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WES MOORE, Governor Ch. 214
Chapter 214
(Senate Bill 915)
AN ACT concerning
State Board of Physicians – Delegation of Duties – Alterations
FOR the purpose of requiring an individual to be registered with the State Board of
Physicians to perform limited X–ray machine operations in the State; establishing
certain disciplinary procedures for limited X–ray machine operators; recodifying
certain provisions of law related to registered cardiovascular invasive specialists and
supervised medical graduates; authorizing a physician assistant to perform X–ray
duties under certain circumstances; and generally relating to the delegation of duties
by physicians and physician assistants.
BY repealing and reenacting, with amendments,
Article – Health Occupations
Section 14–206(e)(2)(viii), 14–306, 14–602, and 15–302.1(c)
Annotated Code of Maryland
(2021 Replacement Volume and 2025 Supplement)
BY repealing and reenacting, without amendments,
Article – Health Occupations
Section 14–206(e)(2)(ix)
Annotated Code of Maryland
(2021 Replacement Volume and 2025 Supplement)
BY adding to
Article – Health Occupations
Section 14–206(e)(2)(x), 14–306.1, 14–306.2, 14–306.3, and 14–306.4
Annotated Code of Maryland
(2021 Replacement Volume and 2025 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health Occupations
14–206.
(e) A disciplinary panel may issue a cease and desist order or obtain injunctive
relief against an individual for:
(2) Representing to the public, by title, description of services, methods,
procedures, or otherwise, that the individual is authorized to practice:
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Ch. 214 2026 LAWS OF MARYLAND
(viii) Genetic counseling in this State, in violation of § 14–5G–24 of
this title; [or]
(ix) As a physician assistant in this State, in violation of § 15–402 of
this article; or
(X) LIMITED X–RAY MACHINE OPERATION IN THE STATE, IN
VIOLATION OF § 14–306.3 OF THIS TITLE; OR
14–306.
(a) [Except as provided in subsections (e) and (f) of this section, to] TO the extent
[permitted] AUTHORIZED by the rules, regulations, and orders of the Board, an individual
to whom duties are delegated by a licensed physician or physician assistant may perform
those duties without a license as provided in this section.
(b) The individuals to whom duties may be delegated under this section include
any individual authorized to practice any other health occupation regulated under this
article or § 13–516 of the Education Article.
(c) (1) The Board shall adopt rules and regulations to delineate the scope of
this section.
(2) Before [it] THE BOARD adopts any rule or regulation under this
section, the Board shall invite and consider proposals from any individual or health group
that could be affected by the rule or regulation.
(d) (1) If a duty that is to be delegated under this section is a part of the
practice of a health occupation that is regulated under this article by another board, any
rule or regulation concerning that duty shall be adopted jointly by the Board of Physicians
and the board that regulates the other health occupation.
(2) If the two boards cannot agree on a proposed rule or regulation, the
proposal shall be submitted to the Secretary for a final decision.
[(e) Except as otherwise provided in this section and in accordance with
regulations adopted by the Board, an individual may perform X–ray duties without a
license only if the duties:
(1) Do not include:
(i) Computerized or noncomputerized tomography;
(ii) Fluoroscopy;
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WES MOORE, Governor Ch. 214
(iii) Invasive radiology;
(iv) Mammography;
(v) Nuclear medicine;
(vi) Radiation therapy; or
(vii) Xerography;
(2) Are limited to X–ray procedures of the:
(i) Chest;
(ii) Spine, including the:
1. Cervical spine;
2. Lumbar spine;
3. Sacroiliac joints;
4. Sacrum and coccyx; and
5. Thoracic spine;
(iii) Lower extremities, including:
1. Toes;
2. The foot;
3. The ankle;
4. The calcaneus;
5. The tibia and fibula;
6. The knee and patella; and
7. The femur; and
(iv) Upper extremities, including:
1. Fingers;
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Ch. 214 2026 LAWS OF MARYLAND
2. The hand;
3. The wrist;
4. The forearm;
5. The elbow;
6. The humerus;
7. The shoulder;
8. The clavicle;
9. Acromioclavicular joints; and
10. The scapula; and
(3) Are performed:
(i) In the physician’s office under the supervision of a licensed
physician or radiologic technologist who is on–site or able to provide immediately available
direction; and
(ii) 1. By an individual who has:
A. Attested to the completion of at least 6 months of clinical
care experience; and
B. Completed a limited scope X–ray educational program
consisting of at least 115 hours of didactic training delivered by a radiologic technologist
certified by the American Registry of Radiologic Technologists providing instruction in
radiographic anatomy, procedures, and pathology, digital image acquisition and display,
fundamentals, ethics, and laws of health care, human anatomy and physiology, image
production and analysis, imaging equipment and radiation production, medical
terminology, and patient care;
C. Completed at least 480 hours of clinical training and
successfully completed a minimum of five competencies in each body part listed in item (2)
of this subsection under the direct supervision of a radiologic technologist certified by the
American Registry of Radiologic Technologists;
D. Achieved a passing score, as determined by the Board, on
the American Registry of Radiologic Technologists examination for limited scope of practice
in radiography or an alternative examination approved by the Board; and
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WES MOORE, Governor Ch. 214
E. Registered with the Board attesting to the completion of
the requirements of this item and the completion of at least 24 hours of approved continuing
education credits earned during the 2–year period immediately following the date of initial
registration and every 2 years thereafter; or
2. By a licensed physician assistant who has completed a
course that includes anterior–posterior and lateral radiographic studies of extremities on
at least 20 separate patients under the direct supervision of the delegating physician or
radiologist using a mini C–arm or similar low–level radiation machine to perform
nonfluoroscopic X–ray procedures, if the duties:
A. Include only the X–ray procedures described in paragraph
(2)(iii) of this subsection; and
B. Are performed pursuant to a Board–approved delegation
agreement that includes a request to perform advanced duties under § 15–302(c)(2) of this
article.
