State Board of Physicians - Delegation of Duties - Alterations

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
Italics indicate opposite chamber/conference committee amendments.
*sb0915*

SENATE BILL 915
J2 (6lr3493)
ENROLLED BILL
— Finance/Health —
Introduced by Senator Mautz

Read and Examined by Proofreaders:

_______________________________________________
Proofreader.
_______________________________________________
Proofreader.

Sealed with the Great Seal and presented to the Governor, for his approval this

_______ day of _______________ at _________________ _______ o’clock, ________M.

______________________________________________
President.

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
2 SENATE BILL 915

BY repealing and reenacting, without amendments, 1
Article – Health Occupations 2
Section 14–206(e)(2)(ix) 3
Annotated Code of Maryland 4
(2021 Replacement Volume and 2025 Supplement) 5

BY adding to 6
Article – Health Occupations 7
Section 14–206(e)(2)(x), 14–306.1, 14–306.2, 14–306.3, and 14–306.4 8
Annotated Code of Maryland 9
(2021 Replacement Volume and 2025 Supplement) 10

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 11
That the Laws of Maryland read as follows: 12

Article – Health Occupations 13

14–206. 14

(e) A disciplinary panel may issue a cease and desist order or obtain injunctive 15
relief against an individual for: 16

(2) Representing to the public, by title, description of services, methods, 17
procedures, or otherwise, that the individual is authorized to practice: 18

(viii) Genetic counseling in this State, in vio lation of § 14 –5G–24 of 19
this title; [or] 20

(ix) As a physician assistant in this State, in violation of § 15–402 of 21
this article; or 22

(X) LIMITED X–RAY MACHINE OPERATIO N IN THE STATE, IN 23
VIOLATION OF § 14–306.3 OF THIS TITLE; OR 24

14–306. 25

(a) [Except as provided in subsections (e) and (f) of this section, to] TO the extent 26
[permitted] AUTHORIZED by the rules, regulations, and orders of the Board, an individual 27
to whom duties are delegated by a licensed physician or physician assistant may perform 28
those duties without a license as provided in this section. 29

(b) The individuals to whom duties may be delegated under this section include 30
any individual authorized to practice any other health occupation regulated under this 31
article or § 13–516 of the Education Article. 32

SENATE BILL 915 3

(c) (1) The Board shall adopt rules and regulations to delineate the scope of 1
this section. 2

(2) Before [it] THE BOARD adopts any rule or regulation under this 3
section, the Board shall invite and consider proposals from any individual or health group 4
that could be affected by the rule or regulation. 5

(d) (1) If a duty that is to be delegated under this section is a part of the 6
practice of a health occupation that is regulated under this article by another board, any 7
rule or regulation concerning that duty shall be adopted jointly by the Board of Physicians 8
and the board that regulates the other health occupation. 9

(2) If the two boards cannot agree on a proposed rule or regulation, the 10
proposal shall be submitted to the Secretary for a final decision. 11

[(e) Except as otherwise provided in this section and in accordance with 12
regulations adopted by the Board, an individua l may perform X –ray duties without a 13
license only if the duties: 14

(1) Do not include: 15

(i) Computerized or noncomputerized tomography; 16

(ii) Fluoroscopy; 17

(iii) Invasive radiology; 18

(iv) Mammography; 19

(v) Nuclear medicine; 20

(vi) Radiation therapy; or 21

(vii) Xerography; 22

(2) Are limited to X–ray procedures of the: 23

(i) Chest; 24

(ii) Spine, including the: 25

1. Cervical spine; 26

2. Lumbar spine; 27

3. Sacroiliac joints; 28
4 SENATE BILL 915

4. Sacrum and coccyx; and 1

5. Thoracic spine; 2

(iii) Lower extremities, including: 3

1. Toes; 4

2. The foot; 5

3. The ankle; 6

4. The calcaneus; 7

5. The tibia and fibula; 8

6. The knee and patella; and 9

7. The femur; and 10

(iv) Upper extremities, including: 11

1. Fingers; 12

2. The hand; 13

3. The wrist; 14

4. The forearm; 15

5. The elbow; 16

6. The humerus; 17

7. The shoulder; 18

8. The clavicle; 19

9. Acromioclavicular joints; and 20

10. The scapula; and 21

(3) Are performed: 22

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(i) In the physician’s office under the supervision of a licensed 1
physician or radiologic technologist who is on–site or able to provide immediately available 2
direction; and 3

(ii) 1. By an individual who has: 4

A. Attested to the completion of at least 6 months of clinical 5
care experience; and 6

B. Completed a limited scope X –ray educational program 7
consisting of at least 115 hours of didactic training delivered by a radiologic technologist 8
certified by the American Registry of Radiologic Technologists provid ing instruction in 9
radiographic anatomy, procedures, and pathology, digital image acquisition and display, 10
fundamentals, ethics, and laws of health care, human anatomy and physiology, image 11
production and analysis, imaging equipment and radiation productio n, medical 12
terminology, and patient care; 13

