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CODE OF MARYLAND REGULATIONS

Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE

Subtitle 40 BOARD OF PODIATRIC MEDICAL EXAMINERS

10.40.1 Examination and Post-Graduate Training

10.40.2 Continuing Education Requirements

10.40.3 Collection of Fees

10.40.4 Code of Ethics

10.40.5 Hearing Procedures

10.40.6 Advertising

10.40.7 Civil Penalties

10.40.8 Interpretation of Terms in the Maryland Podiatry Act

10.40.9 Compelling Public Disclosures


Chapter 01 Examination and Post-Graduate Training

Authority: Health Occupations Article, § 16-205(a)(1), 16-302(f), 16-304, and 16-305, Annotated Code of Maryland

.1 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Board" means the Maryland State Board of Podiatric Medical Examiners.

(2) "Maryland Board Examination" means the test administered by the Maryland State Board of Podiatric Medical Examiners.

(3) "Maryland Licensing Examination" means the test the Maryland State Board of Podiatric Medical Examiners administers to applicants for licensure.

(4) "National Board Examination" means the test administered by the National Board of Podiatric Medical Examiners.

(5) "PMLexis Examination" means the test Local Government Research Corporation (LGR) Examinations administers to applicants for licensure.

.2 Examinations.

A. Only graduates of podiatric medical colleges which at the time of the applicant's graduation had standards equivalent to the standards for colleges approved by the Council on Education of the American Podiatric Medical Association are eligible for examination.

B. The Board requires the following examinations for licensure:

(1) The National Board Examination;

(2) The Maryland Board Examination, which consists of the following two parts:

(a) The Maryland Licensing Examination, and

(b) The PMLexis Examination.

C. The examinations specified in §B(2) of this regulation may be prepared by the Board or by a recognized national or state testing or licensing agency, with the approval of the Board.


D. On the National Board Examination, an applicant shall obtain a passing score as set by the National Board of Podiatric Medical Examiners. This result is required in order to be eligible to take the Maryland Board Examination and, after that, to be licensed by the Board.

E. On the Maryland Board Examination, an applicant shall obtain a passing score, as set by the PMLexis Examination Committee, rounded to the next lower whole integer (that is, truncated). For example, a recommended cut score of 69.6 shall be rounded down to a passing score of 69.

F. The examination shall be taken within 1 year of the date of the application.

G. The Maryland Board Examination may include, but is not limited to, the following subject areas:

(1) Physiology;

(2) Pharmacology;

(3) Diagnostic techniques;

(4) Pathology;

(5) Patient management;

(6) Surgical procedures;

(7) Biomechanics;

(8) Dermatology;

(9) Orthopedics;

(10) Podopediatrics.

H. An individual found by the Board to have engaged in conduct which subverts or attempts to subvert the licensing examination may, at the discretion of the Board, have the results of his licensing examination withheld, or declared invalid, or both. In addition, an individual who has subverted or attempted to subvert the licensing examination may be found ineligible for future licensure following a determination that the individual lacks good moral character as required by Health Occupations Article, § 16-302(b), Annotated Code of Maryland, or is guilty of a violation of Health Occupations Article, § 16- 311(a)(1), Annotated Code of Maryland. Conduct which subverts or attempts to subvert the licensing examination includes, but is not limited to:

(1) Conduct which violates the security of the examination materials, including but not limited to:

(a) Removing from the examination room any of the examination materials,

(b) Reproducing a portion of any past or future licensing examination,

(c) Aiding by any means in the reproduction of any portions of a past or future licensing examination, or

(d) Selling, distributing, buying, receiving, or having unauthorized possession of any portion of a future or current licensing examination;

(2) Conduct which violates the standard of test administration, including, but not limited to:

(a) Communicating with any other examinee during the administration of the licensing examination,

(b) Copying answers from another examinee or permitting one's answers to be copied by another examinee during the administration of the licensing examination, or

(c) Having in one's possession during the administration of the licensing examination any books, notes, written or printed materials or data of any kind, other than the examination materials distributed;

(3) Conduct which violates the credentialing process, including but not limited to:

(a) Falsifying or misrepresenting education credentials or other information required for admission to the licensing examination,

(b) Impersonating an examinee, or

(c) Having an impersonator take the licensing examination on one's behalf.

.3 Applications.

A. Applications should be filed not later than 30 days before the date of the examination.

B. Application fees are not refundable or transferable

.4 Location of Exams.

A. Board examinations may be given in any locality in the State as determined by the Board of Podiatric Medical Examiners.

B. The applicant will be notified of the location of the examination when his application is approved.

.5 Waiver of Examination.

An applicant for licensure by waiver of examination shall be required to comply with the conditions of Health Occupations Article, § 16-305, Annotated Code of Maryland.

.6 Post-Graduate Clinical Training.

A. Except as otherwise provided in this regulation, an applicant who submits an application for a license after January 1, 1990 shall complete 1 year of post-graduate clinical training in a residency program approved by the Council on Education of the


American Podiatric Medical Association, or its successor, and approved by the Board, in order to be eligible for the examination.