(f) (1) In accordance with regulations adopted by the Board, a licensed
physician may delegate duties to a registered cardiovascular invasive specialist assisting
in the physician’s performance of fluoroscopy if:
(i) The delegated duties are limited to a cardiac catheterization
procedure performed in a hospital cardiac catheterization laboratory;
(ii) The physician is physically present and personally directs each
act performed by the registered cardiovascular invasive specialist;
(iii) The registered cardiovascular invasive specialist has completed
the training and education and has the experience required by regulations adopted by the
Board; and
(iv) The hospital in which the cardiac catheterization laboratory is
located has verified and documented that the registered cardiovascular invasive specialist
has completed the training and education and has the experience required by regulations
adopted by the Board.
(2) The hospital in which the cardiac catheterization laboratory is located
and the physician delegating duties to a registered cardiovascular invasive specialist under
this subsection are responsible for ensuring that all requirements of this subsection are
met for each procedure.
(3) A disciplinary panel may impose a civil penalty of up to $5,000 for each
instance of a hospital’s failure to comply with the requirements of this subsection.
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(g) (1) (i) In this subsection the following words have the meanings
indicated.
(ii) “Direct supervision” means oversight exercised by a delegating
physician who is:
1. Personally treating the patient;
2. In the same medical office as the patient and the
supervised medical graduate; and
3. Immediately available to provide assistance and guidance
to the supervised medical graduate for the duration of the completion of a delegated duty.
(iii) “Supervised medical graduate” means an individual who:
1. Has a degree of:
A. Doctor of medicine from a medical school that is accredited
by an accrediting organization that the Board recognizes in its regulations; or
B. Doctor of osteopathy from a school of osteopathy in the
United States, its territories or possessions, Puerto Rico, or Canada that has standards for
graduation equivalent to those established by the American Osteopathic Association; and
2. Has passed parts 1 and 2 of:
A. The United States Medical Licensing Examination; or
B. The Comprehensive Osteopathic Medical Licensing
Examination of the United States.
(2) Subject to paragraph (3) of this subsection and in accordance with
regulations adopted by the Board, a supervised medical graduate may perform delegated
duties under direct supervision.
(3) An individual may not practice as a supervised medical graduate for a
period of more than 2 years.
(4) For the purposes of this subsection, a delegating physician is not
required to be in the presence of a patient and a supervised medical graduate during the
completion of a delegated duty.
(h) In accordance with regulations adopted by the Board, a physician’s office that
employs an individual authorized to perform X–ray duties without a license under
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WES MOORE, Governor Ch. 214
subsection (e) of this section is responsible for ensuring that all requirements of subsection
(e) of this section are met for each X–ray examination performed.
(i) If an unlicensed individual performs X–ray duties without meeting the
requirements of subsection (e) of this section, the Board may impose a civil penalty of up
to:
(1) $5,000 for each violation on the physician’s office where the violation
occurred; and
(2) $1,000 for each violation on the individual who committed the
violation.]
14–306.1.
