CHAPTER
Med 100 ORGANIZATION, DEFINITIONS AND
PUBLIC INFORMATION
Statutory
Authority: RSA 329:9
REVISION NOTE:
Document #9900, effective 4-12-11,
adopted, amended, readopted with amendments, or repealed many rules in Chapters
Med 100 through Med 600. In Chapter Med
100 on organizational rules, Document #9900 adopted a new rule Med 102.08
defining “Medical Review Subcommittee (MRSC)” and readopted with amendments Med
104.01 and Med 105.03. However, the Joint
Legislative Committee on Administrative Rules (JLCAR) had not approved the
rules in Document #9900 pursuant to RSA 541-A:13. Therefore, although the rules in Chapter Med
100 in Document #9900 were organizational rules, they expired after 8 years on 4-12-19
pursuant to RSA 541-A:17, as amended through 2009, 232:5.
PART
Med 101 PURPOSE AND SCOPE
Med 101.01 Purpose and Scope.
(a)
The rules of this title implement the statutory responsibilities of the
(1) RSA 329, Physicians and Surgeons; and
(2) RSA 328-D, Physician Assistants.
(b)
The board's statutory responsibilities include, but are not limited to:
(1) The examination and licensing of all
practitioners listed in (a) above;
(2) The development of ethical and other professional
standards to be followed by licensees under those chapters;
(3) The process for investigating allegations of
misconduct and imposing disciplinary sanctions on licensees; and
(4) The development of continuing professional
education requirements and other requirements for demonstrating professional
competence.
Source. #1136, eff 3-27-78;
ss by #2199, eff 12-2-82; ss by #2910, eff 11-21-84; ss by #4970, eff 11-8-90,
EXPIRED 11-8-96
New. #6554, eff 7-31-97;
ss by #7230, eff 4-11-00
PART
Med 102 DEFINITIONS
Med 102.01 "Administrator" means the person
designated by the board under RSA 329:2 IV to represent their interests and to
direct the staff and operations of the board in an efficient manner.
Source. #4970, eff 11-8-90; amd by #5092, eff 3-13-91; ss by #6554, eff 7-31-97
Med 102.02 "Board" means the
Source. #6554, eff 7-31-97
Med 102.03 "Licensee" means any person holding
a valid license or certification issued by the board under any grant of
statutory authority.
Source. #6554, eff 7-31-97
Med 102.04 "Practice of Medicine" means the
practice of medicine or surgery as defined in RSA 329:1, including procedures
which require the use of lasers, provided, however, that activities which may
lawfully be performed by health care professionals licensed under other New
Hampshire statutes shall not be considered as the practice of medicine.
Source. #6554, eff 7-31-97
Med 102.05 "Physician" means a doctor of medicine or a doctor of osteopathy who holds a
current license to practice issued by the board pursuant to RSA 329.
Source. #6554, eff 7-31-97
Med 102.06 "President" means the president of
the board chosen pursuant to RSA 329:7.
Source. #6554, eff 7-31-97
Med 102.07 "Tentative decision" means a board action
which instructs the board's staff or a board committee to prepare a draft
document which satisfies generally stated policy objectives, subject to
subsequent review and approval by the board.
Source. #6554, eff 7-31-97
Med
102.08 “Medical Review Subcommittee
(MRSC)” means the medical review subcommittee of the board as described in RSA
329:17, V-a.
Source. #9900, eff 4-12-11,
EXPIRED 4-12-19 (see Revision Note at chapter heading for Med 100)
New. ss by #13712, eff
10-1-23
PART
Med 103 ORGANIZATION
Med 103.01 Composition of the Board. The board consists of 11 members who are appointed by the governor and council and shall
meet the eligibility requirements of RSA 329:2, I and RSA 329:4.
Source. #4970, eff 11-8-90,
EXPIRED 11-8-96
New. #6554, eff 7-31-97; ss by
#10125-A, eff 5-9-12
Med 103.02 Officers.
(a)
In December of each year, the board shall elect one member to serve as
president and one member to serve as vice president and one member to be the
board’s designee on the MRSC for the coming year.
(b)
The president shall chair the board’s meetings, establish the order of
its business and approve the actions of the
administrator, consistent with the policies of the board.
(c)
The vice-president shall assume the duties of the president in his or
her absence.
(d) The board shall elect a member as the board’s
designee on the MRSC. That member shall
attend and be a full voting member at the MRSC meetings and as
a consequence be recused from the discussion of disciplinary matters by
the board.
Source. #4970, eff 11-8-90,
EXPIRED 11-8-96
New. #6554, eff 7-31-97; ss by
#10125-A, eff 5-9-12
Med 103.03
Staff. The board shall
employ an executive director, an administrator and such other staff as is
necessary to conduct the board’s day-to-day operations and to fulfill its
statutory duties.
Source. #4970, eff 11-8-90,
EXPIRED 11-8-96
New. #6554, eff 7-31-97; ss by
#10125-A, eff 5-9-12
PART
Med 104 PUBLIC INFORMATION
Med
104.01 Access to Public Records.
(a) To ensure public access to the official
records of the board, the board shall maintain an office in which all public
records shall be open for inspection during regular state working hours. Members of the public may request in writing,
to inspect public records in person or by obtaining a photocopy of such
records.
(b) Requests for copies of public records should be
addressed to the board's administrator at the following address:
Board of Medicine
c/o Office of
Professional Licensure and Certification
7 Eagle Square
Concord, New
Hampshire 03301
(c) Minutes of all board and committee meetings
shall be taken and shall be available for inspection during the board's regular
business hours within 144 hours of the date of the meeting or vote in questions,
unless the 72-hour availability requirements of RSA 91-A:3, III is applicable.
(d) Board records which contain both public and
confidential information shall be provided with the confidential information
deleted.
(e) Final orders in disciplinary matters shall be
retained indefinitely.
Board of Medicine
Philbrook Building
121 South Fruit
Street
Concord,
Source. #4970, eff 11-8-90,
EXPIRED 11-8-96
New. #6554, eff 7-31-97; ss by #9900, eff 4-12-11, EXPIRED 4-12-19 (see
Revision Note at chapter heading for Med 100)
New. #13712, eff
10-1-23
PART
Med 105 MEETINGS, DELIBERATIONS AND
DECISIONS
Med 105.01 Meetings. The board shall meet monthly and at such
additional times as shall be called for by the president or by vote of the
board.
Source. #4970, eff 11-8-90, EXPIRED
11-8-96
New. #6554, eff 7-31-97
Med 105.02 Necessary Quorum. Except as otherwise provided by law, a quorum shall not be required to conduct a
hearing or receive information, but final decisions shall be made only by the
affirmative vote of a majority of the board members eligible to participate in
the matter in question.
Source. #4970, eff 11-8-90,
EXPIRED 11-8-96
New. #6554, eff 7-31-97
Med 105.03 Board Decisions.
(a)
Draft decisions shall not be binding upon the board. Changes in the form or the substance of a
draft decision shall be made as often as necessary to produce a final document
which satisfactorily sets forth the final result the
board intends to reach.
(b)
A majority of the board shall take action when an emergency meeting is required by an imminent peril to the
public health or safety or when the physical presence of a quorum is not
reasonably practical for immediate board action pursuant to RSA 329:7, III, by telephone poll or written ballot
provided that such action is ratified at a subsequent meeting of the board. The
minutes and the procedures for emergency meetings shall comply with RSA 91-A:2.
(c)
The board's final decision shall be issued only after the necessary
majority has voted on the final document.
(d)
A board member who was absent from the meeting at which a draft decision
was reached shall be eligible to vote on the final decision prepared in
accordance with the board's direction if the member is not otherwise recused from
the matter in question.
Source. #4970, eff 11-8-90,
EXPIRED 11-8-96
New. #6554, eff 7-31-97; ss by #9900, eff 4-12-11, EXPIRED 4-12-19 (see
Revision Note at chapter heading for Med 100)
New. #13712, eff
10-1-23
PART
Med 106 APPOINTMENT OF SUBCOMMITTEES
Med 106.01 Committees.
(a)
A committee, appointed by the board to investigate and make
recommendations on matters within the statutory authority of the board, shall
consist of one or more members and shall be chaired by a member of the board.
(b) When expressly authorized by the board, the
authority of a committee shall include:
(1) The retention of qualified non-board members
to serve as members of the committee; and
(2) The retention of paid advisors or consultants
pursuant to Med 329:18 II.
Source. #4970, eff 11-8-90,
EXPIRED 11-8-96
New. #6554, eff 7-31-97
CHAPTER Med 200 RULES OF PRACTICE AND PROCEDURE
REVISION NOTE #1:
Document #9900, effective 4-12-11,
adopted, amended, readopted with amendments, or repealed many rules in Chapters
Med 100 through Med 600. In Chapter Med
200, Document #9900 readopted with amendments selected rules in Parts Med 201, 204,
205, and 206, and readopted with amendments rules Med 201.01 and Med
202.02. Document #9900 also amended Med
208.01(a). Document #9900 repealed Med
210 on nonadjudicatory investigations and adopted a
new rule Med 205.03 on investigations.
Document #9900 replaces all prior filings for rules in the former Med
210. The prior filings affecting Med 210
include the following documents:
#4970, effective 11-8-90, EXPIRED
11-8-96
#6517, effective 5-30-97, EXPIRED
5-30-05
#8662, INTERIM, effective 6-16-06, EXPIRED
12-13-06
#8944-B, effective 7-18-07
Document #9900 also renumbered, but did
not readopt, the existing rule Med 205.03 as Med 205.04. The repeal of Med 210 by Document #9900 necessitated
the renumbering of existing Parts Med 211, Med 212, and Med 213 as,
respectively, Med 210, Med 211, and Med 212.
REVISION
NOTE #2:
Document #13764, effective 10-5-23,
repealed Part Med 201 through Part Bar 212 in Chapter Med 200, titled “Practice
and Procedure”, and renamed the chapter as “Rules of Practice and Procedure”. Document #13764 also adopted a new Part Med
201 titled “Applicability and Waiver of Substantive Rules”, containing rule Med
201.01 titled “Applicability of Plc 200” and rule Med 201.02 titled “Waiver of
Administrative Rules.”
Document
#13764 replaces all prior filings affecting the rules in the former Chapter Med
200. The prior filings included the following
documents. Italics
indicate the rules were subject to expiration only pursuant to RSA 541-A:17, II:
#4970, effective 11-8-90, EXPIRED
11-8-96
#5223, effective 9-12-91
#5402, effective 5-22-92
#5785, effective 2-4-94
#5838, effective 6-17-94
#6517, effective 5-30-97, EXPIRED
5-30-05
#8662, INTERIM, effective 6-16-06, EXPIRED
12-13-06
#8944-A,
effective 7-18-07
#8944-B, effective 7-18-07
#9900, effective
4-12-11
#10125-A,
effective 5-9-12
As practice and procedure rules, the
rules in Document #13764 will not expire except pursuant to RSA 541-A:17, II.
PART Med 201 APPLICABILITY AND
WAIVER OF SUBSTANTIVE RULES
Med 201.01
Applicability of Plc 200.
The Plc 200 rules shall govern with regards to all procedures for:
(a) Adjudicatory proceedings;
(b) Rulemaking submissions, considerations, and
disposition of rulemaking petitions;
(c) Public comment hearings;
(d) Declaratory rulings;
(e) All statements of policy and interpretation;
(f) Explanation of adopted rules;
(g) Voluntary surrender of licenses; and
(h) Petitions for waiver of rule.
Source. (See Revision
Notes #1 and #2 at chapter heading for Med 200) #13764, eff
10-5-23
Med 201.02 Waiver of Administrative Rules.
(a) The board shall initiate a waiver of a
substantive rule upon its own motion by providing affected parties with notice
and opportunity to be heard and issuing an order which finds that waiver would
be necessary to advance the purpose of RSA 329.
(b) Individuals who wish to request a waiver of a
rule shall submit a written request to the board, which includes:
(1)
The rule for which a waiver is requested;
(2)
The anticipated length of time the requested waiver will be needed;
(3)
The reason for requesting the waiver;
(4)
Evidence of how the waiver will provide for the health and safety of the
consumer or licensee;
(5) A
time-limited written compliance plan which sets forth plans to achieve
compliance including an estimated date of compliance; and
(6)
The signature of the applicant.
(c) The board shall consider the following when
determining whether to approve or deny a waiver:
(1)
If adherence to the rule would cause the petitioner unnecessary or undue
hardship;
(2)
If the requested waiver is necessary because of any neglect or
misfeasance on the part of the practitioner;
(3) If
enforcement of the rule would injure a third person(s); and
(4) If
waiver of the rule would injure a third person(s).
(d) The board shall approve a waiver of an
administrative rule request only if:
(1)
Granting a waiver does not have the effect of waiving or modifying a
provision of RSA 329;
(2) The
petitioner has shown good cause exists pursuant to (c) above to waive the
rule.; and
(3)
The board determines that the individual’s plans for compliance with the
rule includes an estimated date of compliance and eventual compliance.
(e) The board, after receiving and reviewing a
request for a waiver requires further information or documents to determine
granting or denying the waiver shall:
(1)
Notify the applicant in writing within 30 days; and
(2)
Specify the information or document the board requires.
(f) The board shall issue a written approval or
denial of the waiver within 60 days of the date that the request is received, unless additional information or documentation is
required. If additional information and
documentation is required, then the board shall issue a written approval or
denial within 60 days of receiving the requested information or documentation.
Source. (See Revision
Notes #1 and #2 at chapter heading for Med 200) #13764, eff
10-5-23
CHAPTER
Med 300 LICENSURE REQUIREMENTS
REVISION NOTE:
Document
#9900, effective 4-12-11, adopted, amended, readopted with amendments, or
repealed many rules in Chapters Med 100 through Med 600. In Chapter Med 300, Document #9900 readopted
with amendments Med 301.01 through Med 301.03, and Parts Med 302, 303, and
306. Document #9900 also adopted Med
305.03 on administrative licenses, and readopted with amendments and renumbered
Med 305.03 as Med 305.04. The source
note for Med 305.04 indicates the former rule number Med 305.03, and the
document numbers and effective dates apply to the rule under the former number.
PART
Med 301 APPLICATION REQUIREMENTS
Med 301.01
Definitions.
(a)
“Administrative license” means a license to engage in professional,
managerial, or administrative activities related to the practice of medicine or
to the delivery of health care services, but does not include the practice of clinical medicine.
(b)
"Applicant" means a physician on whose
behalf an application has been filed.
(c) "Board certified" means
a physician who is currently certified by a medical specialty board recognized
by the American Board of Medical Specialties (ABMS) or by
the American Osteopathic Association (AOA).
(d)
"Clearance" means a document received
directly from a state licensing authority which verifies whether
or not a person has ever been granted a license by that state, the dates
during which that license was valid and whether the licensing authority has
ever taken disciplinary action against that license.
(e)
“Clinical medicine” means medical practice
that includes but is not limited to:
(1) Direct involvement in patient
evaluation, diagnosis, and treatment;
(2) Prescribing any medication;
(3) Delegating medical acts or
prescription authority;
(4) The supervision of physicians,
physician assistants, or registered nurses in the practice of clinical medicine;
or
(5) Direct involvement in medical
decisions impacting population health.
(f)
"Courtesy license" means a license, issued pursuant to RSA
329:14, VII, which shall not exceed 100 calendar days and is restricted to
specific dates and location(s) as indicated on the license. The term includes “locum tenens license.”
(g) "Federation Credentials Verification
Service (FCVS)" means the service provided by the Federation of State Medical Boards
which verifies and maintains a permanent collection of original source documentation of physician
educational, examination and identification documents.
(h)
"Special license" means a license, issued pursuant to RSA 329:14, VI
which is restricted to specific dates and location(s) as indicated on the
license, in the following categories::
(1) “Camp license” as
described in Med 305.02(a); and
(2) “Visiting professor
license” as described in Med 305.02(b).
(i) “Special training license”
means a license, issued pursuant to RSA 329:14, V which is restricted to
specific dates and location(s) as indicated
on the license. The term includes
“resident training license.”.
(j)
“Temporary license” means an unrestricted
license valid for only 6 months pending the applicant’s receipt of an unrestricted
permanent license.
(k)
“Unrestricted permanent license” means a license granted pursuant to RSA
329:14, III that expires biennially on June 30.
Source. #4970, eff 11-8-90; ss by #5908, eff 10-7-94; ss by #6576, eff
9-15-97; amd by #8068, eff 4-10-04; ss by #8662, INTERIM, eff 6-16-06, EXPIRED: 12-13-06
New. #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision
Note at chapter heading for Med 300); ss by #12972, eff 1-10-20
Med 301.02 Application Process.
