In this subtitle the following words have the meanings indicated.
“Board” means the State Board of Physicians.
“Certified genetic counselor” means an individual certified as a genetic counselor by a national certifying board.
“Committee” means the Genetic Counselors Advisory Committee.
“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:
A genetic or medical condition or disease; and
The recurrence of a genetic or medical condition or disease.
“License” means a license issued by the Board to practice genetic counseling.
“Licensed genetic counselor” means an individual who is licensed under this subtitle to practice genetic counseling.
“Licensee” means a licensed genetic counselor.
“National accrediting council” means the Accreditation Council for Genetic Counseling, or its successor, that accredits education programs for genetic counselors.
“National certifying board” means the American Board of Genetic Counseling, or its successor, that certifies genetic counselors.
“Practice genetic counseling” means:
Obtaining and evaluating the medical histories of a patient and the patient’s family members for purposes of a genetic assessment;
Discussing the features, natural history, means of diagnosis, genetic and environmental factors, and management of risk for genetic or medical conditions or diseases;
Identifying, ordering, and coordinating genetic laboratory tests and other diagnostic studies, as appropriate, for purposes of a genetic assessment;
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;
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;
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;
Identifying and using community resources that provide medical, educational, financial, and psychosocial support and advocacy for a genetic or medical condition or disease; or
Providing written documentation of medical, genetic, and counseling information for a patient, a patient’s family members, or appropriate health care professionals.
“Practice genetic counseling” does not include diagnosing or treating an illness, a disease, or a condition.
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 Board shall adopt regulations for the licensure and practice of genetic counseling.
The Board shall set reasonable fees for the issuance and renewal of licenses and the other services the Board provides to genetic counselors.
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.
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 this subtitle.
There is a Genetic Counseling Advisory Committee within the Board.
The Committee consists of members appointed by the Board as follows:
Three shall be licensed genetic counselors;
Three shall be licensed physicians; and
One shall be a consumer member.
Each member of the Committee licensed by the Board must be in good standing with the Board.
The licensed physician members of the Committee must have experience working with genetic counselors.
The consumer member of the Committee:
Must be a member of the general public;
May not be or ever have been:
A genetic counselor;
Any other health care professional; or
In training to be a genetic counselor or other health professional; and
May not:
Participate or ever have participated in a commercial or professional field related to genetic counseling;
Have a household member who participates in a commercial or professional field related to genetic counseling;
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 genetic counselors or to the field of genetic counseling.
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 may not serve more than two consecutive full terms.
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.
From among its members, the Committee shall elect a chair every 2 years.
A quorum of the Committee consists of five 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 genetic counseling; and
Advise the Board on any other matters related to genetic counselors.
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 genetic counseling in the State.
This section does not apply to:
A genetic counselor who is employed in the service of the federal government while practicing within the scope of the employment;
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:
Does not order or coordinate genetic laboratory tests or other diagnostic studies; and
Does not provide consultation in the State for more than a total of 10 patients within a calendar year; or
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.
To qualify for a license to practice genetic counseling, an applicant shall be an individual who meets the requirements of this section.
The applicant must be of good moral character.
The applicant must be at least 18 years old.
The applicant must be a graduate of an appropriate education program approved by the Board.
The applicant shall submit to the Board satisfactory evidence of certification by a national certifying organization approved by the Board.
The applicant shall complete a criminal history records check in accordance with § 14–308.1 of this title.
The applicant shall meet any additional education, training, or examination requirements established 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 a form that the Board requires; and
Pay to the Board an application fee set by the Board.
Subject to subsection (b) of this section, the Board shall issue a license to any 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 applicant 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 genetic counselor license authorizes a licensee to practice genetic counseling in the State while the license is effective.
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.
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 genetic counselor 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 sent before the license expires; and
The amount of the renewal fee.
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:
Is of good moral character;
Pays to the Board a renewal fee set by the Board;
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; and
Meets any additional renewal requirements established by the Board.
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.
A disciplinary panel may impose a civil penalty of up to $100 per continuing education credit in lieu of a sanction under § 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.
The Board shall renew the license of each licensed genetic counselor who meets the requirements of this section.
A license may not be renewed for a term longer than 2 years.
The Board shall reinstate the license of a genetic counselor who has failed to renew a license for any reason if the genetic counselor:
Meets the renewal requirements of this section;
Submits to the Board:
A reinstatement application on the form that the Board requires; and
Satisfactory evidence of compliance with any continuing education or competency requirements; and
Meets any additional requirements established by the Board for reinstatement.
