Source: https://www.mbp.state.md.us/licensure_ahapp_pa.aspx
Timestamp: 2019-04-23 23:58:59+00:00

Document:
PA Dispensing Application and FAQs Available Now!
Graduation from a physician assistant educational program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or its successor.
Applicants who graduate from an accredited physician assistant educational program after October 1, 2003, must have a baccalaureate degree or the equivalent education to a baccalaureate degree.
Current certification by the National Commission on Licensure of Physician Assistants (NCCPA).
Demonstrate oral and written competency in English as required by the Board.
Meet any other requirements established by the Board.
Submit to a criminal history records check.
The Board may accept the Federation Credential Verification Service (FCVS) for primary source verification of a physician assistant's core credentials. For more information about the FCVS, contact them at 817-868-4000; fcvs@fsmb.org or go to their website at https://www.fsmb.org/licensure/fcvs/.
What is a delegation agreement?
A delegation agreement is a document that is executed by a primary supervising physician (PSP) and a PA (PA) containing the requirements of Health Occupations Article, § 15-302, Annotated Code of Maryland.
Applicants are also required to meet additional qualifications.
Core duties are medical acts that are included in the standard curricula of accredited PA education programs.
How long does it take to be licensed?
The application process, on average, may take 3 – 6 weeks. However, the process may take longer depending on the individual applicant’s circumstance or if the individual does not provide the required documentation on a timely basis.
LICENSURE IS ONLY ONE PART OF THE PROCESS. ALL PHYSICIAN ASSISTANTS MUST FILE A DELEGATION AGREEMENT WITH THE BOARD. THE PA MAY BEGIN WORKING ONCE THE BOARD HAS RECEIVED THE COMPLETED DELEGATION AGREEMENT AND ACKNOWLEDGES RECEIPT IN WRITING. BOARD STAFF WILL EMAIL ACKNOWLEDGEMENT LETTERS TO THE PA AND THE PSP.
What are the requirements for reinstatement?
Completion of a reinstatement application approved by the Board.
Payment of a reinstatement fee.
Satisfactory evidence of compliance with the continuing education requirements.
Verification from the Maryland Office of the Comptroller that the applicant has paid all undisputed taxes and unemployment insurance contributions payable to the Comptroller or the Secretary of Labor, Licensing, and Regulation or that the applicant has provided for payment in a manner satisfactory to the unit responsible for collection. (Maryland Health Occupations Code Annotated, § 1-213).
The continuing education requirement does not apply to the first renewal after initial certification or reinstatement of certification.
Current certification by the National Commission on Certification of Physician Assistants (NCCPA).
The Board may request a PA to submit evidence of having met the continuing education requirements specified in this regulation. If a PA cannot demonstrate completion of the required continuing education credit hours, the Board may impose a civil penalty of up to $100 per missing continuing education credit hour.
What is the delegation agreement process for core duties?
PAs and PSPs must file the completed delegation agreement and appropriate fee with the Board. The Board will not accept faxed delegation agreements or walk-ins.
The Board is no longer required to approve a delegation agreement before the PA begins working if the delegation agreement does not include advanced duties.
The PA may begin working once the Board has received the delegation agreement and acknowledges receipt in writing. Board staff will email acknowledgment letters to the PA and the PSP.
The process may take up to seven weeks.
Advanced duties are medical acts that require additional training beyond the basic PA education program required for licensure. Click here for a listing of Advanced Procedures by Specialty .
What is the delegation agreement addendum process for advanced duties in accredited healthcare facilities?
Is accredited by an accrediting agency recognized by the Board.
Through its governing body has already reviewed and approved the PA to perform each requested advanced duty before the delegation agreement with advanced duties is filed with the Board.
A PA may begin working after the Board receives the delegation agreement for advanced duties and acknowledges receipt in writing. Board staff will email acknowledgment letters to the PA and the PSP.
Note: Pursuant to §15-302.1(e), the Board is authorized to disapprove any delegation agreement not meeting the requirements of the law or if the Board believes that a PA is unable to perform the delegated duties safely.
What does the Board consider an accredited facility?
An accredited facility is a hospital or ambulatory surgical facility accredited by The Joint Commission, the American Association for Accreditation of Ambulatory Surgical Facilities, the Accreditation Association for Ambulatory Health Care, is certified to participate in the Medicare program, as enacted by Title XVIII of the Social Security Act or meets the criteria in Health Occupations Article, §15-302(c)(1).
What does the Board consider a non-accredited facility?
Hospitals or ambulatory surgical facilities whose governing body has not approved the PA to perform the requested procedure prior to submitting the advanced duties request to the Board.
What is the delegation agreement process for advanced duties in non-accredited facilities?
Completion of the Delegation Agreement Addendum for Advanced Duties .
Note:A PSP is required to obtain the Board’s approval of a delegation agreement before the PA may administer, monitor or maintain general anesthesia or neuroaxial anesthesia, including spinal and epidural techniques.
Is there a way to expedite the process?
The Board previously approved the PA to perform the advanced duty.
The temporary practice letter will allow a PA to practice while the delegation agreement is pending Board approval. The temporary practice letter request must be submitted with the delegation agreement.
The Board never approved the PA to perform the requested advanced duty.
What is an alternate supervising physician?
An alternate supervising physician (ASP) is a physician designated by a PSP to supervise a PA in accordance with the delegation agreement on file with the Board. As of March 26, 2018, PSPs of PAs do not need to file documentation about ASPs with the Board (in any practice setting). Instead, PSPs must ensure that documentation, with signed confirmation, that each alternate understands and accepts the role as an ASP, is readily available, accessible, and provided to the Board upon request. See COMAR 10.32.03.07A(3)(d).