(a) Persons wishing to practice medicine in New
Hampshire shall submit both the
Federation of State Medical Boards’ Uniform Application, available on
the board’s website, and a “State Addendum,” revised 11/2019, which contains
the information specified in Med 301.03, and the application fee specified in
Table 3.6.1. in Med 306.01.
(b)
An application which is not signed by the applicant shall not be
accepted and shall be returned to the applicant.
(c) The board shall acknowledge receipt of an
application within 60 days and shall notify the applicant of any deficiencies
in the application, including the absence of the application fee, or any
further information needed to clarify the applicant's qualifications. Failure to remedy the deficiencies within 52
weeks of the board’s initial receipt of the application shall result in
dismissal of the application.
(d) Applications shall be granted by the board
pursuant to the requirements set forth in RSA 329:14, II.
(e) If the application is denied, the applicant
shall be provided an opportunity to request a hearing for reconsideration
pursuant to Med 208 on the deficiency issues identified by the board. Any such request shall be received by the
board within 30 days.
Source. #4970, eff 11-8-90;
ss by #5908, eff 10-7-94; ss by #6576, eff 9-15-97, EXPIRED: 9-15-05
New. #8662, INTERIM, eff
6-16-06, EXPIRED: 12-13-06
New. #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision
Note at chapter heading for Med 300); ss by #12972, eff 1-10-20
Med
301.03 Application for an
Unrestricted Permanent License.
(a) Applicants for an unrestricted permanent
license shall provide, or cause to be provided, the following on a form
supplied by the board:
(1) The applicant's name, including any names
previously used;
(2) The applicant's residence and business
addresses and telephone numbers, business e-mail address and business fax number;
(3) The applicant's date of birth, place of birth
and social security number required pursuant to 45 CFR Part 60.8 and RSA
161-B:11, VI-a. The applicant shall
furnish his or her social security number on the line provided below the
following preprinted statement:
"The board
will deny licensure if you refuse to submit your social security number
(SSN). Your professional license will
not display your SSN. Your SSN will not
be made available to the public. The
board is required to obtain your social security number for the purpose of child
support enforcement and in compliance with RSA 161-B:11. This collection of your social security
number is mandatory."
(4) The applicant's educational history including
the names of all institutions attended, the dates of attendance and the degree
awarded;
(5) A certification of medical education received
directly from and verified by FCVS;
(6) If the applicant graduated from a medical
school outside the United States or Canada:
a. Certified copies of an official transcript of
grades and proof of graduation with certified English translation received
directly from and verified by FCVS; and
b. Verification received directly from FCVS that
the applicant holds a current certification from the Educational Commission of
Foreign Medical Graduates (ECFMG);
(7) A listing of all institutions in which the
applicant has pursued post graduate training and a written verification
received directly from FCVS that the applicant has completed at least 2 years
of training which meet the requirements of Med 302.01;
(8) Verification received directly from FCVS that
the applicant has passed one of the licensure examinations listed under Med
303.01;
(9) A listing of every state in which the
applicant holds or has ever held a license and clearances of those licenses
received directly from the licensure authority;
(10) Disclosure of whether the applicant is board
certified and if so, a certified copy of that certification;
(11) Disclosure of whether the applicant has ever
lost or been denied board certification and if so, an explanation for the
circumstances;
(12) Disclosure of whether the applicant has ever
been subject to a claim for malpractice and if so, the circumstances of that
claim;
(13) Disclosure of whether the applicant has ever
taken an examination or applied for licensure under a different name;
(14) Disclosure of whether the applicant has ever
failed any medical licensing examination or been denied the privilege of
finishing or been accused of cheating or improper conduct during any required
examination, and, if so, the circumstances involved;
(15) Disclosure of whether the applicant has ever
been denied a medical license and, if so, the circumstances of that denial;
(16) Disclosure of whether the applicant has ever
had hospital privileges, employment, or appointment at any health care
institution denied, limited, suspended, or revoked or whether the applicant has
ever resigned in lieu of such actions and if so, the circumstances involved;
(17) Disclosure of whether the applicant is
currently under investigation or whether any disciplinary action has been taken
against the applicant during the past 10 years by any governmental authority,
hospital, or health care facility or by any professional medical association,
and, if so, the circumstances involved;
(18) Disclosure of whether the applicant has ever
voluntarily surrendered a license to practice medicine in lieu of facing
disciplinary action or ever withdrawn an application for licensure, hospital
privileges or appointment for any reason and if so the
circumstances involved;
(19) Disclosure of whether the applicant has ever
been a defendant in a criminal proceeding and the circumstances of that
criminal proceeding;
(20) Disclosure of whether the applicant has ever
lost the privilege to possess, dispense, or prescribe controlled substances or
been investigated by any state or federal drug enforcement agencies;
(21) Disclosure of whether the applicant is
currently suffering from any condition, mental or physical, that impairs the
applicant’s judgment or that would otherwise adversely affect his or her ability
to practice medicine in a competent, ethical, and professional manner;
(22) Disclosure of whether the applicant is
currently or has in the past been monitored or treated by a private, state,
medical society or hospital physician health program,
other than through the NH board approved physician health program;
(23) Disclosure of whether the applicant has not
been actively engaged in the practice of clinical medicine within the past 12
months;
(24) A certified copy of the applicant's birth
certificate or passport received directly from FCVS;
(25) A listing of all professional activities
pursued including the dates of such activities since the applicant graduated from
medical school;
(26) Original letters of reference, on letterhead
and addressed to the board, from:
a.
The chief medical officer or president of the medical staff in every
hospital in which the applicant currently holds
staff privileges; or
b. Letters of reference from
2 practicing physicians;
(27) A recent, full face, 2 x 3 inch photograph of
the applicant;
(28) The applicant's notarized signature attesting
to the accuracy of the information provided; and
(29) If applicable, a copy of the applicant's current
Drug Enforcement Administration (DEA) certificate.
(b) Applicants shall include the application fee
required in Table 3.6.1 in Med 306.01.
(c) A temporary license, valid for only 6 months,
shall be issued pursuant to RSA 329:14, III only to applicants for a full New
Hampshire license who have met the requirements of Med 301.03(a) and (b) above,
excluding Med 301.03(a)(5), Med 301.03(a)(6), Med 301.03(a)(7), Med
301.03(a)(8) and Med 301.03(a)(24). Applicants
shall not begin to practice until such time as they receive a temporary
license.
(d) Applicants for temporary license shall also
provide, or cause to be provided, the following:
(1) Evidence of qualifications as follows:
a.
Proof of a full, unrestricted medical license in another state received
directly from the state licensing authority indicating that the applicant’s
license covers the dates in which he or she is practicing in New Hampshire; or
b.
Certified copies of a medical degree diploma, proof of 2 years of postgraduate
training which meet the requirements of Med 302.01, and
proof that the applicant has passed one of the licensure examinations listed
under Med 303.01;
(2) Proof that the applicant has applied to the
FCVS with full intent to complete the FCVS process; and
(3) The temporary license fee specified in Table
3.6.1 in Med 306.01.
Source. #4970, eff
11-8-90; ss by #5908, eff 10-7-94; ss by #6576, eff 9-15-97; amd by #7591, eff 11-14-01; amd
by #8068, eff 4-10-04; amd by #8096, eff 6-5-04; amd by #8662, INTERIM, eff 6-16-06, EXPIRED: 12-13-06
(paragraphs (a)(1)-(27) and (b)); ss by #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision Note at chapter heading for
Med 300); ss by #12972, eff 1-10-20
Med
301.04 Late Renewal and Reinstatement
of License.
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6576, eff 9-15-97; amd
by #7949, eff 9-6-03; amd by #8662, INTERIM, eff
6-16-06, EXPIRED: 12-13-06 (paragraphs (c)-(e)); ss by #8945, eff 7-18-07, EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
moved by #11048 (see Med 401.04)
PART
Med 302 QUALIFICATIONS
Med
302.01 Educational Requirements.
(a) Applicants who have graduated from medical
schools located in the United States or Canada shall confirm that the medical
school is accredited by the Liaison Committee for Medical Education (LCME).
(b) Applicants from medical schools located
outside the United States or Canada shall maintain the academic standard
recognized by the United Nations World Health Organization (UNWHO) and have their
studies confirmed by the Educational Commission for Foreign Medical Graduates
(ECFMG).
(c) Applicants shall have completed at least 2
years of postgraduate medical training, postgraduate year 1, postgraduate year
2, in a program accredited by the Accreditation Council for Graduate Medical
Education (ACGME), the American Osteopathic Association (AOA), or its
equivalent which shall include, at a minimum, the following:
(1)
Board certification in the applicant's area of
specialty; or
(2)
Completion of 10 or more years of practice
combined with proof of 2 years of post-graduate training outside the United
States or Canada.
(d) Applicants who have not completed 2 years of
postgraduate training in an institution accredited by ACGME or AOA shall petition
the board pursuant to Med 205.01 to determine if the applicant's qualifications
meet the requirements of (d) above. Such
petitions shall provide any information in addition to that specified in (d)
above which the applicant wishes the board to consider in making a
determination of equivalency.
Source. #4970, eff 11-8-90; ss by #5908, eff 10-7-94;
ss by #6576, eff 9-15-97, EXPIRED: 9-15-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision Note at chapter heading for
Med 300); ss by #12972, eff 1-10-20
PART
Med 303 EXAMINATIONS
Med
303.01 Examination Requirements.
(a) Applicants for licensure shall have passed
one of the following series of examinations:
(1) National Board of Medical Examiners (NBME),
parts I, II and III;
(2) The Federation Licensing Examination (FLEX),
components 1 and 2;
(3) The United States Medical Licensing
Examination (USMLE), steps 1, 2, Clinical Knowledge and Clinical Skills, and 3;
(4) National Board of Osteopathic Examiners
(NBOE) parts I, II and III; or
(5) The Medical Council of
(b) Applicants who completed one of the following
combinations of examinations on or before December 31, 1999, shall be exempt
from the requirements of (a) above:
(1) One of each of the following:
a. NBME part I, NBOE part I or USMLE step 1;
b. NBME part II, NBOE part II or USMLE step 2,
Clinical Knowledge, and step 2,
Clinical Skills; and
c. NBME part III, NBOE part III or USMLE step 3;
(2)
FLEX component 1 plus USMLE step 3; or
(3) One of each of the following:
a. NBME part I, NBOE part I or USMLE step 1;
b. NBME part II, NBOE part II or USMLE step 2
(Clinical Knowledge) and step 2 (Clinical Skills); and
c.
FLEX Component 2.
(c)
Applicants shall pass each examination
section within 3 attempts. Failure to
pass that section after 3 attempts shall invalidate the entire examination. The board shall waive this examination
requirement for any applicant who is board certified.
(d) A passing grade in each of the required
examinations shall be the passing score as defined by each entity that
administers the examination.
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6576, eff 9-15-97; amd
by #8188, eff 10-12-04; amd by #8662, INTERIM, eff
6-16-06, EXPIRED: 12-13-06 (paragraphs (a)(1), (4), and (5)); ss by #8945, eff
7-18-07; ss by #9900, eff 4-12-11
(see Revision Note at chapter heading for Med 300); ss by #10125-B, eff 5-9-12
Med
303.02 Candidates for USMLE Step 3.
(a) Examination candidates who wish to take USMLE
step 3 in New Hampshire shall apply directly to the Federation of State Medical
Boards (FSMB).
(b)
Examination candidates shall not be eligible for licensure until they
have met the requirements of Med 302 and Med 303 and filed an application for
licensure pursuant to Med 301.03.
(c) Candidates for USMLE step 3 shall:
(1)
Have graduated from a medical school accredited
by the LCME or have completed their medical education from an institution located
outside the United States and have such studies confirmed by the ECFMG;
(2)
Have begun the first academic year of postgraduate training at an institution
accredited by the ACGME, the Royal College of Physicians and
Surgeons of Canada (RCPSC) or the AOA; and
(3)
Have passed USMLE step 1, step 2 (Clinical Knowledge) and step 2
(Clinical Skills) or one of the acceptable combinations of
examinations noted in Med 303.01 (b).
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6576, eff 9-15-97; amd
by #6906, eff 12-4-98; amd by #8188, eff 10-12-04; amd by #8662, INTERIM, eff 6-16-06, EXPIRED: 12-13-06 (paragraphs (a) and (b)); ss by #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision
Note at chapter heading for Med 300); ss by #12972, eff 1-10-20
PART
Med 304 - RESERVED
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96; rpld by #6576, eff 9-15-97
PART
Med 305 SPECIAL, COURTESY, AND TRAINING
LICENSES
Med 305.01 Locum Tenens Licenses.
(a)
Applicants who currently hold a full, unrestricted medical license in
another state, and who wish to practice in New Hampshire for a limited period of
time may apply for a restricted license.
(b)
Locum tenens licenses shall be issued by the board subject to the
following limitations:
(1) No locum tenens license shall be valid for a
period in excess of 100 consecutive calendar days;
(2) Locum tenens licenses shall be valid for
practice only at the location specified on the face of the license;
(3) Only one locum tenens license shall be issued
to any applicant during any 12 month period; and
(4) Locum tenens licenses shall be posted at the
location specified on the face of the license at all times during the period of
licensure.
(c)
Applicants for locum tenens licensure shall provide, or cause to be
provided, the following on or attached to an “Application for Locum Tenens
License,” revised 11/2019:
(1) The applicant's name, gender, and residence
address;
(2) The address(es) and telephone number(s) of
the applicant's prior 3-year practice location(s);
(3) The applicant's date and place of birth;
(4) The name of the institution where the
applicant graduated from medical school and the date of graduation;
(5) The name of the institutions where the
applicant completed his or her post graduate training and the dates of that
training;
(6) Disclosure of whether the applicant has ever
previously applied for licensure in New Hampshire and if so, the date of that
application;
(7) Disclosure of whether the applicant has ever
been subject to disciplinary action by any licensing or certifying agency or by
any hospital or health care institution and if so, the dates and circumstances
of that action;
(8) Disclosure of whether the applicant has had
any medical malpractice suit brought against him or her or has had any claim settled
on his or her behalf in the last 10 years;
(9) The state in which the applicant holds
current licensure and clearance of that license received directly from the
state licensing authority indicating that the applicant’s license covers the
dates in which he or she is practicing in New Hampshire;
(10) The name and address of the New Hampshire
health care facility at which the applicant will be practicing;
(11) The dates during which the applicant will be
practicing and verification of those dates received directly from the New
Hampshire healthcare facility at which the applicant will be practicing;
(12) The signature of the applicant; and
(13) Original letters of reference, on letterhead
and addressed to the board, from:
a. The chief medical officer or president of the
medical staff in every hospital in which the applicant currently holds staff
privileges; or
b. Letters of reference from 2 practicing
physicians.
(d)
Applicants shall include the application fee required in Table 3.6.1 in Med
306.01.
Source. #4970, eff 11-8-90; amd
by #5838, eff 6-17-94; amd by #5908, eff 10-7-94; ss
by #6576, eff 9-15-97; amd by #6906, eff 12-4-98; amd by #8662, INTERIM, eff 6-16-06, EXPIRED: 12-13-06 (paragraphs (a), (c), and (d)); ss by #8945, eff
7-18-07; ss by #9900, eff 4-12-11
(see Revision Note at chapter heading for Med 300); ss by #12972, eff 1-10-20
Med 305.02
Special Camp and Visiting
Professor License.
(a)
Physicians wishing to practice medicine at a New Hampshire
licensed camp facility shall apply for a camp license by submitting an
“Application for a Special License/Camp,” revised 11/2019, which includes the
information contained in (e) below.
(b)
A holder of a camp license is limited to:
(1) Practice only at the specified
licensed camp facility;
(2) Practice only on specific
dates; and
(3) Practice which does not include holding
hospital privileges in New Hampshire.
(c) Physicians wishing to practice
medicine, perform surgery, or do other procedures for the education and
enlightenment of the medical community shall apply for a visiting professor
license by submitting an “Application for Special License/Visiting Professor,”
revised 11/2019, which includes the information contained in (e) below.
(d) A holder of a visiting
professor license is limited to:
(1) Practice only at a specified
licensed New Hampshire hospital in an educational capacity, whether or not
direct patient care is provided;
(2) Practice only on specific
dates; and
(3) Practice for which the patient
is not being charged, provided that:
a. The hospital or facility may charge the
patient for its services and for the services of other health professionals;
b. The hospital or facility shall
not charge the patient for the services rendered by the visiting professor; and
c. The physician abides by the
American Medical Association (AMA) Code of Ethics Rule 6.10 on billing with multiple
providers.
