(a) In this section, "exempt facility" means: (1) A hospital; (2) An ambulatory surgical facility; (3) A federally qualified health center; or (4) Another practice setting listed on a hospital delineation of privileges document. (b) Except as provided in subsection (e) of this section, a physician assistant may perform advanced duties without Board approval if the advanced duty will be performed in an exempt facility and: (1) The physician assistant is supervised by a physician with credentials that have been reviewed by the exempt facility as a condition of employment as an independent contractor or as a member of the medical staff; (2) The physician assistant has credentials that have been reviewed by the exempt facility as a condition of employment as an independent contractor or as a member of the medical staff; and (3) The advanced duty to be delegated to the physician assistant is reviewed and approved in a process approved by the exempt facility before the physician assistant performs the advanced duty. (c) (1) Subject to paragraph (2) of this subsection and subsection (d) of this section and except as provided in subsection (e) of this section, a physician assistant may perform advanced duties in a practice setting that is not an exempt facility only after the physician assistant obtains Board approval of the advanced duty under the collaboration agreement. (2) (i) Subject to subparagraph (ii) of this paragraph, a physician assistant may perform X-ray duties authorized under § 14-306(e) of this article in the medical office of a patient care team physician only after the physician assistant obtains Board approval of the X-ray duty under the collaboration agreement. (ii) A collaboration agreement may authorize the delegation of X-ray duties limited to nonfluoroscopic X-ray procedures of the extremities, anterior-posterior and lateral, not including the head. (d) A physician assistant may not perform the medical acts of administering general anesthesia or neuroaxial anesthesia, including spinal, epidural, and image guided interventional spine procedures. (e) A physician assistant may perform an advanced duty in collaboration with a patient care team physician without prior approval of the Board if: (1) The Board has previously approved the physician assistant to perform the advanced duty in collaboration with a patient care team physician; or (2) The physician assistant has at least 7,000 hours of clinical practice experience. (f) If an advanced duty requires Board approval, the Committee: (1) Shall review the collaboration agreement; (2) May conduct a personal interview of the physician assistant and patient care team physicians; and (3) May recommend to the Board that the collaboration agreement be modified to ensure conformance with the requirements of this title. (g) (1) On review of the Committee's recommendations regarding the request of a patient care team physician to delegate advanced duties as described in a collaboration agreement, the Board may modify the performance of advanced duties under a collaboration agreement if the physician assistant does not meet the applicable education, training, and experience requirements to perform the specified advanced duties. (2) If the Board makes a modification under paragraph (1) of this subsection, the Board: (i) Shall notify the delegating patient care team physician listed in the collaboration agreement and the physician assistant in writing of the particular elements of the advanced duty approval request that were the cause for the modification; and (ii) May not restrict the submission of an amendment to the advanced duty. (h) Documentation demonstrating a physician assistant's authority to perform an advanced duty under this section shall be maintained at the facility in which the physician assistant is performing the advanced duty. (i) Individual members of the Board are not civilly liable for actions regarding the approval, modification, or disapproval of an advanced duty under the collaboration agreement described in this section.
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