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 10.32.03.06 - Delegation Agreements - Approval
Universal Citation: MD Code Reg 10.32.03.06
Current through Register Vol. 51, No. 19, September 20, 2024
A. Review by the Board.
(1) The Board may review a delegation
agreement filed under Regulation .05 of this chapter.
(2) The Board may disapprove a delegation
agreement or delegation of an advanced duty based upon:
(a) Licensure or compliance issues with the
primary supervising physician or the physician assistant;
(b) Failure of the delegation agreement to
meet the requirements of:
(i) Health
Occupations Article, Title 15, Subtitle 3, Annotated Code of Maryland;
or
(ii) Regulation .05 of this
chapter; or
(c) Belief
that the physician assistant cannot safely perform the delegated
duty.
(3) If the Board
disapproves the delegation under §A(2) or C(1) of this regulation, the
primary supervising physician and physician assistant may appeal the decision
using the procedure described in Regulation .12 of this chapter.
(4) Upon notification by the Board that a
delegation agreement or an advanced duty has been denied, the physician
assistant shall immediately cease to practice under the agreement or perform
the advanced duty.
B. Core Duties.
(1) Upon receipt of a delegation
agreement at the Board of Physicians, a physician may delegate and a physician
assistant may perform delegated core medical acts.
(2) The Board shall notify the primary
supervising physician and the physician assistant of the Board's receipt of the
delegation agreement.
C. General Anesthesia and Neuroaxial Anesthesia.
(1) Regardless of setting or other factors, a
supervising physician may not delegate and a physician assistant may not
perform general anesthesia or neuroaxial anesthesia before the Board has
approved the delegation.
(2) The
Board shall provide written notification of approval or disapproval of the
delegation under §C(1) of this regulation.
(3) If the Board disapproves the delegation
under §C(1) of this regulation, the primary supervising physician and
physician assistant may appeal the decision using the procedure described in
Regulation .12 of this chapter.
D. Advanced Duties in a Special Facility.
(1) Upon receipt of a delegation agreement at
the Board of Physicians, a physician may delegate and a physician assistant may
perform delegated core medical acts and advanced duties that have been approved
through the special facility's privileging process.
(2) The Board shall notify the physician
assistant and the primary supervising physician that the Board received the
delegation agreement.
(3) If the
Board disapproves a delegation agreement under §D(1) of this regulation,
the primary supervising physician and physician assistant:
(a) Shall immediately cease to perform the
advanced duty; and
(b) May appeal
the decision using the procedure described in Regulation .12 of this
chapter.
E. Advanced Duties in Settings or Facilities Other than Special Facilities.
(1) Upon receipt of a delegation agreement
under which a physician assistant will perform one or more advanced duties in a
location other than a special facility, the Board shall forward the agreement
to the Committee and request that the Committee make a recommendation to the
Board.
(2) The Committee shall
present its recommendation to the Board for consideration.
(3) If the Board disapproves the delegation
under §E(1) of this regulation, the primary supervising physician and
physician assistant:
(a) Shall immediately
cease to perform the advanced duty; and
(b) May appeal the decision using the
procedure described in Regulation .12 of this chapter.
F. Temporary Practice Letter.
(1) Eligibility. A primary supervising
physician who has filed a delegation agreement under §E(1) of this
regulation for approval to perform one or more advanced duties in a setting
other than a special facility is eligible for a temporary practice letter if
the primary supervising physician and the physician assistant meet the
following criteria:
(a) The Board previously
approved the physician assistant to perform the advanced duty; and
(b) The Board previously approved the primary
supervising physician to supervise a physician assistant in the performance of
the advanced duty.
(2)
Process. An applicant who is requesting a temporary practice letter shall:
(a) Indicate on the delegation agreement that
a temporary practice letter is requested;
(b) Include the name of the physician, the
name of the physician assistant, and the date of the delegation agreement which
satisfies the requirements of §F(1)(a) of this regulation; and
(c) Include the name of the physician, the
name of the physician assistant, and the date of the delegation agreement which
satisfies the requirements of §F(1)(b) of this regulation.
(3) Approval. Issuance of a
temporary practice letter by Board staff entitles the physician assistant to
work in accordance with the proposed delegation agreement until:
(a) Notification that the proposed delegation
agreement has been denied by the Committee or the Board; or
(b) Notification that the proposed delegation
agreement has been approved by the Board.
G. To the extent practicable, the Board shall approve a delegation agreement or take other action with respect to a delegation agreement within 90 days after receiving a completed delegation agreement including any information from the physician assistant and primary supervising physician.
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