before the Board, a disciplinary panel, or any of its other investigatory bodies, in a civil or criminal action:

  (1) The proceedings, records, or files of the Board, a disciplinary panel, or any of its other investigatory bodies are not discoverable and are not admissible in evidence; and

  (2) Any order passed by the Board or disciplinary panel is not admissible in evidence.

(b) This section does not apply to a civil action brought by a party to a proceeding before the Board or a disciplinary panel who claims to be aggrieved by the decision of the Board or the disciplinary panel.

(c) If any medical or hospital record or any other exhibit is subpoenaed and otherwise is admissible in evidence, the use of that record or exhibit in a proceeding before the Board, a disciplinary panel, or any of its other investigatory bodies does not prevent its production in any other proceeding.

#### Section 14-411

(a) In this section, "record" means the proceedings, records, or files of the Board or a disciplinary panel.

(b) Except as otherwise expressly provided in this section and Sec. 14-411.1 of this subtitle, the Board, a disciplinary panel, or any of its other investigatory bodies may not disclose any information contained in a record.

(c) This section may not be construed to prevent or limit the disclosure of:

  (1) General licensure, certification, or registration information maintained by the Board, if the request for release complies with the criteria of Sec. 4-333 of the General Provisions Article;

  (2) Profile information collected and disseminated under Sec. 14-411.1 of this subtitle; or

  (3) Personal and other identifying information of a licensee, as required by the National Practitioner Data Bank for participation in the proactive disclosure service.

(d) The Board shall disclose any information contained in a record to:

  (1) A committee of a hospital, health maintenance organization, or related institution if:

    (i) The committee of a medical hospital staff concerned with licensee discipline or other committee of a hospital, health maintenance organization, or related institution requests the information in writing;

    (ii) A disciplinary panel has issued an order as to a licensee on whom the information is requested; and

    (iii) The Board determines that the information requested is necessary for an investigation or action of the committee as to a medical privilege of a licensee; or

  (2) The Secretary, the Office of Health Care Quality in the Department, the Maryland Health Care Commission, or the Health Services Cost Review Commission for the purpose of investigating quality or utilization of care in any entity regulated by the Office of Health Care Quality or the Health Services Cost Review Commission.

(e) Subsection (d)(2) of this section may not be construed to alter the authority of the Secretary under Sec. 1-203(a) of this article or Sec. 2-106(c) of the Health - General Article.

(f)

  (1) The Board shall notify all hospitals, health maintenance organizations, or other health care facilities where a licensee has privileges, has a provider contract with a health maintenance organization, or is employed of a complaint or report filed against that licensee, if:

    (i) The Board determines, in its discretion, that the hospital, health maintenance organization, or health care facility should be informed about the report or complaint;

    (ii) The nature of the complaint suggests a reasonable possibility of an imminent threat to patient safety; or

    (iii) The complaint or report was as a result of a claim filed in the Health Care Alternative Dispute Resolution Office and a certificate of a qualified expert is filed in accordance with Sec. 3-2A-04(b)(1) of the Courts Article.

  (2) The Board shall disclose any information pertaining to a licensee's competency to practice under the license contained in record to a committee of a hospital, health maintenance organization, or other health care facility if:

    (i) The committee is concerned with licensee discipline and requests the information in writing; and

    (ii) The Board has received a complaint or report pursuant to paragraph (1)(i) and (ii) of this subsection on the licensee on whom the information is requested.

  (3) The Board shall, after formal action is taken pursuant to Sec. 14-406 of this subtitle, notify those hospitals, health maintenance organizations, or health care facilities where the licensee has privileges, has a provider contract with a health maintenance organization, or is employed of its formal action within 10 days after the action is taken and shall provide the hospital, health maintenance organization, or health care facility with periodic reports as to enforcement or monitoring of a formal disciplinary order against a licensee within 10 days after receipt of those reports.

(g) On the request of a person who has made a complaint to the Board regarding a licensee, the Board shall provide the person with information on the status of the complaint.

(h) Following the filing of charges or notice of initial denial of license application, the Board shall disclose the filing to the public on the Board's website.

(i) The Board may disclose any information contained in a record to a licensing or disciplinary authority of another state if:

  (1) The licensing or disciplinary authority of another state that regulates licensees in that state requests the information in writing; and

  (2) The disclosure of any information is limited to the pendency of an allegation of a ground for disciplinary or other action by a disciplinary panel until:

    (i) The disciplinary panel has passed an order under Sec. 14-406 of this subtitle; or

    (ii) A licensee on whom the information is requested authorizes a disclosure as to the facts of an allegation or the results of an investigation before the Board.

(j) The Board may disclose any information contained in a record to a person if:

  (1) A licensee on whom any information is requested authorizes the person to receive the disclosure;

  (2) The person requests the information in writing; and

  (3) The authorization for the disclosure is in writing.

(k) The Board may disclose any information contained in a record to the State Medical Assistance Compliance Administration, the Secretary of the U.S. Department of Health and Human Services or the Secretary's designee, or any health occupational regulatory board if:

  (1)

    (i) The State Medical Assistance Compliance Administration or any health occupational regulatory board requests the information in writing; or

    (ii) The Secretary of the U.S. Department of Health and Human Services or the Secretary's designee is entitled to receive the information or have access to the information under 42 U.S.C. Sec. 1396r-2;

  (2)

    (i) A disciplinary panel has issued an order under Sec. 14-406 of this subtitle; or

    (ii) An allegation is pending before the Board or a disciplinary panel; and

  (3) The Board determines that the requested information is necessary for the proper conduct of the business of that administration or board.

(l) If the Board or a disciplinary panel determines that the information contained in a record concerns possible criminal activity, the Board or the disciplinary panel shall disclose the information to a law enforcement or prosecutorial official.

(m) The Board may permit inspection of records for which inspection otherwise is not authorized by a person who is engaged in a research project if:

  (1) The researcher submits to the executive director and the Board approves a written request that:

    (i) Describes the purpose of the research project;

    (ii) Describes the intent, if any, to publish the findings;

    (iii) Describes the nature of the requested personal records;

    (iv) Describes the safeguards that the researcher would take to protect the identity of the persons in interest; and

    (v) States that persons in interest will not be contacted unless the executive director approves and monitors the contact;

  (2) The executive director is satisfied that the proposed safeguards will prevent the disclosure of the identity of persons in interest; and

  (3) The researcher makes an agreement with the executive director that:

    (i) Defines the scope of the research project;

    (ii) Sets out the safeguards for protecting the identity of the persons in interest; and

    (iii) States that a breach of any condition of the agreement is a breach of contract.

(n) On the request of a person who has testified in a Board or Office of Administrative Hearings proceeding, the Board shall provide to the person who testified a copy of the portion of the transcript of that person's testimony.

(o)

  (1) The Board may publish a summary of any allegations of grounds for disciplinary or other action.

  (2) A summary may not identify:

    (i) Any person who makes an allegation to the Board or any of its investigatory bodies;

    (ii) A licensee about whom an allegation is made; or

    (iii) A witness in an investigation or a proceeding before the Board or any of its investigatory bodies.

(p) The Board shall disclose information in a record upon the request of the Governor, Secretary, or Legislative Auditor, in accordance with Sec. 2-1223(a) of the State Government Article. However, the Governor, Secretary, or Auditor, or any of their employees may not disclose personally identifiable information from any of these records which are otherwise confidential by law.

(q) This section does not apply to:

  (1) Any disclosure of a record by the Board to a disciplinary panel or any of its other investigatory bodies; or

  (2) A licensee, certificate holder, or registration holder who has been charged under this title or a party to a proceeding before the Board or a disciplinary panel who claims to be aggrieved by the decision of the Board or the disciplinary panel.

(r) If any information contained in any medical or hospital document or any other exhibit is otherwise open for disclosure under law, the use of that document or exhibit in any record of the Board, a disciplinary panel, or any of its other investigatory bodies does not prevent its disclosure in any other proceeding.

#### Section 14-411.1

(a) In this section, "health maintenance organization" has the meaning stated in Sec. 19-701 of the Health - General Article.

(b) The Board shall create and maintain a public individual profile on each licensee that includes the following information:

  (1) A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under Sec. 14-404 of this subtitle based on the charges or has rescinded the charges;

  (2) A description of any disciplinary action taken by the Board or a disciplinary panel against the licensee within the most recent 10-year period that includes a copy of the public order;

  (3) A description in summary form of any final disciplinary action taken by a licensing board in any other state or jurisdiction against the licensee within the most recent 10-year period;

  (4) A description of a conviction or entry of a plea of guilty or nolo contendere by the licensee for a crime involving moral turpitude reported to the Board under Sec. 14-416 of this subtitle; and

  (5) As reported to the Board by the licensee, education and practice information about the licensee including:

    (i) The name of any medical school that the licensee attended and the date on which the licensee graduated from the school;

    (ii) A description of any internship and residency training;

    (iii) A description of any specialty board certification by a recognized board of the American Board of Medical Specialties or the American Osteopathic Association;

    (iv) The name of any hospital where the licensee has medical privileges;

    (v) The location of the licensee's primary practice setting;

    (vi) Whether the licensee participates in the Maryland Medical Assistance Program;

    (vii) Whether the licensee maintains medical professional liability insurance; and

    (viii) The number of medical malpractice final court judgments and arbitration awards against the licensee within the most recent 10-year period.

(c) In addition to the requirements of subsection (b) of this section, the Board shall:

  (1) Following the filing of charges or notice of initial denial of a license application, disclose the filing to the public on the Board's website;

  (2) Provide appropriate and accessible Internet links from the Board's website:

    (i) To the extent available, to the appropriate portion of the website of each health maintenance organization licensed in this State which will allow the public to ascertain the names of the physicians affiliated with the health maintenance organization; and

    (ii) To the appropriate portion of the website of the American Medical Association;

  (3) Include a statement on each licensee's profile of information to be taken into consideration by a consumer when viewing a licensee's profile, including factors to consider when evaluating a licensee's malpractice data, and a disclaimer stating that a charging document does not indicate a final finding of guilt by a disciplinary panel; and

  (4) Provide on the Board's website:

    (i) Notification that a person may contact the Board by telephone, electronic mail, or written request to find out whether the number of medical malpractice settlements involving a particular licensee totals three or more with a settlement amount of $1,000,000 or greater within the most recent 5-year period as reported to the Board; and

    (ii) A telephone number, electronic mail address, and physical address through which a person may contact the Board to request the information required to be provided under item (i) of this item.

(d) The Board:

  (1) On receipt of a written request for a licensee's profile from any  person, shall forward a written copy of the profile to the person;

  (2) Shall maintain a website that serves as a single point of entry where all licensee profile information is available to the public on the Internet; and

  (3) On receipt of a verbal, electronic, or written  request in accordance with subsection (c)(3) of this section, shall  provide the information within 2 business days of the request.

(e) The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee's profile.

(f) The Board shall include information relating to charges filed against a licensee by a disciplinary panel and any final disciplinary action taken by a disciplinary panel against a licensee in the licensee's profile within 10 days after the charges are filed or the action becomes final.

(g) This section does not limit the Board's authority to disclose information as required under Sec. 14-411 of this subtitle.

#### Section 14-412

(a) If a person is a member of the Board or a legally authorized agent of the Board and is investigating, prosecuting, participating in a hearing, or otherwise acting on an allegation of a ground for Board action made to the Board, the person shall have the immunity from liability described under Sec. 5-715(b) of the Courts and Judicial Proceedings Article.

(b) A person who makes an allegation of a ground for Board action to the Board shall have the immunity from liability described under Sec. 5-715(c) of the Courts and Judicial Proceedings Article.

#### Section 14-413

(a)

  (1) Except as provided in subsections (b) and (d) of this section, each employer of a licensed physician shall submit to the Board a report if:

    (i) The employer:

      (1) Reduced, suspended, revoked, restricted, denied, conditioned, or did not renew the licensed physician's clinical privileges, employment, or other ability to practice or treat patients;

      (2) Involuntarily terminated or restricted the licensed physician's employment or staff membership; or

      (3) Asked the licensed physician to voluntarily resign because of the licensed physician's conduct or while the licensed physician is being investigated; and

    (ii) The action described under item (i) of this paragraph was taken:

      (1) For reasons that might be grounds for disciplinary action under Sec. 14-404 of this subtitle;

      (2) Because the licensed physician may have engaged in an act that may constitute unprofessional conduct;

      (3) Because the licensed physician may be unable to practice medicine with reasonable skill and safety because of a physical or mental condition or professional incompetence; or

      (4) Because the licensed physician may have harmed or placed one or more patients or the public at unreasonable risk of harm by engaging in an act that creates an immediate or continuing danger.

  (2) Each report submitted under paragraph (1) of this subsection shall include:

    (i) The action taken by the employer;

    (ii) A detailed explanation of the reasons for the action, including references to specific patient medical records, if any, that informed the employer's action; and

    (iii) The steps taken by the employer to investigate the conduct of the licensed physician.

  (3)

    (i) The Board may request from the employer additional information regarding an action described in paragraph (1) of this subsection that was taken by the employer.

    (ii) If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information.

(b) If an employer knows that the conduct of a licensed physician requires that the employer submit a report under subsection (a)(1) of this section because the licensed physician is impaired by alcohol or another substance, the employer is not required to report the licensed physician to the Board if:

  (1) The employer knows that the licensed physician is:

    (i) In a substance use disorder treatment program that is accredited by The Joint Commission or is certified by the Department; or

    (ii) Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders;

  (2) The employer is able to verify that the licensed physician remains in the treatment program until successful discharge; and

  (3) The action or condition of the licensed physician has not caused injury to any person while the physician is practicing as a licensed physician.

(c) If the employer knows that the licensed physician is noncompliant with the substance use disorder treatment program, the employer of the licensed physician shall report the licensed physician's noncompliance to the Board.

(d)

  (1) The Board may extend the reporting time under this section for good cause shown.

  (2) A person is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of substance use disorder patient records.

(e) The Board may enforce this section by subpoena.

(f) Any person shall have the immunity from liability described under Sec. 5-715(d) of the Courts and Judicial Proceedings Article for giving any of the information required by this section.

(g) An employer required to make a report to the Board under this section shall submit the report within 10 days after the action requiring the report.

(h) A report made under this section is privileged, not subject to inspection under the Public Information Act, and not subject to subpoena or discovery in any civil action other than a proceeding arising out of a hearing and decision of the Board or a disciplinary panel under this title.

(i)

  (1) A disciplinary panel may impose a civil penalty of up to $10,000 for knowingly failing to report under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $10,000 per incident for a report made by an employer in bad faith.

  (3) The Board shall remit any penalty collected under this subsection into the General Fund of the State.

#### Section 14-414

(a) Except as otherwise provided in this subtitle, an employer may not employ an individual to practice medicine without a license.

(b) A disciplinary panel may impose a civil penalty in an amount not exceeding $10,000 for a violation of this section.

(c) The Board shall remit any penalty collected under this section into the Board of Physicians Fund.

#### Section 14-415

If a physician is engaged in the private practice of medicine in this State, the physician shall display the notice developed under Sec. 1-207 of this article conspicuously in each office where the physician is engaged in practice.

#### Section 14-416

(a) Each court shall report to the Board each conviction of or entry of a plea of guilty or nolo contendere by a physician for any crime involving moral turpitude.

(b) The court shall submit the report within 10 days after the conviction or entry of the plea.

### Subtitle 5. Miscellaneous Provisions

#### Section 14-502

(a) In this section, "the Maryland Institute for Emergency Medical Services Systems" means the State agency described in Sec. 13-503 of the Education Article.

(b) This section applies to:

  (1) MedChi;

  (2) A component medical society of MedChi;

  (3) A committee of MedChi or of a component medical society of MedChi;

  (4) A committee appointed by or established in the Maryland Institute for Emergency Medical Services Systems;

  (5) A hospital, related institution, or other health care facility staff committee;

  (6) A hospital, related institution, or other health care facility credentials committee or its equivalent;

  (7) The chief executive officer of a hospital, related institution, or other health care facility;

  (8) The dean of any medical school in this State;

  (9) A member of the Board;

  (10) A casualty insurer writing medical professional liability insurance in this State;

  (11) A utilization committee of:

    (i) A nonprofit health service plan; or

    (ii) A health insurer doing business in this State;

  (12) The chief executive officer of an alternative health system;

  (13) The medical director of an alternative health system;

  (14) A medical review committee appointed by or established in an alternative health system; and

  (15) A physician.

(c) A person described in subsection (b) of this section shall have the immunity from liability described under Sec. 5-638 of the Courts and Judicial Proceedings Article for giving information to any hospital, hospital medical staff, related institution, or other health care facility, alternative health system, professional society, medical school, or professional licensing board.

#### Section 14-503

(a) A physician may not represent to the public that the physician is board certified unless:

  (1) The physician is board certified; and

  (2) The physician discloses the full name of the board from which the physician is certified and the name of the specialty or subspecialty in which the physician is certified.

(b) A physician may advertise only as permitted by the rules and regulations of the Board and subject to subsection (a) of this section.

#### Section 14-504

(a) This section does not apply to a dentist performing acupuncture in connection with the practice of dentistry if the dentist is licensed or otherwise authorized to practice dentistry under Title 4 of this article.

(b) Unless licensed under Title 1A of this article, a physician shall be registered by the Board before the physician may perform acupuncture in this State.

(c) The Board shall register to perform acupuncture any physician who meets the following requirements:

  (1)

    (i) Successful completion of at least 200 hours of training in a program of study in acupuncture, including any examinations required under the program, approved for category 1 continuing medical education credit by an institution accredited or recognized by the Accreditation Council on Continuing Medical Education; or

    (ii) Successful completion of a course of study approved by the Board which includes at least 200 hours of instruction in:

      (1) General and basic aspects of acupuncture;

      (2) Specific uses and techniques of acupuncture; and

      (3) Indications and contraindications of acupuncture administration;

  (2) Ability to communicate in the English language;

  (3) Payment of application and registration fees; and

  (4) Other reasonable conditions determined by the Board.

(d) A physician who is registered under this section may perform acupuncture on or off the premises of the physician's office.

(e) A physician who performs acupuncture may advertise only as permitted by the rules and regulations of the Board.

(f) The Board may adopt rules and regulations to carry out the provisions of this section.

(g) Subject to the hearing provisions of Sec. 14-405 of this title, a disciplinary panel, on the affirmative vote of a majority of its quorum, may reprimand or place a physician who performs acupuncture on probation or suspend or revoke the registration of a physician for:

  (1) Any conduct prohibited under the provisions of this section or prohibited under any regulation adopted pursuant to the provisions of this section;

  (2) Except in an emergency life-threatening situation where it is not feasible or practicable, failing to comply with the Centers for Disease Control and Prevention's guidelines on universal precautions; or

  (3) Failing to display the notice required under subsection (h) of this section.

(h) If a physician who performs acupuncture is engaged in the private practice of acupuncture in this State, the physician who performs acupuncture shall display the notice developed under Sec. 1-207 of this article conspicuously in each office where the physician is engaged in practice.

#### Section 14-505

(a)

  (1) A licensed physician or registered nurse who is primarily responsible for the treatment of an individual for a burn injury described in paragraph (2) of this subsection shall as soon as practicable notify the county fire chief or administrator, or designee, or, if neither office exists, the State Fire Marshal or designee. If treatment occurs at a hospital, the treating physician or designee shall be responsible for giving the notice required by this section.

  (2) The provisions of paragraph (1) of this subsection apply to a burn injury:

    (i) Causing 2nd or 3rd degree burns to 5 percent or more of the patient's body;

    (ii) To the upper respiratory tract or laryngeal edema caused by inhaling super-heated air;

    (iii) Which causes death; or

    (iv) Which is likely to cause death.

  (3) The provisions of paragraph (1) of this subsection do not apply to a sunburn.

(b) Notice under this section shall include:

  (1) The name and address of the patient, if known;

  (2) A description of the burn injury;

  (3) The reported cause of the burn injury, if given;

  (4) The patient's prognosis; and

  (5) Any other fact concerning the burn injury which might assist in detecting arson.

(c) If an investigation is conducted after notification is given under subsection (a) of this section, the investigating agency shall report its findings on an incident reporting system report and send it to the State Fire Marshal's office for retention.

#### Section 14-506

(a) In this section, "the Maryland Institute for Emergency Medical Services Systems" means the State agency described in Sec. 13-503 of the Education Article.

(b) The following records and other information are confidential records:

  (1) Any record and other information obtained by MedChi, a component society of MedChi, the Maryland Institute for Emergency Medical Services Systems, a hospital staff committee, or a national medical society or group organized for research, if that record or information identifies any person; and

  (2) Any record of a proceeding or transaction before the entity or individual that contracts with the Board or one of its committees that relates to any investigation or report under Sec. 14-401.1 of this title as to an allegation of grounds for disciplinary or other action.

(c) Access to and use of any confidential record described in subsection (b) of this section is regulated by Sec.Sec. 5-601 and 10-205(b) of the Courts Article.

(d) This section does not restrict the publication of any statistics or other information that does not disclose the identity of any person.

#### Section 14-507

(a)

  (1) In this section the following words have the meanings indicated.

  (2) "Immediate follow-up care" is that period of contact lens fitting time required to reach a contact lens prescription that is appropriate to the documented clinical needs of the patient.

  (3) "Replacement contact lens prescription" means a prescription prepared by a licensed physician containing the information specified in this section and written expressly for the purpose of providing lenses which have already been properly fitted.

(b) A licensed physician shall ensure that each replacement contact lens prescription that the licensed optometrist prescribes for contact lenses:

  (1) Contains all the information necessary for the replacement contact lens prescription to be properly dispensed, including but not limited to the:

    (i) Lens manufacturer;

    (ii) Type of lens;

    (iii) Power of the lens;

    (iv) Base curve;

    (v) Lens size;

    (vi) Name of the patient;

    (vii) Date the prescription was given to the patient;

    (viii) Name and office location of the licensed physician who writes the replacement contact lens prescription; and

    (ix) Expiration date of the replacement contact lens prescription; and

  (2) Is reduced to writing and placed in the patient's permanent file.

(c)

  (1)

    (i) After a licensed physician releases the patient from immediate follow-up care, the patient may request the replacement contact lens prescription from the licensed physician.

    (ii) If, after examination, the patient's prescription has not changed since the last examination, a licensed physician shall comply with the provisions of paragraph (2) of this subsection without requiring the patient to purchase contact lenses or to undergo immediate follow-up care.

  (2)

    (i) Upon the request of a patient of a licensed physician, and without cost to the patient, the licensed physician shall provide the patient's replacement contact lens prescription to the patient or the patient's designee.

    (ii) In responding to a request under paragraph (1)(i) of this subsection, a licensed physician shall transmit the contact lens prescription by mail, telephone, facsimile, e-mail, or any other means of communication that will, under normal circumstances, result in the designee receiving the information within 7 business days after the patient's request.

    (iii) The replacement contact lens prescription that the licensed physician provides the patient under subparagraph (i) of this paragraph:

      (1) Shall contain the information necessary for the proper duplication of the current prescription of the patient;

      (2) Shall contain, subject to the provisions of subsection (d) of this section, an expiration date for the replacement contact lens prescription of not more than 24 months from the time the patient was first examined; and

      (3) May contain wearing guidelines or specific instructions for use of the contact lenses by the patient, or both.

(d) The licensed physician shall enter into the patient's medical record the valid clinical reasons for a shorter expiration date and shall provide the patient with a written and oral explanation of the clinical reasons for a shorter expiration date.

(e) When a patient's prescription is dispensed by a person other than the licensed physician or a person associated directly or indirectly with the licensed physician, the licensed physician is not liable for any injury to or condition of a patient caused solely by the negligence of the dispenser.

(f) A licensed physician who releases a replacement contact lens prescription to a patient may provide the patient with a written statement that wearing improperly fitted contact lenses may cause harm to the patient's eyes and that the patient should have an eye examination if there are any changes in the patient's vision, including pain or vision loss.

(g)

  (1) A licensed physician who fills or provides a contact lens prescription shall maintain a record of that prescription in accordance with Sec. 4-403 of the Health - General Article.

  (2) A person other than a licensed physician who fills a contact lens prescription shall maintain a record of that prescription for 5 years.

(h) The Board may impose a civil fine of no more than $1,000 on a licensed physician who fails to provide a replacement contact lens prescription or who knowingly dispenses contact lenses without a valid and unexpired replacement contact lens prescription, or who otherwise fails to comply with this title.

#### Section 14-508

(a) Each licensee practicing medicine in the State shall notify a patient in writing if:

  (1) The licensee does not maintain medical professional liability insurance coverage; or

  (2) The licensee's medical professional liability insurance coverage has lapsed for any period of time and the licensee's coverage has not been renewed.

(b) The written notification provided to the patient under subsection (a) of this section must be:

  (1) Provided:

    (i) At the first visit by the patient during any period in which the licensee does not maintain medical professional liability insurance, unless the visit is for the purpose of receiving incidental medical care that will be rendered free of charge; and

    (ii) As part of each informed consent obtained before any procedure or operation discussed or offered for the patient's consideration is performed;

  (2) Signed by the patient at the time of the patient's visit or the informed consent is signed; and

  (3) Retained by the licensee as part of the licensee's patient records.

(c) Each licensee practicing medicine in the State who does not maintain medical professional liability insurance coverage shall post this information in a conspicuous location in the licensee's place of practice.

#### Section 14-509

(a) In this section, "ACCME" means the Accrediting Council for Continuing Medical Education.

(b) A physician may dispense a topical medication that is approved by the federal Food and Drug Administration for the treatment of hypotrichosis without obtaining a dispensing permit or completing the continuing education required under Sec. 12-102(c)(2)(ii) of this article if the physician:

  (1) Otherwise complies with the requirements of Sec. 12-102(c)(2)(ii) of this article; and

  (2) Has received a special class of written permit from the Board.

(c) The Board may issue a special class of written permit to a physician under subsection (b) of this section if the physician:

  (1) Completes 1 hour of continuing medical education per year on the dispensing of topical medications developed by an ACCME-accredited Maryland nonprofit or governmental entity; and

  (2) Pays to the Board a $100 permit fee.

