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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
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*hb1047*
HOUSE BILL 1047
J2 6lr2415
CF SB 915
By: Delegate Hutchinson
Introduced and read first time: February 9, 2026
Assigned to: Health
Committee Report: Favorable
House action: Adopted
Read second time: March 1, 2026
CHAPTER ______
AN ACT concerning 1
State Board of Physicians – Delegation of Duties – Alterations 2
FOR the purpose of requiring an individual to be registered with the State Board of 3
Physicians to perform limited X–ray machine operations in the State ; establishing 4
certain disciplinary procedures for limited X–ray machine operators; recodifying 5
certain provisions of law related to registered cardiovascular invasive specialists and 6
supervised medical graduates; authorizing a physician assistant to perform X –ray 7
duties under certain circumstances; and generally relating to the delegation of duties 8
by physicians and physician assistants. 9
BY repealing and reenacting, with amendments, 10
Article – Health Occupations 11
Section 14–206(e)(2)(viii), 14–306, 14–602, and 15–302.1(c) 12
Annotated Code of Maryland 13
(2021 Replacement Volume and 2025 Supplement) 14
BY repealing and reenacting, without amendments, 15
Article – Health Occupations 16
Section 14–206(e)(2)(ix) 17
Annotated Code of Maryland 18
(2021 Replacement Volume and 2025 Supplement) 19
BY adding to 20
Article – Health Occupations 21
Section 14–206(e)(2)(x), 14–306.1, 14–306.2, 14–306.3, and 14–306.4 22
2 HOUSE BILL 1047
Annotated Code of Maryland 1
(2021 Replacement Volume and 2025 Supplement) 2
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 3
That the Laws of Maryland read as follows: 4
Article – Health Occupations 5
14–206. 6
(e) A disciplinary panel may issue a cease and desist order or obtain injunctive 7
relief against an individual for: 8
(2) Representing to the public, by title, description of services, methods, 9
procedures, or otherwise, that the individual is authorized to practice: 10
(viii) Genetic counseling in this State, in violation of § 14 –5G–24 of 11
this title; [or] 12
(ix) As a physician assistant in this State, in violation of § 15–402 of 13
this article; or 14
(X) LIMITED X–RAY MACHINE OPERATION IN THE STATE, IN 15
VIOLATION OF § 14–306.3 OF THIS TITLE; OR 16
14–306. 17
(a) [Except as provided in subsections (e) and (f) of this section, to] TO the extent 18
[permitted] AUTHORIZED by the rules, regulations, and orders of the Board, an individual 19
to whom duties are delegated by a licensed physician or physician assistant may perform 20
those duties without a license as provided in this section. 21
(b) The individuals to whom duties may be delegated under this section include 22
any individual authorized to practice any other health occupation regulated under this 23
article or § 13–516 of the Education Article. 24
(c) (1) The Board shall adopt rules and regulations to delineate the scope of 25
this section. 26
(2) Before [it] THE BOARD adopts any rule or regulation under this 27
section, the Board shall invite and consider proposals from any individual or health group 28
that could be affected by the rule or regulation. 29
(d) (1) If a duty that is to be delegated under this section is a part of the 30
practice of a health occupation that is regulated under this article by another board, any 31
HOUSE BILL 1047 3
rule or regulation concerning that duty shall be adopted jointly by the Board of Physicians 1
and the board that regulates the other health occupation. 2
(2) If the two boards cannot agree on a proposed rule or regulation, the 3