B. This regulation does not apply to applicants who:

(1) Apply for a limited license; or

(2) Qualify for a waiver of examination.

C. The Board may waive the requirement of this regulation at the request of an applicant who:

(1) Has practiced podiatry in another state for at least 5 years immediately before applying for a license in Maryland; and

(2) Is not eligible for a reciprocal waiver of examination.

.7 Speech Impairment.

A. An applicant who claims a speech impairment shall submit a written request to the Board:

(1) With the applicant' s initial licensure application; or

(2) Within 1 year of development of the impairment.

B. The Board retains the right to waive the 1-year time limit.

C. An applicant may claim a speech impairment only if:

(1) A speech impairment exists; and

(2) The Board:

(a) Was properly notified of the impairment at the time of initial licensure, or

(b) Determines that a medical or surgical event created the impairment after licensure.

D. If an applicant has a properly claimed and documented speech impairment, the Board may grant or renew a license only if the applicant is able to effectively communicate with health care providers and patients.

E. The Board recognizes the following as proof of the applicant' s ability to communicate effectively:

(1) Documentation from:

(a) A speech-language pathologist who is currently licensed to practice speech pathology in the United States indicating that the applicant can communicate in a professionally competent manner with patients and other health care providers, or

(b) Three Maryland licensed podiatrists that attest to the fact that the applicant can communicate in a professionally competent manner with patients and other health care providers; and

(2) A personal hearing before the Board during which the applicant relays the manner in which the applicant would:

(a) Obtain a history,

(b) Conduct a physical examination,

(c) Order additional tests,

(d) Obtain consultations, and

(e) Relay the results of the examination and treatment plan to a patient.

Administrative History
Effective date: December 22, 1973
Regulation .01C amended effective October 24, 1983 (10:21 Md. R. 1902)
Regulation .02B amended effective February 4, 1976 (3:3 Md. R. 150); October 24, 1983 (10:21 Md. R. 1902)
------------
Chapter revised effective July 29, 1985 (12:15 Md. R. 1520)
Regulation .01 amended effective March 5, 1990 (17:4 Md. R. 496); December 5, 1994 (21:24 Md. R. 1989)
Regulation .02 amended effective December 5, 1994 (21:24 Md. R. 1989)
Regulation .02A-----D, G amended effective March 5, 1990 (17:4 Md. R. 496)
Regulation .04A amended effective March 5, 1990 (17:4 Md. R. 496)
Regulation .06 adopted effective May 1, 1989 (16:8 Md. R. 910)
Regulation .07 adopted effective October 18, 1999 (26:21 Md. R. 1630)
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Chapter 02 Continuing Education Requirements

Authority: Health Occupations Article, §16-308, Annotated Code of Maryland

.1 Scope.

These regulations govern all podiatrists licensed to practice in the State.

.2 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Blue registration card" means a registration document provided by the Board to a licensee which is signed by an authorized individual to verify the licensee' s attendance at the continuing education program.

(2) "Board" means the Board of Podiatric Medical Examiners.

(3) "Credit hour" means 1 program hour.

.3 License Renewal.

A. Periodic renewal of each practitioner' s license is contingent upon the submission, upon request of the Secretary of the Board, of satisfactory proof of attendance and completion

of the required number of credit hours of continuing education programs approved by the Board.

B. Annually, the Board shall establish the required number of credit hours. Except as set forth in §E of this regulation, the required number of credit hours may not exceed 50 hours for 2 years.

C. The Board may refuse to renew the license of any podiatrist who fails to comply with these regulations.

D. The licensee shall earn the required number of credit hours on or before December 1 of the license renewal year.

E. If by December 1 of the license renewal year, the licensee fails to earn the required number of credit hours, the licensee may request an extension of time until December 31 of the license renewal year to earn the required number of credit hours plus an additional number of credit hours as established by the Board. The Board at its discretion, upon good cause shown, may grant an extension of time up to or beyond December 31, and may impose a requirement that the licensee earn up to double the number of required credit hours still to be earned. For example, if on December 1 the licensee has earned only 40 of the 50 required credit hours, the licensee may be required to earn 20 credit hours to meet the continuing education requirement.

.4 Accreditation.

A. Accreditation by the Board of continuing education programming will be based solely upon the content of the programs. These programs shall be directed toward improvement, advancement, and extension of professional skill and knowledge relating to the practice of podiatry.

B. Upon review of program content by the Board, credit shall be approved for the following:

(1) Continuing education programs given by a college of podiatric medicine approved by the Council on Education of the American Podiatric Medical Association;

(2) Lectures and scheduled courses at national and regional meetings of the American Podiatric Medical Association;

(3) Continuing education programs given or arranged by the Education Committee of the Maryland Podiatric Medical Association.

C. Upon review of program content by the Board, credit may be approved for local, state, regional, or national continuing education courses including postgraduate studies, institutes, seminars, lectures, conferences, workshops, extension studies, home study, approved residency programs, or other forms of continuing education approved by the Board.

D. After review of program content, the Board may withdraw its approval of a previously accredited program, and shall notify all attendant State practitioners of this action as soon as possible.

