Current through Register 1531, September 27, 2024
(1)
Prerequisites to Initial
Licensure. The Board shall determine whether an applicant is
qualified, competent and of good moral character to hold a full active license to
practice medicine. In order to qualify for a full medical license, an applicant
shall meet all of the following minimum requirements for licensure:
(a) Be 18 years of age or older;
(b) Possess Good Moral Character;
(c) Have Premedical Education as described in
243 CMR 2.02(2)(a);
(d) Have a
Medical School Education as described in either 243 CMR 2.02 or
2.03;
(e) Have Postgraduate Medical Training as
described in either 243 CMR 2.02 or
2.03;
(f) Pass a Professional Examination as
described in 243 CMR 2.02(3) or (4);
(g) Complete Pain Management Training, as
described in M.G.L. c. 94C, § 18;
(h) Participate in a Risk Management Program as
described in M.G.L. c. 112, § 5;
(i) Agree to refrain from balance billing
Medicare recipients, if the applicant has agreed to treat Medicare recipients, as
provided in M.G.L. c. 112, § 2;
(j) Sign and swear to the contents of his or
her Licensing Application;
(k) Pay a
registration fee, as described in
243 CMR 2.05(1)
and
801 CMR
4.02(243);
(l) Demonstrate Proficiency in Electronic
Health Records, as required by M.G.L. c. 112, § 2;
(m) Obtain professional liability malpractice
insurance of at least $100,000/$300,000 coverage amounts, as provided in
243 CMR
2.07(16), if providing patient
care in the Commonwealth;
(n) Certify
that he or she is in compliance with the laws of the Commonwealth relating to
taxes, the reporting of employees and independent contractors, and the
withholding and remitting of child support, pursuant to M.G.L. c. 62C, §
49A;
(o) Complete Domestic Violence
and Sexual Violence Training;
(p)
Apply for or participate in MassHealth, either as a provider of services or as a
nonbilling provider for the limited purpose of ordering and referring services
covered under MassHealth, and provided that regulations governing such limited
participation are promulgated under M.G.L. c. 118E; and
(q) Complete Child Abuse and Neglect
Training.
(2)
Procedure for Obtaining an Initial Full License for Graduates of
Medical Schools in the United States, Canada and the Commonwealth of Puerto
Rico. In order to qualify for a full medical license, an applicant
shall meet the prerequisites to licensure in 243 CMR 2.02(1) and the following
requirements, in addition to other requirements for licensure as set forth in
243 CMR 2.00 and M.G.L. c. 112.
(a)
Premedical
Education. An applicant shall have completed a minimum of two or
more academic years at a legally chartered college or university. Such premedical
training shall include courses in biology, inorganic chemistry, organic chemistry
and physics, or their equivalent as determined by the Board.
(b)
Medical Education.
An applicant for an initial full license shall have completed and attended for
four academic years of instruction, of not less than 32 weeks in each academic
year, or courses which in the opinion of the Board are equivalent thereto, in one
or more legally chartered medical schools, and have received the degree of doctor
of medicine from a medical school accredited by the LCME, or a doctor of
osteopathy degree from an osteopathic school accredited by the AOA.
(c)
Postgraduate Medical
Training. Each applicant for a full license, whose application is
received by the Board on or after February 1, 2012, must have completed two years
of postgraduate medical training in an ACGME or AOA approved, or accredited
Canadian program. In the case of sub-specialty clinical fellowship programs,
however, the Board may accept postgraduate training in a hospital that has an
ACGME or AOA approved, or accredited Canadian, postgraduate medical training
program in the primary specialty. In its discretion, the Board may consider an
applicant who has completed one year of ACGME or AOA approved, or accredited
Canadian, postgraduate training and who:
1.
Holds a current, active, unrestricted full medical license in another
state;
2. Demonstrates continuous
clinical activity; and
3. Is board
certified by either ABMS or AOA.
