Licensing of radiologic technologists

105 CMR: DEPARTMENT OF PUBLIC HEALTH

105 CMR 125.000: LICENSING OF RADIOLOGIC TECHNOLOGISTS

Section

125.001: Scope and Purpose 125.002: General Provisions 125.003: Definitions 125.004: Radiologic Technologist Licensing Disciplines 125.005: Qualifications and Application for Radiologic Technologist License 125.006: Requirements for Licensure in an Advanced Practice Discipline 125.007: Licensure Fee and Term 125.008: Temporary Licensing of Radiologic Technologists 125.009: Continuing Education 125.010: License Renewal 125.011: Expired Licenses 125.012: Posting of License Documents 125.013: Required Reporting 125.014: Student Clinical Education 125.015: Complaints 125.020: Grounds for Suspension of a License or Immediate Cessation of Activity 125.021: Grounds for Denial, Modification, Limitation, Revocation or Refusal to Renew a License 125.022: Enforcement Procedures 125.023: Severability 125.024: Waiver

125.001: Scope and Purpose

.000 sets out the requirements to obtain and maintain a license to practice as a Radiologic Technologist in the Commonwealth of Massachusetts. The purpose of 105 CMR 125.000 is to establish minimum standards necessary for an individual to become licensed as a Radiologic Technologist and to specify enforcement procedures for violations of .000.

125.002: General Provisions

(A) In accordance with M.G.L. c. 111, § 5L, no person shall perform the duties of a Radiologic Technologist without holding a current license from the Department.

(B) No licensed Radiologic Technologist shall conduct work in an advanced practice discipline, as described in .000, unless specifically authorized by the Department to practice in that specialization.

(C) Nothing in .000 shall be construed as preventing or restricting the practice, services or activities of: (1) any person licensed in the Commonwealth by any other statute from engaging in the profession for which he or she is licensed; or (2) any person employed as a Radiologic Technologist by the U.S. government or any agency of it, if such person provides services solely under the direction or control of the organization by which he or she is employed.

(D) Radiologic Technologists shall abide by the Standard of Ethics set forth by each corresponding certification agency and/or professional society.

(E) A Radiologic Technologist, including those licensed in an advanced practice discipline, may not interpret images, make diagnoses, or prescribe medications or therapies.

125.003: Definitions

As used in .000:

ACR means the American College of Radiology.

(Mass. Register #1567, 02/13/2026)

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ACRT means the Advisory Commission for Radiologic Technologists.

Advanced Practice Discipline means an area of medical imaging or radiation therapy practice in which a radiologic technologist has successfully completed a post-primary certification and registration.

AED means Automated External Defibrillator.

ARRT means the American Registry of Radiologic Technologists.

BLS means Basic Life Support.

CBRPA means the Certification Board for Radiology Practitioner Assistants.

CEU means continuing education unit which equals one contact hour per credit. One contact hour equals 50 minutes of educational instructional activity.

Commissioner means the Commissioner of the Massachusetts Department of Public Health.

Computed Tomography (CT) means the practice and performance of those activities, actions, duties, and responsibilities contained within and defined by the Practice Standards for Medical Imaging and Radiation Therapy, Computed Tomography Practice Standards, as published by the American Society of Radiological Technologists or equivalent publication approved by the Department. For the purposes of .000, licensing in CT refers to Diagnostic CT, and excludes CT exams performed for therapeutic radiation treatment planning of delivery (CT simulators), or for calculating attenuation coefficients for Nuclear Medicine and PET studies (PET-CT and SPECT-CT), or dental cone beam CT, or Cone Beam CT utilized for external beam radiation therapy planning.

CPR means Cardiopulmonary Resuscitation.

Department means the Massachusetts Department of Public Health.

JRCERT means the Joint Review Committee on Education in Radiologic Technology.

JRCNMT means the Joint Review Committee on educational programs in Nuclear Medicine Technology.

Limited Scope of Practice in Radiography means the individual who practices radiologic technology in up to two of the following procedure categories: chest, extremities, skull/sinuses, spine, or podiatric radiography.

Mammography means the practice and performance of those activities, actions, duties, and responsibilities contained within the Practice Standards of Medical Imaging and Radiation Therapy, Mammography Practice Standards, as published by the American Society of Radiological Technologist or equivalent publication approved by the Department.

Mammography Radiologic Technologist means the individual who holds a license to practice within the mammography radiography category.

