# COMAR Title 30 — Maryland Institute for Emergency Medical Services Systems (MIEMSS)

## Subtitle 02 — Emergency Medical Services Providers

### Chapter 02 — Licensure and Certification

**Authority:** Education Article, §13-516, Annotated Code of Maryland

**Administrative History:** Effective date: January 1, 1999 (25:26 Md. R. 1926)

**Administrative History:** Regulations .01—.09 amended effective July 1, 2002 (29:12 Md. R. 930)

**Administrative History:** Regulation .02 amended effective May 30, 2011 (38:11 Md. R. 672); December 12, 2013 (40:24 Md. R. 2017); June 9, 2025 (52:11 Md. R. 533)

**Administrative History:** Regulation .03 amended effective May 30, 2011 (38:11 Md. R. 672); December 12, 2013 (40:24 Md. R. 2017); May 12, 2014 (41:9 Md. R. 523); June 9, 2025 (52:11 Md. R. 533)

**Administrative History:** Regulation .03D amended as an emergency provision effective March 3, 2022 (49:7 Md. R. 462); amended permanently effective July 11, 2022 (49:14 Md. R. 705)

**Administrative History:** Regulation .04 amended as an emergency provision effective December 22, 2008 (36:2 Md. R. 98); amended permanently effective March 23, 2009 (36:6 Md. R. 492); June 9, 2025 (52:11 Md. R. 533)

**Administrative History:** Regulation .04 amended effective May 30, 2011 (38:11 Md. R. 672); December 12, 2013 (40:24 Md. R. 2017)

**Administrative History:** Regulation .04D, E amended effective May 12, 2014 (41:9 Md. R. 523)

**Administrative History:** Regulation .05 amended effective May 30, 2011 (38:11 Md. R. 672); December 12, 2013 (40:24 Md. R. 2017); May 9, 2016 (43:9 Md. R. 531); June 9, 2025 (52:11 Md. R. 533)

**Administrative History:** Regulation .06 amended effective May 30, 2011 (38:11 Md. R. 672); June 9, 2025 (52:11 Md. R. 533)

**Administrative History:** Regulation .06D amended effective December 19, 2005 (32:25 Md. R. 1944)

**Administrative History:** Regulation .06H, J amended effective December 12, 2013 (40:24 Md. R. 2017)

**Administrative History:** Regulation .07 repealed and new Regulation .07 adopted effective October 4, 2010 (37:20 Md. R. 1396)

**Administrative History:** Regulation .07 amended effective December 12, 2013 (40:24 Md. R. 2017); June 9, 2025 (52:11 Md. R. 533)

**Administrative History:** Regulation .07F amended effective April 9, 2018 (45:7 Md. R. 347)

**Administrative History:** Regulation .08 amended effective June 9, 2025 (52:11 Md. R. 533)

**Administrative History:** Regulation .08A, C amended effective December 12, 2013 (40:24 Md. R. 2017)

**Administrative History:** Regulation .09 amended effective December 12, 2013 (40:24 Md. R. 2017); June 9, 2025 (52:11 Md. R. 533)

**Administrative History:** Regulation .09B amended effective April 9, 2018 (45:7 Md. R. 347)

**Administrative History:** Regulation .09B, D amended effective May 30, 2011 (38:11 Md. R. 672)

**Administrative History:** Regulation .13 adopted as an emergency provision effective June 1, 2020 (47:13 Md. R. 640); adopted permanently effective October 5, 2020 (47:20 Md. R. 877)

**Administrative History:** Regulation .13 amended as an emergency provision effective March 2, 2022 (49:7 Md. R. 462); amended permanently effective July 11, 2022 (49:14 Md. R. 705)

#### Regulation .01 Application.

*COMAR 30.02.02.01*

A. An applicant for licensure, certification, or renewal shall submit to MIEMSS a completed application on a form the EMS Board requires.

B. Each application shall be signed by the applicant and any other individuals required by the EMS Board.

C. An applicant for licensure, certification, or renewal shall submit, with the application, evidence demonstrating that the applicant has successfully met all requirements.