(d)
Examination. An
applicant for full licensure shall fulfill the examination requirements for
licensure as set forth in 243 CMR 2.02(3) or (4), whichever applies;
and
(e)
Pain Management
Training. Applicants who prescribe controlled substances shall, as a
prerequisite to obtaining or renewing a medical license, complete appropriate
Pain Management Training and opioid education, according to M.G.L. c. 94C, §
18 and
243 CMR 2.00. Pain Management
Training shall consist of at least three credits of Board-approved continuing
medical education and may be used toward the required ten credits of risk
management training.
(f)
EHR Proficiency Requirement.
1.
Demonstrating EHR
Proficiency. An applicant for an initial full license must
demonstrate proficiency in the use of electronic health records (EHR), as
required by M.G.L. c. 112, § 2. An applicant shall demonstrate proficiency
in the use of EHR once, and in one of the following ways:
a. Participation in a Meaningful Use program as
an eligible professional;
b.
Employment with, credentialed to provide patient care at, or in a contractual
agreement with an eligible hospital or critical access hospital with a CMS
Meaningful Use program;
c.
Participation as either a Participant or an Authorized User in the Massachusetts
Health Information Highway;
d.
Completion of three hours of a Category 1 EHR-related CME course that discusses,
at a minimum, the core and menu objectives and the CQMs for Meaningful Use. These
three EHR credits may be used toward the required ten risk management CME
credits.
2.
Exemptions. Exemptions must be claimed each licensing
cycle if applicable. The following are exempt from the requirement to demonstrate
EHR Proficiency:
a. An applicant who will not be
engaged in the practice of medicine as defined in
243 CMR
2.01(4);
b. An applicant for an Administrative
License;
c. An applicant for a
Volunteer License;
d. An applicant on
active duty as a member of the National Guard or of a uniformed service called
into service during a national emergency or crisis; or
e. An applicant for an Emergency Restricted
License.
(g)
Participating in a Risk Management Program. The
applicant shall agree to participate in a risk management program as a condition
of licensure, as required by M.G.L. c. 112, § 5 and
243 CMR 3.00: The
Establishment of and Participation in Qualified Patient Care Assessment Programs,
Pursuant to M.G.L. c. 112, § 5, and M.G.L. c. 111, § 203. The
applicant must agree to participate in a risk management program that meets or
exceeds the rules, procedures and standards set forth in
243 CMR 3.00.
(h)
Prohibition on Balance Billing
of Medicare Beneficiaries. The applicant shall agree, if he or she
agrees to treat Medicare beneficiaries, that he or she shall accept as payment in
full the Medicare fee schedule amount for the services performed, and shall not
balance bill a Medicare beneficiary as provided in M.G.L. c. 112, § 2, and
243 CMR
2.07(15).
(i)
Mandatory Medical Malpractice
Insurance. Whenever an applicant renders direct or indirect patient
care in Massachusetts, he or she shall maintain professional liability insurance
in an amount of at least $100,000 per claim, $300,000 minimum annual aggregate,
pursuant to
243 CMR
2.07(16).
1. Pursuant to
243 CMR
2.07(16), coverage may be on
an individual or shared limit basis. Coverage shall be continued until the
expiration of any relevant statutes of limitations relevant to the events or
occurrences covered.
2. The following
licensees are not subject to the medical malpractice insurance requirement:
a. Licensees with no direct or indirect
responsibility for patient care in the Commonwealth; or
b. Licensees whose patient care in the
Commonwealth is limited to professional services rendered at or on behalf of
federal, state, county or municipal health care facilities; or
c. Limited licensees pursuant to M.G.L. c. 112,
§ 9.
(j)
Domestic Violence and Sexual Violence Training. Pursuant
to M.G.L. c. 112, § 264, applicants and licensees shall participate in
Domestic Violence and Sexual Violence Training once as a condition for licensure,
renewal, revival or reinstatement of licensure. The Board, in consultation with
the Department of Public Health, will identify programs or courses of study that
meet the standards required by this provision and provide its licensees with a
list of such programs or courses. This is a one-time training
requirement.