### Subtitle 5A. Respiratory Care Practitioners

#### Section 14-5A-01

(a) In this subtitle the following words have the meanings indicated.

(b) "Board" means the State Board of Physicians.

(c) "Committee" means the Respiratory Care Advisory Committee established under Sec. 14-5A-05 of this subtitle.

(d) "License" means a license issued by the Board to practice respiratory care.

(e) "Licensed respiratory care practitioner" means a respiratory care practitioner who is licensed by the Board to practice respiratory care.

(f) "Licensee" means a licensed respiratory care practitioner.

(g) "National certifying board" means the National Board for Respiratory Care or a certifying organization that has certification requirements equivalent to the National Board for Respiratory Care and that has been approved by the Board.

(h)

  (1) "Practice respiratory care" means to evaluate, care for, and treat, including the diagnostic evaluation of, individuals who have deficiencies and abnormalities that affect the pulmonary system and associated aspects of the cardiopulmonary and other systems under the supervision of and in collaboration with a physician.

  (2) "Practice respiratory care" includes:

    (i) Providing direct and indirect respiratory care services that are safe, aseptic, preventive, and restorative;

    (ii) Practicing the principles, techniques, and theories derived from cardiopulmonary medicine;

    (iii) Evaluating and treating individuals whose cardiopulmonary functions have been threatened or impaired by developmental defects, the aging process, physical injury, disease, or actual or anticipated dysfunction of the cardiopulmonary system;

    (iv) Observing and monitoring physical signs and symptoms, general behavior, and general physical response to respiratory care procedures and determining if initiation, modification, or discontinuation of a treatment regimen is warranted;

    (v) Transcribing and implementing written or oral orders regarding the practice of respiratory care;

    (vi) Using evaluation techniques that include cardiopulmonary function assessments, gas exchange, the need and effectiveness of therapeutic modalities and procedures, and the assessment and evaluation of the need for extended care and home care procedures, therapy, and equipment; and

    (vii) Applying the use of techniques, equipment, and procedures involved in the administration of respiratory care, including:

      (1) Except for general anesthesia, therapeutic and diagnostic gases;

      (2) Prescribed medication for inhalation or direct tracheal installation;

      (3) The administration of analgesic agents by subcutaneous injection or inhalation for the performance of respiratory care procedures;

      (4) Nonsurgical insertion, maintenance, and removal of artificial airways;

      (5) Advanced cardiopulmonary measures;

      (6) Cardiopulmonary rehabilitation;

      (7) Mechanical ventilation or physiological life support systems;

      (8) Collection of body fluids and blood samples for evaluation and analysis;

      (9) Insertion of diagnostic arterial access lines; and

      (10) Collection and analysis of exhaled respiratory gases.

(i) "Supervision" means the responsibility of a physician to exercise on-site or immediately available direction for a licensed respiratory care practitioner performing delegated medical acts.

#### Section 14-5A-02

This subtitle does not limit:

(1) The right of an individual to practice a health occupation that the individual is authorized to practice under this article; or

(2) The right of a licensed home medical equipment provider to provide home medical equipment services as defined under Title 19, Subtitle 4A of the Health - General Article.

#### Section 14-5A-03

The Board shall adopt regulations for the licensure and practice of respiratory care.

#### Section 14-5A-04

(a)

  (1) The Board shall set reasonable fees for the issuance of and renewal of licenses and the other services it provides to respiratory care practitioners.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure program and the other services provided to respiratory care practitioners, including the cost of providing a rehabilitation program for respiratory care practitioners under Sec. 14-401.1(g) of this title.

(b)

  (1) The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller of the State.

  (2) The Comptroller shall distribute all fees to the Board established under Sec. 14-201 of this title.

(c) The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this subtitle.

#### Section 14-5A-05

There is a Respiratory Care Advisory Committee within the Board.

#### Section 14-5A-06

(a) The Committee consists of seven members appointed by the Board as follows:

  (1) Three licensed respiratory care practitioners;

  (2) Three licensed physicians:

    (i) One of whom is a specialist in thoracic surgery;

    (ii) One of whom is a specialist in pulmonary medicine; and

    (iii) One of whom is a specialist in anesthesiology; and

  (3) One consumer member.

(b) Each member of the Committee licensed by the Board must be in good standing with the Board.

(c) The consumer member of the Committee:

  (1) Must be a member of the general public;

  (2) May not be or ever have been:

    (i) A respiratory care practitioner;

    (ii) Any other health care professional; or

    (iii) In training to be a respiratory care practitioner or other health professional; and

  (3) May not:

    (i) Participate or ever have participated in a commercial or professional field related to respiratory care;

    (ii) Have a household member who participates in a commercial or professional field related to respiratory care;

    (iii) Have had within 2 years before appointment a financial interest in a person regulated by the Board; or

    (iv) Have had within 2 years before appointment a financial interest in the provision of goods or services to respiratory care practitioners or to the field of respiratory care.

(d) Each member of the Committee must be a resident of the State.

(e)

  (1) The term of a member is 3 years.

  (2) The terms of members are staggered as required by regulation.

  (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

  (4) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.

  (5) A member may not serve more than two consecutive full terms.

(f)

  (1) From among its members, the Committee shall elect a chair once every 2 years.

  (2) The chair, or the chair's designee, shall serve in an advisory capacity to the Board as a representative of the Committee.

(g) A quorum of the Committee consists of four members.

#### Section 14-5A-07

In addition to the powers set forth elsewhere in this subtitle, the Committee:

(1) Shall:

  (i) Develop and recommend to the Board:

    (1) Regulations to carry out this subtitle; and

    (2) Any statutory changes that affect the profession; and

  (ii) Keep a record of its meetings; and

(2) May:

  (i) Provide recommendations regarding the practice of respiratory care; and

  (ii) Advise the Board on any other matters related to respiratory care practitioners.

#### Section 14-5A-08

(a) Except as otherwise provided in this subtitle or Sec.Sec. 10-14A-03 and 10-14B-03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice respiratory care in this State.

(b) This section does not apply to:

  (1) A respiratory care practitioner employed in the service of the federal government while practicing within the scope of the employment;

  (2) A respiratory care practitioner student enrolled in an education program which is accredited by an approved accrediting organization while practicing respiratory care in the program; or

  (3) An individual practicing respiratory care who is licensed by and residing in another jurisdiction if:

    (i) The individual is participating in the transportation of a patient from that individual's jurisdiction of licensure into the State;

    (ii) The individual practices respiratory care only during the transportation of the patient;

    (iii) The individual does not practice respiratory care on another individual who is not the patient being transported into the State; and

    (iv) The individual does not practice respiratory care in the State for more than a total of 14 days within a calendar year.

#### Section 14-5A-09

(a) To qualify for a license, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall be of good moral character.

(c) The applicant shall be at least 18 years old.

(d) The applicant shall:

  (1) Meet any educational, training, or examination requirements established by the Board including:

    (i) Graduation from an appropriate educational program as determined by the Board; and

    (ii) Certification by a national certifying board approved by the Board; and

  (2) Demonstrate oral and written competency in English as required by the Board.

(e) The applicant shall complete a criminal history records check in accordance with Sec. 14-308.1 of this title.

#### Section 14-5A-10

To apply for a license, an applicant shall:

(1) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title;

(2) Submit an application to the Board on the form that the Board requires; and

(3) Pay to the Board the application fee set by the Board.

#### Section 14-5A-11

(a) Subject to subsection (b) of this section, the Board shall issue the appropriate license to an applicant who meets the requirements of this subtitle for that license.

(b)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether to issue a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 14-308.1 of this title has not been received.

#### Section 14-5A-12

A respiratory care practitioner license authorizes the licensee to practice respiratory care while the license is effective.

#### Section 14-5A-13

(a)

  (1) The term of a license issued by the Board may not exceed 3 years.

  (2) A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.

(b) At least 1 month before the license expires, the Board shall send to the licensee a renewal notice that states:

  (1) The date on which the current license expires;

  (2) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and

  (3) The amount of the renewal fee.

(c) Except as otherwise provided in this subtitle, before a license expires, the licensee periodically may renew it for an additional term, if the licensee:

  (1) Is of good moral character;

  (2) Pays to the Board a renewal fee set by the Board;

  (3) Submits to the Board:

    (i) A renewal application on the form that the Board requires; and

    (ii) Satisfactory evidence of compliance with any continuing education or competency requirements and other requirements set under this section for license renewal; and

  (4) Meets any additional renewal requirements established by the Board.

(d)

  (1) In addition to any other qualifications and requirements established by the Board, the Board may establish continuing education or competency requirements as a condition to the renewal of licenses under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $100 per continuing education credit in lieu of a sanction under Sec. 14-5A-17 of this subtitle, for a first offense, for the failure of a licensee to obtain the continuing education credits required by the Board.

(e)

  (1) The Board shall renew the license of each licensee who meets the requirements of this section.

  (2) A license may not be renewed for a term longer than 2 years.

(f) The Board shall reinstate the license of a respiratory care practitioner who has failed to renew the license for any reason if the respiratory care practitioner:

  (1) Meets the renewal requirements of this section;

  (2) Submits to the Board:

    (i) A reinstatement application on the form that the Board requires; and

    (ii) Satisfactory evidence of compliance with any continuing education or competency requirements; and

  (3) Meets any additional requirements established by the Board for reinstatement.

(g)

  (1) Beginning October 1, 2016, the Board shall require a criminal history records check in accordance with Sec. 14-308.1 of this title for:

    (i) Renewal applicants as determined by regulations adopted by the Board; and

    (ii) Each former licensee who files for reinstatement under subsection (f) of this section.

  (2) On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether disciplinary action should be taken, based on the criminal history record information, against a licensee who renewed or reinstated a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.

  (3) The Board may renew or reinstate a license only if the licensee or applicant attests that the licensee or applicant has submitted to a criminal history records check under Sec. 14-308.1 of this title.

#### Section 14-5A-14

(a) A licensee shall notify the Board in writing of a change in name or address within 30 days after the change.

(b) A licensee who fails to comply with subsection (a) of this section is subject to an administrative penalty of $100.

#### Section 14-5A-16

Unless a disciplinary panel agrees to accept the surrender of a license, a licensed respiratory care practitioner may not surrender the license nor may the license lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.

#### Section 14-5A-17

(a) Subject to the hearing provisions of Sec. 14-405 of this title, a disciplinary panel, on the affirmative vote of a majority of a quorum of the disciplinary panel, may deny a license to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke a license, if the applicant or licensee:

  (1) Fraudulently or deceptively obtains or attempts to obtain a license for the applicant, licensee, or for another;

  (2) Fraudulently or deceptively uses a license;

  (3) Is guilty of:

    (i) Immoral conduct in the practice of respiratory care; or

    (ii) Unprofessional conduct in the practice of respiratory care;

  (4) Is:

    (i) Professionally incompetent;

    (ii) Physically incompetent; or

    (iii) Mentally incompetent;

  (5) Abandons a patient;

  (6) Is habitually intoxicated;

  (7) Is addicted to or habitually abuses any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article;

  (8) Provides professional services while:

    (i) Under the influence of alcohol; or

    (ii) Using any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article or any other drug that is in excess of therapeutic amounts or without valid medical indication;

  (9) Promotes the sale of services, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

  (10) Willfully makes or files a false report or record in the practice of respiratory care;

  (11) Willfully fails to file or record any report as required under law, willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record a report;

  (12) Breaches patient confidentiality;

  (13) Pays or agrees to pay any sum or provide any form of remuneration or material benefit to any person for bringing or referring a patient or accepts or agrees to accept any sum or any form of remuneration or material benefit from an individual for bringing or referring a patient;

  (14) Willfully makes a misrepresentation while practicing respiratory care;

  (15) Willfully practices respiratory care with an unauthorized individual or aids an unauthorized individual in the practice of respiratory care;

  (16) Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine;

  (17) Is disciplined by a licensing or disciplinary authority or is convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (18) Fails to meet appropriate standards for the delivery of respiratory care performed in any inpatient or outpatient facility, office, hospital or related institution, domiciliary care facility, patient's home, or any other location in this State;

  (19) Willfully submits false statements to collect fees for which services are not provided;

  (20)

    (i) Has been subject to investigation or disciplinary action by a licensing or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under the Board's disciplinary statutes; and

    (ii) Has:

      (1) Surrendered the license issued by the state or country; or

      (2) Allowed the license issued by the state or country to expire or lapse;

  (21) Willfully fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

  (22) Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes;

  (23) Practices or attempts to practice beyond the authorized scope of practice;

  (24) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

  (25) Practices or attempts to practice a respiratory care procedure or uses or attempts to use respiratory care equipment if the applicant or licensee has not received education and training in the performance of the procedure or the use of the equipment;

  (26) Fails to cooperate with a lawful investigation conducted by the Board or a disciplinary panel;

  (27) Fails to practice under the supervision of a physician or violates a supervisory order of a supervising physician; or

  (28) Fails to complete a criminal history records check under Sec. 14-308.1 of this title.

(b) Except as otherwise provided in the Administrative Procedure Act, before the Board or a disciplinary panel takes any action under subsection (a) of this section, it shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board or the disciplinary panel in accordance with the hearing requirements of Sec. 14-405 of this title.

(c)

  (1) On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a license if the licensee is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

  (2) After completion of the appellate process if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a license on the certification by the Office of the Attorney General.

(d)

  (1) If, after a hearing under Sec. 14-405 of this title, a disciplinary panel finds that there are grounds under subsection (a) of this section to suspend or revoke a license, to reprimand a licensee, or to place a licensee on probation, the disciplinary panel may impose a fine subject to the Board's regulations in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

  (2) The Board shall pay any fines collected under this section into the General Fund of the State.

(e) In addition to any sanction authorized under this section, a disciplinary panel may require a licensee to comply with specified terms and conditions determined by the disciplinary panel.

#### Section 14-5A-17.1

(a)

  (1) Any person aggrieved by a final decision of the Board or a disciplinary panel under this subtitle may take a direct judicial appeal.

  (2) The appeal shall be made as provided for judicial review of final decisions in the Administrative Procedure Act.

(b) An order of the Board or a disciplinary panel may not be stayed pending review.

(c) The Board may appeal from any decision that reverses or modifies an order of the Board or a disciplinary panel.

#### Section 14-5A-18

(a)

  (1) Except as provided in subsections (b) and (d) of this section, an employer of a licensed respiratory care practitioner shall submit to the Board a report if:

    (i) The employer:

      (1) Reduced, suspended, revoked, restricted, denied, conditioned, or did not renew the licensed respiratory care practitioner's clinical privileges, employment, or other ability to practice or treat patients;

      (2) Involuntarily terminated or restricted the licensed respiratory care practitioner's employment or staff membership; or

      (3) Asked the licensed respiratory care practitioner to voluntarily resign because of the licensed respiratory care practitioner's conduct or while the licensed respiratory care practitioner is being investigated; and

    (ii) The action described under item (i) of this paragraph was taken:

      (1) For reasons that might be grounds for disciplinary action under Sec. 14-5A-17 of this subtitle;

      (2) Because the licensed respiratory care practitioner may have engaged in an act that may constitute unprofessional conduct;

      (3) Because the licensed respiratory care practitioner may be unable to practice respiratory care with reasonable skill and safety because of a physical or mental condition or professional incompetence; or

      (4) Because the licensed respiratory care practitioner may have harmed or placed one or more patients or the public at unreasonable risk of harm by engaging in an act that creates an immediate or continuing danger.

  (2) A report submitted under paragraph (1) of this subsection shall include:

    (i) The action taken by the employer;

    (ii) A detailed explanation of the reasons for the action, including references to specific patient medical records, if any, that informed the employer's action; and

    (iii) The steps taken by the employer to investigate the conduct of the licensed respiratory care practitioner.

  (3)

    (i) The Board may request from the employer additional information regarding an action described in paragraph (1) of this subsection that was taken by the employer.

    (ii) If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information.

(b) If an employer knows that the conduct of a licensed respiratory care practitioner requires that the employer submit a report under subsection (a)(1) of this section because the licensed respiratory care practitioner is impaired by alcohol or another substance, the employer is not required to report the respiratory care practitioner to the Board if:

  (1) The employer knows that the licensed respiratory care practitioner is:

    (i) In a substance use disorder treatment program that is accredited by The Joint Commission or is certified by the Department; or

    (ii) Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders;

  (2) The employer is able to verify that the licensed respiratory care practitioner remains in the treatment program until successful discharge; and

  (3) The action or condition of the licensed respiratory care practitioner has not caused injury to any person while the respiratory care practitioner is practicing as a licensed respiratory care practitioner.

(c) If the employer knows that the licensed respiratory care practitioner is noncompliant with the substance use disorder treatment program, the employer of the licensed respiratory care practitioner shall report the licensed respiratory care practitioner's noncompliance to the Board.

(d)

  (1) The Board may extend the reporting under this section for good cause shown.

  (2) A person is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of substance use disorder patient records.

(e) The Board may enforce this section by subpoena.

(f) Any person shall have the immunity from liability described under Sec. 5-715(d) of the Courts Article for giving any of the information required by this section.

(g) An employer required to make a report to the Board under this section shall submit the report within 10 days after the action requiring the report.

(h) A report made under this section is privileged, not subject to inspection under the Public Information Act, and not subject to subpoena or discovery in any civil action other than a proceeding arising out of a hearing and decision of the Board or a disciplinary panel under this title.

(i)

  (1) A disciplinary panel may impose a civil penalty of up to $5,000 for knowingly failing to report under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $5,000 per incident for a report made by an employer in bad faith.

  (3) The Board shall remit any penalty collected under this subsection into the General Fund of the State.

#### Section 14-5A-18.1

(a) Following the filing of charges or notice of initial denial of a license application, the Board shall disclose the filing to the public on the Board's Web site.

(b) The Board shall create and maintain a public individual profile on each licensee that includes the following information:

  (1) A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under Sec. 14-5A-17 of this subtitle based on the charges or has rescinded the charges;

  (2) A description of any disciplinary action taken by the Board or a disciplinary panel against the licensee within the most recent 10-year period that includes a copy of the public order;

  (3) A description in summary form of any final disciplinary action taken by a licensing board in any other state or jurisdiction against the licensee within the most recent 10-year period if the Board knows about the disciplinary action;

  (4) A description of a conviction or entry of a plea of guilty or nolo contendere by the licensee for a crime involving moral turpitude that is the basis for disciplinary action taken under Sec. 14-5A-17(c) of this subtitle; and

  (5) The public address of the licensee.

(c) In addition to the requirements of subsection (b) of this section, the Board shall include on each licensee's profile a statement of information to be taken into consideration by a consumer when viewing a licensee's profile, including a disclaimer stating that a charging document does not indicate a final finding of guilt by a disciplinary panel.

(d) The Board:

  (1) On receipt of a written request for a licensee's profile from any person, shall forward a written copy of the profile to the person; and

  (2) Shall maintain a Web site that serves as a single point of entry where all licensee profile information is available to the public on the Internet.

(e) The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee's profile.

(f) The Board shall include information relating to charges filed against a licensee by a disciplinary panel and any final disciplinary action taken by a disciplinary panel against a licensee in the licensee's profile within 10 days after the charges are filed or the action becomes final.

#### Section 14-5A-19

(a) Subject to subsection (c) of this section, on the application of an individual whose license has been revoked, a disciplinary panel, on the affirmative vote of a majority of the quorum of the disciplinary panel, may reinstate a revoked license.

(b) A disciplinary panel may not reinstate a revoked license that has been revoked for a period of more than 1 year unless the licensee:

  (1) Meets the requirements for reinstatement as established under this title; and

  (2) Completes a criminal history records check in accordance with Sec. 14-308.1 of this title.

#### Section 14-5A-20

Except as otherwise provided in this subtitle, a person may not practice, attempt to practice, or offer to practice respiratory care in this State unless licensed to practice respiratory care by the Board.

#### Section 14-5A-21

(a) Unless authorized to practice respiratory care under this subtitle, a person may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the person is authorized to practice respiratory care in this State.

(b) Unless authorized to practice respiratory care under this subtitle, a person may not use the abbreviation "R.C.P." or any other words, letters, or symbols with the intent to represent that the person practices respiratory care.

#### Section 14-5A-22

A person may not provide, attempt to provide, offer to provide, or represent that the person provides respiratory care unless the respiratory care is provided by an individual who is authorized to practice respiratory care under this subtitle.

#### Section 14-5A-22.1

(a) Except as otherwise provided in this subtitle, a licensed physician may not employ or supervise an individual practicing respiratory care without a license.

(b) Except as otherwise provided in this subtitle, an employer may not employ an individual practicing respiratory care without a license.

(c) A disciplinary panel may impose a civil penalty of up to $5,000 for a violation of this section.

(d) The Board shall remit any penalty collected under this subsection into the General Fund of the State.

#### Section 14-5A-23

(a) A person who violates Sec. 14-5A-20, Sec. 14-5A-21, or Sec. 14-5A-22 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 or imprisonment not exceeding 1 year or both.

(b) A person who violates Sec. 14-5A-20, Sec. 14-5A-21, or Sec. 14-5A-22 of this subtitle is subject to a civil fine of not more than $5,000 to be levied by a disciplinary panel.

(c) The Board shall pay any penalty collected under this section into the Board of Physicians Fund.

#### Section 14-5A-24

This subtitle may be cited as the "Maryland Respiratory Care Practitioners Act".

#### Section 14-5A-25

Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act and subject to the termination of this title under Sec. 14-702 of this title, this subtitle and all rules and regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2030.

### Subtitle 5B. Radiation Therapy, Radiography, Nuclear Medicine Technology, and Radiology Assistance

#### Section 14-5B-01

(a) In this subtitle the following words have the meanings indicated.

(b) "Board" means the State Board of Physicians.

(c) "Certification" means recognition of an individual who has satisfied certain standards required by a national certifying board.

(d) "Committee" means the Radiation Therapy, Radiography, Nuclear Medicine Technology, and Radiology Assistance Advisory Committee of the Board.

(e) Repealed.

(f) "License" means a license issued by the Board to practice as a radiation therapist, radiographer, nuclear medicine technologist, or radiologist assistant.

(g) "Licensed nuclear medicine technologist" means a nuclear medicine technologist who is licensed by the Board to practice nuclear medicine technology.

(h) "Licensed radiation therapist" means a radiation therapist who is licensed by the Board to practice radiation therapy.

(i) "Licensed radiographer" means a radiographer who is licensed by the Board to practice radiography.

(j) "Licensed radiologist assistant" means an individual who is licensed to practice radiology assistance under the supervision of a licensed physician who:

  (1) Specializes in radiology; and

  (2) Is certified by:

    (i) The American Board of Radiology;

    (ii) The American Osteopathic Board of Radiology;

    (iii) The British Royal College of Radiology; or

    (iv) The Canadian College of Physicians and Surgeons.

(k) "Licensee" means an individual who is licensed by the Board to practice as a radiation therapist, a radiographer, a nuclear medicine technologist, or radiologist assistant.

(l) "National certifying board" means:

  (1) The American Registry of Radiologic Technologists;

  (2) The Nuclear Medicine Technology Certifying Board; or

  (3) Another certifying organization approved by the Board.

(m) "Practice nuclear medicine technology" means to:

  (1) Prepare and administer radiopharmaceuticals to human beings; or

  (2) Conduct in vivo detection and measurement of radioactivity for medical purposes to assist in the diagnosis and treatment of disease or injury.

(n) "Practice radiation therapy" means to perform tumor localization radiography and apply therapeutic doses of radiation for the treatment of disease or injury.

(o) "Practice radiography" means to use ionizing radiation to:

  (1) Demonstrate portions of the human body to assist in the diagnosis or localization of disease or injury; or

  (2) Perform tumor localization radiography.

(p) "Practice radiology assistance" means to practice radiography and to perform:

  (1) Fluoroscopy and selected radiology procedures;

  (2) Patient assessment; and

  (3) Patient management.

(q) "Supervision" means the responsibility of a licensed physician to exercise on-site or immediately available direction for licensees.

#### Section 14-5B-02

This subtitle does not limit the right of an individual to practice a health occupation that the individual is authorized to practice under this article.

#### Section 14-5B-03

The Board shall adopt regulations to carry out the provisions of this subtitle.

#### Section 14-5B-04

(a)

  (1) The Board shall set reasonable fees for the issuance of and renewal of licenses and other services it provides to licensees.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure program and the other services provided to licensees, including the cost of providing a rehabilitation program for licensees under Sec. 14-401.1(g) of this title.

(b)

  (1) The Board shall pay all fees collected under the provisions of this subtitle to the State Comptroller.

  (2) The Comptroller shall distribute all fees to the Board established under Sec. 14-201 of this title.

(c) The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this subtitle.

#### Section 14-5B-05

(a) There is a Radiation Therapy, Radiography, Nuclear Medicine Technology, and Radiology Assistance Advisory Committee within the Board.

(b)

  (1) The Committee consists of nine members appointed by the Board.

  (2) Of the nine members:

    (i) One shall be a licensed physician who specializes in radiology;

    (ii) One shall be a licensed physician who specializes in radiology and who supervises a radiologist assistant;

    (iii) One shall be a licensed physician who specializes in nuclear medicine;

    (iv) One shall be a licensed physician who specializes in radiation oncology;

    (v) One shall be a licensed radiation therapist;

    (vi) One shall be a licensed radiographer;

    (vii) One shall be a licensed radiologist assistant;

    (viii) One shall be a licensed nuclear medicine technologist; and

    (ix) One shall be a consumer member.

(c) Each member of the Committee licensed by the Board must be in good standing with the Board.

