In this subtitle the following words have the meanings indicated. “Board” means the State Board of Physicians. “Committee” means the Polysomnography Advisory Committee established under § 14–5C–05 of this subtitle. “License” means a license issued by the Board. “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. “Practice polysomnography” means: Monitoring and recording physiologic data during sleep, including sleep–related respiratory disturbances under the supervision of a licensed physician; or 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. “Practice polysomnography” includes: Providing polysomnography services that are safe, aseptic, preventive, and restorative; 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; 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; 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 Applying the use of techniques, equipment, and procedures involved in the evaluation of polysomnography, including: Continuous positive airway pressure or bi–level positive airway pressure titration on spontaneously breathing patients; Supplemental low flow oxygen therapy during polysomnogram; Capnography during polysomnogram; Cardiopulmonary resuscitation; Pulse oximetry; PH probe placement and monitoring; Esophageal pressure; Sleep staging including surface electroencephalography, surface electrooculography, and surface submental electromyography; Surface electromyography of arms and legs; Electrocardiography; Respiratory effort including thoracic and abdominal; Plethysmography blood flow; Snore monitoring; Audio or video monitoring; Implementation of a written or verbal order from a licensed physician that requires the practice of polysomnography; 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 Monitoring the effects an oral device, used to treat sleep apnea, has on sleep patterns, provided that: The device does not extend into the trachea; A dentist has evaluated the structures of the patient’s oral and maxillofacial region for purposes of fitting; A dentist made or directed the making of the oral device; and A dentist directs the use of the oral device. “Registered polysomnographic technologist” means a polysomnographic technologist who is registered by the Board of Registered Polysomnographic Technicians. “Student” means an individual who, in accordance with section 14–5C–09(c) of this subtitle, is: Enrolled in an accredited educational program in order to qualify for a license under this title; and Performing polysomnography services within the accredited program under the supervision of a licensed physician and without compensation. “Supervision” means general or direct supervision of a licensed polysomnographic technologist by a licensed physician.

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; 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 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.

The Board shall adopt regulations for the licensure and practice of polysomnography.

The Board shall set reasonable fees for the issuance of and renewal of licenses and other services it provides to polysomnographic technologists. 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 § 14–401.1(g) of this title. The Board shall pay all fees collected under the provisions of this subtitle to the Comptroller. The Comptroller shall distribute all fees to the Board. 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.

There is a Polysomnography Advisory Committee within the Board.

The Committee consists of seven members appointed by the Board as follows: Three licensed polysomnographic technologists; Three licensed physicians who are board certified in sleep medicine: One of whom is a specialist in psychiatry or internal medicine; One of whom is a specialist in pulmonary medicine; and One of whom is a specialist in neurology; and One consumer member. Each member of the Committee licensed by the Board must be in good standing with the Board. The consumer member of the Committee: Must be a member of the general public; May not be or ever have been: A polysomnographic technologist; Any other health care professional; or In training to be a polysomnographic technologist or other health care professional; and May not: Participate or ever have participated in a commercial or professional field related to polysomnography; Have a household member who participates in a commercial or professional field related to polysomnography; Have had within 2 years before appointment a financial interest in a person regulated by the Board; or 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. Each member of the Committee must be a resident of the State. The term of a member is 3 years. The terms of members are staggered as required by regulation. At the end of a term, a member continues to serve until a successor is appointed and qualifies. 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. A member may not serve more than two consecutive full terms. From among its members, the Committee shall elect a chair once every 2 years. The chair, or the chair’s designee, shall serve in an advisory capacity to the Board as a representative of the Committee. A quorum of the Committee consists of four members.

In addition to the powers set forth elsewhere in this subtitle, the Committee: Shall: Develop and recommend to the Board: Regulations to carry out this subtitle; and Any statutory changes that affect the profession; and Keep a record of its meetings; and May: Provide recommendations regarding the practice of polysomnography; and Advise the Board on any other matters related to polysomnographic technologist practitioners.

Except as otherwise provided in this subtitle or §§ 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. This section does not apply to: A student enrolled in an education program under § 14–5C–09(c)(3) of this subtitle while practicing polysomnography in that program; 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 A polysomnographic technologist employed in the service of the federal government while practicing within the scope of the employment.