#### Regulation .02 Fees.

*COMAR 30.02.02.02*

A. The fee for licensure or certification, renewal of licensure or certification, examination, and reexamination is waived for an applicant who, on the date of application, is a member or employee of a fire, rescue, public safety, or EMS agency of a unit of State or federal government or political subdivision of the State, or a volunteer fire, rescue, or ambulance company, association, or agency, or an employee of a commercial ambulance service licensed under Education Article, §13-515, Annotated Code of Maryland.

B. The fee for the emergency medical responder, emergency medical technician, and paramedic written examinations and each reexamination  are established by the National Registry of Emergency Medical Technicians.

C. The fee for the practical examination for emergency medical technician is $65.

D. The fee for reciprocal certification or licensure is $35.

#### Regulation .03 Requirements.

*COMAR 30.02.02.03*

A. An individual applying for reciprocal licensure or certification shall meet the requirements of Regulation .04 of this chapter.

B. To qualify for licensure or certification, an applicant other than an applicant under §A of this regulation shall be 18 years old or older, except an individual:

  (1) Who is between the ages of 16 and 18 may apply for emergency medical responder or emergency medical technician examination and certification with written permission from a parent or legal guardian;

  (2) Shall be 16 years old or older before participating in any BLS clinical training or internship; and

  (3) Shall be 18 years old or older before participating in any ALS clinical training or internship.

C. In addition to the requirements of §B of this regulation, an applicant for emergency medical responder certification shall:

  (1) Have successfully completed an emergency medical responder course approved by the EMS Board;

  (2) Submit to MIEMSS evidence of current active status registration as an emergency medical responder with the National Registry of Emergency Medical Technicians, including:

    (a) Successfully completing the practical certification examination administered in conjunction with the emergency medical responder course; and

    (b) Passing an emergency medical responder cognitive certification examination administered by the National Registry of Emergency Medical Technicians.

D. In addition to the requirements of §B of this regulation, an applicant for emergency medical technician certification shall:

  (1) Have successfully completed:

    (a) An emergency medical technician course approved by the EMS Board; or

    (b) If the applicant is a licensed nurse, licensed physician, or certified physician assistant, the health care provider to emergency medical technician program;

  (2) Have successfully completed an internship approved by MIEMSS;

  (3) Submit to MIEMSS evidence of current active status registration as an emergency medical technician with the National Registry of Emergency Medical Technicians, including:

    (a) Successfully completing the emergency medical technician practical certification examination administered by MIEMSS; and

    (b) Passing an emergency medical technician cognitive certification examination administered by the National Registry of Emergency Medical Technicians; and

  (4) Be currently affiliated with an EMS operational program.

E. In addition to the requirements of §B of this regulation, an applicant for initial paramedic licensure shall:

  (1) Have successfully completed:

    (a) A paramedic course approved by the EMS Board;

    (b) If the applicant is a licensed nurse, licensed physician, or certified physician assistant, the health care provider to paramedic program; or

    (c) If the applicant is a CRT, the paramedic bridge course;

  (2) Have successfully completed immediately before application for licensure:

    (a) At least 12 full months of experience in providing patient care as an emergency medical technician with an EMS operational program;

    (b) At least 150 documented ambulance responses providing patient care, including patient assessment, with an EMS operational program;

    (c) If the applicant is a licensed nurse, licensed physician, or certified physician assistant, the health care provider to paramedic program; or

    (d) If the applicant is a CRT, the paramedic bridge course;

  (3) Submit evidence of current active status registration as a paramedic with the National Registry of Emergency Medical Technicians;

  (4) Successfully complete a MIEMSS-approved protocol orientation; and;

  (5) Be currently affiliated with an ALS EMS operational program.

F. In addition to the requirements of §B of this regulation, an applicant for EMD licensure shall:

  (1) Have successfully completed:

    (a) The basic telecommunicator course or an equivalent course approved by the Maryland 9-1-1 Board; or

    (b) 2,000 hours of public safety call-taking or call-allocating experience;

  (2) Have successfully completed an EMD training program approved by the EMS Board; and

  (3) Be affiliated with an EMD operational program which has been approved by the EMS Board.

