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<chapter num="01" heading="Income Tax Credits for Preceptors in Areas with Health Care Workforce Shortages" title_num="10" subtitle_num="01">
  <regulation prefix="Regulation" num=".01" heading="Purpose.">
    <paragraph num="A.">
      <text>The purpose of this chapter is to establish regulatory provisions related to the State income tax credit program for the following qualified health care practitioners who serve as preceptors without compensation in health care workforce shortage areas:</text>
      <paragraph num="(1)">
        <text>Physicians;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Advanced practice registered nurses;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Physician assistants;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Registered nurses; and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Licensed practical nurses.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>This chapter describes the procedures used by the Maryland Department of Health to assess eligibility of applicants, process applications, and certify income tax credits for approved applications.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Applicant” means an individual:</text>
        <paragraph num="(a)">
          <text>Who has submitted an application to the Department requesting State income tax credit; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Whose status for receipt of a tax credit certification has not yet been determined.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>“Department” means the Maryland Department of Health.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Health Care Practitioner” means an individual who is:</text>
        <paragraph num="(a)">
          <text>A health care practitioner, as defined in Tax-General Article, §10–752, Annotated Code of Maryland;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>An advanced practice registered nurse as defined in Health Occupations Article, §8-101, Annotated Code of Maryland;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>A registered nurse as defined in Health Occupations Article, §8-101, Annotated Code of Maryland; or</text>
        </paragraph>
        <paragraph num="(d)">
          <text>A licensed practical nurse as defined in Health Occupations Article, §8-101, Annotated Code of Maryland.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>“Health care workforce shortage area” means:</text>
        <paragraph num="(a)">
          <text>A health professional shortage area;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A medically underserved area;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>A medically underserved population;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Federally designated rural areas;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>State defined shortage areas;</text>
        </paragraph>
        <paragraph num="(f)">
          <text>State defined rural areas; or</text>
        </paragraph>
        <paragraph num="(g)">
          <text>Other areas defined as in need by the Secretary of Health or Governor or as otherwise determined by the Department in consultation with the Governor’s Workforce Development Board.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>“Income tax credit” means a nonrefundable credit against State income tax.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Preceptor” means a health care practitioner participating in a preceptorship program.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“Preceptorship program” has the meaning as stated in Tax-General Article, §§10–738, and 10-752, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(8)">
        <text>“Rotation” means a minimum of:</text>
        <paragraph num="(a)">
          <text>100 hours of community-based clinical training between a:</text>
          <paragraph num="(i)">
            <text>Medical student and a licensed physician preceptor;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Physician assistant student and a licensed physician, nurse practitioner, or physician assistant preceptor in family medicine, general internal medicine, or general pediatrics practice or setting; or</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>90 hours of community-based clinical training between a:</text>
          <paragraph num="(i)">
            <text>Nurse practitioner student and a licensed physician or nurse practitioner preceptor;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>A registered nurse student and an advanced practice registered nurse or registered nurse preceptor; or</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>A licensed practical nurse student and an advanced practice registered nurse, registered nurse, or licensed practical nurse preceptor.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(9)">
        <text>“Taxable year” means the annual accounting period for keeping records and reporting income and expenses that starts on January 1 and ends on December 31 of the same year.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Program Eligibility.">
    <text>A healthcare practitioner preceptor in a preceptorship program is eligible for an income tax credit if the individual served:</text>
    <paragraph num="A.">
      <text>Without compensation for a minimum of three rotations; and</text>
    </paragraph>
    <paragraph num="B.">
      <text>In a health care workforce shortage area.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Application Procedures.">
    <paragraph num="A.">
      <text>Applicant.</text>
      <paragraph num="(1)">
        <text>By the published deadlines, on the form designated by the Department, an applicant shall:</text>
        <paragraph num="(a)">
          <text>Submit a complete application to the Department;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Facilitate submission of application components by all contributors; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Provide any supporting documentation as requested by the Department.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>An applicant may voluntarily withdraw the application without prejudice.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>An applicant may submit a new application subject to §B of this regulation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>The Department shall receive applications by January 5 for the previous taxable year during which rotations were completed.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The Department shall:</text>