(e)
Applicants for either a camp or visiting professor license shall
provide, or cause to be provided, the following on or attached to the
applicable form above:
(1) The applicant's name and
residence address;
(2) The address(es) and telephone
number(s) of the applicant's practice locations for the previous 3 years;
(3) The applicant's date of birth,
place of birth, and social security number;
(4) The name of the institution where the
applicant graduated from medical school and the date of graduation;
(5) The name of the institutions where the
applicant completed his or her post graduate training and the dates of that training;
(6) Disclosure of whether the
applicant has ever previously applied for licensure in New Hampshire and if so,
the date of that application;
(7) Disclosure of whether the applicant has ever
been subject to disciplinary action by any licensing or certifying agency or by any
hospital or health care institution and if so, the dates and circumstances of
that action;
(8) Disclosure of whether the
applicant is board certified and if so, the specialty in which that
certification is held;
(9) The name of the New
Hampshire licensed facility at which the applicant will be practicing;
(10) The dates during which the applicant will
practice and verification of those dates received directly from the New Hampshire
licensed facility;
(11) The state in which the applicant currently
holds a license and clearance of that license received directly from the state
licensing authority indicating that the applicant’s license covers the dates in
which he or she is practicing in New Hampshire; and
(12) The signature of the applicant.
(f)
Applicants shall include the application fee for special license
required in Table 3.6.1. in Med 306.01.
Source. #4970, eff 11-8-90; ss by #5838, eff 6-17-94;
ss by #6576, eff 9-15-97, EXPIRED: 9-15-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision Note at chapter heading for
Med 300); ss by #12972, eff 1-10-20
Med 305.03 Administrative License.
(a)
An applicant for an administrative license shall complete the same
application and meet the same requirements as an applicant for unrestricted
permanent licensure. However, the
applicant for an administrative license shall not be required to show that the
applicant has been engaged in the practice of clinical medicine.
(b)
The holder of an administrative license shall not engage in clinical
medicine.
(c)
The holder of an administrative license shall pay the same fees and meet
all other requirements for issuance and renewal of that license as a licensee
with a unrestricted permanent license.
Source. #9900,
eff 4-12-11 (see Revision Note at chapter heading for Med 300); ss by #12972,
eff 1-10-20
Med
305.04 Resident Training License.
(a)
The board shall issue training licenses, pursuant to RSA 329:14, V, to
persons pursuing post graduate training in a health facility approved for this
purpose by the ACGME or the AOA.
(b)
Training licenses shall only be valid for the practice of medicine when
limited to:
(1) Practice under the auspices of the training
program and in healthcare facilities which are affiliated with that program;
(2) Practice under the direct supervision of a
medical officer of the training program who shall be a physician licensed in
New Hampshire; and
(3) Practice during the dates specified by the
training license, or until such time as the licensee separates from the
training program for any reason.
(c)
Applicants for resident training license shall provide, or cause to be
provided, the following on or attached to the “Application for Training License
Resident and Graduate Fellows,” revised 11/2019:
(1) Name and current residence address and
telephone number of the applicant;
(2) Date and place of birth;
(3) Name of the medical school attended, the
dates attended, and the year of graduation;
(4) Name of the hospital where the applicant will
be training;
(5) Name of the ACGME or AOA accredited training
program in which the applicant is enrolled and the signature of the director of
graduate medical education certifying that the applicant is currently enrolled
and that the information on the application matches that on file with the
training program;
(6) Beginning and ending dates of the training
program in which the applicant is enrolled and the signature of the program
director certifying that the applicant is approved for entry into that specific
program;
(7) Certified copy of the ECFMG certificate held
by the applicant if the applicant graduated from a medical school outside the United
States or Canada;
(8) Certification received directly from the NBME
that the applicant has taken and passed USMLE steps 1, step 2 (Clinical
Knowledge), and 2 (Clinical Skills);
(9) Disclosure of whether the applicant has ever
previously resigned from a graduate medical education program or been
reprimanded, sanctioned, restricted or disciplined in any way by such a
program;
(10) Disclosure of whether the applicant has ever
held a license in any state and if so, clearance of that license received
directly from the licensing authority;
(11) Disclosure of whether the applicant has ever
been convicted of a felony, and if so the circumstances involved;
(12) Disclosure of whether the applicant has ever
been dependent on alcohol or drugs and if so, a description of the treatment
program pursued; and
(13) The signature of the applicant.
(d)
Applicants shall include the resident training license fee required in
Table 3.6.1. in Med 306.01.
(e)
Resident training licenses shall expire 4 years from the date of
issuance.
(f)
Holders of training licenses shall notify the board immediately upon
separation from the residency program if training is discontinued prior to the
expected termination date specified in (c)(6) above.
Source. #4970, eff 11-8-90; amd
by #5223, eff 9-12-91; ss by #6576, eff 9-15-97; amd
by #7340, eff 8-3-00; amd by #8662, INTERIM, eff
6-16-06, EXPIRED: 12-13-06 (paragraphs
(a), (b), (c)(1)-(4), (c)(6)-(13)and (d)); ss by #8945, eff 7-18-07; ss and renumbered by #9900, eff
4-12-11 (from Med 305.03) (see Revision Note at chapter heading for Med 300); ss by #12972, eff 1-10-20
PART Med 306 FEES
Med
306.01 Fees. The fees required by the board under RSA 329
shall be as set forth in table 3.6.1 below:
Table 3.6.1 Fees
Type |
Fee |
Temporary
License |
$
50 |
Application
for Unrestricted Permanent Licensure |
$300 |
Renewal
Application for Unrestricted Permanent Licensure |
$350 |
Application
for Administrative Licensure |
$300 |
Renewal
Application for Administrative Licensure |
$350 |
Late
Renewal Application for Unrestricted Permanent Licensure or Administrative 000000000000Licensure
within 90 days of expiration date pursuant to RSA 329:16-e |
$700 |
Reinstatement
Application for Unrestricted Permanent or Administrative Licensure |
$350 |
Application
for Courtesy (Locum Tenens) License |
$150 |
Application for Special License |
$ 75 |
Application for Resident Training
License |
$ 50 |
Application for Physician Assistant
Licensure |
$115 |
Renewal Application for Physician
Assistant Licensure |
$ 65 |
Late Renewal Application for Physician
Assistant Licensure within 90 days of expiration date |
$130 |
Reinstatement Application for Physician
Assistant Licensure |
$115 |
|
|
Duplicate license pocketcard |
$ 10 |
Duplicate wall certificate |
$ 25 |
Verification of license |
$ 20 |
|
|
Lists of Licensees: |
|
All licensed physicians on paper or
labels |
$100 |
All licensed physicians on disk or by
e-mail |
$ 50 |
Licensed
physicians practicing in N.H. on paper or labels |
$
50 |
Licensed
physicians practicing in N.H. on disk or by e-mail |
$
25 |
Licensed
physicians in just one specialty, county, city or town on paper or labels |
$
20 |
Licensed
physicians in just one specialty, county, city or town on disk or by e-mail |
$
10 |
Source. #4970, eff 11-8-90; amd
by #5223, eff 9-12-91; ss by #5908, eff 10-7-94; ss by #6576, eff 9-15-97, amd by #7312, eff 6-24-00; ss by #7949, eff 9-6-03; ss by
#8037, eff 2-10-04; amd by #8068, eff 4-10-04; ss by
#8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision Note at chapter heading for
Med 300); ss by #12972, eff 1-10-20
CHAPTER
Med 400 RENEWAL, CONTINUING EDUCATION
AND ONGOING REQUIREMENTS
REVISION NOTE:
Document
#9900, effective 4-12-11, adopted, amended, readopted with amendments, or
repealed many rules in Chapters Med 100 through Med 600. In Chapter Med 400, Document #9900 readopted
with amendments selected rules in Parts Med 401, 403, and 412, and readopted
with amendments all the rules in Parts Med 402, 407, 408, 409, and 410. Document #9900 also adopted Med 403.03 on
notice of action, readopted and renumbered Med 403.03 on noncompliance as Med
403.04, and adopted Part Med 413 on settlement agreements and consent orders. The source note for Med 403.04 indicates the
former rule number Med 403.03, and the document numbers and effective dates
apply to the rule under the former number.
PART
Med 401 RENEWAL OF LICENSE
Med 401.01 Expiration of License. Each license shall automatically expire on
July 1 of the year in which the licensee's renewal is set to occur, unless the
licensee has applied to the board for renewal of license by June 30 of the year
in which the licensee’s renewal is set to occur.
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6517, eff 5-30-97; ss by #7949, eff 9-6-03;
ss by #8945, eff 7-18-07, EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11048, eff 3-2-16
Med 401.02 Renewal of License. Any licensee wishing to renew a license shall
submit:
(a)
The renewal application supplied by the
board on or before June 30 of the year in which the licensee's renewal is set
to occur;
(b)
The fee specified by Med 306.01; and
(c)
Proof of completion of the continuing
education requirements of Med 402.
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6517, eff 5-30-97; amd
by #7949, eff 9-6-03; amd by #8662, INTERIM, eff
6-16-06, EXPIRED: 12-13-06 (paragraph (c));
ss by #8945, eff 7-18-07, EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11048, eff 3-2-16
Med
401.03 Renewal Application.
(a)
The licensee shall complete and file a renewal application provided by
the board and tender the renewal fee specified by Med 306.01.
(b)
The applicant shall include on the renewal form:
(1) The name and business address and telephone
number, business e-mail address and business fax number of renewing licensee;
(2) The home address and telephone number of
renewing licensee;
(3) Whether the applicant is
currently in active practice;
(4) What specialty the
licensee practices and whether the applicant is board certified;
(5) A listing of other states in which the
licensee currently holds an active license;
(6) A listing of all hospitals in which the applicant
currently holds privileges;
(7) The applicant’s US Drug Enforcement Agency
(DEA) license number, the state of issuance and the expiration date;
(8) Whether the applicant has been the subject of
disciplinary action, or has been denied a license or surrendered a license in any state or jurisdiction during
the past 24 months;
(9) Whether the applicant is
currently or has in the past been monitored or treated by a private, state,
medical society, or hospital physician health program other than through the NH
board approved physician health program or has been restricted in any manner by
the US Drug Enforcement Agency (DEA);
(10) Whether the applicant is
currently suffering from any condition, mental or physical, that impairs the
applicant’s judgment or that would otherwise adversely affect his or her
ability to practice medicine in a competent,
ethical and professional manner;
(11) Whether the applicant has
been found guilty or pleaded no contest to any felony or misdemeanor charges
during the past 24 months;
(12) Whether the applicant has been found guilty
or pleaded no contest to any driving under the influence violations or has been subject to an administrative
finding for driving under the influence in the past 24 months;
(13) Whether the applicant has
been the subject of any investigation or disciplinary proceeding or been
reported to the National Practitioners Data Bank (NPDB) during the past 24
months;
(14) Whether the applicant has
lost or been denied any hospital privileges or had such privileges restricted
in any way during the past 24 months;
(15) Whether any malpractice claims have been made
against the applicant during the past 24 months;
(16) If the applicant has
answered in the affirmative to any inquiries under (7) - (14), a written
explanation of the circumstances which caused the applicant to respond in the
affirmative;
(17) Whether the applicant has an ownership
interest in an entity which provides diagnostic or therapeutic services.
Pursuant to RSA 125:25-c, the applicant shall list all diagnostic and
therapeutic services provided by any entity in which the applicant has an
ownership interest;
(18) The last 4
digits of the applicant’s social security number on the line provided below the
following preprinted statement:
"The board will deny licensure if you refuse to submit the last 4
digits of your social security number (SSN).
Your professional license will not display your SSN. Your SSN will not be made available to the
public. The board is required to obtain
your social security number for the purpose of child support enforcement and in
compliance with RSA 161-B:11. This
collection of your social security number is mandatory."; and
(19) The applicant's signature and the
date of the applicant's signature, certifying the accuracy of his or her
responses under the penalty for unsworn falsification pursuant to RSA 641:3.
(c)
An application for renewal which is not completed in its entirety or
which does not include payment of the renewal fee shall be returned
to the licensee unprocessed with a letter stating the reason(s) for the return.
(d) Pursuant to RSA 126-A:5, XVIII-a(a) and RSA
330-A:10-a, licensees shall complete, as part of their renewal application, the
New Hampshire division of public health service’s health professions survey
issued by the state office of rural health and primary care, department of
health and human services.
(e) The board shall provide licensees with the
opportunity to opt out of the survey.
Written notice of the opt-out opportunity shall be provided with the
renewal application. The opt out form shall be available on the NH state office
of rural health and primary care website and the board’s website.
(f) Licensees choosing to opt-out of the survey
shall submit a completed opt out form described in He-C 801.04, to the state
office of rural health and primary care, department of health and human
services, via one of the following:
(1) Mail;
(2) Email; or
(3) Fax.
(g) Information contained in the opt-out forms shall
be kept confidential in the same accord with the survey form results, pursuant
to RSA 126-A:5, XVIII-a(c).
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6517, eff 5-30-97; amd
by #7949, eff 9-6-03; amd by #8096, eff 6-5-04; amd by #8429, eff 9-13-05; amd by
#8662, INTERIM, eff 6-16-06, EXPIRED: 12-13-06 (paragraphs (a), (b)(2)-(6), (14) and (15), now (15) and (17), and (c));
ss by #8945, eff 7-18-07; ss by
#9900, eff 4-12-11 (see Revision Note at chapter heading for Med 400); amd by #10876, eff 7-8-15; amd by
#11048, eff 3-2-16; ss by #12972, eff 1-10-20
Med 401.04 Late Renewal and Reinstatement of License.
(a)
Any licensee who allows his or her license to lapse by reason of error,
omission, nonpayment of the biennial renewal fee, or failure to submit proof of
completion of continuing education may request late renewal within 90 days
following the expiration of the license by providing a written request for late
renewal which demonstrates:
(1) An inadvertent failure to
renew the license; and
(2) A statement that the
licensee has not continued to practice during the period of expiration.
(b)
If a license expires or lapses as a result of a licensee being ordered
to active duty with the armed services or the National Guard, the licensee shall have one year from the date of discharge or
release from the armed service to apply for renewal and all late fees shall be
waived.
(c)
Any licensee whose license has expired by reason of error, omission, or
neglect to pay the biennial renewal fee beyond 90 days
after expiration of the license, whose license has been included on the
inactive list pursuant to RSA 329:16-h, or whose license has been suspended or
revoked by the board shall be eligible to apply for reinstatement barring any order
or agreement to the contrary, at the time of their original disciplinary
action, by filing the application specified in (d) below.
(d)
Applicants for reinstatement shall provide, pursuant to (b) above, or
cause to be provided, on a “Physician Reinstatement Application,” revised
11/2019:
(1) The same information required
in Med 301.03 (a) (1-27) excluding Med 301.03 (a) (4-8) and Med 301.03 (a)
(24); and
(2) Proof of completion of
continuing education which meets the requirements of Med 402.01.
(e)
Applicants for reinstatement shall pay the reinstatement fee specified
in Med 306.01 Table 3.6.1.
(f)
Applicants for reinstatement of a suspended or revoked license shall
have the burden of persuading the board that the actions which were the basis
for the original disciplinary action have been satisfactorily remediated, that
no additional charges of misconduct are pending, and that the applicant meets
all the character and competency requirements of an applicant for initial licensure.
Source. #4970, eff 11-8-90; amd
by #5223, eff 9-12-91; ss by #6517, eff 5-30-97; ss by #7949, eff 9-6-03; ss by
#8945, eff 7-18-07, EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss and renumbered by #11048, eff 3-2-16 (formerly Med 401.03); ss by #12972,
eff 1-10-20
Med 401.05 Denial of Renewal.
(a)
Renewal of a license shall be denied if,
after notice and an opportunity for hearing, there is evidence to establish
that:
(1)
Continuing medical education has not been fulfilled pursuant to Med 402;
(2) The applicant has failed to
provide complete or accurate information on the renewal application;
(3) The applicant has committed any unethical act
for which discipline could be imposed under RSA 329:17, VI;
(4)
If the applicant has previously surrendered a license under Med
412.03(a) and has failed to comply with any necessary requirements of Med
412.02;
(5)
Reasons for which an initial application could be denied under RSA
329:14, II; or
(6)
The applicant failed to register for the Controlled Drug Prescription
Health and Safety Program pursuant to RSA 318-B:33, II and Ph 1503.01 (a).