(d) The consumer member of the Committee:

  (1) Must be a member of the general public;

  (2) May not be or ever have been:

    (i) A radiation therapist, radiographer, radiologist assistant, or nuclear medicine technologist;

    (ii) Any other health care professional; or

    (iii) In training to be a radiation therapist, radiographer, radiologist assistant, nuclear medicine technologist, or other health care professional; and

  (3) May not:

    (i) Participate or ever have participated in a commercial or professional field related to radiation therapy, radiography, nuclear medicine technology, or radiology assistance;

    (ii) Have a household member who participates in a commercial or professional field related to radiation therapy, radiography, nuclear medicine technology, or radiology assistance;

    (iii) Have had within 2 years before appointment a financial interest in a person regulated by the Board; or

    (iv) Have had within 2 years before appointment a financial interest in the provision of goods or services to radiation therapists, radiographers, radiology assistants, or nuclear medicine technologists or to the field of radiation therapy, radiography, nuclear medicine technology, or radiology assistance.

(e) Each member of the Committee must be a resident of the State.

(f)

  (1) From among its members, the Committee shall elect a chair once every 2 years.

  (2) The chair, or the chair's designee, shall serve in an advisory capacity to the Board as a representative of the Committee.

(g)

  (1) The term of a member is 3 years.

  (2) The terms of members are staggered as required by regulation.

  (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

  (4) A member may not serve more than two consecutive full terms.

  (5) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.

(h) A quorum of the Committee consists of five members.

#### Section 14-5B-06

In addition to the powers set forth elsewhere in this subtitle, the Committee:

(1) Shall:

  (i) Develop and recommend to the Board:

    (1) Regulations to carry out this subtitle; and

    (2) Any statutory changes that affect the profession; and

  (ii) Keep a record of its meetings; and

(2) May:

  (i) Provide recommendations regarding the practice of radiation therapy, radiography, nuclear medicine technology, and radiology assistance; and

  (ii) Advise the Board on any other matters related to radiation therapists, radiographers, nuclear medicine technologists, and radiologist assistants.

#### Section 14-5B-07

(a)

  (1) A licensee may only practice under the supervision of a licensed physician.

  (2) The failure of a licensed physician to properly supervise a licensee is unprofessional conduct in the practice of medicine under Sec. 14-404(a)(3) of this title.

(b)

  (1) Except as provided in paragraph (2) of this subsection, the practice of a radiation therapist, radiographer, nuclear medicine technologist, or radiologist assistant is limited to those procedures, operations, preparations, and practices listed in regulation.

  (2) A radiologist assistant may not:

    (i) Interpret images;

    (ii) Make diagnoses; or

    (iii) Prescribe medications or therapies.

#### Section 14-5B-08

(a)

  (1) Except as otherwise provided in this subtitle or Sec.Sec. 10-14A-03 and 10-14B-03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice radiation therapy, radiography, nuclear medicine technology, or radiology assistance in this State.

  (2) A radiologist assistant may not:

    (i) Interpret images;

    (ii) Make diagnoses; or

    (iii) Prescribe medications or therapies.

(b) This section does not apply to:

  (1) A radiation therapist, radiographer, nuclear medicine technologist, or radiology assistant employed in the service of the federal government while practicing within the scope of the employment; or

  (2) A radiation therapy student, a radiography student, a nuclear medicine technology student, or a radiology assistant student enrolled in an education program which is accredited by an approved accrediting organization while practicing radiation therapy, radiography, nuclear medicine technology, or radiology assistance in that program.

#### Section 14-5B-09

(a) To qualify for a license, an applicant shall be an individual who meets the requirements of this section.

(b) Except as provided in subsection (c) of this section, the applicant shall:

  (1) Be of good moral character;

  (2) Be at least 18 years old;

  (3) Demonstrate oral and written competency in English as required by the Board;

  (4) Meet any educational, training, or examination requirements established by the Board, including:

    (i) Graduation from an appropriate educational program as determined by the Board; and

    (ii) Certification; and

  (5) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title.

(c) To qualify for a license to practice as a radiologist assistant, an applicant shall:

  (1) Be issued a general license to perform radiography;

  (2) Complete an advanced academic program with a nationally recognized radiology curriculum that results in a baccalaureate degree, post baccalaureate certificate, or graduate degree and incorporates a radiologist-directed clinical preceptorship;

  (3) Be certified in advanced cardiac life support; and

  (4) Be certified as a radiologist assistant by the American Registry of Radiologic Technologists.

(d) Except for requirements adopted by the Board for license renewal under Sec. 14-5B-12 of this subtitle, nothing in this subtitle may be construed to require an individual who is certified by the Board as a radiation oncology/therapy technologist, medical radiation technologist, or nuclear medicine technologist as of October 1, 2008, to meet additional education, training, or examination requirements.

#### Section 14-5B-10

(a) To apply for a license, an applicant shall:

  (1) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title;

  (2) Submit an application to the Board on the form that the Board requires; and

  (3) Pay to the Board the application fee set by the Board.

(b) Subject to subsection (c) of this section, the Board shall issue the appropriate license to an applicant who meets the requirements of this subtitle for that license.

(c)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether to issue a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 14-308.1 of this title has not been received.

#### Section 14-5B-11

(a) Licensure as a radiation therapist authorizes an individual to practice radiation therapy in the State while the license is effective.

(b) Licensure as a radiographer authorizes an individual to practice radiography in the State while the license is effective.

(c) Licensure as a nuclear medicine technologist authorizes an individual to practice nuclear medicine technology in the State while the license is effective.

(d) Licensure as a radiologist assistant authorizes an individual to practice radiology assistance in the State while the license is effective.

#### Section 14-5B-12

(a)

  (1) The term of a license issued by the Board may not exceed 3 years.

  (2) A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.

(b) At least 1 month before the license expires, the Board shall send to the licensee a renewal notice that states:

  (1) The date on which the current license expires;

  (2) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and

  (3) The amount of the renewal fee.

(c) Except as otherwise provided in this subtitle, before a license expires, the licensed individual may periodically renew it for an additional term, if the individual:

  (1) Is of good moral character;

  (2) Pays to the Board a renewal fee set by the Board;

  (3) Submits to the Board:

    (i) A renewal application on the form that the Board requires; and

    (ii) Satisfactory evidence of compliance with any continuing education or competency requirements and other requirements required by the Board for license renewal; and

  (4) Meets any additional renewal requirements established by the Board.

(d)

  (1) In addition to any other qualifications and requirements established by the Board, the Board may establish continuing education or competency requirements as a condition to the renewal of licenses under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $100 per continuing medical education credit in lieu of a sanction under Sec. 14-5B-14 of this subtitle, for a first offense, for the failure of a licensee to obtain the continuing medical education credits required by the Board.

(e)

  (1) The Board shall renew the license of each individual who meets the renewal requirements of this section.

  (2) A license may not be renewed for a term longer than 2 years.

(f) The Board shall reinstate the license of a radiation therapist, radiographer, nuclear medicine technologist, or radiologist assistant who has failed to renew a license for any reason if the radiation therapist, radiographer, nuclear medicine technologist, or radiologist assistant:

  (1) Meets the renewal requirements of this section;

  (2) Submits to the Board:

    (i) A reinstatement application on the form that the Board requires; and

    (ii) Satisfactory evidence of compliance with any continuing education or competency requirements; and

  (3) Meets any additional requirements established by the Board for reinstatement.

(g)

  (1) Beginning October 1, 2016, the Board shall require a criminal history records check in accordance with Sec. 14-308.1 of this title for:

    (i) Renewal applicants as determined by regulations adopted by the Board; and

    (ii) Each former licensee who files for reinstatement under subsection (f) of this section.

  (2) On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether disciplinary action should be taken, based on the criminal history record information, against a licensee who renewed or reinstated a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.

  (3) The Board may renew or reinstate a license only if the licensee or applicant attests that the licensee or applicant has submitted to a criminal history records check under Sec. 14-308.1 of this title.

#### Section 14-5B-12.1

(a) A licensee shall notify the Board in writing of a change in name or address within 30 days after the change.

(b) A licensee who fails to comply with subsection (a) of this section is subject to an administrative penalty of $100.

#### Section 14-5B-13

Unless a disciplinary panel agrees to accept the surrender of a license, a licensee may not surrender the license and the license may not lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.

#### Section 14-5B-14

(a) Subject to the hearing provisions of Sec. 14-405 of this title, a disciplinary panel, on the affirmative vote of a majority of the quorum of the disciplinary panel, may deny a license to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke a license, if the applicant or licensee:

  (1) Fraudulently or deceptively obtains or attempts to obtain a license for the applicant, licensed individual, or for another;

  (2) Fraudulently or deceptively uses a license;

  (3) Is guilty of:

    (i) Immoral conduct in the practice of radiation therapy, radiography, nuclear medicine technology, or radiology assistance; or

    (ii) Unprofessional conduct in the practice of radiation therapy, radiography, nuclear medicine technology, or radiology assistance;

  (4) Is:

    (i) Professionally incompetent;

    (ii) Physically incompetent; or

    (iii) Mentally incompetent;

  (5) Abandons a patient;

  (6) Is habitually intoxicated;

  (7) Is addicted to or habitually abuses any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article;

  (8) Provides professional services while:

    (i) Under the influence of alcohol; or

    (ii) Using any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article or any other drug that is in excess of therapeutic amounts or without valid medical indication;

  (9) Promotes the sale of services, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

  (10) Willfully makes or files a false report or record in the practice of radiation therapy, radiography, nuclear medicine technology, or radiology assistance;

  (11) Willfully fails to file or record any report as required under law, willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record a report;

  (12) Breaches patient confidentiality;

  (13) Pays or agrees to pay any sum or provide any form of remuneration or material benefit to any person for bringing or referring a patient or accepts or agrees to accept any sum or any form of remuneration or material benefit from an individual for bringing or referring a patient;

  (14) Willfully makes a misrepresentation while practicing radiation therapy, radiography, nuclear medicine technology, or radiology assistance;

  (15) Willfully practices radiation therapy, radiography, nuclear medicine technology, or radiology assistance with an unauthorized individual or aids an unauthorized individual in the practice of radiation therapy, radiography, nuclear medicine technology, or radiology assistance;

  (16) Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine;

  (17) Is disciplined by a licensing or disciplinary authority or is convicted or disciplined by a court of any state or country, or is disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (18) Fails to meet appropriate standards for the delivery of quality radiation therapy, radiography, nuclear medicine technology, or radiology assistance care performed in any outpatient surgical facility, office, hospital or related institution, or any other location in this State;

  (19) Willfully submits false statements to collect fees for which services are not provided;

  (20)

    (i) Has been subject to investigation or disciplinary action by a licensing or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under the Board's disciplinary statutes; and

    (ii) Has:

      (1) Surrendered the license issued by the state or country; or

      (2) Allowed the license issued by the state or country to expire or lapse;

  (21) Willfully fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

  (22) Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes;

  (23) Practices or attempts to practice beyond the authorized scope of practice;

  (24) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

  (25) Practices or attempts to practice a radiation therapy, radiography, nuclear medicine technology, or radiology assistance procedure or uses radiation therapy, radiography, nuclear medicine technology, or radiology assistance equipment if the applicant or licensee has not received education, internship, training, or experience in the performance of the procedure or the use of the equipment;

  (26) Fails to cooperate with a lawful investigation conducted by the Board or a disciplinary panel;

  (27) Fails to practice under the supervision of a physician or violates a supervisory order of a supervising physician; or

  (28) Fails to complete a criminal history records check under Sec. 14-308.1 of this title.

(b) Except as otherwise provided in the Administrative Procedure Act, before the Board or a disciplinary panel takes any action under subsection (a) of this section, it shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board or the disciplinary panel in accordance with the hearing requirements of Sec. 14-405 of this title.

(c)

  (1) On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a licensee if the licensee is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

  (2) After completion of the appellate process if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a license on the certification by the Office of the Attorney General.

(d)

  (1) If, after a hearing under Sec. 14-405 of this title, a disciplinary panel finds that there are grounds under subsection (a) of this section to suspend or revoke a license, to reprimand a licensee, or to place a licensee on probation, the disciplinary panel may impose a fine subject to the Board's regulations in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

  (2) The Board shall pay any fines collected under this section into the General Fund of the State.

(e) In addition to any sanction authorized under this section, a disciplinary panel may require a licensee to comply with specified terms and conditions determined by the disciplinary panel.

#### Section 14-5B-14.1

(a)

  (1) Any person aggrieved by a final decision of the Board or a disciplinary panel under this subtitle may take a direct judicial appeal.

  (2) The appeal shall be made as provided for judicial review of final decisions in the Administrative Procedure Act.

(b) An order of the Board or a disciplinary panel may not be stayed pending review.

(c) The Board may appeal from any decision that reverses or modifies the order of the Board or a disciplinary panel.

#### Section 14-5B-15

(a)

  (1) Except as provided in subsections (b) and (d) of this section, each employer of a licensee shall submit to the Board a report if:

    (i) The employer:

      (1) Reduced, suspended, revoked, restricted, denied, conditioned, or did not renew the licensee's clinical privileges, employment, or other ability to practice or treat patients;

      (2) Involuntarily terminated or restricted the licensee's employment or staff membership; or

      (3) Asked the licensee to voluntarily resign because of the licensee's conduct or while the licensee is being investigated; and

    (ii) The action described under item (i) of this paragraph was taken:

      (1) For reasons that might be grounds for disciplinary action under Sec. 14-5B-14 of this subtitle;

      (2) Because the licensee may have engaged in an act that may constitute unprofessional conduct;

      (3) Because the licensee may be unable to practice nuclear medicine technology, radiation therapy, radiography, or radiology assistance with reasonable skill and safety because of a physical or mental condition or professional incompetence; or

      (4) Because the licensee may have harmed or placed one or more patients or the public at unreasonable risk of harm by engaging in an act that creates an immediate or continuing danger.

  (2) Each report submitted under paragraph (1) of this subsection shall include:

    (i) The action taken by the employer;

    (ii) A detailed explanation of the reasons for the action, including references to specific patient medical records, if any, that informed the employer's action; and

    (iii) The steps taken by the employer to investigate the conduct of the licensee.

  (3)

    (i) The Board may request from the employer additional information regarding an action described in paragraph (1) of this subsection that was taken by the employer.

    (ii) If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information.

(b) If an employer knows that the conduct of a licensee requires that the employer submit a report under subsection (a)(1) of this section because the licensee is impaired by alcohol or another substance, the employer is not required to report the licensee to the Board if:

  (1) The employer knows that the licensee is:

    (i) In a substance use disorder treatment program that is accredited by The Joint Commission or is certified by the Department; or

    (ii) Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders;

  (2)

    (i) The employer is able to verify that the licensee remains in the treatment program until successful discharge; and

    (ii) The action or condition of the licensee has not caused injury to any person while the licensee is practicing as a licensed nuclear medicine technologist, licensed radiation therapist, licensed radiographer, or licensed radiologist assistant.

(c) If the employer knows that the licensee is noncompliant with the substance use disorder treatment program, the employer of the licensee shall report the licensee's noncompliance to the Board.

(d)

  (1) The Board may extend the reporting under this section for good cause shown.

  (2) A person is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of substance use disorder patient records.

(e) The Board may enforce this section by subpoena.

(f) Any person shall have the immunity from liability described under Sec. 5-715(d) of the Courts Article for giving any of the information required by this section.

(g) An employer required to make a report to the Board under this section shall submit the report within 10 days after the action requiring the report.

(h) A report made under this section is privileged, not subject to inspection under the Public Information Act, and not subject to subpoena or discovery in any civil action other than a proceeding arising out of a hearing and decision of the Board or a disciplinary panel under this title.

(i)

  (1) A disciplinary panel may impose a civil penalty of up to $5,000 for knowingly failing to report under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $5,000 per incident for a report made by an employer in bad faith.

  (3) The Board shall remit any penalty collected under this subsection into the General Fund of the State.

#### Section 14-5B-15.1

(a) Following the filing of charges or notice of initial denial of license application, the Board shall disclose the filing to the public on the Board's Web site.

(b) The Board shall create and maintain a public individual profile on each licensee that includes the following information:

  (1) A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under Sec. 14-5B-14 of this subtitle based on the charges or has rescinded the charges;

  (2) A description of any disciplinary action taken by the Board or a disciplinary panel against the licensee within the most recent 10-year period that includes a copy of the public order;

  (3) A description in summary form of any final disciplinary action taken by a licensing board in any other state or jurisdiction against the licensee within the most recent 10-year period if the Board knows of the disciplinary action;

  (4) A description of a conviction or entry of a plea of guilty or nolo contendere by the licensee for a crime involving moral turpitude that is the basis for disciplinary action taken under Sec. 14-5B-14(c) of this subtitle; and

  (5) The public address of the licensee.

(c) In addition to the requirements of subsection (b) of this section, the Board shall include on each licensee's profile a statement of information to be taken into consideration by a consumer when viewing a licensee's profile, including a disclaimer stating that a charging document does not indicate a final finding of guilt by a disciplinary panel.

(d) The Board:

  (1) On receipt of a written request for a licensee's profile from any person, shall forward a written copy of the profile to the person; and

  (2) Shall maintain a Web site that serves as a single point of entry where all licensee profile information is available to the public on the Internet.

(e) The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee's profile.

(f) The Board shall include information relating to charges filed against a licensee by a disciplinary panel and any final disciplinary action taken by a disciplinary panel against a licensee in the licensee's profile within 10 days after the charges are filed or the action becomes final.

#### Section 14-5B-16

(a) Subject to subsection (b) of this section, on the application of an individual whose license has been revoked, a disciplinary panel may reinstate a revoked license.

(b) A disciplinary panel may not reinstate a revoked license that has been revoked for a period of more than 1 year unless the licensee:

  (1) Meets the requirements for reinstatement as established under this title; and

  (2) Completes a criminal history records check in accordance with Sec. 14-308.1 of this title.

#### Section 14-5B-17

(a) Except as otherwise provided in this subtitle, a person may not practice, attempt to practice, or offer to practice radiation therapy in this State unless licensed to practice radiation therapy by the Board.

(b) Except as otherwise provided in this subtitle, a person may not practice, attempt to practice, or offer to practice nuclear medicine technology in this State unless licensed to practice nuclear medicine technology by the Board.

(c) Except as otherwise provided in this subtitle, a person may not practice, attempt to practice, or offer to practice radiography in this State unless licensed to practice radiography by the Board.

(d) Except as otherwise provided in this subtitle, a person may not practice, attempt to practice, or offer to practice radiology assistance in this State unless licensed to practice radiology assistance by the Board.

#### Section 14-5B-18

(a) Unless authorized to practice radiation therapy, radiography, nuclear medicine technology, or radiology assistance under this subtitle, a person may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the person is authorized to practice radiation therapy, radiography, nuclear medicine technology, or radiology assistance  in this State.

(b) A person may not provide, attempt to provide, offer to provide, or represent that the person provides radiation therapy, radiography, nuclear medicine technology, or radiology assistance care unless the radiation therapy, radiography, nuclear medicine technology, or radiology assistance care is provided by an individual who is authorized to practice radiation therapy, radiography, nuclear medicine technology, or radiology assistance under this subtitle.

#### Section 14-5B-18.1

(a) Except as otherwise provided in this subtitle, a licensed physician may not employ or supervise an individual practicing radiation therapy, radiography, nuclear medicine technology, or radiology assistance without a license.

(b) Except as otherwise provided in this subtitle, an employer may not employ an individual practicing radiation therapy, radiography, nuclear medicine technology, or radiology assistance without a license.

(c) A disciplinary panel may impose a civil penalty of up to $5,000 for employing an individual without a license under this section.

(d) The Board shall remit any penalty collected under this section into the General Fund of the State.

#### Section 14-5B-19

(a) A person who violates Sec. 14-5B-17 or Sec. 14-5B-18 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 or imprisonment not exceeding 1 year or both.

(b) A person who violates Sec. 14-5B-17 or Sec. 14-5B-18 of this subtitle is subject to a civil fine of not more than $5,000 to be levied by a disciplinary panel.

(c) The Board shall pay any penalty collected under this section into the Board of Physicians Fund.

#### Section 14-5B-20

This subtitle may be cited as the "Maryland Radiation Therapy, Radiography, Nuclear Medicine Technology, and Radiology Assistance Act".

#### Section 14-5B-21

Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act, and subject to the termination of this title under Sec. 14-702 of this title, this subtitle and all rules and regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2030.

### Subtitle 5C. Polysomnographic Technologists

#### Section 14-5C-01

(a) In this subtitle the following words have the meanings indicated.

(b) "Board" means the State Board of Physicians.

(c) "Committee" means the Polysomnography Advisory Committee established under Sec. 14-5C-05 of this subtitle.

(d) "License" means a license issued by the Board.

(e) "Licensed polysomnographic technologist" means a polysomnographic technologist who is licensed by the Board under this subtitle to practice polysomnography under the supervision of a licensed physician.

(f)

  (1) "Practice polysomnography" means:

    (i) Monitoring and recording physiologic data during sleep, including sleep-related respiratory disturbances under the supervision of a licensed physician; or

    (ii) Using data collected under item (i) of this paragraph for the purposes of assisting a licensed physician in the diagnosis and treatment of sleep and wake disorders.

  (2) "Practice polysomnography" includes:

    (i) Providing polysomnography services that are safe, aseptic, preventive, and restorative;

    (ii) Diagnosing and treating individuals who suffer from sleep disorders as a result of developmental defects, the aging process, physical injury, disease, or actual or anticipated somatic dysfunction;

    (iii) Observing and monitoring physical signs and symptoms, general behavior, and general physical response to polysomnographic evaluation and determining whether initiation, modification, or discontinuation of a treatment regimen is warranted;

    (iv) Using evaluation techniques that include limited cardiopulmonary function assessments, the need and effectiveness of therapeutic modalities and procedures, and the assessment and evaluation of the need for extended care; and

    (v) Applying the use of techniques, equipment, and procedures involved in the evaluation of polysomnography, including:

      (1) Continuous positive airway pressure or bi-level positive airway pressure titration on spontaneously breathing patients;

      (2) Supplemental low flow oxygen therapy during polysomnogram;

      (3) Capnography during polysomnogram;

      (4) Cardiopulmonary resuscitation;

      (5) Pulse oximetry;

      (6) PH probe placement and monitoring;

      (7) Esophageal pressure;

      (8) Sleep staging including surface electroencephalography, surface electrooculography, and surface submental electromyography;

      (9) Surface electromyography of arms and legs;

      (10) Electrocardiography;

      (11) Respiratory effort including thoracic and abdominal;

      (12) Plethysmography blood flow;

      (13) Snore monitoring;

      (14) Audio or video monitoring;

      (15) Implementation of a written or verbal order from a licensed physician that requires the practice of polysomnography;

      (16) Monitoring the effects a nasal device, used to treat sleep apnea, has on sleep patterns provided that the device does not extend into the trachea; and

      (17) Monitoring the effects an oral device, used to treat sleep apnea, has on sleep patterns, provided that:

      (A) The device does not extend into the trachea;

      (B) A dentist has evaluated the structures of the patient's oral and maxillofacial region for purposes of fitting;

      (C) A dentist made or directed the making of the oral device; and

      (D) A dentist directs the use of the oral device.

(g) "Registered polysomnographic technologist" means a polysomnographic technologist who is registered by the Board of Registered Polysomnographic Technicians.

(h) "Student" means an individual who, in accordance with section 14-5C-09(c) of this subtitle, is:

  (1) Enrolled in an accredited educational program in order to qualify for a license under this title; and

  (2) Performing polysomnography services within the accredited program under the supervision of a licensed physician and without compensation.

(i) "Supervision" means general or direct supervision of a licensed polysomnographic technologist by a licensed physician.

#### Section 14-5C-02

This subtitle does not limit:

(1) The right of an individual to practice a health occupation that the individual is authorized to practice under this article;

(2) The right of a licensed home medical equipment provider to provide home medical equipment services as defined under Title 19, Subtitle 4A of the Health - General Article; or

(3) The right of a licensed respiratory care practitioner to practice respiratory care within the scope of practice of the respiratory care practitioner's license, including practicing respiratory care in a sleep laboratory.

#### Section 14-5C-03

The Board shall adopt regulations for the licensure and practice of polysomnography.

#### Section 14-5C-04

(a)

  (1) The Board shall set reasonable fees for the issuance of and renewal of licenses and other services it provides to polysomnographic technologists.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure program and the other services provided to polysomnographic technologists, including the cost of providing a rehabilitation program for polysomnographic technologists under Sec. 14-401.1(g) of this title.

(b)

  (1) The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller.

  (2) The Comptroller shall distribute all fees to the Board.

(c) The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this subtitle.

#### Section 14-5C-05

There is a Polysomnography Advisory Committee within the Board.

#### Section 14-5C-06

(a) The Committee consists of seven members appointed by the Board as follows:

  (1) Three licensed polysomnographic technologists;

  (2) Three licensed physicians who are board certified in sleep medicine:

    (i) One of whom is a specialist in psychiatry or internal medicine;

    (ii) One of whom is a specialist in pulmonary medicine; and

    (iii) One of whom is a specialist in neurology; and

  (3) One consumer member.

(b) Each member of the Committee licensed by the Board must be in good standing with the Board.

(c) The consumer member of the Committee:

  (1) Must be a member of the general public;

  (2) May not be or ever have been:

    (i) A polysomnographic technologist;

    (ii) Any other health care professional; or

    (iii) In training to be a polysomnographic technologist or other health care professional; and

  (3) May not:

    (i) Participate or ever have participated in a commercial or professional field related to polysomnography;

    (ii) Have a household member who participates in a commercial or professional field related to polysomnography;

    (iii) Have had within 2 years before appointment a financial interest in a person regulated by the Board; or

    (iv) Have had within 2 years before appointment a financial interest in the provision of goods or services to polysomnographic technologists or to the field of polysomnography.

(d) Each member of the Committee must be a resident of the State.

(e)

  (1) The term of a member is 3 years.

  (2) The terms of members are staggered as required by regulation.

  (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

  (4) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.

  (5) A member may not serve more than two consecutive full terms.

(f)

  (1) From among its members, the Committee shall elect a chair once every 2 years.

  (2) The chair, or the chair's designee, shall serve in an advisory capacity to the Board as a representative of the Committee.

(g) A quorum of the Committee consists of four members.