(A) IN ACCORDANCE WITH REGULATIONS ADOPTED BY THE BOARD, A
LICENSED PHYSICIAN MAY DELEGATE DUTIES TO A REGISTERED CARDIOVASCULAR
INVASIVE SPECIALIST ASSISTING IN THE PHYSICIAN’S PERFORMANCE OF
FLUOROSCOPY IF:
(1) THE DELEGATED DUTIES ARE LIMITED TO A CARDIAC
CARDIAC
CATHETERIZATION PROCEDURE PERFORMED IN A HOSPITAL
CATHETERIZATION LABORATORY;
(2) THE PHYSICIAN IS PHYSICALLY PRESENT AND PERSONALLY
DIRECTS EACH ACT PERFORMED BY THE REGISTERED CARDIOVASCULAR INVASIVE
SPECIALIST;
(3) THE REGISTERED CARDIOVASCULAR INVASIVE SPECIALIST HAS
COMPLETED THE TRAINING AND EDUCATION AND HAS THE EXPERIENCE REQUIRED
BY REGULATIONS ADOPTED BY THE BOARD; AND
(4) THE HOSPITAL IN WHICH THE CARDIAC CATHETERIZATION
LABORATORY IS LOCATED HAS VERIFIED AND DOCUMENTED THAT THE REGISTERED
CARDIOVASCULAR INVASIVE SPECIALIST HAS COMPLETED THE TRAINING AND
EDUCATION AND HAS THE EXPERIENCE REQUIRED BY REGULATIONS ADOPTED BY
THE BOARD.
(B) THE HOSPITAL IN WHICH THE CARDIAC CATHETERIZATION
LABORATORY IS LOCATED AND THE PHYSICIAN DELEGATING DUTIES TO A
REGISTERED CARDIOVASCULAR INVASIVE SPECIALIST UNDER THIS SECTION ARE
RESPONSIBLE FOR ENSURING THAT ALL REQUIREMENTS OF THIS SECTION ARE MET
FOR EACH PROCEDURE.
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(C) A DISCIPLINARY PANEL MAY IMPOSE A CIVIL PENALTY OF UP TO $5,000
FOR EACH INSTANCE OF A HOSPITAL’S FAILURE TO COMPLY WITH THE
REQUIREMENTS OF THIS SECTION.
14–306.2.
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.
(2) “ON–SITE SUPERVISION” MEANS OVERSIGHT EXERCISED BY A
DELEGATING PHYSICIAN WHO IS:
(I) PERSONALLY TREATING THE PATIENT;
(II) IN THE SAME MEDICAL OFFICE AS THE PATIENT AND THE
SUPERVISED MEDICAL GRADUATE; AND
(III) IMMEDIATELY AVAILABLE TO PROVIDE ASSISTANCE AND
GUIDANCE TO THE SUPERVISED MEDICAL GRADUATE FOR THE DURATION OF THE
COMPLETION OF A DELEGATED DUTY.
(3) “SUPERVISED MEDICAL GRADUATE” MEANS AN INDIVIDUAL WHO:
(I) HAS A DEGREE OF:
1. DOCTOR OF MEDICINE FROM A MEDICAL SCHOOL
THAT IS ACCREDITED BY AN ACCREDITING ORGANIZATION THAT THE BOARD
RECOGNIZES IN ITS REGULATIONS; OR
2. DOCTOR OF OSTEOPATHY FROM A SCHOOL OF
OSTEOPATHY IN THE UNITED STATES, ITS TERRITORIES OR POSSESSIONS, PUERTO
RICO, OR CANADA THAT HAS STANDARDS FOR GRADUATION EQUIVALENT TO THOSE
ESTABLISHED BY THE AMERICAN OSTEOPATHIC ASSOCIATION; AND
(II) HAS PASSED PARTS 1 AND 2 OF:
1. THE UNITED STATES MEDICAL LICENSING
EXAMINATION; OR
2. THE COMPREHENSIVE OSTEOPATHIC MEDICAL
LICENSING EXAMINATION OF THE UNITED STATES.
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WES MOORE, Governor Ch. 214
(B) SUBJECT TO SUBSECTION (C) OF THIS SECTION AND IN ACCORDANCE
WITH REGULATIONS ADOPTED BY THE BOARD, A SUPERVISED MEDICAL GRADUATE
MAY PERFORM DELEGATED DUTIES UNDER ON–SITE SUPERVISION.
(C) AN INDIVIDUAL MAY NOT PRACTICE AS A SUPERVISED MEDICAL
GRADUATE FOR A PERIOD OF MORE THAN 2 YEARS.
(D) FOR THE PURPOSES OF THIS SECTION, A DELEGATING PHYSICIAN IS
NOT REQUIRED TO BE IN THE PRESENCE OF A PATIENT AND A SUPERVISED MEDICAL
GRADUATE DURING THE COMPLETION OF A DELEGATED DUTY.