C. Completed at least 480 hours of clinical training and 14
successfully completed a minimum of five competencies in each body part listed in item (2) 15
of this subsection under the direct supervision of a radiolog ic technologist certified by the 16
American Registry of Radiologic Technologists; 17

D. Achieved a passing score, as determined by the Board, on 18
the American Registry of Radiologic Technologists examination for limited scope of practice 19
in radiography or an alternative examination approved by the Board; and 20

E. Registered with the Board attesting to the completion of 21
the requirements of this item and the completion of at least 24 hours of approved continuing 22
education credits earned during the 2–year period immediately following the date of initial 23
registration and every 2 years thereafter; or 24

2. By a licensed physician assistant who has completed a 25
course that includes anterior –posterior and lateral radiographic studies of extremities on 26
at least 2 0 separate patients under the direct supervision of the delegating physician or 27
radiologist using a mini C –arm or similar low –level radiation machine to perform 28
nonfluoroscopic X–ray procedures, if the duties: 29

A. Include only the X–ray procedures described in paragraph 30
(2)(iii) of this subsection; and 31

B. Are performed pursuant to a Board –approved delegation 32
agreement that includes a request to perform advanced duties under § 15–302(c)(2) of this 33
article. 34

(f) (1) In accordance with regulations ad opted by the Board, a licensed 35
physician may delegate duties to a registered cardiovascular invasive specialist assisting 36
in the physician’s performance of fluoroscopy if: 37
6 SENATE BILL 915

(i) The delegated duties are limited to a cardiac catheterization 1
procedure performed in a hospital cardiac catheterization laboratory; 2

(ii) The physician is physically present and personally directs each 3
act performed by the registered cardiovascular invasive specialist; 4

(iii) The registered cardiovascular invasive specialist has completed 5
the training and education and has the experience required by regulations adopted by the 6
Board; and 7

(iv) The hospital in which the cardiac catheterization laboratory is 8
located has verified and documented that the registered cardiovascular invasive specialist 9
has completed the training and education and has the experience required by regulations 10
adopted by the Board. 11

(2) The hospital in which the cardiac catheterization laboratory is located 12
and the physician delegating duties to a registered cardiovascular invasive specialist under 13
this subsection are responsible for ensuring that all requirements of this subsection are 14
met for each procedure. 15

(3) A disciplinary panel may impose a civil penalty of up to $5,000 for each 16
instance of a hospital’s failure to comply with the requirements of this subsection. 17

(g) (1) (i) In this subsection the following words have the meanings 18
indicated. 19

(ii) “Direct supervision” means oversight exercised by a delegating 20
physician who is: 21

1. Personally treating the patient; 22

2. In the same medical office as the patient and the 23
supervised medical graduate; and 24

3. Immediately available to provide assistance and guidance 25
to the supervised medical graduate for the duration of the completion of a delegated duty. 26

(iii) “Supervised medical graduate” means an individual who: 27

1. Has a degree of: 28

A. Doctor of medicine from a medical school that is accredited 29
by an accrediting organization that the Board recognizes in its regulations; or 30

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B. Doctor of osteopathy from a school of osteopathy in the 1
United States, its territories or possessions, Puerto Rico, or Canada that has standards for 2
graduation equivalent to those established by the American Osteopathic Association; and 3

2. Has passed parts 1 and 2 of: 4

A. The United States Medical Licensing Examination; or 5

B. The Comprehensive Osteopathic Medical Licensing 6
Examination of the United States. 7

(2) Subject to paragraph (3) of this subsection and in accordance with 8
regulations adopted by the Board, a supervised medical graduate may perform delegated 9
duties under direct supervision. 10

(3) An individual may not practice as a supervised medical graduate for a 11
period of more than 2 years. 12

(4) For the purposes of this subsection, a delegating physician is not 13
required to be in the presence of a patient and a supervised medical graduate during the 14
completion of a delegated duty. 15

(h) In accordance with regulations adopted by the Board, a physician’s office that 16
employs an individual authorized to perform X –ray duties without a license under 17
subsection (e) of this section is responsible for ensuring that all requirements of subsection 18
(e) of this section are met for each X–ray examination performed. 19

(i) If an unlicensed individual performs X –ray duties without meeting the 20
requirements of subsection (e) of this section, the Board may impose a civil penalty of up 21
to: 22

(1) $5,000 for each violation on the physician’s office where the violation 23
occurred; and 24

(2) $1,000 for each violation on the individual who committed the 25
violation.] 26

14–306.1. 27

(A) IN ACCORDANCE WITH RE GULATIONS ADOPTED BY THE BOARD, A 28
LICENSED PHYSICIAN MAY DELEGATE DUTIES TO A REGISTERED CARDIOVASCULAR 29
INVASIVE SPECIALIST ASSISTING IN THE PHY SICIAN’S PERFORMANCE OF 30
FLUOROSCOPY IF: 31

