A.      Before a physician may delegate medical acts and before a physician assistant (PA)   may perform medical acts, the PA and primary supervising  shall file with the Board:

  • A delegation agreement on the Board approved form; and
  • The required fee as specified in Regulation

 B.     The delegation agreement shall include the following information:

  • The primary supervising physician’s Maryland license number;
  • A description of the supervising physician’s qualifications to supervise a PA;
  • The PA’s Maryland license number;
  • The location and settings where the PA will practice;
  • The scope of the primary and alternate physicians’ practices;
  • The delegated medical acts which the PA will perform, including
    • Core duties; and
    •  Any advanced duties;
  • A description of the continuous supervision mechanisms that the primary supervising physician will useA description of how the PA’s performance will be evaluated; and
  • Any other information deemed necessary by the Board to carry out the provisions of Health Occupations Article, Title 15, Annotated Code of Maryland.

 C.     The primary supervising physician shall make the following attestations as a part of the delegation agreement:

  • All medical acts to be delegated to the PA are within the scope of practice of the primary or alternate supervising physician and appropriate to the PA’s education, training, and level of competence;
  • The primary supervising physician will utilize the mechanisms of continuous supervision as described in the delegation agreement;
  • The primary supervising physician will accept responsibility for any care given by the PA;
  • The primary supervising physician will respond in a timely manner when contacted by the PA; and
  • The primary supervising physician may not supervise more than 4 Pas at any one time, except as permitted in a:
    •  Hospital;
    • Correctional facility;
    • Detention center; or
    • Public health facility

 D.     Except as provided in this Regulation, if a delegation agreement includes delegation of one or more advanced duties, the delegation agreement shall include the following additional information and documentation:

  • In a special facility:
    •  A description of the advanced duty and the education, training and experience that qualifies the PA to perform the advanced duty; and
    • A copy of the approved delineation of duties from the governing board of the health care facility stating that the PA has been approved by the facility to perform the advanced duty; or
  • In a setting other than a special facility:
    • A description of the advanced duties to be delegated;
    • Documentation of the advanced duty and the education, training and experience that qualifies the PA to perform the advanced duty;
    • The level of supervision that the primary supervising physician will use when the PA is performing the advanced duty; and
    • Documentation described in Regulations, if the delegation agreement includes a request for a temporary practice letter allowing the PA to perform an advanced duty before approval by the Board.

 E.      If a delegation agreement includes the delegation of general anesthesia or neuroaxial anesthesia, the delegation agreement shall include all of the information specified in regulation.