E. Approved credits may be applied toward fulfillment of the continuing education requirement only in the renewal period in which they are earned.

.5 Substantiation of Credits.

A. It is the responsibility of each podiatrist to keep accurate records of attendance at approved continuing education programs and to substantiate those records for the current licensing period upon request. Each podiatrist shall maintain records of attendance for a 5-year period.

B. The Board, by registered mail, may at any time request that within 10 working days a podiatrist substantiate the credits earned by providing satisfactory proof of attendance and completion at approved continuing education programs.

C. The licensee shall show satisfactory proof of attendance and completion of approved continuing education programs. The licensee shall provide to the Board the original signed blue registration cards and syllabi of the programs attended.

D. The Board shall disallow the requested credits in question, if the licensee is unable to substantiate the required credit hours. The Board may not renew a license if the required continuing education criteria are not met as specified in B-----C of this regulation. Violation of this regulation may result in revocation or suspension of license or the imposition of other appropriate sanctions.

E. Willful submission of fraudulent information to the Secretary constitutes a violation of these regulations and may result in revocation or suspension of license or the imposition of other appropriate sanctions.

F. The Board may verify any information received regarding content, certification, and attendance of a continuing education program.

.6 Change of Credit Requirement.

The Board, by majority vote, may vary the number of required credit hours, but except as set forth in Regulation .03E of this chapter, these may not exceed 50 hours every 2 years. The Board shall notify each podiatrist of the change at the time of renewal, which is effective in the year following that renewal, and remains in effect until further notice.

07 Reinstatement.

A. A practitioner may obtain reinstatement by submitting evidence of having met the continuing education requirements equal to those required for the period during which the individual has not held an active license, provided that this requirement does not exceed 125 hours.

B. This regulation applies to any practitioner who:

(1) Has been on inactive status; or

(2) Applies to the Board for reinstatement of the license within 5 years after the license expires.

.08 Severability.

If any provision of these regulations or its application to any person or circumstances is held invalid, this invalidity may not affect other provisions or applications of the regulation which can be given effect without the invalid provision or application, and to this end, the provisions of this regulation are declared severable.

Administrative History
Effective date: February 4, 1976 (3:3 Md. R. 150)
Regulation .02 amended effective October 24, 1994 (21:21 Md. R. 1814)
Regulation .02A amended effective October 15, 1990 (17:20 Md. R. 2428)
Regulation .03A amended effective October 15, 1990 (17:20 Md. R. 2428)
Regulation .03B amended effective October 24, 1983 (10:21 Md. R. 1902
Regulation .03C amended effective October 15, 1990 (17:20 Md. R. 2428)
Regulation .03D adopted effective August 3, 1977 (4:16 Md. R. 1213)
Regulation .03D amended effective October 15, 1990 (17:20 Md. R. 2428); April 14, 2003 (30:7 Md. R. 488)
Regulation .03E amended effective April 14, 2003 (30:7 Md. R. 488)
Regulation .04 amended effective October 24, 1994 (21:21 Md. R. 1814)
Regulation .04B and D amended effective October 15, 1990 (17:20 Md. R. 2428)
Regulation .05 amended effective October 24, 1994 (21:21 Md. R. 1814)
Regulation .05A amended effective October 15, 1990 (17:20 Md. R. 2428)
Regulation .05B amended effective August 3, 1977 (4:16 Md. R. 1213); October 15, 1990 (17:20 Md. R. 2428)
Regulation .05C amended effective October 15, 1990 (17:20 Md. R. 2428)
Regulation .06 amended effective June 15, 1979 (6:12 Md. R. 1050); repealed effective May 15, 1981 (8:10 Md. R. 877)
Regulation .06 adopted effective October 24, 1983 (10:21 Md. R. 1902)
Regulation .06 amended effective October 15, 1990 (17:20 Md. R. 2428); October 24, 1994 (21:21 Md. R. 1814)
Regulation .07 repealed effective October 15, 1990 (17:20 Md. R. 2428)
Regulation .08 amended effective September 5, 1980 (7:18 Md. R. 1740)
Regulation .08 amended and recodified to Regulation .07 effective October 15, 1990 (17:20 Md. R. 2428)
Regulation .09 recodified to Regulation .08 effective October 15, 1990 (17:20 Md. R. 2428)
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Chapter 03 Collection of Fees

Authority: Health Occupations Article, §16-206, Annotated Code of Maryland

.1 Scope.

These regulations govern all persons licensed as podiatrists in the State.

.2 Fees.