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(1) THE DELEGATED DUTIES ARE LIMITED TO A CAR DIAC 1
CATHETERIZATION PROC EDURE PERFORMED IN A HOSPITAL CARDIAC 2
CATHETERIZATION LABORATORY; 3

(2) THE PHYSICIAN IS PHYS ICALLY PRESENT AND P ERSONALLY 4
DIRECTS EACH ACT PERFORMED BY THE REGISTERED CARDIOVASCULAR INVASIVE 5
SPECIALIST; 6

(3) THE REGISTERED CARDIO VASCULAR INVASIVE SP ECIALIST HAS 7
COMPLETED THE TRAINING AND EDUCATION AND HAS THE EXPERIENCE REQUIRED 8
BY REGULATIONS ADOPTED BY THE BOARD; AND 9

(4) THE HOSPITAL IN WHICH THE CARDIAC CATHETER IZATION 10
LABORATORY IS LOCATED HAS VERIFIED AND DOCUMENTED THAT THE REGISTERED 11
CARDIOVASCULAR INVAS IVE SPECIALIST HAS C OMPLETED THE TRAININ G AND 12
EDUCATION AND HAS TH E EXPERIENCE REQUIRE D BY REGULATIONS ADO PTED BY 13
THE BOARD. 14

(B) THE HOS PITAL IN WHICH THE C ARDIAC CATHETERIZATI ON 15
LABORATORY IS LOCATE D AND THE PHYSICIAN DELEGATING DUTIES TO A 16
REGISTERED CARDIOVASCULAR INVASIVE SPECI ALIST UNDER THIS SEC TION ARE 17
RESPONSIBLE FOR ENSURING THAT ALL REQUIREMENTS OF THIS SECTION ARE MET 18
FOR EACH PROCEDURE. 19

(C) A DISCIPLINARY PANEL MAY IMPOSE A CIVIL PENALTY OF UP TO $5,000 20
FOR EACH INSTANCE OF A HOSPITAL ’S FAILURE TO COMPLY WITH THE 21
REQUIREMENTS OF THIS SECTION. 22

14–306.2. 23

(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 24
INDICATED. 25

(2) “ON–SITE SUPERVISION ” MEANS OVERSIGHT EXER CISED BY A 26
DELEGATING PHYSICIAN WHO IS: 27

(I) PERSONALLY TREATING THE PATIENT; 28

(II) IN THE SAME MEDICAL O FFICE AS THE PATIENT AND THE 29
SUPERVISED MEDICAL GRADUATE; AND 30

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(III) IMMEDIATELY AVAILABLE TO PROVIDE ASSISTANCE AND 1
GUIDANCE TO THE SUPE RVISED MEDICAL GRADU ATE FOR THE DURATION OF THE 2
COMPLETION OF A DELEGATED DUTY. 3

(3) “SUPERVISED MEDICAL GRADUATE” MEANS AN INDIVIDUAL WHO: 4

(I) HAS A DEGREE OF: 5

1. DOCTOR OF MEDICINE FR OM A MEDICAL SC HOOL 6
THAT IS ACCREDITED B Y AN ACCREDITING ORG ANIZATION THAT THE BOARD 7
RECOGNIZES IN ITS REGULATIONS; OR 8

2. DOCTOR OF OSTEOPATHY FROM A SCHOOL OF 9
OSTEOPATHY IN THE UNITED STATES, ITS TERRITORIES OR POSSESSIONS, PUERTO 10
RICO, OR CANADA THAT HAS STANDARDS FOR GRADUATION EQUIVALENT TO THOSE 11
ESTABLISHED BY THE AMERICAN OSTEOPATHIC ASSOCIATION; AND 12

(II) HAS PASSED PARTS 1 AND 2 OF: 13

1. THE UNITED STATES MEDICAL LICENSING 14
EXAMINATION; OR 15

2. THE COMPREHENSIVE OSTEOPATHIC MEDICAL 16
LICENSING EXAMINATION OF THE UNITED STATES. 17

(B) SUBJECT TO SUBSECTION (C) OF THIS SECTION AND IN ACCORDANCE 18
WITH REGULATIONS ADOPTED BY THE BOARD, A SUPERVISED MEDICAL GRADUATE 19
MAY PERFORM DELEGATED DUTIES UNDER ON–SITE SUPERVISION. 20

(C) AN INDIVIDUAL MAY NOT PRACTICE AS A SUPERVISED MEDICAL 21
GRADUATE FOR A PERIOD OF MORE THAN 2 YEARS. 22

(D) FOR THE PURPOSES OF T HIS SECTION , A DELEGATING PHYSICI AN IS 23
NOT REQUIRED TO BE IN THE PRESENCE OF A PATIENT AND A SUPERVISED MEDICAL 24
GRADUATE DURING THE COMPLETION OF A DELEGATED DUTY. 25

