Code of Massachusetts Regulations › 243 CMR - BOARD OF REGISTRATION IN MEDICINE › Title 243 CMR 2.00 - Licensing and the practice of medicine › Section 2.01 - Scope and Construction

Current through Register 1525, July 5, 2024
(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
.
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 whereby a 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 county or 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 technology in health care settings. HIT may include
				computerized physician order entry systems, 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 any full 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 lawfully engaged 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 may include education in any of 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 may include study of 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.