The following fees are established by the Board:

A. License fees:

(1) Application fee ... $50;

(1-1) Eligibility verification for PM Lexis examination ... $50; (1-2) Original license fee:

(a) January issue ... $850;

(b) July issue ... $650;

(2) Limited license fee ... $50;

(3) Podiatrist inactive license fee ... $150;

(4) Reciprocity license fee (valid—calendar year of issue) ... $400;

B. License renewal fees:

(1) Biennial license renewal fee (payable in $425 annual payments) ... $850;

(2) Inactive license renewal fee (payable annually) ... $25;

(3) Late renewal fee ... $100;

C. Reinstatement fees:

(1) Reinstatement of inactive license fee (license valid—calendar year of issue) ... $200;

(2) Reinstatement of expired license fee (license valid through calendar year of issue) ...$750;


D. Other fees:

(1) Certification of license fee ... $25;

(2) Duplicate license fee ... $25;

(3) Registration of professional corporation fee ... $50;

(4) Dispensing prescription drug permit fee (payable every 5 years) ... $5;

(5) Penalty for failure to maintain correct address with the Board ... $100;

(6) Roster of licensees fee ... $100;

(7) Request for copy of public orders ... $25.

.3 Change of Fees.

Fees are subject to change by action of the Board of Podiatric Medical Examiners. All licensees and applicants will be notified of the change.

Administrative History
Effective date: February 4, 1976 (3:3 Md. R. 150)
Regulation .02 amended as an emergency provision effective August 18, 1992 (19:18 Md. R. 1653) (Emergency provisions are temporary and not printed in COMAR)
Regulation .02 amended effective February 19, 1993 (20:3 Md. R. 259); April 14, 2003 (30:7 Md. R. 488)
Regulation .02A amended as an emergency provision effective June 15, 1988 (15:14 Md. R. 1653); emergency status expired December 12, 1988
Regulation .02A—H amended effective February 20, 1989 (16:3 Md. R. 344); February 3, 1992 (19:2 Md. R. 154)
Regulation .02C amended effective February 5, 2001 (28:2 Md. R. 100)
Regulation .02D amended effective September 5, 1980 (7:18 Md. R. 1740)
Regulation .02E—G adopted effective August 4, 1976 (3:16 Md. R. 852)
Regulation .02H adopted effective September 5, 1980 (7:18 Md. R. 1740)
Regulation .02I, J adopted effective February 3, 1992 (19:2 Md. R. 154)
Regulation .03 amended effective March 5, 1990 (17:4 Md. R. 496)

Chapter 04 Code of Ethics

Authority: Health Occupations Article, §§1-212 and 16-205, Annotated Code of Maryland

.1 Scope.

This chapter applies to licensed podiatrists in Maryland.

.2 Sexual Misconduct.

A. A podiatrist may not engage in sexual misconduct.

B. Sexual misconduct includes, but is not limited to:

(1) Sexual behavior with a patient in the context of a professional evaluation, treatment, procedure, or other service to the patient, regardless of the setting in which the professional service is provided;

(2) Sexual behavior with a patient on the pretense of therapeutic intent of benefit;

(3) Sexual acts, sexual conduct, vaginal intercourse, or any genital contact, as defined in Criminal Law Article §3-301(e)—(g), Annotated Code of Maryland;

(4) Solicitation of a sexual relationship, whether consensual or nonconsensual, with a patient;

(5) Sexual advances requesting sexual favors;

(6) Therapeutically inappropriate or intentional touching of a sexual nature;

(7) A verbal comment of a sexual nature;

(8) Physical contact of a sexual nature with a patient;

(9) Discussion of unnecessary sexual matters while treating a patient;

(10) The taking of photographs of patients for a sexual purpose;

(11) Sexual harassment of staff or students;

(12) An unnecessary sensual act or comment; or

(13) Sexual contact with an incompetent or unconscious patient.


.3 Penalties.

Violation of Regulation .02 of this chapter may result in the Board taking action to reprimand a licensee or place the licensee on probation, or suspend or revoke the licensee' s license. The Board may also impose a penalty not exceeding $5,000.


Administrative History
Effective date: October 2, 2000 (27:19 Md. R. 1726)
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Chapter 05 Hearing Procedures

Authority: Health Occupations Article, §§16-313 and 16-314; State Government Article, §10-206; Annotated Code of Maryland

.1 Scope.

These regulations apply to all formal hearings before the Board of Podiatric Medical Examiners or its designee.

.2 Notice of Hearing.

A. Written notice of a hearing shall be sent by the Board to all interested parties at least 30 days before the hearing. The notice shall state the date, time, place, and nature of the hearing. It shall also state the authority of the agency to hold the hearing, the charges involved in the proceeding, and the specific section of each statute and regulation including a procedural regulation that is pertinent. It shall also state, concisely and simply, the facts that are asserted. If the facts cannot be stated in detail when the notice is given, the issues that are involved shall be stated. If subsequent amendment of the issues is necessary, the issues shall be fully stated as soon as practicable.

B. Service upon a party shall be delivery of the charging document and a copy of the complaint to the party in person. Instead of personal service, the Board may serve the charging document and a copy of the complaint by registered or certified mail, restricted delivery, return receipt requested.

.3 Representation of Parties.

Each party appearing at a formal hearing has the right to appear in person or with counsel, or both.

.4 Prehearing Procedures.