14–306.3. 26

(A) IN ACCORDANCE WITH RE GULATIONS ADOPTED BY THE BOARD, AN 27
INDIVIDUAL MAY PERFO RM X–RAY DUTIES AS A LIMI TED X–RAY MACHINE 28
OPERATOR REGISTERED WITH THE BOARD UNDER THIS SECT ION WITHOUT A 29
LICENSE IF THE X–RAY PROCEDURES: 30

10 SENATE BILL 915

(1) DO NOT INCLUDE: 1

(I) COMPUTERIZED OR NONCOMPUTERIZED TOMOGRAPHY; 2

(II) FLUOROSCOPY; 3

(III) INVASIVE RADIOLOGY; 4

(IV) MAMMOGRAPHY; 5

(V) NUCLEAR MEDICINE; 6

(VI) RADIATION THERAPY; OR 7

(VII) XEROGRAPHY; 8

(2) ARE LIMITED TO X–RAY PROCEDURES OF: 9

(I) THE CHEST; 10

(II) THE SPINE, INCLUDING: 11

1. THE CERVICAL SPINE; 12

2. THE LUMBAR SPINE; 13

3. THE SACROILIAC JOINTS; 14

4. THE SACRUM AND COCCYX; AND 15

5. THE THORACIC SPINE; 16

(III) LOWER EXTREMITIES, INCLUDING: 17

1. TOES; 18

2. THE FOOT; 19

3. THE ANKLE; 20

4. THE CALCANEUS; 21

5. THE TIBIA AND FIBULA; 22
SENATE BILL 915 11

6. THE KNEE AND PATELLA; AND 1

7. THE FEMUR; AND 2

(IV) UPPER EXTREMITIES, INCLUDING: 3

1. FINGERS; 4

2. THE HAND; 5

3. THE WRIST; 6

4. THE FOREARM; 7

5. THE ELBOW; 8

6. THE HUMERUS; 9

7. THE SHOULDER; 10

8. THE CLAVICLE; 11

9. ACROMIOCLAVICULAR JOINTS; AND 12

10. THE SCAPULA; 13

(3) ARE PERFORMED UNDER T HE SUPERVISION OF A LICENSED 14
PHYSICIAN OR RADIOGRAPHER WHO IS ON–SITE OR ABLE TO PROVIDE IMMEDIATELY 15
AVAILABLE DIRECTION; AND 16

(4) ARE PERFORMED BY AN INDIVIDUAL WHO HAS REGISTERED WITH 17
THE BOARD AND ATTESTS: 18

(I) TO THE SUCCESSFUL COMPLETION OF AT LEAST 6 MONTHS 19
OF CLINICAL CARE EXPERIENCE; 20

(II) TO THE SUCCESSFUL COMPLETION OF: 21

1. A LIMITED X–RAY EDUCATIONAL PROGRAM; OR 22

2. THE FIRST YEAR OF AN ACCREDITED RADIOLOGI C 23
TECHNOLOGIST PROGRAM IN GOOD STANDING WITH THE BOARD; 24
12 SENATE BILL 915

(III) TO THE SUCCESSFUL COM PLETION OF AT LEAST 115 150 1
115 HOURS OF DIDACTIC TR AINING DELIVERED BY A RADIOLOGIC TECHNOLOGIST 2
CERTIFIED BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS 3
PROVIDING INSTRUCTIO N IN RADIOGRAPHIC AN ATOMY, PROCEDURES, AND 4
PATHOLOGY, DIGITAL IMAGE ACQUISITION AND DISPLAY, FUNDAMENTALS, ETHICS, 5
AND LAWS OF HEALTH C ARE, HUMAN ANATOMY AND PH YSIOLOGY, IMAGE 6
PRODUCTION AND ANALYSIS, IMAGING EQUIPMENT AND RADIATION PRODUCTION, 7
MEDICAL TERMINOLOGY, AND PATIENT CARE; 8

(IV) TO THE SUCCESSFUL COMPLETION OF AT LEAST 480 HOURS 9
OF CLINICAL TRAINING; 10

(V) TO THE SUCCESSFUL COMPLETION OF A MINIMUM OF FIVE 11
COMPETENCIES IN EACH BODY PART LISTED UND ER SUBSECTION (A)(2) OF THIS 12
SECTION UNDER THE DI RECT SUPERVISION OF A RADIOLOGIC TECHNOL OGIST 13
CERTIFIED BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS; AND 14

(VI) TO THE SUCCESSFUL ACH IEVEMENT OF A PASSIN G SCORE, 15
AS DETERMINED BY THE BOARD, ON THE AMERICAN REGISTRY OF RADIOLOGIC 16
TECHNOLOGISTS EXAMINA TION FOR LIMITED SCO PE OF PRACTICE IN 17
RADIOGRAPHY OR AN ALTERNATIVE EXAMINATION APPROVED BY THE BOARD. 18