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8945, eff 7-18-07; amd by #10876, eff 7-8-15;
paras. (a)(1)-(3) EXPIRED: 7-18-15; amd by #10925,
INTERIM, eff 9-4-15, EXPIRES: 3-2-16; amd by #11048,
eff 3-2-16
PART Med 402 CONTINUING MEDICAL
EDUCATION
Med 402.01 Continuing Medical Education.
(a)
All licensed physicians shall complete 100 hours of approved continuing
medical education (CME) requirements every 2 years, 40 hours
of which shall be in Category I, and no more than 60 credit hours of which
shall be in Category II.
(b)
Category I courses shall be those courses or activities which satisfy
the current requirements of the American Medical Association's Physician's
Recognition Award program (PRA), as set forth in the AMA's current PRA bulletin,
or which are fully equivalent to these requirements and satisfy the CME
requirements of the New Hampshire Osteopathic Association. Such courses shall be considered approved for
purposes of Med 402.
(c)
Licensees shall acquaint themselves with the requirements
of the PRA program or the New Hampshire Osteopathic Association, and may obtain
a copy of the AMA's PRA bulletin by contacting the:
American Medical
Association
AMA Plaza
330 N Wabash
Avenue, Suite 39300
Chicago, Illinois
60611-5885
Telephone Number
(312) 464-4677.
(d)
Licensees who were previously licensed in another state may continue to
take continuing medical education courses in accordance with a previously
established PRA renewal cycle.
(e) Each year of full-time
training in a residency accredited by the Accreditation Council for Graduate
Medical Education (ACGME) or the American Osteopathic Association (AOA), each
accredited fellowship taken in the United States shall be awarded 50 Category I CME credit hours.
(f)
Completion of a degree in a medically-related field
shall be awarded 25 Category I credit hours as stated on official documentation.
(g)
Passage of an American Specialty Board
examination, whether for initial eligibility or for recertification, shall be
accepted as the equivalent of 100 category I CME credit hours.
(h) Annual Certificates of
Competency/Recertification exams shall be awarded credits as stated on official
documentation from the relevant board certifying agency.
(i) Licensees who show proof of being up to date
on a program of maintenance of certification by the physician’s specialty
organization, deemed adequate by the board, shall be considered to have
completed their continuing medical education requirement for the preceding 2
years.
(j)
Category II credit hours shall be awarded on the
basis of actual time spent on the educational aspects of the course or activity.
(k)
Category II CME courses shall include the
following courses and activities:
(1) CME lectures and
seminars not designated as Category I;
(2) Time
spent teaching medical courses to practicing physicians, residents, physician
assistants, physician assistant students, preceptees, medical students, or
allied health professionals;
(3) Presentation or publication of
a scientific paper to a medical audience or in a medical journal;
(4) Unsupervised learning
activities of the type described in Med 402.01(l); and
(5) Meritorious learning
experiences which provide a unique educational benefit to a licensee and meet
the requirements of Med 402.01(m).
(l)
Allowable non-supervised Category II CME activities
shall include:
(1) Self-instruction,
including journal reading and the use of television and other audiovisual
materials;
(2) The education a physician received from a
consultant;
(3) Participation in programs
concerned with review and evaluation of patient care; and
(4) Time spent in a self-assessment
examination, not including examinations and quizzes published in journals.
(m)
Meritorious learning experiences for which Category
II CME credit hours shall be awarded shall be documented by a narrative report
demonstrating the presence of the following features:
(1) The educational need served by the activity;
(2) A description of the activity, including the
educational content and the manner in which the learning occurred;
(3) The time spent on the project, itemized to
show the total time spent and the time spent on the direct educational aspects
of the project for which CME credit is claimed; and
(4) The number of credit hours claimed, which
number shall not exceed the number of full hours actually spent on the
direct educational aspects of the project and shall exclude transportation to
and other preliminary time expended.
(n)
A licensee may claim 10 Category II CME credit hours for the
presentation or publication of a scientific paper as of the
date of the publication or presentation, and one CME credit hour for each full
hour of actual participation in courses or activities recognized in Med
402.01(k)(1), (2) or (4), upon successful completion of the course or activity.
(o)
Pursuant to RSA 318-B:40, all licensees required
to register with the controlled drug prescription health and safety program
shall complete 3 credit hours of approved online continuing education or pass
an online examination in the area of pain management or addiction disorders.
(p)
Licensees may satisfy the requirements in (o) above
by taking CMEs that:
(1) Are AMA PRA Category 1
credits or AACME accredited; and
(2) Reference opioid
prescribing for the management or treatment of pain or opioid use disorders in
the course abstract and learning objectives.
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8945, eff 7-18-07; ss by
#9900, eff 4-12-11 (see Revision Note at chapter heading for Med 400); ss by
#12972, eff 1-10-20
Med 402.02 Reporting Requirements.
(a) Licensees shall submit a biennial CME report
using a form which shall be provided to him or her prior to December 31st of
the final year of their cycle. This form
provided by the board, or an independent contractor designated by the board,
shall be completed and returned on or before February 28th of the
physician’s renewal year. Failure of any
licensees to receive this form shall not relieve them of the obligation to
comply with these rules. This form shall
be a necessary part of the licensee's biennial license renewal application.
(b)
The New Hampshire Medical Society (NHMS) shall audit and investigate the
annual continuing education reports of each licensed physician, and shall
prepare a written report which records the credits awarded to each licensee
during the 2 year period applicable to each licensee. NHMS shall report to the board the failure of
any licensee to fulfill the CME requirements.
Unless excused by the board for good cause shown, including accident,
illness, hardship, or other circumstances beyond the control of the licensee,
the board shall issue a late fee if CMEs are not completed by December 31 of
the final year of their cycle.
(c)
The licensee shall provide the following on or with
the form relative to continuing medical education:
(1) The applicant's name;
(2) The applicant's business address
and telephone number;
(3) Copies of documents which
establish that the requirements of Med 402.01 have been met;
(4) In the case of all Category I courses for
which CME credit is claimed, copies of documents which establish
that the course satisfies the requirements of Med 402.01(b) and include the
following information:
a. The name and headquarters address of the
sponsor and any co-sponsor;
b. The course title and the fields of medicine
involved;
c. A description of the type of course and the
learning activities involved;
d. The inclusive dates of attendance; and
e. The number of credit hours certified for the
activity;
(5) In the case of Category II CME activities,
copies of documents which establish the following information:
a. The full name of the organizational sponsor
or co-sponsor;
b. The sponsor or co-sponsor's headquarters
office address and telephone number;
c. The program title and a description of the
program's content; and
d. The inclusive dates of the licensee's
attendance.;
(6) In the case of claimed medical
teaching activities, copies of documents which establish the following
information:
a. The type of educational program which was
conducted and a description of the exact role the licensee played in that
program;
b. The name, business address, and telephone number
of the institution or organization sponsoring the education program;
c. The subject covered by the education program;
d. The type and educational level of students
attending the educational program; and
e. The inclusive dates of the licensee's participation
in the educational program;
(7) In the case of claimed publications or
presentations, copies of documents which establish the following
information:
a. The title of the paper or article presented or
published;
b. The name, sponsor, and location of the
conference or the name, business address, and telephone number of the medical
journal involved; and
c. The date of the presentation or publication;
and
(8) In the case of claimed non-supervised CME
activities, copies of documents which establish the following information:
a. The type of material or activity involved;
b. The title and a thorough description of the
type of activity involved;
c. The sponsor of the activity involved; and
d. The inclusive dates of the licensee's participation
in the activity involved.
Source. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8945, eff 7-18-07; ss by
#9900, eff 4-12-11 (see Revision Note at chapter heading for Med 400); ss by
#12972, eff 1-10-20
Med 402.03
Waiver of CME Deadlines.
(a)
The board shall consider petitions for waiver of CME deadlines which
meet the requirements of Med 212.01, if:
(1) Such petitions are filed before the
expiration of the 2 year CME period in question;
(2) Late filing is justified by a showing of good
cause and not merely neglect; and
(3) A specific
timetable is proposed for completing specific courses which will meet the petitioner's
CME's deficiency.
(b)
Good cause under (a)(2) above shall include, but not be limited to,
illness, death of a family member, or other reason beyond
the control of the petitioner.
(c)
If the petition for waiver of CME deadline is approved by
the board, the board shall allow up to a 6-month extension to complete the CME
requirements.
Source. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED: 12-13-06
New. #8945, eff 7-18-07; ss by
#9900, eff 4-12-11 (see Revision Note at chapter heading for Med 400); ); ss by
#12972, eff 1-10-20
PART
Med 403 ONGOING REQUIREMENTS
Med 403.01 Severance of Connection. All licensees shall notify the board in
writing within 30 days after they sever connection with any commitment to
practice medicine for any reason, either personal, professional, or
disciplinary.
Source. #4970, eff 11-8-90; amd
by #5223, eff 9-12-91; amd by #5402, eff 5-22-92; ss by
#6517, eff 5-30-97, EXPIRED:5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8945, eff 7-18-07; ss by #10331, eff 5-8-13;
ss by #13628, eff 7-2-23
Med 403.02 Change
of Address.
(a) All licensees and
applicants for licensure shall notify the board of any change in home or
business address, including any change in e-mail address, in writing within 30
days of such change.
(b) A licensee whose
mail is returned to the board by the post office due to a wrong address shall
be issued a letter of concern pursuant to RSA 329:17, VII-a.
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED: l
12-13-06
New. #8945, eff 7-18-07; ss by
#9900, eff 4-12-11 (see Revision Note at chapter heading for Med 400); ss by
#10125-B, eff 5-9-12, EXPIRED: 5-9-22
New. #13628, eff 7-2-23
Med 403.03 Notice of Action. All licensees and applicants for licensure
shall notify the board of any notice of complaint, legal action, or asserted
claim for medical injury, or disciplinary action received from this or any
other jurisdiction or from any health care facility licensed
by the State of New Hampshire within 30 days of receipt by the licensee. Licensees shall also notify the board of any
misdemeanor or felony criminal convictions within 30 days of the trial court disposition
of the case.
Source. #9900, eff 4-12-11 (see Revision Note at
chapter heading for Med 400); ss by #12972, eff 1-10-20
Med 403.04 Noncompliance. Failure to complete continuing medical
education requirements or to submit documentation of such completion in a
timely fashion, shall result in denial of license renewal.
Source. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8945, eff 7-18-07; ss and renumbered by
#9900, eff 4-12-11 (from Med 403.03) (see Revision Note at chapter heading for
Med 400); ss by #12972, eff 1-10-20
Med
403.05 Letters of Good Standing. Licensees who wish to request a license verification
or a letter of good standing from the board shall complete and submit
a “Letter of Good Standing Request Form”, revised 11/2019, to the board along
with the $20.00 fee.
Source. #12972, eff 1-10-20
PART
Med 404 DISCIPLINARY SANCTIONS - EXPIRED
REVISION
NOTE:
Although Document #6517, effective 5-30-97,
had included a repeal of Parts Med 404 through Med 406, these rules had already
expired on 11-8-96. Parts Med 404
through Med 406 had been last filed in Document #4970, effective 11-8-90, and
no repeal was necessary.
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96 (See
Revision Note at part heading for Med 404)
PART
Med 405 LICENSE SURRENDER WHEN
DISCIPLINARY ALLEGATIONS ARE PENDING - EXPIRED
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96 (See
Revision Note at part heading for Med 404)
PART
Med 406 UNETHICAL CONDUCT - EXPIRED
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96 (See
Revision Note at part heading for Med 404)
PART Med 407 PROFESSIONALS’ HEALTH PROGRAM
Med
407.01 Definitions.
(a)
"Contract" means a contract voluntarily
entered into between a licensee and a program that has been approved pursuant
to Med 407.02, which contains requirements designed to protect the public from
harm.
(b)
“Director” means a person designated by a program
to oversee the program of a licensee under the terms of the contract or to provide
physical or mental care to said licensee.
(c)
“Monitor” means the individual or individuals who
are charged with overseeing the programs’ recommendations.
(d) "Program" means an
organization approved by the board to design and provide dependable oversight
programs for licensees impaired or potentially impaired by physical or mental
illness including addiction to alcohol and other drugs.
(e)
"Therapy" means a patient-therapist
relationship prescribed by the contract for the purpose of treatment.
(f)
"Treatment standards" means the current
standards of practice established by medical specialties recognized by the
American Board of Medical Specialties.
Source. #5402, eff 5-22-92; ss by #5690, eff 8-26-93; rpld by #6517, eff 5-30-97; ss by #7150, eff 12-7-99; ss by
#8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision Note at chapter heading for
Med 400); ss by #12972, eff 1-10-20
Med 407.02 Approved Professionals’ Health Program.
(a)
Only programs which have been approved by the board shall be recognized
as an acceptable vehicle for monitoring the treatment, rehabilitation, or
improvement of a licensee, or for the protection of the public.
(b)
Only programs which meet the minimum standards of Med 407.03 shall be
approved by the board, which shall maintain a listing of
approved programs.
(c)
A program may obtain general approval from the board by filing a petition
with the board requesting approval and demonstrating
that the program complies with the standards of Med 407.03.
(d)
General approval of a program shall not
constitute approval of the appropriateness of the program in the case of any
given licensee.
(e)
A licensee's participation in a program shall not be disclosed to the
board unless the licensee violates the terms of his or her contract or requests
such consideration by motion or signed authorization.
(f)
Individual programs, and motions requesting approval of such programs,
shall be kept confidential except to the extent they are incorporated into
public settlement agreements or disciplinary actions, or become evidence in
disciplinary hearings in situations where a violation of the terms of the
contract is relevant to the misconduct or disciplinary action at issue.
(g)
Individual licensees who have been accepted into an
approved program shall not be relieved of their obligation to provide relevant
information regarding their treatment for physical or mental disability,
disease, disorder, or condition or substance abuse on their annual license renewal
applications.
Source. #5402, eff 5-22-92; ss by #5690, eff 8-26-93;
rpld by #6517, eff 5-30-97; ss by #7150, eff 12-7-99;
ss by #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision
Note at chapter heading for Med 400); ss by #12972, eff 1-10-20
Med 407.03 Standards for Approved Programs.
(a)
Monitors, directors, and therapists involved in an
approved program shall:
(1) Be licensed or certified health care practitioners;
(2) Fully disclose in writing any disciplinary action,
including reprimand or restriction, taken against them by any licensing,
certifying, or credentialing agency or professional society; and
(3) Be readily accessible to the licensee.
(b)
An approved program shall not assign a monitor, director, or therapist
to a licensee's case if there is any question of that person's
objectivity, dependability, or commitment.
(c)
Disciplinary action shall disqualify a person
from serving as a monitor, director, or therapist if the discipline involved
conduct similar in nature to the issues being monitored and the discipline
occurred within 5 years of the date he or she would provide services to the
licensee under the auspices of the program.
(d)
An approved program shall require, to the maximum
extent possible, that participating licensees make full disclosure of all
relevant facts to the monitor, and provide the monitor with continuing,
unrestricted access to the licensee's medical records and any other records of
the licensee, except for patient records, relevant to the condition or conduct
being addressed by the program.
(e)
An approved program shall employ written contracts which contain
specific and objectively determinable requirements to be met by the
participating licensees. The contract
and any amendments or modifications thereto shall be signed
by the licensee and the director.
(f)
An approved program which addresses a treatable or modifiable condition
of a participating licensee shall employ a written
contract which includes a detailed treatment or corrective action plan which:
(1) Identifies the licensing requirements of
treatment providers;
(2) Specifies the frequency of treatment;
(3) Requires reports to the board administrator
from director(s) regarding relapse or other contract violations; and
(4) Describes in detail if required urine
screening or other physical monitoring is included in the plan, such monitoring
provisions and the licensee's obligations thereunder.
(g)
An approved program shall employ written contract
with participating licensees which requires the program to keep detailed
records of the licensee's participation in all aspects of the program.
(h)
An approved program shall employ a written contract with participating
licensees which require the program to inform the board
immediately when he or she verifies that the licensee has not met any of the
program requirements contained in his or her contract.
(i) An approved program shall employ a written contract
with participating licensees which authorizes the monitor to keep records
concerning the licensee's participation in the program confidential unless they
are released by the licensee, except in cases where
the licensee has been reported to the board pursuant Med 407.03(h) for
violating a requirement of the contract. In such cases, the monitor's records
shall be made available to the board upon request and the monitor shall cooperate
with the board in any disciplinary action undertaken by the board which relates
to the condition or conduct addressed by the licensee's contract.
