Consent Agreements With Massachusetts Licensing Boards
Many Board complaints that aren’t dismissed end in a consent agreement: a negotiated settlement between you and the Board. A Board’s first draft is a starting point, not a final offer. The label, the length, the conditions, and above all the wording of what you admit can usually be negotiated, and that wording follows you to every employer, insurer and state licensing board for the rest of your career. Don’t sign one until a lawyer has reviewed it. Call (978) 273-8337.
Negotiated by someone who knows what the terms mean in practice.
I’ve been a registered respiratory therapist since 2005 and a registered nurse since 2010. As a respiratory therapist I spent many years at the bedside providing hands-on respiratory care. As a nurse I’ve worked in critical care and the intensive care unit of an acute care hospital, and I’ve held management roles in that setting. From hospital management I know how monitoring conditions, supervision requirements and practice restrictions play out on an actual unit, and I negotiate terms you can realistically meet.
— Richard Alan Gaudet, JD, RN, RRT
What a consent agreement is
A consent agreement resolves a complaint without a contested hearing. Under the rules of most Massachusetts health boards, it can include any action the Board could order after a hearing, an agreement that you’ll refrain from practice, and other terms permitted by law (for example 261 CMR 4.04(4); 234 CMR 9.04(4); 263 CMR 6.04(4); 247 CMR 10.06(6)). The Psychologists Board can likewise offer a consent agreement or resolve a matter informally instead of issuing an Order to Show Cause (251 CMR 1.07).
What it can include
Outcome in the agreement
Is it discipline?
Practice
Stayed probation
No (at boards that offer it)
Yes, with temporary conditions
Reprimand
Yes, a public rebuke
Yes, without conditions
Probation
Yes
Yes, with conditions
Suspension, for a period or until conditions are met
Yes
No
Agreement to refrain from practice
Depends on the wording
No
Surrender of the license
Yes, at most boards
No
Common conditions include continuing education, practice monitoring or supervision, workplace reports, limits on prescribing or practice settings, evaluations, treatment, and toxicology testing. A board may also resolve a complaint with a fine where the law allows (for example 261 CMR 4.04(7)). At the Psychologists Board, supervision terms are spelled out in detail, including an approved supervisor with no prior relationship to you and regular written reports (251 CMR 1.09(3)).
What becomes public, and who finds out
Orders and consent agreements are public records at most boards, whether or not they’re disciplinary (for example 261 CMR 4.04(6); 234 CMR 9.04(6); 263 CMR 6.04(6)).
Board actions are generally reported to national practitioner databanks, which hospitals, insurers and other states check.
Other states where you hold a license may take reciprocal action based on Massachusetts discipline.
Employers, credentialing committees and insurers will see it, and you’ll be asked about it on future applications and renewals.
Any action on your license also applies to your right to renew it, unless the agreement says otherwise (for example 261 CMR 4.04(5)).
Physicians: the Assurance of Discontinuance
The Board of Medicine has a separate tool for minor violations: an Assurance of Discontinuance (243 CMR 1.03(13)). It isn’t available where the complaint alleges patient harm or drug or alcohol impairment. When the Complaint Committee is ready to recommend formal charges, it can instead refer the matter to a conference with a hearing officer, where you and the Board’s disciplinary unit can propose an assurance that includes:
A recitation of the circumstances
Your assurance that the conduct will stop
A sanction, or your agreement to pay the cost of the investigation
Your agreement that violating it is prima facie evidence of a violation
The hearing officer and the Board must approve it within 60 days of the referral, or the matter goes back to the formal track. Note that the Board must report an Assurance of Discontinuance to national data reporting systems (243 CMR 1.03(13)(e)), so it isn’t invisible.
What to negotiate
The label. Stayed probation isn’t discipline; probation is. A practice restriction framed as voluntary may be reported differently than one imposed as a sanction. Small differences in wording change how the agreement is reported and read.
The facts. The agreement recites what happened. Whether you “admit” the allegations, “do not contest” them, or agree only that the Board “could find” them matters to employers, insurers, other boards and any lawsuit.
Length and early release. Ask for a defined term and a path to end it early after full compliance.
Conditions you can actually meet: realistic monitoring schedules, testing frequency, approved settings and hours, and who pays.