(B) IF THE APPLICANT COMP LETED THE FIRST YEAR OF AN ACCREDITED 19
RADIOLOGIC TECHNOLOGIST EDUCATIONAL PROG RAM, THE PROGRAM DIRECTOR 20
OF THE EDUCATIONAL P ROGRAM SHALL PROVIDE AN ATTESTATION DIREC TLY TO 21
THE BOARD STATING THAT TH E APPLICANT MEETS OR EXCEEDS THE 22
REQUIREMENTS OF SUBS ECTION (A)(4)(I), (II)2, (III), (IV), (V), AND (VI) OF THIS 23
SECTION. 24

(C) AN INDIVIDUAL SEEKING REGISTRATION UNDER THIS SECTION SHALL: 25

(1) APPLY FOR REGISTRATION ON A FORM SUPPLIED BY THE BOARD; 26

(2) PAY THE REGISTRATION FEE ESTABLISHED BY THE BOARD; AND 27

(3) COMPLETE ANY OTHER RE QUIREMENTS ESTABLISH ED BY THE 28
BOARD. 29

(D) IF AN INDIVIDUAL WAS DENIED A LICENSE BY THE BOARD, THE 30
INDIVIDUAL IS NOT ELIGIBLE FOR REGISTRATION UNDER THIS SECTION. 31

SENATE BILL 915 13

(E) AN INDIVIDUAL REGISTE RED UNDER THIS SECTION SHALL COMPLETE 1
AT LEAST 24 HOURS OF APPROVED CO NTINUING EDUCATION C REDITS EARNED 2
DURING THE 2–YEAR PERIOD IMMEDIAT ELY PRECEDING THE EX PIRATION OF A 3
REGISTRATION. 4

(F) (1) THE TERM OF A REGISTRATION MAY NOT EXCEED 3 YEARS. 5

(2) A REGISTRATION SHALL EXPIRE ON A DATE ESTABLISHED BY THE 6
BOARD. 7

(3) TO RENEW A REGISTRATION, THE REGISTRANT MUST: 8

(I) APPLY FOR RENEWAL ON A FORM SUPPLIED BY THE BOARD; 9

(II) PAY THE RENEWAL FEE ESTABLISHED BY THE BOARD; AND 10

(III) COMPLETE ANY OTHER RE QUIREMENTS ESTABLISHED BY 11
THE BOARD. 12

(G) AN APPLICANT FOR REGI STRATION SHALL COMPL ETE A CRIMINAL 13
HISTORY RECORDS CHECK IN ACCORDANCE WITH § 14–308.1 OF THIS SUBTITLE. 14

(H) (1) THE BOARD SHALL SET REASO NABLE FEES FOR THE I SSUANCE 15
AND RENEWAL OF REGISTRATIONS AND OTHER SERVICES PROVIDED. 16

(2) THE FEES CHARGED SHALL BE SET SO AS TO PRODUCE FUNDS TO 17
APPROXIMATE THE COST OF MAINTAINING THE R EGISTRATION PROGRAM AND 18
OTHER SERVICES PROVIDED TO REGISTRANTS UNDER THIS SECTION. 19

(I) IN ACCORDANCE WITH RE GULATIONS ADOPTED BY THE BOARD, A 20
PHYSICIAN’S OFFICE THAT EMPLOY S AN INDIVIDUAL AUTH ORIZED TO PERFORM 21
X–RAY DUTIES WITHOUT A LICENSE UNDER THIS S ECTION IS RESPONSIBL E FOR 22
ENSURING THAT ALL REQUIREMENTS OF THIS SECTION ARE MET FOR EACH X–RAY 23
EXAMINATION PERFORMED. 24

(J) IF AN UNREGISTERED INDIVIDUAL PERFORMS X–RAY DUTIES WITHOUT 25
MEETING THE REQUIREMENTS OF THIS SECTION, THE BOARD MAY IMPOSE A CIVIL 26
PENALTY OF UP TO: 27

(1) $5,000 FOR EACH VIOLATION ON THE PHYSICIAN’S OFFICE WHERE 28
THE VIOLATION OCCURRED; AND 29

14 SENATE BILL 915

(2) $1,000 FOR EACH VIOLATION O N THE INDIVIDUAL WHO 1
COMMITTED THE VIOLATION. 2

14–306.4. 3

(A) SUBJECT TO THE HEARIN G PROVISIONS OF § 14–405 OF THIS TITLE, A 4
DISCIPLINARY PANEL, ON THE AFFIRMATIVE VOTE OF A MAJORITY OF THE QUORUM 5
OF THE DISCIPLINARY PAN EL, MAY DENY A REGISTRAT ION TO PRACTICE AS A 6
LIMITED X–RAY MACHINE OPERATOR TO ANY APPLICANT, REPRIMAND ANY LIMITED 7
X–RAY MACHINE OPERATOR REGISTRANT, PLACE ANY REGISTRANT ON PROBATION, 8
OR SUSPEND OR REVOKE A REGISTRATION, IF THE APPLICANT OR REGISTRANT: 9