G. In determining whether any experience or internship required for licensure or certification has been completed, the EMS Board shall give credit to the individual for all relevant experience as a service member.

H. The EMS Board shall credit any training and education provided by the military and completed by a service member toward any training or education requirements for licensure or certification if the training or education is determined by the EMS Board to be:

  (1) Substantially equivalent to the training or education required by the EMS Board; and

  (2) Not otherwise contrary to any other licensing requirement.

#### Regulation .04 Reciprocity.

*COMAR 30.02.02.04*

A. To obtain reciprocal licensure or certification, an applicant shall:

  (1) Submit to MIEMSS a completed application on a form the EMS Board requires;

  (2) Be at least the minimum age required for licensure or certification as set forth in Regulation .03B(2) of this chapter; and

  (3) Be currently affiliated with an EMS operational program providing at least the level of services for which the individual is seeking reciprocal licensure or certification, unless applying for reciprocal certification as an emergency medical responder.

B. In addition to the requirements of §A of this regulation, an applicant for emergency medical responder reciprocal certification shall:

  (1) Submit evidence of current:

    (a) Certification as an emergency medical responder in another state; or

    (b) Registration with the National Registry of Emergency Medical Technicians as an emergency medical responder.

C. In addition to the requirements of §A of this regulation, an applicant for emergency medical technician reciprocal certification shall:

  (1) Submit evidence of current:

    (a) Certification as an emergency medical technician, advanced emergency medical technician, or paramedic in another state if that state follows the national educational standards; or

    (b) Registration with the National Registry of Emergency Medical Technicians as an emergency medical technician, advanced emergency medical technician, or paramedic; and

  (2) Successfully complete a:

    (a) MIEMSS-approved protocol orientation; and

    (b) MIEMSS-approved technical proficiency verification.

D. In addition to the requirements of §A of this regulation, an applicant for reciprocal paramedic licensure shall:

  (1) Submit evidence of active status registration as a paramedic with the National Registry of Emergency Medical Technicians; and

  (2) Successfully complete a MIEMSS-approved protocol orientation.

E. Expiration Date.

  (1) For an EMR or EMT who is issued a certificate by reciprocity:

    (a) Between February 1 and July 31, the expiration date shall be July 31 plus 1 year; or

    (b) Between August 1 and January 31, the expiration date shall be January 31 plus 1 year.

  (2) For a paramedic who is issued a license by reciprocity, the expiration shall be 30 days after the individual’s current National Registry of Emergency Medical Technicians certification expires.

#### Regulation .05 Examination and Reexamination.

*COMAR 30.02.02.05*

A. An applicant for EMD licensure who has completed an approved training program which provides its own examination shall be examined and reexamined in accordance with the policies of that training program.

B. An applicant for emergency medical technician certification or paramedic licensure is subject to the examination and reexamination policies and procedures of the National Registry of Emergency Medical Technicians..

C. If an applicant for emergency medical technician fails a first or second practical certification examination, the applicant may retake the practical examination:

  (1) Within 6 months of failing the first or second practical examination as provided in this regulation; and

  (2) Only after receiving remedial instruction in the areas of practical examination deficiency.

D. If an applicant for emergency medical technician certification fails the third practical certification examination, the applicant shall successfully complete a minimum of 9 hours of remedial education, which shall include technical skills, and pass the National Registry of Emergency Medical Technicians certification examination, after which the applicant may attempt the practical certification examination three more times, consistent with the procedure in §C of this regulation.

E. If an applicant for emergency medical technician certification fails the fourth, fifth, and sixth practical certification examination authorized under §D of this regulation, then the applicant shall successfully complete an approved emergency medical technician course in its entirety and pass the National Registry of Emergency Medical Technicians certification examination before taking another emergency medical technician practical certification examination.

#### Regulation .06 Issuance of License or Certificate.

*COMAR 30.02.02.06*

A. A license or certificate shall be issued to each applicant meeting all applicable requirements of this subtitle for the level of licensure or certification sought.