(k)
MassHealth Requirement. Pursuant to M.G.L. c. 112,
§§ 2 and 9, applicants and licensees shall apply to participate in
MassHealth, either as a provider of services or as a non billing provider for the
limited purpose of ordering and referring services in the MassHealth program, as
a condition for licensure, renewal, revival or reinstatement of licensure. A
physician who is not engaged in the practice of medicine is exempt from the
MassHealth requirement. This is a one-time licensing requirement.
(l)
Child Abuse and Neglect
Training. Pursuant to M.G.L. c. 119, § 51A(k), applicants and
licensees shall complete training in recognizing and reporting suspected child
abuse and neglect. Physicians may comply with the training requirement by:
receiving training in child abuse and neglect assessment in medical school
education or postgraduate training; completing a hospital-sponsored training
program in recognizing the signs of child abuse and neglect; completing CME in
identifying and reporting child abuse and neglect; completing a Board-approved
online training program or completing a specialized certification. This is a
one-time training requirement.
(m)
Compliance with Tax Laws. Pursuant to M.G.L. c. 62C,
§ 49A, the applicant for a license to practice medicine shall certify, upon
penalties of perjury, that he or she has complied with all the laws of the
Commonwealth relating to taxes, the reporting of employees and contractors, and
the withholding and remitting of child support. The commissioner of the
department of revenue shall notify the board of any returns due or any taxes
payable for an applicant.
1. Upon reasonable
cause, the commissioner of the department of revenue may issue a waiver of the
certification requirement in M.G.L. c. 62C, § 49A.
2. The existence of a non-frivolous appeal of
an unfiled tax return or a tax due or an overdue child support assessment, or the
existence of a payment agreement with the department of revenue with which the
applicant is fully compliant, shall not prevent the issuance of the full
license.
3. The commissioner of the
department of revenue shall confirm for the Board when the applicant is in good
standing with respect to returns due or taxes payable.
(n)
Certificate of
Registration. If the Board determines that an applicant is
qualified, competent and of good moral character, such applicant will be
registered as a licensed physician and entitled to a certificate in testimony
thereof signed by the chair and secretary.
(3) Examination
Requirements.
(a)
Conduct Prior to and During an Examination. Applicants
who engage in the conduct described in 243 CMR 2.02(3)(a)1. through 3. shall have
their test materials confiscated, shall be denied permission to complete the
examination and shall be required to leave the examination room:
1. Removing test materials from the examination
room; reproducing in any manner or aiding in the reproduction of test materials;
selling, distributing, buying or having unauthorized possession of test
materials; or
2. Communicating with
any other examinee during the exam; copying answers or permitting answers to be
copied; having in one's possession, during the examination, any material other
than the examination materials; failure to obey instructions to stop working or
starting an examination prior to being authorized to do so; or
3. Falsifying or misrepresenting educational
credentials or other information required for admission to the exam; having
another person take the exam on one's behalf.
(b)
Examinations Completed January
1, 2000 or Later. An applicant for an initial full license, except
those who satisfy the requirements of 243 CMR 2.02(3)(c), must submit evidence,
including certification by the examining body, of having achieved a passing score
on each of Steps 1, 2, and 3 of the USMLE, or received a passing score on each of
the three levels of NBME's COMLEX exam, within a seven-year time period,
beginning with the examination date when the examinee first passes a step of
either exam. An applicant for an initial full license must submit evidence of
having successfully completed all parts of the MCCQE.
(c)
The Seven-year
Rule An applicant who fails to pass Step 3 of the USMLE, or level 3
of the COMLEX, within three attempts, shall be required to take one additional
year of ACGME or AOA approved postgraduate training between the third and fourth
attempt. If the applicant did not complete an additional year of ACGME or AOA
approved postgraduate training between the third and fourth attempt at Step 3 or
level 3, the applicant is not eligible for Massachusetts licensure.
If an applicant for licensure fails to pass Step 1 of the USMLE
or Level 1 of the COMLEX after four attempts, the applicant is not eligible for
Massachusetts licensure. No waiver is available to any candidate that did not
pass Step 1 of the USMLE or Level 1 of the COMLEX on the fourth attempt.
