Bill Name: Senate Bill 167 (SB 167)

Primary Sponsor: Senator Mary Carozza

Status: 05/16/2024 Approved by Governor goes into effect 10/1/2024

AmSpa’s Take: Reducing the amount of regulation and paperwork with which advanced practitioners such as physician assistants (PAs) and nurse practitioners (NPs) need to comply to practice frees up time and resources that can be better spent seeing patients, improving their skills and developing their practices.

Outlook: This bill is in the first steps of the process.

Analysis: Currently, Maryland physician assistants (PAs) practice under the supervision of a physician. This supervising physician delegates the health care tasks that the PA may perform. The relationship is formalized using a written delegation agreement, which lays out what tasks and medications are authorized. SB 167 would change the PA’s practice to one of collaboration with a physician or group of physicians.

Under SB 167, “collaboration” means the communications and decision-making process among members of a patient’s health care team. It includes developing a plan of care, exchanging observations and assessments, and making appropriate referrals or accessing additional resources. The PA’s scope of practice could include evaluating, diagnosing, prescribing and dispensing medications, and delegating tasks to others. This collaboration would not require that physician to be on site while the PA is practicing, provided they are available to speak via electronic means. This collaborative relationship is governed by a written collaboration agreement between the PA and the physician(s). SB 167 only requires that the agreement be developed by the physician(s) and the PA, outline the collaboration between them and submit it to the board. Optionally, the agreements may provide additional details, procedures to follow or limitations on the PA’s practice. Newly licensed PAs would be required to be mentored for an initial 18 months by a designated collaborating physician. Physicians would be limited to collaborating with no more than eight PAs at a time.

The majority of states allow nurse practitioners to practice independently. More recently, many states have been giving more freedom and autonomy to PAs as well. SB 167 is squarely within this trend. If you would like additional information, to read the language of the bill or to contact the sponsors or committee, you can find the information you need through this link.