B. The license or certificate shall bear the emergency medical service clinician’s name, identification number, the effective date of the license or certificate, and the expiration date of the license or certificate.

C. An applicant may not provide patient care as an EMS clinician until the applicant has received a current license or certificate from the EMS Board, except under supervision and in the course of participating in an education program that has been approved by the EMS Board.

D. An EMS clinician shall, whenever possible, carry the identification card issued by MIEMSS showing the clinician is licensed or certified by the EMS Board while performing the EMS clinician’s duties.

E. MIEMSS shall maintain a registry of licensed or certified EMS clinicians.

F. An EMS provider shall notify the MIEMSS Office of Education, Licensure and Certification in writing within 30 days of any change in:

  (1) Name;

  (2) Address;

  (3) Email;

  (4) Phone number; or

  (5) Affiliation with an EMS operational program.

G. Unless renewed or extended, the term of a license or certificate shall expire on the expiration date shown on the license or certificate.

H. Unless the certificate is the initial certificate issued under COMAR 30.02.02.04 or is extended, revoked, or suspended, the certificate of an emergency medical responder or emergency medical technician is valid:

  (1) In the initial certification period for at least 36 months, but not more than 42 months, as follows:

    (a) Applicants for emergency medical responder and emergency medical technician certification who successfully complete the certification requirements between February 1 and July 31 are issued a certificate which is effective from the date of successful completion of all certification requirements and expires on July 31, 3 years from the year of issuance; or

    (b) Applicants for emergency medical responder and emergency medical technician certification who successfully complete the emergency medical technician [examination] requirements between August 1 and January 31 are issued a certificate which is effective from the date of successful completion of all certification requirements and expires on January 31, 3 years from the year of issuance; and

  (2) In each subsequent certification period, for a period of 3 years from the previous expiration date.

I. Unless the license is extended, revoked, or suspended, the license of a CRT is valid for 2 years from the previous expiration date.

J. Unless the license is extended, revoked, or suspended, the license of a paramedic is valid:

  (1) In the initial licensure period, from the date of successful completion of all licensure requirements until 30 days after the expiration of the individual's registration with the National Registry of Emergency Medical Technicians; and

  (2) In each subsequent licensure period, until 30 days after the expiration of the individual’s registration with the National Registry of Emergency Medical Technicians.

K. Unless the license is extended, revoked, or suspended, the license of an EMD is valid:

  (1) In the initial licensure period,  for at least 24 months, but not more than 32 months, as follows:

    (a) Applicants for EMD licensure who register with a national organization approved by the EMS Board between January 1 and June 30 are issued a license that is effective from the date of successful completion of all required certification examinations and expires on June 30, 2 years from the year of issuance; or

    (b) Applicants for EMD licensure who register with a national organization approved by the EMS Board between July 1 and December 31 are issued a certificate that is effective from the date of successful completion of all required certification examinations and expires on December 31, 2 years from the year of issuance; and

  (2) In each subsequent licensure period, for a period of 2 years from the previous expiration date.

#### Regulation .07 Renewal.

*COMAR 30.02.02.07*

A. Prior to the expiration date of each license or certificate, MIEMSS shall send renewal notices to each EMS clinician whose license or certificate is expiring using the clinician’s contact information required under Regulation .06F of this chapter.

B. The renewal notice shall state the date the current license or certificate expires.

C. An EMS clinician who wishes to renew a license or certificate shall submit an application and any required supporting materials as specified in each applicable part of this chapter to MIEMSS on a form approved by MIEMSS at least 2 weeks before the expiration date.

D. For an emergency medical responder whose certificate, including any extension, expires after July 31, 2025, and is applying for renewal as an emergency medical responder, the individual shall submit to MIEMSS evidence of:

  (1) Current active status registration as an emergency medical responder or higher with the National Registry of Emergency Medical Technicians; or

  (2) Documentation of the successful completion of:

    (a) 8 hours of continuing education in categories designated by the State EMS Medical Director during the clinician’s current certification cycle;

    (b) Three of the most recent years of Annual EMS Protocol Updates; and

    (c) A MIEMSS-approved technical proficiency verification.

