<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.09.55.03" title_num="10" subtitle_num="09" chapter_num="55" heading="Conditions for Participation.">
  <paragraph num="A.">
    <text>A physician assistant shall:</text>
    <paragraph num="(1)">
      <text>Meet all general provider requirements set forth in COMAR 10.09.36; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If delivering services via telehealth, comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>A physician assistant shall:</text>
    <paragraph num="(1)">
      <text>Have a written and executed delegation agreement with a licensed physician approved by the Board, or as required by the state in which services are provided; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the primary supervising physician delegates the prescribing of controlled dangerous substances to a physician assistant, if required by applicable law, the physician assistant shall:</text>
      <paragraph num="(a)">
        <text>Obtain a Maryland Controlled Dangerous Substance (MCDS) license from the Maryland Division of Drug Control; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>After obtaining an MCDS license:</text>
        <paragraph num="(i)">
          <text>Register with the Drug Enforcement Administration (DEA); and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Obtain a license from the DEA.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>To participate as a provider, the physician assistant shall submit to the Program a copy of the provider's:</text>
    <paragraph num="(1)">
      <text>Current approved delegation agreement; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Current license to practice in the state in which services are provided.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Modification of Delegation Agreement.</text>
    <paragraph num="(1)">
      <text>If the provider's approved written delegation agreement with the physician is modified or terminated by either party, the physician assistant and supervising physician shall notify the Program within 5 days in writing.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the delegation agreement is modified, the physician assistant and the supervising physician shall submit to the Program a copy of the modified or new written agreement.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If the duties of the physician assistant are limited, reduced, or result in other changes of employment that might be grounds for disciplinary actions under Health Occupations Article, §15-314, Annotated Code of Maryland, the supervising physician, hospital, alternative health care system, or employer shall notify the Program immediately or within 5 days in writing.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>A physician assistant may practice in Maryland:</text>
    <paragraph num="(1)">
      <text>Only in accordance with the delegation agreement approved by the Board; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If out-of-State, only in accordance with the scope of practice allowed by the licensing authority in the state in which services are provided.</text>
    </paragraph>
  </paragraph>
</regulation>