<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.32.12.06" title_num="10" subtitle_num="32" chapter_num="12" heading="RCIS Assistance in the Delegating Physician’s Performance of Fluoroscopy.">
  <paragraph num="A.">
    <text>Scope of Regulation.</text>
    <paragraph num="(1)">
      <text>This regulation governs:</text>
      <paragraph num="(a)">
        <text>A licensed physician’s delegation of technical acts to an RCIS assisting in the physician’s performance of fluoroscopy provided the delegation is in accordance with the entirety of this chapter; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The responsibilities of the hospital in which the cardiac catheterization laboratory is located to verify and document the qualifications of an RCIS and to ensure that all requirements of Health Occupations Article, §14-306, Annotated Code of Maryland and this regulation are met for each procedure.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>This regulation does not limit a licensed physician from delegating technical acts to an RCIS who is not assisting in the physician’s performance of fluoroscopy provided the delegation is in accordance with Regulations .01—.05 of this chapter.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>An RCIS assisting in a delegating physician’s performance of fluoroscopy shall:</text>
    <paragraph num="(1)">
      <text>Possess an active RCIS certification issued by Cardiovascular Credentialing International or another credentialing body approved by the Board;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Complete 40 hours of:</text>
      <paragraph num="(a)">
        <text>Accredited didactic education in fluoroscopic radiation physics and fluoroscopic patient safety; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Clinical fluoroscopic training supervised by a radiologist, radiographer, or radiologist assistant who is physically present in the room with the RCIS to instruct the clinical fluoroscopic training;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>In the hospital, wear an identification badge displaying in readily visible type:</text>
      <paragraph num="(a)">
        <text>The name of the RCIS; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A designation by the hospital of verification of the RCIS’ credentials and completion of requirements to assist in a physician’s performance of fluoroscopy; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Comply with any additional requirements as established by:</text>
      <paragraph num="(a)">
        <text>MDE;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The Joint Commission; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Federal and State laws and regulations.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Responsibilities.</text>
    <paragraph num="(1)">
      <text>The hospital shall:</text>
      <paragraph num="(a)">
        <text>Verify that the RCIS has met the requirements in §B of this regulation before permitting an RCIS to assist in a delegating physician’s performance of fluoroscopy;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Issue to the RCIS an identification badge in accordance with §B(3) of this regulation;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Keep on-site all documentation of the RCIS’ certification and the additional training required under this regulation;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Permit the Board, at any reasonable hour, to inspect the hospital’s documentation of the RCIS’ certification and training to ensure compliance with this regulation;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Regarding radiation machines and fluoroscopy services, comply with any additional requirements as established by:</text>
        <paragraph num="(i)">
          <text>MDE;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The Joint Commission; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Federal and State laws and regulations; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(f)">
        <text>Verify that the acts delegated to the RCIS are in accordance with the scope of this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The delegating physician shall:</text>
      <paragraph num="(a)">
        <text>Exercise direct supervision of the RCIS when the RCIS is assisting the delegating physician in the delegating physician’s performance of fluoroscopy;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Delegate only technical acts involved in the physician’s performance of fluoroscopy in accordance with Regulation .03 of this chapter; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Verbally direct each technical act performed by the RCIS.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>The RCIS:</text>
      <paragraph num="(a)">
        <text>May not perform fluoroscopy;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Shall perform technical acts to assist the delegating physician in the delegating physician’s performance of fluoroscopy only upon verbal direction from the delegating physician;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>May not delegate any act to another individual; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>May not engage in prohibited conduct as set out in Regulation .05 of this chapter.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>