E. For an emergency medical technician whose certificate, including any extension, expires after July 31, 2025, and is applying for renewal as an emergency medical technician, the individual shall submit to MIEMSS evidence of:

  (1) Affiliation with an EMS operational program;

  (2) Completion of the 3 most recent years of Annual EMS Protocol Updates; and

  (3) Either:

    (a) Current active status registration as an emergency medical technician or higher with the National Registry of Emergency Medical Technicians; or

    (b) Successful completion of 24 hours of continuing education in categories designated by the State EMS Medical Director during the clinician’s current certification cycle, of which a minimum of 1 hour up to a maximum of 9 hours may be devoted to technical skills, including MIEMSS-approved technical proficiency verification.

F. For a CRT whose license, including any extension, expires after July 31, 2025, and is applying for renewal as a CRT the individual shall submit to MIEMSS evidence of:

  (1) Affiliation with an EMS operational program;

  (2) Completion of the two most recent years of Annual EMS Protocol Updates; and

  (3) Either:

    (a) Current active status registration as a paramedic with the National Registry of Emergency Medical Technicians and completion of any MIEMSS-assigned ALS education; or

    (b) Documentation of successful completion of:

      (i) 60 hours of continuing education equivalent to the requirements of a paramedic renewing with the National Registry of Emergency Medical Technicians including any MIEMSS-assigned ALS education during the clinician’s renewal cycle; and

      (ii) A MIEMSS-approved technical proficiency verification.

G. For a paramedic whose license, including any extension, expires after July 31, 2025, and is applying for renewal as a paramedic, the individual shall submit to MIEMSS evidence of:

  (1) Affiliation with an EMS operational program;

  (2) Completion of the two most recent years of Annual EMS Protocol Updates;

  (3) Completion of any MIEMSS-assigned ALS education during the clinician’s current renewal cycle; and

  (4) Current active status registration as a paramedic with the National Registry of Emergency Medical Technicians.

H. If applying for renewal as an EMD the individual shall submit evidence of:

  (1) Affiliation with an EMS operational program; and

  (2) Either:

    (a) Continued, active status certification as an EMD by a national organization approved by the EMS Board; or

    (b) Successful completion of 24 hours of approved EMD-related continuing education offered by an approved EMD educational program.

I. MIEMSS may extend a license or certificate for up to 6 months upon receipt of a written request for an extension before the expiration date.

J. Upon completion of the requirements for renewal, the individual shall receive a certificate or license valid for the appropriate certification or licensure period minus the period of any extension.

#### Regulation .08 Inactive Status.

*COMAR 30.02.02.08*

A. The EMS Board may place an EMS clinician on inactive status if the EMS clinician:

  (1) Fails to maintain affiliation with any required EMS operational program;

  (2) Applies for inactive status by submitting an application on a form the EMS Board requires;

  (3) In the case of a paramedic [or a CRT initially licensed after June 30, 2001], fails to maintain continuous, active status registration with the National Registry of Emergency Medical Technicians [as a provider], unless the [provider] paramedic has requested and received an extension of the individual's license from MIEMSS[.]; or

  (4) Fails to complete a MIEMSS-approved technical proficiency verification for renewal.

B. An EMS clinician on inactive status may not provide emergency medical services in this State except in rare instances at the scene of a medical emergency.

C. An EMS clinician on inactive status may apply for active status if the individual:

  (1) Submits an application on a form the EMS Board requires;

  (2) Is affiliated with any required EMS operational program;

  (3) If applying for reinstatement as a paramedic, provides evidence of current active status registration as a paramedic with the National Registry of Emergency Medical Technicians; and

  (4) If the individual has been on inactive status for a period greater than 1 year, [attends a skills review session approved by MIEMSS, or conducted by an approved ALS training program.] completes the most recent protocol update course and a MIEMSS-approved technical proficiency verification.