If an applicant for licensure fails to pass Step 2 of the USMLE
or Level 2 of the COMLEX after four attempts, the applicant is not eligible for
Massachusetts licensure. No waiver is available to any applicant that did not
pass Step 2 of the USMLE or Level 2 of the COMLEX on the fourth attempt.
If an applicant for licensure fails to pass Step 3 of the USMLE
or Level 3 of the COMLEX after four attempts, the applicant is not eligible for
Massachusetts licensure. No waiver is available to any candidate that did not
pass Step 3 of the USMLE or Level 3 of the COMLEX on the fourth attempt.
1.
Joint Degree Waiver of
Seven-year Rule. The Board may grant a waiver of the seven-year
examination completion requirement in the case of an applicant who is actively
pursuing another advanced doctoral study, provided:
a. The applicant requesting a waiver of the
seven-year rule must be enrolled in a LCME accredited program and be a student in
good standing.
b. The Board shall
consider the length of time the applicant is beyond the seven years; a candidate
requesting a waiver of the seven-year rule will be required to present a
verifiable and rational explanation for his or her inability to meet the
seven-year requirement. In no case will a waiver be granted beyond a total period
of ten years for completion of all three steps of the USMLE.
2.
Other Reasons for Requesting a
Waiver of the Seven-year Rule. In very limited and extraordinary
circumstances, the Board, subject to any policies or guidelines that may be
adopted and in effect on the date of the waiver petition, may grant a
case-by-case exception to the seven-year period upon petition by an applicant for
licensure and demonstration by the applicant of:
a. A verifiable and rational explanation for
the failure to satisfy the regulation;
b. Strong academic and post-graduate record;
and
c. A compelling totality of
circumstances.
(4)
Examinations Completed before
January 1, 2000. Applicants may submit evidence, including
certification by the examining body, of having achieved scores acceptable to the
Board on the following combinations of exams, if satisfactorily completed before
January 1, 2000, in lieu of passing scores on the USMLE or
COMLEX:
(a) Part I of the examination of the
NBME or Step 1 of the USMLE, and Part II of examination of the NBME or Step 2 of
the USMLE, and Part III of the examination of the NBME or Step 3 of the USMLE;
or
(b) Both Component 1 and Component
2 of the FLEX; or
(c) All parts of
the MCCQE; or
(d) Individual state
examinations given prior to June 19, 1970, which are satisfactory to the Board;
or
(e) Component 1 of the FLEX and
Step 3 of the USMLE; or
(f) Component
2 of the FLEX and:
1. Part I and Part II of the
examination of the NBME; or
2. Step 1
and Step 2 of the USMLE; or
3. Part I
of the examination of the NBME and Step 2 of the USMLE; or
4. Step 1 of the USMLE and Part II of the
examination of the NBME.
(5)
FLEX Requirements.
(a) Beginning with the June 1985 examination,
an applicant who has received the passing score of 75 or higher on Component 1
and 2 has passed the licensing examination. Prior to the June 1985 examination,
an applicant who completed the FLEX in one sitting and has received a passing
grade of a FLEX weighted average of 75% or higher has passed the licensing
examination.
(b) An applicant who
applies on the basis of an examination taken in June 1985 or later must have
received a passing score of 75 or higher on each of the two components and be
otherwise qualified. An applicant who applies on the basis of an examination
taken prior to June 1985 must have taken the FLEX in one sitting, must have
received a grade of a FLEX weighted average of 75% or higher and be otherwise
qualified.
(6)
Restricted Licenses.
(a)
Nature of
Restrictions. The Board shall determine whether an applicant is
qualified, competent and of good moral character to hold a restricted license to
practice medicine. An applicant for a license issued under M.G.L. c. 112, §
5A shall first satisfy all the applicable prerequisites to licensure outlined in
243 CMR 2.02(1), except the electronic health records requirement in 243 CMR
2.02(1)(l) shall not be required. If the Board determines that an applicant's
qualifications and professional training indicate that the Board should restrict
his or her practice of medicine, the Board may issue a license restricted to any
of the following:
1. A specialty or specified
procedures within the specialty in which the applicant is a diplomate;
or
2. A specified health care
facility in which the applicant will practice under the supervision of a fully
licensed specified physician; or
3.