#### Section 14-5C-07

In addition to the powers set forth elsewhere in this subtitle, the Committee:

(1) Shall:

  (i) Develop and recommend to the Board:

    (1) Regulations to carry out this subtitle; and

    (2) Any statutory changes that affect the profession; and

  (ii) Keep a record of its meetings; and

(2) May:

  (i) Provide recommendations regarding the practice of polysomnography; and

  (ii) Advise the Board on any other matters related to polysomnographic technologist practitioners.

#### Section 14-5C-08

(a) Except as otherwise provided in this subtitle or Sec.Sec. 10-14A-03 and 10-14B-03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice polysomnography in this State.

(b) This section does not apply to:

  (1) A student enrolled in an education program under Sec. 14-5C-09(c)(3) of this subtitle while practicing polysomnography in that program;

  (2) A respiratory care practitioner who was licensed by the Board to practice respiratory care on or before December 31, 2012, and whose duties include practicing polysomnography; or

  (3) A polysomnographic technologist employed in the service of the federal government while practicing within the scope of the employment.

#### Section 14-5C-09

(a) To qualify for a license, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall:

  (1) Be of good moral character;

  (2) Be at least 18 years old; and

  (3) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title.

(c) An applicant for a polysomnographic technologist license shall:

  (1) Have passed the national certifying examination given by the Board of Registered Polysomnographic Technologists or another examination approved by the Board;

  (2) Submit to the Board proof of certification as a registered polysomnographic technologist or other national certification approved by the Board;

  (3)

    (i)

      (1) Have graduated from a polysomnographic educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs; or

      (2)

        (A) Have graduated from a sleep technologist educational program that is accredited by the American Academy of Sleep Medicine; and

      (B) Have completed a clinical component of an educational program as established by the Committee and approved by the Board;

    (ii)

      (1) Have graduated from a respiratory care educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs; and

      (2) Have completed the Committee on Accreditation for Respiratory Care's curriculum for a polysomnography certificate that is accredited by the Commission on Accreditation of Allied Health Education Programs; or

    (iii)

      (1) Have graduated from an electroneuro-diagnostic educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs; and

      (2) Have completed additional units, modules, and courses of instruction focused on polysomnographic technology that are accredited by the Commission on Accreditation of Allied Health Education Programs; and

  (4) Meet any other educational or clinical requirements established by the Committee and approved by the Board.

#### Section 14-5C-11

To apply for a license, an applicant shall:

(1) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title;

(2) Submit an application to the Board on the form that the Board requires; and

(3) Pay to the Board the application fee set by the Board.

#### Section 14-5C-12

(a) Subject to subsection (b) of this section, the Board shall issue a license to an applicant who meets the requirements of this subtitle.

(b)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether to issue a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 14-308.1 of this title has not been received.

#### Section 14-5C-13

(a) A license authorizes a polysomnographic technologist to practice polysomnography in this State while the license is effective.

(b) A licensed polysomnographic technologist may practice polysomnography in:

  (1) A hospital sleep laboratory; or

  (2) A stand-alone sleep center.

#### Section 14-5C-14

(a)

  (1) The term of a license issued by the Board may not exceed 3 years.

  (2) A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.

(b) At least 1 month before a license expires, the Board shall send to the licensed polysomnographic technologist, by first-class mail to the last known address of the licensed polysomnographic technologist, a renewal notice that states:

  (1) The date on which the current license expires;

  (2) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and

  (3) The amount of the renewal fee.

(c) Except as otherwise provided in this subtitle, before a license expires, the licensed polysomnographic technologist periodically may renew it for an additional term, if the licensee:

  (1) Otherwise is entitled to be licensed;

  (2) Is of good moral character;

  (3) Pays to the Board a renewal fee set by the Board; and

  (4) Submits to the Board:

    (i) A renewal application on the form that the Board requires; and

    (ii) Satisfactory evidence of compliance with any continuing education or competency requirements and other requirements set under this section for license renewal.

(d) In addition to any other qualifications and requirements established by the Board, the Board may establish continuing education or competency requirements as a condition of the renewal of a license under this section.

(e) The Board shall renew the license of each licensee who meets the requirements of this section.

(f) The Board may reinstate the license of a polysomnographic technologist who has failed to renew the license for any reason, and who applies for reinstatement after the license has expired, if the polysomnographic technologist:

  (1) Meets the renewal requirements of this section;

  (2) Pays to the Board the reinstatement fee set by the Board; and

  (3) Meets any other requirements established by regulation.

(g)

  (1) Beginning October 1, 2016, the Board shall require a criminal history records check in accordance with Sec. 14-308.1 of this title for:

    (i) Renewal applicants as determined by regulations adopted by the Board; and

    (ii) Each former licensee who files for reinstatement under subsection (f) of this section.

  (2) On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether disciplinary action should be taken, based on the criminal history record information, against a licensee who renewed or reinstated a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.

  (3) The Board may renew or reinstate a license only if the licensee or applicant attests that the licensee or applicant has submitted to a criminal history records check under Sec. 14-308.1 of this title.

(h) A disciplinary panel may impose a civil penalty of up to $100 per continuing education credit in lieu of a sanction under Sec. 14-5C-17 of this subtitle, for a first offense for failure of a licensee to obtain the continuing education credits required by the Board.

#### Section 14-5C-14.1

(a) A licensee shall notify the Board in writing of a change in name or address within 30 days after the change.

(b) A licensee who fails to comply with subsection (a) of this section is subject to an administrative penalty of $100.

#### Section 14-5C-16

Unless a disciplinary panel agrees to accept the surrender of a license, a licensed polysomnographic technologist may not surrender the license nor may the license lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.

#### Section 14-5C-17

(a) Subject to the hearing provisions of Sec. 14-405 of this title, a disciplinary panel, on the affirmative vote of a majority of a quorum of the disciplinary panel, may deny a license to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke a license, if the applicant or licensee:

  (1) Fraudulently or deceptively obtains or attempts to obtain a license for the applicant, licensee, or for another;

  (2) Fraudulently or deceptively uses a license;

  (3) Is guilty of:

    (i) Immoral conduct in the practice of polysomnography; or

    (ii) Unprofessional conduct in the practice of polysomnography;

  (4) Is:

    (i) Professionally incompetent;

    (ii) Physically incompetent; or

    (iii) Mentally incompetent;

  (5) Abandons a patient;

  (6) Is habitually intoxicated;

  (7) Is addicted to or habitually abuses any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article;

  (8) Provides professional services while:

    (i) Under the influence of alcohol; or

    (ii) Using any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article or any other drug that is in excess of therapeutic amounts or without valid medical indication;

  (9) Promotes the sale of services, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

  (10) Willfully makes or files a false report or record in the practice of polysomnography;

  (11) Willfully fails to file or record any report as required under law, willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record a report;

  (12) Breaches patient confidentiality;

  (13) Pays or agrees to pay any sum or provide any form of remuneration or material benefit to any person for bringing or referring a patient or accepts or agrees to accept any sum or any form of remuneration or material benefit from an individual for bringing or referring a patient;

  (14) Willfully makes a misrepresentation while practicing polysomnography;

  (15) Willfully practices polysomnography with an unauthorized individual or aids an unauthorized individual in the practice of polysomnography;

  (16) Willfully delegates a polysomnographic duty to an unlicensed individual;

  (17) Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine;

  (18) Is disciplined by a licensing or disciplinary authority or is convicted or disciplined by a court of any state or country, or is disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (19) Fails to meet appropriate standards for the delivery of polysomnographic services performed in a hospital sleep laboratory or a stand-alone sleep center;

  (20) Willfully submits false statements to collect fees for which services are not provided;

  (21)

    (i) Has been subject to investigation or disciplinary action by a licensing or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under the Board's disciplinary statutes; and

    (ii) Has:

      (1) Surrendered the license, if any, issued by the state or country; or

      (2) Allowed the license, if any, issued by the state or country to expire or lapse;

  (22) Willfully fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

  (23) Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes;

  (24) Practices or attempts to practice beyond the authorized scope of practice;

  (25) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

  (26) Practices or attempts to practice a polysomnography procedure or uses or attempts to use polysomnography equipment if the applicant or licensee has not received education and training in the performance of the procedure or the use of the equipment;

  (27) Fails to cooperate with a lawful investigation conducted by the Board; or

  (28) Fails to complete a criminal history records check under Sec. 14-308.1 of this title.

(b) Except as otherwise provided in Title 10, Subtitle 2 of the State Government Article, before the Board or a disciplinary panel takes any action under subsection (a) of this section, it shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board or the disciplinary panel in accordance with the hearing requirements of Sec. 14-405 of this title.

(c)

  (1) On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a license if the licensee is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

  (2) After completion of the appellate process if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a license on the certification by the Office of the Attorney General.

(d)

  (1) If, after a hearing under Sec. 14-405 of this title, a disciplinary panel finds that there are grounds under subsection (a) of this section to suspend or revoke a license, to reprimand a licensee, or to place a licensee on probation, the disciplinary panel may impose a fine subject to the Board's regulations in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

  (2) The Board shall pay any fines collected under this section into the General Fund of the State.

(e) In addition to any sanction authorized under this section, a disciplinary panel may require a licensee to comply with specified terms and conditions determined by the disciplinary panel.

#### Section 14-5C-18

(a)

  (1) Except as provided in subsections (b) and (d) of this section, each employer of a licensed polysomnographic technologist shall submit to the Board a report if:

    (i) The employer:

      (1) Reduced, suspended, revoked, restricted, denied, conditioned, or did not renew the licensed polysomnographic technologist's clinical privileges, employment, or other ability to practice or treat patients;

      (2) Involuntarily terminated or restricted the licensed polysomnographic technologist's employment or staff membership; or

      (3) Asked the licensed polysomnographic technologist to voluntarily resign because of the licensed polysomnographic technologist's conduct or while the licensed polysomnographic technologist is being investigated; and

    (ii) The action described under item (i) of this paragraph was taken:

      (1) For reasons that might be grounds for disciplinary action under Sec. 14-5C-17 of this subtitle;

      (2) Because the licensed polysomnographic technologist may have engaged in an act that may constitute unprofessional conduct;

      (3) Because the licensed polysomnographic technologist may be unable to practice polysomnography with reasonable skill and safety because of a physical or mental condition or professional incompetence; or

      (4) Because the licensed polysomnographic technologist may have harmed or placed one or more patients or the public at unreasonable risk of harm by engaging in an act that creates an immediate or continuing danger.

  (2) Each report submitted under paragraph (1) of this subsection shall include:

    (i) The action taken by the employer;

    (ii) A detailed explanation of the reasons for the action, including references to specific patient medical records, if any, that informed the employer's action; and

    (iii) The steps taken by the employer to investigate the conduct of the licensed polysomnographic technologist.

  (3)

    (i) The Board may request from the employer additional information regarding an action described in paragraph (1) of this subsection that was taken by the employer.

    (ii) If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information.

(b) If an employer knows that the conduct of a licensed polysomnographic technologist requires that the employer submit a report under subsection (a)(1) of this section because the licensed polysomnographic technologist is impaired by alcohol or another substance, the employer is not required to report the technologist to the Board if:

  (1) The employer knows that the licensed polysomnographic technologist is:

    (i) In a substance use disorder treatment program that is accredited by The Joint Commission or is certified by the Department; or

    (ii) Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders; and

  (2)

    (i) The employer is able to verify that the licensed polysomnographic technologist remains in the treatment program until successful discharge; and

    (ii) The action or condition of the licensed polysomnographic technologist has not caused injury to any person while the licensed polysomnographic technologist is practicing as a licensed polysomnographic technologist.

(c) If the employer knows that the licensed polysomnographic technologist is noncompliant with the substance use disorder treatment program, the employer of the licensed polysomnographic technologist shall report the licensed polysomnographic technologist's noncompliance to the Board.

(d)

  (1) The Board may extend the reporting under this section for good cause shown.

  (2) A person is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of substance use disorder patient records.

(e) The Board may enforce this section by subpoena.

(f) Any person shall have the immunity from liability described under Sec. 5-715(d) of the Courts Article for giving any of the information required by this section.

(g) An employer required to make a report to the Board under this section shall submit the report within 10 days after the action requiring the report.

(h) A report made under this section is privileged, not subject to inspection under the Public Information Act, and not subject to subpoena or discovery in any civil action other than a proceeding arising out of a hearing and decision of the Board or a disciplinary panel under this title.

(i)

  (1) A disciplinary panel may impose a civil penalty of up to $5,000 for knowingly failing to report under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $5,000 per incident for a report made by an employer in bad faith.

  (3) The Board shall remit any penalty collected under this subsection into the General Fund of the State.

#### Section 14-5C-18.1

(a) Following the filing of charges or notice of initial denial of license application, the Board shall disclose the filing to the public on the Board's Web site.

(b) The Board shall create and maintain a public individual profile on each licensee that includes the following information:

  (1) A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under Sec. 14-5C-17 of this subtitle based on the charges or has rescinded the charges;

  (2) A description of any disciplinary action taken by the Board or a disciplinary panel against the licensee within the most recent 10-year period that includes a copy of the public order;

  (3) A description in summary form of any final disciplinary action taken by a licensing board in any other state or jurisdiction against the licensee within the most recent 10-year period if the Board knows of the disciplinary action;

  (4) A description of a conviction or entry of a plea of guilty or nolo contendere by the licensee for a crime involving moral turpitude that is the basis for disciplinary action taken under Sec. 14-5C-17(c) of this subtitle; and

  (5) The public address of the licensee.

(c) In addition to the requirements of subsection (b) of this section, the Board shall include on each licensee's profile a statement of information to be taken into consideration by a consumer when viewing a licensee's profile, including a disclaimer stating that a charging document does not indicate a final finding of guilt by a disciplinary panel.

(d) The Board:

  (1) On receipt of a written request for a licensee's profile from any person, shall forward a written copy of the profile to the person; and

  (2) Shall maintain a Web site that serves as a single point of entry where all licensee profile information is available to the public on the Internet.

(e) The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee's profile.

(f) The Board shall include information relating to charges filed against a licensee by a disciplinary panel and any final disciplinary action taken by a disciplinary panel against a licensee in the licensee's profile within 10 days after the charges are filed or the action becomes final.

#### Section 14-5C-19

(a) Subject to subsection (b) of this section, on the application of an individual whose license has been revoked, a disciplinary panel, on the affirmative vote of a majority of its full authorized membership, may reinstate a revoked license.

(b) A disciplinary panel may not reinstate a revoked license that has been revoked for a period of more than 1 year unless the licensee:

  (1) Meets the requirements for reinstatement as established under this title; and

  (2) Completes a criminal history records check in accordance with Sec. 14-308.1 of this title.

#### Section 14-5C-20

Except as otherwise provided in this subtitle, a person may not practice, attempt to practice, or offer to practice polysomnography in this State unless licensed to practice polysomnography by the Board.

#### Section 14-5C-21

(a) Unless authorized to practice polysomnography under this subtitle, a person may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the person is authorized to practice polysomnography in this State.

(b) Unless authorized to practice polysomnography under this subtitle, a person may not use the abbreviation "P.S.G." or any other words, letters, or symbols with the intent to represent that the person practices polysomnography.

#### Section 14-5C-22

A person may not provide, attempt to provide, offer to provide, or represent that the person provides polysomnography unless the polysomnography is provided by an individual who is authorized to practice polysomnography under this subtitle.

#### Section 14-5C-22.1

(a) Except as otherwise provided in this subtitle, a licensed physician may not employ or supervise an individual practicing polysomnography without a license.

(b) Except as otherwise provided in this subtitle, an employer may not employ an individual practicing polysomnography without a license.

(c) A disciplinary panel may impose a civil penalty of not more than $5,000 for a violation of this section.

(d) The Board shall pay any penalty collected under this subsection into the General Fund of the State.

#### Section 14-5C-23

(a) A person who violates Sec. 14-5C-20, Sec. 14-5C-21, or Sec. 14-5C-22 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 or imprisonment not exceeding 1 year or both.

(b) A person who violates Sec. 14-5C-20, Sec. 14-5C-21, or Sec. 14-5C-22 of this subtitle is subject to a civil fine of not more than $5,000 to be levied by a disciplinary panel.

(c) The Board shall pay any penalty collected under this section into the Board of Physicians Fund.

#### Section 14-5C-24

This subtitle may be cited as the "Maryland Polysomnography Act".

#### Section 14-5C-25

Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act and subject to the termination of this title under Sec. 14-702 of this title, this subtitle and all regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2030.

### Subtitle 5D. Athletic Trainers

#### Section 14-5D-01

(a) In this subtitle the following words have the meanings indicated.

(b) "Alternate supervising physician" means one or more physicians designated by the supervising physician to provide supervision of an athletic trainer:

  (1) During the absence of the supervising physician; and

  (2) In accordance with the evaluation and treatment protocol on file with the Board.

(c) "Athletic individual" means an individual who participates in an athletic activity, a job function, or a job-related activity that requires physical strength, range of motion, flexibility, control, speed, stamina, or agility.

(d) "Board" means the State Board of Physicians.

(e) "Committee" means the Athletic Trainer Advisory Committee established under Sec. 14-5D-04 of this subtitle.

(e-1) "Dry needling" means an intramuscular manual therapy that:

  (1) Involves the insertion of one or more solid needles into the muscle and related tissues to effect change in the muscle and related tissues;

  (2) Requires ongoing evaluation, assessment, and reevaluation of an impairment;

  (3) Is used only in parts of the body with neuromuscular or musculoskeletal links to an impairment; and

  (4) Is not performed for:

    (i) The purposes of acupuncture as defined in Sec. 1A-101 of this article; or

    (ii) Any purpose outside of the scope of practice of athletic trainers.

(f) "Evaluation and treatment protocol" means a document that is executed by a physician and an athletic trainer that meets the requirements of Sec. 14-5D-11 of this subtitle.

(g) "License" means a license issued by the Board to practice athletic training.

(h) "Licensed athletic trainer" means an individual who is licensed by the Board to practice athletic training.

(i) "Licensed health care practitioner" means an individual licensed, certified, or otherwise authorized to practice a health occupation under this article.

(j) "National certifying board" means the National Athletic Trainers' Association Board of Certification, Inc., or its successor organization.

(k) "Nonsupervising physician" means a physician licensed by the Board who is not the supervising physician of the licensed athletic trainer.

(l) "Outside referral" means a request for treatment from a nonsupervising physician or licensed health care practitioner.

(m)

  (1) "Practice athletic training" means application of the following principles and methods for managing injuries for athletic individuals in good overall health under the supervision of a licensed physician:

    (i) Prevention and wellness promotion;

    (ii) Clinical evaluation, examination, assessment, and determination of a plan of care, including appropriate referrals;

    (iii) Immediate care and emergency care; and

    (iv) Treatment, rehabilitation, and reconditioning.

  (2) "Practice athletic training" includes:

    (i) Organization and administration of an athletic training program;

    (ii) Instruction to coaches, athletes, parents, medical personnel, and community members regarding the care and prevention of injuries; and

    (iii) Recognition and management of a concussion, including management of an athletic individual's progressive return to activity.

  (3) "Practice athletic training" does not include:

    (i) The practice of:

      (1) Chiropractic, including adjustments, manipulation, or high velocity mobilizations of the spine or extremities;

      (2) Massage therapy;

      (3) Medicine;

      (4) Occupational therapy;

      (5) Physical therapy; or

      (6) Podiatry;

    (ii) The reconditioning of systemic neurologic injuries, conditions, or disease; or

    (iii) The treatment of disease.

(n) "Supervising physician" means a physician who has been approved by the Board to supervise one or more athletic trainers.

(o) "Supervision" means the responsibility of a physician to provide ongoing and immediately available instruction, in person, by telephone, or by other electronic means, that is adequate to ensure the safety and welfare of a patient and is appropriate to the setting.

#### Section 14-5D-02

This subtitle does not limit the right of an individual to practice a health occupation that the individual is authorized to practice under this article.

#### Section 14-5D-03

(a)

  (1) The Board shall set reasonable fees for the issuance and renewal of licenses and the other services it provides to athletic trainers.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure program and the other services provided to athletic trainers, including the cost of providing a rehabilitation program for athletic trainers under Sec. 14-401.1(g) of this title.

(b)

  (1) The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller.

  (2) The Comptroller shall distribute all fees to the Board.

(c) The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this subtitle.

#### Section 14-5D-04

There is an Athletic Trainer Advisory Committee within the Board.

#### Section 14-5D-05

(a) The Committee consists of seven members appointed by the Board as follows:

  (1) Three licensed athletic trainers;

  (2) Three licensed physicians:

    (i) At least one of whom is a specialist in orthopedic or sports medicine; and

    (ii) Two of whom previously or currently have partnered with or directed an athletic trainer; and

  (3) One consumer member.

(b) The Board shall appoint at least one of the athletic trainer members from a list of names submitted by the Maryland Athletic Trainers Association, Inc.

(c) Each member of the Committee licensed by the Board must be in good standing with the Board.

(d) The consumer member of the Committee:

  (1) Must be a member of the general public;

  (2) May not be or ever have been:

    (i) An athletic trainer;

    (ii) Any other health care professional; or

    (iii) In training to be an athletic trainer or other health professional; and

  (3) May not:

    (i) Participate or ever have participated in a commercial or professional field related to athletic training;

    (ii) Have a household member who participates in a commercial or professional field related to athletic training;

    (iii) Have had within 2 years before appointment a financial interest in the provision of goods or services to athletic trainers or to the field of athletic training; or

    (iv) Have had within 2 years before appointment a financial interest in a person regulated by the Board.

(e) Each member of the Committee must be a resident of the State.

(f)

  (1) The term of a member is 3 years.

  (2) The terms of members are staggered as required by regulation.

  (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

  (4) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.

  (5) A member may not serve more than two consecutive full terms.

(g)

  (1) From among its members, the Committee shall elect a chair every 2 years.

  (2) The chair shall serve in an advisory capacity to the Board as a representative of the Committee.

(h) A quorum of the Committee consists of four members.

#### Section 14-5D-06

In addition to the powers set forth elsewhere in this subtitle, the Committee:

(1) Shall:

  (i) Develop and recommend to the Board:

    (1) Regulations to carry out this subtitle; and

    (2) Any statutory changes that affect the profession; and

  (ii) Keep a record of its meetings; and

(2) May:

  (i) Provide recommendations regarding the practice of athletic training; and

  (ii) Advise the Board on any other matters related to athletic trainers.

#### Section 14-5D-07

(a) Except as otherwise provided in this subtitle or Sec.Sec. 10-14A-03 and 10-14B-03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice athletic training in the State.

(b) This section does not apply to:

  (1) An athletic trainer employed in the service of the federal government while practicing within the scope of the employment;

  (2) An individual employed by or under contract with an entity located in another state who represents that entity:

    (i) At an athletic event in the State;

    (ii) For a period of time not to exceed 45 days within a calendar year; and

    (iii) By providing athletic training services to individuals representing the entity at the event; or

  (3) A student enrolled in an education program that meets the criteria of Sec. 14-5D-08(c)(2) of this subtitle while engaged in an unpaid, clinical educational experience of athletic training.

#### Section 14-5D-08

(a) To qualify for a license, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall:

  (1) Be of good moral character;

  (2) Be at least 18 years old; and

  (3) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title.

(c) The applicant shall:

  (1) Have a current certification by a national certifying board approved by the Board;

  (2) Have received a bachelor's or master's degree from an athletic training educational program that is accredited by the Commission on Accreditation of Athletic Training Education or its successor;

  (3) Demonstrate oral and written competency in English as required by the Board; and

  (4) Meet any other requirements established by the Board.

(d) The Board shall waive the education requirements under this section if an individual was certified by the National Athletic Trainers' Association Board of Certification, Inc., on or before October 1, 2012, and is currently in good standing.

#### Section 14-5D-09

(a) To apply for a license, an applicant shall:

  (1) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title;

  (2) Submit an application to the Board on the form that the Board requires; and

  (3) Pay to the Board the application fee set by the Board.

(b) Subject to subsection (c) of this section, the Board shall issue the appropriate license to an applicant who meets the requirements of this subtitle for that license.

(c)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether to issue a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 14-308.1 of this title has not been received.

#### Section 14-5D-10

(a) An athletic trainer license authorizes the licensee to practice athletic training services in the State while the license is effective.

(b) A licensed athletic trainer shall practice athletic training in accordance with the evaluation and treatment protocol between the athletic trainer and a licensed physician.

#### Section 14-5D-11

(a) Nothing in this title may be construed to authorize an athletic trainer to practice except under the supervision of a licensed physician.

(b) Before an athletic trainer may practice athletic training, the athletic trainer shall:

  (1) Obtain a license under this subtitle;

  (2) Enter into a written evaluation and treatment protocol with a licensed physician; and

  (3) Except as provided in Sec. 14-5D-11.3(a) of this subtitle, submit an original, signed copy of the evaluation and treatment protocol for Board approval.

(c) An evaluation and treatment protocol shall:

  (1) Describe the qualifications of the licensed physician and licensed athletic trainer;

  (2) Describe the physician supervision mechanisms that the physician will use to give direction to the athletic trainer;

  (3) Describe the treatment procedures the athletic trainer may perform;

  (4) Describe tasks the athletic trainer may not perform;

  (5) Describe specialized tasks the supervising physician is delegating to the athletic trainer to perform with documentation of competencies, certification, credentials, or any other requirements established by the Board to support the delegation of the specialized tasks;

  (6) Indicate whether the athletic trainer may accept outside referrals from nonsupervising physicians and other licensed health care practitioners;

  (7) Designate an alternate supervising physician, if appropriate or necessary; and

  (8) Contain an attestation that states the supervising physician will be responsible for providing ongoing and immediately available instruction that is adequate to ensure the safety and welfare of a patient and is appropriate to the setting.