14–306.3.
(A) IN ACCORDANCE WITH REGULATIONS ADOPTED BY THE BOARD, AN
INDIVIDUAL MAY PERFORM X–RAY DUTIES AS A LIMITED X–RAY MACHINE
OPERATOR REGISTERED WITH THE BOARD UNDER THIS SECTION WITHOUT A
LICENSE IF THE X–RAY PROCEDURES:
(1) DO NOT INCLUDE:
(I) COMPUTERIZED OR NONCOMPUTERIZED TOMOGRAPHY;
(II) FLUOROSCOPY;
(III) INVASIVE RADIOLOGY;
(IV) MAMMOGRAPHY;
(V) NUCLEAR MEDICINE;
(VI) RADIATION THERAPY; OR
(VII) XEROGRAPHY;
(2) ARE LIMITED TO X–RAY PROCEDURES OF:
(I) THE CHEST;
(II) THE SPINE, INCLUDING:
1. THE CERVICAL SPINE;
2. THE LUMBAR SPINE;
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Ch. 214 2026 LAWS OF MARYLAND
3. THE SACROILIAC JOINTS;
4. THE SACRUM AND COCCYX; AND
5. THE THORACIC SPINE;
(III) LOWER EXTREMITIES, INCLUDING:
1. TOES;
2. THE FOOT;
3. THE ANKLE;
4. THE CALCANEUS;
5. THE TIBIA AND FIBULA;
6. THE KNEE AND PATELLA; AND
7. THE FEMUR; AND
(IV) UPPER EXTREMITIES, INCLUDING:
1. FINGERS;
2. THE HAND;
3. THE WRIST;
4. THE FOREARM;
5. THE ELBOW;
6. THE HUMERUS;
7. THE SHOULDER;
8. THE CLAVICLE;
9. ACROMIOCLAVICULAR JOINTS; AND
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WES MOORE, Governor Ch. 214
10. THE SCAPULA;
(3) ARE PERFORMED UNDER THE SUPERVISION OF A LICENSED
PHYSICIAN OR RADIOGRAPHER WHO IS ON–SITE OR ABLE TO PROVIDE IMMEDIATELY
AVAILABLE DIRECTION; AND
(4) ARE PERFORMED BY AN INDIVIDUAL WHO HAS REGISTERED WITH
THE BOARD AND ATTESTS:
(I) TO THE SUCCESSFUL COMPLETION OF AT LEAST 6 MONTHS
OF CLINICAL CARE EXPERIENCE;
(II) TO THE SUCCESSFUL COMPLETION OF:
1. A LIMITED X–RAY EDUCATIONAL PROGRAM; OR
2. THE FIRST YEAR OF AN ACCREDITED RADIOLOGIC
TECHNOLOGIST PROGRAM IN GOOD STANDING WITH THE BOARD;
(III) TO THE SUCCESSFUL COMPLETION OF AT LEAST 115 150
115 HOURS OF DIDACTIC TRAINING DELIVERED BY A RADIOLOGIC TECHNOLOGIST
CERTIFIED BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS
PROVIDING INSTRUCTION IN RADIOGRAPHIC ANATOMY, PROCEDURES, AND
PATHOLOGY, DIGITAL IMAGE ACQUISITION AND DISPLAY, FUNDAMENTALS, ETHICS,
AND LAWS OF HEALTH CARE, HUMAN ANATOMY AND PHYSIOLOGY, IMAGE
PRODUCTION AND ANALYSIS, IMAGING EQUIPMENT AND RADIATION PRODUCTION,
MEDICAL TERMINOLOGY, AND PATIENT CARE;
(IV) TO THE SUCCESSFUL COMPLETION OF AT LEAST 480 HOURS
OF CLINICAL TRAINING;
(V) TO THE SUCCESSFUL COMPLETION OF A MINIMUM OF FIVE
COMPETENCIES IN EACH BODY PART LISTED UNDER SUBSECTION (A)(2) OF THIS
SECTION UNDER THE DIRECT SUPERVISION OF A RADIOLOGIC TECHNOLOGIST
CERTIFIED BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS; AND
(VI) TO THE SUCCESSFUL ACHIEVEMENT OF A PASSING SCORE,
AS DETERMINED BY THE BOARD, ON THE AMERICAN REGISTRY OF RADIOLOGIC
TECHNOLOGISTS EXAMINATION FOR LIMITED SCOPE OF PRACTICE IN
RADIOGRAPHY OR AN ALTERNATIVE EXAMINATION APPROVED BY THE BOARD.
