MA Emergency Orders and Rules Addressing COVID-19

Updated 5/4/2020

Public officials in Massachusetts have issued a series of executive orders and modified government regulations in response to the Novel Coronavirus.  Please contact McLane Middleton with questions about these Emergency Orders.

March 10, 2020 – Governor Baker declared a of State of Emergency, Executive Order No. 591, giving the Administration more flexibility to issue recommendations, directives, and orders as circumstances may require.

Emergency Orders Issued by Governor Baker and the Department of Public Health:

May 1, 2020

• Masks and Face Coverings – Governor Baker issued and order requiring the use of cloth masks or face coverings in public places where social distancing is not possible. This Order replaces Department of Public Health guidance related to the use of masks or face coverings that was issued on April 10, 2020.

 

April 28, 2020

• Nurseries, Greenhouses, Garden Centers, and Agricultural Supply Stores Guidance – The Department of Public Health issued revised guidance related to the operation of nurseries, greenhouses, garden centers, and agricultural supply stores. This guidance replaces the guidance that was issued on April 4, 2020.
• Hotel and Motel Guidance and FAQ – The Department of Public Health issued revised guidance for operations of hotels and motels related to Governor Baker’s April 28, 2020 order extending the prohibition on gatherings of 10 or more people. This guidance and FAQ replace guidance that was issued on March 31, 2020 and an FAQ that was issued on April 2, 2020.
• Extension of Non-Essential Business Closure – Governor Baker extended the previously issued order closing non-essential businesses and organizations for in-person operations until May 18, 2020.
• Extension of Prohibition on Gatherings of 10 or More People Order and Guidance – Governor Baker issued an order extending the prohibition on gatherings of 10 or more people until May 18, 2020.
• Extension of Governor’s Council Remote Meetings – Governor Baker issued an order extending the authorization for the Governor’s Council to meet remotely.
• Clinical Lab Referrals for COVID-19 Testing – the Department of Public Health temporarily suspended G.L. c. 111D, § 8A, in part, to allow certain persons or companies to refer patients or specimens for the purpose of conducting COVID-19 tests to clinical laboratories in which there is a direct or indirect ownership interest under certain circumstances.
• Out-of-Hospital Dialysis Unit Staffing – The Department of Public Health temporarily suspended G.L. c. 111, § 53 and 105 CMR 145.150 to remove the requirement that out-of-hospital dialysis units maintain a ratio of 1 staff member to every 3 patients.

 

April 27, 2020

• Farmers’ Markets, Farm Stands, and CSAs – The Department of Public Health issued an order regarding the operation of farmers’ markets, farm stands, and CSAs.

 

April 20, 2020

• Crisis Standards of Care Order and Guidance – The Department of Public Health issued clarified guidance and an emergency order regarding crisis standards of care for triage of critically ill patients that may be activated in the event that the public health emergency caused by COVID-19 creates demand for critical care resources that outstrips supply.

 

April 16, 2020

• Emergency Childcare Programs – Governor Baker authorized the Department of Early Education and Care (“EEC”) to implement emergency residential programs and placement agencies for children as necessary to provide capability and capacity for effective isolation and quarantine to prevent the spread of COVID-19.

 

April 14, 2020

• Non-Healthcare Essential Service Worker Exposure Guidance – The Department of Public Health issued guidance regarding procedures to be followed when essential service workers who are not healthcare workers, are exposed to or may have had exposure to a person with suspected or confirmed COVID-19.

 

April 9, 2020

• Accelerated Licensing for Foreign Medical Doctors – Governor Baker directed the Board of Registration in Medicine to adopt a procedure for expediting the licensure of certain physicians who are graduates of International Medical Schools and who are currently practicing medicine in the United States under a limited license.
• Nursing Practice Licensure Order and Guidance – Governor Baker temporarily exempted students who have graduated from certain registered nursing or practical nursing programs and senior nursing students who are attending the last semester of certain registered nursing or practical nursing programs from the prohibitions against the unlicensed practice of nursing specified in G.L. c. 112, §§ 80, 80A and 80B, provided that the individuals are providing health care services in response to COVID-19.
• Insurance Coverage for COVID-19 Treatment – Governor Baker issued an order mandating insurers to cover all medically necessary emergency department and in-patient services, including all professional, diagnostic and laboratory services, related to COVID-19 at both in-network and out-of-network providers, with no cost to the patient.