(1) FRAUDULENTLY OR DECEP TIVELY OBTAINS OR AT TEMPTS TO 10
OBTAIN A REGISTRATION FOR THE APPLICANT, REGISTRANT, OR FOR ANOTHER; 11

(2) FRAUDULENTLY OR DECEPTIVELY USES A REGISTRATION; 12

(3) IS GUILTY OF: 13

(I) IMMORAL CONDUCT IN TH E PRACTICE OF LIMITED X–RAY 14
MACHINE OPERATION; OR 15

(II) UNPROFESSIONAL CONDUCT IN THE PRACTICE OF LIMITED 16
X–RAY MACHINE OPERATION; 17

(4) IS: 18

(I) PROFESSIONALLY INCOMPETENT; 19

(II) PHYSICALLY INCOMPETENT; OR 20

(III) MENTALLY INCOMPETENT; 21

(5) ABANDONS A PATIENT; 22

(6) IS HABITUALLY INTOXICATED; 23

(7) IS ADDICTED TO OR HAB ITUALLY ABUSES ANY N ARCOTIC OR 24
CONTROLLED DANGEROUS SUBSTANCE AS DEFINED IN § 5–101 OF THE CRIMINAL 25
LAW ARTICLE; 26

(8) PROVIDES PROFESSIONAL SERVICES WHILE: 27

SENATE BILL 915 15

(I) UNDER THE INFLUENCE OF ALCOHOL; OR 1

(II) USING ANY NARCOTIC OR CONTROLLED DANGEROUS 2
SUBSTANCE AS DEFINED IN § 5–101 OF THE CRIMINAL LAW ARTICLE OR ANY OTHER 3
DRUG THAT IS IN EXCESS OF THERAPEUTIC AMOUNTS OR WITHOUT VALID MEDICAL 4
INDICATION; 5

(9) PROMOTES THE S ALE OF SERVICES , DRUGS, DEVICES, 6
APPLIANCES, OR GOODS TO A PATIEN T SO AS TO EXPLOIT T HE PATIENT FOR 7
FINANCIAL GAIN; 8

(10) WILLFULLY MAKES OR FILES A FALSE REPORT OR RECORD IN THE 9
PRACTICE OF LIMITED X–RAY MACHINE OPERATION; 10

(11) WILLFULLY FAILS TO FILE OR RECORD ANY REPORT AS REQUIRED 11
UNDER LAW, WILLFULLY IMPEDES OR OBSTRUCTS THE FILING OR RECORDING OF A 12
REPORT, OR INDUCES ANOTHER TO FAIL TO FILE OR RECORD A REPORT; 13

(12) BREACHES PATIENT CONFIDENTIALITY; 14

(13) PAYS OR AGREES TO PAY ANY SUM OR PROVIDE ANY FORM OF 15
REMUNERATION OR MATE RIAL BENEFIT TO ANY PERSON FOR BRINGING OR 16
REFERRING A PATIENT OR ACCEPTS OR AGREES TO ACCEPT ANY SUM OR ANY FORM 17
OF REMUNERATION OR MATERIAL BENEFIT FROM AN INDIVIDUAL FOR BRINGING OR 18
REFERRING A PATIENT; 19

(14) WILLFULLY MAKES A MISR EPRESENTATION WHILE PRACTICING 20
LIMITED X–RAY MACHINE OPERATION; 21

(15) WILLFULLY PRACTICES L IMITED X–RAY MACHINE OPERATIO N 22
WITH AN UNAUTHORIZED INDIVIDUAL OR AIDS A N UNAUTHORIZED INDIV IDUAL IN 23
THE PRACTICE OF LIMITED X–RAY MACHINE OPERATION; 24

(16) OFFERS, UNDERTAKES, OR AGREES TO CURE OR TREAT DISEASE 25
BY A SECRET METHOD, TREATMENT, OR MEDICINE; 26

(17) IS DISCIPLINED BY A LICENSING OR DISCIPLINARY AUTHORITY OR 27
IS CONVICTED OR DISC IPLINED BY A COURT O F ANY STATE OR COUNT RY OR IS 28
DISCIPLINED BY ANY BRANCH OF THE UNIFORMED SER VICES OR THE U.S. 29
DEPARTMENT OF VETERANS AFFAIRS FOR AN ACT THAT WOULD BE GROUNDS FOR 30
DISCIPLINARY ACTION UNDER THE BOARD’S DISCIPLINARY STATUTES; 31

16 SENATE BILL 915

(18) FAILS TO MEET APPROPRIATE STANDARDS FOR THE DELIVERY OF 1
QUALITY LIMITED X–RAY MACHINE OPERATIO N CARE PERFORMED IN ANY 2
OUTPATIENT SURGICAL FACILITY, OFFICE, HOSPITAL OR RELATED INSTITUTION, OR 3
ANY OTHER LOCATION IN THIS STATE; 4