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(B) IF THE APPLICANT COMPLETED THE FIRST YEAR OF AN ACCREDITED
RADIOLOGIC TECHNOLOGIST EDUCATIONAL PROGRAM, THE PROGRAM DIRECTOR
OF THE EDUCATIONAL PROGRAM SHALL PROVIDE AN ATTESTATION DIRECTLY TO
THE BOARD STATING THAT THE APPLICANT MEETS OR EXCEEDS THE
REQUIREMENTS OF SUBSECTION (A)(4)(I), (II)2, (III), (IV), (V), AND (VI) OF THIS
SECTION.
(C) AN INDIVIDUAL SEEKING REGISTRATION UNDER THIS SECTION SHALL:
(1) APPLY FOR REGISTRATION ON A FORM SUPPLIED BY THE BOARD;
(2) PAY THE REGISTRATION FEE ESTABLISHED BY THE BOARD; AND
(3) COMPLETE ANY OTHER REQUIREMENTS ESTABLISHED BY THE
BOARD.
(D) IF AN INDIVIDUAL WAS DENIED A LICENSE BY THE BOARD, THE
INDIVIDUAL IS NOT ELIGIBLE FOR REGISTRATION UNDER THIS SECTION.
(E) AN INDIVIDUAL REGISTERED UNDER THIS SECTION SHALL COMPLETE
AT LEAST 24 HOURS OF APPROVED CONTINUING EDUCATION CREDITS EARNED
DURING THE 2–YEAR PERIOD IMMEDIATELY PRECEDING THE EXPIRATION OF A
REGISTRATION.
(F) (1) THE TERM OF A REGISTRATION MAY NOT EXCEED 3 YEARS.
(2) A REGISTRATION SHALL EXPIRE ON A DATE ESTABLISHED BY THE
BOARD.
(3) TO RENEW A REGISTRATION, THE REGISTRANT MUST:
(I) APPLY FOR RENEWAL ON A FORM SUPPLIED BY THE BOARD;
(II) PAY THE RENEWAL FEE ESTABLISHED BY THE BOARD; AND
(III) COMPLETE ANY OTHER REQUIREMENTS ESTABLISHED BY
THE BOARD.
(G) AN APPLICANT FOR REGISTRATION SHALL COMPLETE A CRIMINAL
HISTORY RECORDS CHECK IN ACCORDANCE WITH § 14–308.1 OF THIS SUBTITLE.
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WES MOORE, Governor Ch. 214
(H) (1) THE BOARD SHALL SET REASONABLE FEES FOR THE ISSUANCE
AND RENEWAL OF REGISTRATIONS AND OTHER SERVICES PROVIDED.
(2) THE FEES CHARGED SHALL BE SET SO AS TO PRODUCE FUNDS TO
APPROXIMATE THE COST OF MAINTAINING THE REGISTRATION PROGRAM AND
OTHER SERVICES PROVIDED TO REGISTRANTS UNDER THIS SECTION.
(I) IN ACCORDANCE WITH REGULATIONS ADOPTED BY THE BOARD, A
PHYSICIAN’S OFFICE THAT EMPLOYS AN INDIVIDUAL AUTHORIZED TO PERFORM
X–RAY DUTIES WITHOUT A LICENSE UNDER THIS SECTION IS RESPONSIBLE FOR
ENSURING THAT ALL REQUIREMENTS OF THIS SECTION ARE MET FOR EACH X–RAY
EXAMINATION PERFORMED.
(J) IF AN UNREGISTERED INDIVIDUAL PERFORMS X–RAY DUTIES WITHOUT
MEETING THE REQUIREMENTS OF THIS SECTION, THE BOARD MAY IMPOSE A CIVIL
PENALTY OF UP TO:
(1) $5,000 FOR EACH VIOLATION ON THE PHYSICIAN’S OFFICE WHERE
THE VIOLATION OCCURRED; AND
(2) $1,000 FOR EACH VIOLATION ON THE INDIVIDUAL WHO
COMMITTED THE VIOLATION.
14–306.4.
