1 of 1
SENATE DOCKET, NO. 1823 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 1402
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Jason M. Lewis
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act improving healthcare delivery for underserved residents of the commonwealth.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :Jason M. LewisFifth MiddlesexJack Patrick Lewis7th Middlesex1/20/2023Joanne M. ComerfordHampshire, Franklin and Worcester1/30/2023Jacob R. OliveiraHampden, Hampshire and Worcester1/30/2023Julian CyrCape and Islands2/10/2023Carmine Lawrence Gentile13th Middlesex2/10/2023Vanna Howard17th Middlesex2/14/2023Michael O. MooreSecond Worcester2/15/2023James B. EldridgeMiddlesex and Worcester2/17/2023 1 of 6
SENATE DOCKET, NO. 1823 FILED ON: 1/20/2023
SENATE . . . . . . . . . . . . . . No. 1402
By Mr. Lewis, a petition (accompanied by bill, Senate, No. 1402) of Jason M. Lewis, Jack
Patrick Lewis, Joanne M. Comerford, Jacob R. Oliveira and other members of the General Court
for legislation to improve healthcare delivery for underserved residents of the commonwealth.
Public Health.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
_______________
An Act improving healthcare delivery for underserved residents of the commonwealth.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Chapter 112 of the General Laws, as appearing in the 2020 Official Edition,
2is hereby amended by striking out Section 9, and inserting in place thereof the following
3section:-
4 Section 9.
5 (a) An applicant for limited registration under this section may, upon payment of a fee to
6be determined annually by the commissioner of administration under the provision of section
7three B of chapter seven, be registered by the board as an intern, fellow or medical officer for
8such time as it may subscribe if the applicant furnishes the board with satisfactory proof of the
9following:
10 (1) The applicant is eighteen or over and of good moral character. 2 of 6
11 (2) (i) The applicant has creditably completed two years of a premedical course of study
12in a college or university and not less than three and one-half years of study in a legally chartered
13medical school having the power to grant degrees in medicine; or (ii) if not enrolled in or a
14graduate of a legally chartered medical school in the United States or Canada, the applicant is the
15holder of a standard certificate granted after an examination by the Education Council for
16Foreign Medical Graduates, unless granted an exemption by the board; or (iii) the applicant has
17completed two years of premedical education in a college or university of the United States,
18Canada or Puerto Rico and if the applicant has studied medicine in a medical school outside the
19United States, Canada or Puerto Rico that is recognized by the World Health Organization, has
20completed all the formal requirements for the degree corresponding to doctor of medicine, except
21internship and social service, and has completed a year of clinical clerkship approved by the
22liaison committee on medical education of the American Medical Association.
23 (3) The applicant has been appointed as an intern, fellow or medical officer in a hospital
24or other institution of the commonwealth, or of a county or municipality thereof, or in a hospital
25or clinic which is incorporated under the laws of the commonwealth or in a clinic which is
26affiliated with a hospital licensed by the department of public health under authority of section
27seventy-one of chapter one hundred and eleven, or in an out-patient clinic operated by the
28department of mental health, or in the department of public health for duty in clinics or in
29programs operated or approved by the department of public health, or in programs approved by
30the board of registration in medicine in the commonwealth and leading toward certification by
31specialty boards recognized by the American Medical Association.
32 (4) The applicant has applied to participate in the medical assistance program
33administered by the secretary of health and human services in accordance with chapter 118E and 3 of 6
34Title XIX of the Social Security Act and any federal demonstration or waiver relating to the
35medical assistance program for the limited purpose of ordering and referring services covered
36under the program if regulations governing such limited participation are promulgated under
37chapter 118E.
38 Such limited registration shall entitle the applicant to practice medicine only in the
39hospital, institution, clinic or program designated on the applicant’s certificate of limited
40registration, or outside such hospital, institution, clinic or program for the treatment, under
41supervision of one of its medical officers who is a duly registered physician, of persons accepted
42by it as patients, or in any hospital, institution, clinic or program affiliated for training purposes
43with the hospital, institution, clinic or program designated on such certificate, which affiliation is
44approved by the board and in any case under regulations established by such hospital, institution,
45clinic or program. The name of any hospital, institution, clinic or program so affiliated and so
46approved shall also be indicated on such certificate. Limited registration under this section may
47be revoked at any time by the board.