(d) An athletic trainer may accept an outside referral from a nonsupervising physician or licensed health care practitioner if:

  (1) The supervising physician specifies in the evaluation and treatment protocol that the athletic trainer may accept referrals from a nonsupervising physician or licensed health care practitioner;

  (2) The nonsupervising physician or licensed health care practitioner has seen the athletic individual and has written an order for the care of the athletic individual; and

  (3) The treatment procedures to be used by the athletic trainer are:

    (i) Within the scope of practice of an athletic trainer; and

    (ii) Included in the evaluation and treatment protocol that the athletic trainer has entered into with the supervising physician.

(e)

  (1) An athletic trainer may provide treatment for not more than 14 days to an athletic individual with an injury that affects job function or job-related activity unless the athletic trainer has received a referral from a health care provider licensed under this article other than under this subtitle to treat the individual.

  (2) For the purpose of paragraph (1) of this subsection, preventive care is not considered treatment.

(f) Subject to the notice required under Sec. 14-5D-11.2 of this subtitle, an athletic trainer may terminate an evaluation and treatment protocol filed with the Board under this section at any time.

(g)

  (1) In the event of the sudden departure, incapacity, or death of the primary supervising physician of an athletic trainer, or change in license status that results in the primary supervising physician being unable to legally practice medicine, an alternate supervising physician designated under subsection (c) of this section may supervise the athletic trainer for not longer than 15 days following the event.

  (2) If there is no designated alternate supervising physician or the designated alternate supervising physician does not agree to supervise the athletic trainer, the athletic trainer may not practice until the athletic trainer receives approval of a new evaluation and treatment protocol under Sec. 14-5D-11.3 of this subtitle.

  (3) An alternate supervising physician or other licensed physician may assume the role of primary supervising physician by submitting a new evaluation and treatment protocol to the Board for approval under subsection (b) of this section.

  (4) The Board may terminate an evaluation and treatment protocol if:

    (i) The athletic trainer has a change in license status that results in the athletic trainer being unable to legally practice athletic training;

    (ii) At least 15 days have elapsed since an event listed under paragraph (1) of this subsection if there is an alternate supervising physician designated under subsection (c) of this section; or

    (iii) Immediately after an event listed under paragraph (1) of this subsection if there is no alternate supervising physician designated under subsection (c) of this section.

(h) An athletic trainer whose evaluation and treatment protocol is terminated may not practice athletic training until the athletic trainer receives preliminary approval of a new evaluation and treatment protocol under Sec. 14-5D-11.3 of this subtitle.

(i) In the event of a sudden departure, incapacity, or death of a supervising physician, a designated alternate supervising physician may assume the role of the supervising physician by submitting an evaluation and treatment protocol to the Board within 15 days of the event.

#### Section 14-5D-11.1

(a) Except as otherwise provided in this subtitle, a licensed physician may not employ or supervise an individual practicing athletic training without a license or without an approved evaluation and treatment protocol.

(b) Except as otherwise provided in this subtitle, an employer may not employ an individual practicing athletic training without a license or without an approved evaluation and treatment protocol.

(c) A disciplinary panel may impose a civil penalty of up to $5,000 on a person who employs or supervises an individual without a license or without an approved evaluation and treatment protocol.

#### Section 14-5D-11.2

(a) A physician or an employer shall notify the Board within 10 days of the termination of an athletic trainer for reasons that would be grounds for discipline under this subtitle.

(b) A supervising physician and an athletic trainer shall notify the Board within 10 days of the termination of the relationship under an evaluation and treatment protocol.

#### Section 14-5D-11.3

(a)

  (1) An athletic trainer may assume the duties under an evaluation and treatment protocol on the date that the Board acknowledges receipt of the completed evaluation and treatment protocol appropriate to the scope of practice if the protocol is given preliminary approval by Board staff and:

    (i) The evaluation and treatment protocol does not include specialized tasks; or

    (ii) The evaluation and treatment protocol includes specialized tasks that the Board previously has approved under Sec. 14-5D-11 of this subtitle.

  (2) If an evaluation and treatment protocol includes specialized tasks that have not been previously approved by the Board under Sec. 14-5D-11 of this subtitle, an athletic trainer may only perform the specialized task after receiving written approval from the Board.

(b) The Board may disapprove an evaluation and treatment protocol or a specialized task included in the evaluation and treatment protocol if the Board determines that:

  (1) The evaluation and treatment protocol does not meet the requirements of Sec. 14-5D-11(c) of this subtitle;

  (2) The athletic trainer is unable to perform the specialized task safely; or

  (3) The specialized task is outside the practice scope of an athletic trainer.

(c) If the Board disapproves an evaluation and treatment protocol or a specialized task included in an evaluation and treatment protocol, the Board shall send to the primary supervising physician and the athletic trainer written notice of the disapproval.

(d) An athletic trainer who receives notice of a disapproval under subsection (c) of this section shall immediately cease practicing under the evaluation and treatment protocol or performing the specialized task.

(e) An individual member of the Board is not civilly liable for any act or omission relating to the approval, modification, or disapproval of an evaluation and treatment protocol.

#### Section 14-5D-11.4

(a) A licensed athletic trainer shall be approved by the Board before the licensed athletic trainer may perform dry needling as a specialized task.

(b)

  (1) The Board shall issue an approval to perform dry needling to a licensed athletic trainer who provides proof of completion of at least 80 hours of instruction in a continuing education course approved by:

    (i) The National Athletic Trainers' Association;

    (ii) The Board of Certification for the Athletic Trainer; or

    (iii) The armed forces.

  (2) Of the 80 hours of instruction required under paragraph (1) of this subsection, at least 40 hours of instruction shall be in the following course content areas:

    (i) Theory and application of dry needling;

    (ii) Dry needling technique, including spine and extremities;

    (iii) Dry needling indications and contraindications;

    (iv) Infection control, the Occupational Safety and Health Administration's Bloodborne Pathogen Protocol, and safe handling of needles;

    (v) Emergency preparedness and response procedures related to complications associated with dry needling; and

    (vi) Appropriate documentation of dry needling.

  (3) Of the 80 hours of instruction required under paragraph (1) of this subsection, at least 40 hours shall be practical, hands-on instruction in the application and technique of dry needling that is completed under the guidance of a licensed health care practitioner who:

    (i) Is approved to perform dry needling; and

    (ii) Has practiced dry needling for at least 5 years.

  (4) The instruction required under this subsection shall include an assessment of the licensed athletic trainer's competency to perform dry needling that is performed by the instructor of the approved course.

#### Section 14-5D-11.5

(a)

  (1) Except as provided in subsections (b) and (d) of this section, each employer of a licensed athletic trainer shall submit to the Board a report if:

    (i) The employer:

      (1) Reduced, suspended, revoked, restricted, denied, conditioned, or did not renew the licensed athletic trainer's clinical privileges, employment, or other ability to practice or treat patients;

      (2) Involuntarily terminated or restricted the licensed athletic trainer's employment or staff membership; or

      (3) Asked the licensed athletic trainer to voluntarily resign because of the licensed athletic trainer's conduct or while the licensed athletic trainer is being investigated; and

    (ii) The action described under item (i) of this paragraph was taken:

      (1) For reasons that might be grounds for disciplinary action under Sec. 14-5D-14 of this subtitle;

      (2) Because the licensed athletic trainer may have engaged in an act that may constitute unprofessional conduct;

      (3) Because the licensed athletic trainer may be unable to practice athletic training with reasonable skill and safety because of a physical or mental condition or professional incompetence; or

      (4) Because the licensed athletic trainer may have harmed or placed one or more patients or the public at unreasonable risk of harm by engaging in an act that creates an immediate or continuing danger.

  (2) A report required under paragraph (1) of this subsection shall include:

    (i) The action taken by the employer;

    (ii) A detailed explanation of the reasons for the action, including references to specific patient medical records, if any, that informed the employer's action; and

    (iii) The steps taken by the employer to investigate the conduct of the licensee.

  (3)

    (i) The Board may request from the employer additional information regarding an action described in paragraph (1) of this subsection that was taken by the employer.

    (ii) If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information.

(b) If an employer knows that the conduct of a licensed athletic trainer requires that the employer submit a report under subsection (a)(1) of this section because the licensed athletic trainer is impaired by alcohol or another substance, the employer is not required to report the licensed athletic trainer to the Board if:

  (1) The employer knows that the licensed athletic trainer is:

    (i) In a substance use disorder treatment program that is accredited by The Joint Commission or is certified by the Department; or

    (ii) Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders;

  (2) The employer is able to verify that the licensed athletic trainer remains in the treatment program until successful discharge; and

  (3) The action or condition of the licensed athletic trainer has not caused injury to any person while the licensed athletic trainer is practicing as a licensed athletic trainer.

(c) If the employer knows that the licensed athletic trainer is noncompliant with the substance use disorder treatment program, the employer of the licensed athletic trainer shall report the licensed athletic trainer's noncompliance to the Board.

(d)

  (1) The Board may extend the reporting under this section for good cause shown.

  (2) A person is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of substance use disorder patient records.

(e) The Board may enforce this section by subpoena.

(f) Any person shall have the immunity from liability described under Sec. 5-715(d) of the Courts Article for giving any of the information required by this section.

(g) An employer required to make a report to the Board under this section shall submit the report within 10 days after the action requiring the report.

(h) A report made under this section is privileged, not subject to inspection under the Public Information Act, and not subject to subpoena or discovery in any civil action other than a proceeding arising out of a hearing and decision of the Board or a disciplinary panel under this title.

(i)

  (1) A disciplinary panel may impose a civil penalty of up to $5,000 for knowingly failing to report under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $5,000 per incident for a report made by an employer in bad faith.

  (3) The Board shall remit any penalty collected under this subsection into the General Fund of the State.

#### Section 14-5D-12

(a)

  (1) The term of a license issued by the Board may not exceed 3 years.

  (2) A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.

(b) At least 1 month before a license expires, the Board shall send to the licensee a renewal notice that states:

  (1) The date on which the current license expires;

  (2) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and

  (3) The amount of the renewal fee.

(c) Except as otherwise provided in this subtitle, before a license expires, the licensee periodically may renew it for an additional term, if the licensee:

  (1) Otherwise is entitled to be licensed;

  (2) Is of good moral character;

  (3) Pays to the Board a renewal fee set by the Board; and

  (4) Submits to the Board:

    (i) A renewal application on the form that the Board requires;

    (ii) Satisfactory evidence of compliance with any continuing education or competency requirements; and

    (iii) Any other requirements set under this section for license renewal.

(d) In addition to any other qualifications and requirements established by the Board, the Board may establish continuing education or competency requirements as a condition of the renewal of licenses under this section.

(e) The Board shall renew the license of each licensee who meets the requirements of this section.

(f) The Board shall reinstate the license of an athletic trainer who has failed to renew the license for any reason if the athletic trainer:

  (1) Applies for reinstatement;

  (2) Meets renewal and reinstatement requirements; and

  (3) Pays to the Board the reinstatement fee set by the Board.

(g) A disciplinary panel may impose a civil penalty of up to $100 per continuing education credit in lieu of a sanction under Sec. 14-5D-14 of this subtitle, for a first offense for failure of a licensee to obtain the continuing education credits required by the Board.

(h)

  (1) Beginning October 1, 2016, the Board shall require a criminal history records check in accordance with Sec. 14-308.1 of this title for:

    (i) Renewal applicants as determined by regulations adopted by the Board; and

    (ii) Each former licensee who files for reinstatement under subsection (f) of this section.

  (2) On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether disciplinary action should be taken, based on the criminal history record information, against a licensee who renewed or reinstated a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.

  (3) The Board may renew or reinstate a license only if the licensee or applicant attests that the licensee or applicant has submitted to a criminal history records check under Sec. 14-308.1 of this title.

#### Section 14-5D-12.1

(a) A licensee shall notify the Board in writing of a change in name or address within 30 days after the change.

(b) A licensee who fails to comply with subsection (a) of this section is subject to an administrative penalty of $100.

#### Section 14-5D-13

Unless the Board agrees to accept the surrender of a license, a licensed athletic trainer may not surrender the license nor may the license lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee. 

#### Section 14-5D-14

(a) Subject to the hearing provisions of Sec. 14-405 of this title, a disciplinary panel, on the affirmative vote of a majority of a quorum of the disciplinary panel, may deny a license to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke a license, if the applicant or licensee:

  (1) Fraudulently or deceptively obtains or attempts to obtain a license for the applicant, licensee, or for another;

  (2) Fraudulently or deceptively uses a license;

  (3) Is guilty of:

    (i) Immoral conduct in the practice of athletic training; or

    (ii) Unprofessional conduct in the practice of athletic training;

  (4) Is:

    (i) Professionally incompetent;

    (ii) Physically incompetent; or

    (iii) Mentally incompetent;

  (5) Abandons a patient;

  (6) Habitually is intoxicated;

  (7) Is addicted to, or habitually abuses, any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article;

  (8) Provides professional services while:

    (i) Under the influence of alcohol; or

    (ii) Using any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article, or any other drug that is in excess of therapeutic amounts or without valid medical indication;

  (9) Promotes the sale of services, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

  (10) Willfully makes or files a false report or record in the practice of athletic training;

  (11) Willfully fails to file or record any report as required under law, willfully impedes or obstructs the filing or recording of the report, or induces another to fail to file or record the report;

  (12) Breaches patient confidentiality;

  (13) Pays or agrees to pay any sum or provide any form of remuneration or material benefit to any individual for bringing or referring a patient or accepts or agrees to accept any sum or any form of remuneration or material benefit from an individual for bringing or referring a patient;

  (14) Willfully makes a misrepresentation while practicing athletic training;

  (15) Willfully practices athletic training with an unauthorized individual or aids an unauthorized individual in the practice of athletic trainer services;

  (16) Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine;

  (17) Is disciplined by a licensing, certifying, or disciplinary authority or is convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (18) Fails to meet appropriate standards for the delivery of athletic training services;

  (19) Willfully submits false statements to collect fees for which services have not been provided;

  (20)

    (i) Has been subject to investigation or disciplinary action by a licensing or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under the Board's disciplinary statutes; and

    (ii) Has:

      (1) Surrendered the license issued by the state or country; or

      (2) Allowed the license issued by the state or country to expire or lapse;

  (21) Willfully fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

  (22) Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes;

  (23) Practices or attempts to practice beyond the authorized scope of practice;

  (24) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

  (25) Practices or attempts to practice an athletic training procedure or uses or attempts to use athletic training equipment if the applicant or licensee has not received education and training in the performance of the procedure or the use of the equipment;

  (26) Fails to cooperate with a lawful investigation conducted by the Board or a disciplinary panel;

  (27) Fails to practice under the supervision of a physician or violates the approved evaluation and treatment protocol;

  (28) Violates an order of the Board or a disciplinary panel, including any condition of probation;

  (29) Fails to complete a criminal history records check under Sec. 14-308.1 of this title; or

  (30) Performs dry needling without the approval of the Board issued under Sec. 14-5D-11.4 of this subtitle.

(b)

  (1) On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a license if the licensee is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

  (2) After completion of the appellate process, if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a license on the certification by the Office of the Attorney General.

(c)

  (1) If, after a hearing under Sec. 14-405 of this title, a disciplinary panel finds that there are grounds under subsection (a) of this section to suspend or revoke a license, to reprimand a licensee, or to place a licensee on probation, the disciplinary panel may impose a fine subject to the Board's regulations in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

  (2) The Board shall pay any fines collected under this section into the General Fund of the State.

(d) In addition to any sanction authorized under this section, a disciplinary panel may require a licensee to comply with specified terms and conditions determined by the disciplinary panel.

#### Section 14-5D-15

(a)

  (1) Except as otherwise provided in Sec. 10-226 of the State Government Article, before the Board or a disciplinary panel takes any action under Sec. 14-5D-14 of this subtitle, the Board or the disciplinary panel shall give the individual against whom the action is contemplated an opportunity for a hearing before a hearing officer.

  (2) The hearing officer shall give notice and hold the hearing in accordance with Title 10, Subtitle 2 of the State Government Article.

  (3) The Board or a disciplinary panel may administer oaths in connection with any proceedings under this section.

(b)

  (1) Any person aggrieved by a final decision of the Board or a disciplinary panel under this subtitle may take a direct judicial appeal.

  (2) The appeal shall be made as provided for judicial review of final decisions in the Administrative Procedure Act.

(c) An order of the Board or a disciplinary panel may not be stayed pending review.

(d) The Board may appeal from any decision that reverses or modifies an order of the Board or a disciplinary panel.

#### Section 14-5D-16

(a) Subject to subsection (b) of this section, on the application of an individual whose license has been revoked, a disciplinary panel may reinstate a revoked license.

(b) A disciplinary panel may not reinstate a revoked license that has been revoked for a period of more than 1 year unless the licensee:

  (1) Meets the requirements for reinstatement as established under this title; and

  (2) Completes a criminal history records check in accordance with Sec. 14-308.1 of this title.

#### Section 14-5D-16.1

(a) Following the filing of charges or notice of initial denial of license application, the Board shall disclose the filing to the public on the Board's Web site.

(b) The Board shall create and maintain a public individual profile on each licensee that includes the following information:

  (1) A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under Sec. 14-5D-14 of this subtitle based on the charges or has rescinded the charges;

  (2) A description of any disciplinary action taken by the Board or a disciplinary panel against the licensee within the most recent 10-year period that includes a copy of the public order;

  (3) A description in summary form of any final disciplinary action taken by a licensing board in any other state or jurisdiction against the licensee within the most recent 10-year period if the Board knows of the disciplinary action;

  (4) A description of a conviction or entry of a plea of guilty or nolo contendere by the licensee for a crime involving moral turpitude that is the basis for disciplinary action taken under Sec. 14-5D-14(b) of this subtitle; and

  (5) The public address of the licensee.

(c) In addition to the requirements of subsection (b) of this section, the Board shall include on each licensee's profile a statement of information to be taken into consideration by a consumer when viewing a licensee's profile, including a disclaimer stating that a charging document does not indicate a final finding of guilt by a disciplinary panel.

(d) The Board:

  (1) On receipt of a written request for a licensee's profile from any person, shall forward a written copy of the profile to the person; and

  (2) Shall maintain a Web site that serves as a single point of entry where all licensee profile information is available to the public on the Internet.

(e) The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee's profile.

(f) The Board shall include information relating to charges filed against a licensee by a disciplinary panel and any final disciplinary action taken by a disciplinary panel against a licensee in the licensee's profile within 10 days after the charges are filed or the action becomes final.

#### Section 14-5D-17

Unless authorized to practice athletic training under this subtitle, a person may not:

(1) Practice athletic training in this State;

(2) Attempt to practice or offer to practice athletic training in this State;

(3) Represent to the public by title, by description of services, methods, or procedures, or otherwise, that the person is authorized to practice athletic training in this State; or

(4) Use the abbreviation "A.T.", "A.T.L.", "L.A.T.", or any other words, letters, or symbols with the intent to represent that the person practices athletic training.

#### Section 14-5D-18

(a) A person who violates Sec. 14-5D-17 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 or imprisonment not exceeding 1 year or both.

(b) A person who violates Sec. 14-5D-17 of this subtitle is subject to a civil fine of not more than $5,000 to be levied by a disciplinary panel.

(c) The Board shall pay any penalty collected under this section into the Board of Physicians Fund.

#### Section 14-5D-19

This subtitle may be cited as the "Maryland Athletic Trainers Act".

#### Section 14-5D-20

Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act and subject to the termination of this title under Sec. 14-702 of this title, this subtitle and all rules and regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2030.

### Subtitle 5E. Perfusionists

#### Section 14-5E-01

(a) In this subtitle the following words have the meanings indicated.

(b) "Board" means the State Board of Physicians.

(c) "Committee" means the Perfusion Advisory Committee established under Sec. 14-5E-05 of this subtitle.

(d) "License" means a license issued by the Board to practice perfusion.

(e) "Licensed perfusionist" means a perfusionist who is licensed by the Board under this subtitle to practice perfusion.

(f)

  (1) "Practice perfusion" means to perform the functions necessary for the support, treatment, measurement, or supplementation of the cardiovascular, circulatory, or respiratory systems, or other organs to ensure the safe management of physiologic functions by monitoring and analyzing the parameters of the systems under an order and the supervision of a licensed physician.

  (2) "Practice perfusion" includes:

    (i) Cardiopulmonary bypass for adult, pediatric, and neonatal patients;

    (ii) Extracorporeal circulatory support for renal, neurological, hepatic, and vascular surgery;

    (iii) Extracorporeal resuscitation;

    (iv) Extracorporeal circulation for long-term support of failing respiratory or cardiac function;

    (v) Extracorporeal membrane oxygenation;

    (vi) Extracorporeal carbon dioxide removal;

    (vii) Myocardial protection;

    (viii) Perfusion-assisted direct coronary artery bypass;

    (ix) Hemofiltration and hemodialysis;

    (x) Anticoagulation and hemostasis monitoring, analysis, and intervention;

    (xi) Thermal regulation;

    (xii) Blood gas and blood chemistry monitoring, analysis, and intervention;

    (xiii) Physiological monitoring, analysis, and intervention;

    (xiv) Administration of blood components and pharmaceuticals;

    (xv) Administration of anesthetic agents through a heart lung machine at the direction of an anesthesiologist;

    (xvi) Ventricular assist device and mechanical circulatory support management;

    (xvii) Intra-aortic balloon counterpulsation;

    (xviii) Temporary pacemaker management;

    (xix) Periodic flow augmentation therapy;

    (xx) Autotransfusion;

    (xxi) Platelet gel production, autologous hemocyte tissue matrix production;

    (xxii) Nondifferentiated progenitor cell harvest bone marrow aspirate concentrate;

    (xxiii) Acute normovolemic hemodilution;

    (xxiv) Isolated limb or organ delivery of chemotherapeutics, progenitor cells, gene therapy vectors, and other items;

    (xxv) Organ procurement and preservation;

    (xxvi) Thermogenic lavage;

    (xxvii) Electrophysiological analysis;

    (xxviii) Therapeutic hyperthermia;

    (xxix) Intravascular membrane oxygenation; and

    (xxx) Renal perfusion.

(g) "Student" means an individual who, in accordance with Sec. 14-5E-09(c) of this subtitle, is:

  (1) Enrolled in an accredited educational program to qualify for a license under this subtitle; and

  (2) Performing perfusion services within the accredited program under the supervision of a licensed perfusionist and without compensation.

(h) "Supervision" means the responsibility of a licensed physician to exercise on site or immediately available direction for a licensed perfusionist to ensure the safety and welfare of patients during the course of perfusion.

#### Section 14-5E-02

This subtitle does not limit the right of an individual to practice a health occupation that the individual is authorized to practice under this article.

#### Section 14-5E-03

The Board shall adopt regulations for the licensure and practice of perfusion.

#### Section 14-5E-04

(a)

  (1) The Board shall set reasonable fees for the issuance and renewal of licenses and other services it provides to perfusionists.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure program and the other services provided to perfusionists, including the cost of providing a rehabilitation program for perfusionists under Sec. 14-401.1(g) of this title.

(b)

  (1) The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller.

  (2) The Comptroller shall distribute all fees to the Board.

(c) The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this subtitle.

#### Section 14-5E-05

There is a Perfusion Advisory Committee within the Board.

#### Section 14-5E-06

(a) The Committee consists of seven members, appointed by the Board as follows:

  (1) Three licensed perfusionists;

  (2) Three licensed physicians, at least one of whom performs cardiac or cardio-thoracic surgery or is a cardiac anesthesiologist; and

  (3) One consumer member.

(b) Each member of the Committee licensed by the Board must be in good standing with the Board.

(c) The consumer member of the Committee:

  (1) Must be a member of the general public;

  (2) May not be or ever have been:

    (i) A perfusionist;

    (ii) Any other health care professional; or

    (iii) In training to be a perfusionist or other health professional; and

  (3) May not:

    (i) Participate or ever have participated in a commercial or professional field related to perfusion;

    (ii) Have a household member who participates in a commercial or professional field related to perfusion;

    (iii) Have had within 2 years before appointment a financial interest in a person regulated by the Board; or

    (iv) Have had within 2 years before appointment a financial interest in the provision of goods or services to perfusionists or to the field of perfusion.

(d) Each member of the Committee must be a resident of the State.

(e)

  (1) The term of a member is 3 years.

  (2) The terms of members are staggered as required by regulation.

  (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

  (4) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.

  (5) A member may not serve more than two consecutive full terms.

(f)

  (1) From among its members, the Committee shall elect a chair every 2 years.

  (2) The chair shall serve in an advisory capacity to the Board as a representative of the Committee.

(g) A quorum of the Committee consists of four members.

#### Section 14-5E-07

In addition to the powers set forth elsewhere in this subtitle, the Committee:

(1) Shall:

  (i) Develop and recommend to the Board:

    (1) Regulations to carry out this subtitle; and

    (2) Any statutory changes that affect the profession; and

  (ii) Keep a record of its meetings; and

(2) May:

  (i) Provide recommendations regarding the practice of perfusion; and

  (ii) Advise the Board on any other matters related to perfusionists.

#### Section 14-5E-08

(a) Except as otherwise provided in this subtitle or Sec.Sec. 10-14A-03 and 10-14B-03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice perfusion in this State.

(b) This section does not apply to:

  (1) A student enrolled in an education program under Sec. 14-5E-09(c)(2) of this subtitle while practicing perfusion in that program; or

  (2) A perfusionist employed in the service of the federal government while practicing within the scope of the employment.

#### Section 14-5E-09

(a) To qualify for a license, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall:

  (1) Be of good moral character;

  (2) Be at least 18 years old; and

  (3) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title.

(c) An applicant for a license to practice perfusion shall:

  (1)

    (i) Submit to the Board satisfactory evidence of certification as a certified perfusionist or other national certification approved by the Board; and

    (ii) Meet any other educational or clinical requirements established by the Committee and approved by the Board; or

  (2)

    (i) Submit to the Board satisfactory evidence of graduation from a perfusion educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs, or the Commission's predecessor or successor; and

    (ii) Meet any other educational or clinical requirements established by the Committee and approved by the Board.