D. A clinician whose license is on inactive status, as specified in §A, may apply for renewal if all other requirements for renewal are met.

E. Except in the instance of an EMS clinician on active military duty, inactive status does not affect the term of an EMS clinician's license or certificate.

F. An EMS clinician on active military duty may be granted an extended inactive status that shall end 1 year after the date of deactivation from active military duties that otherwise prevent the clinician from completing the requirements to maintain certification or licensure.

G. A fee is not charged to change from inactive to active status.

#### Regulation .09 Reinstatement.

*COMAR 30.02.02.09*

A. An individual whose license or certificate has expired and who has failed to renew the license or certificate may be reinstated as an EMS clinician if all requirements for reinstatement are met.

B. An applicant for reinstatement as an EMS clinician shall apply for reinstatement:

  (1) As an emergency medical responder, not later than 3 years after the expiration of the applicant’s emergency medical responder certification, or at any time if the applicant has current active status registration as an emergency medical responder with the National Registry of Emergency Medical Technicians;

  (2) As an emergency medical technician, not later than 3 years after the expiration of the applicant’s emergency medical technician certification, or at any time if the applicant has active status registration as an emergency medical technician with the National Registry of Emergency Medical Technicians;

  (3) As an EMD, not later than 2 years after the expiration of the applicant’s EMD licensure, or at any time if the applicant has current active status registration with a nationally-recognized EMD program;

  (4) As a CRT, not later than 2 years after the expiration of the applicant’s CRT licensure, or at any time if the applicant has current active registration as a paramedic with the National Registry of Emergency Medical Technicians; or

  (5) As a paramedic, at any time if the applicant has current active status registration as a paramedic with the National Registry of Emergency Medical Technicians.

C. An applicant for reinstatement as an EMS clinician shall:

  (1) Successfully complete all requirements for renewal;

  (2) If applying for reinstatement as an EMD, emergency medical technician, CRT, or paramedic, be affiliated with an EMS operational program; and

  (3) If applying for reinstatement as an emergency medical technician, CRT, or paramedic, successfully complete a MIEMSS-approved EMS protocol orientation.

D. Upon fulfilling the requirements for reinstatement of a certificate or license, the date of expiration of the new certificate or license shall be:

  (1) The date of expiration of the certificate or license had not lapsed; or

  (2) The date of an initial certificate or license under Regulation .06 of this chapter if the expiration date of the lapsed certificate or license has passed.

#### Regulation .10 Surrender.

*COMAR 30.02.02.10*

Subject to COMAR 30.02.05.13, an EMS provider who possesses a valid license or certificate issued by the EMS Board may surrender that license or certificate and be issued a license or certificate for a lower level of EMS provider licensure or certification which is valid for up to 1 year.

#### Regulation .11 Replacement.

*COMAR 30.02.02.11*

A duplicate license or certificate shall be issued for a lost, stolen, or destroyed license or certificate upon:

A. Written request of the EMS provider; and

B. Payment of a fee of $5.

#### Regulation .12 Denials.

*COMAR 30.02.02.12*

A. The EMS Board may deny a license or certificate to an individual who has engaged in prohibited conduct under COMAR 30.02.04.

B. Any proceedings concerning a complaint of misconduct by an applicant shall be in accordance with COMAR 30.02.05 and 30.02.06.

C. Procedures for Denial.

  (1) The EMS Board shall deny a license or certificate to individuals failing to submit the documentation or meet the standards and requirements established by statute or regulation for the licensing or certification of an EMS provider.

  (2) The EMS Board may delegate its functions under this section to MIEMSS.

  (3) Notice of denial of an application for initial licensure, certification, renewal or reinstatement of licensure or certification, or reciprocal licensure or certification under this section shall be sent to the applicant by first class mail at the address provided by the applicant on the application.

  (4) The denial notice shall inform the applicant of the:

    (a) Basis for the denial;

    (b) Applicant's right to request a hearing on the denial; and

    (c) Procedures for requesting a hearing.

