Code of Massachusetts Regulations 243 CMR - BOARD OF REGISTRATION IN MEDICINE
Here’s a detailed overview of 243 CMR – Board of Registration in Medicine (Massachusetts), covering the key parts and updates:
📘 Structure of 243 CMR
According to the Trial Court Law Libraries, the regulation is organized into five parts:
1.00: Disciplinary proceedings for physicians
2.00: Licensing and practice of medicine
3.00: Qualified patient care assessment programs
4.00: Disciplinary proceedings for acupuncturists
5.00: The practice of acupuncture (mass.gov)
1.00 – Disciplinary Proceedings
Covers grounds, adjudication, sanctions, and license revocation/reinstatement rules.
Includes confidentiality of investigations and outlines procedures for hearings, decisions, fines (up to $10,000), suspension, revocation (minimum 5 years), and reinstatement timelines (mass.gov).
2.00 – Licensing & Practice
Details licensure requirements, including pathways for graduates of international medical schools and Fifth-Pathway programs (basic/clerkship, documentation, equivalency standards) (law.cornell.edu).
Recent amendments banned delegation of medical services to unlicensed individuals (e.g., BP interpretation) and enhanced informed consent rules, requiring written policies and clear documentation of responsible persons (jdsupra.com).
3.00 – Patient Care Assessment Programs
Effective February 1, 2012, mandates that physicians/institutions implement credentialing, peer review, QA, utilization review, and risk management programs to proactively identify and prevent substandard care (mass.gov).
Emphasizes confidentiality and immunity protections for internal reviews.
4.00 & 5.00 – Acupuncture
Section 4 deals with disciplining acupuncturists.
Section 5 defines and governs the practice of acupuncture.
📌 Staying Current
Massachusetts regularly proposes amendments to its medical regulations, including 243 CMR. For instance, in March 2025, emergency amendments were introduced to reflect the Massachusetts Shield Law, ensuring protections for providers of reproductive and gender-affirming care (mass.gov, sec.state.ma.us, mass.gov, sec.state.ma.us).
To stay updated, visit the Mass.gov "Physician Regulations, Policies and Guidelines" page or the Proposed Amendments section (mass.gov).
💡 Key Changes You Should Know (2024–2025):
No delegation of medical acts (BP interpretation, etc.) to unlicensed staff (natlawreview.com).
Informed consent: Physicians must now document written policies, detailed discussions, and responsible parties (natlawreview.com).
Shield Law codification into disciplinary and licensing regs, with public hearings held (e.g., March 21, 2025) (sec.state.ma.us).
✅ Summary Table
| Part | Focus Area |
|---|---|
| 1.00 | Disciplinary procedures, hearings, sanctions, confidentiality |
| 2.00 | Initial/renewal licensing, international grads, delegation & informed consent |
| 3.00 | Quality assurance and patient care review programs |
| 4.00 | Acupuncturist disciplinary procedures |
| 5.00 | Regulation of acupuncture practice |
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