Prohibitions on performing certain procedures or operations, or prohibitions on
performing procedures or operations under certain circumstances; or
4. In any other manner deemed appropriate by
the Board based on the Board's assessment of the applicant's qualifications and
professional training.
(b)
Emergency Restricted License for a Displaced Physician.
The Board may issue an emergency restricted license to practice to a physician
licensed in another state, who has been displaced from his or her medical
practice by reason of a federally-declared disaster, provided the physician
applies for the emergency restricted license under the sponsorship of a licensed
Massachusetts physician. An emergency restricted license issued for this purpose
shall expire no later than three months after the date of issuance, or upon
issuance of a full, unrestricted license, if sooner. If the Board approves a
restricted licensee's application for a full, unrestricted license, the issue
date of the full unrestricted license shall be the issue date of the emergency
restricted license. An emergency restricted license may be restricted by
location, specialty or any other manner as described in 243 CMR 2.02(6)(a). For
purposes of 243 CMR 2.02(6)(a), a sponsoring physician must have a full, active,
unrestricted Massachusetts license, and must be readily available on a continuing
basis to provide guidance to the applicant regarding his or her responsibilities
under 243 CMR and the statutes of the Commonwealth. Each restricted licensee
shall provide the Board with proof of appropriate insurance coverage for
malpractice claims.
(7)
Limited Licenses.
(a)
Purpose. Under M.G.L. c. 112, § 9, the Board issues
a limited license to a person who has received an appointment as an intern,
resident or fellow at a health care facility or in a training program approved by
the Board. The Board shall determine whether an applicant is qualified, competent
and of good moral character to hold a limited license to practice medicine. A
limited license enables a person to complete his or her medical
training.
(b)
Prerequisites and Exceptions. Applicants for a Limited
License shall satisfy the requirements of 243 CMR 2.02(1), except the following:
1. 243 CMR 2.02(1)(e): Post-graduate
Training;
2. 243 CMR
2.02(1)(f): Professional Examination;
3. 243 CMR 2.02(1)(g): Pain Management
Training;
4. 243 CMR
2.02(1)(h): Participating in a Risk Management
Program;
5. 243 CMR
2.02(1)(i): Agreement to not Balance Bill Medicare
Patients;
6. 243 CMR
2.02(1)(l): Demonstration of Proficiency in Electronic Health
Records;
7. 243 CMR
2.02(1)(q): Child Abuse and Neglect Training..
(c)
Emergency Restricted
Limited License. The Board may issue an emergency restricted limited
license to practice to a person who has been displaced from his or her medical
training by reason of a federally-declared disaster, provided the person has
received an appointment as an intern, resident or fellow at a health care
facility or in a training program approved by the Board, and such program
sponsors the person for the emergency restricted limited license. Applicants for
an Emergency Restricted Limited License shall satisfy the requirements of 243 CMR
2.02(7)(b). An emergency restricted license issued for this purpose shall expire
no later than three months after the date of issuance, or upon issuance of a
limited license, if sooner. If the Board approves a restricted licensee's
application for a limited license, the issue date of the limited license shall be
the issue date of the emergency restricted limited license. An emergency
restricted limited license may be restricted by location, specialty or any other
manner as described in
243 CMR 2.00. For purposes of
243 CMR 2.02(7), a sponsoring training program or health care facility must
designate a physician who is readily available on a continuing basis to provide
guidance to the applicant regarding his or her responsibilities under 243 CMR and
the laws of the Commonwealth. (d)
Requirements for a Limited Medical
License. In order to qualify for a limited medical license, an
applicant shall meet the following requirements, in addition to other applicable
requirements for licensure as set forth in
243 CMR 2.00 and relevant
sections of M.G.L. c. 112:
1.
Medical Education. Each applicant for a limited license
must satisfy the degree requirements of 243 CMR 2.02(1)(a) through (d) or be a
graduate of a Fifth Pathway program.