(A) SUBJECT TO THE HEARING PROVISIONS OF § 14–405 OF THIS TITLE, A
DISCIPLINARY PANEL, ON THE AFFIRMATIVE VOTE OF A MAJORITY OF THE QUORUM
OF THE DISCIPLINARY PANEL, MAY DENY A REGISTRATION TO PRACTICE AS A
LIMITED X–RAY MACHINE OPERATOR TO ANY APPLICANT, REPRIMAND ANY LIMITED
X–RAY MACHINE OPERATOR REGISTRANT, PLACE ANY REGISTRANT ON PROBATION,
OR SUSPEND OR REVOKE A REGISTRATION, IF THE APPLICANT OR REGISTRANT:
(1) FRAUDULENTLY OR DECEPTIVELY OBTAINS OR ATTEMPTS TO
OBTAIN A REGISTRATION FOR THE APPLICANT, REGISTRANT, OR FOR ANOTHER;
(2) FRAUDULENTLY OR DECEPTIVELY USES A REGISTRATION;
(3) IS GUILTY OF:
(I) IMMORAL CONDUCT IN THE PRACTICE OF LIMITED X–RAY
MACHINE OPERATION; OR
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(II) UNPROFESSIONAL CONDUCT IN THE PRACTICE OF LIMITED
X–RAY MACHINE OPERATION;
(4) IS:
(I) PROFESSIONALLY INCOMPETENT;
(II) PHYSICALLY INCOMPETENT; OR
(III) MENTALLY INCOMPETENT;
(5) ABANDONS A PATIENT;
(6) IS HABITUALLY INTOXICATED;
(7) IS ADDICTED TO OR HABITUALLY ABUSES ANY NARCOTIC OR
CONTROLLED DANGEROUS SUBSTANCE AS DEFINED IN § 5–101 OF THE CRIMINAL
LAW ARTICLE;
(8) PROVIDES PROFESSIONAL SERVICES WHILE:
(I) UNDER THE INFLUENCE OF ALCOHOL; OR
(II) USING ANY NARCOTIC OR CONTROLLED DANGEROUS
SUBSTANCE AS DEFINED IN § 5–101 OF THE CRIMINAL LAW ARTICLE OR ANY OTHER
DRUG THAT IS IN EXCESS OF THERAPEUTIC AMOUNTS OR WITHOUT VALID MEDICAL
INDICATION;
(9) PROMOTES THE SALE OF SERVICES, DRUGS, DEVICES,
APPLIANCES, OR GOODS TO A PATIENT SO AS TO EXPLOIT THE PATIENT FOR
FINANCIAL GAIN;
(10) WILLFULLY MAKES OR FILES A FALSE REPORT OR RECORD IN THE
PRACTICE OF LIMITED X–RAY MACHINE OPERATION;
(11) WILLFULLY FAILS TO FILE OR RECORD ANY REPORT AS REQUIRED
UNDER LAW, WILLFULLY IMPEDES OR OBSTRUCTS THE FILING OR RECORDING OF A
REPORT, OR INDUCES ANOTHER TO FAIL TO FILE OR RECORD A REPORT;
(12) BREACHES PATIENT CONFIDENTIALITY;
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WES MOORE, Governor Ch. 214
(13) PAYS OR AGREES TO PAY ANY SUM OR PROVIDE ANY FORM OF
REMUNERATION OR MATERIAL BENEFIT TO ANY PERSON FOR BRINGING OR
REFERRING A PATIENT OR ACCEPTS OR AGREES TO ACCEPT ANY SUM OR ANY FORM
OF REMUNERATION OR MATERIAL BENEFIT FROM AN INDIVIDUAL FOR BRINGING OR
REFERRING A PATIENT;
(14) WILLFULLY MAKES A MISREPRESENTATION WHILE PRACTICING
LIMITED X–RAY MACHINE OPERATION;
(15) WILLFULLY PRACTICES LIMITED X–RAY MACHINE OPERATION
WITH AN UNAUTHORIZED INDIVIDUAL OR AIDS AN UNAUTHORIZED INDIVIDUAL IN
THE PRACTICE OF LIMITED X–RAY MACHINE OPERATION;
(16) OFFERS, UNDERTAKES, OR AGREES TO CURE OR TREAT DISEASE
BY A SECRET METHOD, TREATMENT, OR MEDICINE;
(17) IS DISCIPLINED BY A LICENSING OR DISCIPLINARY AUTHORITY OR
IS CONVICTED OR DISCIPLINED BY A COURT OF ANY STATE OR COUNTRY OR IS
DISCIPLINED BY ANY BRANCH OF THE UNIFORMED SERVICES OR THE U.S.
