Protocol · PharmD · Massachusetts
Practice Protocol for Pharmacists in Massachusetts
Required. Massachusetts law names the instrument a Collaborative Practice Agreement (CPA), and the clinical protocol is the content that instrument carries. Below: the board that governs it, what it must contain, and the terms it has to carry.
Represents MA's Collaborative Drug Therapy Management (CDTM) tier (247 CMR 16.00), not base pharmacist licensure. CDTM is permanently physician-agreement-dependent with no independence pathway; community-pharmacy CDTM is limited to 9 enumerated chronic conditions and Schedule VI (non-controlled) drugs only.
What a Massachusetts Collaborative Practice Agreement (CPA) must contain
Governed by the Massachusetts Board of Registration in Pharmacy. Each numbered item is a statutory requirement the Collaborative Practice Agreement (CPA) must satisfy.
Massachusetts does not require the Pharmacist to hold a collaborative practice agreement in order to practice pharmacy generally. To engage in collaborative drug therapy management for a specific collaborative practice, however, the Pharmacist (who must have training and experience relevant to that practice) and the Physician shall enter into a written and signed Collaborative Practice Agreement ("CPA"), consistent with M.G.L. c. 112 §§ 24B1/2–24B3/4 and 247 CMR 16.00. The collaborative practice defined by the CPA must be within the scope of the Physician's own practice.
The CPA shall be subject to review and renewal at least every two (2) years, and a current copy shall be kept at the Pharmacist's practice site.
- The Collaborative Practice Agreement (CPA) also carries 1 scope, 1 education, 1 registration and 1 authority clauses, authored in the document itself.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the Collaborative Practice Agreement (CPA) has to carry, from Massachusetts's supervision rules.
Proximity
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Percentage set by agreement · As needed
No periodic percentage-based chart review is codified. Instead, each prescriptive action taken under the CPA (initiating, modifying, or discontinuing therapy) must be documented and the supervising physician notified within 24 hours (247 CMR 16.03).
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
community-pharmacy CDTM: Covered by the practice agreement · no controlled-substance authority
Limited to 9 enumerated chronic conditions (asthma, COPD, diabetes, hypertension, hyperlipidemia, CHF, HIV/AIDS, osteoporosis, and identified comorbidities); may extend existing therapy up to two additional 30-day periods, and administer vaccines. Schedule II–V controlled substances are explicitly excluded; only Schedule VI (non-controlled) prescribing is authorized (247 CMR 16.03).
hospital/long-term-care/hospice/ambulatory-clinic CDTM (as opposed to community pharmacy): Covered by the practice agreement · no controlled-substance authority
247 CMR 16.02 requires a pharmacist with prescriptive authority under any CDTM setting to maintain controlled-substance registration, which suggests institutional CDTM scope may reach controlled substances more broadly than the community-pharmacy tier; the entry shows the conservative reading.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — No pharmacist-ownership requirement is generally understood to apply to Massachusetts pharmacy registration (M.G.L. c. 112, § 39 et seq.); a licensed pharmacist must retain professional control over dispensing
Materially more permissive than the M.G.L. c. 156A professional-corporation regime governing PA/NP/CRNA/CNM/CNS/RN above, consistent with the pattern seen in every other state on file.
Sources for the supervision rules (1)
About Massachusetts's rules
Full practice authority (Acts 2020, c. 260, § 36; 244 CMR 4.00) lets NPs, PMHNPs and CNMs practice independently in Massachusetts: CNMs immediately, NPs and PMHNPs after a Board-attested transition (244 CMR 4.07). PAs and CRNAs have no independent-practice pathway. Massachusetts's professional-corporation ownership rules (M.G.L. c. 156A) are notably strict, and APRN and PA entity ownership remains unsettled.
Other clinicians in Massachusetts: see the state overview.