Medical Radiography means the practice and performance of those activities, actions, duties, and responsibilities contained within and defined by the Practice Standards of Medical Imaging and Radiation Therapy, Radiography Practice Standards, as published by the American Society of Radiologic Technologists, or equivalent publication approved by the Department.

NMTCB means the Nuclear Medicine Technology Certification Board.

Nuclear Medicine means the practice and performance of those activities, actions, duties, and responsibilities contained within, and defined by, the Practice Standards for Nuclear Medicine as published by the Society of Nuclear Medicine, American Society of Radiologic Technologist, or equivalent publication approved by the Department.

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Nuclear Medicine Advanced Associate (NMAA) means the advanced practice and performance of those activities, actions, duties, and responsibilities contained within, and defined, by the scope of practice of the Nuclear Medicine Advanced Associate as published by the Society of Nuclear Medicine and Molecular Imaging, or equivalent publication approved by the Department. Nuclear Medicine includes the performance of PET procedures.

PET means Positron Emission Tomography.

Radiation Therapy means the practice and performance of those activities, actions, duties, and responsibilities contained within, and defined by, the Practice Standards for Medical Imaging and Radiation Therapy, Radiation Therapy Practice Standards as published by the American Society of Radiologic Technologists, or equivalent publication approved by the Department.

Radiologic Technologist means the individual who practices radiologic technology in Radiography, Nuclear Medicine, Radiation Therapy, Mammography, Computed Tomography, Positron Emission Tomography, Limited Scope of Practice in Radiology, or any combination thereof.

Radiologist Assistant means those Radiologic Technologists who have successfully completed an educational program recognized by the Department for Radiologist Assistant and who may perform non-invasive and invasive radiology procedures using image guidance as appropriate and follows the Practice Standards for Medical Imaging and Radiation Therapy, Radiologist Assistant Practice Standards as published by the American Society of Radiologic Technologists.

125.004: Licensing Disciplines

The Department shall issue licenses to Radiologic Technologists in one or more of the following disciplines. (A) Limited Scope of Practice in Radiography (B) Radiography (C) Nuclear Medicine (D) Radiation Therapy (E) Mammography, which also requires a full license in Radiography (F) Computed Tomography, which also requires a full license in Radiography, and/or Nuclear Medicine, and/or Radiation Therapy (G) Radiologist Assistant which also requires a full license in Radiography or Radiation Therapy (H) Positron Emission Tomography, which also requires a full license in Nuclear Medicine, Radiography or Radiation Therapy (I) Nuclear Medicine Advanced Associate, which also requires a full license in Nuclear Medicine

125.005: Qualifications and Application for Radiologic Technologist License

(A) An applicant for licensure as a Radiologic Technologist shall at the time of application: (1) Be at least 18 years old; and (2) Have successfully completed a four-year course of study in a secondary school approved in Massachusetts, or hold a high school diploma from another state, or have passed an approved equivalency test; and (3) Have successfully completed a course of study as a Radiologic Technologist at an education program approved by the Department; and (4) Have successfully passed the examination for full Radiologic Technologist or Limited Scope of Practice in Radiography administered by ARRT or other national or international certifying board approved by the Department; and (5) Except for Limited Scope of Practice in Radiography, have a valid certification or registration from ARRT or other national or international certifying board approved by the Department.

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(B) An applicant for a Limited Scope of Practice in Radiography may apply to practice in up to two of the following procedure specialties: chest, extremities, skull/sinuses, spine, or podiatric radiography, by submitting appropriate course of study in these procedure specialties to the Department and by achieving a passing score set by the Commonwealth of Massachusetts on the Limited Scope of Practice in Radiography Examination administered by ARRT or other national or international certifying board approved by the Department. Limited Scope of Practice licensees may not practice in the following procedure specialties: Fluoroscopy, Contrast Media, Mobile and Remote Imaging.

(C) An applicant for a licensure shall submit to the Department: (1) a completed application on a form provided by the Department; (2) a copy of the current Board certification or registration from ARRT or other national or international certifying board approved by the Department or, for Limited Scope of Practice in Radiography, documentation of course completion in up to two specialties as specified in .005(B); and (3) the appropriate fee established by the Executive Office of Administration and Finance; and (4) if applying for a license in an advanced practice discipline, additional documentation as specified in .006.