2.
Examination
Requirements. Each applicant for a limited license must submit
evidence of having achieved a passing score on Steps 1 and 2 of the USMLE, or the
first two Levels of the COMLEX exam, or having received a certificate from the
MCCQE.
3.
ECFMG
Certification. International medical graduates, other than graduates
of a Fifth Pathway program, shall submit ECFMG certification valid as of the date
of issuance.
4.
ACGME or
AOA Approved Position. Each applicant for a limited license must
submit proof of an appointment to an ACGME or AOA approved postgraduate training
program in Massachusetts, or a fellowship in a Massachusetts health care
facility, which conducts on its premises ACGME or AOA approved
programs.
(8)
Procedure for Issuing a Limited License. Any applicant
who meets all of the requirements of 243 CMR 2.02(8) to the satisfaction of the
Board will be granted a limited license and is entitled to a certificate of
registration signed by the chair and the secretary of the Board.
(a)
Limited License Is Specific to
Training Program. A limited license authorizes a limited licensee to
practice medicine only in the specified training program. The licensee may only
practice at the training program or at the health care facility designated on the
limited license or at the facility's approved affiliates. Limited licensees may,
however, practice for up to eight weeks in any single year of residency at a
non-designated facility, if that facility is a teaching hospital with three or
more ACGME or AOA accredited programs. A limited licensee may practice medicine
only under the supervision of a full licensee who has been credentialed by the
facility where the limited licensee is practicing pursuant to 243 CMR 2.02(8).
The Board will not issue more than one limited license to a person at a
time.
(b)
Report of
Disciplinary Actions to the Board. A health care facility that takes
a disciplinary action against a limited licensee in a training program must
report this action to the Board. In the event that a limited licensee terminates
his or her appointment at a health care facility or his or her participation in a
training program prior to the limited license's expiration date, or has his or
her appointment or participation terminated, the health care facility designated
on the license shall submit to the Board, pursuant to M.G.L. c. 111, § 53B,
a written notice of termination which sets forth the reasons for the termination
and is signed by the director or the administrator of the health care facility or
training program.
(9)
Duration of a Limited License.
(a)
The Duration of a Limited
License Shall Be One Academic Year. The Board may, subject to any
guidelines that have been adopted by the Licensing Committee and the Board, issue
a limited license for the duration of a trainee's enrollment in an ACGME or AOA
training program. The issuance of a limited license beyond a total of seven years
of practice pursuant to a limited license may be granted only by a majority vote
of the Board.
(b) Nothing in 243 CMR
2.02(9) shall limit the Board's authority to revoke a limited license at any time
in accordance with M.G.L. c. 112, § 9.
(10)
Restrictions on Billing by
Limited Licensees. In a training program, a full licensee may bill
for the services of a limited licensee, but only if such services are rendered as
part of the training program under the direct supervision of a full licensee.
Except as provided in the preceding sentence, no one may bill for the services of
a limited licensee, but the salary of a limited licensee may constitute part of a
health care facility's service charges.
(11)
Volunteer
License.
(a)
Purpose. In order to encourage physician volunteerism
and to serve the public health, the Board establishes a Volunteer License
category. The Board shall determine whether an applicant is qualified, competent
and of good moral character to hold a volunteer license to practice medicine. To
qualify for a volunteer license, an applicant shall satisfy the prerequisites for
a full initial license as set forth in 243 CMR 2.02(1), except for 243 CMR
2.02(1)(l). In satisfaction of 243 CMR 2.02(1)(k), the candidate shall pay a
Volunteer License application fee, if one is established by the secretary of
administration and finance pursuant to M.G.L. c. 7, § 3B. The Board may
require that the applicant successfully pass a clinical skills assessment or
other professional evaluation of clinical competency. The Volunteer License is
chosen voluntarily by the applicant, and the Board shall not involuntarily impose
this license status on an applicant or licensee.
1.