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 licensed genetic counselor who files for reinstatement under subsection (f) of this section.
On receipt of the criminal history record information of a licensed genetic counselor 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 licensed genetic counselor 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 licensed genetic counselor or applicant attests that the licensed genetic counselor or applicant has submitted a criminal history records check under § 14–308.1 of this title.
In this section the following words have the meanings indicated.
“Qualified supervisor” means:
An individual who:
Is licensed to practice as a genetic counselor under this subtitle; and
Has practiced for a minimum of 3 years after passing the national certifying examination; or
A physician who has been licensed in the State for a minimum of 5 years.
“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.
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:
Has graduated from a genetic counseling program accredited by the Accreditation Council for Genetic Counselors;
Has met all qualifications for licensure except for certification from the American Board of Genetic Counselors; and
Has applied for the first available national certifying examination.
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.
As a condition of licensure, the supervised genetic counselor shall work under the supervision of a qualified supervisor.
The supervised genetic counselor and the qualified supervisor shall enter into a supervision contract that:
Specifies the manner of supervision as required by the Board;
Is signed by the supervised genetic counselor and the qualified supervisor; and
Is maintained by both the supervised genetic counselor and the qualified supervisor and made available to the Board.
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.
A supervised genetic counselor license may not be valid for more than 1 year after the date of issuance.
A supervised genetic counselor license expires on the earliest of:
The issuance of a genetic counselor license to the supervised genetic counselor;
The expiration date printed on the supervised genetic counselor license; or
On notice of the second failure of the supervised genetic counselor to pass the certification examination.
A supervised genetic counselor who has not passed the examination within two examination cycles may not continue practicing under the supervised genetic counselor license.
A supervised genetic counselor is subject to discipline under § 14–5G–19 of this subtitle to the same extent as a genetic counselor.
A licensee shall notify the Board in writing of a change of 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 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.
A disciplinary panel may issue a cease and desist order for:
Practicing genetic counseling without a license or with an unauthorized person; or
Supervising or aiding an unauthorized person in the practice of genetic counseling.
Subject to the hearing provisions of § 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:
Fraudulently or deceptively obtains or attempts to obtain a license for the applicant or licensee or for another;
Fraudulently or deceptively uses a license;
Is guilty of:
Immoral conduct while practicing genetic counseling; or
Unprofessional conduct while practicing genetic counseling;
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 genetic counseling;
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 genetic counseling;
Willfully practices genetic counseling with an unauthorized individual or aids an unauthorized individual in practicing genetic counseling;
Willfully delegates a genetic counseling duty to an unlicensed individual;
Establishes a pattern of excessive or medically unnecessary procedures or treatment;
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 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 genetic counseling services;
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;
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 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;
Fails to cooperate with a lawful investigation of the Board or a disciplinary panel;
Fails to complete a criminal history records check under § 14–308.1 of this title; or
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.
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 § 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.
Any person aggrieved by a final decision of the Board or a disciplinary panel under this subtitle may take a direct judicial appeal.
The appeal shall be made as provided for judicial review of final decisions in the Administrative Procedure Act.
An order of the Board or a disciplinary panel may not be stayed pending review.
The Board may appeal from any decision that reverses or modifies an order of the Board or a disciplinary panel.
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:
The employer:
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;
Involuntarily terminated or restricted the licensed genetic counselor’s employment or staff membership; or
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
The action described under item (i) of this paragraph was taken:
For reasons that might be grounds for disciplinary action under § 14–5G–18 of this subtitle;
Because the licensed genetic counselor may have engaged in an act that may constitute unprofessional conduct;
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
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.
A report required 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 genetic counselor.
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 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:
The employer knows that the licensed genetic counselor is:
In a substance use disorder treatment program that is accredited by The Joint Commission or that 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 genetic counselor remains in the treatment program until successful discharge; and
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.
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.
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 website.
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 § 14–5G–18 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;
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 § 14–5G–18(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 website 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 genetic counseling in this State unless licensed to practice genetic counseling by the Board.
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.
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.
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.
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.
Except as otherwise provided in this subtitle, an employer may not employ an individual practicing genetic counseling without a license.
A disciplinary panel may impose a civil penalty of up to $5,000 for a violation of this section.
The Board shall remit any penalty collected under this section into the General Fund of the State.
A person who violates § 14–5G–23, § 14–5G–24, or § 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.
A person who violates § 14–5G–23, § 14–5G–24, or § 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.
The Board shall pay any penalty collected under this section into the Board of Physicians Fund.
This subtitle may be cited as the Maryland Genetic Counseling 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, 2031.