To qualify for a license, an applicant shall be an individual who meets the requirements of this section. The applicant shall: Be of good moral character; Be at least 18 years old; and Complete a criminal history records check in accordance with § 14–308.1 of this title. An applicant for a polysomnographic technologist license shall: Have passed the national certifying examination given by the Board of Registered Polysomnographic Technologists or another examination approved by the Board; Submit to the Board proof of certification as a registered polysomnographic technologist or other national certification approved by the Board; Have graduated from a polysomnographic educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs; or Have graduated from a sleep technologist educational program that is accredited by the American Academy of Sleep Medicine; and Have completed a clinical component of an educational program as established by the Committee and approved by the Board; Have graduated from a respiratory care educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs; and 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 Have graduated from an electroneuro–diagnostic educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs; and 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 Meet any other educational or clinical requirements established by the Committee and approved by the Board.

To apply for a license, an applicant shall: Complete a criminal history records check in accordance with § 14–308.1 of this title; Submit an application to the Board on the form that the Board requires; and Pay to the Board the application fee set by the Board.

Subject to subsection (b) of this section, the Board shall issue a license to an applicant who meets the requirements of this subtitle. On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with § 14–308.1 of this title, in determining whether to issue a license, the Board shall consider: The age at which the crime was committed; The nature of the crime; The circumstances surrounding the crime; The length of time that has passed since the crime; Subsequent work history; Employment and character references; and Other evidence that demonstrates whether the licensee poses a threat to the public health or safety. The Board may not issue a license if the criminal history record information required under § 14–308.1 of this title has not been received.

A license authorizes a polysomnographic technologist to practice polysomnography in this State while the license is effective. A licensed polysomnographic technologist may practice polysomnography in: A hospital sleep laboratory; or A stand-alone sleep center.

The term of a license issued by the Board may not exceed 3 years. A license expires on a date set by the Board, unless the license is renewed for an additional term as provided in this section. 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: The date on which the current license expires; 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 The amount of the renewal fee. 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: Otherwise is entitled to be licensed; Is of good moral character; Pays to the Board a renewal fee set by the Board; and Submits to the Board: A renewal application on the form that the Board requires; and Satisfactory evidence of compliance with any continuing education or competency requirements and other requirements set under this section for license renewal. 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. The Board shall renew the license of each licensee who meets the requirements of this section. 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: Meets the renewal requirements of this section; Pays to the Board the reinstatement fee set by the Board; and Meets any other requirements established by regulation. Beginning October 1, 2016, the Board shall require a criminal history records check in accordance with § 14–308.1 of this title for: Renewal applicants as determined by regulations adopted by the Board; and Each former licensee who files for reinstatement under subsection (f) of this section. On receipt of the criminal history record information of a licensee forwarded to the Board in accordance with § 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: The age at which the crime was committed; The nature of the crime; The circumstances surrounding the crime; The length of time that has passed since the crime; Subsequent work history; Employment and character references; and Other evidence that demonstrates whether the licensee poses a threat to the public health or safety. 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 § 14–308.1 of this title. A disciplinary panel may impose a civil penalty of up to $100 per continuing education credit in lieu of a sanction under § 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.

A licensee shall notify the Board in writing of a change in name or address within 30 days after the change. A licensee who fails to comply with subsection (a) of this section is subject to an administrative penalty of $100.

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.

