Code of Massachusetts Regulations
244 CMR - BOARD OF REGISTRATION IN NURSING
Title 244 CMR 4.00 - Advanced Practice Registered Nursing
Section 4.05 - Eligibility Requirements for Advanced Practice Registered Nurse (APRN) Authorization

Universal Citation: 244 MA Code of Regs 244.4

Current through Register 1518, March 29, 2024

(1) Certified Registered Nurse Anesthetist (CRNA).

(a) To be eligible for initial Board authorization to practice as a CRNA, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a CRNA; and

ii. holds accreditation from a Board recognized national accrediting organization for academic programs; and

b. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmaco-therapeutics.

4. Current CRNA certification granted by a Board Recognized APRN Certifying Organization;

5. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B;

6. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth; and

7. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(b) To be eligible for renewal of the Board's authorization to practice as a CRNA, the CRNA must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required at MGL c. 112, § 74, and as established by Board policy;

3. Current CRNA certification granted by a Board Recognized APRN Certifying Organization;

4. Payment of the required fees as established by the Executive Office of Administration and Finance; and

5. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(c) Nurses who obtained initial Board authorization to practice as a CRNA prior to August 1, 2014 may renew their authorization in accordance with the provisions of 244 CMR 4.05(1)(b), even if they do not meet requirements for initial authorization to practice as a CRNA set forth in 244 CMR 4.05(1)(a) or 4.05(1)(d).

(d) Initial Authorization of CRNA by Reciprocity. To be eligible for reciprocal Board authorization to practice as a CRNA from another jurisdiction, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a CRNA; and

ii. holds accreditation from a Board recognized national accrediting organization for academic programs; or

b. Satisfactory completion of a formal education program in addition to academic nursing preparation which meets the standards of a Board recognized national accrediting organization for academic programs and which has as its objective the preparation of nurses to perform as a CRNA; and

c. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmaco-therapeutics.

4. Current license or authorization as a CRNA in another state, the District of Columbia, or a U.S. Territory in good standing;

5. Current CRNA certification granted by a Board Recognized APRN Certifying Organization;

6. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B.;

7. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth; and

8. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(e) The Board may revoke, suspend, or refuse to renew its authorization permitting an RN to practice as a CRNA or otherwise discipline the authorization and/or the RN license if it determines, after an adjudicatory hearing conducted in accordance with M.G.L. c. 30A, that the person fails to meet any regulation requirement. In addition, the Board may impose discipline for any of the reasons set forth in M.G.L. c. 112, §§ 61 and 74.

(2) Certified Nurse Midwife (CNM).

(a) To be eligible for initial Board authorization to practice as a CNM, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a CNM;

ii. holds accreditation from a Board recognized national accrediting organization for academic programs; and

b. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmaco-therapeutics.

4. Current CNM certification granted by a Board Recognized APRN Certifying Organization;

5. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B;

6. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth; and

7. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(b) To be eligible for renewal of the Board's authorization to practice as a CNM, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required at MGL c. 112, § 74, and as established by Board policy;

3. Current CNM certification granted by a Board Recognized APRN Certifying Organization;

4. Payment of the required fees as established by the Executive Office of Administration and Finance; and

5. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(c) Nurses who obtained initial Board authorized practice as a CNM prior to August 1, 2014 may renew their authorization in accordance with the provisions of 244 CMR 4.05(2)(b), even if they do not meet the requirements for initial authorization to practice as a CNM set fourth in 244 CMR 4.05(2)(a) or 4.05(2)(d).

(d) Initial Authorization of CNM by Reciprocity. To be eligible for reciprocal Board authorization to practice as a CNM from another jurisdiction, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a CNM; and

ii. holds accreditation from a Board recognized national accrediting organization for academic programs; or

b. Satisfactory completion of a formal educational program in addition to academic nursing preparation which meets the standards of a Board recognized national accrediting organization for academic programs and which has as its objective the preparation of nurses to practice as a CNM; and

c. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmaco-therapeutics.