(19) WILLFULLY SUBMITS FALSE STATEMENTS TO COLLECT FEES FOR 5
WHICH SERVICES ARE NOT PROVIDED; 6

(20) (I) HAS BEEN SUBJECT TO I NVESTIGATION OR DISC IPLINARY 7
ACTION BY A DISCIPLINARY AUTHORITY OR BY A COURT OF ANY STATE OR COUNTRY 8
FOR AN ACT THAT WOUL D BE GROUNDS FOR DIS CIPLINARY ACTION UND ER THE 9
BOARD’S DISCIPLINARY STATUTES; AND 10

(II) HAS: 11

1. SURRENDERED THE LICEN SE, REGISTRATION, 12
CERTIFICATION, OR PERMIT ISSUED BY THE STATE OR COUNTRY; OR 13

2. ALLOWED THE LICENSE , REGISTRATION, 14
CERTIFICATION, OR PERMIT ISSUED BY THE STATE OR COUNTRY TO E XPIRE OR 15
LAPSE; 16

(21) WILLFULLY FAILS TO RE PORT SUSPECTED CHILD ABUSE IN 17
VIOLATION OF § 5–704 OF THE FAMILY LAW ARTICLE; 18

(22) SELLS, PRESCRIBES, GIVES AWAY, OR ADMINISTERS DRUGS FOR 19
ILLEGAL OR ILLEGITIMATE MEDICAL PURPOSES; 20

(23) PRACTICES OR ATTEMPTS TO PRACTICE BEYOND T HE 21
AUTHORIZED SCOPE OF PRACTICE; 22

(24) REFUSES, WITHHOLDS FROM , DENIES, OR DISCRIMINATES 23
AGAINST AN INDIVIDUA L WITH REGARD TO THE PROVISION OF PROFESS IONAL 24
SERVICES FOR WHICH T HE LICENSEE IS LICEN SED AND QUALIFIED TO RENDER 25
BECAUSE THE INDIVIDUAL IS HIV POSITIVE; 26

(25) PRACTICES OR ATTEMPTS TO PRACTICE A LIMITED X–RAY 27
MACHINE OPERATION PROCEDURE OR USES LIMITED X–RAY MACHINE OPERATION 28
EQUIPMENT IF THE APPLICANT OR REGISTRANT HAS NOT RECEIVED AN EDUCATION, 29
AN INTERNSHIP , TRAINING, OR EXPERIENCE IN THE PERFORMANCE OF THE 30
PROCEDURE OR THE USE OF THE EQUIPMENT; 31

SENATE BILL 915 17

(26) FAILS TO COOPERATE WI TH A LAWFUL INVESTIG ATION 1
CONDUCTED BY THE BOARD OR A DISCIPLINARY PANEL; 2

(27) FAILS TO PRACTICE UND ER THE SUPERVISION O F A LICENSED 3
PHYSICIAN OR LICENSED RADIOGRAPHER OR VIOLATES A SUPERVISORY ORDER OF 4
A SUPERVISING PHYSICIAN OR SUPERVISING RADIOGRAPHER; OR 5

(28) FAILS TO COMPLETE A C RIMINAL HISTORY RECO RDS CHECK 6
UNDER § 14–308.1 OF THIS SUBTITLE. 7

(B) EXCEPT AS OTHERWISE P ROVIDED IN THE ADMINISTRATIVE 8
PROCEDURE ACT, BEFORE THE BOARD OR A DISCIPLINARY PANEL T AKES ANY 9
ACTION UNDER SUBSECTION (A) OF THIS SECTION, THE BOARD OR A DISCIPLINARY 10
PANEL SHALL GIVE THE INDIVIDUAL AGAINST W HOM THE ACTION IS 11
CONTEMPLATED AN OPPO RTUNITY FOR A HEARIN G BEFORE THE BOARD OR THE 12
DISCIPLINARY PANEL I N ACCORDA NCE WITH THE HEARING REQUIREMENTS OF § 13
14–405 OF THIS TITLE. 14

(C) (1) ON THE FILING OF CERTIFIED DOCKET ENTRIES WITH THE BOARD 15
BY THE OFFICE OF THE ATTORNEY GENERAL, A DISCIPLINARY PANEL SHALL ORDER 16
THE SUSPENSION OF A REGISTRATION IF THE REGISTRANT IS C ONVICTED OF OR 17
PLEADS GUILTY OR NOL O CONTENDERE WITH RE SPECT TO A CRIME INV OLVING 18
MORAL TURPITUDE , WHETHER OR NOT ANY A PPEAL OR OTHER PROCE EDING IS 19
PENDING TO HAVE THE CONVICTION OR PLEA SET ASIDE. 20