(j)
An approved program shall include no language in any contract with a
licensee or make representations to any person which indicates:
(1) The monitor is an agent of the board or is
performing functions of the board;
(2) Participation in the approved program will
determine whether disciplinary action is taken by the board or the severity of
such discipline; or
(3) The board is financially or otherwise
responsible for any aspect of the licensee's participation in the program.
(k)
An approved program may advertise its approved status and the fact that
it is an appropriate vehicle for licensees who:
(1) Have been directed to participate in such a
program by a board disciplinary order or agreement; or
(2) Wish to propose to the board that their
participation in a monitoring program be considered by the board in disposing
of pending or potential disciplinary allegations.
Source. #5402, eff 5-22-92; ss by #5690, eff 8-26-93;
amd by #5838, eff 6-17-94; rpld
by #6517, eff 5-30-97; ss by #7150, eff 12-7-99; ss by #8945, eff 7-18-07; ss by
#9900, eff 4-12-11 (see Revision Note at chapter heading for Med 400); ss by #12972,
eff 1-10-20
PART
Med 408 DISCIPLINARY MATTERS
Med 408.01 Initiation of Action.
(a)
The board shall instruct the MRSC to investigate possible misconduct in
accordance with RSA 329:17, II, III, III-a, III-b(a), IV, and V, RSA 151:6-b,
and in response to written complaints.
(b)
Except as required by Med 408.01(a), the MRSC shall undertake misconduct
investigations, and recommend the settlement of misconduct investigations and
the assessment of administrative fines as a matter of prosecutorial discretion,
based upon its assessment of the allegations and the nature of the
evidence. The board shall review any and
all recommendations made by the MRSC and commence disciplinary actions on its
own motion.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision
Note at chapter heading for Med 400); ss by #12972, eff 1-10-20
Med 408.02 Action on Complaints.
(a)
Upon receipt of a written complaint, the MRSC shall investigate the
allegations contained therein pursuant to the procedures outlined in Med 205.02
and Med 205.03.
(b)
The board shall take final action on complaints in the manner provided
by Med 205.02 and Med 205.03.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision
Note at chapter heading for Med 400); ss by #12972, eff 1-10-20
Med 408.03 Disciplinary Sanctions.
(a)
Other than immediate license suspensions authorized by RSA 329:18-b, the
board shall impose disciplinary sanctions only:
(1) After prior notice and an opportunity to be
heard; or
(2) Pursuant to a mutually agreed upon settlement
or consent decree.
(b)
After finding that misconduct has occurred, the board shall impose any
disciplinary sanction authorized by RSA 329:17, VI, if, after considering the
factors in (c) below, the board determines that disciplinary sanctions are
warranted.
(c) Before imposing disciplinary sanctions, the
board shall consider the following factors:
(1) The seriousness of the offense;
(2) The licensee's prior disciplinary record;
(3) The licensee's state of mind at the time of
the offense;
(4) The licensee's acknowledgment of his or her
wrongdoing;
(5) The licensee's willingness to cooperate with
the board's investigation;
(6) The purpose of the rule or statute violated;
(7) The potential harm to public health and
safety;
(8) The deterrent effect upon other
practitioners; and
(9) The nature and extent of the enforcement
activities required of the board as a result of the offense.
(d)
Copies of board orders imposing disciplinary sanctions, including all
settlement agreements or consent decrees, shall be sent to the licensing body
of each state in which the licensee is licensed and to such other entities,
organizations, associations, or boards as are required to be notified under
applicable state or federal law. The
board administrator shall also issue a press release to news organizations
providing a summary of any and all disciplinary actions taken.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision
Note at chapter heading for Med 400); ss by #12972, eff 1-10-20
PART
Med 409 IMMEDIATE LICENSE SUSPENSION IN
SPECIAL CIRCUMSTANCES
Med 409.01 Suspension Pending Completion of
Disciplinary Proceedings.
(a)
When the board receives information indicating that a licensee has engaged
in or is likely to engage in professional conduct which poses an immediate
danger to life or health, the board shall issue an order pursuant to RSA
329:18-b which sets forth the alleged misconduct and immediately suspends the
license for up to 120 days pending completion of an adjudicatory proceeding on
the specified issues, which hearing shall be commenced within 10 days.
(b)
No hearing date established in a disciplinary proceeding commenced under
Med 409.01(a) shall be postponed at the request of the licensee unless the
licensee also agrees to continue the suspension period pending issuance of the
board's final decision.
(c)
To effectuate (b) above, the licensee may sign a preliminary agreement not
to practice as proposed by hearing counsel which shall include the following
stipulations:
(1) The licensee recognizes that professional
misconduct allegations are now pending against the licensee before the board;
and
(2) The licensee agrees that during the pendency
of the investigation and until the board issues a further order, the licensee
will not:
a. practice medicine;
b. treat or see patients; or
c. write prescriptions.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision
Note at chapter heading for Med 400); ss by #12972, eff
1-10-20
PART
Med 410 DISCIPLINARY ACTION TAKEN IN
OTHER JURISDICTIONS
Med 410.01 Reciprocal Discipline.
(a)
When the board receives notice that a licensee has been subjected to
disciplinary action related to professional conduct by the licensing authority
of another jurisdiction, the board shall issue an order directing the licensee
to demonstrate why reciprocal discipline should not be imposed in New
Hampshire.
(b)
The board shall impose any disciplinary sanction authorized by RSA
329:17, VI or RSA 329:17-c in a disciplinary proceeding brought under this
rule, but shall provide notice to the licensee if, in considering the factors
on Med 408.03, it intends to consider
sanctions which exceed those imposed by other jurisdictions.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision Note at
chapter heading for Med 400); ss by
#12972, eff 1-10-20
PART
Med 411 ADMINISTRATIVE FINES
Med
411.01 Liability For Fines.
(a) Adjudicative procedures seeking the assessment
of an administrative fine shall be commenced against any person subject to such
fines or penalties under any provision of RSA 329:9, XV, when the board possesses
evidence indicating that a violation has occurred.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07, EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11048, eff 3-2-16
Med 411.02 Criteria For Setting Fines.
(a)
Administrative fines shall be assessed
and compromised in accordance with the factors stated in Med 408.03(c) and the
following additional considerations:
(1) The cost of any investigation or hearing
conducted by the board; and
(2) The licensee's ability to pay a fine assessed
by the board.
(b)
Administrative fines imposed by the board
shall not exceed $3,000 per offense or, in the case of continuing violations,
$300 for each day that the violation continues to a maximum fine of $100,000,
whichever is greater.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07, EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11048, eff 3-2-16; ss by #13083, eff 8-7-20
Med 411.03 Procedures for Assessing and Collecting
Fines.
(a)
Payment of a fine shall be included among the options available for
settling disciplinary allegations,
and shall be
included among the types of disciplinary sanctions imposed after notice and
hearing.
(b)
In cases where the board initially intends to limit disciplinary
sanctions against a licensee to an administrative fine, or in cases involving nonlicensees, the board shall issue a "notice of
apparent liability" describing the alleged offense, stating the amount of
the assessed fine, and notifying the alleged offender that her or she must pay
or compromise the fine by a date certain or request that an administrative
hearing be held. If a hearing is requested, the notice of apparent liability
shall be withdrawn and a notice of hearing shall be issued. In such hearings,
the board's disciplinary options shall not be limited to the assessment of an
administrative fine.
(c)
Nonpayment of a fine by a licensee in contravention of an order,
agreement or promise to pay, shall be a separate ground for discipline by the
board or a basis for denying a subsequent license application.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07, EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11048, eff 3-2-16
PART
Med 412 VOLUNTARY SURRENDER OF A LICENSE
Med 412.01 Procedure for Surrendering A License. License surrender may be requested by a
licensee at any time by filing a petition or motion with the board.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07, EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11048, eff 3-2-16
Med 412.02 Effect of Voluntary License Surrender.
(a) A licensee who voluntarily
surrenders a license shall retain no right or privilege in a
(b)
A licensee who reapplies for licensure in
(c)
Surrender or non-renewal of a license shall not preclude the board from
investigating or completing a disciplinary proceeding based upon the licensee's
professional conduct while the license was still in effect. Such investigations
and proceedings shall be handled in the same manner as other disciplinary
investigations and proceedings.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07, EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11048, eff 3-2-16
Med 412.03 Terms of Voluntary Surrender.
(a)
A licensee who wishes to surrender his or her license as part of a
settlement of a misconduct allegation, or allegations, shall reach a written
settlement agreement with hearing counsel, who, in turn, shall offer it to the
board.
(b)
Any license surrender offered to the board under (a), above, that occurs
after information is provided to the board under RSA 329:17, I, II, III, IV, or
V, shall include the following information:
(1) That the board has commenced an investigation
against the licensee pursuant to RSA 329:18;
(2) That the license surrender has occurred in
settlement of pending allegations;
(3) Whether the board has issued a notice of hearing;
(4) That the license surrender shall be reported
as discipline;
(5) A general statement of the allegations by
hearing counsel;
(6) A statement that the disposition of the
disciplinary allegations shall be resolved before any future application is
submitted by the licensee in New Hampshire; and
(7) A waiver by
the licensee that any issues of speedy hearing or spoliation of the evidence shall
be waived should the licensee later apply for a license from the board.
(c)
The board shall decline to accept a license surrender under (a), above,
if the board determines the licensee has declined to disclose material
information concerning the alleged misconduct.
(d) The statement of allegations by hearing
counsel concerning the alleged misconduct under Med 412.03(b)(5) shall be exempt from public
disclosure provisions of RSA 91-A if provided on a separate document and if
subject to a recognized exception of RSA 91-A.
(e)
The board shall not disclose information acquired in an investigation
except:
(1) With the permission of the licensee and if
such disclosure would include patient information, with the permission of such patients;
(2) To law enforcement:
a. When specifically required by statute;
b. If the information relates to a potential
violation of a criminal law; or
c. In response to a subpoena or other court
order; or
(3) To health licensing agencies in this state or
any other jurisdiction when the licensee holds, has held, or has applied for a
license with that agency.
(f)
When considering whether to accept a license surrender under (a), above,
the board shall consider a written representation by the licensee that he or
she will not again seek licensure in New Hampshire.
(g)
License surrender under (a), above, shall constitute disciplinary
action. The fact of license surrender
and the terms of any settlement agreement pertaining thereto shall be
distributed to all relevant licensing authorities and professional societies in
the same manner as a final decision containing a specific finding of
professional misconduct.
(h)
License surrender under (a), above, shall not apply to non-disciplinary
remedial proceedings or allegations against any person licensed by the board
alleging only an affliction of a physical or mental disability, disease, disorder,
or condition deemed dangerous to the public health.
Source. (See Revision Note #1 at chapter heading for
Med 500) #8945, eff 7-18-07; ss by #9900, eff 4-12-11 (see Revision Note at
chapter heading for Med 400); ss by #10097, eff 3-9-12; ss by #13482, eff 11-19-22
PART
Med 413 Settlement Agreements and Consent Orders
Med 413.01 Negotiating a Settlement Agreement. A licensee may engage in settlement
negotiations with hearing counsel at any time until the board issues a final
order in accordance with Med 208.01(a).
Source. #9900, eff 4-12-11 (see Revision Note at
chapter heading for Med 400); ss by #12972, eff 1-10-20
Med 413.02 Reviewing a Settlement Agreement.
(a)
Hearing counsel may present a proposed settlement agreement to the board
by petition, as outlined in Med 205.03(l), at any time until the board issues a
final order in accordance with Med 208.01(a).
(b)
Upon receipt of a signed, negotiated proposed settlement agreement, the
board shall place the matter on its agenda for its next regularly scheduled
board meeting.
(c)
Board members shall review the proposed settlement agreement in
conjunction with completed ROIs on the matter.
(d)
After deliberation, the board shall:
(1) Accept the proposed settlement agreement;
(2) Reject the proposed settlement agreement as
too lenient;
(3) Reject the proposed settlement agreement as
too stringent; or
(4) Reject the
proposed settlement agreement and provide hearing counsel with general
provisions of guidance. However, the
board shall not engage in settlement negotiations with the parties.
(e)
The board shall consider the factors listed in Med 408.03(c) when making
a determination under (d) above.
(f)
The board shall decline to accept a settlement agreement under (d)
above, if the board determines the licensee has declined to disclose material
information concerning the alleged misconduct.
(g) The statement of allegations by hearing
counsel concerning the alleged misconduct under Med 412.03(b)(5) shall be exempt from public
disclosure provisions of RSA 91-A if provided on a separate document and if
subject to a recognized exception of the right to know law.
(h)
The board shall not disclose information acquired in an investigation
except:
(1) With the permission of the licensee and if
such disclosure would include patient information, with the permission of such
patients;
(2) To law enforcement:
a. When specifically required by statute;
b. If the information relates to a potential
violation of a criminal law; or
c. In response to a subpoena or other court
order; or
(3) To health licensing agencies in this state or
any other jurisdiction when the licensee holds, has held, or has applied for a
license with that agency.
(i) Accepted settlement agreements shall
constitute disciplinary action. Distribution shall be in accordance with Med
408.03(d).
Source. #9900, eff 4-12-11 (see Revision Note at chapter
heading for Med 400); ss by #10097, eff 3-9-12; ss by #13482, eff 11-19-22
CHAPTER
Med 500 ETHICAL STANDARDS
REVISION NOTE #1:
Document
#8945, effective 7-18-07, readopted with amendments and renumbered the former
Parts Med 502 through Med 506 as Med 408 through Med 412, as follows:
Med
502 Disciplinary
Matters,
renumbered as Med 408.
Med 503 Immediate License Suspension
in Certain Circumstances, renumbered as
Med 409.
Med 504 DISCIPLINARY ACTION TAKEN IN OTHER JURISDICTIONS, renumbered as Med
410.
Med 505 ADMINISTRATIVE FINES, renumbered as Med 411.
Med
506 VOLUNTARY SURRENDER OF A LICENSE,
renumbered as Med 412.
Document
#8945 superseded all prior filings for the former Med 502 through Med 506. See Med 408 through Med 412 for subsequent
filings in these areas. The filings
affecting the former Med 502 through Med 506 include the following documents:
For
Med 502:
#1136,
eff 3-27-78
#2199, eff 12-2-82
#2910,
eff 11-21-84
#4970,
eff 11-8-90
#5223,
eff 9-12-91
#5782,
eff 2-3-94
#5838,
eff 6-17-94
#5908,
eff 10-7-94
#6517,
eff 5-30-97, EXPIRED 5-30-05
#8662,
INTERIM, eff 6-16-06, EXPIRED 12-13-06
For
Med 503 through Med 506:
#6517,
eff 5-30-97, EXPIRED 5-30-05
#8662,
INTERIM, eff 6-16-06, EXPIRED 12-13-06
REVISION NOTE #2:
Document
#9900, effective 4-12-11, adopted, amended, readopted with amendments, or
repealed many rules in Chapters Med 100 through Med 600. In Chapter Med 500, Document #9900 readopted
with amendments Med 501.02.
PART
Med 501 ETHICAL STANDARDS
Med
501.01 Obligation to Obey.
(a) The ethical standards set forth in this part
shall bind all licensees, and violation of any such standard shall constitute
unprofessional conduct within the meaning of RSA 329:17, VI(d).
(b) Conduct proscribed by these ethical
standards, when performed by an unlicensed person or during a prior period of
licensure, shall also be a basis for denying an application for licensure or
issuing a restricted license.
Source. #1136, eff 3-27-78; as amd
by #1203, eff 7-16-78; ss by #2199, eff 12-2-82; ss by #2910, eff 11-21-84; ss
by #4970, eff 11-8-90; ss by #5782, eff 2-3-94; ss by #6517, eff 5-30-97; amd by #7150, eff 12-7-99; amd by
#8068, eff 4-10-04; amd by #8662, INTERIM, eff
6-16-06, EXPIRED: 12-13-06 (para (b)); ss
by #8945, eff 7-18-07 (see Revision Note #1 at chapter heading for Med 500);
EXPIRED: 7-18-15
New. #10925, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11048, eff 3-2-16
Med 501.02 Standards of Conduct.
(a)
A licensee shall inform the board of a principal address to which all
official board communications shall be directed, and also of all addresses
where he or she is practicing. The
establishment of a business address or the change or abandonment of a business
address shall be reported to the board within 30 days.