125.006: Requirements for Licensure in an Advanced Practice Discipline

(A) To work in an advanced practice discipline, a Radiologic Technologist must obtain a license from the Department that authorizes the individual to work in the specified advanced practice discipline. To qualify for licensure in Massachusetts in an advanced practice discipline, the applicant must: (1) Have a current Massachusetts Radiologic Technologist license; and (2) Have successfully passed the ARRT, NMTCB or CBRPA exam in the advanced practice discipline as specified in .006(B); and (3) Submit to the Department documentation of certification or registration approved by the Department in the advanced practice discipline as specified in .006(B).

(B) A Radiologic Technologist may work in the following advanced practice disciplines upon completion of the corresponding training and upon receiving a license from the Department to practice in that advanced practice discipline: (1) A Computed Tomography Technologist (CT Technologist) shall have passed the Computed Tomography examination administered by the ARRT or the NMTCB. (2) A Mammography Radiologic Technologist (Mammographer) shall have passed the Mammography Technologist examination administered by the ARRT. (3) A Radiologist Assistant shall have passed the Radiology Assistant examination administered by the ARRT or the Radiology Practitioner Assistant examination administered by the CBRPA. (4) A Positron Emission Tomography (PET) Radiologic Technologist with a primary license in Radiography or Radiation Therapy shall have passed the Positron Emission Tomography examination administered by the NMTCB. (5) A Nuclear Medicine Advanced Associate (NMAA) shall have passed the Nuclear Medicine Advanced Associate examination administered by the NMTCB.

(C) A licensed Radiologic Technologist who is working towards an advanced discipline may perform procedures under appropriate supervision and gain the clinical experience needed to meet the eligibility requirements.

125.007: Licensure Fee and Term

(A) Each applicant for a license shall submit the fee prescribed by the Executive Office for Administration and Finance, 801 CMR 4.02: Fees for Licenses, Permits, and Services to Be Charged by State Agencies.

(B) The term of a license shall be from the date the license is issued through the last day of the applicant's birth month in the next odd numbered year.

105 CMR: DEPARTMENT OF PUBLIC HEALTH

125.008: Temporary Licensing of Radiologic Technologists

(A) Minimum Licensure Application Requirements. An individual who does not meet the licensure requirements specified in .005, may apply for a temporary license to practice as a Radiologic Technologist in Massachusetts for a period not to exceed one year, provided that: (1) the individual is 18 years of age or older; and (2) the individual has either: (a) successfully completed all requirements of a JRCERT/JRCNMT accredited or Department-approved equivalent program prior to application for examination and has provided proof of completion of said requirements to the Department; or (b) has been determined to be eligible for examination by the American Registry of Radiologic Technologists, Nuclear Medicine Technology Certification Board or other certifying agency recognized by the Department.

(B) Temporary licenses will not be issued for Limited Scope of Practice in Radiography.

125.009: Continuing Education

(A) Continuing Education Requirements. CEUs must be obtained through an agency recognized by the Department. Except as otherwise provided in .009(A), all licensees shall obtain a minimum of 24 CEUs during each two-year license renewal cycle. The following requirements apply to specific disciplines: (1) Limited Scope of Practice in Radiography. Individuals licensed as a Limited Scope of Practice in Radiography shall obtain the required 24 CEUs during each two-year license renewal cycle as follows: (a) ten CEUs must be in the discipline of Radiography; and (b) two CEUs must be in radiation safety; and (c) the 12 remaining CEUs must be earned in topics directly related to health care practice, radiation safety/radiation protection, or their specialty. (2) Radiologic Technologist (Single Discipline). Individuals licensed in one discipline shall obtain the required 24 CEUs during each two-year license renewal cycle as follows: (a) ten CEUs must be in the discipline in which the individual is licensed; and (b) two CEUs must be in radiation safety; and (c) the remaining 12 CEUs must be earned in topics directly related to health care practice, radiation safety/radiation protection, or their specialty. (3) Radiologic Technologist (Multiple Discipline). Individuals licensed in more than one discipline shall obtain the required 24 CEUs during each two-year license renewal cycle as follows: (a) four CEUs must be in each discipline in which the individual is licensed; and (b) two CEUs must be in radiation safety/radiation protection; and (c) the remaining CEUs must be earned in topics directly related to health care practice, radiation safety, or their specialty. (4) Mammography Technologist. Individuals licensed as a Mammography Radiologic Technologist shall obtain the required 24 CEUs during each two-year license renewal cycle as follows: (a) 12 CEUs must be in Mammography; and (b) two CEUs must be in radiation safety; and (c) four CEUs must be in Radiography; and (d) the remaining six CEUs must be in topics directly related to health care practice, radiation safety, Radiography or Mammography. (5) Radiologist Assistant. Individuals licensed as a Radiologist Assistant shall obtain a minimum of 50 CEUs during each two-year license renewal cycle as follows: (a) 48 CEUs must be included in the ARRT's Continuing Education Requirements and can include advanced level CPR certification; and (b) two CEUs must be in radiation safety/radiation protection. (6) Nuclear Medicine Advanced Associate Individuals licensed as a Nuclear Medicine Advanced Associate shall obtain a minimum of 50 CEUs during each two-year license renewal cycle as follows: (a) 48 CEUs must be included in the NMTCB's Continuing Education Requirements; and (b) two CEUs must be in radiation safety/radiation protection.