DEPARTMENT OF VETERANS AFFAIRS FOR AN ACT THAT WOULD BE GROUNDS FOR
DISCIPLINARY ACTION UNDER THE BOARD’S DISCIPLINARY STATUTES;
(18) FAILS TO MEET APPROPRIATE STANDARDS FOR THE DELIVERY OF
QUALITY LIMITED X–RAY MACHINE OPERATION CARE PERFORMED IN ANY
OUTPATIENT SURGICAL FACILITY, OFFICE, HOSPITAL OR RELATED INSTITUTION, OR
ANY OTHER LOCATION IN THIS STATE;
(19) WILLFULLY SUBMITS FALSE STATEMENTS TO COLLECT FEES FOR
WHICH SERVICES ARE NOT PROVIDED;
(20) (I) HAS BEEN SUBJECT TO INVESTIGATION OR DISCIPLINARY
ACTION BY A DISCIPLINARY AUTHORITY OR BY A COURT OF ANY STATE OR COUNTRY
FOR AN ACT THAT WOULD BE GROUNDS FOR DISCIPLINARY ACTION UNDER THE
BOARD’S DISCIPLINARY STATUTES; AND
(II) HAS:
1. SURRENDERED THE LICENSE, REGISTRATION,
CERTIFICATION, OR PERMIT ISSUED BY THE STATE OR COUNTRY; OR
2. ALLOWED THE LICENSE, REGISTRATION,
CERTIFICATION, OR PERMIT ISSUED BY THE STATE OR COUNTRY TO EXPIRE OR
LAPSE;
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Ch. 214 2026 LAWS OF MARYLAND
(21) WILLFULLY FAILS TO REPORT SUSPECTED CHILD ABUSE IN
VIOLATION OF § 5–704 OF THE FAMILY LAW ARTICLE;
(22) SELLS, PRESCRIBES, GIVES AWAY, OR ADMINISTERS DRUGS FOR
ILLEGAL OR ILLEGITIMATE MEDICAL PURPOSES;
(23) PRACTICES OR ATTEMPTS TO PRACTICE BEYOND THE
AUTHORIZED SCOPE OF PRACTICE;
(24) REFUSES, WITHHOLDS FROM, DENIES, OR DISCRIMINATES
AGAINST AN INDIVIDUAL WITH REGARD TO THE PROVISION OF PROFESSIONAL
SERVICES FOR WHICH THE LICENSEE IS LICENSED AND QUALIFIED TO RENDER
BECAUSE THE INDIVIDUAL IS HIV POSITIVE;
(25) PRACTICES OR ATTEMPTS TO PRACTICE A LIMITED X–RAY
MACHINE OPERATION PROCEDURE OR USES LIMITED X–RAY MACHINE OPERATION
EQUIPMENT IF THE APPLICANT OR REGISTRANT HAS NOT RECEIVED AN EDUCATION,
AN INTERNSHIP, TRAINING, OR EXPERIENCE IN THE PERFORMANCE OF THE
PROCEDURE OR THE USE OF THE EQUIPMENT;
(26) FAILS TO COOPERATE WITH A LAWFUL INVESTIGATION
CONDUCTED BY THE BOARD OR A DISCIPLINARY PANEL;
(27) FAILS TO PRACTICE UNDER THE SUPERVISION OF A LICENSED
PHYSICIAN OR LICENSED RADIOGRAPHER OR VIOLATES A SUPERVISORY ORDER OF
A SUPERVISING PHYSICIAN OR SUPERVISING RADIOGRAPHER; OR
(28) FAILS TO COMPLETE A CRIMINAL HISTORY RECORDS CHECK
UNDER § 14–308.1 OF THIS SUBTITLE.
(B) EXCEPT AS OTHERWISE PROVIDED IN THE ADMINISTRATIVE
PROCEDURE ACT, BEFORE THE BOARD OR A DISCIPLINARY PANEL TAKES ANY
ACTION UNDER SUBSECTION (A) OF THIS SECTION, THE BOARD OR A DISCIPLINARY
PANEL SHALL GIVE THE INDIVIDUAL AGAINST WHOM THE ACTION IS
CONTEMPLATED AN OPPORTUNITY FOR A HEARING BEFORE THE BOARD OR THE
DISCIPLINARY PANEL IN ACCORDANCE WITH THE HEARING REQUIREMENTS OF §
14–405 OF THIS TITLE.
(C) (1) ON THE FILING OF CERTIFIED DOCKET ENTRIES WITH THE BOARD
BY THE OFFICE OF THE ATTORNEY GENERAL, A DISCIPLINARY PANEL SHALL ORDER
THE SUSPENSION OF A REGISTRATION IF THE REGISTRANT IS CONVICTED OF OR
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WES MOORE, Governor Ch. 214
PLEADS GUILTY OR NOLO CONTENDERE WITH RESPECT TO A CRIME INVOLVING
MORAL TURPITUDE, WHETHER OR NOT ANY APPEAL OR OTHER PROCEEDING IS
PENDING TO HAVE THE CONVICTION OR PLEA SET ASIDE.