(b)
A licensee shall submit only complete, truthful, and correct information
in any application or other document filed with or statement made to the board.
(c)
A licensee shall cooperate with investigations and requests for
information from the board and from other licensing or credentialing organizations.
(d)
A licensee shall maintain a complete and accurate medical record of all
patient encounters.
(e)
Records shall be entirely legible and include but not be limited to:
(1) A history, an exam, a diagnosis, and a plan
appropriate for the licensee’s specialty; and
(2) Documentation of all drug prescriptions
including name and dose.
(f)
The responsible party shall promptly honor all requests made by a
patient or an authorized agent of a patient, for complete copies of the patient’s
medical record in accordance with the following standards:
(1) The patient shall have the right to have his
or her request for medical records by either themselves or an authorized agent
of the patient promptly honored. The responsible party or entity that controls
the medical records shall have the ultimate responsibility to comply with the
request. In the case of a practice owned and controlled by a licensee, the
responsible party shall be the licensee and the licensee shall be ultimately
responsible for transferring copies of medical records regardless of whether
the licensee had delegated this task to another person or organization. In the
case of an employed licensee, the responsible party shall be the employer or
organization and the ultimate responsibility for transferring copies of the
medical records shall fall upon the employer or organization, pursuant to these
rules and RSA 151:21, X;
(2) Upon the patient’s request, the responsible
party shall provide copies of the medical records, either a specified portion
or the entire contents depending on the patient’s request, regardless of whether
the licensee created the records or the records were provided to the licensee
by another health care provider;
(3) The responsible party may charge the actual
cost of duplication for x-rays or other color photographs;
(4) Upon receipt of a written release, the requested
transfer of medical records shall:
a. Not be delayed, including for non-payment of
services or non-payment of copying costs and of costs for transmitting of
medical records; and
b. Be accomplished in any case within 30 days
from receipt of the signed release, unless the nature of the medical treatment
requires an immediate response from the licensee;
(5) In the case of patients who are minors or are
legally incapacitated, the responsible party shall release medical records to a
third party who is legally responsible for authorizing medical treatment for
the patient;
(6) Medical records shall be released to that
third party on the same basis that they would
otherwise be for
the patient if the licensee possesses written documentation establishing the
legal guardianship in question;
(7) The responsible party may require written
authorization for release of medical records, but, in no instance, shall the
responsible party require the personal appearance of the patient prior to accepting
a release;
(8) The licensee shall retain a complete copy of
all patient medical records for at least 7 years from the date of the patient’s
last contact with the licensee, unless,
before that date, the patient has requested that the file be transferred to
another health provider;
(9) If a licensee retires, moves from the area or
decides to stop treating a patient or group of patients, the licensee shall:
a. Provide notice to those active patients which
explains that the licensee is no longer
available to them;
b. Ensure that their records can be transferred
to another health care provider as requested by the patient; and
c. Whenever possible, notice shall be provided
at least 30 days prior to cessation of treatment; and
(10) After transfer of the licensee’s medical
records which meets the requirements of (9) above, the licensee shall be
relieved of further responsibility for complying with requests for copies of
records.
(g)
A licensee shall know and have available in his or her office information
regarding where patients may go to file complaints regarding their treatment or
billing. Such information shall be
furnished immediately upon request of the patient.
(h)
A licensee shall adhere to the Code of Medical Ethics: Current Opinions
With Annotations (June 2016 Edition) as adopted by the American Medical
Association, as cited in Appendix II. In
the Code of Medical Ethics – Current Opinions With Annotations Opinion 8.19,
“immediate family member” shall include cohabiting significant others or other
cohabiting individuals. A licensee shall
adhere to the ethical rules incorporated by reference at the time of the
conduct at issue.
(i) Deviation from these treatment standards shall
constitute unprofessional conduct within the meaning of RSA 329:17, VI,(c) and
a violation of Med 501.01(a).
(j)
Licensees shall register for the Controlled Drug Prescription Health and
Safety Program pursuant to the requirements of RSA 318-B:33, II and Ph
1503.01(a). Failure to register shall
constitute unprofessional conduct within the meaning of RSA 329:17, VI (d)
pursuant to RSA 318-B:36, IV and Ph 1503.01 (a) and (g).
(k)
Applicants shall have 90 days from the date of issuance of a license to
register with the Controlled Drug Prescription Health and Safety Program. Failure to register within 90 days shall
constitute unprofessional conduct within the meaning of RSA 329:17, VI (d)
pursuant to Ph 1503.01 (a).
(l)
The knowing disclosure of Controlled Drug Prescription Health and Safety
Program information shall constitute unprofessional conduct within the meaning
of RSA 329:17, VI (d) pursuant to RSA 318-B:36, IV.
(m)
The unauthorized use of the Controlled Drug Prescription Health and Safety
Program information shall constitute unprofessional conduct within the meaning
of RSA 329:17, VI (d) and shall be grounds disciplinary action pursuant to RSA
318-B:36, V.
(n)
A licensee shall not engage in the prescribing or dispensing of
controlled substances in schedules II-IV without having registered with the
Controlled Drug Prescription Health and Safety Program pursuant to RSA
318-B:36, III. The prescribing or
dispensing of a controlled substance in schedules II-IV by a licensee who has
not registered shall constitute unprofessional conduct within the meaning of
RSA 329:17, VI (d) pursuant to RSA 318-B:36, III.
Source. #1203, eff 7-l6-78; ss by
#2199, eff 12-2-82; ss by #2910, eff 11-21-84; ss by #4970, eff 11-8-90; amd by #5223, eff 9-12-91; ss by #5782, eff 2-3-94; ss by
#6517, eff 5-30-97; ss by #7150, eff 12-7-99; amd by
#7868, eff 4-4-03; amd by #8429, eff 9-13-05; ss by
#8945, eff 7-18-07 (see Revision Note #1 at chapter heading for Med 500); ss by
#9900, eff 4-12-11 (see Revision Note #2 at chapter heading for Med 500); ss by
#10331, eff 5-8-13; amd by #10876, eff 7-8-15;
amd in (i) by #10969,
EMERGENCY RULE, eff 11-6-15, EXPIRES: 5-4-16; amd in
(i) by #11089, REPEAL OF EMERGENCY RULE, eff 5-3-16;
ss by #12972, eff 1-10-20
PART Med 502 OPIOID PRESCRIBING
Med 502.01 Applicability. This part shall apply to the prescribing of
opioids for the management or treatment of non-cancer and non-terminal pain,
and shall not apply to the supervised administration of opioids in a health
care setting.
Source. #11090, eff 5-3-16; ss by #12038, eff 1-1-17
Med 502.02 Noncompliance with Standards as
Unprofessional Conduct. Noncompliance with the standards set forth in
this part may constitute unprofessional conduct as used in NH RSA 329:17,
VI(d).
Source. #11090, eff 5-3-16; ss by #12038, eff 1-1-17
Med
502.03 Definitions.
Except where the context makes another meaning manifest, the following words
have the meanings indicated when used in this chapter:
(a) “Acute pain” means the normal, predicted
physiological response to a noxious chemical, thermal, or mechanical stimulus
and typically is associated with invasive procedures, trauma, and disease. It
can be time-limited, often less than 3 months in duration;
(b) “Administer” means an act whereby a single
dose of a drug is instilled into the body of, applied to the body of, or
otherwise given to a person for immediate consumption or use;
(c) “Addiction” means a primary, chronic, neurobiologic disease with genetic, psychosocial, and
environmental factors influencing its development and manifestations. It is
characterized by behaviors that include impaired control over drug use,
craving, compulsive use, or continued use despite harm. The term does not
include physical dependence and tolerance, which are normal physiological
consequences of extended opioid therapy for pain;
(d) “Chronic pain” means a state in which pain
persists beyond the usual course of an acute disease or healing of an injury, or
that might or might not be associated with an acute or chronic pathologic
process that causes continuous or intermittent pain over months or years. It
also includes intermittent episodic pain that might require periodic
treatment. For the purposes of these
rules, chronic pain does not include pain from cancer or pain
from terminal disease. “Chronic pain” includes but is not limited to
pain commonly referred to as "chronic," "intractable,"
"high impact," "chronic episodic," and "chronic
relapsing."
(e) “Clinical coverage” means specified and
prearranged coverage that is available 24 hours a day, 7 days a week, to assist
in the management of patients with chronic pain;
(f) “Dose unit” means one pill, one capsule, one
patch, or one liquid dose;
(g) “Medication-assisted treatment” means any
treatment of opioid addiction that includes a medication, such as methadone,
buprenorphine, or naltrexone, that is approved by the FDA for opioid
detoxification or maintenance treatment;
(h) “Morphine milligram equivalent (MEE)” means a
conversion of various opioids to a morphine equivalent dose by the use of board-approved
conversion tables;
(i) “Prescription” means a verbal, or written, or
facsimile, or electronically transmitted order for medications, for
self-administration by an individual patient.
(j) “Risk assessment” means a process for predicting
a patient’s likelihood of misusing or abusing opioids in order to develop and
document a level of monitoring for that patient;
(k) “Treatment agreement” means a written
agreement that outlines the joint responsibilities of licensee and patient; and
(l) “Treatment plan” means a written plan that
reflects the particular benefits and risks of opioid use for each individual
patient and establishes goals, expectations, methods, and time course for
treatment.
Source. #11090, eff 5-3-16; ss by #12038, eff 1-1-17
(from Med 502.02); ss by #13248, eff 8-6-21
Med
502.04 Acute Pain. If opioids are indicated and clinically appropriate
for prescription for acute pain, prescribing licensees shall:
(a) Conduct and document a physical examination
and history;
(b) Consider the patient’s risk for opioid
misuse, abuse, or diversion and prescribe for the lowest effective dose for a
limited duration;
(c) Document the prescription and rationale for
all opioids according to Med 501.02(d) and (e);
(d) Ensure that the patient has been provided
information that contains the following:
(1) Risk of side effects,
including addiction and overdose resulting in death;
(2) Risks of keeping unused medication;
(3) Options for safely securing
and disposing of unused medication; and
(4) Danger in operating motor
vehicle or heavy machinery;
(e) Comply with all federal and state controlled
substances laws, rules, and regulations;
(f) Complete a board-approved risk assessment
tool, such as the evidence-based screening tool Screener and Opioid Assessment
for Patients with Pain (SOAPP);
(g) Document an appropriate pain treatment plan
and consideration of non-pharmacological modalities and non-opioid therapy;
(h) Utilize a written informed consent that
explains the following risks associated with opioids:
(1) Addiction;
(2) Overdose and death;
(3) Physical dependence;
(4) Physical side effects;
(5) Hyperalgesia;
(6) Tolerance; and
(7) Crime victimization;
(i) In an emergency department, urgent care
setting, or walk-in clinic:
(1) Not prescribe more than the
minimum amount of opioids medically necessary to treat the patient’s medical
condition. In most cases, an opioid prescription of 3 or fewer days is
sufficient, but a licensee shall not prescribe for more than 7 days; and
(2) If prescribing an opioid
for acute pain that exceeds a board-approved limit, document the medical condition
and appropriate clinical rationale in the patient’s medical record.
(j) Prescribers shall not be obligated to
prescribe opioids for more than 30 days, but if opioids are indicated and appropriate
for persistent, unresolved acute pain that extends beyond a period of 30 days,
the licensee shall conduct an in-office follow-up with the patient prior to
issuing a new opioid prescription.
Source. #11090, eff 5-3-16; ss by #12038, eff 1-1-17
(from Med 502.03)
Med 502.05 Chronic Pain.
(a) This section shall only apply to the
treatment of “chronic pain” as defined in Med 502.03(d) and shall not apply to
the treatment of pain from cancer or pain from terminal disease.
(b) If
opioids are indicated and prescribed for chronic pain, prescribing licensees
shall:
(1) Conduct and document a history and physical
examination;
(2) Conduct and document a risk assessment,
including, but not be limited to, the use of an evidence-based screening tool
such as the Screener and Opioid Assessment for Patients with Pain (SOAPP);
(3) Document the prescription and rationale for
all opioids according to Med 501.02(d) and (e);
(4) Prescribe opioid analgesics in a
measured and monitored manner and administered in the lowest amount necessary
to control pain.
(5) Comply with all federal and state controlled
substances laws, rules, and regulations;
(6) Utilize a written informed consent that
explains the following risks associated with opioids:
a. Addiction;
b. Overdose and death;
c. Physical dependence;
d. Physical side effects;
e. Hyperalgesia;
f. Tolerance; and
g. Crime victimization;
(7) Create and discuss a treatment plan with the
patient. This shall include, but not be limited to the goals of treatment, in
terms of pain management, restoration of function, safety, time course for
treatment, and consideration of non-pharmacological modalities and non-opioid therapy.
Informed consent documents and treatment agreements may be part of one document
for the sake of convenience;
(8) Utilize a written treatment agreement that is
included in the medical record, and specifies conduct that triggers the titration, discontinuation, or
tapering of opioids based on ongoing, objective evaluation of the patient’s
injury or illness as required for ongoing successful treatment of chronic pain;
(9) The treatment agreement shall also address,
at a minimum, the following:
a. The requirement of safe medication use and
storage;
b. The requirement of obtaining opioids from
only one prescriber or practice;
c. The consent to periodic and random drug
testing; and
d. The prescriber’s responsibility to be available
or to have clinical coverage available;
(10) Document the consideration of a consultation
with an appropriate specialist in the following circumstances:
a. When a patient is at high risk for abuse or
addiction; or
b. When a patient has a co-morbid
psychiatric disorder;
(11) Reevaluate treatment plan and use of opioids
at least twice a year;
(12) Require random and periodic urine drug testing
at least annually for all patients using opioids for longer than 90 days.
Unanticipated findings shall be addressed in a manner that supports the health
of the patient;
(13) Have clinical coverage available for 24 hours
per day, 7 days per week, to assist in the management of patients;
(14) The prescriber may forego the requirements
for a written treatment agreement and for periodic drug testing for patients:
a. Who are residents in a long-term, non-rehabilitative
nursing home facility where medications are administered by licensed staff; or
b. Who are being treated for episodic intermittent
pain and receiving no more than 50 dose units of opioids in a 3 month period;
and
(15) Be allowed to continue prescribing opioid treatment, when there is no
indication of misuse or diversion, for patients:
a. Who experience chronic illness or injury which
results in chronic pain; and
b. Who are on a managed and monitored regimen of
opioid analgesic treatment which has resulted in an increase in functionality
and quality of life.
Source. #11090, eff 5-3-16; ss by #12038, eff 1-1-17
(from Med 502.04); ss by #13248, eff 8-6-21
Med 502.06 Prescription Drug Monitoring Program.
(a) Prescribers
required to register with the program under RSA 318-B:31-40, or their delegate,
shall query the prescription drug monitoring program to obtain a history of schedule
II-IV controlled substances dispensed to a patient, prior to prescribing an
initial schedule II, III, and IV opioids for the management or treatment of
this patient’s pain and then periodically and at least twice per year, except
when:
(1) Controlled medications are to
be administered to patients in a health care setting;
(2) The program is inaccessible
or not functioning properly, due to an internal or external electronic issue; or
(3) An emergency department is
experiencing a higher than normal patient volume such that querying the program
database would materially delay care.
(b) A licensee shall document the exceptions
described in (a)(2) and (3) above in the patient’s medical record.
Source. #11090, eff 5-3-16; ss by #12038, eff 1-1-17
(from Med 502.05)
Med 502.07 Medication Assisted Treatment.
(a) Licensees who prescribe medication assisted
treatment shall adhere to the principles outlined in the American Society of Addiction
Medicine’s National Practice Guideline For the Use of Medications in the
Treatment of Addiction Involving Opioid Use (2015) found at http://www.asam.org/quality-practice/guidelines-and-consensus-documents/npg/complete-guideline as cited in Appendix II.
Source. #12038, eff 1-1-17 (from Med 502.06)
CHAPTER Med 600 PHYSICIAN
ASSISTANT
Statutory Authority: RSA 328-D:10, I
REVISION
NOTE:
Document #9900, effective 4-12-11,
adopted, amended, readopted with amendments, or repealed many rules in Chapters
Med 100 through Med 600. In Chapter Med
600, Document #9900 readopted with amendments Med 602.01, 602.02, 604.01,
608.01, 609.02, and 611.01. Document
#9900 also repealed Med 601.06 defining “Physician Assistant Advisory Committee
(PAAC)”, which necessitated the renumbering, but not readoption, of Med 601.07,
601.08, and 601.09 as, respectively, Med 601.06, 601.07, and 601.08. The source notes for Med 601.06, 601.07, and
601.08 indicate the former rule numbers, and the document numbers and effective
dates apply to the rules under the former number. The prior filings affecting the former Med
601.06 include the following documents:
#1497, effective 11-29-79
#2197, effective 12-2-82
#2199, effective 12-2-82
#2910, effective 11-21-84
#4745, effective 1-25-90, EXPIRED
1-25-96
#6472, effective 3-25-97, EXPIRED
3-25-05
#8678, effective 7-11-06
PART Med 601 CHAPTER
DEFINITIONS
Med 601.01 "Applicant"
means “applicant” as defined in RSA 328-D:1, I namely “a physician assistant
who has submitted an application for licensure.”
