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A. INTRODUCTION
These instructions explain how to complete and file the Professional
Organization Disciplinary Action Report (Form POD-1). This report
is designed to provide the Board of Registration in Medicine with
a record of any disciplinary action taken by a professional organization
(as defined below) against any person licensed by the Board of Registration
in Medicine (i.e., a Medical Doctor or a Doctor of Osteopathy).
Filing of this report is required by Chapter 112, section 5B of
the Massachusetts General Laws. Communications with the Board, as
required under this statute, are provided with certain legal protections.
(See Chapter 112, section 5G.)
B. INSTRUCTIONS
(1) Completing the Report:
Your responses should be typed or printed legibly. Please be brief
but complete. If you need additional space, attach extra sheets.
You should keep a copy of each report filed for your own records.
(2) Filing the Report:
A report must be filed with the Board no later than 30 days after
the actual imposition or initiation of a disciplinary action, whether
or not the action has been or may be appealed. A separate report
must be filed for each licensee disciplined and for each disciplinary
proceeding.
When complete, reports should be sent by registered or certified
mail to:
Data Repository Counsel
Board of Registration in Medicine
200 Harvard Mill Square, Suite 330
Wakefield, MA 01880
(3) Who Must File:
The following entities are required to report disciplinary actions
on this form: any professional medical association, society, body,
professional standards review organization, or similarly constituted
professional organization, whether or not such association, society,
body, or organization is local, regional, national or international
in scope.
(4) Definition of "Disciplinary Action":
"Disciplinary action" includes, but is not limited to,
revocation, suspension, censure, reprimand, restriction, non renewal,
denial or restriction of privileges, or resignation. A denial or
restriction of privileges or a resignation shall be reported only
when the resignation or the denial or restriction of privileges
is related in any way to (a) the applicant's competence to practice
medicine or (b) a complaint or allegation regarding any violation
of law or regulation, including but not limited to the regulations
of the board, or hospital, health care facility or professional
medical association by-laws, whether or not the complaint or allegation
specifically cites violation of a specified law, regulation, or
by-law [G.L. c.112. sec. 5B].
The Board appreciates your cooperation in completing and filing
Professional Organization Disciplinary Action Reports. Please contact
the Board's Data Repository Counsel at 781.876.8200 with any questions.
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