Scope and Construction

(1) Purpose. 243 CMR 2.00 is the Board of Registration in Medicine's directions concerning licensing and the practice of medicine. The purpose of 243 CMR 2.01 through 2.06 is to ensure that the Board issues certificates of registration only to qualified competent physicians of good moral character and to strengthen the Board’s licensing processes. The purpose of 243 CMR 2.07 through 2.04 is to prescribe substantive standards which will promote the public health, safety, and welfare and inform physicians of the Board's expectations and requirements. The Board requires that every physician in the Commonwealth has notice of 243 CMR 1.00 through 3.00 and expects that he or she will practice medicine in accordance with 243 CMR 2.00. (2) Authority. The Board adopts 243 CMR 2.00 under the authority of M.G.L. c. 13, §§ 9 through 11; M.G.L. c. 112, §§ 2 through 12DD; and M.G.L. c. 112, §§ 61 through 65E and 88. (3) Structure. 243 CMR 2.00 is organized as follows: 243 CMR 2.01 contains general provisions relating to all of 243 CMR 2.00; Part 1 consists of 243 CMR 2.02 through 2.06, the regulations relating to the licensing of physicians, and Part 2 consists of 243 CMR 2.07 through 2.15, the regulations relating to the practice of medicine. (4) Definitions. For the purposes of 243 CMR 1.00 through 3.00, the terms listed in 243 CMR 2.01(4) have the following meanings, unless otherwise provided: ABMS means the American Board of Medical Specialties. Accredited Canadian Postgraduate Medical Training means training which has been accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC), the College of Family Physicians of Canada (CFPC), or the Federation of Medical Licensing Authorities of Canada (FMRAC). ACGME means the Accreditation Council for Graduate Medical Education. Adjudicatory Hearing means a hearing conducted in accordance with M.G.L. c. 30A and with 243 CMR 1.00: Disciplinary Proceedings for Physicians. (Mass. Register #1545, 4/11/2025) AMA means the American Medical Association. AOA means the American Osteopathic Association. Board means the Board of Registration in Medicine established by M.G.L. c. 13, § 10. Canadian Medical Graduate means a person who attained an M.D. or D.O. degree from an accredited Canadian medical school. Change of License Status refers to a voluntary process wherebya full, active licensee may apply to the Board to change his or her active license status to an Inactive, Volunteer, Administrative, Retired or Restricted license status. Change of license status also refers to the voluntary process whereby a Volunteer, Administrative, Inactive, Retired or Lapsed licensee may apply to the Board for a change of license status. Child Abuse and Neglect Training means the education and training to recognize and report suspected child abuse or neglect required by M.G.L. c. 119, § 51A(k). Clinical Quality Measures (CQM) means, in the context of Meaningful Use, the processes, experiences or outcomes of patient care, observations or treatment that relate to one or more quality aims for health care such as effective, safe, efficient, patient-centered, equitable and timely care. COMLEX means Comprehensive Osteopathic Medical Licensing Examination - USA. Continuing Medical Education (CME) means educational activities that serve to maintain, develop or increase the knowledge, skills and professional performance and relationships that a physician uses to provide services for patients, the public or profession. CORI means Criminal Offender Record Information, as defined in M.G.L. c. 6, § 167. Data means any material upon which written, drawn, spoken, visual, or electromagnetic information or images are recorded or preserved, regardless of physical form or characteristics, as defined in M.G.L. c. 93H, § 1. Data Subject means the individual to whom personal data refers, as defined in M.G.L. c. 66A, § 1. Data Subject shall not include corporations, corporate trusts, partnerships, limited partnerships, trusts, sole proprietorships, or other business, not-for-profit or charitable entities. Domestic Violence and Sexual Violence Training means the education and training required by M.G.L. c. 112, § 264. ECFMG means Educational Commission for Foreign Medical Graduates. Electronic means relating to technology having electrical, digital, magnetic, wireless, optical, electromagnetic or similar capabilities. An electronic record is a record created, generated, sent, communicated, received, or stored by electronic means. Electronic Health Record (EHR) means an electronic record of patient health information generated by one or more encounters in any health care delivery setting. Electronic Health Record Systems include computerized physician order entry (CPOE), e-prescribing and other health information systems. End-of-life Care refers to the medical and ethical issues surrounding the end of a patient's life. End-of-life issues include the type and extent of medical care, services, treatments, medications and other options that may be available to the patient. End-of-life care includes palliative care as defined by 105 CMR 130.1900: Definitions Applicable to 105 CMR 130.1901. Fifth Pathway means a program of medical education which meets all of the following requirements: (a) Completion of two years of premedical education in a U.S. college or university acceptable to the Board; (b) Completion of all the formal requirements for the degree corresponding to doctor of