Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 4 › Subtitle 32 - BOARD OF PHYSICIANS › Chapter 10.32.03 - Delegation of Duties by a Licensed Physician - Physician Assistant › Section 10.32.03.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Accredited" means accredited by the
				  Accreditation Review Commission on Education for the Physician Assistant or its
				  successor.
(2) "Advanced duties"
				  means medical acts that require additional training beyond the basic physician
				  assistant education program required for licensure.
(3) "Alternate supervising physician" means
				  one or more physicians designated by the primary supervising physician to
				  provide supervision in accordance with the delegation agreement on file with
				  the Board.
(4) "Ambulatory surgical
				  facility" means a facility:
(a) Accredited by:
(i) The American Association for
				  Accreditation of Ambulatory Surgical Facilities;
(ii) The Accreditation Association for
				  Ambulatory Health Care; or
(iii)
				  The Joint Commission on the Accreditation of Health Care Organizations;
				  or
(b) Certified to
				  participate in the Medicare Program, as enacted by Title XVIII of the Social
				  Security Act.
(5)
				  "Applicant" means an individual who applies to the State Board of Physicians
				  for licensure as a physician assistant, or for approval of a delegation
				  agreement.
(6) "Board" means the
				  State Board of Physicians.
(7)
				  "Category I hours" means hours of continuing medical education given in
				  formally organized programs pertinent to the practice of physician assistant
				  duties, accredited by the American Academy of Physician Assistants, the
				  American Academy of Family Physicians, the Accreditation Council on Continuing
				  Medical Education, the Medical and Chirurgical Faculty of Maryland, or
				  equivalent certifying bodies.
(8)
				  "Committee" means the Physician Assistant Advisory Committee.
(9) "Controlled dangerous substances" means
				  any drug listed as such in Criminal Law Article, Annotated Code of
				  Maryland.
(10) "Core duties" means
				  medical acts that are included in the standard curricula of accredited
				  physician assistant education programs.
(11) "Correctional facility" means a State or
				  local correctional facility.
(12)
				  "Delegation agreement" means a document that is executed by a supervising
				  physician and a physician assistant containing the requirements of Health
				  Occupation Article, §15-302, Annotated Code of Maryland, and this
				  chapter.
(13) "Detention center"
				  means a State or local detention center.
(14) "Dispense" means to dispense starter
				  dosages or drug samples.
(15) "Drug
				  sample" means a unit of a prescription drug that is intended to promote the
				  sale of the drug and is not intended for sale.
(16) "English-speaking professional school"
				  means a school:
(a) That offers a degree
				  after graduation from high school;
(b) That is in the United States, its
				  territories and possessions, or the British Commonwealth; and
(c) Where all academic and clinical courses
				  are taught in English.
(17) "Hospital" means:
(a) A hospital as defined under
				  Health-General Article, §19-301(g), Annotated Code of Maryland;
(b) A comprehensive care facility that:
(i) Meets the requirements of a
				  hospital-based skilled nursing facility under
				  42 U.S.C. §
														1395i-3; and
(ii) Offers acute care in the same building;
				  and
(c) An emergency
				  room that is physically connected to a hospital or a freestanding medical
				  facility that is licensed under Health-General Article, Title 19, Subtitle 3A,
				  Annotated Code of Maryland.
(18) "Joint Commission" means the
				  organization formerly known as the Joint Commission on Accreditation of Health
				  Care Organizations.
(19) "NCCPA"
				  means the National Commission on Certification of Physician Assistants,
				  Inc.
(20) "On-site" means the
				  physical presence of the supervising physician on the premises of the facility
				  where the physician assistant performs delegated medical acts.
(21) "Physician" means an individual who is
				  licensed by the Board to practice medicine.
(22) "Physician assistant" means an
				  individual who is licensed to practice medicine with physician
				  supervision.
(23) "Practice as a
				  physician assistant" means the performance of medical acts that are:
(a) Delegated by a supervising physician to a
				  physician assistant;
(b) Within the
				  supervising physician's scope of practice; and
(c) Appropriate to the physician assistant's
				  education, training, and experience.
(24) "Prescriptive authority" means the
				  authority delegated by a supervising physician to a physician assistant to:
(a) Prescribe and administer:
(i) Controlled dangerous
				  substances;
(ii) Prescription
				  drugs; and
(iii) Medical
				  devices;
(b) Give
				  verbal, written, or electronic orders for medications; and
(c) Dispense starter dosages or drug
				  samples.
(25) "Primary
				  supervising physician" means a physician who:
(a) Completes a delegation agreement that
				  meets the requirements under Health Occupations Article, §§
												15-301(d)
				  and (e) and 15-302, Annotated Code of Maryland;
(b) Acts as the physician responsible to
				  ensure that a physician assistant practices medicine in accordance with Health
				  Occupations Article, Title 15, Annotated Code of Maryland and this
				  chapter;
(c) Ensures that a
				  physician assistant practices within the scope of practice of the primary
				  supervising physician or a designated alternate supervising physician, as
				  specified in Regulation .07A(4) of this chapter; and
(d) Ensures that a list of alternate
				  supervising physicians is maintained at the practice setting, as specified in
				  Regulation .07A(3) of this chapter.
(26) "Privileging process" means the review
				  process used by a special facility to determine:
(a) Whether a physician assistant may
				  practice; and
(b) Which advanced
				  duties the physician assistant may perform in a special facility.
(27) "Public health facility"
				  means a site where clinical public health services are rendered under the
				  auspices of the Department, a local health department in a county, or the
				  Baltimore City Health Department.
(28) "Special facility" means a hospital or
				  ambulatory surgical facility which meets all of the following criteria:
(a) The facility has reviewed the credentials
				  of the supervising physician as a condition of employment, as an independent
				  contractor, or as a member of the medical staff;
(b) The facility has reviewed the credentials
				  of the physician assistant as a condition of employment, as an independent
				  contractor, or as a member of the medical staff; and
(c) The governing body of the facility has
				  reviewed and approved the physician assistant's performing of the advanced duty
				  in accord with a privileging process.
(29) "Starter dosage" means an amount of a
				  drug sufficient to begin therapy:
(a) Of short
				  duration of 72 hours or less; or
(b) Before obtaining a larger quantity of the
				  drug to complete therapy.
(30) Supervision.
(a) "Supervision" means the responsibility of
				  the physician to exercise on-site supervision or provide immediately available
				  direction for physician assistants performing delegated medical acts.
(b) "Supervision" includes:
(i) Oversight of the physician assistant and
				  acceptance of direct responsibility for the patient services and care rendered
				  by the physician assistant;
(ii)
				  Continuous availability to the physician assistant either in person, through
				  written instructions, or by electronic means; and
(iii) Designation of one or more alternate
				  supervising physicians.
(31) "Training" means the education or
				  on-the-job training a physician assistant:
(a)
				  Receives after initial licensure as a physician assistant; and
(b) Requires to perform advanced
				  duties.