D. Hearings under §C of this regulation shall be governed by COMAR 30.02.06.

#### Regulation .13 Requirements for Individuals with a Provisional License or Certificate to Obtain a Full License or Certificate.

*COMAR 30.02.02.13*

A. A holder of a provisional EMS license or certificate issued pursuant to either the Executive Order Augmenting the Emergency Medical Services Workforce (Order Number 20-03-19-03) under authority of the Proclamation of March 5, 2020, as extended from time to time, in which the Governor of Maryland proclaimed that a state of emergency and catastrophic health emergency existed within the entire State of Maryland in an effort to control and prevent the spread of COVID-19, or the Executive Order Augmenting the Emergency Medical Services Workforce (Order Number 22-01-04-02) under authority of the Proclamation of January 4, 2022, as extended from time to time, in which the Governor of Maryland proclaimed that a state of emergency and catastrophic health emergency existed within the entire State of Maryland in an effort to control and prevent the spread of COVID-19, shall receive a license or certificate under Education Article, §13-516, Annotated Code of Maryland, provided the holder submits an application and completes the requirements set forth below within the required time frame and provided the holder does not have a pending disciplinary matter or is otherwise subject to denial. During the required time frame, the holder will remain provisionally licensed or certified and may continue to practice EMS. If the holder fails to submit an application or complete the requirements within the required time frame, the provisional certificate or license will expire.

B. Emergency Medical Technician.

  (1) Provisional EMT Certification Obtained as a Student.

    (a) A provisional EMT who obtained provisional EMT certification as a student shall complete the requirements of Regulation .03D of this chapter by May 11, 2022, if the provisional EMT certification was received prior to August 12, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022.

    (b) A provisional EMT who obtained provisional EMT certification as a student and who was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency shall have met the requirement to complete an internship under Regulation .03D(2) of this chapter.

  (2) Provisional EMT Certification Obtained via Reciprocity. A provisional EMT who obtained EMT certification via reciprocity shall by May 11, 2022, if the provisional EMT certification was received prior to August 12, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

    (a) If registered with the National Registry of Emergency Medical Technicians (NREMT) as an EMT, successfully complete a protocol review session approved by MIEMSS; or

    (b) If not registered with the NREMT as an EMT:

      (i) Document successful completion of 24 hours of EMS continuing education within the past 12 months; and

      (ii) Successfully complete a protocol review session approved by MIEMSS.

  (3) Provisional EMT Certification Obtained Through Reinstatement. A provisional EMT who held an expired EMT certificate and was reinstated with a provisional certificate shall meet the following requirements by May 11, 2022, if the provisional EMT certification was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

    (a) If the provisional EMT has previously passed the NREMT cognitive exam, the provisional EMT shall:

      (i) Provide documentation that while holding a provisional certificate the provisional EMT was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency; and

      (ii) Document successful completion of 24 hours of EMS continuing education in the past 12 months;

    (b) If the provisional EMT has never passed the NREMT cognitive examination and was lapsed for 1 year or less, the provisional EMT shall by May 11, 2022, if the provisional EMT certification was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

      (i) Provide documentation that while holding a provisional certificate the provisional EMT was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency; and

      (ii) Document successful completion of 24 hours of EMS continuing education within the past 12 months;

    (c) If the provisional EMT has never passed the NREMT cognitive examination and was lapsed for more than 1 year but not more than 3 years, the provisional EMT shall by May 22, 2022, if the provisional EMT certification was received prior to August 5, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

      (i) Provide documentation that while holding a provisional certificate the provisional EMT was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency;

      (ii) Document successful completion of 24 hours of EMS continuing education within the past 12 months; and

      (iii) Successfully complete the cognitive reinstatement examination approved by MIEMSS; or

    (d) If the provisional EMT has never passed the NREMT cognitive examination and was lapsed for more than 3 years, the provisional EMT shall by May 11, 2022, if the provisional EMT certification was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMT certification was received after January 4, 2022:

      (i) Provide documentation that while holding a provisional certificate the provisional EMT was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency;

      (ii) Document successful completion of 24 hours of EMS continuing education within the past 12 months; and

      (iii) Successfully complete the cognitive and psychomotor reinstatement examinations approved by MIEMSS.