#### Section 14-5E-10

(a) Except as provided in subsection (b) of this section, an applicant who otherwise qualifies for a license under Sec. 14-5E-09(c)(2) of this subtitle is entitled to be licensed for a single 2-year term before taking the national certifying examination given by the American Board of Cardiovascular Perfusion or its successor organization or another examination given or approved by the Board.

(b)

  (1) If an applicant was prevented from taking the national certifying examination before the single 2-year license expires because of extenuating circumstances, the applicant may apply to the Board for an extension of the term of the license.

  (2) The Board shall adopt regulations to carry out paragraph (1) of this subsection that include:

    (i) Criteria that an applicant must meet to receive an extension under paragraph (1) of this subsection; and

    (ii) Provisions as to the length of time that a license may be extended.

#### Section 14-5E-11

(a) To apply for a license, an applicant shall:

  (1) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title;

  (2) Submit an application to the Board on the form that the Board requires; and

  (3) Pay to the Board the application fee set by the Board.

(b) Subject to subsection (c) of this section, the Board shall issue a license to an applicant who meets the requirements of this subtitle.

(c)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether to issue a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 14-308.1 of this title has not been received.

#### Section 14-5E-12

A license authorizes an individual to practice perfusion in this State while the license is effective.

#### Section 14-5E-13

(a)

  (1) A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.

  (2) The term of a license issued by the Board may not exceed 3 years.

(b) At least 1 month before a license expires, the Board shall send to the licensed perfusionist a renewal notice that states:

  (1) The date on which the current license expires;

  (2) The date by which the renewal application must be received by the Board for the renewal to be issued and sent before the license expires;

  (3) The amount of the renewal fee; and

  (4) For licensees who qualified for an initial license under Sec. 14-5E-09(c)(2) of this subtitle, that the licensee must submit satisfactory evidence of a passing score on the examination as required under subsection (c)(2) of this section.

(c)

  (1) Except as otherwise provided in this subtitle, before a license expires, the licensed perfusionist periodically may renew it for an additional term, if the licensee:

    (i) Otherwise is entitled to be licensed;

    (ii) Is of good moral character;

    (iii) Pays to the Board a renewal fee set by the Board; and

    (iv) Except as provided in paragraph (2) of this subsection, submits to the Board:

      (1) A renewal application on the form that the Board requires; and

      (2) Satisfactory evidence of compliance with any continuing education or competency requirements and other requirements set under this section for license renewal.

  (2) A licensee who qualified for an initial license under Sec. 14-5E-09(c)(2) of this subtitle shall submit to the Board satisfactory evidence of a passing score on the national certifying examination given by the American Board of Cardiovascular Perfusion or its successor organization or another examination given or approved by the Board.

(d) In addition to any other qualifications and requirements established by the Board, the Board shall establish continuing education or competency requirements as a condition of the renewal of a license under this section.

(e)

  (1) The Board shall renew the license of each licensee who meets the requirements of this section.

  (2) The Board may not renew the license of a licensee who fails to submit satisfactory evidence of a passing score on the examination as required under subsection (c)(2) of this section.

(f) The Board shall reinstate the license of an individual who has failed to renew the license for any reason if the individual:

  (1) Applies for reinstatement after the date the license expires;

  (2) Meets the renewal requirements of this section; and

  (3) Pays to the Board the reinstatement fee set by the Board.

(g)

  (1) Beginning October 1, 2016, the Board shall require a criminal history records check in accordance with Sec. 14-308.1 of this title for:

    (i) Renewal applicants as determined by regulations adopted by the Board; and

    (ii) Each former licensee who files for reinstatement under subsection (f) of this section.

  (2) On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether disciplinary action should be taken, based on the criminal history record information, against a licensee who renewed or reinstated a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.

  (3) The Board may renew or reinstate a license only if the licensee or applicant attests that the licensee or applicant has submitted to a criminal history records check under Sec. 14-308.1 of this title.

(h) A disciplinary panel may impose a civil penalty of up to $100 per continuing education credit in lieu of a sanction under Sec. 14-5E-16 of this subtitle, for a first offense for failure of a licensee to obtain the continuing education credits required by the Board.

#### Section 14-5E-14

(a)

  (1) A licensee shall notify the Board in writing of a change in name or address within 30 days after the change.

  (2) A licensed perfusionist who fails to comply with the requirements of paragraph (1) of this subsection is subject to an administrative penalty of $100.

(b) Each licensed perfusionist shall:

  (1) Keep a copy of the license in the licensee's employment file; and

  (2) Make the license available for inspection on request.

#### Section 14-5E-15

Unless a disciplinary panel agrees to accept the surrender of a license, a licensed perfusionist may not surrender the license nor may the license lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.

#### Section 14-5E-16

(a) Subject to the hearing provisions of Sec. 14-405 of this title, a disciplinary panel, on the affirmative vote of a majority of the quorum of the disciplinary panel, may deny a license to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke a license, if the applicant or licensee:

  (1) Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or licensee or for another;

  (2) Fraudulently or deceptively uses a license;

  (3) Is guilty of:

    (i) Immoral conduct in the practice of perfusion; or

    (ii) Unprofessional conduct in the practice of perfusion;

  (4) Is:

    (i) Professionally incompetent;

    (ii) Physically incompetent; or

    (iii) Mentally incompetent;

  (5) Abandons a patient;

  (6) Is habitually intoxicated;

  (7) Is addicted to or habitually abuses any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article;

  (8) Provides professional services while:

    (i) Under the influence of alcohol; or

    (ii) Using any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article or any other drug that is in excess of therapeutic amounts or without valid medical indication;

  (9) Promotes the sale of services, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

  (10) Willfully makes or files a false report or record in the practice of perfusion;

  (11) Willfully fails to file or record any report as required under law, willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record a report;

  (12) Breaches patient confidentiality;

  (13) Pays or agrees to pay any sum or provide any form of remuneration or material benefit to any person for bringing or referring a patient or accepts or agrees to accept any sum or any form of remuneration or material benefit from an individual for bringing or referring a patient;

  (14) Willfully makes a misrepresentation while practicing perfusion;

  (15) Willfully practices perfusion with an unauthorized individual or aids an unauthorized individual in the practice of perfusion;

  (16) Willfully delegates a perfusion duty to an unlicensed individual;

  (17) Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine;

  (18) Is disciplined by a licensing or disciplinary authority or is convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (19) Fails to meet appropriate standards for the delivery of perfusion services;

  (20) Willfully submits false statements to collect fees for which services are not provided;

  (21)

    (i) Has been subject to investigation or disciplinary action by a licensing or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under the Board's disciplinary statutes; and

    (ii) Has:

      (1) Surrendered the license, if any, issued by the state or country; or

      (2) Allowed the license, if any, issued by the state or country to expire or lapse;

  (22) Willfully fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

  (23) Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes;

  (24) Practices or attempts to practice beyond the authorized scope of practice;

  (25) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

  (26) Practices or attempts to practice a perfusion procedure or uses or attempts to use perfusion equipment if the applicant or licensee has not received education and training in the performance of the procedure or the use of the equipment;

  (27) Fails to cooperate with a lawful investigation of the Board or a disciplinary panel; or

  (28) Fails to complete a criminal history records check under Sec. 14-308.1 of this title.

(b) Except as otherwise provided in Title 10, Subtitle 2 of the State Government Article, before the Board or a disciplinary panel takes any action under subsection (a) of this section, it shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board or the disciplinary panel in accordance with the hearing requirements of Sec. 14-405 of this title.

(c)

  (1) On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a license if the licensee is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

  (2) After completion of the appellate process if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a license on the certification by the Office of the Attorney General.

(d)

  (1) If, after a hearing under Sec. 14-405 of this title, a disciplinary panel finds that there are grounds under subsection (a) of this section to suspend or revoke a license, to reprimand a licensee, or place a licensee on probation, the disciplinary panel may impose a fine subject to the Board's regulations in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

  (2) The Board shall pay any fines collected under this section into the General Fund.

(e) In addition to any sanction authorized under this section, a disciplinary panel may require a licensee to comply with specified terms and conditions determined by the disciplinary panel.

#### Section 14-5E-17

(a)

  (1) Any person aggrieved by a final decision of the Board under this subtitle may take a direct judicial appeal.

  (2) The appeal shall be made as provided for judicial review of final decisions in Title 10, Subtitle 2 of the State Government Article.

(b) An order of the Board may not be stayed pending review.

(c) The Board may appeal from any decision that reverses or modifies its order.

#### Section 14-5E-18

(a)

  (1) Except as provided in subsections (b) and (d) of this section, each employer of a licensed perfusionist shall submit to the Board a report if:

    (i) The employer:

      (1) Reduced, suspended, revoked, restricted, denied, conditioned, or did not renew the licensed perfusionist's clinical privileges, employment, or other ability to practice or treat patients;

      (2) Involuntarily terminated or restricted the licensee's employment or staff membership; or

      (3) Asked the licensee to voluntarily resign because of the licensed perfusionist's conduct or while the licensee is being investigated; and

    (ii) The action described under item (i) of this paragraph was taken:

      (1) For reasons that might be grounds for disciplinary action under Sec. 14-5E-16 of this subtitle;

      (2) Because the licensed perfusionist may have engaged in an act that may constitute unprofessional conduct;

      (3) Because the licensed perfusionist may be unable to practice perfusion with reasonable skill and safety because of a physical or mental condition or professional incompetence; or

      (4) Because the licensed perfusionist may have harmed or placed one or more patients or the public at unreasonable risk of harm by engaging in an act that creates an immediate or continuing danger.

  (2) A report required under paragraph (1) of this subsection shall include:

    (i) The action taken by the employer;

    (ii) A detailed explanation of the reasons for the action, including references to specific patient medical records, if any, that informed the employer's action; and

    (iii) The steps taken by the employer to investigate the conduct of the licensed perfusionist.

  (3)

    (i) The Board may request from the employer additional information regarding an action described in paragraph (1) of this subsection that was taken by the employer.

    (ii) If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information.

(b) If an employer knows that the conduct of a licensed perfusionist requires that the employer submit a report under subsection (a)(1) of this section because the licensed perfusionist is impaired by alcohol or another substance, the employer is not required to report the licensed perfusionist to the Board if:

  (1) The employer knows that the licensed perfusionist is:

    (i) In a substance use disorder treatment program that is accredited by The Joint Commission, or is certified by the Department; or

    (ii) Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders; and

  (2)

    (i) The employer is able to verify that the licensed perfusionist remains in the treatment program until successful discharge; and

    (ii) The action or condition of the licensed perfusionist has not caused injury to any person while the perfusionist is practicing as a licensed perfusionist.

(c) If the employer knows that the licensed perfusionist is noncompliant with the substance use disorder program, the employer of the licensed perfusionist shall report the licensed perfusionist's noncompliance to the Board.

(d)

  (1) The Board may extend the reporting under this section for good cause shown.

  (2) A person is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of substance use disorder patient records.

(e) The Board may enforce this section by subpoena.

(f) Any person shall have the immunity from liability described under Sec. 5-715(d) of the Courts Article for giving any of the information required by this section.

(g) An employer required to make a report to the Board under this section shall submit the report within 10 days after the action requiring the report.

(h) A report made under this section is privileged, not subject to inspection under the Public Information Act, and not subject to subpoena or discovery in any civil action other than a proceeding arising out of a hearing and decision of the Board or a disciplinary panel under this title.

(i)

  (1) A disciplinary panel may impose a civil penalty of up to $5,000 for knowingly failing to report under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $5,000 per incident for a report made by an employer in bad faith.

  (3) The Board shall remit any penalty collected under this subsection into the General Fund of the State.

#### Section 14-5E-18.1

(a) Following the filing of charges or notice of initial denial of license application, the Board shall disclose the filing to the public on the Board's Web site.

(b) The Board shall create and maintain a public individual profile on each licensee that includes the following information:

  (1) A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under Sec. 14-5E-16 of this subtitle based on the charges or has rescinded the charges;

  (2) A description of any disciplinary action taken by the Board or a disciplinary panel against the licensee within the most recent 10-year period that includes a copy of the public order;

  (3) A description in summary form of any final disciplinary action taken by a licensing board in any other state or jurisdiction against the licensee within the most recent 10-year period;

  (4) A description of a conviction or entry of a plea of guilty or nolo contendere by the licensee for a crime involving moral turpitude that is the basis for disciplinary action taken under Sec. 14-5E-16(c) of this subtitle; and

  (5) The public address of the licensee.

(c) In addition to the requirements of subsection (b) of this section, the Board shall include on each licensee's profile a statement of information to be taken into consideration by a consumer when viewing a licensee's profile, including a disclaimer stating that a charging document does not indicate a final finding of guilt by a disciplinary panel.

(d) The Board:

  (1) On receipt of a written request for a licensee's profile from any person, shall forward a written copy of the profile to the person; and

  (2) Shall maintain a Web site that serves as a single point of entry where all licensee profile information is available to the public on the Internet.

(e) The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee's profile.

(f) The Board shall include information relating to charges filed against a licensee by a disciplinary panel and any final disciplinary action taken by a disciplinary panel against a licensee in the licensee's profile within 10 days after the charges are filed or the action becomes final.

#### Section 14-5E-19

(a) Subject to subsection (c) of this section, on the application of an individual whose license has been revoked, a disciplinary panel, on the affirmative vote of a majority of its full authorized membership, may reinstate a revoked license.

(b) A disciplinary panel may not reinstate a revoked license that has been revoked for a period of more than 1 year unless the licensee:

  (1) Meets the requirements for reinstatement as established under this title; and

  (2) Completes a criminal history records check in accordance with Sec. 14-308.1 of this title.

#### Section 14-5E-20

Except as otherwise provided in this subtitle, a person may not practice, attempt to practice, or offer to practice perfusion in this State unless licensed to practice perfusion by the Board.

#### Section 14-5E-21

(a) Unless authorized to practice perfusion under this subtitle, a person may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the person is authorized to practice perfusion in this State.

(b) Unless authorized to practice perfusion under this subtitle, a person may not use the titles "certified clinical perfusionist", "licensed perfusionist", or "licensed clinical perfusionist", the abbreviations "C.C.P.", "L.P.", or "L.C.P.", or any other words, letters, or symbols with the intent to represent that the person practices perfusion, holds a certificate as a certified clinical perfusionist issued by the American Board of Cardiovascular Perfusion or its successor entity, or holds a license as a licensed perfusionist issued by the Board.

#### Section 14-5E-22

A person may not provide, attempt to provide, offer to provide, or represent that the person provides perfusion services unless the perfusion is provided by an individual who is authorized to practice perfusion under this subtitle.

#### Section 14-5E-22.1

(a) Except as otherwise provided in this subtitle, a licensed physician may not employ or supervise an individual practicing perfusion without a license.

(b) Except as otherwise provided in this subtitle, an employer may not employ an individual to practice perfusion without a license.

(c) A disciplinary panel may impose a civil penalty of up to $5,000 for a violation of this section.

(d) The Board shall remit any penalty collected under this section into the General Fund of the State.

#### Section 14-5E-23

(a) A person who violates any provision of Sec.Sec. 14-5E-20 through 14-5E-22 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 or imprisonment not exceeding 1 year or both.

(b) A person who violates any provision of Sec.Sec. 14-5E-20 through 14-5E-22 of this subtitle is subject to a civil fine of not more than $5,000 to be levied by a disciplinary panel.

(c) The Board shall pay any penalty collected under this section into the Board of Physicians Fund.

#### Section 14-5E-24

This subtitle may be cited as the Maryland Perfusion Act.

#### Section 14-5E-25

Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act and subject to the termination of this title under Sec. 14-702 of this title, this subtitle and all regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2030.

### Subtitle 5F. Naturopathic Doctors

#### Section 14-5F-01

(a) In this subtitle the following words have the meanings indicated.

(b) "Approved naturopathic medical program" means a naturopathic medical education program:

  (1) In the United States that:

    (i) Provides the degree of Doctor of Naturopathy or Doctor of Naturopathic Medicine;

    (ii) Offers a 4-year graduate-level, full-time didactic and supervised clinical training;

    (iii) Is accredited, or has achieved candidacy status for accreditation, by the Council on Naturopathic Medical Education or an equivalent federally and Board-recognized accrediting body for naturopathic medical programs; and

    (iv) Is part of an institution of higher education that is either accredited, or is a candidate for accreditation, by a regional or national institutional accrediting agency recognized by the United States Secretary of Education; or

  (2) In a diploma-granting, degree-equivalent college or university in Canada that:

    (i) Offers graduate-level, full-time didactic and supervised clinical training;

    (ii) Is accredited, or has achieved candidacy status for accreditation, by the Council on Naturopathic Medical Education or an equivalent federally and Board-recognized accrediting body for naturopathic medical programs; and

    (iii) Has provincial approval for participation in government-funded student aid programs.

(c) "Board" means the State Board of Physicians.

(d) "Committee" means the Naturopathic Medicine Advisory Committee.

(e) "Council" means the Naturopathic Doctors Formulary Council.

(f)

  (1) "Device" means a device used in the diagnosis, treatment, or prevention of disease.

  (2) "Device" does not include:

    (i) Any surgical or dental instrument;

    (ii) Any physical therapy equipment;

    (iii) Any X-ray apparatus; or

    (iv) Any component part or accessory of any of the items listed in items (i) through (iii) of this paragraph.

(g) "Emergency use epinephrine" means a portable, disposable drug delivery device or product approved by the federal Food and Drug Administration that contains a premeasured single dose of epinephrine that is used to treat anaphylaxis in an emergency situation.

(h) "Formulary" means a list of drugs and devices developed and adopted in accordance with Sec. 14-5F-04.1 of this subtitle.

(i) "Licensed naturopathic doctor" means a naturopathic doctor who is licensed to practice naturopathic medicine.

(j) "Naturopathic doctor" means an individual who practices naturopathic medicine.

(k)

  (1) "Naturopathic medicine" means the prevention, diagnosis, and treatment of human health conditions, injury, and disease using only patient education and naturopathic therapies and therapeutic substances recognized by the Council of Naturopathic Medical Education.

  (2) "Naturopathic medicine" includes:

    (i) Counseling;

    (ii) The practice of the mechanical sciences of healing, including mechanotherapy, articular manipulation, corrective and orthopedic gymnastics, hydrotherapy, electrotherapy, and phototherapy;

    (iii) The practice of the material sciences of healing, including nutrition, phytotherapy, treatment by natural substances, and external applications; and

    (iv) Prescribing, dispensing, or administering nonprescription and prescription drugs and devices listed in the formulary.

(l) "Naturopathic musculoskeletal mobilization" means the treatment by manual and other mechanical means of all body tissues exclusive of high-velocity thrusts at or beyond the end range of normal joint motion.

(m) "Nonprescription drug" means a drug that:

  (1) May be sold without a prescription; and

  (2) Is labeled for use by a consumer in accordance with State and federal law.

(n) "Prescription drug" means any drug defined in Sec. 503(b) of the federal Food, Drug, and Cosmetic Act if the drug's label is required to bear the statement "Rx only".

#### Section 14-5F-02

The purposes of this subtitle are to:

(1) Protect the health, safety, and welfare of the public, and specifically protect individuals who are the direct recipients of services regulated by this subtitle;

(2) Maintain standards in the delivery of naturopathic medical services to the public;

(3) Ensure that the health care provided by qualified naturopathic doctors is accessible and available to the residents of the State; and

(4) Provide a means of identifying qualified naturopathic doctors in the State.

#### Section 14-5F-03

This subtitle does not limit the right of:

(1) An individual to practice a health occupation that the individual is authorized to practice under this article;

(2) An individual from treating the individual or the individual's family based on the individual's religious or health beliefs; or

(3) A person that sells vitamins and herbs from providing information about the person's products.

#### Section 14-5F-04

The Board shall adopt regulations for the licensure and practice of naturopathic medicine.

#### Section 14-5F-04.1

(a)

  (1) There is a Naturopathic Doctors Formulary Council within the Board.

  (2) The Council consists of the following members:

    (i) The Deputy Secretary of Public Health Services, or the Deputy Secretary's designee; and

    (ii) The following members, appointed by the Board:

      (1) Two individuals who:

      (A) Practice naturopathic medicine in the State;

      (B) Are certified by the North American Board of Naturopathic Examiners;

      (C) Have a minimum of 2 years experience; and

      (D) Are licensed naturopathic doctors;

      (2) Two licensed physicians who practice in the State;

      (3) One pharmacist who has a background in pharmacognosy and who practices in the State; and

      (4) One consumer.

  (3)

    (i) The term of an appointed member is 4 years.

    (ii) At the end of a term, an appointed member continues to serve until a successor is appointed.

  (4) A member of the Council:

    (i) May not receive compensation as a member of the Council; but

    (ii) Is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.

  (5) The Board shall designate the chair of the Council.

  (6) The Board shall provide staff for the Council.

(b) The Council shall:

  (1) Develop and recommend to the Board a formulary for use by licensed naturopathic doctors;

  (2) Annually review the formulary adopted by the Board under subsection (c) of this section to determine if any changes are necessary for compliance with current prescribing standards or the practice of naturopathic medicine;

  (3) Otherwise review the formulary at the direction of the Board; and

  (4) Make recommendations to the Board based on the reviews conducted under items (2) and (3) of this subsection.

(c)

  (1) The Board shall adopt a formulary based on the recommendations of the Council made under subsection (b) of this section.

  (2) The Board may modify or reject any recommendation of the Council regarding the formulary.

(d)

  (1) The formulary adopted by the Board shall include:

    (i) Nonprescription drugs and devices;

    (ii) Prescription oxygen and emergency use epinephrine; and

    (iii) Prescription diaphragms and cervical caps for contraception.

  (2) The formulary may not include:

    (i) Except as provided in paragraph (1)(ii) and (iii) of this subsection, prescription drugs or devices; or

    (ii) Controlled substances.

#### Section 14-5F-05

(a)

  (1) The Board shall set reasonable fees for the issuance and renewal of licenses and the other services the Board provides to naturopathic doctors.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure program and the other services provided to naturopathic doctors.

(b)

  (1) The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller.

  (2) The Comptroller shall distribute all fees to the Board established under Sec. 14-201 of this title.

(c) The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by the provisions of this subtitle.

#### Section 14-5F-06

There is a Naturopathic Medicine Advisory Committee within the Board.

#### Section 14-5F-07

(a)

  (1) The Committee consists of five members appointed by the Board as follows:

    (i) Two shall be licensed naturopathic doctors;

    (ii) One shall be a licensed physician;

    (iii) One shall be a licensed physician with experience working with naturopathic doctors; and

    (iv) One shall be a consumer member.

  (2) The Board shall appoint the naturopathic doctor members from a list of names submitted by the Maryland Association of Naturopathic Physicians.

(b) Each member of the Committee licensed by the Board must be in good standing with the Board.

(c) The consumer member of the Committee:

  (1) Must be a member of the general public;

  (2) May not be or ever have been:

    (i) A licensed naturopathic doctor;

    (ii) Any other health care professional; or

    (iii) In training to be a naturopathic doctor or other health professional; and

  (3) May not:

    (i) Participate or ever have participated in a commercial or professional field related to naturopathic medicine;

    (ii) Have a household member who participates in a commercial or professional field related to naturopathic medicine;

    (iii) Have had within 2 years before appointment a financial interest in a person regulated by the Board; or

    (iv) Have had within 2 years before appointment a financial interest in the provision of goods or services to naturopathic doctors or to the field of naturopathic medicine.

(d) Each member of the Committee must be a resident of the State.

(e)

  (1) The term of a member is 3 years.

  (2) The terms of members are staggered as required by regulation.

  (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

  (4) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.

  (5) A member may not serve more than two consecutive full terms.

(f) From among its members, the Committee shall elect a chair every 2 years.

(g) A quorum of the Committee consists of three members.

#### Section 14-5F-08

In addition to the powers set forth elsewhere in this subtitle, the Committee:

(1) Shall:

  (i) Develop and recommend to the Board:

    (1) Regulations to carry out this subtitle; and

    (2) Any statutory changes that affect the profession; and

  (ii) Keep a record of its meetings; and

(2) May:

  (i) Provide recommendations regarding the practice of naturopathic medicine; and

  (ii) Advise the Board on any other matters related to naturopathic doctors.

#### Section 14-5F-09

A person shall have the immunity from liability described under Sec. 5-715 of the Courts and Judicial Proceedings Article for giving information to the Committee or otherwise participating in its activities.

#### Section 14-5F-10

(a) Except as otherwise provided in this subtitle or Sec.Sec. 10-14A-03 and 10-14B-03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice naturopathic medicine in the State.

(b) This section does not apply to:

  (1) A naturopathic doctor who is employed in the service of the federal government while practicing within the scope of the employment;

  (2) A student who is enrolled in an approved naturopathic medical program while the student is participating in a course of study under the supervision of a licensed naturopathic doctor or a licensed professional in the field of study;

  (3) An individual who is licensed in another state to practice naturopathic medicine and whose practice of naturopathic medicine in the State is limited to examination, recommendation, or testimony in litigation; or

  (4) A naturopathic doctor licensed by and residing in another jurisdiction, if the naturopathic doctor is engaged in consultation with the naturopathic doctor in the State about a particular patient and does not direct patient care.

(c) The Board may not discriminate, in any manner, against any applicant or licensee for reason of sex, age, race, color, creed, sexual orientation, gender identity, disability, or national origin.

#### Section 14-5F-11

(a) To qualify for a license, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant shall be of good moral character.

(c) The applicant shall be at least 21 years old.

(d) Except as provided in Sec. 14-5F-12 of this subtitle, the applicant shall:

  (1) Have a doctorate in naturopathic medicine from an approved naturopathic medical program; and

  (2) Pass  the competency-based national naturopathic licensing examination Part I and Part II administered by the North American Board of Naturopathic Examiners, or its successor agency that has been nationally recognized to administer a naturopathic examination that represents federal standards of education and training.

(e) An applicant shall be physically and mentally capable of safely practicing naturopathic medicine with or without reasonable accommodation.