proposal shall be submitted to the Secretary for a final decision. 4
[(e) Except as otherwise provided in this section and in accordance with 5
regulations adopted by the Board, an individual may perform X –ray duties without a 6
license only if the duties: 7
(1) Do not include: 8
(i) Computerized or noncomputerized tomography; 9
(ii) Fluoroscopy; 10
(iii) Invasive radiology; 11
(iv) Mammography; 12
(v) Nuclear medicine; 13
(vi) Radiation therapy; or 14
(vii) Xerography; 15
(2) Are limited to X–ray procedures of the: 16
(i) Chest; 17
(ii) Spine, including the: 18
1. Cervical spine; 19
2. Lumbar spine; 20
3. Sacroiliac joints; 21
4. Sacrum and coccyx; and 22
5. Thoracic spine; 23
(iii) Lower extremities, including: 24
1. Toes; 25
2. The foot; 26
4 HOUSE BILL 1047
3. The ankle; 1
4. The calcaneus; 2
5. The tibia and fibula; 3
6. The knee and patella; and 4
7. The femur; and 5
(iv) Upper extremities, including: 6
1. Fingers; 7
2. The hand; 8
3. The wrist; 9
4. The forearm; 10
5. The elbow; 11
6. The humerus; 12
7. The shoulder; 13
8. The clavicle; 14
9. Acromioclavicular joints; and 15
10. The scapula; and 16
(3) Are performed: 17
(i) In the physician’s office under the supervision of a licensed 18
physician or radiologic technologist who is on–site or able to provide immediately available 19
direction; and 20
(ii) 1. By an individual who has: 21
A. Attested to the completion of at least 6 months of clinical 22
care experience; and 23
B. Completed a limited scope X –ray educational program 24
consisting of at least 115 hours of didactic training delivered by a radiologic technologist 25
certified by the American Registry of Radiologic Technologists providing instruction in 26
HOUSE BILL 1047 5
radiographic anatomy, procedures, and pathology, digital image acquisition and display, 1
fundamentals, ethics, and laws of health care, human anatomy and physiology, image 2
production and analysis, imaging equipment and radiation production, medical 3
terminology, and patient care; 4
C. Completed at least 480 hours of clinical training and 5
successfully completed a minimum of five competencies in each body part listed in item (2) 6
of this subsection under the direct supervision of a radiologic technologist certified by the 7
American Registry of Radiologic Technologists; 8
D. Achieved a passing score, as determined by the Boa rd, on 9
the American Registry of Radiologic Technologists examination for limited scope of practice 10
in radiography or an alternative examination approved by the Board; and 11
E. Registered with the Board attesting to the completion of 12
the requirements of this item and the completion of at least 24 hours of approved continuing 13
education credits earned during the 2–year period immediately following the date of initial 14
registration and every 2 years thereafter; or 15
2. By a licensed physician assistant who has completed a 16
course that includes anterior –posterior and lateral radiographic studies of extremities on 17
at least 20 separate patients under the direct supervision of the delegating physician or 18
radiologist using a mini C –arm or similar low –level radiat ion machine to perform 19
nonfluoroscopic X–ray procedures, if the duties: 20
A. Include only the X–ray procedures described in paragraph 21
(2)(iii) of this subsection; and 22
B. Are performed pursuant to a Board –approved delegation 23
agreement that includes a request to perform advanced duties under § 15–302(c)(2) of this 24
article. 25
(f) (1) In accordance with regulations adopted by the Board, a licensed 26
physician may delegate duties to a registered cardiovascular invasive specialist assisting 27
in the physician’s performance of fluoroscopy if: 28