A. Prehearing Conferences. The Board may set a prehearing conference as it deems appropriate.

B. Oaths, Subpoenas. The Board or its designee may administer oaths and compel the attendance of witnesses and the production of physical evidence before it from witnesses upon whom process is lawfully served by subpoena issued over the signature of the President or Secretary and the seal of the Board. Upon a request by a party and statement under oath that the testimony or evidence is necessary to his or her defense, the Board shall issue a subpoena in his behalf.

C. All motions filed by a party with the Board , or the Office of Administrative Hearings, as appropriate, shall be accompanied by a memorandum of points and authorities and shall be filed at least 15 days before the hearing. A copy shall be served on the opposing party. A response must be filed with the Board or the Office of Administrative Hearings, as appropriate, at least 7 days before the hearing, and a copy shall be served on the opposing party.

D. Discovery on Request. By written request served on the other party and filed with the Board, or the Office of Administrative Hearings, as appropriate, a party may require another party to produce, within 15 days, the following:

(1) A list of witnesses to be called;

(2) Copies of documents intended to be produced at the hearing; or

(3) Both §D(1) and (2) of this regulation.

E. Mandatory Discovery.

(1) Each party shall provide to the other party not later than 15 days before the prehearing conference, if scheduled, or 45 days before the scheduled hearing date, whichever is earlier:

(a) The name and curriculum vitae of any expert witness who will testify at the hearing; and

(b) A detailed written report summarizing the expert' s testimony, which includes the opinion offered and the factual basis and reasons underlying the opinion.

(2) If the Board, or the Office of Administrative Hearings, as appropriate, finds that the report is not sufficiently specific, or otherwise fails to comply with the requirements of this section, the Board, or the Office of Administrative Hearings, as appropriate, shall exclude from the hearing the testimony of the expert and any report of the expert.

(3) The Board, or the Office of Administrative Hearings, as appropriate, shall consider and decide arguments regarding the sufficiency of the report:

(a) At the prehearing conference, if scheduled; or

(b) Immediately before the scheduled hearing.

(4) If an expert adopts a sufficiently specific charging document as the expert' s report, that adoption satisfies the requirements set forth in this section.

F. Parties are not entitled to discovery of items other than as listed in §§D and E of this regulation.

G. Both parties have a continuing duty to supplement their disclosures of witnesses and documents.

H. Absent unforeseen circumstances which would otherwise impose an extraordinary hardship on a party, witnesses or documents may not be added to the list:

(1) After the prehearing conference, if scheduled; or

(2) Later than 15 days before the hearing, if no prehearing conference is scheduled.

I. The prohibition against adding witnesses does not apply to witnesses or documents to be used for impeachment or rebuttal purposes.

J. Construction.

(1) In hearings conducted by an administrative law judge of the Office of Administrative Hearings, this regulation shall, whenever possible, be construed as supplementing and in harmony with COMAR 28.02.01.

(2) In the event of a conflict between this regulation and COMAR 28.02.01, this regulation applies.

.5 Conduct of the Hearing.

A. Duties of Presiding Officer.

(1) Each hearing shall be held before not less than a quorum of the Board unless the hearing authority is delegated pursuant to State Government Article, § 10-207, Annotated Code of Maryland.

(2) For purposes of a hearing under these regulations, four board members present and entitled to vote shall constitute a quorum. Board action shall be by majority vote. If the hearing authority has been delegated, the provisions of State Government Article, § 10- 212, Annotated Code of Maryland, apply to the decision.

(3) The President or the President' sdesignee, who may be either a Board member or an administrative law judge under State Government Article, § 9-1601--9-1610, Annotated Code of Maryland, shall be the presiding officer, and shall have complete charge of the hearing, permit the examination of witnesses, admit evidence, rule on the admissibility of evidence, and adjourn or recess the hearing from time to time. The presiding officer, at his discretion, may set reasonable time limits in arguments and presentation of evidence. The presiding officer shall be responsible for decorum in hearings and can suspend the proceedings as necessary to maintain decorum.

B. Legal Advisor and Counsel for the Board. The Board may request the Office of the Attorney General to participate in any hearing to present the case on behalf of the Board, and, upon such a request, this counsel has all the rights with regard to the submission of evidence, examination and cross-examination of witnesses, presentation of summation and argument, and filing of objections, exceptions, and motions as counsel for any party. The Board may also request a representative of the Office of the Attorney General to act as a legal advisor to the Board as to questions of evidence and law.

C. Order of Procedure. The State shall present its case first. Then the respondent shall present his case. After this the State may present rebuttal.

D. Examination of Witnesses and Introduction of Evidence.

(1) The rules of evidence in all hearings under these regulations shall be as set forth in State Government Article, § 10-201 et seq., Annotated Code of Maryland.

(2) Each party has the right on every genuine issue to call witnesses and present evidence, cross-examine every witness called by the agency or other party, submit rebuttal evidence, present summation and argument, and file objections, exceptions, and motions. When a party is represented by counsel, all the submissions of evidence, examination and cross-examination of witnesses, and filing of objections, exceptions, and motions shall be done and presented solely by this counsel.

(3) The presiding officer, or any person designated by him for the purpose, may examine any witness called by any party. He may call as a witness any person in attendance at the hearing. Any member of the Board may examine any witness called by any party.