(f) If an applicant is licensed, certified, or registered to practice naturopathic medicine or any other health occupation in another state, the applicant shall be in good standing with the applicable state licensing, certification, or registration authority.

(g) An applicant shall complete a criminal history records check in accordance with Sec. 14-308.1 of this title.

#### Section 14-5F-12

To apply for a license, an applicant shall:

(1) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title;

(2) Submit an application to the Board on a form that the Board requires;

(3) Pay to the Board an application fee set by the Board; and

(4) If the applicant has been licensed, certified, or registered to practice naturopathic medicine in another state, submit all evidence relating to:

  (i) Any disciplinary action taken or any administrative penalties assessed against the applicant by the appropriate state licensing, certification, or registration authority; and

  (ii) Any consent agreements the applicant entered into that contain conditions placed on the applicant's professional conduct and practice, including any voluntary surrender of a license.

#### Section 14-5F-12.1

(a) To practice naturopathic medicine in the State, a naturopathic doctor shall maintain at all times a collaboration and consultation agreement with a physician licensed in the State.

(b) Before an individual may practice naturopathic medicine in the State, the individual shall:

  (1) Obtain a license under this subtitle;

  (2) Enter into a collaboration and consultation agreement with a physician licensed in the State; and

  (3) Attest to the completion of the collaboration and consultation agreement on a form provided by the Board.

(c) A collaboration and consultation agreement shall:

  (1) State that the applicant has a collaboration and consultation agreement with a physician licensed in the State;

  (2) Include the name and license number of the physician with whom the applicant has a collaboration and consultation agreement;

  (3) State that the applicant will refer patients to and consult with physicians and other health care providers licensed or certified under this article as needed; and

  (4) States that the applicant will require patients to sign a consent form that states that the applicant's practice of naturopathic medicine is limited to the scope of practice established in Sec. 14-5F-14 of this subtitle.

(d) A naturopathic doctor shall inform the physician named in the collaboration and consultation agreement that the physician has been named.

(e) Subject to the notice required under Sec. 14-5F-12.2 of this subtitle, a naturopathic doctor and a licensed physician may terminate a collaboration and consultation agreement at any time.

(f) In the event of the sudden departure, incapacity, or death of the named licensed physician or change in license status that results in the named licensed physician being unable to practice medicine, the naturopathic doctor may not practice in the State until the naturopathic doctor enters into a new collaboration and consultation agreement.

(g) A naturopathic doctor whose collaboration and consultation agreement is terminated may not practice naturopathic medicine in the State.

#### Section 14-5F-12.2

(a) A physician or an employer shall notify the Board within 10 days after the termination of a naturopathic doctor for reasons that would be grounds for discipline under this subtitle.

(b) A physician named in a collaboration and consultation agreement with a naturopathic doctor and a naturopathic doctor shall notify the Board within 10 days after the termination of a collaboration and consultation agreement.

#### Section 14-5F-13

(a) Subject to subsection (b) of this section, the Board shall issue a license to any applicant who meets the requirements of this subtitle.

(b)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether to issue a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 14-308.1 of this title has not been received.

#### Section 14-5F-14

(a) A license authorizes a licensee, consistent with naturopathic education and training and competence demonstrated by passing the naturopathic physician licensing examination, to:

  (1) Order and perform physical and laboratory examinations for diagnostic purposes, including phlebotomy, clinical laboratory tests, orificial examinations, electrocardiograms with over read by a cardiologist, and physiological function tests;

  (2) Order diagnostic imaging studies and interpret the reports of diagnostic imaging studies;

  (3) Dispense or order natural medicines of mineral, animal, or botanical origin, including food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, enzymes, botanicals and their extracts, botanical medicines, homeopathic medicines, and all dietary supplements and nonprescription drugs listed in the formulary that use various routes of administration, including oral, nasal, auricular, ocular, rectal, vaginal, transdermal, and intramuscular;

  (4) Administer natural medicines of mineral, animal, or botanical origin, including food, extracts of food, nutraceuticals, vitamins, amino acids, minerals, enzymes, botanicals and their extracts, botanical medicines, homeopathic medicines, and all dietary supplements and nonprescription drugs listed in the formulary using various routes of administration, including oral, nasal, auricular, ocular, rectal, vaginal, and transdermal;

  (5) Administer emergency use epinephrine;

  (6) Administer or perform hot or cold hydrotherapy, naturopathic physical medicine, electromagnetic energy, and therapeutic exercise for the purpose of providing basic therapeutic care services, except that if a referral to another licensed provider is appropriate for ongoing rehabilitation or habilitation services, the naturopathic doctor shall make the referral;

  (7) Provide health education and health counseling; and

  (8) Perform naturopathic musculoskeletal mobilization.

(b) A license does not authorize a licensee to:

  (1) Except for a prescription drug or device included in the formulary under Sec. 14-5F-04.1(d)(1)(ii) or (iii) of this subtitle, prescribe, dispense, or administer any prescription drug or device;

  (2) Perform surgical procedures;

  (3) Practice or claim to practice as a medical doctor or physician, an osteopath, a dentist, a podiatrist, an optometrist, a psychologist, a nurse practitioner, a physician assistant, a chiropractor, a physical therapist, an acupuncturist, or any other health care professional unless licensed under this article;

  (4) Use general or spinal anesthetics;

  (5) Administer ionizing radioactive substances for therapeutic purposes;

  (6) Perform chiropractic adjustments or manipulations that include high-velocity thrusts at or beyond the end range of normal joint motion unless the licensee is also a licensed chiropractor;

  (7) Perform acupuncture unless the licensee is also a licensed acupuncturist; or

  (8) Prescribe, dispense, or administer any prescription or nonprescription drug or device listed in the formulary for cosmetic purposes.

#### Section 14-5F-15

(a)

  (1) The term of a license issued by the Board may not exceed 3 years.

  (2) A license expires on a date set by the Board, unless the license is renewed as provided in this section.

(b) At least 1 month before the license expires, the Board shall send to the licensee a renewal notice that states:

  (1) The date on which the current license expires;

  (2) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and

  (3) The amount of the renewal fee.

(c) The Board shall renew the license of a licensee who:

  (1) Submits a renewal application on the form that the Board requires;

  (2) Is of good moral character;

  (3) Pays a renewal fee set by the Board;

  (4) Is otherwise entitled to be licensed;

  (5) Meets the continuing education requirements adopted by the Board; and

  (6) Provides evidence of biennial cardiopulmonary resuscitation certification.

(d)

  (1) Beginning October 1, 2016, the Board shall require a criminal history records check in accordance with Sec. 14-308.1 of this title for:

    (i) Renewal applicants as determined by regulations adopted by the Board; and

    (ii) Each former licensee who files for reinstatement under Sec. 14-5F-16(b) of this subtitle.

  (2) On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether disciplinary action should be taken, based on the criminal history record information, against a licensee who renewed or reinstated a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.

  (3) The Board may renew or reinstate a license only if the licensee or applicant attests that the licensee or applicant has submitted to a criminal history records check under Sec. 14-308.1 of this title.

(e) A disciplinary panel may impose a civil penalty of up to $100 per continuing education credit in lieu of a sanction under Sec. 14-5F-18 of this subtitle, for a first offense for failure of a licensee to obtain the continuing education credits required by the Board.

#### Section 14-5F-15.1

(a) A licensee shall notify the Board in writing of a change in name or address within 30 days after the change.

(b) A licensee who fails to comply with subsection (a) of this section is subject to an administrative penalty of $100.

#### Section 14-5F-16

(a)

  (1) The Board may place a licensee on inactive status if the licensee submits to the Board:

    (i) An application for inactive status on the form required by the Board; and

    (ii) The inactive status fee set by the Board.

  (2) The Board shall issue a license to a naturopathic doctor who is on inactive status if the individual is otherwise entitled to be licensed under this subtitle and submits to the Board:

    (i) Satisfactory evidence of compliance with the requirements of Sec. 14-308.1 of this title;

    (ii) Satisfactory evidence of compliance with the continuing education requirements the Board adopts for this purpose; and

    (iii) A reinstatement fee set by the Board.

(b) The Board shall reinstate the license of a naturopathic doctor who has failed to renew the license for any reason if the naturopathic doctor:

  (1) Meets the renewal requirements of  Sec. 14-5F-15 of this subtitle;

  (2) Pays to the Board a reinstatement fee set by the Board; and

  (3) Submits to the Board satisfactory evidence of compliance with the qualifications and requirements adopted by the Board under this subtitle for license reinstatements.

#### Section 14-5F-17

(a) Unless the Board agrees to accept the surrender of a license, a licensed naturopathic doctor may not surrender the license nor may the license lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.

(b) The Board may set conditions on its agreement with the licensee under investigation or against whom charges are pending to accept surrender of the license.

#### Section 14-5F-18

(a) Subject to the hearing provisions of Sec. 14-405 of this title, a disciplinary panel, on the affirmative vote of a majority of a quorum of the disciplinary panel, may deny a license to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke a license of any licensee if the applicant or licensee:

  (1) Is habitually intoxicated, or is addicted to or habitually abuses any narcotic or controlled dangerous substance, as defined in Sec. 5-101 of the Criminal Law Article, or any drug without a valid prescription or indication, or provides professional services while under the influence of alcohol or using any narcotic or controlled dangerous substance, as defined in Sec. 5-101 of the Criminal Law Article;

  (2) Is:

    (i) Professionally incompetent;

    (ii) Physically incompetent; or

    (iii) Mentally incompetent;

  (3) Has entered into a consent agreement with or has been assessed an administrative penalty by a licensing authority in another state;

  (4) Fraudulently or deceptively obtains, attempts to obtain, or uses a license for the applicant, the licensee, or another;

  (5) Is disciplined by a licensing, certifying, or disciplinary authority or is convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (6) Uses false, deceptive, or misleading advertising;

  (7) Advertises, practices, or attempts to practice under a name other than the applicant's or licensee's own name;

  (8) Aids, assists, employs, or advises any unlicensed individual to practice naturopathic medicine in violation of this subtitle;

  (9) Willfully makes or files a false report or record in the practice of naturopathic medicine;

  (10) Willfully or negligently fails to file a report or record as required by law, willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record a report;

  (11) Pays or receives any commission, bonus, kickback, or rebate, or engages in any split-fee arrangement in any form with a licensed physician, organization, agency, or other person, either directly or indirectly, for patients referred to health care providers;

  (12) Exercises influence within a patient-doctor relationship for purposes of engaging a patient in sexual activity;

  (13) Engages in sexual misconduct with a patient;

  (14) Fails to keep written medical records justifying the course of treatment of a patient;

  (15) Engages in an act or omission that does not meet generally accepted standards of practice of naturopathic medicine or of safe care of patients, whether or not actual injury to a patient is established;

  (16) Delegates professional responsibilities to an individual when the licensee delegating the responsibilities knows or has reason to know that the individual is not qualified by training, experience, or licensure to perform the responsibilities;

  (17) Promotes the sale of services, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

  (18) Breaches patient confidentiality;

  (19) Is guilty of:

    (i) Immoral conduct in the practice of naturopathic medicine; or

    (ii) Unprofessional conduct in the practice of naturopathic medicine;

  (20) Offers, undertakes, or agrees to cure or treat a disease by a secret method, treatment, or medicine;

  (21) Willfully fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

  (22) Sells, prescribes, gives away, or administers drugs for illegal or illegitimate purposes;

  (23) Denies or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

  (24) Fails to cooperate with a lawful investigation of the Board;

  (25) Abandons a patient;

  (26) Violates any provision of this title or any regulation adopted by the Board; or

  (27) Fails to complete a criminal history records check under Sec. 14-308.1 of this title.

(b) Except as otherwise provided in Title 10, Subtitle 2 of the State Government Article, before the Board or a disciplinary panel takes any action under subsection (a) of this section, it shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board or the disciplinary panel in accordance with the hearing requirements of Sec. 14-405 of this title.

(c)

  (1) On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a license if the licensee is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

  (2) After completion of the appellate process if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a license on the certification by the Office of the Attorney General.

(d)

  (1) If, after a hearing under Sec. 14-405 of this title, a disciplinary panel finds that there are grounds under subsection (a) of this section to suspend or revoke a license, to reprimand a licensee, or to place a licensee on probation, the disciplinary panel may impose a fine subject to the Board's regulations in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

  (2) The Board shall pay any fines collected under this section into the General Fund.

(e) In addition to any sanction authorized under this section, a disciplinary panel may require a licensee to comply with specified terms and conditions determined by the disciplinary panel.

#### Section 14-5F-19

(a)

  (1) Except as provided in subsections (b) and (d) of this section, each employer of a licensed naturopathic doctor shall submit to the Board a report if:

    (i) The employer:

      (1) Reduced, suspended, revoked, restricted, denied, conditioned, or did not renew the licensed naturopathic doctor's clinical privileges, employment, or other ability to practice or treat patients;

      (2) Involuntarily terminated or restricted the licensed naturopathic doctor's employment or staff membership; or

      (3) Asked the licensee to voluntarily resign because of the licensed naturopathic doctor's conduct or while the licensee is being investigated; and

    (ii) The action described under item (i) of this paragraph was taken:

      (1) For reasons that might be grounds for disciplinary action under Sec. 14-5F-18 of this subtitle;

      (2) Because the licensed naturopathic doctor may have engaged in an act that may constitute unprofessional conduct;

      (3) Because the licensed naturopathic doctor may be unable to practice naturopathy with reasonable skill and safety because of a physical or mental condition or professional incompetence; or

      (4) Because the licensed naturopathic doctor may have harmed or placed one or more patients or the public at unreasonable risk of harm by engaging in an act that creates an immediate or continuing danger.

  (2) A report required under paragraph (1) of this subsection shall include:

    (i) The action taken by the employer;

    (ii) A detailed explanation of the reasons for the action, including references to specific patient medical records, if any, that informed the employer's action; and

    (iii) The steps taken by the employer to investigate the conduct of the licensed naturopathic doctor.

  (3)

    (i) The Board may request from the employer additional information regarding an action described in paragraph (1) of this subsection that was taken by the employer.

    (ii) If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information.

(b) If an employer knows that the conduct of a licensed naturopathic doctor requires that the employer submit a report under subsection (a)(1) of this section because the licensed naturopathic doctor is impaired by alcohol or another substance, the employer is not required to report the naturopathic doctor to the Board if:

  (1) The employer knows that the licensed naturopathic doctor is:

    (i) In a substance use disorder treatment program that is accredited by The Joint Commission or is certified by the Department; or

    (ii) Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders;

  (2) The employer is able to verify that the licensed naturopathic doctor remains in the treatment program until successful discharge; and

  (3) The action or condition of the licensed naturopathic doctor has not caused injury to any person while the naturopathic doctor is practicing as a licensed naturopathic doctor.

(c) If the employer knows that the licensed physician is noncompliant with the substance use disorder treatment programs, the employer of the licensed naturopathic doctor shall report the licensed naturopathic doctor's noncompliance to the Board.

(d)

  (1) The Board may extend the reporting under this section for good cause shown.

  (2) A person is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of substance use disorder patient records.

(e) The Board may enforce this section by subpoena.

(f) Any person shall have the immunity from liability described under Sec. 5-715(d) of the Courts Article for giving any of the information required by this section.

(g) An employer required to make a report to the Board under this section shall submit the report within 10 days after the action requiring the report.

(h) A report made under this section is privileged, not subject to inspection under the Public Information Act, and not subject to subpoena or discovery in any civil action other than a proceeding arising out of a hearing and decision of the Board or a disciplinary panel under this title.

(i)

  (1) A disciplinary panel may impose a civil penalty of up to $5,000 for knowingly failing to report under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $5,000 per incident for a report made by an employer in bad faith.

  (3) The Board shall remit any penalty collected under this subsection into the General Fund of the State.

#### Section 14-5F-20

(a) Following the filing of charges or notice of initial denial of a license application, the Board shall disclose the filing to the public on the Board's website.

(b) The Board shall create and maintain a public individual profile on each licensee that includes the following information:

  (1) A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under Sec. 14-5F-18 of this subtitle based on the charges or has rescinded the charges;

  (2) A description of any disciplinary action taken by the Board or a disciplinary panel against the licensee within the most recent 10-year period that includes a copy of the public order;

  (3) A description in summary form of any final disciplinary action taken by a licensing board in any other state or jurisdiction against the licensee within the most recent 10-year period if the Board knows about the disciplinary action;

  (4) A description of a conviction or entry of a plea of guilty or nolo contendere by the licensee for a crime involving moral turpitude that is the basis for disciplinary action taken under Sec. 14-5F-18(c) of this subtitle; and

  (5) The public address of the licensee.

(c) In addition to the information required under subsection (b) of this section, the Board shall include on each licensee's profile a statement of information to be taken into consideration by a consumer when viewing a licensee's profile, including a disclaimer stating that a charging document does not indicate a final finding of guilt by a disciplinary panel.

(d) The Board:

  (1) On receipt of a written request for a licensee's profile from any person, shall forward a written copy of the profile to the person; and

  (2) Shall maintain a website that serves as a single point of entry where all licensee profile information is available to the public on the Internet.

(e) The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee's profile.

(f) The Board shall include information relating to charges filed against a licensee by a disciplinary panel and any final disciplinary action taken by a disciplinary panel against a licensee in the licensee's profile within 10 days after the charges are filed or the action becomes final.

#### Section 14-5F-21

(a) The Board shall give notice and hold a hearing in accordance with the Administrative Procedure Act.

(b) The individual may be represented at the hearing by counsel.

(c) Over the signature of an officer or the administrator of the Board, the Board or a disciplinary panel may issue subpoenas and administer oaths in connection with any investigation under this subtitle and any hearings or proceedings before the Board or a disciplinary panel.

(d) If, without lawful excuse, a person disobeys a subpoena from the Board or a disciplinary panel or an order by the Board or a disciplinary panel to take an oath or to testify or answer a question, then, on petition of the Board, a court of competent jurisdiction may punish the person as for contempt of court.

(e) If, after due notice, the individual against whom the action is contemplated fails or refuses to appear, the Board or a disciplinary panel may hear and determine the matter.

#### Section 14-5F-22

If the Board or a disciplinary panel finds that there are grounds for action under Sec. 14-5F-18 of this subtitle, the Board or the disciplinary panel shall pass an order in accordance with the Administrative Procedure Act.

#### Section 14-5F-23

(a)

  (1) Any person aggrieved by a final decision of the Board or a disciplinary panel under this subtitle in a contested case, as defined in the Administrative Procedure Act, may take a direct judicial appeal.

  (2) The appeal shall be made as provided for judicial review of final decisions in the Administrative Procedure Act.

(b) An order of the Board or a disciplinary panel may not be stayed pending judicial review.

(c) The Board may appeal from any decision that reverses or modifies an order of the Board or a disciplinary panel.

#### Section 14-5F-24

(a) Subject to subsection (c) of this section, if the Board has revoked or suspended the license of a licensee, the Board may not reinstate the license until the Board is satisfied that the individual:

  (1) Has complied with all the terms and conditions in the final order; and

  (2) Is capable of safely engaging in the practice of naturopathic medicine.

(b) The Board may not reinstate the license of an individual whose license was revoked by the Board within 6 months after the date of the revocation.

(c) A disciplinary panel may not reinstate a surrendered or revoked license that has been surrendered or revoked for a period of more than 1 year unless the licensee:

  (1) Meets the requirements for reinstatement as established under this title; and

  (2) Completes a criminal history records check in accordance with Sec. 14-308.1 of this title.

#### Section 14-5F-25

(a) A disciplinary panel may issue a cease and desist order for:

  (1) Practicing naturopathic medicine without a license or with an unauthorized person; or

  (2) Supervising or aiding an unauthorized person in the practice of naturopathic medicine.

(b) Except as otherwise provided in this subtitle, a licensed physician may not employ an individual practicing naturopathic medicine without a license or without a collaboration and consultation agreement.

(c) Except as otherwise provided in this subtitle, an employer may not employ an individual practicing naturopathic medicine without a license or without a collaboration and consultation agreement.

(d) A disciplinary panel may impose a civil penalty of up to $5,000 for a violation of this section.

(e) The Board shall remit any penalty collected under this section into the General Fund of the State.

#### Section 14-5F-26

A licensed naturopathic doctor shall follow any federal, State, or local law that governs:

(1) The control of contagious and infectious diseases; and

(2) The reporting of births and deaths.

#### Section 14-5F-27

A licensed naturopathic doctor may receive a fee for professional consultation services.

#### Section 14-5F-28

If a naturopathic doctor is engaged in the private practice of naturopathic medicine in the State, the naturopathic doctor shall display the notice developed under Sec. 1-207 of this article conspicuously in each office where the naturopathic doctor is engaged in practice.

#### Section 14-5F-29

(a) Except as otherwise provided in this subtitle, an individual may not practice, attempt to practice, or offer to practice naturopathic medicine in this State without a license.

(b) An individual who violates subsection (a) of this section or Sec. 14-5F-30 of this subtitle is guilty of a felony and on conviction is subject to a fine not exceeding $10,000 or imprisonment not exceeding 5 years or both.

(c) Any individual who violates subsection (a) of this section or Sec. 14-5F-30 of this subtitle is subject to a civil fine of not more than $50,000 to be levied by a disciplinary panel.

(d) The Board shall pay any penalty collected under this section into the Board of Physicians Fund.

#### Section 14-5F-30

(a) Unless an individual is licensed to practice naturopathic medicine, the individual may not:

  (1) Represent to the public by title, by description of services, methods, or procedures, or otherwise, that the individual is licensed by the Board to practice naturopathic medicine;

  (2) Use the title "doctor of naturopathic medicine", "doctor of naturopathy", "naturopathic doctor", or "naturopath"; or

  (3) Use the initials "N.D.", "ND", "NMD", or "N.M.D." after the name of the individual.

(b) An individual licensed to practice naturopathic medicine in the State may not use the title "physician".

#### Section 14-5F-31

This  subtitle may be cited as the Maryland Naturopathic Medicine Act.

#### Section 14-5F-32

Subject to the evaluation and reestablishment provisions of the Program Evaluation Act, this subtitle and all rules and regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2030.

### Subtitle 5G. Genetic Counselors

#### Section 14-5G-01

(a) In this subtitle the following words have the meanings indicated.

(b) "Board" means the State Board of Physicians.

(c) "Certified genetic counselor" means an individual certified as a genetic counselor by a national certifying board.

(d) "Committee" means the Genetic Counselors Advisory Committee.

(e) "Genetic assessment" means the integration of genetic laboratory test results and other diagnostic studies with the medical histories of a patient and the patient's family members to assess the risk for the patient or the patient's family members of:

  (1) A genetic or medical condition or disease; and

  (2) The recurrence of a genetic or medical condition or disease.

(f) "License" means a license issued by the Board to practice genetic counseling.

(g) "Licensed genetic counselor" means an individual who is licensed under this subtitle to practice genetic counseling.

(h) "Licensee" means a licensed genetic counselor.

(i) "National accrediting council" means the Accreditation Council for Genetic Counseling, or its successor, that accredits education programs for genetic counselors.

(j) "National certifying board" means the American Board of Genetic Counseling, or its successor, that certifies genetic counselors.

(k)

  (1) "Practice genetic counseling" means:

    (i) Obtaining and evaluating the medical histories of a patient and the patient's family members for purposes of a genetic assessment;

    (ii) Discussing the features, natural history, means of diagnosis, genetic and environmental factors, and management of risk for genetic or medical conditions or diseases;

    (iii) Identifying, ordering, and coordinating genetic laboratory tests and other diagnostic studies, as appropriate, for purposes of a genetic assessment;

    (iv) Using the medical histories obtained under item (i) of this paragraph and the results of genetic laboratory tests and other diagnostic studies ordered under item (iii) of this paragraph for purposes of a genetic assessment;

    (v) Explaining the clinical implications of genetic laboratory tests and other diagnostic studies and the results of the tests and studies and communicating the risk factors for genetic or medical conditions or diseases identified by a genetic assessment;

    (vi) Evaluating the responses of a patient and the patient's family members to the results of a genetic assessment and providing counseling and anticipatory guidance for a genetic or medical condition or disease;

    (vii) Identifying and using community resources that provide medical, educational, financial, and psychosocial support and advocacy for a genetic or medical condition or disease; or

    (viii) Providing written documentation of medical, genetic, and counseling information for a patient, a patient's family members, or appropriate health care professionals.

  (2) "Practice genetic counseling" does not include diagnosing or treating an illness, a disease, or a condition.

#### Section 14-5G-02

This subtitle does not limit the right of an individual to practice a health occupation that the individual is authorized to practice under this article.

#### Section 14-5G-03

The Board shall adopt regulations for the licensure and practice of genetic counseling.

#### Section 14-5G-04

(a)

  (1) The Board shall set reasonable fees for the issuance and renewal of licenses and the other services the Board provides to genetic counselors.

  (2) The fees charged shall be set so as to produce funds to approximate the cost of maintaining the licensure program and the other services provided to genetic counselors.

(b)

  (1) The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller.

  (2) The Comptroller shall distribute all fees to the Board.

(c) The fees shall be used to cover the actual documented direct and indirect costs of fulfilling the statutory and regulatory duties of the Board as provided by this subtitle.

#### Section 14-5G-05

There is a Genetic Counseling Advisory Committee within the Board.

#### Section 14-5G-06

(a) The Committee consists of members appointed by the Board as follows:

  (1) Three shall be licensed genetic counselors;

  (2) Three shall be licensed physicians; and

  (3) One shall be a consumer member.

(b) Each member of the Committee licensed by the Board must be in good standing with the Board.

(c) The licensed physician members of the Committee must have experience working with genetic counselors.

(d) The consumer member of the Committee:

  (1) Must be a member of the general public;

  (2) May not be or ever have been:

    (i) A genetic counselor;

    (ii) Any other health care professional; or

    (iii) In training to be a genetic counselor or other health professional; and

  (3) May not:

    (i) Participate or ever have participated in a commercial or professional field related to genetic counseling;

    (ii) Have a household member who participates in a commercial or professional field related to genetic counseling;

    (iii) Have had within 2 years before appointment a financial interest in a person regulated by the Board; or

    (iv) Have had within 2 years before appointment a financial interest in the provision of goods or services to genetic counselors or to the field of genetic counseling.