(i) The delegated duties are limited to a cardiac catheterization 29
procedure performed in a hospital cardiac catheterization laboratory; 30
(ii) The physician is physically present and personally directs each 31
act performed by the registered cardiovascular invasive specialist; 32
(iii) The registered cardiovascular invasive specialist has completed 33
the training and education and has the experience required by regulations adopted by the 34
Board; and 35
6 HOUSE BILL 1047
(iv) The hospital in which the cardiac catheterization laboratory is 1
located has verified and documented that the registered cardiovascular invasive specialist 2
has completed the training and education and has the experience required by regulations 3
adopted by the Board. 4
(2) The hospital in which the cardiac catheterization laboratory is located 5
and the physician delegating duties to a registered cardiovascular invasive specialist under 6
this subsection are responsible for ensuring that all requirements of this subsectio n are 7
met for each procedure. 8
(3) A disciplinary panel may impose a civil penalty of up to $5,000 for each 9
instance of a hospital’s failure to comply with the requirements of this subsection. 10
(g) (1) (i) In this subsection the following words have the meanings 11
indicated. 12
(ii) “Direct supervision” means oversight exercised by a delegating 13
physician who is: 14
1. Personally treating the patient; 15
2. In the same medical office as the patient and the 16
supervised medical graduate; and 17
3. Immediately available to provide assistance and guidance 18
to the supervised medical graduate for the duration of the completion of a delegated duty. 19
(iii) “Supervised medical graduate” means an individual who: 20
1. Has a degree of: 21
A. Doctor of medicine from a medical school that is accredited 22
by an accrediting organization that the Board recognizes in its regulations; or 23
B. Doctor of osteopathy from a school of osteopathy in the 24
United States, its territories or possessions, Puerto Rico, or Canada that has standards for 25
graduation equivalent to those established by the American Osteopathic Association; and 26
2. Has passed parts 1 and 2 of: 27
A. The United States Medical Licensing Examination; or 28
B. The Comprehensive Osteopathic Medical Licensing 29
Examination of the United States. 30
HOUSE BILL 1047 7
(2) Subject to paragraph (3) of this subsection and in accordance with 1
regulations adopted by the Board, a supervised medical graduate may perform delegated 2
duties under direct supervision. 3
(3) An individual may not practice as a supervised medical graduate for a 4
period of more than 2 years. 5
(4) For the purposes of this subsection, a delegating physician is not 6
required to be in the presence of a patient and a supervised medical graduate during the 7
completion of a delegated duty. 8
(h) In accordance with regulations adopted by the Board, a physician’s office that 9
employs an individual authorized to perform X –ray duties without a license under 10
subsection (e) of this section is responsible for ensuring that all requirements of subsection 11
(e) of this section are met for each X–ray examination performed. 12
(i) If an unlicensed individual performs X –ray duties without meeting the 13
requirements of subsection (e) of this section, the Board may impose a civil penal ty of up 14
to: 15
(1) $5,000 for each violation on the physician’s office where the violation 16
occurred; and 17
(2) $1,000 for each violation on the individual who committed the 18
violation.] 19
14–306.1. 20
(A) IN ACCORDANCE WITH RE GULATIONS ADOPTED BY THE BOARD, A 21
LICENSED PHYSICIAN MAY DELEGATE DUTIES TO A REGISTERED CARDIOVASCULAR 22