.6 Records and Transcripts.

A. The Board shall prepare an official record, which shall include all pleadings, testimony, exhibits, and other memoranda or material filed in the proceeding.

B. A stenographic record of the proceedings shall be made at the expense of the Board. This record need not be transcribed, however, unless requested by a party, or by the Board. The cost of any typewritten transcripts of any proceeding, or part of it, shall be paid by the party requesting the transcripts.

.7 Decision and Order.

Each decision and order rendered by the Board shall be in writing and shall be accompanied by findings of fact and conclusions of law. A copy of the decision and order and accompanying findings and conclusions shall be delivered or mailed promptly to each party or attorney of record.

.8 Rehearings.

A. A party aggrieved by the decision and order rendered may apply for rehearing within 10 days after service on him of the decision and order. Action on the application shall lie in the discretion of the Board.

B. Unless otherwise ordered, neither the rehearing nor the application for it shall stay the enforcement of the order, or excuse the person affected by it for failure to comply with its terms.

C. The Board may consider facts not presented in the original hearing, including facts arising after the date of the original hearing, and may by new order abrogate, change, or modify its original order.

.9 Appeal.

A person whose license has been revoked or suspended by the Board, or any person placed on probation or reprimand under this regulation may have a judicial review of the Board' s decision as provided by law.


.10 Hearing Costs.

A. If, after a hearing, a licensee is found to have violated Health Occupations Article,

§16-312, Annotated Code of Maryland, the Board shall impose a fee on the licensee that shall approximate the Board' s cost of bringing the proceedings against the licensee.

B. The hearing costs may include the following:

(1) Services of court reporters;

(2) Transcriptions of the hearing record by court reporters;

(3) Expenses related to witnesses appearing for the State;

(4) Obtaining or reproducing documents, exhibits, or other evidentiary items;

(5) Hearing-related per diems and expenses for Board members; or

(6) Other expenses directly related to the investigation and prosecution of the disciplinary action against the licensee.

Administrative History
Effective date: December 19, 1983 (10:25 Md. R. 2269)
Regulation .01 amended effective March 5, 1990 (17:4 Md. R. 497) September 18, 2000 (27:18 Md. R. 1665)
Regulation .02A amended effective March 5, 1990 (17:4 Md. R. 497)
Regulation .03 amended effective September 18, 2000 (27:18 Md. R. 1665)
Regulation .04 amended effective September 18, 2000 (27:18 Md. R. 1665)
Regulation .04C amended effective March 5, 1990 (17:4 Md. R. 497)
Regulation .05A, B, D amended effective March 5, 1990 (17:4 Md. R. 497)
Regulation .10 adopted effective August 6, 2001 (28:15 Md. R. 1397)
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Chapter 06 Advertising

Authority: Health Occupations Article, § 16-205(a)(1) and 16- 311(a)(20), Annotated Code of Maryland

.1 Scope.

These regulations govern advertising by all podiatrists in Maryland.

.2 Definitions.

A. In this chapter, the following words have the meanings indicated.

B. Terms Defined.

(1) "Advertising" means calling to the attention of the public the services one has to offer.

(2) "Board" means the State Board of Podiatric Medical Examiners.

(3) "Podiatrist" means an individual who holds, or is required to hold, a current license to practice podiatry in Maryland

.3 Advertising.

A. A podiatrist may advertise the services offered by the podiatrist subject to the provisions of this regulation.

B. Advertisements. Subject to Regulation .04, a podiatrist may place advertisements in any form of print or electronic media.

C. An advertisement may not include statements:

(1) Containing misrepresentation of facts;

(2) Likely to mislead or deceive because in context the statement makes only a partial disclosure of relevant facts;

(3) Likely to create false or unjustified expectations of favorable results;

(4) Relating to fees without reasonable disclosure of all relevant variables so that the statement would not be misunderstood or be deceptive to a layman;

(5) Conveying the impression that the podiatrist could influence improperly a public body, official, corporation, or a person on behalf of a patient;

(6) Containing representations or implications that in reasonable probability can be expected to cause an ordinarily prudent person to misunderstand or be deceived;

(7) Containing representations that the podiatrist is willing to perform any procedure which is illegal under the laws or regulations of Maryland or the United States;

(8) That fail to include the name of at least one podiatrist rendering services under the particular practice or trade name at the location advertised; or

(9) That fail to state that the practitioner is a podiatrist.

D. A podiatrist shall be accountable under this regulation if the podiatrist uses an agent, partnership, professional association, or health maintenance organization to implement actions prohibited by this regulation.

.4 Solicitation.

A. A podiatrist may not engage in solicitation, including but not limited to, in person, telephone, or direct mail solicitation which:

(1) Amounts to fraud, undue influence, intimidation or over reaching; or

(2) Contains statements which would be improper under Regulation .03C.

B. A podiatrist shall be accountable under this regulation if the podiatrist uses an agent, partnership, professional association, or health maintenance organization to implement actions prohibited by this regulation.