Source. #4745, eff
1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21 (formerly Med 601.02)
Med 601.02 "Approved
program" means a program for the education and training of physician
assistants that is accredited by the American Medical Association's Committee
on Allied Health Education and Accreditation, or the Commission on
Accreditation of Allied Health Education Programs or by its successor.
Source. #1497, eff
11-29-79; ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21 (formerly Med 601.03)
Med 601.03 "National
certification" means to hold a current physician assistant certificate
issued by the National Commission on Certification of Physician Assistants
(NCCPA).
Source. #1497, eff
11-29-79; ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21 (formerly Med 601.04)
Med 601.04 "Physician
assistant (PA)" means "physician assistant" as defined in RSA
328-D:1, III.
Source. #1497, eff
11-29-79; ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21 (formerly Med 601.05)
Med 601.05 "Prescription"
means “prescription” as defined in RSA 318:1, XVI, namely “a verbal, or
written, or facsimile or electronically transmitted order for drugs, medicines
and devices by a practitioner licensed in the United States, to be compounded
and dispensed by licensed pharmacists in a duly registered pharmacy, and to be
kept on file for a period of 4 years. A written order shall include an
electronic transmission prescription received and retained in a form complying
with rules adopted pursuant to RSA 318:5-a, XV. Prescriptions may also apply to
the finished products dispensed or administered by the licensed pharmacist in
the registered pharmacy, on order of a licensed practitioner as defined in this
section.”
Source. #1497, eff
11-29-79; ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21 (formerly
Med 601.06)
Med 601.06 "Participating Physician" means “ participating
physician” as defined in RSA 328-D:1, II-c., namely, “a physician practicing as a sole practitioner, a physician designated
by a group of physicians to represent their physician group, or a physician
designated by a health care facility to represent that facility, who enters
into a collaboration agreement with a physician assistant in accordance with
this chapter”.
Source. #4745, eff
1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06; renumbered by #9900 (from
Med 601.07) (see Revision Note at chapter heading for Med 600); EXPIRED:
7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16 (formerly Med 601.07); ss by #13249, eff 8-6-21; ss by
#13803, eff 12-31-23
Med 601.07 "Collaboration"
means “collaboration” as defined in RSA 328-D:1, II-a., namely “a physician assistant's consultation with or referral to
an appropriate physician or other health care professional as indicated based
on the patient's condition, the physician assistant's education, training, and
experience, and the applicable standards of care.”
Source. #1497, eff
11-29-79; ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90; ss by #4902, eff 8-3-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06; renumbered by #9900 (from
Med 601.08) (see Revision Note at chapter heading for Med 600); EXPIRED:
7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #11049, eff 3-2-16 (formerly Med 601.08); ss by
#13249, eff 8-6-21; ss by #13803, eff 12-31-23
PART Med 602 SUPERVISION OF
A PHYSICIAN ASSISTANT
Med 602.01 Responsibility
of the Physician Assistant.
(a) A physician
assistant is responsible for their own medical decision making. A participating physician included in a
collaboration agreement with a physician assistant shall not, by the existence
of the collaboration agreement alone, be legally liable for the actions or
inactions of the physician assistant. This
shall not otherwise limit the liability of the participating physician.
(b) The physician
assistant shall have current valid professional liability coverage.
Source. #1497, eff
11-29-79, ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90; ss by #4902, eff 8-3-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06; ss by #9900, eff 4-12-11
(see Revision Note at chapter heading for Med 600); ss by #12972, eff 1-10-20;
ss by #13249, eff 8-6-21; ss by #13803, eff 12-31-23
Med 602.02 Number of Physician Assistants Supervised.
(a) A physician shall not be the RSP for more physician
assistants than
are authorized by institutional policy or clinical guidelines established and
regulated at the practice level.
(b) A physician shall, upon board request,
identify the physician assistants for whom the physician serves as RSP. A physician assistant shall, upon board
request, identify a list of all current RSPs.
(c) Physician assistants employed in 2 or more
separate medical jobs shall have a designated RSP in each setting.
Source. #1497, eff
11-29-79, ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06; ss by #9900, eff 4-12-11
(see Revision Note at chapter heading for Med 600); ss by #12972, eff 1-10-20;
ss by #13249, eff 8-6-21
Med 602.03 Collaboration
Agreement.
(a)
Except as provided in RSA 328-D:15, III and RSA 328-D:16, II, a physician
assistant shall engage in practice as a physician assistant in this state only
if the physician assistant has entered into a written collaboration agreement
with a sole practice physician or a physician representing a group or health
system so long as the sole practitioner or at least one physician in the group
or health system practices in a similar area of medicine as the physician
assistant, and is a licensed New Hampshire physician.
(b)
A collaboration agreement shall include all of the following:
(1) Processes for
collaboration and consultation with the appropriate physician and other health
care professional as indicated based on the patient's condition and the
physician assistant's education, training, and experience, and the applicable
standards of care;
(2) An
acknowledgment that the physician assistant's scope of practice shall be
limited to medical care that is within the physician assistant's education,
training, and experience as outlined in RSA 328-D:3-b, VII-XIII;
(3) A statement
that although collaboration occurs between the physician assistant and
physicians and other health care professionals, a physician shall be accessible
for consultation in person, by telephone, or electronic means at all times when
a physician assistant is practicing; and
(4) The signatures
of the physician assistant and the participating physician. No other signatures
shall be required.
(c) The collaboration agreement shall be updated
as necessary.
(d)
In the event of the unanticipated unavailability of a participating
physician practicing as a sole practitioner due to serious illness or death, a
physician assistant may continue to practice for not more than a 30-day period
without entering into a new collaboration agreement with another participating
physician.
(e)
The collaboration agreement shall be kept on file at the practice and
made available to the board upon request.
Source. #4745, eff
1-25-90; ss by #4902, eff 8-3-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21; ss by #13803, eff 12-31-23
Med 602.04 Change of Supervisory Relationship.
(a) If, for any reason, a physician
assistant discontinues a supervised relationship with the RSP the PA shall
immediately report this fact to the board in writing.
(b) The physician assistant shall not practice
until such time as a new registered supervising physician, who shall comply
with the requirements for supervision set forth under Med 602.01, has filed a
written acceptance of supervisory responsibility with the board.
Source. #6472, eff
3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21
PART Med 603 SCOPE OF
PRACTICE OF PHYSICIAN ASSISTANT
Med 603.01 Scope of Practice.
(a) The scope of practice of the physician assistant
shall be defined by agreement with the RSP. The scope of practice of the physician
assistant shall be limited to and no broader than the scope of practice and
privileges of the supervising physician.
(b) Medical services shall be performed by a physician assistant
as outlined in the practice agreement.
(c) Orders written by a physician assistant shall
be consistent with the terms of the practice agreement.
(d) Physician assistants shall perform practice-related
activities, including but not limited to, the ordering of diagnostic or
therapeutic services to be implemented by other health professionals, under the
requirements for supervision set forth under Med 602.01.
Source. #1497, eff
11-29-79, ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90; ss by #4902, eff 8-3-90, EXPIRED 8-3-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21
PART Med 604 APPLICATION
FOR LICENSURE
Med 604.01 Application Form.
(a) Applicants for
licensure as a physician assistant shall complete and submit form “Application
for Certification as a Physician Assistant,” revised 6/2021, containing the
following:
(1) Name, home address, email address, and telephone number of the
applicant;
(2) Date of birth, place of birth, gender of the applicant and social
security number required pursuant to 45CFR Part 60.8 and RSA 161-B:11, VI-a.
The applicant shall furnish his or her social security number on the line
provided below the following preprinted statement:
“The board will deny licensure if you refuse to submit your social
security number (SSN). Your professional
license will not display your SSN. Your SSN will not be made available to the
public. The board is required to obtain your SSN for the purpose of child
support enforcement and in compliance with RSA 161-B:11. This collection of
your SSN is mandatory.”;
(3) Documentation of completion
of an approved program of education as defined in Med 601.02;
(4) Verification from the
licensing authority of any other state license ever held by the applicant which
shows such license to be in good standing,
through the use of the “Licensure Verification Form” dated 6/2021;
(5) Documentation that the
applicant has passed an initial examination administered by the NCCPA and
continues to hold a valid national certificate issued by that organization or
its successor agency;
(6) A statement indicating
whether the applicant has ever been refused a license or certification by any
other licensing or certifying body and if so, the circumstances of the
incident;
(7) A statement indicating
whether the applicant has ever been or has reason to believe that he or she is
the subject of any kind of disciplinary investigation or action by any hospital,
healthcare organization, or
licensing or certifying body and if so, the nature of the allegations and the
subsequent disposition of the action;
(8) A statement indicating
whether the applicant has ever been convicted of a felony or misdemeanor, and,
if so, the name of the court, the details of the offense, the date of conviction
and the sentence imposed;
(9) A statement indicating
whether the applicant is currently or has in the past been monitored or treated
by a private, state, medical society, or hospital physician health program
other than the NH board-approved physician health program;
(10) A statement indicating
whether the applicant is currently suffering from any condition, mental or
physical, that impairs their judgment or that would otherwise adversely affect
his or her ability to practice medicine in a competent, ethical, and professional
manner;
(11) A statement that the applicant
has arranged for the direct submission of letters of reference from 2
physicians, who have served in an advisory capacity to the applicant;
(12) Signature and 3 x 5 inch
full face photograph of the applicant; and
(13) A signed, affidavit
stating the following:
“[NAME] of [ADDRESS], being duly sworn, says that (s)he is the
person referred to in the above application for certification (and photograph
below) as a Physician Assistant in the state of New Hampshire; that (s)he is a
graduate of an approved program for Physician Assistants; and that all
statements herein or attached hereto are each and all true in every respect.”
(b) A copy of the applicant’s curriculum vitae or
resume shall accompany the application.
(c) Letters of reference required in (a)(11) above
shall be original, signed documents submitted directly to the board on
professional letterhead.
(d) Applicants shall include the application fee
required in Table 3.6.1 in Med 306.01.
Source. #1497, eff
11-29-79, ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06; ss by #9900, eff 4-12-11
(see Revision Note at chapter heading for Med 600); ss by #12972, eff 1-10-20;
ss by #13249, eff 8-6-21
PART
Med 605 REQUIREMENTS FOR LICENSURE
Med 605.01 Educational Requirements. The applicant shall be a graduate of an approved
physician assistant training program as defined in Med 601.02.
Source. #1497, eff 11-29-79,
ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff 11-21-84;
ss by #4745, eff 1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21
Med
605.02 Professional Character.
(a) The applicant shall adhere to the
requirements of RSA 328-D and the rules of this chapter, and shall not have
previously engaged in activities for which disciplinary sanctions might be
imposed under Med 609.
Source. #1497, eff
11-29-79, ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16
PART
Med 606 - RESERVED
Source. #1497, eff 11-29-79,
ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff 11-21-84;
ss by #4745, eff 1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
PART Med
607 REINSTATEMENT OF LICENSE
Med 607.01 Reinstatement of Lapsed Licenses.
(a) A 90 day grace period to apply for renewal
shall be allowed, subject to an additional late fee pursuant to Med 306.01. If the renewal application is not received by the
grace period date, the license shall be considered lapsed.
(b) If a license expires or lapses as a result of a
licensee being ordered to active duty with the armed services, the licensee
shall have one year from the date of discharge or release from the armed service
to apply for renewal and all late fees shall be waived.
(c) If a physician assistant license lapses, the
physician assistant shall be eligible to apply for reinstatement.
(d) Applicants for reinstatement of a lapsed
license shall pay the reinstatement fee set forth in Med 306.01, Table 3.6.1.
(e) Applicants for reinstatement shall complete and
file a “Physician Assistant Reinstatement Application” form, dated 6/2021 which
contains the following:
(1) The same information
required in Med 604.01(a)(1-13) excluding Med 604.01(a)(3), the place of birth, and the gender of the applicant; and
(2) A chronological history
of the applicant's employment since the original license was lapsed.
Source. #1497, eff
11-29-79, ss by #2199, eff 12-2-82; ss by #2197, eff 12-2-82; ss by #2910, eff
11-21-84; ss by #4745, eff 1-25-90; ss by #4902, eff 8-3-90, EXPIRED 8-3-96
New. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21
PART Med 608 LICENSE
RENEWAL
Med 608.01 Renewal Application.
(a) On or before October 31, of every other year, the board shall forward a license renewal application
for the coming year to each licensee. The applicant shall file the completed
renewal application no later than December 31. For the transition from annual to
biennial renewal, licensees who were initially licensed in odd-numbered years
prior to 2021 shall renew by December 31, 2021 and every 2 years thereafter,
and licensees who were initially licensed in even-numbered years shall renew by
December 31, 2022 and every 2 years thereafter.
(b) Persons seeking renewal of a physician
assistant license shall complete and submit form “Physician Assistant Renewal
Application,” revised 6/2021, containing, on or as an attachment to the
application, the following:
(1) Name, telephone number,
email address, and home address of the licensee, including street address and
mailing address;
(2) Place(s) of employment,
business address, and business
telephone number and business email address;
(3) Name and New Hampshire
license number of RSP;
(4) Other states where the
licensee holds a current license;
(5) Copy of current national
certification issued by the NCCPA;
(6) The applicant’s US Drug
Enforcement Agency (DEA) license number, the state of issuance,
and the expiration date;
(7) Whether the applicant has,
within the past 12 months, been found guilty or pleaded no contest to any
felony or misdemeanor;
(8) Whether the applicant
has terminated a relationship with a registered supervisory physician or
terminated employment for any reason during the past 12 months;
(9) Whether the applicant
has been the subject of disciplinary action, or has been denied a license or surrendered
a license in any state or jurisdiction within the past 12 months;
(10) Whether the applicant
is currently or has in the past 12 months been monitored or treated by a
private, state, medical society, or hospital physician health program other
than through the NH board approved physician health program or has been
restricted in any manner by the US Drug Enforcement Agency (DEA);
(11) Whether the applicant
is suffering from any condition, mental or physical, that impairs their judgment
or that would otherwise adversely affect his or her ability to practice
medicine in a competent, ethical, and professional manner;
(12) Whether the applicant
has been the subject of any investigation or disciplinary proceeding or has been
reported to the National Practitioners Data Bank (NPDB) within the past 12
months;
(13) Whether any
malpractice claims have been made against the applicant within the past 12 months;
(14) If responses to
questions (6) through (11) above are in the affirmative, a written explanation
of the circumstances;
(15) Whether the applicant
has registered with the Controlled Drug Health and Safety Program (also known
as the N.H. Prescription Drug Monitoring Program);
(16) The renewal applicant
shall furnish the last 4 digits of his or her social security number required
pursuant to 45 CFR Part 60.8 and RSA 161-B:11, VI-a. The applicant shall
furnish the last 4 digits of his or her social security number on the line
provided below the following preprinted statement: “The board will deny
licensure if you refuse to submit your social security number (SSN). Your
professional license will not display your SSN.
Your SSN will not be made available to the public. The board is required
to obtain your SSN for the purpose of child support enforcement and in
compliance with RSA 161-B:11. This
collection of your SSN is mandatory.”;
(17) The applicant's
signature and the date of the applicant's signature, certifying the accuracy of
his or her responses under the penalty for unsworn falsification pursuant to
RSA 641:3; and
(18) The fee required in
Med 306.01.
(c) Applications
which do not contain all of the information required in section (b) above shall
not be accepted for filing and shall be returned, unprocessed to the applicant.
(d) Pursuant to RSA
126-A:5, XVIII-a(a) and RSA 330-A:10-a, licensees shall complete, as part of
their renewal application, the New Hampshire division of public health
service’s health professions survey issued by the state office of rural health
and primary care, department of health and human services.