C. Paramedic.

  (1) Provisional Paramedic License Obtained as a Student. A provisional paramedic who obtained provisional licensure as a student shall:

    (a) Pass the NREMT cognitive examination by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022; and

    (b) Pass the NREMT psychomotor examination and document current active, nonprovisional status registration as a paramedic with the NREMT by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022.

  (2) Provisional Paramedic License Obtained via Reciprocity. A provisional paramedic who obtained provisional licensure via reciprocity shall by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022:

    (a) Document current active, nonprovisional status as a paramedic with the NREMT; and

    (b) Successfully complete a protocol review session approved by MIEMSS.

  (3) Provisional Paramedic License Obtained Through Reinstatement. A provisional paramedic who obtained provisional licensure through reinstatement shall by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022, provide documentation that while holding a provisional license the provisional paramedic was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency, and documentation of:

    (a) Both of the following:

      (i) Current active, nonprovisional status as a paramedic with the NREMT; and

      (ii) Successful completion of a protocol review session approved by MIEMSS; or

    (b) All of the following:

      (i) A passing score on the NREMT cognitive examination by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022;

      (ii) A passing score on the NREMT psychomotor examination and current active, nonprovisional status registration as a paramedic with the NREMT by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received after January 4, 2022; and

      (iii) Successful completion of a protocol review session approved by MIEMSS by May 11, 2022, if the provisional paramedic license was received prior to August 15, 2021, or by November 30, 2022, if the provisional paramedic license was received by January 4, 2022.

D. Emergency Medical Responder.

  (1) Provisional EMR Certification Obtained as a Student. A provisional EMR who obtained EMR certification as a student shall complete the requirements of Regulation .03C of this chapter by May 11, 2022, if the provisional EMR certificate was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMR certificate was received by January 4, 2022.

  (2) Provisional EMR Certification Obtained Through Reinstatement. A provisional EMR who obtained provisional EMR certification through reinstatement shall by May 11, 2022, if the provisional EMR certificate was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMR certificate was received after January 4, 2022, provide documentation that the provisional EMR was affiliated with an EMS operational program and provided EMS during the catastrophic health emergency.

  (3) Provisional EMR Certification Obtained via Reciprocity. A provisional EMR who obtained provisional EMR certification via reciprocity shall by May 11, 2022, if the provisional EMR certificate was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMR certificate was received after January 4, 2022, provide documentation that while holding the provisional certificate the provisional EMR affiliated with an EMS operational program and provided EMS during the catastrophic health emergency.

E. Cardiac Rescue Technician. Provisional CRT License Obtained Through Reinstatement. A provisional CRT who held an expired CRT license and was reinstated with a provisional license shall by May 11, 2022, if the provisional CRT license was received prior to August 15, 2021, or by November 30, 2022, if the provisional CRT license was received after January 4, 2022:

  (1) Document successful completion of 60 hours of continuing education equivalent to the requirements for National Registry paramedic renewal within the past 24 months; and

  (2) Successfully complete a protocol review session approved by MIEMSS.

F. Emergency Medical Dispatcher.

  (1) Provisional EMD License Obtained as a Student. A provisional EMD who obtained provisional EMD licensure as a student shall complete the requirements of COMAR 30.02.03.03G by May 11, 2022, if the provisional EMD license was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMD license was received by January 4, 2022.

  (2) Provisional EMD License Obtained via Reciprocity. A provisional EMD who obtained provisional licensure via reciprocity shall meet the requirements of Regulation .04D of this chapter by May 11, 2022, if the provisional EMD license was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMD license was received by January 4, 2022.

  (3) Provisional EMD Licensure Obtained Through Reinstatement. A provisional EMD who held an expired EMD license and was reinstated with a provisional EMD license shall meet the requirements of Regulation .09D of this chapter by May 11, 2022, if the provisional EMD license was received prior to August 15, 2021, or by November 30, 2022, if the provisional EMD license was received by January 4, 2022.