Maryland Medical Laser Laws & State Regulations
The information provided is for general education purposes. Please consult with a healthcare attorney for proper legal guidance for all cosmetic laser operation laws and regulations within your designated state. This information is NOT intended to be legal advise or a substitute for legal guidance. This information may be incomplete or outdated. You need to contact a healthcare attorney & State government for most updated information.
Department of Health and Mental Hygiene
Board of Physician Quality Insurance
Declaratory Ruling 00-1 (issued 30 October 2002)
RE: The use of lasers for hair removal
In October 2002, the Board issued a Declaratory Ruling (00-1) stating that the use of lasers for hair removal is a surgical act. Only physicians, certified nurse practitioners, registered nurses under Board of Nursing Declaratory Ruling (9701), and physician assistants may use lasers for hair removal. “Cosmetic medical procedures” is Chapter 10.32.09, Code of Maryland Regulations.
A. This chapter governs the performance, delegation, assignment, and supervision of cosmetic medical procedures, and the use of cosmetic medical devices by a physician or under a physician’s direction.
B. This chapter does not govern use of medical procedures or medical devices for the purpose of treating a disease.
C. This chapter does not endorse or certify the safety of any cosmetic medical device or cosmetic medical procedure.
D. This chapter does not authorize the delegation of any duties to any person who is not licensed under Health Occupations
03 Physician Qualifications.
A. License. A physician shall obtain a license to practice medicine in Maryland before the physician may perform, delegate, assign, or supervise cosmetic medical procedures or the use of cosmetic medical devices.
(1) A physician who performs, assigns, supervises, or delegates the performance of cosmetic medical procedures by a nonphysician first shall obtain training in the indications for and performance of the cosmetic medical procedures and operation of any cosmetic medical device to be used.
(2) Training programs provided by a manufacturer or vendor of cosmetic medical devices or supplies may not be a physician’s only education in the cosmetic medical procedures or the operation of the cosmetic medical devices to be used.
(3) ACCME or AOA approved continuing education, or completion of an ACGME or AOA accredited postgraduate program that includes training in the cosmetic medical procedure performed satisfies this requirement. Title 14 of the Maryland Code, 14-306, authorizes the BPQA to adopt rules and regulations relating to duties delegated by a licensed physician. “Cosmetic medical procedures” is Chapter 10.32.09, Code of Maryland Regulations.
10.32.09.05 .05 Physician Responsibilities.
A. A physician shall:
(1) Develop and maintain at each site where the delegated, assigned, or supervised cosmetic medical procedures will be rendered written office protocols for each such cosmetic medical procedure;
(2) Personally perform the initial assessment of each patient;
(3) Prepare a written treatment plan for each patient, including diagnosis and planned course of treatment and specification of the device and device settings to be used;
(4) Obtain informed consent of the patient to be treated by a non-physician;
(5) Except as indicated in §B or C of this regulation, provide onsite supervision whenever a non-physician is performing cosmetic medical procedures or using cosmetic medical devices;
(6) Retain responsibility for any acts delegated to a nonphysician; and
(7) Create and maintain medical records in a manner consistent with accepted medical practice and in compliance with Health
General Article, Title 4, Subtitles 3 and 4, Annotated Code of Maryland, and with Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. §1320d-2, as amended, and 45 CFR Parts 160 and 164, as amended).
B. The Board may approve a delegation agreement for a physician assistant that permits the physician to delegate performance of cosmetic medical procedures under immediately available supervision after the physician has evaluated the patient and developed a written treatment plan.
C. A delegation agreement for a physician assistant that includes cosmetic medical procedures and is approved by the Board before May 2009, is not affected by this chapter.
10.32.09.07 .07 Training of Non-Physicians.
A. The physician is responsible for assuring that any individual to whom the physician delegates or assigns the performance of a cosmetic medical procedure or the operation of a cosmetic medical device is properly trained. Training shall include both theoretical instruction and clinical instruction.
B. Theoretical instruction shall include:
(1) Cosmetic-dermatological indications and contraindications for treatment;
(2) Identification of realistic and expected outcomes of each procedure;
(3) Selection, maintenance, and utilization of equipment;
(4) Appropriate technique for each procedure, including infection control and safety precautions;
(5) Pharmacological intervention specific to the procedure;
(6) Identification of complications and adverse reactions for each procedure;
(7) Emergency procedures to be used in the event of:
(b) Adverse reactions;
(c) Equipment malfunction; or
(d) Any other interruption of a procedure; and
(8) Appropriate documentation of the procedure in the patient’s chart.
C. Clinical instruction shall include:
(1) Observation of performance of the procedure or use of the device by an individual experienced in performing the procedure; and
(2) Performing the procedure or using the device under the direct supervision of the delegating physician who is present and observing the procedure a sufficient number of times to assure that the non-physician is competent to perform the procedure without direct supervision.