Collaborative Practice Agreement · NP
Massachusetts Written Collaborative Arrangement for Nurse Practitioners
Required. The Written Collaborative Arrangement is the written instrument Massachusetts law names for a Nurse Practitioner working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
Full practice authority (Acts 2020 c.260 §36) lets NPs practice independently after 2 years of supervised practice under mutually-agreed guidelines (or 3 years' independent-practice authority from another state) and Board attestation — not automatic (244 CMR 4.06–4.07). Some secondary sources cite '2,000 hours'; the regulation itself states years, not hours — treat the hours figure as unconfirmed.
Independent practice requires: 2 years of supervised practice under mutually-agreed guidelines with a Qualified Healthcare Professional (244 CMR 4.07), OR ≥3 years of independent-practice authority already held in another state/territory; submission of a Board attestation — independence is not automatic upon hitting the threshold.
What a Massachusetts Written Collaborative Arrangement must contain
Governed by the Massachusetts Board of Registration in Nursing and the Massachusetts Board of Registration in Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
Until the Nurse Practitioner completes two thousand (2,000) hours of supervised clinical practice, the Nurse Practitioner shall practice under a written collaborative arrangement with the Physician (or with an experienced Nurse Practitioner, as 244 CMR 4.00 permits), consistent with M.G.L. c. 112 § 80B et seq. Once the Nurse Practitioner completes that transition-to-practice period, no collaborative or supervisory arrangement is required for diagnosis, treatment, or prescribing.
A supervisor-verification form recognized by the Massachusetts Board of Registration in Nursing shall be used to document the collaborative arrangement during the transition-to-practice period.
- The Written Collaborative Arrangement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- 247 CMR 16.00regulation
Massachusetts Board of Registration in Pharmacy regulation on collaborative drug therapy management, implementing M.G.L. c. 112, §§ 24B1/2–24B3/4.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
before the 2-/3-year independent-practice threshold is reached: Available remotely (no on-site requirement)
244 CMR 4.06/4.07 require only 'mutually agreed upon guidelines' with a Qualified Healthcare Professional addressing scope and consultation triggers — no on-site or mile/minute standard is codified.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
before the 2-/3-year independent-practice threshold is reached: Separate prescribing terms required · controlled substances permitted
Schedule II–V per M.G.L. c. 94C §7; requires MA Controlled Substance Registration and/or DEA registration and MassPAT compliance for opioids.
after the 2-/3-year threshold and Board attestation: Covered by the practice agreement · controlled substances permitted
Prescribes independently with no supervising-physician review; same registration requirements apply.
Written agreement
Required
True for the default pre-independence case (mutually-agreed practice guidelines with a Qualified Healthcare Professional). Once the 2-/3-year threshold is met and the Board attestation is filed, no supervisory or collaborative agreement of any kind is required — full independent practice, including prescribing.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional Corporation under M.G.L. c. 156A. Whether nurse-owned PCs/PLLCs are an available pathway for NP-delivered care in MA (as they are in NC/VA) was not confirmed from primary statutory text in this research pass — treat as an open item, not a settled fact.
Ownership eligibility is a separate legal question from independent clinical practice status above — reaching independent-practice authority under 244 CMR 4.07 does not itself resolve the c. 156A ownership question.
Legal sources for these rules (4)
- Acts of 2020, c. 260, §36 — An Act Promoting a Resilient Health Care System That Puts Patients First
- 244 CMR 4.06 — Advanced Practice Registered Nursing, Scope of Practicesecondary
- 244 CMR 4.07 — Advanced Practice Registered Nursing, Prescriptive Practicesecondary
- Massachusetts Board of Registration in Medicine — NP and PA Licensing Guidesecondary
About Massachusetts's rules
Full practice authority (Acts 2020, c. 260, §36; 244 CMR 4.00) let NPs, PMHNPs, and CNMs practice independently in MA — CNMs immediately, NPs/PMHNPs after a Board-attested transition (244 CMR 4.07). PAs and CRNAs have no independent-practice pathway. MA's professional-corporation ownership rules (M.G.L. c. 156A) are notably strict; this file could not independently re-verify APRN/PA-specific PLLC eligibility this pass — treat CPOM entries as open items.
Other clinicians in Massachusetts: see the state overview.