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Behavioral Health Providers
Prior Authorization Requirements For Providers Prescribing Buprenorphine-Containing Products

Prior authorization requirements are up to the discretion of the state Medicaid program or insurance company.

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Education Required for Addiction Counselor Credentialing

Massachusetts credentials two types of addiction counselors. A Licensed Alcohol and Drug Counselor (LADC) I requires a graduate degree, complete relevant education courses and 6,000 hours of experience. A LADC II requires, at minimum, a high school diploma and complete relevant education courses. An individual with a bachelor's degree may earn the credential after 4,000 hours of supervised practice and an individual without a degree will need 6,000. 105 Code of Mass. Reg. 168Massachusetts Bureau of Substance Addiction Services and Massachusetts Board of Substance Abuse Counselor Certification

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Licensed Professional Counselor Ability to Diagnose

A licensed mental health counselor may provide services to individuals, families or groups. Counselors may assess, diagnosis and treat mental and emotional disorders. They may also use psychoeducational techniques aimed at prevention of such disorders, and consultation to individuals, couples, families, groups, organizations and communities. 262 Code Mass. Reg. §2.02

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Peer Support Specialist Certification or Credentialing Authority

The standards for the certification of peer specialists, including experience, training, and supervision requirements, are developed and administered by a third-party, non-profit certification provider.

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Advanced Practice Registered Nurses
Certified Nurse Midwife Practice and Prescriptive Authority

Full independent practice and prescriptive authority.

Nurse midwives shall practice within a health care system and have clinical relationships with obstetrician-gynecologists that provide for consultation, collaborative management or referral, as indicated by the health status of the patient. Nurse midwifery care shall be consistent with the standards of care established by the American College of Nurse Midwives.

Nurse midwives may engage in prescriptive practice without guidelines or supervision. Code Mass. Reg. §244-4.06; Code Mass. Reg. §244-4.07

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Nurse Practitioner Practice and Prescriptive Authority

Full practice authority but transition to independent prescribing authority.

A NP will only practice in the clinical category(s) for which the CNP has attained and maintained certification. NPs with less than two years of experience need guidelines for prescriptive practice and will be supervised by a Qualified Healthcare Professional (physician or NP with independent practice authority). After this period, the NP may independently prescribe. Code Mass. Reg. §244-4.07

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Nurse Practitioner Authority to Sign POLST Forms

Although not codified, NPs are authorized to sign medical orders for life-sustaining treatment (MOLST) forms. Please see the Massachusetts MOLST website for more information.

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Nurse Practitioner as a Primary Care Provider

NPs are recognized in state policy as primary care providers. If a health care carrier requires the designation of a primary care provider, the carrier must provide its insured with an opportunity to select a participating provider nurse practitioner as a primary care provider or to change its primary care provider to a participating provider nurse practitioner at any time during their coverage period. Mass. Gen. Laws Ann. tit. 22 ch.176R §4

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Optometrists
Authority to Perform Ophthalmic Procedures

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. Mass. Gen. Laws Ann. tit. 16 ch. 112 §66

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Injectable Authority

Optometrists may not administer medication through injection. Mass. Gen. Laws Ann. tit. 16 ch. 112 §66B

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Prescription of Controlled Substances

Optometrists may prescribe schedule IV controlled substances required for the diagnosis, prevention, management or treatment of abnormal ocular conditions or diseases.  Mass. Gen. Laws Ann. tit. 16 ch. 112 §66B

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Oral Health Providers
Dental Hygienists with Direct Access

A dental hygienist who has at least three years of practice experience and a written collaborative agreement with a local or state government agency or institution, or licensed dentist may provide dental hygiene services without supervision in public health settings (e.g., hospitals, medical facilities, schools, community clinics, etc.). The patient must also be provided a written referral to a dentist and an assessment of future oral health needs. Mass. Gen. Laws Ann. tit. 16 ch. 112 §51

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Dental Therapists

Statute does not identify dental therapists as an oral health provider.

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Practice of Teledentistry

Massachusetts does not explicitly allow for the practice of teledentistry.

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Pharmacists
Administration of COVID-19 Vaccine

Massachusetts has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

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Prescription Adaptation

Massachusetts does not allow pharmacists to modify prescriptions.

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Prescription of Hormonal Contraceptives

As of August 4th, 2022, pharmacists can dispense emergency contraception pills (ECP) through a statewide standing order, pursuant to chapter 127 of the acts of 2022, An Act Expanding Protections for Reproductive and Gender-Affirming Care. There are two types of ECP that have been approved by the U.S. Food and Drug Administration (FDA) to prevent pregnancy after unprotected sex or sexual assault: ulipristal acetate (UPA or ella®) and levonorgestrel (LNG, Plan B One-Step®, or generic versions). The pharmacist shall provide the patient with instructions based on selected ECP.

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Prescription of Tobacco Cessation Aids

Massachusetts does not allow pharmacists to prescribe tobacco cessation aids.

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Physician Assistants
Physician Assistant Practice and Prescriptive Authority

Supervision by a physician required for practice and prescriptive authority.

PAs, depending upon their level of professional training and experience as determined by a supervising physician, may perform medical services of a general nature and may order tests and therapeutics in assisting physicians in private practice, in group practices or in health care facilities, consistent with any applicable bylaws and policies of such facilities. Mass. Gen. Laws tit. 16 ch. 112, §9E

Any PA who holds a full license, issued by the board, may issue written or oral prescriptions or medication orders for a patient, provided that he or she does so in accordance with all applicable state and federal laws and regulations.

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Number of PAs Supervised

Massachusetts currently has no provisions related to the number of PAs a physician can supervise.

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Chart Co-Signatures

Chart co-signatures may be determined at the practice level except for Schedule II controlled substances.

Any prescription or medication order issued by a PA for a Schedule II controlled substance shall be reviewed by his or her supervising physician, or by a temporary supervising physician within 96 hours after its issuance. Mass Code Reg. tit. 263 §5.06(3)

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Adaptable Proximity Requirements

Statute allows adaptable proximity.

Notwithstanding any other provisions of law, a PA may perform medical services when such services are rendered under the supervision of a registered physician. Such supervision shall be continuous but shall not require the personal presence of the supervising physician or physicians. Mass. Gen. Laws tit. 17 ch. 112, §9E

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Scope of Practice Determination

A PA may perform any services under the supervision of a physician within the PA's competency and scope of services. Mass. Reg. Code tit. 263 §5.04

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