Title: Massachusetts Advance Practice Registered Nurse Prescriptive Authority in Veteran Health Administration or Other Qualified Federal Entities in Jurisdictions Other than Massachusetts

Advisory Ruling Number: 10-02

Authority: The Massachusetts Board of Registration in Nursing (Board) issues this Advisory Ruling on Nursing practice pursuant to Massachusetts General Laws ("G.L."), chapter 30A, section 8 and chapter 112, section 80B.

Date Issued: October 13, 2010

Scope of Practice: Advance Practice Registered Nurse (APRN)

Purpose: After consultation with the Massachusetts Board of Registration in Medicine (7/29/10) and the Massachusetts Drug Control Program (7/28/10), the Board of Registration in Nursing (Board) issues this Advisory Ruling to clarify the prescriptive authority of Board authorized Advance Practice Registered Nurses (APRN) employed in Veterans Health Administration (VHA) or other qualified federal entities in a jurisdiction other than Massachusetts. Board regulations require a Massachusetts-licensed supervising physician develop guidelines and oversee the prescriptive practice of the APRN [i]. VHA policy [ii] requires APRNs who prescribe controlled substances to be authorized to do so by their state of licensure or registration. In Massachusetts, M.G.L. c. 112, § 81 provides that employees of the federal government in Massachusetts are not subject to the provisions of M.G.L. c. 112, §§ 80 and 80A. M.G.L. c. 112 § 80B provides that advanced practice nursing regulations related to prescriptive practice be promulgated by the BORN in conjunction with BORIM.

Advisory: In the following limited circumstances (described in (a) through (c) below), a Board authorized APRN may have a supervising physician who has an unrestricted, full, valid license in a jurisdiction other than Massachusetts as long as the physician reads and complies with other aspects of 244 CMR 4.00, including without limitation 244 CMR 4.05.

Required conditions for a non-Massachusetts supervising physician to supervise a Massachusetts APRN:

a. a nurse with an otherwise valid Massachusetts RN license and APRN authorization is practicing at a VHA facility or as a federal employee in another qualified federal entity in another jurisdiction and,

b. the nurse is subject to any applicable laws of that jurisdiction, and

c. the nurse otherwise meets the qualifications of the VHA or other federal entity and the facility in which he or she is employed.

In this circumstance, the supervising physician would not be required to hold valid Massachusetts registration to issue written or oral prescriptions or medication orders. It is acceptable for the physician to hold such registration in his/her state of licensure as required by his/her own license and by the federal employer.

[i] 244 CMR 4.05 http://www.mass.gov/Eeohhs2/docs/dph/regs/244cmr004.pdf pdf format of 244 CMR 4.00: Advanced Practice Registered Nursing

[ii] www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=1300.04

This information is provided by the Division of Health Professions Licensure within the Department of Public Health.