Massachusetts Nursing Board Adopts Independent Practice Rules

Posted By American Med Spa Association, Thursday, June 10, 2021

Update July 9: The Board of Registration in Nursing will hold a public hearing on the emergency amendments Friday, July 16, 2021 at 1:00 p.m. All interested parties are encouraged to submit written testimony via email with the subject line “BORN: 244 CMR 4.00” sent to by 5:00 p.m. on Friday, July 16, 2021.
The Massachusetts Board of Registration in Nursing approved a set of emergency rules to permit permanent independent practice for advance practice registered nurses (APRN). The need for the emergency rule has to do with how independent practice came about. In an effort to bolster access to health care during the COVID-19 pandemic, Massachusetts temporarily removed the requirement for APRNs to have a physician supervise their prescriptive practices. This allowed APRNs to be independent throughout the pandemic, which would have expired in June of this year. In December, however, independence was made permanent though contingent on having admin rules to govern practice and training. The redlined version of these rules are available in full here.

These rules provide for the needed credentialing of APRNs as well as a supervised transition period. In order to initially be authorized as an APRN, applicants must:

APRNs who practice as certified registered nurse anesthetists (CRNA), certified nurse practitioners (CNP) or psychiatric nurse mental health clinical specialist (PNMHCS) may initially engage in prescriptive practice when supervised by a “Qualified Healthcare Professional.” Once they have completed at least two years of supervised practice, they can apply to be authorized to prescribe without supervision. The Qualified Healthcare Professional can be a physician who is board-certified in the APRN’s specialty or another APRN who shares the same specialty and has been prescribing for at least three years—either three years independently or two supervised and one independent. It remains the APRN’s responsibility to maintain documentation that they meet all practice requirements.
These emergency rules are in effect now. The board will go ahead with the normal rule adoption process to make these permanent. There is some possibility that the final rule may differ from this emergency version based on the adoption and hearing process. We will be monitoring these rules for final adoption.