 

April 8, 2020

• COVID-19 Data Collection and Reporting – The Department of Public Health ordered health care providers to make every reasonable effort to collect complete demographic information on patients with confirmed or suspected COVID-19, and include such information when ordering a COVID-19 test. Laboratories conducting COVID-19 tests were also ordered to report such information to the Department of Public Health in accordance with 105 C.M.R. 300.170.

 

April 7, 2020

• Grocery Store Occupancy – The Department of Public Health issued an order governing grocery store operations including limiting occupancy to 40% of maximum permitted occupancy levels, monitoring the number of customers entering and exiting, and monitoring lines that form outside of store to maintain appropriate distancing.

 

April 6, 2020

• Oral Prescription Follow Up Order and Guidance – The Department of Public Health temporarily extended the time within which certain oral prescriptions must be reduced to writing under G.L. c. 94C, §§ 18(c) and 20(c), from 7 days to 15 business days.

 

April 4, 2020

• COVID Pharmacy Assistance Team – The Department of Public Health temporarily authorized the COVID Pharmacy Assistance Team to request prescription refills (including prescriptions for continuation of chronic condition therapy without remaining refills), transfer prescriptions, discuss medications lists and prescription history with providers and pharmacies, and facilitate the dispensing and delivery of medications, on behalf of quarantined individuals in MA.
• Nurseries, Greenhouses, Garden Centers and Agricultural Supply Stores – The Department of Public Health issued guidance related to the operation of nurseries, greenhouses, garden centers, and agricultural supply stores.

 

April 3, 2020

• Expanded APRN Practice at Department of Mental Health Facilities – The Department of Public Health temporarily authorized certain advanced practice registered nurses who hold certification in the field of psychiatric mental health to perform certain specific functions under G.L. c. 123, that are otherwise designated to physicians only.
• Pharmacy Hand Sanitizer Order – The Department of Public Health issued an updated order permitting licensed pharmacies to create and sell hand sanitizer over the counter. This order replaces a previous March 15^th Order.
• Maximizing Available Health Care Providers Updated Order and Guidance – The Department of Public Health issued an updated order under which health care providers who are licensed and in good standing in another state shall be issued a corresponding Massachusetts license that shall remain valid during the state of emergency. Health care providers licensed under this order are authorized to provide services within the scope of practice authorized by the license in such profession, both in-person in Massachusetts and across State lines into Massachusetts using telemedicine. Certain Massachusetts-issued licenses shall be immediately renewed or reactivated upon request and shall remain valid until 90 days following termination of the state of emergency. Applicable renewal fees or late renewal fees are waived. This order replaces a previous March 29^th order.

 

April 2, 2020

• Skilled Nursing Care and Staffing in Assisted Living Residences Order and Guidance – The Department of Public Health temporarily suspended certain requirements of G.L. c. 19D, § 11, and 651 C.M.R. 12.06(5)(b) and 12.07, such that nurses employed by an Assisted Living Residence (“ALR”) may provide skilled nursing care provided they hold a valid license to provide such care, the prohibition on retaining residents who required skilled care for more than 90 consecutive days is suspended, and staffing requirements are suspended and training requirements are waived under certain circumstances.
• Construction Enforcement Procedures and Construction Supplemental Guidelines – The Baker-Polito Administration issued guidance related to the enforcement of COVID-19 safety guidelines and procedures for construction sites.

 

April 1, 2020

• Medication Administration in Community Programs – The Department of Public Health temporarily suspended G.L. c. 94C, § 7, in part, to allow non-Medication Administration Program Certified (non-MAP Certified) staff in Community Programs to possess and administer rescue inhalers, epinephrine auto-injectors and oxygen to individuals in Community Programs pursuant to existing patient prescriptions and administration orders.

 

March 31, 2020

• Extension of Non-Essential Business Closure Order and Updated Essential Services Categories– Governor Baker issued an order extending the closure of non-essential businesses and organizations for in-person operations until May 4, 2020.
• Extension of Prohibition on Gatherings of 10 or More People Order and Guidance – Governor Baker issued an order extending the prohibition on gatherings of 10 or more people until May 4, 2020.
• Hotel & Motel Guidance – The Department of Public Health released guidance for hotels and motels related to the extension of the Governor’s Order prohibiting gatherings of 10 or more people.
• Stay at Home Advisory – The Department of Public Health announced that the Stay-At-Home Advisory issued on March 24, 2020 remains in effect.