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(B) Each licensed Radiologic Technologist must maintain documentation of CEUs obtained for the current renewal cycle and previous renewal cycle at each workplace where employed as a Radiologic Technologist and shall make such records available to Department inspectors upon request. Acceptable evidence of CEUs includes certificates of attendance and/or certificates of completion of CEU activities from any agency recognized by the Department, as set forth in .005(A).

(C) CEU requirements begin on the first day of the individual's birth month, in the year the license is renewed, through the last day of the month prior to the individual's birth month, 24 months later.

(D) Probation Status. (1) A licensee who fails to meet the CEU requirements during a licensing cycle will be placed on probation. In order to be removed from probation the licensee must obtain, within three months from the expiration date of the license, the number of CEUs lacking from the CEUs needed and any penalty CEUs assessed against the licensee. (2) The penalty CEUs will be equal to the number of CEUs that were lacking in the licensing cycle. The CEUs submitted to satisfy the probation requirements cannot be used to fulfill the current licensing cycle. In addition, the licensee shall be required to obtain the necessary 24 CEUs by the end of the licensing cycle to remain in compliance with .009(A). (3) Licensees on probation who do not comply with these requirements within three months of being put on probation will be subject to enforcement action in accordance with the provisions of .000.

125.010: License Renewal

(A) To renew a license, the licensee shall submit the following at least 21 calendar days before the current license's expiration date: (1) a renewal application; and (2) evidence of completion of CEU requirements as specified in .009(A); and (3) the renewal fee prescribed by the Executive Office for Administration and Finance, 801 CMR 4.02: Fees for Licenses, Permits, and Services to Be Charged by State Agencies; and (4) except for Limited Scope of Practice in Radiography, a valid copy of their ARRT or NMTCB certificate.

(B) Failure to receive notification by the Department prior to the expiration date will not be an excuse for failure to file a timely renewal.

(C) The Department will not renew the license of an individual who is in violation of any provision of .000 at the time of renewal.

125.011: Expired Licenses

(A) When the valid period of a license has expired, the number of CEUs required for renewal shall be as follows: (1) When renewal is sought within six months following the expiration of the license, the applicant must submit: (a) evidence of having obtained the CEU requirements specified in 105 CMR 125.009(A) during the previous renewal cycle and, (b) a valid ARRT or NMTCB certificate, except for Limited Scope of Practice in Radiography. (2) When renewal is sought more than six months following the expiration of a license, the applicant must submit: (a) evidence of having obtained the CEU requirements specified in 105 CMR 125.009(A) during the previous renewal cycle and, (b) one additional CEU per month following the expiration of the license, and, (c) a valid ARRT or NMTCB certificate, except for Limited Scope of Practice in Radiography.

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(B) When renewal is sought more than six months following the expiration of a license, applicants must submit an application for a license as provided in .005.

(C) A Radiologic Technologist whose license has expired is prohibited from working as a Radiologic Technologist in Massachusetts.

125.012: Posting of License Documents

A Radiologic Technologist shall provide public notice of licensure status by ensuring that either: (A) the facility where the Radiologic Technologist is employed posts the original license or a copy of the license at the place of employment in full view of patients; or (B) the facility where the Radiologic Technologist is employed prominently displays on a wall at the facility in full view of patients a listing of all employees licensed in Radiologic Technology, provided that the listing clearly identifies each licensee with: (1) license number and name; (2) discipline the license is in; and (3) license expiration date.