(e) Each member of the Committee must be a resident of the State.

(f)

  (1) The term of a member is 3 years.

  (2) The terms of members are staggered as required by regulation.

  (3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

  (4) A member may not serve more than two consecutive full terms.

  (5) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.

(g) From among its members, the Committee shall elect a chair every 2 years.

(h) A quorum of the Committee consists of five members.

#### Section 14-5G-07

In addition to the powers set forth elsewhere in this subtitle, the Committee:

(1) Shall:

  (i) Develop and recommend to the Board:

    (1) Regulations to carry out this subtitle; and

    (2) Any statutory changes that affect the profession; and

  (ii) Keep a record of its meetings; and

(2) May:

  (i) Provide recommendations regarding the practice of genetic counseling; and

  (ii) Advise the Board on any other matters related to genetic counselors.

#### Section 14-5G-08

(a) Except as otherwise provided in this subtitle or Sec.Sec. 10-14A-03 and 10-14B-03 of the State Government Article, an individual shall be licensed by the Board before the individual may practice genetic counseling in the State.

(b) This section does not apply to:

  (1) A genetic counselor who is employed in the service of the federal government while practicing within the scope of the employment;

  (2) An individual who resides in and holds an active license in another state if the individual is engaged in consultation with a physician or genetic counselor licensed in the State about a particular patient and the individual:

    (i) Does not order or coordinate genetic laboratory tests or other diagnostic studies; and

    (ii) Does not provide consultation in the State for more than a total of 10 patients within a calendar year; or

  (3) A student enrolled in a genetic counseling training program that is accredited by a national accrediting organization recognized by the Board in regulations while the student is practicing genetic counseling in the program and doing the assigned duties at any office of a licensed physician or genetic counselor, hospital, clinic, or similar facility.

#### Section 14-5G-09

(a) To qualify for a license to practice genetic counseling, an applicant shall be an individual who meets the requirements of this section.

(b) The applicant must be of good moral character.

(c) The applicant must be at least 18 years old.

(d) The applicant must be a graduate of an appropriate education program approved by the Board.

(e) The applicant shall submit to the Board satisfactory evidence of certification by a national certifying organization approved by the Board.

(f) The applicant shall complete a criminal history records check in accordance with Sec. 14-308.1 of this title.

(g) The applicant shall meet any additional education, training, or examination requirements established by the Board.

#### Section 14-5G-10

To apply for a license, an applicant shall:

(1) Complete a criminal history records check in accordance with Sec. 14-308.1 of this title;

(2) Submit an application to the Board on a form that the Board requires; and

(3) Pay to the Board an application fee set by the Board.

#### Section 14-5G-11

(a) Subject to subsection (b) of this section, the Board shall issue a license to any applicant who meets the requirements of this subtitle.

(b)

  (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether to issue a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

  (2) The Board may not issue a license if the criminal history record information required under Sec. 14-308.1 of this title has not been received.

#### Section 14-5G-12

(a) A genetic counselor license authorizes a licensee to practice genetic counseling in the State while the license is effective.

(b) If, while practicing genetic counseling, a licensed genetic counselor determines that a patient requires a diagnosis or treatment, the genetic counselor shall refer the patient to a licensed physician or another appropriate health care practitioner.

#### Section 14-5G-13

(a)

  (1) The term of a license issued by the Board may not exceed 3 years.

  (2) A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section.

(b) At least 1 month before a license expires, the Board shall send to the licensed genetic counselor a renewal notice that states:

  (1) The date on which the current license expires;

  (2) The date by which the renewal application must be received by the Board for the renewal to be issued and sent before the license expires; and

  (3) The amount of the renewal fee.

(c) Except as otherwise provided in this subtitle, before a license expires, a licensed genetic counselor periodically may renew it for an additional term if the licensee:

  (1) Is of good moral character;

  (2) Pays to the Board a renewal fee set by the Board;

  (3) Submits to the Board:

    (i) A renewal application on the form that the Board requires; and

    (ii) Satisfactory evidence of compliance with any continuing education or competency requirements and other requirements set under this section for license renewal; and

  (4) Meets any additional renewal requirements established by the Board.

(d)

  (1) In addition to any other qualifications and requirements established by the Board, the Board may establish continuing education or competency requirements as a condition to the renewal of licenses under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $100 per continuing education credit in lieu of a sanction under  Sec. 14-5G-18 of this subtitle, for a first offense, for the failure of a licensee to obtain the continuing education credits required by the Board.

(e)

  (1) The Board shall renew the license of each licensed genetic counselor who meets the requirements of this section.

  (2) A license may not be renewed for a term longer than 2 years.

(f) The Board shall reinstate the license of a genetic counselor who has failed to renew a license for any reason if the genetic counselor:

  (1) Meets the renewal requirements of this section;

  (2) Submits to the Board:

    (i) A reinstatement application on the form that the Board requires; and

    (ii) Satisfactory evidence of compliance with any continuing education or competency requirements; and

  (3) Meets any additional requirements established by the Board for reinstatement.

(g)

  (1) The Board shall require a criminal history records check in accordance with Sec. 14-308.1 of this title for:

    (i) Renewal applicants as determined by regulations adopted by the Board; and

    (ii) Each former licensed genetic counselor who files for reinstatement under subsection (f) of this section.

  (2) On receipt of the criminal history record information of a licensed genetic counselor forwarded to the Board in accordance with Sec. 14-308.1 of this title, in determining whether disciplinary action should be taken, based on the criminal history record information, against a licensed genetic counselor who renewed or reinstated a license, the Board shall consider:

    (i) The age at which the crime was committed;

    (ii) The nature of the crime;

    (iii) The circumstances surrounding the crime;

    (iv) The length of time that has passed since the crime;

    (v) Subsequent work history;

    (vi) Employment and character references; and

    (vii) Other evidence that demonstrates whether the licensee poses a threat to the public health or safety.

  (3) The Board may renew or reinstate a license only if the licensed genetic counselor or applicant attests that the licensed genetic counselor or applicant has submitted a criminal history records check under Sec. 14-308.1 of this title.

#### Section 14-5G-14

(a)

  (1) In this section the following words have the meanings indicated.

  (2) "Qualified supervisor" means:

    (i) An individual who:

      (1) Is licensed to practice as a genetic counselor under this subtitle; and

      (2) Has practiced for a minimum of 3 years after passing the national certifying examination; or

    (ii) A physician who has been licensed in the State for a minimum of 5 years.

  (3) "Supervision" means the ongoing, direct, clinical review for the purposes of training or teaching by a qualified supervisor who monitors the performance of a supervised genetic counselor's supervised interaction with a patient and provides regular documented face-to-face meetings and consultation, chart reviews, guidance, and instructions with respect to the clinical skills and competencies of the supervised genetic counselor.

(b) Except as provided in subsection (c) of this section, on or after January 1, 2024, the Board shall issue a supervised genetic counselor license to an applicant who:

  (1) Has graduated from a genetic counseling program accredited by the Accreditation Council for Genetic Counselors;

  (2) Has met all qualifications for licensure except for certification from the American Board of Genetic Counselors; and

  (3) Has applied for the first available national certifying examination.

(c) The Board may not issue a license under subsection (b) of this section if the applicant has failed the American Board of Genetic Counseling certification examination two or more times.

(d)

  (1) As a condition of licensure, the supervised genetic counselor shall work under the supervision of a qualified supervisor.

  (2) The supervised genetic counselor and the qualified supervisor shall enter into a supervision contract that:

    (i) Specifies the manner of supervision as required by the Board;

    (ii) Is signed by the supervised genetic counselor and the qualified supervisor; and

    (iii) Is maintained by both the supervised genetic counselor and the qualified supervisor and made available to the Board.

(e) The supervised genetic counselor may not represent to the public, by description of services, methods, or procedures, or otherwise, that the supervised genetic counselor is a licensed genetic counselor.

(f)

  (1) A supervised genetic counselor license may not be valid for more than 1 year after the date of issuance.

  (2) A supervised genetic counselor license expires on the earliest of:

    (i) The issuance of a genetic counselor license to the supervised genetic counselor;

    (ii) The expiration date printed on the supervised genetic counselor license; or

    (iii) On notice of the second failure of the supervised genetic counselor to pass the certification examination.

(g) A supervised genetic counselor who has not passed the examination within two examination cycles may not continue practicing under the supervised genetic counselor license.

(h) A supervised genetic counselor is subject to discipline under Sec. 14-5G-19 of this subtitle to the same extent as a genetic counselor.

#### Section 14-5G-15

(a) A licensee shall notify the Board in writing of a change of name or address within 30 days after the change.

(b) A licensee who fails to comply with subsection (a) of this section is subject to an administrative penalty of $100.

#### Section 14-5G-16

Unless a disciplinary panel agrees to accept the surrender of a license, a licensee may not surrender the license nor may the license lapse by operation of law while the licensee is under investigation or while charges are pending against the licensee.

#### Section 14-5G-17

A disciplinary panel may issue a cease and desist order for:

(1) Practicing genetic counseling without a license or with an unauthorized person; or

(2) Supervising or aiding an unauthorized person in the practice of genetic counseling.

#### Section 14-5G-18

(a) Subject to the hearing provisions of Sec. 14-405 of this title, a disciplinary panel, on the affirmative vote of a majority of the quorum of the disciplinary panel, may deny a license to any applicant, reprimand any licensee, place any licensee on probation, or suspend or revoke a license, if the applicant or licensee:

  (1) Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or licensee or for another;

  (2) Fraudulently or deceptively uses a license;

  (3) Is guilty of:

    (i) Immoral conduct while practicing genetic counseling; or

    (ii) Unprofessional conduct while practicing genetic counseling;

  (4) Is:

    (i) Professionally incompetent;

    (ii) Physically incompetent; or

    (iii) Mentally incompetent;

  (5) Abandons a patient;

  (6) Is habitually intoxicated;

  (7) Is addicted to or habitually abuses any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article;

  (8) Provides professional services while:

    (i) Under the influence of alcohol; or

    (ii) Using any narcotic or controlled dangerous substance as defined in Sec. 5-101 of the Criminal Law Article or any other drug that is in excess of therapeutic amounts or without valid medical indication;

  (9) Promotes the sale of services, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain;

  (10) Willfully makes or files a false report or record in the practice of genetic counseling;

  (11) Willfully fails to file or record any report as required under law, willfully impedes or obstructs the filing or recording of a report, or induces another to fail to file or record a report;

  (12) Breaches patient confidentiality;

  (13) Pays or agrees to pay any sum or provide any form of remuneration or material benefit to any person for bringing or referring a patient or accepts or agrees to accept any sum or any form of remuneration or material benefit from an individual for bringing or referring a patient;

  (14) Willfully makes a misrepresentation while practicing genetic counseling;

  (15) Willfully practices genetic counseling with an unauthorized individual or aids an unauthorized individual in practicing genetic counseling;

  (16) Willfully delegates a genetic counseling duty to an unlicensed individual;

  (17) Establishes a pattern of excessive or medically unnecessary procedures or treatment;

  (18) Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine;

  (19) Is disciplined by a licensing or disciplinary authority or is convicted or disciplined by a court of any state or country, or disciplined by any branch of the uniformed services or the U.S. Department of Veterans Affairs, for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (20) Fails to meet appropriate standards for the delivery of genetic counseling services;

  (21) Willfully submits false statements to collect fees for which services are not provided;

  (22)

    (i) Has been subject to investigation or disciplinary action by a licensing or disciplinary authority or by a court of any state or country for an act that would be grounds for disciplinary action under the Board's disciplinary statutes; and

    (ii) Has:

      (1) Surrendered the license, if any, issued by the state or country; or

      (2) Allowed the license, if any, issued by the state or country to expire or lapse;

  (23) Willfully fails to report suspected child abuse in violation of Sec. 5-704 of the Family Law Article;

  (24) Practices or attempts to practice beyond the authorized scope of practice;

  (25) Refuses, withholds from, denies, or discriminates against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render because the individual is HIV positive;

  (26) Practices or attempts to practice genetic counseling procedures or uses or attempts to use genetic assessments if the applicant or licensee has not received education and training in the performance of the procedure or the use of the genetic assessment;

  (27) Fails to cooperate with a lawful investigation of the Board or a disciplinary panel;

  (28) Fails to complete a criminal history records check under Sec. 14-308.1 of this title; or

  (29) Violates any provision of this title or any rule or regulation pertaining to genetic counseling that is adopted by the Board, the State, or the federal government.

(b) Except as otherwise provided in the Administrative Procedure Act, before the Board or a disciplinary panel takes any action under subsection (a) of this section, it shall give the individual against whom the action is contemplated an opportunity for a hearing before the Board or the disciplinary panel in accordance with the hearing requirements of Sec. 14-405 of this title.

(c)

  (1) On the filing of certified docket entries with the Board by the Office of the Attorney General, a disciplinary panel shall order the suspension of a license if the licensee is convicted of or pleads guilty or nolo contendere with respect to a crime involving moral turpitude, whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

  (2) After completion of the appellate process, if the conviction has not been reversed or the plea has not been set aside with respect to a crime involving moral turpitude, a disciplinary panel shall order the revocation of a license on the certification by the Office of the Attorney General.

(d)

  (1) If, after a hearing under Sec. 14-405 of this title, a disciplinary panel finds that there are grounds under subsection (a) of this section to suspend or revoke a license, to reprimand a licensee, or to place a licensee on probation, the disciplinary panel may impose a fine subject to the Board's regulations in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

  (2) The Board shall pay any fines collected under this section into the General Fund of the State.

(e) In addition to any sanction authorized under this section, a disciplinary panel may require a licensee to comply with specified terms and conditions determined by the disciplinary panel.

#### Section 14-5G-19

(a)

  (1) Any person aggrieved by a final decision of the Board or a disciplinary panel under this subtitle may take a direct judicial appeal.

  (2) The appeal shall be made as provided for judicial review of final decisions in the Administrative Procedure Act.

(b) An order of the Board or a disciplinary panel may not be stayed pending review.

(c) The Board may appeal from any decision that reverses or modifies an order of the Board or a disciplinary panel.

#### Section 14-5G-20

(a)

  (1) Except as provided in subsections (b) and (d) of this section, each employer of a licensed genetic counselor shall submit to the Board a report if:

    (i) The employer:

      (1) Reduced, suspended, revoked, restricted, denied, conditioned, or did not renew the licensed genetic counselor's clinical privileges, employment, or other ability to practice or treat patients;

      (2) Involuntarily terminated or restricted the licensed genetic counselor's employment or staff membership; or

      (3) Asked the licensed genetic counselor to voluntarily resign because of the licensed genetic counselor's conduct or while the licensed genetic counselor is being investigated; and

    (ii) The action described under item (i) of this paragraph was taken:

      (1) For reasons that might be grounds for disciplinary action under Sec. 14-5G-18 of this subtitle;

      (2) Because the licensed genetic counselor may have engaged in an act that may constitute unprofessional conduct;

      (3) Because the licensed genetic counselor may be unable to practice genetic counseling with reasonable skill and safety because of a physical or mental condition or professional incompetence; or

      (4) Because the licensed genetic counselor may have harmed or placed one or more patients or the public at unreasonable risk of harm by engaging in an act that creates an immediate or continuing danger.

  (2) A report required under paragraph (1) of this subsection shall include:

    (i) The action taken by the employer;

    (ii) A detailed explanation of the reasons for the action, including references to specific patient medical records, if any, that informed the employer's action; and

    (iii) The steps taken by the employer to investigate the conduct of the licensed genetic counselor.

  (3)

    (i) The Board may request from the employer additional information regarding an action described in paragraph (1) of this subsection that was taken by the employer.

    (ii) If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information.

(b) If an employer knows that the conduct of a licensed genetic counselor requires that the employer submit a report because the licensed genetic counselor is impaired by alcohol or another substance, the employer is not required to report the licensed genetic counselor to the Board if:

  (1) The employer knows that the licensed genetic counselor is:

    (i) In a substance use disorder treatment program that is accredited by The Joint Commission or that is certified by the Department; or

    (ii) Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders; and

  (2)

    (i) The employer is able to verify that the licensed genetic counselor remains in the treatment program until successful discharge; and

    (ii) The action or condition of the licensed genetic counselor has not caused injury to any person while the genetic counselor is practicing as a licensed genetic counselor.

(c) If the employer knows that the licensed genetic counselor is noncompliant with the substance use disorder treatment program, the employer of the licensed genetic counselor shall report the licensed genetic counselor's noncompliance to the Board.

(d)

  (1) The Board may extend the reporting under this section for good cause shown.

  (2) A person is not required under this section to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of substance use disorder patient records.

(e) The Board may enforce this section by subpoena.

(f) Any person shall have the immunity from liability described under Sec. 5-715(d) of the Courts Article for giving any of the information required by this section.

(g) An employer required to make a report to the Board under this section shall submit the report within 10 days after the action requiring the report.

(h) A report made under this section is privileged, not subject to inspection under the Public Information Act, and not subject to subpoena or discovery in any civil action other than a proceeding arising out of a hearing and decision of the Board or a disciplinary panel under this title.

(i)

  (1) A disciplinary panel may impose a civil penalty of up to $5,000 for knowingly failing to report under this section.

  (2) A disciplinary panel may impose a civil penalty of up to $5,000 per incident for a report made by an employer in bad faith.

  (3) The Board shall remit any penalty collected under this subsection into the General Fund of the State.

#### Section 14-5G-21

(a) Following the filing of charges or notice of initial denial of license application, the Board shall disclose the filing to the public on the Board's website.

(b) The Board shall create and maintain a public individual profile on each licensee that includes the following information:

  (1) A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under Sec. 14-5G-18 of this subtitle based on the charges or has rescinded the charges;

  (2) A description of any disciplinary action taken by the Board or a disciplinary panel against the licensee within the most recent 10-year period that includes a copy of the public order;

  (3) A description in summary form of any final disciplinary action taken by a licensing board in any other state or jurisdiction against the licensee within the most recent 10-year period;

  (4) A description of a conviction or entry of a plea of guilty or nolo contendere by the licensee for a crime involving moral turpitude that is the basis for disciplinary action taken under Sec. 14-5G-18(c) of this subtitle; and

  (5) The public address of the licensee.

(c) In addition to the requirements of subsection (b) of this section, the Board shall include on each licensee's profile a statement of information to be taken into consideration by a consumer when viewing a licensee's profile, including a disclaimer stating that a charging document does not indicate a final finding of guilt by a disciplinary panel.

(d) The Board:

  (1) On receipt of a written request for a licensee's profile from any person, shall forward a written copy of the profile to the person; and

  (2) Shall maintain a website that serves as a single point of entry where all licensee profile information is available to the public on the Internet.

(e) The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee's profile.

(f) The Board shall include information relating to charges filed against a licensee by a disciplinary panel and any final disciplinary action taken by a disciplinary panel against a licensee in the licensee's profile within 10 days after the charges are filed or the action becomes final.

#### Section 14-5G-22

(a) Subject to subsection (b) of this section, on the application of an individual whose license has been revoked, a disciplinary panel, on the affirmative vote of a majority of its full authorized membership, may reinstate a revoked license.

(b) A disciplinary panel may not reinstate a revoked license that has been revoked for a period of more than 1 year unless the licensee:

  (1) Meets the requirements for reinstatement as established under this title; and

  (2) Completes a criminal history records check in accordance with Sec. 14-308.1 of this title.

#### Section 14-5G-23

Except as otherwise provided in this subtitle, a person may not practice, attempt to practice, or offer to practice genetic counseling in this State unless licensed to practice genetic counseling by the Board.

#### Section 14-5G-24

(a) Unless authorized to practice genetic counseling under this subtitle, a person may not represent to the public by title, by description of services, methods, or procedures, or otherwise, that the person is authorized to practice genetic counseling in this State.

(b) Unless authorized to practice genetic counseling under this subtitle, a person may not use the titles "genetic counselor", "licensed genetic counselor", "certified genetic counselor", "gene counselor", "genetic consultant", "genetic associate", or any words, letters, or symbols with the intent to imply that the person practices genetic counseling or is a certified genetic counselor or licensed genetic counselor.

#### Section 14-5G-25

A person may not provide, attempt to provide, offer to provide, or represent that the person provides genetic counseling services unless the genetic counseling is provided by an individual who is authorized to practice genetic counseling under this subtitle.

#### Section 14-5G-26

(a) Except as otherwise provided in this subtitle, a licensed genetic counselor or a licensed physician may not employ or supervise an individual practicing genetic counseling without a license.

(b) Except as otherwise provided in this subtitle, an employer may not employ an individual practicing genetic counseling without a license.

(c) A disciplinary panel may impose a civil penalty of up to $5,000 for a violation of this section.

(d) The Board shall remit any penalty collected under this section into the General Fund of the State.

#### Section 14-5G-27

(a) A person who violates Sec. 14-5G-23, Sec. 14-5G-24, or Sec. 14-5G-25 of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 or imprisonment not exceeding 1 year or both.

(b) A person who violates Sec. 14-5G-23, Sec. 14-5G-24, or Sec. 14-5G-25 of this subtitle is subject to a civil fine of not more than $5,000 to be levied by a disciplinary panel.

(c) The Board shall pay any penalty collected under this section into the Board of Physicians Fund.

#### Section 14-5G-28

This subtitle may be cited as the Maryland Genetic Counseling Act.

#### Section 14-5G-29

Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act and subject to the termination of this title under Sec. 14-702 of this title, this subtitle and all regulations adopted under this subtitle shall terminate and be of no effect after July 1, 2031.

### Subtitle 6. Prohibited Acts; Penalties

#### Section 14-601

Except as otherwise provided in this title:

(1) A person may not practice, attempt to practice, or offer to practice medicine in the State unless licensed by the Board; and

(2) A licensee on inactive status under Sec. 14-320 of this subtitle or emeritus status under Sec. 14-320.1 of this subtitle may not:

  (i) Practice, attempt to practice, or offer to practice medicine in the State; or

  (ii) Delegate medical acts.

#### Section 14-602

(a) Unless authorized to practice medicine under this title, a person may not represent to the public, by description of services, methods, or procedures, or otherwise, that the person is authorized to practice medicine in this State.

(b) Except as otherwise provided in this article, a person may not use the words or terms "Dr.", "doctor", "physician", "D.O.", or "M.D." with the intent to represent that the person practices medicine, unless the person is:

  (1) Licensed to practice medicine under this title;

  (2) A physician licensed by and residing in another jurisdiction, while engaging in consultation with a physician licensed in this State;

  (3) A physician employed in the service of the federal government while practicing within the scope of the employment;

  (4) A physician who resides in and is licensed to practice medicine by any state adjoining this State and whose practice extends into this State;

  (5) An individual in a postgraduate medical program that is accredited by an accrediting organization recognized by the Board in regulations while the individual is practicing medicine in the program; or

  (6) A licensee who is on emeritus status under Sec. 14-320.1 of this title, provided that the licensee does not represent to the public that the licensee is authorized to practice medicine in the State.

(c) An unlicensed individual who acts under Sec. 14-302, Sec. 14-306, Sec. 14-306.1, Sec. 14-306.2, or Sec. 14-306.3 of this title may use the word "physician" together with another word to describe the occupation of the individual as in phrases such as "physician's assistant" or "physician's aide".

#### Section 14-603

A person may not make any false statement, report, or representation to the Board or a disciplinary panel.

#### Section 14-605

(a) This section does not apply to a physician or group of physicians who:

  (1) Have exclusive contracts with a health maintenance organization;

  (2) Treat only the patients of the health maintenance organization; and

  (3) Agree to accept full assignment for covered services rendered.

(b) If a physician is engaged in the private practice of medicine in this State, the physician shall display a notice written in English that is plainly visible to patients in the office of the physician concerning whether the physician:

  (1) Is a participating physician under the Medicare program and, therefore, accepts assignment for all Medicare claims;

  (2) Accepts Medicare assignment on a case-by-case basis; or

  (3) Does not accept Medicare assignment in any case.

#### Section 14-606

(a)

  (1) Except as provided in paragraph (4) of this subsection, a person who violates any provision of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 5 years or both.

  (2) A person who violates any provision of Sec. 14-503 of this title is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $500.

  (3) A person who is required to give notice under Sec. 14-505 ("Reporting burn treatment") of this title, and who fails to give the required notice, may be subject to a civil penalty of not more than $100.

  (4) Except as provided in paragraph (5) of this subsection, a person who violates Sec. 14-601 or Sec. 14-602 of this subtitle is:

    (i) Guilty of a felony and on conviction is subject to a fine not exceeding $10,000 or imprisonment not exceeding 5 years or both; and

    (ii) Subject to a civil fine of not more than $50,000 to be levied by a disciplinary panel.

  (5) The provisions of paragraph (4) of this subsection do not apply to a former licensee who has failed to renew a license under Sec. 14-316 of this title if:

    (i) Less than 60 days have elapsed since the expiration of the license; and

    (ii) The former licensee has applied for license reinstatement, including payment of the reinstatement fee.

(b) The Board shall pay any penalty collected under this section into the Board of Physicians Fund.

#### Section 14-607

(a) Knowingly selling or dispensing replacement contact lenses without a valid and unexpired replacement contact lens prescription shall be considered a violation of this title.

(b) The Board shall investigate any alleged violation of this section or Sec. 14-507 of this title and may enforce any provision of this title by injunction or other appropriate proceedings.

(c) An action under this section is in addition to and not instead of criminal prosecution under Sec. 14-606 of this subtitle.

### Subtitle 7. Short Title; Termination of Title

#### Section 14-701

This title may be cited as the "Maryland Medical Practice Act".

#### Section 14-702

Subject to the evaluation and reestablishment provisions of the Program Evaluation Act, this title and all rules and regulations adopted under this title shall terminate and be of no effect after July 1, 2030. 

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Md. Code Ann., Health Occ. (as displayed at mgaleg.maryland.gov, October 16, 2026)