4. Current license or authorization as a CNM in another state, the District of Columbia, or a U.S. Territory in good standing;

5. Current CNM certification granted by a Board Recognized APRN Certifying Organization;

6. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B;

7. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth; and

8. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(e) The Board may revoke, suspend, or refuse to renew its authorization permitting an RN to practice as a CNM or otherwise discipline the authorization and/or the RN license if it determines, after an adjudicatory hearing conducted in accordance with M.G.L. c. 30A, that the person fails to meet any regulation requirement. In addition, the Board may impose discipline for any of the reasons set forth in M.G.L. c. 112, §§ 61 and 74.

(3) Certified Nurse Practitioner (CNP).

(a) To be eligible for initial Board authorization to practice as a CNP, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a CNP; and

ii. holds accreditation from a Board recognized national accrediting organization for academic programs; and

b. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmacotherapeutics.

4. Current CNP certification granted by a Board Recognized APRN Certifying Organization;

5. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B;

6. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth; and

7. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(b) To be eligible for renewal of the Board's authorization to practice as a CNP, the CNP must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required at M.G.L. c. 112, § 74, and as established by Board policy;

3. Current CNP certification granted by a Board Recognized APRN Certifying Organization;

4. Payment of the required fees as established by the Executive Office of Administration and Finance; and

5. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(c) Nurses who obtained initial Board authorized practice as a CNP prior to August 1, 2014 may renew their authorization in accordance with the provisions of 244 CMR 4.05(3)(b), even if they do not meet requirements for initial authorization to practice as a CNP set forth in 244 CMR 4.05(3)(a) or 4.05(3)(d).

(d) Initial Authorization of CNP by Reciprocity. To be eligible for reciprocal Board authorization to practice as a CNP from another jurisdiction, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a CNP; and

ii. holds accreditation from a Board recognized national accrediting organization for academic programs; or

b. Satisfactory completion of a formal educational program in addition to academic nursing preparation which meets the standards of a Board recognized national accrediting organization for academic programs and which has as its objective the preparation of professional nurses to practice as a CNP; and

c. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmacotherapeutics.

4. Current license or authorization as a CNP in another state, the District of Columbia, or a U.S. Territory in good standing;

5. Current CNP certification granted by a Board Recognized APRN Certifying Organization;

6. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B;

7. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth; and

8. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(e) The Board may revoke, suspend, or refuse to renew its authorization permitting a RN to practice as a CNP or otherwise discipline the authorization and/or the RN license if it determines, after an adjudicatory hearing conducted in accordance with M.G.L. c. 30A, that the person fails to meet any regulation requirement. In addition, the Board may impose discipline for any of the reasons set forth in M.G.L. c. 112, §§ 61 and 74.

(4) Psychiatric Nurse Mental Health Clinical Specialist (PNMHCS).

(a) To be eligible for initial Board authorization to practice as a PNMHCS, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a PNMHCS; and

ii. holds accreditation from a Board recognized national accrediting organization for academic programs; and

b. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmacotherapeutics.

4. Current PNMHCS certification granted by a Board Recognized APRN Certifying Organization;

5. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B;

6. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth; and

7. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(b) To be eligible for renewal of the Board's authorization to practice as a PNMHCS, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required at M.G.L. c. 112, § 74, and as established by Board policy;

3. Current PNMHCS certification granted by a Board Recognized APRN Certifying Organization;

4. Payment of the required fees as established by the Executive Office of Administration and Finance; and

5. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(c) Nurses who obtained initial Board authorized practice as a PNMHCS prior to August 1, 2014 may renew their authorization in accordance with the provisions of 244 CMR 4.05(4)(b), even if they do not meet requirements for initial authorization to practice as a PCNS set forth in 244 CMR 4.05(4)(a) or 4.05(4)(d).