INVASIVE SPECIALIST ASSISTING IN THE PHY SICIAN’S PERFORMANCE OF 23
FLUOROSCOPY IF: 24
(1) THE DELEGATED DUTIES ARE LIMITED TO A CAR DIAC 25
CATHETERIZATION PROC EDURE PERFORMED IN A HOSPITAL CARDIAC 26
CATHETERIZATION LABORATORY; 27
(2) THE PHYSICIAN IS PHYS ICALLY PRESENT AND P ERSONALLY 28
DIRECTS EACH ACT PERFORMED BY THE REGISTERED CARDIOVASCULAR INVASIVE 29
SPECIALIST; 30
(3) THE REGISTERED CARDIO VASCULAR INVASIVE SP ECIALIST HAS 31
COMPLETED THE TRAINING AND EDUCATION AND HAS THE EXPERIENCE REQUIRED 32
BY REGULATIONS ADOPTED BY THE BOARD; AND 33
8 HOUSE BILL 1047
(4) THE HOSPITAL IN WHICH THE CARDIAC CATHETER IZATION 1
LABORATORY IS LOCATED HAS VERIFIED AND DOCUMENTED THAT THE REGISTERED 2
CARDIOVASCULAR INVAS IVE SPECIALIS T HAS COMPLETED THE TRAINING AND 3
EDUCATION AND HAS TH E EXPERIENCE REQUIRE D BY REGULATIONS ADO PTED BY 4
THE BOARD. 5
(B) THE HOSPITAL IN WHICH THE CARDIAC CATHETER IZATION 6
LABORATORY IS LOCATE D AND THE PHYSICIAN DELEGATING DUTIES TO A 7
REGISTERED CARDIOVASCULAR INVASIVE SPECIALIST UNDER THIS SECTION ARE 8
RESPONSIBLE FOR ENSURING THAT ALL REQUIREMENTS OF THIS SECTION ARE MET 9
FOR EACH PROCEDURE. 10
(C) A DISCIPLINARY PANEL MAY IMPOSE A CIVIL PENALTY OF UP TO $5,000 11
FOR EACH INSTANCE OF A HOSPITAL ’S FAILURE TO COMPLY WITH THE 12
REQUIREMENTS OF THIS SECTION. 13
14–306.2. 14
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS 15
INDICATED. 16
(2) “ON–SITE SUPERVISION” MEANS OVERSIGHT EXER CISED BY A 17
DELEGATING PHYSICIAN WHO IS: 18
(I) PERSONALLY TREATING THE PATIENT; 19
(II) IN THE SAME MEDICAL O FFICE AS THE PATIENT AND THE 20
SUPERVISED MEDICAL GRADUATE; AND 21
(III) IMMEDIATELY AVAILABLE TO PROVIDE ASSISTANC E AND 22
GUIDANCE TO THE SUPE RVISED MEDICAL GRADU ATE FOR THE DURATION OF THE 23
COMPLETION OF A DELEGATED DUTY. 24
(3) “SUPERVISED MEDICAL GRADUATE” MEANS AN INDIVIDUAL WHO: 25
(I) HAS A DEGREE OF: 26
1. DOCTOR OF MEDICINE FR OM A MEDICAL SCHOOL 27
THAT IS ACCREDITED B Y AN ACCREDITING ORG ANIZATION THAT THE BOARD 28
RECOGNIZES IN ITS REGULATIONS; OR 29
2. DOCTOR OF OSTEOPATHY FROM A SC HOOL OF 30
OSTEOPATHY IN THE UNITED STATES, ITS TERRITORIES OR POSSESSIONS, PUERTO 31
HOUSE BILL 1047 9
RICO, OR CANADA THAT HAS STANDARDS FOR GRADUATION EQUIVALENT TO THOSE 1
ESTABLISHED BY THE AMERICAN OSTEOPATHIC ASSOCIATION; AND 2
(II) HAS PASSED PARTS 1 AND 2 OF: 3
1. THE UNITED STATES MEDICAL LICENSING 4
EXAMINATION; OR 5
2. THE COMPREHENSIVE OSTEOPATHIC MEDICAL 6
LICENSING EXAMINATION OF THE UNITED STATES. 7
(B) SUBJECT TO SUBSECTION (C) OF THIS SECTION AND IN ACCORDANCE 8
WITH REGULATIONS ADOPTED BY THE BOARD, A SUPERVISED MEDICAL GRADUATE 9
MAY PERFORM DELEGATED DUTIES UNDER ON–SITE SUPERVISION. 10
(C) AN INDIVIDUAL MAY NOT PRACTICE AS A SUPERV ISED MEDICAL 11
GRADUATE FOR A PERIOD OF MORE THAN 2 YEARS. 12
(D) FOR THE PURPOSES OF T HIS SECTION, A DELEGATING PHYSICI AN IS 13
NOT REQUIRED TO BE IN THE PRESENCE OF A PATIENT AND A SUPERVISED MEDICAL 14
GRADUATE DURING THE COMPLETION OF A DELEGATED DUTY. 15
14–306.3. 16
(A) IN ACCORDANCE WITH RE GULATIONS ADOPTED BY THE BOARD, AN 17
INDIVIDUAL MAY PERFO RM X–RAY DUTIES AS A LIMITED X–RAY MACHINE 18
OPERATOR REGISTERED WITH THE BOARD UNDER THIS SECTION WITHOUT A 19
LICENSE IF THE X–RAY PROCEDURES: 20
(1) DO NOT INCLUDE: 21
(I) COMPUTERIZED OR NONCOMPUTERIZED TOMOGRAPHY; 22
(II) FLUOROSCOPY; 23
(III) INVASIVE RADIOLOGY; 24
(IV) MAMMOGRAPHY; 25
(V) NUCLEAR MEDICINE; 26
(VI) RADIATION THERAPY; OR 27
10 HOUSE BILL 1047
(VII) XEROGRAPHY; 1
(2) ARE LIMITED TO X–RAY PROCEDURES OF: 2
(I) THE CHEST; 3
(II) THE SPINE, INCLUDING: 4
1. THE CERVICAL SPINE; 5
2. THE LUMBAR SPINE; 6
3. THE SACROILIAC JOINTS; 7
4. THE SACRUM AND COCCYX; AND 8
5. THE THORACIC SPINE; 9
(III) LOWER EXTREMITIES, INCLUDING: 10