Serving the Public
Health. As part of the application for a volunteer license, a
candidate shall submit the following information:
a. A written statement from the applicant
outlining the scope and duration of services to be provided by him or
her;
b. A written statement from the
director of the applicant's proposed work site outlining the scope and duration
of the applicant's responsibilities; and
c. Evidence satisfactory to the Board that the
volunteer physician's proposed work will serve the public interest. An example of
work that serves the public interest is treating a medical population in need
that may not otherwise have access to medical care.
(b)
Issuance of
Volunteer License. An applicant who meets all of the requirements of
243 CMR 2.02(11) to the satisfaction of the Board will be granted a volunteer
license and is entitled to a certificate of registration signed by the chair and
the secretary of the Board.
(c)
Scope of Practice for Volunteer Status. A licensee
engaged in volunteer practice shall be subject to the same conditions and
responsibilities as a full licensee, and may not accept compensation in any form
for his or her practice of medicine.
(d)
Termination. A
volunteer license issued in accordance with 243 CMR 2.02(11) may be renewed
biennially. A volunteer license shall terminate automatically when it expires
upon its expiration date or upon Board approval of a full license application. A
volunteer licensee engaged in patient care is required to have professional
malpractice liability insurance as in 243 CMR 2.02(1)(m).
(e)
Change in License
Status.
1.
From Retired
to Volunteer License. A licensee holding a Retired inactive license
may apply to the Board for a change of license status from Retired inactive
status to a Volunteer active license. The licensee shall complete an application
for a Volunteer license. If the licensee has been away from the clinical practice
of medicine for two or more years, the Board may require the completion of a
Board-approved clinical skills assessment program, physician supervision or
monitoring, CMEs, medical education or other such requirements to assist the
licensee in reentering the clinical practice of medicine.
2.
From Full to Volunteer
License. If a physician with a full license wishes to change his or
her license category to a volunteer license, he or she may file a Request for a
Change of License Category with the Board. Such a request may be made at the time
of license renewal or anytime during the license term.
3.
From Volunteer to Full
License. A licensee holding a volunteer license may apply to the
Board for a change of license status from a Volunteer license to a full license.
The licensee shall complete an application for a full license and pay the
difference between the volunteer license application fee and the full license
application fee.
(12)
Administrative
License. The Board shall determine whether an applicant is
qualified, competent and of good moral character to hold an administrative
license to practice medicine. In order to qualify for an administrative license,
an applicant shall satisfy the educational and postgraduate training requirements
for a full license as set forth in at 243 CMR 2.02(1), except for 243 CMR
2.02(1)(g), (l) and (m) and the following requirements:
(a)
General. The Board
may issue an administrative license to an applicant whose primary
responsibilities are those of an administrative or academic nature; such as
professional managerial, administrative, or supervisory activities related to the
practice of medicine or the delivery of health care services or medical research,
the practice of investigative medicine or the administration of health insurance
organizations. The Administrative License status is chosen voluntarily by the
applicant, and the Board shall not involuntarily impose this license status on an
applicant or licensee. An administrative license does not include the authority
to diagnose or treat patients, issue prescriptions for drugs or controlled
substances, delegate medical acts or prescriptive authority, or issue opinions
regarding medical necessity.
(b)
Malpractice Insurance Requirements. A physician with an
administrative license is not required to have professional malpractice liability
insurance.
(c)
Issuance
of License. An applicant who meets all of the requirements of 243
CMR 2.02(1), except for 243 CMR 2.02(1)(g) and (m), to the satisfaction of the
Board will be granted an administrative license and is entitled to a certificate
of registration signed by the chair and the secretary of the Board.
(d)
Biennial. An
administrative license issued in accordance with 243 CMR 2.02(12) may be renewed
biennially. An administrative license shall terminate automatically upon Board
approval of a full license application.
(e)
Change in License
Status.
1.
From Full to
Administrative License. If a physician with a Full license wishes to
change his or her license category to an Administrative license, he or she may
file a request for a Change of License status with the Board.
2.