.5 Advertisement of Free, Discounted, or Reduced Fee Podiatric Goods or Services.

A. It is false and misleading advertising for a podiatrist to advertise or otherwise represent that any goods or services (for example, examination or X-rays) shall be offered or performed for:

(1) Free when the podiatrist in fact requests or receives a fee for reimbursement, directly or indirectly, for providing those goods or services; or

(2) A discounted or reduced fee when the podiatrist in fact requests or receives, directly or indirectly, a higher fee or reimbursement for providing those goods or services.

B. In addition to the free, discounted, or reduced price goods or services, a podiatrist, who has not obtained the written informed consent of the patient in the form as shown in

§ C of this regulation, may not for a fee offer or provide any podiatric goods or services to a patient within 72 hours of the date the patient presents a coupon, voucher, similar document, or advertisement offering:

(1) "Free" podiatric goods or services; or

(2) Podiatric goods or services for a discounted or reduced fee.

C. The podiatrist shall use the following Consent to Treatment Form and shall retain the form in the patient' s file:

PLEASE READ WITH CARE CONSENT TO TREATMENT IMMEDIATELY AFTER RECEIPT OF

FREE/DISCOUNTED/REDUCED PRICE GOODS OR SERVICES INTRODUCTION

The Board of Podiatric Medical Examiners wishes to inform you that, under the law of Maryland, you may not be charged a fee for podiatric goods or services which have been advertised as "free". Nor may you be charged more than the "reduced or discounted" fee advertised for particular podiatric goods or services.

In addition, before a podiatrist may charge you a fee to treat immediately or within 72 hours a problem diagnosed at the time you received free, reduced, or discounted podiatric goods or services, you shall consent in writing to accept that treatment. The podiatrist shall explain to you whether he or she thinks that you need the treatment immediately or within 72 hours, or whether your condition does not require immediate treatment. The decision to accept treatment immediately or at a later date is always your decision.

If you desire to accept treatment immediately or within 72 hours of today, please sign this document as required by law. Please be aware that you may be financially responsible for payment for the goods or services you receive.

INFORMATION PROVIDED

This podiatrist has explained to me the diagnosis of my condition and I understand it.

This podiatrist has explained the treatment alternatives and their risks to me and I understand them.

This podiatrist has explained the likely cost of each of the treatment alternatives and I understand it.

This podiatrist has explained to me the treatment he or she believes I need and I understand it.

This podiatrist has explained to me why I need the treatment immediately (within 72 hours of today) and I understand it.

CONSENT TO TREATMENT

I have received my free, reduced, or discounted goods or services. I am accepting treatment today or within 72 hours of today' s date and I fully understand that I may be charged for the treatment rendered.

Date

Patient' s Signature Witness' Signature Podiatrist' s Signature


.6 Penalties for Violation.

The Board may enforce this chapter against the podiatrist by any appropriate ground for disciplinary action, under Health Occupations Article, § 16-311, Annotated Code of Maryland.

Administrative History
Effective date: April 4, 1988 (15:7 Md. R. 849)
Regulation .02B amended effective March 5, 1990 (17:4 Md. R. 497)
Regulation .03C amended effective March 5, 1990 (17:4 Md. R. 497)
Regulation .05 recodified to .06 and new Regulation .05 adopted effective October 12, 1992 (19:20 Md. R. 1815)
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Chapter 07 Civil Penalties

Authority: Health Occupations Article, § 16-205 and 16-312, Annotated Code of Maryland

.1 Scope.

These regulations establish the standards by which the Board may impose an administrative monetary penalty not exceeding $5,000 on any individual licensed under Health Occupations Article, Title 16, Annotated Code of Maryland, for an act or omission proscribed under Health Occupations Article, § 16-312(a).

.2 Definitions.

A. In this chapter, the following terms have the meaning indicated.

B. Terms Defined.

(1) "Board" means the Board of Podiatric Medical Examiners.

(2) "Licensee" means an individual licensed by the Board to practice podiatry including the holder of a limited license.

(3) "Violation" means an act or omission proscribed under Health Occupations Article, § 16-312(a).

.3 Authority to Impose Administrative Monetary Penalty.

A. After a hearing under Health Occupations Article, § 16-314, Annotated Code of Maryland, and COMAR 10.40.05, the Board may impose an administrative monetary penalty of $5,000 or less under this chapter on a licensee who commits a violation.

B. A penalty under § A may be imposed:

(1) In addition to any reprimand, probation, suspension, or revocation; and

(2) For each occasion the licensee commits a violation.

.4 Factors to be Considered in the Assessment of Penalties.

The Board shall consider the following factors in determining whether to impose a penalty and the amount of any penalty:

A. The extent to which the individual derived any financial benefit from the violation;

B. The willfulness of the improper conduct;

C. The extent of actual or potential public harm caused by the violation;

D. The cost of investigating and prosecuting the case against the individual;

E. The individual' s history of any previous violation.

.5 Payment of Penalties.

A. The individual shall pay to the Board, on the date of its order, any administrative monetary penalty imposed under this chapter.