(2) AFTER COMPLETION OF T HE APPELLATE PROCESS , IF THE 21
CONVICTION HAS NOT BEEN REVERSED OR THE PLEA HAS NOT BEEN SET ASIDE WITH 22
RESPECT TO A CRIME I NVOLVING MORAL TURPI TUDE, A DISCIPLINARY PANEL 23
SHALL ORDER THE REVO CATION OF A REGISTRA TION ON THE CERTIFIC ATION BY 24
THE OFFICE OF THE ATTORNEY GENERAL. 25

(D) IF, AFTER A HEARING UNDER § 14–405 OF THIS TITLE, A DISCIPLINARY 26
PANEL FINDS THAT THERE ARE GROUNDS UNDER SUBSECTION (A) OF THIS SECTION 27
TO SUSPEND OR REVOKE A REGISTRATION, TO REPRIMAND A REGIS TRANT, OR TO 28
PLACE A REGISTRANT O N PROBATION , THE DISCIPLINARY PAN EL MAY IMPOSE A 29
FINE SUBJECT TO THE BOARD’S REGULATIONS IN ADD ITION TO SUSPENDING OR 30
REVOKING THE LICENSE , REPRIMANDING THE REG ISTRANT, OR PLACING THE 31
REGISTRANT ON PROBATION. 32

(E) IN ADDITION TO ANY SA NCTION AUTHORIZED UNDER THIS SECTION , A 33
DISCIPLINARY PANEL MAY REQUIRE A RE GISTRANT TO COMPLY W ITH SPECIFIED 34
TERMS AND CONDITIONS DETERMINED BY THE DISCIPLINARY PANEL. 35

18 SENATE BILL 915

14–602. 1

(a) Unless authorized to practice medicine under this title, a person may not 2
represent to the public, by description of services, m ethods, or procedures, or otherwise, 3
that the person is authorized to practice medicine in this State. 4

(b) Except as otherwise provided in this article, a person may not use the words 5
or terms “Dr.”, “doctor”, “physician”, “D.O.”, or “M.D.” with the intent to represent that the 6
person practices medicine, unless the person is: 7

(1) Licensed to practice medicine under this title; 8

(2) A physician licensed by and residing in another jurisdiction, while 9
engaging in consultation with a physician licensed in this State; 10

(3) A physician employed in the service of the federal government while 11
practicing within the scope of the employment; 12

(4) A physician who resides in and is licensed to practice medicine by any 13
state adjoining this State and whose practice extends into this State; 14

(5) An individual in a postgraduate medical program that is accredited by 15
an accrediting organization recognized by the Board in regulations while the individual is 16
practicing medicine in the program; or 17

(6) A licensee w ho is on emeritus status under § 14 –320.1 of this title, 18
provided that the licensee does not represent to the public that the licensee is authorized 19
to practice medicine in the State. 20

(c) An unlicensed individual who acts under § 14–302 [or], § 14–306, § 14–306.1, 21
§ 14–306.2, OR § 14–306.3 of this title may use the word “physician” together with another 22
word to describe the occupation of the individual as in phrases such as “physician’s 23
assistant” or “physician’s aide”. 24

15–302.1. 25

(c) (1) Subject to par agraph (2) of this subsection and subsection (d) of this 26
section and except as provided in subsection (e) of this section, a physician assistant may 27
perform advanced duties in a practice setting that is not an exempt facility only after the 28
physician assistant obtains Board approval of the advanced duty under the collaboration 29
agreement. 30

(2) [(i) Subject to subparagraph (ii) of this paragraph, a ] A physician 31
assistant may perform X –ray duties [authorized under § 14 –306(e) of this article ] in the 32
medical office of a patient care team physician [only after the] IF: 33

SENATE BILL 915 19

(I) THE PHYSICIAN ASSISTA NT HAS COMPLETED A C OURSE 1
THAT INCLUDES RADIOG RAPHIC STUDIES OF TH E EXTREMITIES OF AT LEAST 20 2
SEPARATE PATIENTS; 3

(II) THE X–RAYS ARE LIMITED TO THE EXTREMITIES; 4

(III) THE X–RAYS ARE PERFORMED U NDER THE DIRECT 5
SUPERVISION OF A COLLABORATING PHYSICIAN OR RADIOLOGIST; 6

(IV) THE X–RAYS ARE PERFORMED U SING A MINI C–ARM OR A 7
SIMILAR LOW–LEVEL RADIATION MACHINE TO PERFORM NONFLUOROSCOPIC X–RAY 8
PROCEDURES; AND 9

(V) THE physician assistant obtains Board approval of the X –ray 10
duty AS AN ADVANCED DUTY under the collaboration agreement. 11

[(ii) A collaboration agreement may authorize the delegation of X–ray 12
duties limited to nonfluoroscopic X –ray procedures of the extremities, anterior–posterior 13
and lateral, not including the head.] 14

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 15
October 1, 2026. 16

Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.