1. TOES; 11
2. THE FOOT; 12
3. THE ANKLE; 13
4. THE CALCANEUS; 14
5. THE TIBIA AND FIBULA; 15
6. THE KNEE AND PATELLA; AND 16
7. THE FEMUR; AND 17
(IV) UPPER EXTREMITIES, INCLUDING: 18
1. FINGERS; 19
2. THE HAND; 20
3. THE WRIST; 21
4. THE FOREARM; 22
HOUSE BILL 1047 11
5. THE ELBOW; 1
6. THE HUMERUS; 2
7. THE SHOULDER; 3
8. THE CLAVICLE; 4
9. ACROMIOCLAVICULAR JOINTS; AND 5
10. THE SCAPULA; AND 6
(3) ARE PERFORMED UNDER THE SUPERVISIO N OF A LICENSED 7
PHYSICIAN OR RADIOGRAPHER WHO IS ON–SITE OR ABLE TO PROVIDE IMMEDIATELY 8
AVAILABLE DIRECTION; AND 9
(4) ARE PERFORMED BY AN INDIVIDUAL WHO HAS REGISTERED WITH 10
THE BOARD AND ATTESTS: 11
(I) TO THE SUCCESSFUL COMPLETION OF AT LEAST 6 MONTHS 12
OF CLINICAL CARE EXPERIENCE; 13
(II) TO THE SUCCESSFUL COMPLETION OF: 14
1. A LIMITED X–RAY EDUCATIONAL PROGRAM; OR 15
2. THE FIRST YE AR OF AN ACCREDITED RADIOLOGIC 16
TECHNOLOGIST PROGRAM IN GOOD STANDING WITH THE BOARD; 17
(III) TO THE SUCCESSFUL COMPLETION OF AT LEAST 115 HOURS 18
OF DIDACTIC TRAINING DELIVERED BY A RADIO LOGIC TECHNOLOGIST C ERTIFIED 19
BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS PROVIDI NG 20
INSTRUCTION IN RADIO GRAPHIC ANATOMY , PROCEDURES, AND PATHOLOGY , 21
DIGITAL IMAGE ACQUISITION AND DISPLAY, FUNDAMENTALS, ETHICS, AND LAWS OF 22
HEALTH CARE , HUMAN ANATOMY AND PH YSIOLOGY, IMAGE PRODUCTION AND 23
ANALYSIS, IMAGING EQUIPMENT AN D RADIATION PRODUCTION , MEDICAL 24
TERMINOLOGY, AND PATIENT CARE; 25
(IV) TO THE SUCCESSFUL COMPLETION OF AT LEAST 480 HOURS 26
OF CLINICAL TRAINING; 27
12 HOUSE BILL 1047
(V) TO THE SUCCESSFUL COMPLETION OF A MINIMUM OF FIVE 1
COMPETENCIES IN EACH BODY PART LISTED UNDER SUBSECTION (A)(2) OF THIS 2
SECTION UNDER THE DIRECT SUP ERVISION OF A RADIOL OGIC TECHNOLOGIST 3
CERTIFIED BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS; AND 4
(VI) TO THE SUCCESSFUL ACH IEVEMENT OF A PASSING SCORE, 5
AS DETERMINED BY THE BOARD, ON THE AMERICAN REGISTRY OF RADIOLOGIC 6
TECHNOLOGISTS EXAMINA TION FOR LIMITED SCO PE OF PRACTICE IN 7
RADIOGRAPHY OR AN ALTERNATIVE EXAMINATION APPROVED BY THE BOARD. 8
(B) IF THE APPLICANT COMP LETED THE FIRST YEAR OF AN ACCREDITED 9
RADIOLOGIC TECHNOLOGIST EDUCATIONAL PROG RAM, THE PROGRAM DIRECTOR 10
OF THE EDUCATIONAL P ROGRAM SHALL PROVIDE AN ATTESTATION DIREC TLY TO 11
THE BOARD STATING THAT TH E APPLICANT MEETS OR EXCEEDS THE 12
REQUIREMENTS OF SUBSECTION (A)(4)(I), (II)2, (III), (IV), (V), AND (VI) OF THIS 13
SECTION. 14
(C) AN INDIVIDUAL SEEKING REGISTRATION UNDER THIS SECTION SHALL: 15
(1) APPLY FOR REGISTRATION ON A FORM SUPPLIED BY THE BOARD; 16
(2) PAY THE REGISTRATION FEE ESTABLISHED BY THE BOARD; AND 17
(3) COMPLETE ANY OTHER RE QUIREMENTS ESTABLISH ED BY THE 18
BOARD. 19
(D) IF AN INDIVIDUAL WAS DENIED A LICENSE BY THE BOARD, THE 20
INDIVIDUAL IS NOT ELIGIBLE FOR REGISTRATION UNDER THIS SECTION. 21
(E) AN INDIVIDUAL REGISTERED UNDER THIS SECTION S HALL COMPLETE 22
AT LEAST 24 HOURS OF APPROVED CO NTINUING EDUCATION C REDITS EARNED 23
DURING THE 2–YEAR PERIOD IMMEDIATELY PRECEDING THE EXPIRA TION OF A 24
REGISTRATION. 25
(F) (1) THE TERM OF A REGISTRATION MAY NOT EXCEED 3 YEARS. 26
(2) A REGISTRATION SHALL EXPIRE ON A DATE ESTABLISHED BY THE 27
BOARD. 28
(3) TO RENEW A REGISTRATION, THE REGISTRANT MUST: 29
(I) APPLY FOR RENEWAL ON A FORM SUPPLIED BY THE BOARD; 30
HOUSE BILL 1047 13
(II) PAY THE RENEWAL FEE ESTABLISHED BY THE BOARD; AND 1
(III) COMPLETE ANY OTHER RE QUIREMENTS ESTABLISHED BY 2
THE BOARD. 3
(G) AN APPLICANT FOR REGI STRATION SHALL COMPL ETE A CRIMINAL 4
HISTORY RECORDS CHECK IN ACCORDANCE WITH § 14–308.1 OF THIS SUBTITLE. 5
(H) (1) THE BOARD SHALL SET REASONABLE FEES FOR THE ISSUANCE 6
AND RENEWAL OF REGISTRATIONS AND OTHER SERVICES PROVIDED. 7