      <paragraph num="(1)">
        <text>Accept applications received during the application period for Department review;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Approve the application if the:</text>
        <paragraph num="(a)">
          <text>Application is complete;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Applicant is determined to be eligible; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Funds are available in the appropriate Fund based on precepted student type;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>Disapprove an application if the application:</text>
        <paragraph num="(a)">
          <text>Fails to provide sufficient information or comply with requested documentation to determine eligibility;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Has the appropriate documentation but is determined to be ineligible; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Does not satisfy the requirements established by law or the Department; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>Provide the applicant with written notice of the final disposition of the application within 45 calendar days of receipt of an application.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Appeal of Disapproval of Application.</text>
      <paragraph num="(1)">
        <text>An applicant may appeal the decision to disapprove an application by submitting an appeal request in writing to the Department within 30 calendar days of the date on the notice of the disapproved application.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>If an applicant submits an appeal, the Department, within 60 calendar days of receipt of the appeal, shall:</text>
        <paragraph num="(a)">
          <text>Sustain or reverse the decision on the application; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Provide written notice to the applicant:</text>
          <paragraph num="(i)">
            <text>Indicating whether the decision on the application has been sustained or reversed; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Providing an explanation of the decision.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>An applicant may request a hearing within 10 calendar days after the date of written notice of the Department’s disapproval of an application as stated in §D(2) of this regulation. Following receipt of the request, the Department shall follow hearing procedures in accordance with COMAR 10.01.03.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Failure to be present for the hearing without prior notice, communication, or approval from the Department may result in:</text>
        <paragraph num="(a)">
          <text>The appeal nullified and decision sustained;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The hearing on the appeal not being rescheduled; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Appropriate sanctions as determined by the Department.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Verification and Audit of Income Tax Credits.">
    <paragraph num="A.">
      <text>The Department may:</text>
      <paragraph num="(1)">
        <text>Request from an applicant additional information to verify statements in an application; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Use independent verification, such as a preceptor list and preceptor completion letters received by the medical and nursing schools, to verify information reported on an application for an income tax credit.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>The Comptroller shall retain its audit authority under Tax-General Article, Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Income Tax Credits.">
    <paragraph num="A.">
      <text>On approval of an application, the Department shall issue an income tax credit certificate to the approved healthcare practitioner in the amount of $1,000 for each qualifying student rotation for which the healthcare practitioner served as a preceptor.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Income tax credits shall be issued for the taxable year of the application during which the health care practitioner served without compensation.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The total amount of an income tax credit allowed for an individual in a taxable year may not exceed the:</text>
      <paragraph num="(1)">
        <text>Maximum credit amount as indicated in Tax-General Article, §§10–738, 10-739, 10-739.1, and 10-752, Annotated Code of Maryland; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>State income tax imposed for that individual for that taxable year.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Any unused amount of an income tax credit for a taxable year may not be carried over to any other taxable year by the preceptor, as referenced in Tax-General Article, §§10–738, 10-739, 10-739.1, and 10-752, Annotated Code of Maryland.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Responsibilities of the Comptroller.">
    <text>On notification that an income tax credit certificate has been issued by the Department, the Comptroller shall transfer an amount equal to the income tax credit amount stated in the income tax credit certificate from the Nurse Practitioner Preceptorship Tax Credit Fund, the Physician Assistant Preceptorship Tax Credit Fund, or Licensed Practical Nurse and Registered Nurse Preceptorship Tax Credit Fund, to the General Fund.</text>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Expiration of Program.">
    <paragraph num="A.">
      <text>The Department shall issue final income tax credits based on available funds.</text>
    </paragraph>
    <paragraph num="B.">
      <text>This chapter remains in effect until:</text>
      <paragraph num="(1)">
        <text>The date that funding for income tax credits ceases to be available; or</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Sunset on June 30, 2030.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Tax-General Article, §§10-738, 10-739, 10-739-1, and 10.752, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: January 29, 2018 (45:2 Md. R. 68)</annotation>
    <annotation type="History" subtype="Administrative History">Chapter revised effective September 19, 2022 (49:19 Md. R. 868)</annotation>
    <annotation type="History" subtype="Administrative History">Chapter revised effective March 2, 2026 (53:4 Md. R. 184)</annotation>
  </annotations>
</chapter>