medicine or doctor of osteopathy at a medical school outside the United States which is recognized by the World Health Organization; (c) Completion of one academic year of supervised clinical training sponsored by an approved medical school in the United States, the Commonwealth of Puerto Rico or Canada; and (d) Completion of one year of graduate medical education in a program approved by the Liaison Committee on Graduate Medical Education of the American Medical Association. FLEX means the Federation Licensing Examination. FSMB means the Federation of State Medical Boards. Health Care Facility means, for purposes of 243 CMR 2.00, any location where medicine is practiced, a hospital or other institution of the commonwealth, or of a countyor of a municipality within it; a hospital or clinic duly licensed or approved by the Department of Public Health; and an out patient clinic operated by the Department of Mental Health. Health Information Exchange means an electronic platform enabling the transmission of healthcare-related data among providers, payers, personal health records controlled by a patient and government agencies according to national standards, the reliable and secure transfer of data among diverse systems and access to and retrieval of data. Health Information Technology (Health IT or HIT) means the application of computers and technologyin health care settings. HIT mayinclude computerized physician order entrysystems, e-prescribing, electronic health records and other health information technology systems. International Medical School means a medical or osteopathic school in a country other than the United States, the Commonwealth of Puerto Rico or Canada. International Medical Graduate means a graduate of an international medical school. Lapsed License means the automatic expiration of a certificate of registration of anyfull licensee upon the licensee's failure to file a completed renewal application together with the required fee within the time period required. LCME means Liaison Committee on Medical Education. License means a certificate of registration which the Board issues to a person pursuant to the requirements of M.G.L. c. 112, §§ 2, 5A, 9 and 9B, and which authorizes the person to engage in the practice of medicine. There are four categories of licenses: full, limited, temporary and restricted. A full license allows a licensee to practice medicine as an independent practitioner free from specific limitations on his or her practice. Any other category of license restricts a licensee's practice. Licensing Committee means a Committee established by the Board to assist the Board in reviewing license applications filed pursuant to M.G.L. c. 112, §§ 2 through 9B. The Licensing Committee may review the qualifications of applicants and licensees, may conduct an interview, may request additional documentation, may refer an applicant or licensee for an evaluation of health concerns to a Board-approved entity, and may recommend actions to the Board. The Board, with due consideration for patient safety and the public health, safety and welfare, shall determine whether to issue, grant or renew a license, what the license term shall be and whether there shall be any license restrictions. LMCC means Licentiate of the Medical Council of Canada. The Massachusetts Health Information Highway (Mass HIway) means the network, owned and operated by the Massachusetts Executive Office of Health and Human Services (EOHHS) that enables the secure exchange of health information from one hospital or provider to another, regardless of provider affiliation, location or differences in technology. The MassHIway provides a mechanism for the Commonwealth’s entire health care community - residents, providers, public health officials and others - to have appropriate access to health information. MassHealth means the medical assistance program administered by the secretary of health and human services in accordance with M.G.L. c. 118E and Title XIX of the Social Security Act and any federal demonstration project or waiver relating to the medical assistance program. MCCQE means the Medical Council of Canada Qualifying Examination. Meaningful Use means the use of certified EHR technology in a meaningful manner, the electronic exchange of health information to improve the quality of health care and the use of certified EHR technology to submit clinical quality and other measures. Medical School means a legally chartered medical school in any jurisdiction. Medical Student means a person enrolled in a United States or an international medical school. NBME means the National Board of Medical Examiners. NPI means the National Provider Identifier, a unique national identification number issued by the federal government to all providers who bill health insurance plans. Pain Management Training means the education and training required by M.G.L. c. 94C, § 18(e). Such training shall include, but not be limited to, education in opioids and other pain-relieving medications, training in effective pain management, training in how to identify patients at high risk for substance abuse, and training on how to counsel patients on the side effects and addictive natures of prescription medicines and their proper storage and disposal. Personal Data has the same meaning in 243 CMR 2.00 as it does in M.G.L. c. 66A, § 1. Personal Information has the same meaning in 243 CMR 2.00 as it does in M.G.L. c. 93H, § 1. Physician