From Administrative to Full
License. A licensee with an Administrative license may apply to the
Board to change his or her license status to a Full license upon filing a Request
for a Change in License status. The licensee shall submit a proposed reentry into
clinical practice plan, if applicable, and pay the full license application fee.
A reentry into clinical practice plan will describe the applicant's proposal to
resume clinical practice, his or her continuing professional development,
clinical training and other relevant experience during the time period in which
the applicant held an administrative license. The Board may require that a
licensee with an Administrative license status, who wishes to return to clinical
practice, successfully pass a Board-approved clinical skills assessment or other
Board-approved professional determination of clinical competency.
(13)
Temporary License. The Board shall determine whether an
applicant is qualified, competent and of good moral character to hold a temporary
license to practice medicine. In order to qualify for an initial temporary
license, an applicant must meet the requirements of 243 CMR 2.02(1), except 243
CMR 2.02(1)(l) and except as otherwise provided in
243 CMR 2.00, in addition to the
requirements of 243 CMR 2.02(13).
(a)
Academic Faculty Appointment. Pursuant to M.G.L. c. 112,
§ 9B, the Board may issue an Academic Faculty Appointment license. This is a
temporary license that the Board may issue to a visiting physician who is
licensed to practice in another jurisdiction, and who has a temporary faculty
appointment certified by the dean of a medical school in Massachusetts for
purposes of medical education in an accredited hospital associated with the
medical school; and a scope of practice plan certified by the Chair of the
Department, approved by the Board and subject to audit thereof.
1. A temporary license issued under 243 CMR
2.02(13) shall be valid for a period set by the Board, not exceeding 12 months,
may be renewed up to two times, and shall terminate automatically upon
termination of the faculty appointment. A temporary license under 243 CMR
2.02(13) and any renewals thereof shall not exceed three years.
2. In order to renew a temporary license under
243 CMR 2.02(13), the licensee shall complete the following requirements:
a. The opioid education and pain management
training requirement, as described in 243 CMR 2.02(2)(e);
b. The end-of-life care education requirement,
as described in
243 CMR
2.06(6)(b); and
c. 50% of the continuing professional
development requirement for full licensees, as described in
243 CMR
2.06(6).
3. All practice of medicine by a licensee under
243 CMR 2.02(13)(a) must be essential to his or her teaching and shall be
restricted to the specified institution or any of that facility's approved
affiliates.
4. A temporary licensee
may not practice outside the scope of practice that is directly related to his or
her educational and training responsibilities.
(b)
Substitute
Physician.
1.
Holds an
Out-of-state License. Pursuant to M.G.L. c. 112, § 9B, the
Board may issue a temporary license to a physician who is licensed to practice
medicine in another U.S. jurisdiction to permit him or her to act as a substitute
physician for a physician licensed in Massachusetts. A temporary license issued
in accordance with 243 CMR 2.02(13)(b) may be granted only upon written request
of the physician licensed in Massachusetts and shall be limited to a period of
three months or less. A locum tenens physician may be a
substitute physician.
2.
Diplomate of Specialty Board. The Board may issue a
temporary license to a physician eligible for examination or registration in the
Commonwealth who is a diplomate of a specialty board approved by the American
Medical Association or the American Osteopathic Association to permit him or her
to act as a substitute physician for a registered physician in the commonwealth.
This temporary license is granted only upon written request of the licensed
physician, is limited to the specialty in which the applicant is certified and
limited to three months or less.
(c)
Participating in a CME
Course. Pursuant to M.G.L. c. 112, § 9B, the Board may issue a
temporary license to a physician who is licensed to practice in another
jurisdiction, and who is enrolled in a course of continuing medical education in
Massachusetts. A temporary license issued in accordance with 243 CMR 2.02(13)(c)
is limited to continuing medical education activities conducted under the
supervision of a physician licensed in Massachusetts and shall terminate
automatically upon termination of the course and, in any event, at the end of
three months.
(d)
Issuance of License. An applicant who meets all of the
requirements of 243 CMR 2.02(13) to the satisfaction of the Board will be granted
a temporary license and is entitled to a certificate of registration signed by
the chair and the secretary of the Board.