(2) AFTER COMPLETION OF THE APPELLATE PROCESS, IF THE
CONVICTION HAS NOT BEEN REVERSED OR THE PLEA HAS NOT BEEN SET ASIDE WITH
RESPECT TO A CRIME INVOLVING MORAL TURPITUDE, A DISCIPLINARY PANEL
SHALL ORDER THE REVOCATION OF A REGISTRATION ON THE CERTIFICATION BY
THE OFFICE OF THE ATTORNEY GENERAL.
(D) IF, AFTER A HEARING UNDER § 14–405 OF THIS TITLE, A DISCIPLINARY
PANEL FINDS THAT THERE ARE GROUNDS UNDER SUBSECTION (A) OF THIS SECTION
TO SUSPEND OR REVOKE A REGISTRATION, TO REPRIMAND A REGISTRANT, OR TO
PLACE A REGISTRANT ON PROBATION, THE DISCIPLINARY PANEL MAY IMPOSE A
FINE SUBJECT TO THE BOARD’S REGULATIONS IN ADDITION TO SUSPENDING OR
REVOKING THE LICENSE, REPRIMANDING THE REGISTRANT, OR PLACING THE
REGISTRANT ON PROBATION.
(E) IN ADDITION TO ANY SANCTION AUTHORIZED UNDER THIS SECTION, A
DISCIPLINARY PANEL MAY REQUIRE A REGISTRANT TO COMPLY WITH SPECIFIED
TERMS AND CONDITIONS DETERMINED BY THE DISCIPLINARY PANEL.
14–602.
(a) Unless authorized to practice medicine under this title, a person may not
represent to the public, by description of services, methods, or procedures, or otherwise,
that the person is authorized to practice medicine in this State.
(b) Except as otherwise provided in this article, a person may not use the words
or terms “Dr.”, “doctor”, “physician”, “D.O.”, or “M.D.” with the intent to represent that the
person practices medicine, unless the person is:
(1) Licensed to practice medicine under this title;
(2) A physician licensed by and residing in another jurisdiction, while
engaging in consultation with a physician licensed in this State;
(3) A physician employed in the service of the federal government while
practicing within the scope of the employment;
(4) A physician who resides in and is licensed to practice medicine by any
state adjoining this State and whose practice extends into this State;
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Ch. 214 2026 LAWS OF MARYLAND
(5) An individual in a postgraduate medical program that is accredited by
an accrediting organization recognized by the Board in regulations while the individual is
practicing medicine in the program; or
(6) A licensee who is on emeritus status under § 14–320.1 of this title,
provided that the licensee does not represent to the public that the licensee is authorized
to practice medicine in the State.
(c) An unlicensed individual who acts under § 14–302 [or], § 14–306, § 14–306.1,
§ 14–306.2, OR § 14–306.3 of this title may use the word “physician” together with another
word to describe the occupation of the individual as in phrases such as “physician’s
assistant” or “physician’s aide”.
15–302.1.
(c) (1) Subject to paragraph (2) of this subsection and subsection (d) of this
section and except as provided in subsection (e) of this section, a physician assistant may
perform advanced duties in a practice setting that is not an exempt facility only after the
physician assistant obtains Board approval of the advanced duty under the collaboration
agreement.
(2) [(i) Subject to subparagraph (ii) of this paragraph, a] A physician
assistant may perform X–ray duties [authorized under § 14–306(e) of this article] in the
medical office of a patient care team physician [only after the] IF:
(I) THE PHYSICIAN ASSISTANT HAS COMPLETED A COURSE
THAT INCLUDES RADIOGRAPHIC STUDIES OF THE EXTREMITIES OF AT LEAST 20
SEPARATE PATIENTS;
(II) THE X–RAYS ARE LIMITED TO THE EXTREMITIES;
(III) THE X–RAYS ARE PERFORMED UNDER THE DIRECT
SUPERVISION OF A COLLABORATING PHYSICIAN OR RADIOLOGIST;
(IV) THE X–RAYS ARE PERFORMED USING A MINI C–ARM OR A
SIMILAR LOW–LEVEL RADIATION MACHINE TO PERFORM NONFLUOROSCOPIC X–RAY
PROCEDURES; AND
(V) THE physician assistant obtains Board approval of the X–ray
duty AS AN ADVANCED DUTY under the collaboration agreement.
[(ii) A collaboration agreement may authorize the delegation of X–ray
duties limited to nonfluoroscopic X–ray procedures of the extremities, anterior–posterior
and lateral, not including the head.]
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WES MOORE, Governor Ch. 214
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2026.
Approved by the Governor, April 28, 2026.
– 19 –Every fact on this page links to its source, starting with the official bill record.