(2) THE FEES CHARGED SHALL BE SET SO AS TO PRODUCE FUNDS TO 8
APPROXIMATE THE COST OF MAINTAINING THE R EGISTRATION PROGRAM AND 9
OTHER SERVICES PROVIDED TO REGISTRANTS UNDER THIS SECTION. 10
(I) IN ACCORDANCE WITH RE GULATIONS ADOPTED BY THE BOARD, A 11
PHYSICIAN’S OFFICE THAT EMPLOY S AN INDIVIDUAL AUTH ORIZED TO PERFORM 12
X–RAY DUTIES WITHOUT A LICENSE UNDER THIS S ECTION IS RESPONSIBL E FOR 13
ENSURING THAT ALL REQUIREMENTS OF THIS SECTION ARE MET FOR EACH X–RAY 14
EXAMINATION PERFORMED. 15
(J) IF AN UNREGISTERED INDIVIDUAL PERFORMS X–RAY DUTIES WITHOUT 16
MEETING THE REQUIREMENTS OF THIS SECTION, THE BOARD MAY IMPOSE A CIVIL 17
PENALTY OF UP TO: 18
(1) $5,000 FOR EACH VIOLATION ON THE PHYSICIAN’S OFFICE WHERE 19
THE VIOLATION OCCURRED; AND 20
(2) $1,000 FOR EACH VIOLATION O N THE INDIVIDUAL WHO 21
COMMITTED THE VIOLATION. 22
14–306.4. 23
(A) SUBJECT TO THE HEARIN G PROVISIONS OF § 14–405 OF THIS TITLE, A 24
DISCIPLINARY PANEL, ON THE AFFIRMATIVE VOTE OF A MAJORITY OF THE QUORUM 25
OF THE DISCIPLINARY PANEL, MAY DENY A REGISTRATION TO PRACTICE AS A 26
LIMITED X–RAY MACHINE OPERATOR TO ANY APPLICANT, REPRIMAND ANY LIMITED 27
X–RAY MACHINE OPERATOR REGISTRANT, PLACE ANY REGISTRANT ON PROBATION, 28
OR SUSPEND OR REVOKE A REGISTRATION, IF THE APPLICANT OR REGISTRANT: 29
(1) FRAUDULENTLY OR DECEP TIVELY OBTAINS OR AT TEMPTS TO 30
OBTAIN A REGISTRATION FOR THE APPLICANT, REGISTRANT, OR FOR ANOTHER; 31
14 HOUSE BILL 1047
(2) FRAUDULENTLY OR DECEPTIVELY USES A REGISTRATION; 1
(3) IS GUILTY OF: 2
(I) IMMORAL CONDUCT IN TH E PRACTICE OF LIMITED X–RAY 3
MACHINE OPERATION; OR 4
(II) UNPROFESSIONAL CONDUCT IN THE PRACTICE OF LIMITED 5
X–RAY MACHINE OPERATION; 6
(4) IS: 7
(I) PROFESSIONALLY INCOMPETENT; 8
(II) PHYSICALLY INCOMPETENT; OR 9
(III) MENTALLY INCOMPETENT; 10
(5) ABANDONS A PATIENT; 11
(6) IS HABITUALLY INTOXICATED; 12
(7) IS ADDICTED TO OR HABITUALLY ABUSES ANY NARCOTIC OR 13
CONTROLLED DANGEROUS SUBSTANCE AS DEFINED IN § 5–101 OF THE CRIMINAL 14
LAW ARTICLE; 15
(8) PROVIDES PROFESSIONAL SERVICES WHILE: 16
(I) UNDER THE INFLUENCE OF ALCOHOL; OR 17
(II) USING ANY NARCOTIC OR CONTROLLED DANGERO US 18
SUBSTANCE AS DEFINED IN § 5–101 OF THE CRIMINAL LAW ARTICLE OR ANY OTHER 19
DRUG THAT IS IN EXCESS OF THERAPEUTIC AMOUNTS OR WITHOUT VALID MEDICAL 20
INDICATION; 21
(9) PROMOTES THE SALE OF SERVICES, DRUGS, DEVICES, 22
APPLIANCES, OR GOODS TO A PATIEN T SO AS TO EXPLOIT THE PATIENT FOR 23
FINANCIAL GAIN; 24
(10) WILLFULLY MAKES OR FILES A FALSE REPORT OR RECORD IN THE 25
PRACTICE OF LIMITED X–RAY MACHINE OPERATION; 26
HOUSE BILL 1047 15
(11) WILLFULLY FAILS TO FILE OR RECORD ANY REPORT AS REQUIRED 1
UNDER LAW, WILLFULLY IMPEDES OR OBSTRUCTS THE FILING OR RECORDING OF A 2
REPORT, OR INDUCES ANOTHER TO FAIL TO FILE OR RECORD A REPORT; 3
(12) BREACHES PATIENT CONFIDENTIALITY; 4
(13) PAYS OR AGREES TO PAY ANY SUM OR PROVIDE A NY FORM OF 5
REMUNERATION OR MATE RIAL BENEFIT TO ANY PERSON FOR BRINGING OR 6
REFERRING A PATIENT OR ACCEPTS OR AGREES TO ACCEPT ANY SUM OR ANY FORM 7
OF REMUNERATION OR MATERIAL BENEFIT FROM AN INDIVIDUAL FOR BRINGING OR 8
REFERRING A PATIENT; 9
(14) WILLFULLY MAKES A MIS REPRESENTATION WHILE PRACTICING 10
LIMITED X–RAY MACHINE OPERATION; 11
(15) WILLFULLY PRACTICES LIMITED X–RAY MACHINE OPERATIO N 12
WITH AN UNAUTHORIZED INDIVIDUAL OR AIDS A N UNAUTHORIZED INDIV IDUAL IN 13
THE PRACTICE OF LIMITED X–RAY MACHINE OPERATION; 14
(16) OFFERS, UNDERTAKES, OR AGREES TO CURE OR TREAT DISEASE 15
BY A SECRET METHOD, TREATMENT, OR MEDICINE; 16
(17) IS DISCIPLINED BY A LICENSING OR DISCIPLINARY AUTHORITY OR 17
IS CONVICTED OR DISC IPLINED BY A COURT O F ANY STATE OR COUNT RY OR IS 18
DISCIPLINED BY ANY B RANCH OF THE UNIFORM ED SERVICES OR THE U.S. 19