125.013: Required Reporting

A licensee shall notify the Radiation Control Program of the Department within 30 days of: (1) Any legal or disciplinary action or proceeding initiated against the licensee by any other licensing jurisdiction (United States or foreign), any health care institution, any professional society or association, including those referenced in .002(E), any government agency, by any law enforcement agency, or any court for acts or conduct substantially the same as acts or conduct which would constitute grounds for suspension, denial, modification, limitation, revocation, or refusal to renew a license, or which would in any way relate directly or indirectly to their fitness to be licensed as a radiologic technologist; and (2) Any changes to the licensee's name or mailing address.

125.014: Student Clinical Education

(A) Any student enrolled in approved/accredited education programs in Radiography, Nuclear Medicine, Radiation Therapy, Mammography, PET, or CT is permitted to engage in those clinical activities which constitute the Clinical Education component of the program's approved curriculum, so long as such activities occur: (1) Under appropriate levels of supervision as stipulated by program requirements; and (2) Only while the student is enrolled in the program; and (3) Only during and as an integral part of the regularly scheduled clinical education activities.

(B) If for any reason a student must repeat any radiation procedure/exposure, a licensed Radiologic Technologist must directly supervise all activities associated with the repeat radiation procedure/exposure. To satisify the requirement to directly supervise, the licensed Radiologic Technologist must be present with the student, in the room, overseeing all activities associated with the repeat radiation procedure/exposure.

125.015: Complaints

The Department shall investigate every complaint received about practices or acts which may violate M.G.L. c. 111, § 5L or any provision of .000.

(A) If the Department finds that an investigation is not required because the alleged act or practice is not in violation of M.G.L. c. 111, § 5L or .000, then the Department shall notify the complainant of this finding and the reasons on which it is based.

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(B) If the Department finds that an investigation is required, because the alleged act or practice may be in violation of M.G.L. c. 111, § 5L or .000, the Department shall investigate and if a finding is made that the act or practice is in violation of M.G.L. c. 111, § 5L or .000, then the Department shall initiate whatever enforcement actions it deems appropriate as provided in .000.

(C) Investigation of complaints may lead to enforcement actions pursuant to .022.

(D) All oral or written complaints about Radiologic Technologists shall be addressed to the Director, Radiation Control Program, Massachusetts Department of Public Health.

125.020: Grounds for Suspension of a License or Immediate Cessation of Activity

The Commissioner or their designee may summarily suspend a license or order immediate cessation of an activity, prior to a hearing, whenever the Commissioner finds that public health, safety or the environment would be threatened by delay in issuance of an order. A Radiologic Technologist may not practice during the period of a suspension of their license or conduct a prohibited activity after notification of an order of immediate cessation of said activity.

(A) If the Department intends to order immediate suspension of a license or immediate cessation of an activity, the Department will provide written notice stating the reason(s) for an order requiring immediate suspension or immediate cessation of an activity and the provisions of law relied upon. The immediate suspension or order of immediate cessation of an activity shall take effect immediately upon issuance of the notice. (B) The Department shall provide an opportunity for a hearing pursuant to 801 CMR 1.01: Formal Rules promptly after the issuance of an order of immediate suspension or order of immediate cessation of an activity. (C) In cases of suspension of a license or immediate cessation of an activity, the Hearing Officer shall determine whether the Department has proved by a preponderance of the evidence that there existed, immediately prior to or at the time of the suspension or cease and desist order, a threat to public health, safety or the environment. (D) In the event that the Department determines that the violation of state law or of .000 which posed a threat is corrected prior to the decision of the Hearing Officer, the Department may lift the suspension by giving written notice to the licensee.

125.021: Grounds for Denial, Modification, Limitation, Revocation or Refusal to Renew a License

(A) Specific Grounds. The Department may issue an order denying, modifying, limiting, revoking, or refusing to renew a license sought or issued under .000 for any of the following reasons: (1) The applicant or licensee failed to submit the information required for licensure under .000. (2) The applicant failed to meet the requirements for licensure as specified in M.G.L. c. 111, § 5L and/or .000. (3) The applicant or licensee failed to pay licensure and/or registration fees. (4) The applicant or licensee engaged in the practice of Radiologic Technology after the expiration of their license or after such license has been suspended or revoked. (5) The applicant or licensee obtained or attempted to obtain or maintain a license or board certification by fraud, misrepresentation or by the submission of incorrect, false or misleading information. (6) The applicant or licensee engaged in fraudulent or deceptive practice; or practice beyond the authorized scope of the license or with gross incompetence, or with negligence on repeated occasions. (7) The applicant or licensee failed to exercise reasonable care, judgment, knowledge, or ability in the performance of duties or failed to perform those duties within the scope of their training and certification or otherwise engaged in conduct which calls into question the individual's competence to practice.