(d) Initial Authorization of PNMHCS by Reciprocity. To be eligible for reciprocal Board authorization to practice as a PNMHCS from another jurisdiction, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a PNMHCS; and

ii. holds accreditation from a Board recognized national accrediting organization for academic programs; or

b. Satisfactory completion of a formal educational program in addition to academic nursing preparation which meets the standards of a Board recognized national accrediting organization for academic programs and which has as its objective the preparation of nurses to practice as PNMHCS; and

c. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmacotherapeutics.

4. Current license or authorization as a PNMHCS in another state, the District of Columbia, or a U.S. Territory in good standing;

5. Current PNMHCS certification granted by a Board Recognized APRN Certifying Organization;

6. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B;

7. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth; and

8. If engaging in prescriptive practice, completion of training required pursuant to M.G.L. c. 94C, § 18(e).

(e) The Board may revoke, suspend, or refuse to renew its authorization permitting a RN to practice as a PNMHCS or otherwise discipline the authorization and/or the RN license if it determines, after an adjudicatory hearing conducted in accordance with M.G.L. c. 30A, that the person fails to meet any regulation requirement. In addition, the Board may impose discipline for any of the reasons set forth in M.G.L. c. 112, §§ 61 and 74.

(5) Clinical Nurse Specialist (CNS).

(a) To be eligible for initial Board authorization to practice as a CNS, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a CNS; and

ii. holds accreditation from a Board recognized national accrediting organization for academic programs;

b. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmacotherapeutics; and

c. Current CNS certification granted by a Board Recognized APRN Certifying Organization;

4. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B;

5. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth; and

6. Effective until December 31, 2016, the Board will accept current CNS certification granted by a Board-recognized certifying organization as equivalent to 244 CMR 4.05(5)(a)3 b. The CNS who is authorized by the Board on the basis of this equivalent competency will be eligible to renew his or her authorization under 244 CMR 4.05(5)(b).

(b) To be eligible for renewal of the Board's authorization to practice as a CNS, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required at M.G.L. c. 112, § 74, and as established by Board policy;

3. Current CNS certification granted by a Board Recognized APRN Certifying Organization; and

4. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B.

(c) Initial Authorization of CNS by Reciprocity. To be eligible for reciprocal Board authorization to practice as a CNS from another jurisdiction, an applicant must provide proof satisfactory to the Board of the following:
1. Valid Massachusetts RN licensure in good standing;

2. Good moral character as required by M.G.L. c. 112, § 74, and as established by Board policy;

3. Compliance with the following academic requirements:
a. Graduation from a graduate degree program that:
i. is designed to prepare the RN for practice as a CNS; and

ii. holds accreditation from a Board recognized national accrediting organization for academic programs; and

b. Successful completion of, at minimum, core content at the graduate level in advanced assessment, advanced pathophysiology and advanced pharmacotherapeutics;

4. Current license or authorization as a CNS in another state, the District of Columbia, or a U.S. Territory in good standing;

5. Current CNS certification granted by a Board Recognized APRN Certifying Organization;

6. Payment of the required fees as established by the Executive Office of Administration and Finance, unless waived pursuant to M.G.L. c. 112, § 1B; and

7. An attestation, signed under the pains and penalties of perjury, that the applicant participates in, or has applied to participate in, MassHealth as either a provider of services or as a non-billing provider for the purpose of ordering and referring services covered under MassHealth.

8. Effective until December 31, 2016, the Board will accept current CNS certification granted by a Board-recognized certifying organization as equivalent to 244 CMR 4.05(5)(c)3 b. The CNS who is authorized by the Board on the basis of this equivalent competency will be eligible to renew his or her authorization under 244 CMR 4.05(5)(b).

(d) The Board may revoke, suspend, or refuse to renew its authorization permitting a RN to practice as a CNS or otherwise discipline the authorization and/or the RN license if it determines, after an adjudicatory hearing conducted in accordance with M.G.L. c. 30A, that the person fails to meet any regulation requirement. In addition, the Board may impose discipline for any of the reasons set forth in M.G.L. c. 112, §§ 61 and 74.

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