An Act Regarding the Scope of Practice of Registered Cardiovascular Invasive Specialists
Maine Legislature, Session 122, LD 1427
Committee: Business, Research and Economic Development
Sponsors: CLOUGH, BARTLETT, ADAMS, AUSTIN, CURLEY, RECTOR, SEAVEY, BROMLEY, HOBBINS

Legislative Document 
No. 1427 
H.P.991 
House of Representatives, March 22, 2005 
An Act Regarding the Scope of Practice of Registered 
Cardiovascular Invasive Specialists 
Reference to the Committee on Business, Research and Economic Development suggested 
and ordered printed. 
Presented by Representative CLOUGH of Scarborough. 
Cosponsored by Senator BARTLETT of Cumberland and 
1J1~ 
1/7. 71/t?£~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: ADAMS of Portland, AUSTIN of Gray, CURLEY of Scarborough, 
McCORMICK of West Gardiner, RECTOR of Thomaston, SEAVEY of Kennebunkport, 
Senators: BROMLEY of Cumberland, HOBBINS of York. 
Printed on recycleu paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 32 MRSA c. 8 is enacted to read: 
CHAPTER 8 
REGISTERED CARDIOVASCULAR INVASIVE SPECIALISTS 
§43l. 
Definitions 
As 
used 
in this 
chapter, 
unless 
the 
context 
otherwise 
indicates, the following terms have the following meanings. 
1. 
Cardiologist. 
"Cardiologist" means a physician who has 
.successfully completed an approved cardiology training program, 
including, 
but 
not 
limited 
to, 
a 
program 
approved 
by 
the 
Accreditation Council 
for 
Graduate 
Medical 
Education, 
or its 
equivalent or successor. 
2. 
Cardiovascular 
invasive 
specialist. 
"Cardiovascular 
invasive specialist" means a cardiovascular invasive specialist 
who is currently registered by 
a 
cardiovascular credentialing 
organization and who, working under the direct supervision of a 
cardiologist. performs procedures on patients for diagnosis or 
treatment of congenital or acquired heart disease. 
3. 
Supervising cardiologist. 
"Supervising 
cardiologist" 
means 
a physician currently possessing an active, unrestricted 
license to practice medicine in this State who practices in the 
medical specialty of cardiology and has successfully completed a 
residency in cardiology approved by the Accreditation Council for 
Graduate Medical Education or its equivalent or successor. 
4. 
Supervision. 
"Supervision" means medical direction and 
acceptance of responsibility for the cardiac services rendered by 
a 
registered cardiovascular 
invasive 
specialist in 
a 
manner 
provided for 
in law and the 
adopted protocol of 
a 
hospital 
licensed in the State. 
The supervising cardiologist must be in 
the hospital and in the operative area such that the cardiologist 
can be immediately available to participate directly in the care 
of the patient with whom the cardiovascular invasive specialist 
and the cardiologist are jointly involved. 
§432. 
Functions and duties 
Cardiovascular 
invasive 
specialists 
may 
perform 
medical 
tasks and services according to a hospital' s written practice 
protocols 
developed 
for 
cardiovascular 
invasive 
specialists 
Page l-LR0057(l) 
pursuant to section 434. 
Within the 
registered 
cardiovascular 
invasive 
supervision of a cardiologist, may: 
practice protocols 
s~ecialist, 
under 
the 
the 
Baseline 
patien~t"----"a,..s...,s~e",-"",s_ .. 
s,",me....."n",,t"'-L. "_-,P,-e~r-"f,""o<-!r,-,m,-,----,b~a",s",-e~l~i,""n..."e"---.l:p,-,a"-,t,,-~,,,-· >.<e..,n,-"t 
assessment; 
2. 
Evaluate ~atien~~~p~~. Evaluate patient response to 
diagnostic or interventional maneuvers 
and medications during 
cardiac catheterization laboratory procedures; 
3. 
Provide----Pa..t.ie:Q~~r~and drq~inistration. 
Provide 
patient care and drug administration commonly used in the cardiac 
catheterization laboratory under the direction of a qualified 
physician; 
4. 
Act as first assistant. 
Act as first assistant during 
diagnostic and therapeutic catheterization procedures; 
5. 
Monitor 
and 
analyze 
hemodynamic 
data. 
Monitor 
and 
analyze hemodynamic data during all therapeutic and diagnostic 
catheterization procedures; and 
6. 
Assist in advanced cardiac life sqpport procedures. 
Assist in advanced cardiac life support procedures. 
§433. 
Supervision 
A cardiovascular invasive specialist may practice only under 
the supervision of a 
su~ervising cardiologist. 
A supervising 
cardiologist 
may 
not 
supervise 
more 
than 
registered 
cardiovascular invasive specialists at anyone time. 
§434. 
Protocols 
A cardiovascular invasive specialist shall practice within 
the written 
scope 
of 
a 
hospital's practice protocols. 
The 
hospital shall adopt these practice protocols, which must be 
signed 
by 
the 
supervising 
cardiologists 
and 
cardiovascular 
invasive specialists practicing at the hospital. 
Copies of the 
protocols must be on file at all practice sites. 
The protocols 
must include at a minimum the following: 
1. 
Names 
of 
su~ervising cardiologists. 
Names, 
license 
numbers and practice addresses of the supervising cardiologists; 
2. 
N~$ of cardiQya&~~ar invasive specialists. 
Names and 
practice addresses of the cardiovascular invasive specialists; 
3. 
Date of protocols. 
Date the protocols were developed 
and dates they were reviewed or amended; and 
4. 
Situation$ that reIDJ,ire direct evaluation or i.JI'Inediate 
referral. 
Situations 
that 
require 
direct 
evaluation 
by 
or 
immediate referral to a cardiologist. 
§435. 
Limitations 
A cardiovascular invasive specialist may not: 
1. 
Perform unapproved task. 
Perform a task that has not 
been listed and approved on the practice protocols pursuant to 
section 434 currently on file with the hospital; or 
• 
Prescr ibe 
drugs. 
Prescribe 
drugs, 
medications 
or 
devices of any kind. 
§436. 
Identification required 
A 
cardiovascular 
invasive 
specialist 
must 
be 
clearly 
identified to ensure that the cardiovascular invasive specialist 
is 
not 
mistaken 
for 
or 
misrepresented 
as 
a 
physician. 
A 
cardiovascular invasive specialist shall wear a clearly legible 
identification badge at least one 
inch by 
inches in size 
bearing the cardiovascular invasive specialist's name 
and the 
words "Registered Cardiovascular Invasive Specialist." 
Patients 
in hospitals utilizing cardiovascular invasive specialists must 
be 
informed if a 
cardiovascular invasive specialist will 
be 
involved in their cardiac care. 
§437. 
Rules 
The Department of Health and Human Services shall adopt 
rules necessary to ensure implementation of this chapter. 
Rules 
~ted pursuant to this section are routine technical rules 
pursuant to Title 5, chapter 375, subchapter 2-A. 
SUMMARY 
This bill enacts laws governing registered cardiovascular 
invasive specialists. 
The bill requires cardiovascular invasive 
specialists to work within written practice protocols and under 
the supervision of a cardiologist. 
The bill lists functions and 
duties that a cardiovascular invasive specialist may and may not 
perform. 
The 
bill 
requires 
that 
a 
cardiovascular 
invasive 
specialist wear an identification badge that clearly identifies 
the cardiovascular invasive specialist as such.