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(8) The applicant or licensee knowingly permitted, aided or abetted an unlicensed person to perform activities requiring a license or failed to report such activities upon becoming aware of them. (9) The applicant or licensee engaged in or aided in the falsification of radiologic screening/or diagnostic results, including but not limited to, the reporting of such false results to any patient. (10) The applicant or licensee engaged in conduct which endangers public health, safety or the environment. (11) The licensee failed to comply with an order issued by the Department or failed to comply with a consent agreement entered into with the Department. (12) The applicant or licensee failed to remedy or correct a cited violation by the date specified in a written notice from the Department or by the date specified in the plan of correction accepted or modified by the Department. (13) The applicant or licensee violated .000 and has a history of non-compliance with the same or similar violation or has received a warning letter from the Department within the last five years for the same or similar violation. (14) The applicant or licensee has failed to pay civil penalties or criminal fines levied in accordance with .000, or any applicable licensure late fees. (15) The applicant or licensee failed to allow duly authorized agents of the Department to conduct inspections or attempted to impede the work of duly authorized representatives of the Department or the enforcement of any provisions of M.G.L. c. 111, § 5L or .000. (16) The applicant or licensee has been convicted of, pleaded guilty to, or has, in a judicial proceeding, admitted facts sufficient for a finding that he or she is guilty of, any criminal violation relating directly or indirectly to their fitness to be licensed under .000, including, but not limited to the following: (a) Medicare or Medicaid fraud; (b) a crime relating to the activities regulated under M.G.L. c. 111, § 5L and § 5Q and/or .000 and/or 127.000: Licensing of Mammography Facilities; (c) rape, assault or other violent crimes against persons; (d) a drug related crime. (17) The applicant or licensee has been the subject of proceedings which resulted in the suspension, limitation, modification, denial or revocation of their license or refusal of renewal of their license. (18) The applicant or licensee has been disciplined in another jurisdiction in any way by the licensing authority for acts or conduct relating directly or indirectly to their fitness to be licensed as a Radiologic Technologist. (19) The applicant or licensee has failed to report to the Department, within the time period provided by law or regulation, any legal or disciplinary action initiated against the licensee by another licensing jurisdiction (United States or foreign), any health care institution, any professional society or association or credentialing organization, any government agency, any law enforcement agency, or any court for acts or conduct substantially the same as acts or conduct which would constitute grounds for suspension, denial, modification, limitation, revocation or refusal to renew a license under .021 or 125.022, or which would in any way relate directly or indirectly to their fitness to be licensed as a radiologic technologist under .000.

125.022: Enforcement Procedures

(A) Notice of Violation. Whenever the Department finds upon inspection, investigation of a complaint or through information in its possession that an applicant or licensee is not in compliance with provisions of M.G.L. c. 111, § 5L or .000, the Department shall notify the applicant or licensee of such violation or deficiency. The notice shall include a statement of the violations or deficiencies found, the provision of the law relied upon, and a reasonable period of time for correction. A violation or deficiency may result in denial, suspension, revocation or refusal to renew a license; a modification or limitation of a license; a cease and desist order; and/or the imposition of a civil or criminal penalties. After issuing a Notice of Violation, the Department may require a written plan of correction, as specified in .022(B), or proceed to issue a Notice of Intent To Issue an Order, as specified in .022(C).

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(B) Plan of Correction. (1) The applicant or licensee shall, within ten days of receipt of a Notice of Violation, submit to the Department a written plan of correction. The plan shall clearly identify the licensee, state the date, reference the violation or deficiency cited, state specific corrective action(s) and timetable(s) and date(s) for completion for each deficiency cited, and shall be signed by either the applicant or licensee or their designee. (2) The Department will determine whether the written plan of correction sufficiently addresses violations or deficiencies. If upon review of the plan of correction, the Department finds that the applicant or licensee is in compliance with .000 and/or that the applicant or licensee has submitted an acceptable plan of correction, the Department shall notify the applicant or licensee of its findings of compliance and/or its acceptance or modification of the plan of correction. (3) If upon review of the plan of correction, the Department finds the plan of correction is unacceptable, the Department may request that the applicant or licensee amend and resubmit the plan of correction within five days of the date of notice or such other time as the Department may specify for resubmission. (4) If upon review of the plan of correction, the Department determines that an applicant or licensee remains non-compliant with applicable laws and regulations regarding licensure or determines that further enforcement action is warranted, the Department may initiate enforcement procedures as set forth in .022.

