1. A. Authority and Types.

   1. (1) The Secretary may impose one or more principal or alternative sanctions.

   2. (2) Principal Sanctions. The Secretary may impose the following principal sanctions:

      1. (a) Denial of a license;
      2. (b) Suspension of a license; and
      3. (c) Revocation of a license.

   3. (3) Alternative Sanctions. Instead of or in conjunction with lifting a principal sanction, the Secretary may impose one or more of the following alternative sanctions:

      1. (a) A directed plan of correction;
      2. (b) Limitation on testing; and
      3. (c) Training and technical assistance.

2. B. Reasons for Imposition. A laboratory is subject to the imposition of one or more sanctions when the OHCQ finds:

   1. (1) A deficiency identified through an on-site survey or a review of materials submitted by a laboratory, such as applications data, personnel qualification materials, and self-inspection checklists;
   2. (2) Unsuccessful proficiency testing performance;
   3. (3) Demonstrated incompetence, such as showing consistent or repetitive errors in operating equipment or in performing a test or procedure;
   4. (4) False statements made on an application, plan-of-correction, or other form submitted to the OHCQ;
   5. (5) Misrepresentation in obtaining a permit or letter of exception or in operating a laboratory;

   6. (6) Failure to comply with the:

      1. (a) Cancer reporting requirements of Health-General Article, §18-204, Annotated Code of Maryland; and
      2. (b) Infectious disease and submission of clinical material requirements of Health-General Article, §18-205, Annotated Code of Maryland, and COMAR 10.06.01;
   7. (7) Submission of a specimen by a laboratory inside the State to another laboratory that does not possess a license as set forth in COMAR 10.10.03;
   8. (8) Conviction by a court of a violation of the laws of the State pertaining to a medical laboratory; or
   9. (9) Exceeding the 50 test per year limit when operating under a letter of exception—limited testing for rare diseases as set forth in COMAR 10.10.03.05B.

3. C. Factors Affecting Choice of Sanctions. The Secretary shall choose which sanctions to apply to a laboratory based on, but not limited to, the following:

   1. (1) Whether a deficiency poses immediate jeopardy to personal or public health or safety;
   2. (2) The nature, incidence, severity, and duration of the deficiency;
   3. (3) Whether a deficiency has been identified repeatedly;
   4. (4) The inaccuracy or extent of missing laboratory records, such as missing documentation of remedial action or failure to make records available to the OHCQ;
   5. (5) The relationship of one deficiency or group of deficiencies to another deficiency;
   6. (6) The overall compliance history of a laboratory, including but not limited to any period of noncompliance that occurred between determinations of compliance;
   7. (7) The corrective and long-term compliance outcomes the Secretary intends to effect through application of the sanction; and
   8. (8) The progress a laboratory has made toward regulatory compliance following a reasonable opportunity to correct a deficiency.
4. D. Mandatory Revocation of a License. The Secretary shall revoke for 1 year the license of a laboratory that intentionally refers a proficiency test sample to another laboratory for analysis.
5. E. Owning and Operating Prohibition Following Revocation. A person who has owned, operated, or directed a laboratory that has had its license revoked may not, within 1 year of the revocation, apply for a license, or own or operate a laboratory for which a license has been issued under this chapter.

Authority: Health-General Article, §§17-202, 17-206, 17-210, 17-211, and 17-509, Annotated Code of Maryland

Effective date: December 13, 1999 (26:25 Md. R. 1897)

Regulation .01B amended effective June 1, 2009 (36:11 Md. R. 787)

Regulation .02A, B amended effective June 1, 2009 (36:11 Md. R. 787)

Regulation .02B amended effective March 1, 2026 (52:24 Md. R. 1198)

Regulation .04B amended effective June 1, 2009 (36:11 Md. R. 787)

Regulation .05 adopted effective March 27, 2006 (33:6 Md. R. 578)