(e) The board shall provide licensees with the
opportunity to opt out of the survey. Written notice of the opt-out opportunity
shall be provided with the renewal application. The opt out form may be accessed at the state
office of rural health and primary care at https://www.dhhs.nh.gov/dphs/bchs/rhpc/data-center.htm and at
the board’s website at www.oplc.nh.gov/board-medicine.
(f) Licensees choosing to opt-out of the survey
shall submit the completed opt out form described in He-C 801.04, to the State office
of rural health and primary care, department of health and human services,
via one of the following:
(1) Mail;
(2) Email; or
(3) Fax.
(g) Information contained in the opt-out forms
shall be kept confidential in the same accord with the survey form results,
pursuant to RSA 126-A:5 XVIII-a.(c).
Source. #4745, eff
1-25-90, EXPIRED 1-25-96
New. #6472, eff 3-25-97; ss by #6828, eff 8-11-98;
ss by #8678, eff 7-11-06; ss by #9900, eff 4-12-11 (see Revision Note at chapter
heading for Med 600); ss by #10331, eff 5-8-13; ss by #11049, eff 3-2-16; ss by
#12972, eff 1-10-20; ss by #13249, eff 8-6-21
PART Med 609 ETHICAL STANDARDS
Med 609.01 Disciplinary Action.
(a) Professional misconduct by physician
assistants shall include the following:
(1) Holding oneself out as
or permitting another to represent one as a licensed physician;
(2) Performing activities
which are not authorized by the licensee's training or supervising physician's
practice or which are outside the direction and supervision of the RSP;
(3) Habitual use of controlled
drugs or intoxicants;
(4) Conviction of a felony
under the laws of the United States or any state;
(5) Engaging in dishonest,
unprofessional, or immoral
conduct related to the performance of physician assistant activities;
(6) Failing to meet reasonable
standards of medical care;
(7) Failing to report changes in RSP;
(8) Violating the “Guidelines
for Ethical Conduct for the Physician Assistant Profession” of the American Academy
of Physician Assistants adopted in 2000 and reaffirmed in 2013, as specified in
Appendix II;
(9) Practicing as a
physician assistant while being mentally or physically impaired in a manner
which precludes safe and dependable performance;
(10) Engaging in conduct
inconsistent with the basic knowledge and competency expected of any physician
assistant; or
(11) Intentionally injuring
or exploiting any patient or person entrusted to licensee's care as a physician
assistant.
Source. #6472, eff
3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21
Med 609.02 Allegations of Professional Misconduct. Allegations of professional misconduct shall
be investigated and disciplinary action shall be taken in accordance with Med
200 and Med 400, and if applicable, Jus 800 and RSA 328-D:7.
Source. #6472, eff
3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06; ss by #9900, eff 4-12-11
(see Revision Note at chapter heading for Med 600); ss by #12972, eff 1-10-20
Med
609.03 Change of Address. Licensees shall report any change in business
or home address within 30 days of such change.
Source. #6472, eff
3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16
PART Med 610 METHOD OF
PERFORMANCE
Med 610.01 Identification. A physician assistant shall keep his or her
license available for inspection at the primary place of business and shall,
when engaged in his or her professional activities, wear a name tag identifying
themselves as a "physician assistant".
Source. #6472, eff 3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21
Med 610.02 Proximity. The physician assistant
shall ensure that the RSP is available for continuous consultation with the
physician assistant in person or by electronic device.
Source. #6472, eff
3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21
PART Med 611 FEES
Med
611.01 Fees. The fees shall be as
set forth in Table 3.6.1 in Med 306.01.
Source. #6472, eff
3-25-97; ss by #6828, eff 8-11-98; ss by #8678, eff 7-11-06; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 600); ss by #12972, eff
1-10-20
PART Med 612 PRESCRIPTIVE PRACTICE
Med 612.01 Scope of Prescriptive Practice.
(a) Physician assistants shall transmit
prescriptions for any patient only in accordance with a practice agreement, or a patient
specific order of the RSP and in compliance with all requirements of RSA 318 and
RSA 318-B.
(b) Physician assistants, acting in accordance
with a practice agreement, may dispense
samples of prescription drugs as necessary and appropriate for patient care.
(c) Physician assistants shall not engage in the
act of prescribing controlled substances unless they have obtained the proper
registration from the US Drug Enforcement Administration.
(d) A licensed physician assistant may prescribe,
dispense, and administer drugs and medical devices as outlined in the practice agreement in compliance with RSA 318 and RSA 318-B.
(e) Physician assistants may request, receive, and
sign for professional samples and may distribute professional samples to
patients.
Source. #6472, eff
3-25-97, EXPIRED: 3-25-05
New. #8678, eff 7-11-06, EXPIRED: 7-11-14
New. #10926, INTERIM, eff 9-4-15, EXPIRES: 3-2-16;
ss by #11049, eff 3-2-16; ss by #13249, eff 8-6-21
APPENDIX I
RULE |
STATUTE |
Med
102.08 |
RSA
541-A:16, I(a) |
Med 103.01 |
RSA 329:2, I;
RSA 329:4 |
Med 103.02 |
RSA 329:2; RSA
329:3; RSA 329:7 |
Med 103.03 |
RSA 329:2, IV |
Med
104.01 |
RSA
541-A:16, I(a) |
Med
105.03 |
RSA
541-A:16, I(a) |
|
|
Med 201.01 |
RSA 329:9, VI
and XV |
Med 201.02 |
RSA 541-A:16, I
(b) |
|
|
Med 301.01 |
RSA 541-A:7 |
Med
301.01(a)-(f) |
RSA
329:9, XVI |
Med
301.01(g)-(k) |
RSA
329:9, I; 329:9, II; 329:12; 329:14, III |
Med 301.02 |
RSA 329:9, I; RSA
329:12, I (b); RSA 329:14 |
Med 301.03 |
RSA 329:9, I; RSA
329:12, I (a) & (b); RSA 329:14; RSA 161-B:11,
VI-a |
Med
301.03 intro to (a), (a)(1), (a)(3)-(a)(27) and (b) |
RSA
329:12, I(a), (c)(4), (5) and (6), 329:14, II, 161-B:11, VI-a |
Med
301.03(a)(2) |
RSA
329:9, I, 329:9, II and 329:12 |
Med
301.03(a)(28) and (29) |
RSA
329:9, I; 329:14, I |
Med
301.03(c) & (d)(1)-(3) |
RSA
329:14, II; 329:14, III |
Med
301.04 |
RSA
329:9, IV; 329:16-h |
Med
301.04(c), (d) and (e) |
RSA
329:12, I(a) and (b); 329:14, II; 329:16-e |
Med 302.01 |
RSA 329:9, II, RSA
329:12 |
Med 303.01 |
RSA 329:9, II;
329:12, I(d)(6) |
Med
303.01(a)(1), (4) and (5) |
RSA
329:9, III, 329:10, 329:11, 329:12(c)(6) |
Med
303.01(a)(2), (3), and (b)-(c) |
RSA
329:9, II, III; 329:10; 329:12, I(c)(6) |
Med 303.02 |
RSA 329:9, II; RSA
329:12, I (d)(6); RSA 329:14, V(a) |
Med
303.02(a) and (b) |
RSA
329:9, III, 329:12, (c)(6) |
Med
303.02(c)(1)-(3) |
RSA
329:9, II, III; 329:14, V(a) |
Med 305.01 |
RSA 329:9, I,
II; RSA 329:14, VII |
Med
305.01(a) - (d) |
RSA
329:9, I, II, 329:14, VII |
Med 305.02 |
RSA 329:9, I,
II, VIII; RSA 329:14, VI |
Med 305.03 |
RSA 329:9, I,
II; RSA 329:14, VIII |
Med 305.04 |
RSA 329:9, I,
II; RSA 329:14, V(a)-(c) |
Med 306.01 |
RSA 329:9, VII; RSA
329:12, I(a); RSA 329:16-a; RSA 329:16-h |
|
|
Med
401.01 |
RSA
329:16-e; 329:16-a |
Med
401.02
|
RSA
329:16-a |
Med
401.02(c) |
RSA
329:9, II, VII; 329:16-a, 329:16-c; 329:16-g |
Med 401.03 |
RSA 161-B:11,
VI-a; RSA 329:9, I, II; RSA 329:12, I(b); RSA 329:16-a; RSA
329:16-c; RSA 329:16-f, I; RSA 329:16-g; RSA 329:16-h;
RSA 329:18, VI; RSA 318-B:33, II |
Med
401.03(a) |
RSA
329:9, VII; 329:12, I(a); 329:16-a; 329:16-h |
Med
401.03(b) intro. and (b)(1) |
RSA
329:9, II, 329:16-f, I; 329:16-a; 329:18, VI |
Med 401.03(b)(2)-(6), (b)(14) & (15), (c) & (d) |
RSA 329:9, II, VII, 329:16-a, 329:16-c, 329:16-g |
Med 401.03(b)(7) & (b)(8)-(13) |
RSA 329:9, I, II & V; 329:16-a |
Med 401.03(b)(17) |
RSA 161-B:11; 329:9, I; 329:16-a |
Med 401.03(b)(18) |
RSA 329:9, I; 329:16-a |
Med 401.03(b)(19) |
RSA 329:9, I; 329:16-a; 318-B:33, II |
Med
401.03(e) |
RSA
318-B:33, II; 329:9, II; 329:16-a; |
Med 401.04 |
RSA 329:16-e |
Med
401.05 |
RSA
329:9, II, VII, 329:16-e, 329:16-h |
Med
401.05 (a) intro, (1) – (5) |
RSA
329:9, II, VII; 329:16-e; 329:16-h |
Med
401.05 (a) intro., (a)(4)-(5) |
RSA
329:14, II; 329:9, II |
Med
401.05 (a)(6) |
RSA
329:9, II; 329:16-a; 318-B:33, II |
Med 402.01 |
RSA 329:9, II;
RSA 329:16-g |
Med 402.02 |
RSA 329:9, II; RSA
329:16-g |
Med 402.03 |
RSA 329:9, II;
RSA 329:16-g |
Med
403 |
RSA
329:16-f, 329:16-g |
Med 403.01 |
RSA 541-A:16,
I(b) |
Med 403.02 |
RSA 541-A:16,
I(b) |
Med 403.03 |
RSA 329:9, II,
V; RSA 329:16-f; RSA 329:16-g |
Med 403.04 |
RSA 329:9, II;
RSA 329:16-g |
Med 403.05 |
RSA 329:9, II; RSA
541-A:16, I(a) |
Med
407 |
RSA
329:13-b |
Med 407.01 |
RSA 329:13-b;
RSA 541-A:7; RSA 541-A:16, I (b), intro. |
Med 407.02 |
RSA 329:13-b;
RSA 541-A:16, I (b), intro. |
Med 407.03 |
RSA 329:13-b; RSA
541-A:16, I (b), intro. |
Med 408.01 |
RSA 329:9, VI,
XV, XVII-XIX; RSA 329:17 |
Med 408.02 |
RSA 329:9, VI,
XV, XVII-XIX; RSA 329:17 |
Med 408.03 |
RSA 329:9, VI,
XV, XVII-XIX; RSA 329:17 |
Med 409.01 |
RSA 329:9, VI,
XV, XVII-XIX; RSA 329:17 |
Med 410.01 |
RSA 329:9, VI,
XV, XVII-XIX; RSA 329:17 |
Med
411.01 – 411.03 |
RSA
329:9, VX; 329:17, VII (g); RSA 329:2, II(d) |
Med
412.01 – 412.02 |
RSA
329:9, IV |
Med 412.03 |
RSA 329:9, IV,
RSA 541-A:16, I(b) |
Med
413.01 |
RSA
329:9, VI, XV, XVII-XIX; RSA 329:17 |
Med
413.02 |
RSA
329:9, IV, RSA 541-A:16, I(b) |
|
|
Med
501.02 |
RSA
329:9, I, II, V, XV-a; RSA 329:2, II, (a), (b), (d), RSA
329:12, I(b); RSA 329:14, II; RSA 329:17, VI(d); RSA
318-B:33, II; RSA 318-B:36, III, IV, V |
Med 501.01(b) |
RSA 329:14, III, 329:24 |
Med 501.02 |
RSA 329:9, V |
Med
501.02(a) & (b) |
RSA
329:9, I, II & V |
Med
501.02(c)-(i) |
RSA
329:9, V, & XV-a |
Med 501.02 (k) |
RSA 329:2, II
(b); 329:2, II (d); RSA 329:9, V; RSA 329:17, VI (d); RSA 318-B:33, II |
Med 501.02 (l) |
RSA 329:2, II
(d); RSA 329:9, V; RSA 329:17, VI (d); RSA 318-B:33, II; RSA 329:2, II (a); RSA
329:12, I (b); RSA 329:14, II |
Med 501.02 (m) |
RSA 329:2, II
(b); 329:2, II (d); RSA 329:9, V; RSA 329:17 VI Cd); RSA 318-B:36, IV. |
Med 501.02 (n) |
RSA 329:2, II (b);
RSA 329:2, II (d); RSA 329:9, V; RSA 329:17, VI (d); RSA 318-B:36,V |
Med 501.02 (o) |
RSA 329:2, II
(b); RSA 329:2, II (d); RSA 329:9, V; RSA 329:17, VI (d); RSA 318-B:36, III |
Med
502 |
RSA
329:9, V and XV-a |
Med 502.03 |
RSA 329:9, V and
XV-a; RSA 318-B:41, II(d) |
Med 502.05 |
RSA 329:9, V and
XV-a; RSA 318-B:41, II(d) |
|
|
Med 601.01 – Med
601.07 |
RSA 328-D:1 |
Med 602.01 – Med 602.04 |
RSA 328-D:10,
I(f) |
Med 603.01 |
RSA 328-D:10,
I(a) |
Med 604.01 |
RSA 328-D:3, RSA
328-D:10, I(b) and (c) |
Med 605.01 |
RSA 328-D:3; RSA
328-D:10, I(e) |
Med 607.01 |
RSA 328-D:5-a,
I; RSA 328-D:10, I(c) |
Med 608.01 |
RSA 328-D:5; RSA
328-D:10, I(c); RSA 318-B:33, II |
Med 609.01 |
RSA 328-D:6; RSA
328-D:7; RSA 328-D:10, I(d) and (g) |
Med 609.03 |
RSA 328-D:6; RSA 328-D:7; RSA 328-D:10, I(d) and (g) |
Med 610 |
RSA 328-D:10,
I(j) |
Med 611 |
RSA 328-D:2,
III, 328-D:5, RSA 328-D:5-a, I; RSA 329:10(c) |
Med 611.01 |
RSA 328-D:2,
III; RSA 328-D:5; RSA 328-D:5-a, I; RSA 329:10, I (c), (j) |
Med 612 |
RSA 328-D:10, I(a) |
APPENDIX II
Med 501.02(h),
Med 501.02(i)(4), Med 501.02(i)(5)
Med
501.02(h)
Code
of Medical Ethics of the American Medical Association, Current Opinions with Annotations,
2012-2013 Edition. This document is available
at the office of the Board of Medicine, 121 South Fruit Street, Concord,
N.H. 03301 for a fee of $.25 per page.
Med
501.02(i)(4)
Federation of
State Medical Boards Model Policy on the Use of Opioid Analgesics in the Treatment
of Chronic Pain, July 2013.
This document is available at the office of the Board of Medicine,
Med
501.02(i)(5)
Clinical
Guidelines for the Use of Buprenorphrine in the Treatment
of Opioid Addiction, A Treatment Improvement Protocol by the
Appendix III Incorporated References
Rule |
Reference |
Obtain at: |
Med
501.02(h) |
Code
of Medical Ethics of the American Medical Association, Current Opinions with
Annotations, June 2016 Edition. |
Available
at the office of the Board of Medicine, 121 South Fruit Street, Concord,
N.H. 03301 for a fee of $.25 per page. |
Med 502.06
(a) |
The American
Society of Addiction Medicine’s “National Practice Guideline For the Use of
Medications in the Treatment of Addiction Involving Opioid Use,” adopted on
June 1, 2015. |
No cost to download from: |
Med
502.07 (a) |
The
American Society of Addiction Medicine’s “National Practice Guideline For the
Use of Medications in the Treatment of Addiction Involving Opioid Use,”
adopted on June 1, 2015. |
No
cost to download from: |
Med 609.01 (a)
(8) |
“Guidelines for
Ethical Conduct for the Physician Assistant Profession” of the American
Academy of Physician Assistants, adopted in 2000 and reaffirmed in 2013 |
No cost to download
from: https://www.aapa.org/wp-content/uploads/2017/02/16-EthicalConduct.pdf
|