(C) Notice of Department's Intent to Issue an Order. (1) Prior to the Department issuing an order to modify, limit, deny, suspend, revoke or refuse to renew a license, and/or to require a person to cease and desist any activity, and/or to impose civil penalties, and/or issue a reprimand, the applicant or licensee shall be notified in writing of the grounds for the Department's action, the provision(s) of law relied upon, the amount of any civil penalty, and his/her right to request an adjudicatory proceeding and/or judicial review. (2) If a license is to be modified, limited, denied, revoked, suspended, or refused renewal or if an activity is to be ceased or a civil penalty imposed by the Department, then the aggrieved applicant or licensee may request an adjudicatory hearing within 21 days of receipt of notification of the Department's Intent to Issue an Order. Said request shall be filed in accordance with Standard Adjudicatory Rules of Practice and Procedures, 801 CMR 1.01: Formal Rules.

(D) Denial, Revocation or Refusal to Renew Based on Lack of Minimum Qualifications. (1) If the Department determines that the applicant or licensee fails to meet the age, educational, Department-approved training requirements or other requirements for licensure specified by M.G.L. c. 111, § 5L, the Department shall notify the applicant or licensee in writing that their license is being denied, revoked or refused renewal. Said notice shall include the factual basis for the Department's determination. (2) The Department shall afford the applicant or licensee 21 days from receipt of the written notification to submit certified records to show that they meet the age, educational, Department-approved training requirements and other requirements for licensure. (3) The Department shall deny, revoke or refuse to renew the license of that applicant or licensee without further hearing unless the applicant submits the documentation required in .022(D)(2).

(E) Denial, Modification, Limitation, Revocation, or Refusal to Renew a License Based on Failure to File Reports or Pay Fees or Maintain Insurance. In accordance with M.G.L c. 30A, § 13, no hearing shall be afforded where denial, modification, limitation, revocation, suspension or refusal to renew is based solely upon failure of the licensee to file timely reports, schedules or applications, or to pay lawfully prescribed fees, or to maintain insurance coverage as required by any law or regulation.

(F) Administrative Procedures: Denial, Modification, Limitation, Suspension, Revocation or Refusal to Renew a License; Orders to Cease an Activity; Civil Penalties. (1) All adjudicatory proceedings shall be conducted in accordance with M.G.L. c. 30A and 801 CMR 1.01: Formal Rules.

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(2) Except for circumstances specified in .022(D), if the Department determines that a license should be denied, modified, limited, suspended, revoked, or refused renewal, and/or that an applicant or licensee should cease an activity, and/or that a civil penalty should be imposed, and if the Department notifies the applicant or licensee of its intended action, upon receipt of a Notice of Claim for an Adjudicatory Proceeding, the Department shall initiate a hearing pursuant to 801 CMR 1.01: Formal Rules. (3) The Hearing Officer shall determine whether the Department has proved by a preponderance of the evidence that the license should be denied, modified, limited, suspended, revoked or refused renewal; that an activity should cease; and/or that a civil penalty be imposed based on relevant facts as they existed at or prior to the time the Department initiated the hearing procedure. (4) If the Hearing Officer finds any single ground for denial, modification, limitation, suspension, revocation, or refusal to renew a license; for a cessation of an activity; and/or for imposition of a civil penalty, then the Hearing Officer shall render a recommended decision.

(G) Final Agency Decision and Judicial Review. (1) The recommended decision of a Hearing Officer in any adjudicatory proceeding conducted under .000 shall be reviewed by the Commissioner. The Com- missioner's decision upon this review shall constitute a final agency decision in an adjudicatory proceeding subject to judicial review pursuant to M.G.L. c. 30A, § 14. (2) Any applicant or licensee that fails to exercise its right to an adjudicatory proceeding under .000 waives both its right to administrative review by the Commissioner and its right to judicial review pursuant to M.G.L. c. 30A, § 14.