 

March 30, 2020

• Public Company Shareholder Meetings – Governor Baker temporarily suspended the provision in G.L. c. 156D, § 7.08 that prohibits public corporations from holding annual or special meetings of shareholders solely by means of remote communication.
• Adjustment of Essential Provider Rates – Governor Baker ordered the Executive Office of Health and Human Services (“EOHHS”) to designate certain classes of health and human services providers that are responding to COVID-19 and authorized the EOHHS to issue temporary rates and supplemental payments for the designated classes of providers.

 

March 29, 2020

• Maximizing Health Care Provider Availability – The Department of Public Health temporarily authorized health care providers who are licensed and in good standing in another state to provide services within the scope of their out-of-state licenses in Massachusetts, and into Massachusetts using telemedicine, and temporarily authorized the renewal or reactivation of certain Massachusetts-issued health provider licenses that have expired, lapsed or been retired.
• Long Term Care Facility Transfers and Discharges Order – The Department of Public Health temporarily waived MassHealth regulations regarding transfers and discharge of long-term care facility residents, 130 CMR 456.701 through 456.704, and the related fair hearing rules at 130 CMR 610.015 and 610.028 through 610.032 and G.L. c. 111, § 70E, for the limited purpose of safely transferring and discharging all residents living in a long-term care facility that is intended to be used as a designated COVID-19 facility.
• CORI Checks for MA Responds Volunteers – The Department of Public Health temporarily waived the requirement for a notarized CORI Acknowledgment form for CORI checks performed by the Office of Preparedness and Emergency Management (OPEM)  on volunteers who register with MA Responds to respond to COVID-19, and by the Executive Office of Health and Human Services (EOHHS), its agencies, or vendor programs, as necessary to respond to the COVID-19 emergency.

 

March 26, 2020

• State Permit Extensions – Governor Baker temporarily suspended state permitting deadlines and extended the validity of state permits.
• State Business Licensure Extension – Governor Baker extended the validity of any state issued professional license, permit or registration that has expired or will expire during the state of emergency, and that were not extended by the March 15^th, March 17^th, or March 18^th extension orders, for 90 days following the termination of the state of emergency.
• Advanced Practice Registered Nurse Prescriptive Practice Order and Guidance – The Department of Public Health temporarily authorized registered nurses who are in good standing and who hold authorization from the Board of Registration in Nursing to engage in the advanced practice of nursing, to engage in certain prescriptive practices.

 

March 25, 2020

• Grocery Store and Pharmacy Operations – The Department or Public Health ordered grocery stores and pharmacies to provide alternative hours for shoppers 60 and older, deploy strategies for reducing customer and employee exposure to COVID-19, accommodate employees in high-risk populations, close for sufficient time overnight to allow for sanitizing and restocking, and prohibited the use of reusable bags.
• Extension of Closure of Schools and Non-Emergency Child Care Programs and Process to Approve Exempt Emergency Child Care Programs – Governor Baker extended the closure of all public and private schools and non-emergency child care programs until May 4, 2020 and established a process to approve exempt emergency child care programs to serve vulnerable children and families of first responders and essential workers.

 

March 24, 2020

• Nurse Staffing – The Department of Public Health temporarily exempted hospitals from the nurse staffing level requirements of G.L. c. 111, § 231.
• Determination of Need Order and Guidance – The Department of Public Health temporarily suspended the requirement of a Notice of Determination of Need for any person seeking approval for a Substantial Capital Expenditure, Substantial Change in Service, or Transfer of Site necessary to address COVID-19.
• Pharmacy Practice Order and Guidance – The Department of Public Health temporarily modified pharmacy practice.
• Day Programs – The Department of Public Health temporarily ordered day programs overseen by the Executive Office of Health and Human Services to cease providing services in congregate settings.
• Stay at Home Advisory – The Department of Public Health issued a stay at home advisory to all individuals who are not providing essential services.