DEPARTMENT OF VETERANS AFFAIRS FOR AN ACT THAT WOULD BE GROUNDS FOR 20
DISCIPLINARY ACTION UNDER THE BOARD’S DISCIPLINARY STATUTES; 21
(18) FAILS TO MEET APPROPRIATE STANDARDS FOR THE DELIVERY OF 22
QUALITY LIMITED X–RAY MACHINE OPERATIO N CARE PERFORMED IN AN Y 23
OUTPATIENT SURGICAL FACILITY, OFFICE, HOSPITAL OR RELATED INSTITUTION, OR 24
ANY OTHER LOCATION IN THIS STATE; 25
(19) WILLFULLY SUBMITS FALSE STATEMENTS TO COLLECT FEES FOR 26
WHICH SERVICES ARE NOT PROVIDED; 27
(20) (I) HAS BEEN SUBJECT TO I NVESTIGATION OR DISC IPLINARY 28
ACTION BY A DISCIPLINARY AUTHORITY OR BY A COURT OF ANY STATE OR COUNTRY 29
FOR AN ACT THAT WOUL D BE GROUNDS FOR DIS CIPLINARY ACTION UND ER THE 30
BOARD’S DISCIPLINARY STATUTES; AND 31
(II) HAS: 32
16 HOUSE BILL 1047
1. SURRENDERED THE LICEN SE, REGISTRATION, 1
CERTIFICATION, OR PERMIT ISSUED BY THE STATE OR COUNTRY; OR 2
2. ALLOWED THE LICENSE , REGISTRATION, 3
CERTIFICATION, OR PERMIT ISSUED BY THE STATE OR COUNTRY TO E XPIRE OR 4
LAPSE; 5
(21) WILLFULLY FAILS TO RE PORT SUSPECTED CHILD ABUSE IN 6
VIOLATION OF § 5–704 OF THE FAMILY LAW ARTICLE; 7
(22) SELLS, PRESCRIBES, GIVES AWAY, OR ADMINISTERS DRUGS FOR 8
ILLEGAL OR ILLEGITIMATE MEDICAL PURPOSES; 9
(23) PRACTICES OR ATTEMPTS TO PRACTICE BEYOND T HE 10
AUTHORIZED SCOPE OF PRACTICE; 11
(24) REFUSES, WITHHOLDS FROM , DENIES, OR DISCRIMINATES 12
AGAINST AN INDIVIDUA L WITH REGARD TO THE PROVISION OF PROFESS IONAL 13
SERVICES FOR WHICH T HE LICENSEE IS LICEN SED AND QUALIFIED TO RENDER 14
BECAUSE THE INDIVIDUAL IS HIV POSITIVE; 15
(25) PRACTICES OR ATTEMPTS TO PRACTICE A LIMITED X–RAY 16
MACHINE OPERATION PROCEDURE OR USES LIMITED X–RAY MACHINE OPERATION 17
EQUIPMENT IF THE APPLICANT OR REGISTRANT HAS NOT RECEIVED AN EDUCATION, 18
AN INTERNSHIP, TRAINING, OR EXPERIENCE IN THE PERFORMANCE OF THE 19
PROCEDURE OR THE USE OF THE EQUIPMENT; 20
(26) FAILS TO COOPERATE WI TH A LAWFUL INVESTIG ATION 21
CONDUCTED BY THE BOARD OR A DISCIPLINARY PANEL; 22
(27) FAILS TO PRACTICE UND ER THE SUPERVISION O F A LICENSED 23
PHYSICIAN OR LICENSED RADIOGRAPHER OR VIOLATES A SUPERVISORY ORDER OF 24
A SUPERVISING PHYSICIAN OR SUPERVISING RADIOGRAPHER; OR 25
(28) FAILS TO COMPLETE A C RIMINAL HISTORY RECO RDS CHECK 26
UNDER § 14–308.1 OF THIS SUBTITLE. 27
(B) EXCEPT AS OTHERWISE P ROVIDED IN THE ADMINISTRATIVE 28
PROCEDURE ACT, BEFORE THE BOARD OR A DISCIPLINA RY PANEL TAKES ANY 29
ACTION UNDER SUBSECTION (A) OF THIS SECTION, THE BOARD OR A DISCIPLINARY 30
PANEL SHALL GIVE THE INDIV IDUAL AGAINST WHOM T HE ACTION IS 31
CONTEMPLATED AN OPPO RTUNITY FOR A HEARIN G BEFORE THE BOARD OR THE 32
HOUSE BILL 1047 17
DISCIPLINARY PANEL I N ACCORDANCE WITH TH E HEARING REQUIREMEN TS OF § 1
14–405 OF THIS TITLE. 2
(C) (1) ON THE FILING OF CERTIFIED DOCKET ENTRIES WITH THE BOARD 3
BY THE OFFICE OF THE ATTORNEY GENERAL, A DISCIPLINARY PANEL SHALL ORDER 4
THE SUSPENSION OF A REGISTRATION IF THE REGISTRANT IS CO NVICTED OF OR 5
PLEADS GUILTY OR NOL O CONTENDERE WITH RE SPECT TO A CRIME INV OLVING 6
MORAL TURPITUDE , WHETHER OR NOT ANY A PPEAL OR OTHER PROCE EDING IS 7
PENDING TO HAVE THE CONVICTION OR PLEA SET ASIDE. 8
(2) AFTER COMP LETION OF THE APPELL ATE PROCESS , IF THE 9
CONVICTION HAS NOT BEEN REVERSED OR THE PLEA HAS NOT BEEN SET ASIDE WITH 10
RESPECT TO A CRIME I NVOLVING MORAL TURPI TUDE, A DISCIPLINARY PANEL 11
SHALL ORDER THE REVO CATION OF A REGISTRA TION ON THE CERTIFIC ATION BY 12
THE OFFICE OF THE ATTORNEY GENERAL. 13
(D) IF, AFTER A HEARING UNDER § 14–405 OF THIS TITLE, A DISCIPLINARY 14
PANEL FINDS THAT THERE ARE GROUNDS UNDER SUBSECTION (A) OF THIS SECTION 15
TO SUSPEND OR REVOKE A REGISTRATION, TO REPRIMAND A REGIS TRANT, OR TO 16