(H) Civil Penalties. (1) If the Department determines that an applicant or licensee has not complied with an order issued pursuant to M.G.L. c. 111, § 5L or with any provision of M.G.L. c. 111, § 5L or with any applicable rule, regulation, license or registration adopted or issued thereunder, the Department, in lieu of, or in addition to suspending, denying, modifying, limiting, revoking, or refusing renewal of a license, may assess civil penalties in an amount not exceeding $100,000 per violation, subject to the right to a hearing specified in 105 CMR 125.022(C). Such civil penalty may be assessed whether or not the violation was willful. (2) Factors In Determining Amount of Penalty. In determining the amount of the civil penalty, the Department shall consider the following: (a) The willfulness of violation; (b) The actual and potential danger to the public health or the environment; (c) The actual or potential cost of such danger to the public health or the environment; (d) The actual or potential damage or injury to the public health or environment; (e) The actual and potential cost of such damage or injury; (f) The actual or potential cost to the Commonwealth of enforcing provisions of .000; (g) Whether the person being assessed the civil penalty did everything reasonable to prevent failure to comply from occurring, to come into compliance promptly, and to remedy and mitigate whatever harm might have been done as a result of the failure to comply; (h) Whether the person being assessed the civil penalty has previously failed to comply with any order issued pursuant to M.G.L. c. 111, § 5L or any other rule or regulation adopted hereunder; (i) Whether imposition of a civil penalty is likely to deter future noncompliance; (j) The financial condition of the person being assessed the civil penalty; and (k) The public interest. (3) Civil Penalty for Operation without a License. Practicing as a Radiologic Technologist without a license constitutes a violation of law punishable by a civil penalty of up to $100,000. Each day during which a Radiologic Technologist operates without a license shall constitute a separate offense. (4) Payment of the Civil Penalty. If after hearing, or waiver thereof, the Department imposes a civil penalty, then the civil penalty shall be due and payable to the Commonwealth of Massachusetts within 30 days after the date of the final agency action.

105 CMR: DEPARTMENT OF PUBLIC HEALTH

125.022: continued

(5) Non-exclusivity of Civil Penalties. By imposing a civil penalty, the Department does not waive its right to invoke other enforcement procedures, such as modification, limitation, suspension, revocation or refusal to renew a license or registration.

(I) Criminal Enforcement. The Department may elect to enforce any section .000 or provision of M.G.L. c. 111, § 5L by seeking to have criminal sanctions imposed. Any person who violates M.G.L. c. 111, § 5L or any rule, regulation, license, registration, or order adopted or issued under M.G.L. c. 111, § 5N or 5O shall be fined not less than $100 nor more than $2,000, or be imprisoned for a period of not more than two years, or both. Any person who continues to violate the provisions of the aforementioned laws after due notice by the Department shall be fined not less than $1,000 nor more than $20,000 or be imprisoned for a period of not more than 20 years, or both. After due notice has been issued by the Department, each day of such violation shall constitute a separate offense.

(J) Judicial Enforcement. The Department may apply directly to the Supreme Judicial Court or Superior Court to enforce any provision of M.G.L. c. 111, § 5L and/or any rule or regulation, license, registration, or order adopted and issued there under by the Department. When a person is engaged in or about to engage in any act or practice which constitutes or will constitute a violation of such provision, rule, regulation, license, registration, or order, the Department may seek to restrain such act or practice or the use or occupation of premises or parts thereof or such other equitable relief as public health and safety requires.

(K) Nonexclusivity of Enforcement Procedures. None of the enforcement procedures contained in .000 is mutually exclusive. Any enforcement procedures may be invoked simultaneously if the situation so requires.

125.023: Severability

The provisions of .000 are severable. If any section, subsection, paragraph or provision is declared unconstitutional or invalid by a court of competent jurisdiction, the validity of the remaining provisions shall not be so affected.

125.024: Waiver

The Department may waive the application of any provision of .000 with respect to a particular case when in its opinion the enforcement thereof would do manifest injustice, provided that:

(A) The party requesting a waiver shall submit written documentation supporting its request; and

(B) The decision of the Department to grant a waiver shall not conflict with the purpose of .000 and shall not pose a risk to public health or safety.

REGULATORY AUTHORITY

.000: M.G.L. c. 111, §§ 3 and 5L.