SB326, the Physician Assistant Parity Act of 2026, expands the role of physician assistants in a wide range of Maryland health and human services statutes. The bill adds physician assistants to the list of practitioners who may perform or certify actions related to guardianship proceedings, mental health admissions and emergency evaluations, emergency epinephrine and allergy treatment programs, attendant care eligibility, sick leave certification, and certain correctional health decisions involving pregnant incarcerated individuals. It also updates definitions and cross-references so physician assistants are treated similarly to physicians and other advanced practice clinicians in these contexts.
The bill also makes targeted changes affecting certified nurse-midwives and licensed certified midwives, including allowing them to order infirmary admission for pregnant incarcerated individuals and to be included among health care practitioners available for selection in health maintenance organizations. In addition, it requires the Maryland Department of Health to pay for certain emergency evaluation examinations performed by physician assistants when an emergency evaluee cannot pay or lacks insurance coverage. The bill further adds a physician assistant representative to the Statewide Advisory Commission on Immunizations and directs the Maryland Health Care Commission to study whether emergency department stays are longer for involuntary admission cases when overnight staffing includes physician assistants but not enough clinicians authorized to certify admissions.
In terms of state law, SB326 amends provisions in the Correctional Services, Estates and Trusts, Health–General, Human Services, and State Personnel and Pensions Articles. The practical effect is to broaden the scope of licensed physician assistants as authorized signers, evaluators, and certifiers in health-related legal processes, while also recognizing midwives in selected settings. It also creates a reporting requirement for the Maryland Health Care Commission, which must analyze emergency department length-of-stay data and report findings to legislative committees by November 1, 2026.
The overall sentiment around the bill appears strongly favorable and noncontroversial. The recorded votes were unanimous in both chambers, with the Senate passing the bill 45-0 and the House passing it 131-0. No committee transcript material was provided, but the voting history suggests broad bipartisan support for expanding practitioner parity and reducing administrative barriers in health care and related legal procedures.
The main policy issue reflected in the bill is whether physician assistants should be authorized to perform more of the same functions already available to physicians and certain advanced practice clinicians, especially in mental health, emergency, and correctional settings. The only notable point of potential concern is the study directive regarding emergency department delays during overnight shifts, which implies an operational question about whether physician assistants alone are sufficient to support involuntary admission workflows. However, the bill does not appear to have generated recorded opposition, and the final votes indicate little or no controversy.
SB326 amends multiple Maryland statutes to expand physician assistant authority and to align physician assistants, certified nurse-midwives, and licensed certified midwives more closely with other health care practitioners in specified legal and clinical processes. It changes who may certify incapacity, support guardianship petitions, initiate or support mental health admissions and emergency evaluations, prescribe or dispense emergency epinephrine in certain programs, and sign sick leave certificates, while also updating HMO provider-selection rules and adding physician assistants to an immunization advisory commission. The bill also requires state payment for certain physician assistant examinations in emergency-evaluation cases and directs a data review by the Maryland Health Care Commission.
The bill’s reception appears overwhelmingly positive. It passed the Senate 45-0 and the House 131-0, indicating unanimous support in both chambers. The available record shows no committee transcript debate or recorded opposition, suggesting the measure was viewed as a technical but meaningful expansion of practitioner parity rather than a controversial policy change.
There is little evidence of significant contention in the available record. The only substantive policy question embedded in the bill is whether physician assistants should be authorized to perform additional certification and evaluation functions in mental health and emergency settings, and whether their presence affects emergency department length of stay during overnight involuntary-admission cases. The bill’s study requirement suggests some interest in monitoring operational impacts, but the unanimous votes indicate that any concerns were limited or resolved before final passage.