48 (b) Notwithstanding the other provisions of this section, an internationally-trained
49physician who has been licensed or otherwise authorized to practice medicine in a country other
50than the United States shall be eligible to apply for a limited license to practice medicine for a
51renewable one-year term after satisfying the criteria in below paragraph (3), provided, however,
52that such limited registration shall provide a pathway for the issuance of a full unrestricted
53license to practice medicine in accordance with, and upon satisfaction of, the criteria in below
54paragraph (5). 4 of 6
55 (1) Definitions. For the purposes of this subsection, the following terms shall have the
56following meanings —
57 (i) “Commission” shall mean the Educational Commission for Foreign Medical
58Graduates.
59 (ii) “Internationally-trained physician” shall mean a physician who has received a degree
60of doctor of medicine or its equivalent from a legally chartered medical school outside the
61United States recognized by the World Health Organization, who has been licensed or otherwise
62authorized to practice medicine in a country other than the United States, and who has practiced
63medicine for at least one year.
64 (iii) “Licensing Exam” shall mean United States Medical Licensing Examination.
65 (iv) “Massachusetts physician shortage area” shall mean a geographic region or
66population in the commonwealth experiencing a shortage of physicians, especially primary care
67physicians or psychiatrists, relative to population and need.
68 (v) “Participating healthcare facility” shall mean a federally-qualified health center,
69community health center, hospital, or other healthcare facility approved by the board that
70provides an assessment and evaluation program designed to develop, assess, and evaluate an
71internationally-trained physician’s non-clinical skills, according to criteria developed or
72approved by the board; provided, however, that the participating healthcare facility provides
73medical care in a Massachusetts physician shortage area. 5 of 6
74 (2) For the purposes of this subsection, the Massachusetts health care workforce center or
75its equivalent in the department of public health shall assist the board in determining the regions
76or populations comprising a Massachusetts physician shortage area.
77 (3) The board shall issue a limited license to an applicant if the participating facility and
78the applicant submit evidence acceptable to the board that the applicant:
79 (i) is an internationally-trained physician;
80 (ii) has a valid certificate issued by the Commission or other credential evaluation service
81approved by the board, provided, however, that the board may waive such certification at its
82discretion where the applicant is unable to obtain the required documentation from a non-
83cooperating country;
84 (iii) has achieved a passing score on Step 1 and Step 2-Clinical Knowledge (CK) of the
85Licensing Exam;
86 (iv) has entered into an agreement with the participating facility providing that the facility
87shall develop, assess and evaluate the applicant’s familiarity with non-clinical skills and
88standards appropriate for medical practice in the commonwealth, according to assessment and
89evaluation criteria developed or approved by the board;
90 (v) shall enter a full-time full employment relationship with the participating facility after
91the board issues a limited license to practice medicine to the applicant; and
92 (vi) has satisfied other criteria that may be developed by the board in fulfillment of this
93subsection.
94 (4) The 1-year limited license may be renewed no more than once. 6 of 6
95 (5) An internationally-trained physician who provides the board with proof of (i)
96successful completion of the participating facility’s assessment and evaluation program, (ii) a
97passing score on Step 3 of the Licensing Exam, and (iii) any additional prerequisites that the
98board may require, shall be eligible to apply for a renewable 2-year restricted license to practice
99medicine only in a Massachusetts physician shortage area designated by the board; provided,
100however, that any additional prerequisites for eligibility shall not include post-graduate clinical
101training, and that the restricted license shall authorize the holder to practice independently in a
102primary care specialty, psychiatry, or other specialty approved by the board. After 2 years of
103restricted practice, the internationally-trained physician shall be eligible to apply for a full,
104unrestricted license to practice medicine. The 2-year restricted license may be renewed no more
105than once.