Subject to the hearing provisions of § 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: Fraudulently or deceptively obtains or attempts to obtain a license for the applicant, licensee, or for another; Fraudulently or deceptively uses a license; Is guilty of: Immoral conduct in the practice of polysomnography; or Unprofessional conduct in the practice of polysomnography; Is: Professionally incompetent; Physically incompetent; or Mentally incompetent; Abandons a patient; Is habitually intoxicated; Is addicted to or habitually abuses any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article; Provides professional services while: Under the influence of alcohol; or Using any narcotic or controlled dangerous substance as defined in § 5–101 of the Criminal Law Article or any other drug that is in excess of therapeutic amounts or without valid medical indication; Promotes the sale of services, drugs, devices, appliances, or goods to a patient so as to exploit the patient for financial gain; Willfully makes or files a false report or record in the practice of polysomnography; 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; Breaches patient confidentiality; 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; Willfully makes a misrepresentation while practicing polysomnography; Willfully practices polysomnography with an unauthorized individual or aids an unauthorized individual in the practice of polysomnography; Willfully delegates a polysomnographic duty to an unlicensed individual; Offers, undertakes, or agrees to cure or treat disease by a secret method, treatment, or medicine; 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; Fails to meet appropriate standards for the delivery of polysomnographic services performed in a hospital sleep laboratory or a stand–alone sleep center; Willfully submits false statements to collect fees for which services are not provided; 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 Has: Surrendered the license, if any, issued by the state or country; or Allowed the license, if any, issued by the state or country to expire or lapse; Willfully fails to report suspected child abuse in violation of § 5–704 of the Family Law Article; Sells, prescribes, gives away, or administers drugs for illegal or illegitimate medical purposes; Practices or attempts to practice beyond the authorized scope of practice; 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; 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; Fails to cooperate with a lawful investigation conducted by the Board; or Fails to complete a criminal history records check under § 14–308.1 of this title. 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 § 14–405 of this title. 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. 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. If, after a hearing under § 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. The Board shall pay any fines collected under this section into the General Fund of the State. 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.

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: The employer: 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; Involuntarily terminated or restricted the licensed polysomnographic technologist’s employment or staff membership; or 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 The action described under item (i) of this paragraph was taken: For reasons that might be grounds for disciplinary action under § 14–5C–17 of this subtitle; Because the licensed polysomnographic technologist may have engaged in an act that may constitute unprofessional conduct; 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 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. Each report submitted under paragraph (1) of this subsection shall include: The action taken by the employer; 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 The steps taken by the employer to investigate the conduct of the licensed polysomnographic technologist. 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. If an employer receives a request made under subparagraph (i) of this paragraph, the employer shall promptly provide the additional information. 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: The employer knows that the licensed polysomnographic technologist is: In a substance use disorder treatment program that is accredited by The Joint Commission or is certified by the Department; or Under the care of a health care practitioner who is competent and capable of dealing with substance use disorders; and The employer is able to verify that the licensed polysomnographic technologist remains in the treatment program until successful discharge; and 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. 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. The Board may extend the reporting under this section for good cause shown. 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. The Board may enforce this section by subpoena. Any person shall have the immunity from liability described under § 5–715(d) of the Courts Article for giving any of the information required by this section. 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. 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. A disciplinary panel may impose a civil penalty of up to $5,000 for knowingly failing to report under this section. 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. The Board shall remit any penalty collected under this subsection into the General Fund of the State.

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. The Board shall create and maintain a public individual profile on each licensee that includes the following information: A summary of charges filed against the licensee, including a copy of the charging document, until a disciplinary panel has taken action under § 14–5C–17 of this subtitle based on the charges or has rescinded the charges; 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; 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; 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 § 14–5C–17(c) of this subtitle; and The public address of the licensee. 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. The Board: 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 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. The Board shall provide a mechanism for the notification and prompt correction of any factual inaccuracies in a licensee’s profile. 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.

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. A disciplinary panel may not reinstate a revoked license that has been revoked for a period of more than 1 year unless the licensee: Meets the requirements for reinstatement as established under this title; and Completes a criminal history records check in accordance with § 14–308.1 of this title.

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.

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. 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.

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.

Except as otherwise provided in this subtitle, a licensed physician may not employ or supervise an individual practicing polysomnography without a license. Except as otherwise provided in this subtitle, an employer may not employ an individual practicing polysomnography without a license. A disciplinary panel may impose a civil penalty of not more than $5,000 for a violation of this section. The Board shall pay any penalty collected under this subsection into the General Fund of the State.

A person who violates § 14–5C–20, § 14–5C–21, or § 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. A person who violates § 14–5C–20, § 14–5C–21, or § 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. The Board shall pay any penalty collected under this section into the Board of Physicians Fund.

This subtitle may be cited as the “Maryland Polysomnography Act”.

Subject to the evaluation and reestablishment provisions of the Maryland Program Evaluation Act and subject to the termination of this title under § 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.