Assistant (PA) means a person who is duly registered by the Board of Registration of Physician Assistants established by M.G.L. c. 112, § 9F. Supervising physicians and PAs are subject to the requirements of 243 CMR 2.08. The Physician Profile Program means the program established under M.G.L. c. 112, § 5 listing certain information about each physician holding a full license in Massachusetts and disseminating this to the public, primarily through the Board's website on the Internet. Physician Reentry means a return to clinical practice in the discipline in which one has been trained or certified following an extended period of clinical inactivity not resulting from discipline or impairment. The Practice of Medicine means the following conduct, the purpose or reasonably foreseeable effect of which is to encourage the reliance of another person upon an individual's knowledge or skill in the maintenance of human health by the prevention, alleviation, or cure of disease, and involving or reasonably thought to involve an assumption of responsibility for the other person's physical or mental well being: diagnosis, treatment, use of instruments or other devices, or the prescribing, administering, dispensing or distributing of drugs for the relief of diseases or adverse physical or mental conditions. (a) A person who holds himself or herself out to the public as a physician or surgeon, or with the initials "M.D." or "D.O." in connection with his or her name, and who also assumes responsibility for another person's physical or mental well being, is engaged in the practice of medicine. (b) The Practice of Medicine includes the following: 1. Telemedicine, as defined in 243 CMR 2.01: Telemedicine; and 2. Providing an independent medical examination or a disability evaluation. (c) The practice of medicine does not mean the following: 1. Conduct lawfullyengaged in by persons licensed by other boards of registration with authority to regulate such conduct; or 2. Assistance rendered in emergency situations by persons other than licensees. Reinstatement means the action of the Board restoring a revoked license. The Board may impose reasonable restrictions on a reinstated license. Renewal Date means the last day on which the license is in effect. Reviving a License means the restoration of a license that has lapsed or is inactive. Risk Management Program means a patient care assessment program established by the Board pursuant to M.G.L. c. 111, § 203(d) and recognized as a Risk Management Program within the meaning of M.G.L. c. 112, § 5. Risk Management Study or Risk Management CME means instruction in medical malpractice prevention, such as risk identification, patient safety, and medical error prevention. Risk management studies mayinclude education in anyof the following areas: medical ethics, quality assurance, medical-legal issues, patient relations, electronic health record education, end-of-life care, utilization review that directly relates to quality assurance, and aspects of practice management. Risk management CME mayinclude studyof the Board's regulations at 243 CMR 1.00 through 5.00. Specialty Board means a specialty board recognized by the American Board of Medical Specialties, the American Medical Association or the American Osteopathic Association. Telemedicine means the provision of services to a patient by a physician from a distance by electronic communication in order to improve patient care, treatment or services. United States Medical Graduate means a person who attained an M.D. or D.O. degree from a United States medical school. United States Medical School means an LCME accredited school of medicine, or an AOA accredited school of osteopathy, located in the United States. USMLE means the United States Medical Licensing Examination. (5) Computation of Time. Any period of time specified in 243 CMR 2.00 includes every calendar day, whether or not the office of the Board is open on that day, except that, when the last day of the period falls on a day when the Board's office is closed, the period ends instead on the next day on which the office is open. (6) Public Records and Personal Data. Documentaryinformation obtained by the Board during the licensing process concerning an applicant or licensee may be a Public Record, as defined by M.G.L. c. 4, § 7, clause twenty-sixth, or maybe Personal Data, as defined by M.G.L. c. 66A, § 1. The Board may not disclose personal data, unless disclosure is authorized by statute or is otherwise in accordance with M.G.L. c. 66A, § 2 (7) Confidentiality of Personal Information. The security and confidentiality of personal information held by the Board, whether relating to patients, consumers, applicants, licensees or anyother persons, shall be protected bythe Board in accordance with applicable state and federal laws including, but not limited to, the Confidentiality of Alcohol and Drug Abuse Patient Records, (42 C.F.R. Part 2); the Health Insurance Portability and Accountability Act of 1996, (P.L. 104-191); the Patient Safety and Quality Improvement Act of 2005, (P.L. 109-41); the Massachusetts Security Breach Law, (M.G.L. c. 93H); the Massachusetts Privacy Act, (M.G.L. c. 214, § 1B); the Massachusetts Freedom of Information Act, (M.G.L. c. 66A) and the Massachusetts Public Records Law, (M.G.L. c. 4, § 7, clause twenty-sixth). (8) Effective Date. License applications received by the Board on or after August 9, 2019 are governed by 243 CMR 2.00.