In 1991, Governor William Weld promulgated major Workers' Compensation reform legislation. The legislation provided a new direction for Workers' Compensation health care in Massachusetts's. Central to the reform was the Department of Industrial Accidents' (DIA) implementation of a utilization review and quality assessment program to monitor the appropriateness of medical services, as well as the necessity and the effectiveness of treatment for injured/ill employees. Further, the statute reconvened and enhanced the responsibilities of the Health Care Services Board (HCSB). Composed of 13 voluntary members, one of the responsibilities the Board was charged with was the development of treatment guidelines for the appropriate and necessary treatment of Massachusetts's injured/ill workers. These treatment guidelines were accepted and per statute MGL c. 152 promulgated on July 1, 1993, to be used for all health care services rendered on or after October 1, 1993. 

Treatment guidelines or practice algorithms are part of a new direction in health care policy and are considered optimal strategies for patient management around which practice patterns should converge. These treatment guidelines are meant to cover the majority of tests and treatments for each condition for which they apply. The original guidelines were derived from multiple sources including, but not limited to, the American Academy of Orthopedic Surgeons, the state of Washington, Department of Labor and Industries and multi-disciplinary committees of the Health Care Services Board.

MGL c. 152 requires annual review of the guidelines currently in existence. Any interested party may request and/or suggest revision to any guideline by contacting the DIA. Application of these treatment guidelines is a mandatory requirement of 452 CMR 6.0 et seq. for workers' compensation in Massachusetts.