B. Filing an appeal does not stay payment of any penalty imposed by the Board under this chapter.

C. If an individual fails to pay, in whole or in part, any penalty imposed by the Board under this chapter, the Board may not restore, reinstate, or renew the license of the individual until the penalty has been paid in full.

D. The Board may refer all cases of delinquent payment to the Central Collection Unit of the Department of Budget and Fiscal Planning to institute and maintain proceedings and ensure prompt payment.

E. The Board shall pay into the General Fund of the State all monies collected under this chapter.

Administrative History
Effective date: July 25, 1988 (15:15 Md. R. 1810)

Chapter 08 Interpretation of Terms in the Maryland Podiatry Act

Authority: Health Occupations Article, §16-205(a), Annotated Code of Maryland

.1 Scope.

These regulations define and interpret certain terms used in the Maryland Podiatry Act, Health Occupations Article, Title 16, Annotated Code of Maryland.

.2 Definitions.

A. In the Maryland Podiatry Act, the following words have the meanings indicated.

B. Terms Defined.

(1) "Abandons a patient" includes but is not limited to the failure to treat a patient with whom the podiatrist has had a continual patient-podiatrist relationship, for any reason, including nonpayment of a bill, without giving the patient reasonable notice that the relationship is terminated.

(2) "Postgraduate clinical training" means training beyond the Doctor of Podiatric Medicine degree in a program that is accredited by the Council on Podiatric Medical Education of the American Podiatric Medical Association and approved by the Board.

(3) "Unprofessional conduct" includes but is not limited to:

(a) Willful or grossly negligent failure to comply with substantial provisions of federal or State laws, rules, or regulations governing the practice of podiatric medicine;

(b) Exercising undue influence on a patient including the promotion or the sale of services, goods, appliances, or drugs in such manner as to exploit the patient for the financial gain of the practitioner or a third party;

(c) Conduct in the practice of podiatric medicine which evidences moral unfitness to practice the profession;

(d) Practicing or offering to practice beyond the scope permitted by law, or accepting and performing professional responsibilities which the podiatrist knows or has reason to know the podiatrist is not competent to perform;

(e) Delegating podiatric medical responsibilities to a person when the podiatrist delegating these responsibilities knows or has reason to know that the person is not qualified by training, experience, or licensure to perform them;

(f) Performing podiatric medical services which have not been duly authorized by the patient or the patient' s legal representative;

(g) Ordering of excessive tests, treatment, or use of treatment facilities not warranted by the condition of the patient;

(h) Claiming or using any secret or special method of treatment which the podiatrist refuses to divulge to the Board upon request; or

(i) Fragmentation of a general procedure to increase the reimbursement.

.3 Examples of Fragmentation of Billing.

A. By way of illustration, but not limitation, fragmentation of billing in Regulation

.02B(3)(i) includes breaking the following general procedures into the following listed specific procedures:

(1) Keller bunionectomy--a multi-step procedure, which may include any or all of the following:

(a) Resection of medial eminence 1st metatarsal head;

(b) Resection base of proximal phalanx;

(c) Capsulotomy/capsulorrhaphy;

(d) Z-plasty of extensor tendon; and

(e) Sesamoidectomy.

(2) Lesser metatarsal osteotomy--a multi-step procedure, which may include any or all of the following:

(a) Tenoplasty;

(b) Capsulotomy/capsulorrhaphy;

(c) Osteotomy; and

(d) Fixation.

B. Fragmentation of billing is especially egregious when the licensee bills for both the general and specific procedures.

Administrative History
Effective date: November 26, 1990 (17:23 Md. R. 2732)
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Chapter 09 Compelling Purpose Disclosure

Authority: Health Occupations Article, §16-205; State Government Article, §10-617(h)(3); Annotated Code of Maryland

.1 Scope.

A. This chapter permits the Board to disclose investigative information to other agencies, or other entities, or both, under certain circumstances.

B. A custodian may disclose information in a licensing or investigative file if the custodian determines that a compelling public purpose exists to warrant disclosure.

.2 Disclosure for Compelling Public Purpose.

The custodian may find that a compelling public purpose warrants disclosure of information in a licensing or investigative file, regardless of whether there has been a request for the information, and may disclose the information under the following circumstances:

A. The information concerns possible criminal activity, and is disclosed to a federal, state, or local law enforcement or prosecutorial official or authority;

B. The information concerns a possible violation of law, and is disclosed to a federal, state, or local authority that has jurisdiction over the individual whose conduct may be a violation, and the information disclosed is limited to information relevant to the possible violation by that individual; or

C. The information concerns conduct by an individual which the Board reasonably believes may pose a risk to the public health, safety, or welfare, and is disclosed to a law enforcement authority, administrative official or agency that regulates the individual, or to a hospital or other health care facility where the individual has privileges.

.3 Other Disclosures.

This chapter does not prevent or limit the ability of the Board to disclose general licensing information as provided in State Government Article, §10-617(h), Annotated Code of Maryland, or any information which the Board may otherwise disclose by law.

Administrative History
Effective date: April 15, 2002 (29:7 Md. R. 621)
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