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

2. B. Terms Defined.

   1. (1) “ACCME” means the Accreditation Council on Continuing Medical Education.
   2. (2) “ACGME” means the Accreditation Council for Graduate Medical Education.
   3. (3) “AOA” means the American Osteopathic Association.

   4. (4) Cosmetic Medical Device.

      1. (a) “Cosmetic medical device” means a device that alters or damages living tissue.

      2. (b) “Cosmetic medical device” includes any of the following items, when the item is used for cosmetic purposes:

         1. (i) Laser;
         2. (ii) Device emitting light or intense pulsed light;
         3. (iii) Device emitting radio frequency, electric pulses, or sound waves; and
         4. (iv) Devices used for the injection or insertion of foreign or natural substances into the skin, fat, facial tissue, muscle, or bone.

   5. (5) Cosmetic Medical Procedure.

      1. (a) “Cosmetic medical procedure” means a procedure using a cosmetic medical device or medical product to improve an individual's appearance.

      2. (b) “Cosmetic medical procedure” includes the following:

         1. (i) Skin treatments using lasers;
         2. (ii) Skin treatments using intense pulsed light;
         3. (iii) Skin treatments using radio frequencies, microwave, or electric pulses;
         4. (iv) Chemical peels that ablate living skin tissue;
         5. (v) Skin treatments with phototherapy;
         6. (vi) Dermabrasion;
         7. (vii) Subcutaneous, intradermal, or intramuscular injections of medical products;
         8. (viii) Treatments intended to remove or cause destruction of fat; and
         9. (ix) Any treatment using a cosmetic medical device for the purpose of improving an individual's appearance.
   6. (6) “Delegate” means to entrust a duty to a physician assistant under Health Occupations Article, Title 15, Annotated Code of Maryland.
   7. (7) “Delegation” means the entrusting of a duty by a physician to a physician assistant under Health Occupations Article, Title 15, Annotated Code of Maryland.
   8. (8) “Dermabrasion” means an abrasive process to remove epidermis and superficial dermis, resulting in a smoothing of contour irregularities.

   9. (9) “Direct supervision” means oversight exercised by a supervising physician who is:

      1. (a) In the physical presence of a non-physician and a patient; and
      2. (b) Instructing the non-physician in the performance of a cosmetic medical procedure, or observing the performance of a non-physician being trained in the procedure.
   10. (10) “Immediately available supervision” means the responsibility of a licensed physician to provide necessary direction in person, by telephone, or by other electronic means.

   11. (11) “Non-Physician” means an individual who:

       1. (a) Meets the requirements of Regulation .04 of this chapter; and
       2. (b) Is not licensed in Maryland as a physician.

   12. (12) “On-site supervision” means oversight exercised by a supervising physician who is:

       1. (a) Present at the site; and
       2. (b) Able to respond in person during a delegated or assigned cosmetic medical procedure.
   13. (13) “Physician assistant” means a physician assistant with a current certificate to practice in Maryland.

Authority: Health Occupations Article, §§14-205, 14-306, 14-404, 14-606, and 15-302, Annotated Code of Maryland

Effective date: August 23, 2010 (37:17 Md. R. 1185)

Regulation .02B amended effective March 14, 2016 (43:5 Md. R. 386); December 31, 2018 (45:26 Md. R. 1246)