# COMAR Title 10 — Maryland Department of Health

## Subtitle 32 — Board of Physicians

### Chapter 09 — Delegation and Assignment of Performance of Cosmetic Medical Procedures and Use of Cosmetic Medical Devices

#### Regulation .05 Physician Responsibilities.

*COMAR 10.32.09.05*

A. A physician shall:

  (1) Develop and maintain at each site where the delegated, assigned, or supervised cosmetic medical procedures will be rendered written office protocols for each such cosmetic medical procedure;

  (2) Personally perform the initial assessment of each patient;

  (3) Prepare a written treatment plan for each patient, including diagnosis and planned course of treatment and specification of the device and device settings to be used;

  (4) Obtain informed consent of the patient to be treated by a non-physician;

  (5) Except as indicated in §B or C of this regulation, provide onsite supervision whenever a non-physician is performing cosmetic medical procedures or using cosmetic medical devices;

  (6) Retain responsibility for any acts delegated to a non-physician; and

  (7) Create and maintain medical records in a manner consistent with accepted medical practice and in compliance with Health-General Article, Title 4, Subtitles 3 and 4, Annotated Code of Maryland, and with Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. §1320d-2, as amended, and 45 CFR Parts 160 and 164, as amended).

B. The Board may approve a delegation agreement for a physician assistant that permits the physician to delegate performance of cosmetic medical procedures under immediately available supervision after the physician has evaluated the patient and developed a written treatment plan.

C. A delegation agreement for a physician assistant that includes cosmetic medical procedures and is approved by the Board before May 2009, is not affected by this chapter.