Supervision and monitors: who qualifies, who approves them, and what happens if a supervisor leaves.
Reporting language for employers and other states.
Health information: keep clinical details about your own treatment out of the public document where possible.
Surrender and resignation are different
A surrender or resignation ends the case, but often at a steep price:
At the Respiratory Care, Dentistry and PA Boards, an accepted permanent surrender counts as discipline, and the Board may treat the allegations as true (for example 261 CMR 4.04(3)).
At the Pharmacy Board, a voluntary surrender agreement must state that it is not subject to judicial review (247 CMR 10.06(6)(c)).
At the Medicine and Psychologists Boards, a resignation is final, can’t be reconsidered or appealed, and in most cases requires you to give up licenses in other states or not seek them (243 CMR 1.05(5); 251 CMR 1.09(4)).
Never offer a surrender or resignation without advice.
If you violate the agreement
Failing to comply with a consent agreement is its own ground for discipline at every board on the newer template, and at Pharmacy (261 CMR 4.03(1)(d); 234 CMR 9.03(1)(d); 263 CMR 6.03(1)(d); 247 CMR 10.03(1)(j)). An agreement can also authorize the Board to take further action if you don’t comply. Negotiate a notice-and-cure process for minor lapses, such as a missed test or a late report.
When to say no
A consent agreement isn’t always the right answer. Consider a hearing when:
The facts are genuinely disputed, and the Board’s evidence is weak
The proposed terms would end your career anyway, for example a restriction no employer will accept
The admissions would cause serious harm in a parallel lawsuit or criminal case
The Board won’t move from terms far harsher than in comparable cases
The decision depends on the evidence, the risks of a hearing, and what an adverse decision after a hearing would look like.
Checklist before signing
Read every recital of fact. Would you be comfortable with an employer, insurer or another state reading it?
Confirm the label: is this discipline, and how will it be reported?
Check every condition against your real schedule, budget and workplace.
Find the end date and any path to early release.
Know what happens on a slip: is there notice and a chance to cure?
Check the effect on other licenses, registrations and hospital privileges.
Get it reviewed by a lawyer before you sign, not after.
Offered a consent agreement?
Call or text (978) 273-8337, or send a message. I review and negotiate consent agreements for licensed professionals across Massachusetts, in person in Middleton or by video.
Frequently asked questions
Is a consent agreement discipline? It depends on its terms. Stayed probation is not discipline at the boards that offer it, while a reprimand, probation, suspension or surrender is. The wording of the agreement decides how it is reported.
Is a consent agreement public? Generally, yes. At most Massachusetts health boards, orders and consent agreements are public records whether or not they are disciplinary, and Board actions are generally reported to national practitioner databanks.
Can I negotiate the terms? Usually. The label, length, conditions and the description of the facts are commonly negotiated before signing. A Board’s first draft is a starting point.
What is an Assurance of Discontinuance? A Board of Medicine resolution for minor violations, not available where patient harm or impairment is alleged. It must be approved by a hearing officer and the Board, and the Board must report it to national data reporting systems (243 CMR 1.03(13)).
What if I can’t meet a condition of my agreement? Talk to your lawyer before you fall out of compliance. Violating a consent agreement is a separate ground for discipline, so it is better to ask the Board to modify a condition than to miss it.
Richard Alan Gaudet, Esq. is a Massachusetts attorney at the Law Offices of Richard Alan Gaudet, LLC in Middleton, Massachusetts, and an experienced administrative law practitioner who represents licensed professionals in board investigations, responses and hearings. He has been a respiratory therapist since 2005 and a registered nurse since 2010, including in critical care. He earned his J.D. in 2020 and was admitted to the Massachusetts bar in January 2021 and to the U.S. District Court for the District of Massachusetts in 2021. He is a member of the Massachusetts Bar Association. Reach him at 978-273-8337 or rgaudet@gaudetlawoffice.com. Office: 35 Village Rd., Ste 100, Middleton, MA 01949.
ABOUT THIS ARTICLE
This article was prepared by a Massachusetts attorney and is provided solely for general informational and educational purposes directed to members of the general public. It does not constitute legal advice and does not create an attorney-client relationship. The law applicable to any particular situation depends on the specific facts and circumstances of that matter. Readers are encouraged to seek the advice of a licensed Massachusetts attorney before taking any action.