 

March 23, 2020

• Closure of Physical Workspace of Nonessential Businesses Order and Essential Services List – Governor Baker ordered businesses and organizations deemed nonessential to closure their physical workspaces and facilities to customers, workers and the public.
• Group Gatherings – Governor Baker temporarily prohibited gatherings of over 10 people, rescinding and revoking his prior order prohibiting gatherings of over 25 people.
• Cannabis Control Commission Hand Sanitizer – The Department of Public Health temporarily permitted licensed marijuana product manufacturers and medical marijuana treatment centers to create and donate hand sanitizer to certain entities.
• Cremation or Burial at Sea – The Department of Public Health temporarily authorized cremation or burial at sea without a viewing of the decedent by medical examiners or forensic investigators under certain circumstances.

 

March 20, 2020

• RMV In-Person Visits Limited – Governor Baker temporarily allowed the Registry of Motor Vehicles to extend vehicle registrations and modify the conditions of registrations, places and titles, and allowed waiver of certain inspection requirements.
• Smoke Alarm Inspections – Governor Baker temporarily waived the requirement for smoke and CO₂ alarm inspections prior to a residential real estate transaction.

 

March 18, 2020

• Closure of Child Care Programs Order and FAQ – Governor Baker temporarily closed all child care programs and authorized the temporarily creation and operation of emergency child care programs for vulnerable children and children of families who work to maintain health, safety and welfare.
• Professional Licensure Extension – Governor Baker temporarily extended the validity of state issued professional licenses, certificates or registrations, that expired or will expire during the state of emergency, and that were not extended by the March 15^th or March 17^th extension orders, by 90 days from the termination of the state of emergency.
• Disclosure of Addresses of Individuals Testing Positive to COVID-19 – The Department of Public Health ordered local boards of health to disclose the addresses of persons within their jurisdiction who the local board of health has been informed have tested positive for COVID-19.
• Pharmacist and Opioid Misuse Disorder Medication Order and Guidance – The Department of Public Health temporarily permitted pharmacists to administer medication for the treatment of opioid use disorder.
• Physician Assistant Order and Guidance – The Department of Public Health temporarily permitted the flexible reassignment of Physician Assistants.

 

March 17, 2020

• Extension of Health Care Professional Registration – Governor Baker temporarily extended the validity of registrations held by registered nurses, licensed practical nurses, pharmacists and physicians assistants, by 90 days from the termination of the state of emergency, and authorized the practice of telemedicine.
• Access to Physicians’ Services – Governor Baker temporarily expanded access to physicians’ services by extending the validity of physicians’ licenses, permitting certain retired physicians to reactivate their licenses, and permitting certain physicians licensed in other states to receive an emergency Massachusetts license.
• Emergency Medical Service Care – The Department of Public Health issued an order relating to Emergency Medical Services Care and ambulance staffing.
• Emergency Credentialing and Transfers Order and Guidance – The Department of Public Health temporarily implemented expedited credentialing procedures for licensed independent practitioners and expedited transfers of licensed clinical staff among facilities.

 

March 15, 2020

• Suspension of Elementary and Secondary School Operations Until April 6th – Governor Baker ordered a 3-week suspension of school operations at all public and private elementary and secondary elementary schools in the Commonwealth (not including residential and day schools for special needs students) beginning March 17, 2020.
• Hospital Visitor Restrictions Order and Guidance – The Department of Public Health temporarily restricted certain hospital visits.
• Assisted Living Visitor Restrictions Order and Guidance – The Department of Public Health temporarily restricted certain visits to assisted living facilities.
• Pharmacy Hand Sanitizer Order and Guidance – The Department of Public Health temporarily permitted pharmacies and pharmacists to compound and sell hand sanitizer to customers.
•  Cancelation of Elective Procedures Order and Guidance – The Department of Public Health ordered hospitals to cancel non-essential elective procedures.
• Telehealth – The Department of Public Health required all commercial insurers, self-insured health plans, and the Group Insurance Commission to cover medically necessary telehealth services, whether or not related to COVID-19, and prohibited cost-sharing (such as co-pays and co-insurance) for telehealth services related to COVID-19.

 

March 12, 2020

• Open Meeting Law Modifications – Governor Baker temporarily modified the Open Meeting Law to allow state, quasi and local governments to continue to carry out essential functions by providing adequate, alternative means of public access.

 

March 11, 2020

• Nursing Home Visitor Restrictions Order and Guidance – The Department of Public Health temporarily restricted certain visitor access to nursing homes and rest homes.
• Reciprocal Nursing Licensure Policy Changes – The Board of Registration in Nursing updated its policies to process of reciprocal license applications for nurses licensed in another jurisdiction in one business day.