Sec. 10.32.03.02. Definitions

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.