PLACE A REGIST RANT ON PROBATION , THE DISCIPLINARY PAN EL MAY IMPOSE A 17
FINE SUBJECT TO THE BOARD’S REGULATIONS IN ADD ITION TO SUSPENDING OR 18
REVOKING THE LICENSE , REPRIMANDING THE REG ISTRANT, OR PLACING THE 19
REGISTRANT ON PROBATION. 20
(E) IN ADDITION TO ANY SA NCTION AUTHORIZED UNDER THIS SECTI ON, A 21
DISCIPLINARY PANEL M AY REQUIRE A REGISTR ANT TO COMPLY WITH S PECIFIED 22
TERMS AND CONDITIONS DETERMINED BY THE DISCIPLINARY PANEL. 23
14–602. 24
(a) Unless authorized to practice medicine under this title, a person may not 25
represent to the public, by description of services, methods, or procedures, or otherwise, 26
that the person is authorized to practice medicine in this State. 27
(b) Except as otherwise provided in this article, a person may not use the words 28
or terms “Dr.”, “doctor”, “physician”, “D.O.”, or “M.D.” with the intent to represent that the 29
person practices medicine, unless the person is: 30
(1) Licensed to practice medicine under this title; 31
(2) A physician licensed by and residing in another jurisdiction, while 32
engaging in consultation with a physician licensed in this State; 33
(3) A physician employed in the service of the federal government while 34
practicing within the scope of the employment; 35
18 HOUSE BILL 1047
(4) A physician who resides in and is licensed to practice medicine by an y 1
state adjoining this State and whose practice extends into this State; 2
(5) An individual in a postgraduate medical program that is accredited by 3
an accrediting organization recognized by the Board in regulations while the individual is 4
practicing medicine in the program; or 5
(6) A licensee who is on emeritus status under § 14 –320.1 of this title, 6
provided that the licensee does not represent to the public that the licensee is authorized 7
to practice medicine in the State. 8
(c) An unlicensed individual who acts under § 14–302 [or], § 14–306, § 14–306.1, 9
§ 14–306.2, OR § 14–306.3 of this title may use the word “physician” together with another 10
word to describe the occupation of the individual as in phrases such as “physician’s 11
assistant” or “physician’s aide”. 12
15–302.1. 13
(c) (1) Subject to paragraph (2) of this subsection and subsection (d) of this 14
section and except as provided in subsection (e) of this section, a physician assistant may 15
perform advanced duties in a practice setting that is not an exe mpt facility only after the 16
physician assistant obtains Board approval of the advanced duty under the collaboration 17
agreement. 18
(2) [(i) Subject to subparagraph (ii) of this paragraph, a ] A physician 19
assistant may perform X –ray duties [authorized under § 14–306(e) of this article ] in the 20
medical office of a patient care team physician [only after the] IF: 21
(I) THE PHYSICIAN ASSISTA NT HAS COMPLETED A C OURSE 22
THAT INCLUDES RADIOG RAPHIC STUDIES OF TH E EXTREMITIES OF AT LEAST 20 23
SEPARATE PATIENTS; 24
(II) THE X–RAYS ARE LIMITED TO THE EXTREMITIES; 25
(III) THE X–RAYS ARE PERFORMED U NDER THE DIRECT 26
SUPERVISION OF A COLLABORATING PHYSICIAN OR RADIOLOGIST; 27
(IV) THE X–RAYS ARE PERFORMED U SING A MINI C–ARM OR A 28
SIMILAR LOW–LEVEL RADIATION MACHINE TO PERFORM NONFLUOROSCOPIC X–RAY 29
PROCEDURES; AND 30
(V) THE physician assistant obtains Board approval of the X –ray 31
duty AS AN ADVANCED DUTY under the collaboration agreement. 32
HOUSE BILL 1047 19
[(ii) A collaboration agreement may authorize the delegation of X–ray 1
duties limited to nonfluoroscopic X –ray procedures of the extremities, anterior –posterior 2
and lateral, not including the head.] 3
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 4
October 1, 2026. 5
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.