When may a PA practice under the supervision of an ASP?
PAs perform only those medical acts that have been delegated under the delegation agreement filed with the Board and are within the scope of practice of the alternate supervising physician.
When should a PA notify the Board that he/she will no longer be working under the supervision of the PSP whose name appears on the approved delegation agreement on file with the Board?
PAs should notify the Board as soon as they know that their PSP will no longer be with the practice by filing a new delegation agreement.
What happens if my physician assistant (PA) license expires?
If your PA license expires, your delegation agreement (DA) becomes invalid. You must reinstate your license and submit a new DA with a Maryland licensed physician to the Board. The DA must be approved by the Board before you may begin practicing as a physician assistant.
What happens if my primary supervising physician's license expires?
If your primary supervising physician's license expires, the DA becomes invalid. You must submit a new DA with a Maryland licensed physician to the Board. The DA must be approved by the Board before you may begin practicing as a physician assistant.
May a PA practice under an ASP if the PSP is no longer with the practice?
In the event of a sudden departure, incapacity, or death of PSP, a designated ASP may assume the role of the PSP by submitting a new delegation agreement to the Board within 15 days.
What are the requirements for prescriptive authority?
Two years of work experience as a physician assistant.
Federal Drug Enforcement Agency (DEA) registration.
For more information about Maryland controlled dangerous substance registration, contact the Office of Controlled Substances Administration.
For more information about DEA registration, contact the Drug Enforcement Agency.
May a PA dispense prescription drugs?
The PA complies with the requirements under Title 12 and 14 of Health Occupations and applicable Federal law and regulations.
Click to view the Regulations.
Is there a scope of practice that a PA may not practice?
Under certain circumstances, a PA may operate a mini C-arm or similar low-level radiation machine to perform non-fluoroscopic procedures. See Health Occupations Article, §14-306e(3)(iii)B for more information.
Hospitals, related institutions, alternative health care systems, or employers are required to report to the Board any termination of employment of the PA for any reason, including quality of care issues, within 5 days of the termination.
Hospitals, related institutions, alternative health care systems, or employers are also required to report to the Board within 5 days any limitation, reductions or other changes of employment of the change of employment that might be grounds for disciplinary actions under Health Occupations Article, §15-314.
May a PA take x-rays or inject radiopharmaceuticals?
No. A PA must be a licensed radiographer to take x-rays and a licensed nuclear medicine technologist to inject radiopharmaceuticals. (Maryland Health Occupations Code Annotated, § 14-306e).
May a PA pronounce a patient dead?
There is no statute that specifically prohibits a PA from pronouncing death. However, hospitals may have their own policy on who may pronounce death and under what circumstances. Please check your hospital's policy.
May a PA sign an emergency medical services (EMS) do not resuscitate (DNR) orders form?
Yes, a PA may sign EMS/DNR orders in accordance with Health General Article, §5-601(i).
May a PA sign a "regular" DNR in an inpatient facility or hospital?
A PA may sign a non-emergency DNR based on the patient&apos;s treatment preferences if this duty is delegated to the PA by the supervising physician.
May a PA sign a death certificate?
Yes, a PA may sign a death certificate.
May a PA write orders for restraints?
Yes, a PA may write orders for restraints.
"HCFA Restraint Rules Allow Delegation to Physician Assistants – MBP Agrees" In August 1999 the Health Care Financing Administration (HCFA) implemented Medicare rules designed to protect all patients from improper use of restraint and seclusion. The regulations limit the ordering of patient restraint or seclusion to “a physician or other licensed independent practitioner,” which would seem to exclude physician assistants. However, in May 2000, HCFA issued “Interpretive Guidelines” clarifying that physicians may delegate those responsibilities in some instances.
In short, physicians are able to delegate to PA's the ordering of restraints and seclusion and the required face-to-face assessment of the patient within one hour, as long as it is within the PA’s state authorized scope of practice and allowed under hospital policy.
The HCFA regulations, entitled, “Medicare and Medicaid Programs; Hospital conditions of Participation: “Patients’ Rights,” were published in the July 2, 1999, Federal Register. They can be found through the Federal Register. They can be found through the Federal Register Web site at http://www.access.gpo.gov/su_docs/fedreg/a990702c.html. The interpretive guidelines, dated June 2000, are on the Internet at Section 482.13 Condition of Participation: Patient's Rights The reference to PAs is on page A-182. Approved by MBP, December 2001.
Are supervising physicians required to co-sign medical charts?
No. In place of the co-signature, the supervising physician will be required to describe a process, on the delegation agreement, by which the PA's practice is reviewed appropriate to the practice setting and consistent with current standards of acceptable medical practice.
For existing delegation agreements, supervising physicians may wish to keep a written description by which the physician assistant's practice is reviewed on file at the healthcare facility.
May a physician assistant practice psychotherapy?
4,000 hours of supervised clinical experience that is approved by the Board.
A PA should have similar education, training and experience before seeking Board approval to practice psychotherapy.
If a PA does not have the required education, training and experience to practice psychotherapy, what type of treatment may a PA provide for a psychiatric patient?
A PA may provide treatment for a psychiatric patient’s physical problems.
*Includes a $26 assessment fee to fund the Maryland Health Care Commission (MHCC) as required by law (MD Code Annotated Health Occ. §1-209).

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