PA · New Hampshire
Collaborative Drug Therapy Management for Physician Assistants in New Hampshire
Yes, a written agreement with a physician is required before you prescribe and adjust drug therapy. New Hampshire calls it a Written Collaboration Agreement.
RSA 328-D:3-b (as amended by S.B. 228, 2022). A PA below 8,000 hours who practices without at least one NH-licensed physician in the group/practice/ health system must have a written collaboration agreement. Exactly how the obligation applies once a physician IS present in the group was not fully confirmed — verify before treating as settled.
Independent practice requires: ≥8,000 post-graduate clinical practice hours; Board of Medicine waiver of the collaboration-agreement requirement, obtained through the Board's waiver process — the hours threshold alone does not remove the requirement.
What the physician relationship must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Available remotely (no on-site requirement)
RSA 328-D:3-b requires the collaboration agreement to include 'processes for collaboration and consultation with the appropriate physician...as indicated based on the patient's condition' — no physical-presence or mile/minute radius standard is codified.
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Separate prescribing terms required · controlled substances permitted
PAs may hold individual DEA registration and prescribe controlled substances in New Hampshire; the collaboration agreement governs the specifics. New Hampshire sets no PA-specific schedule quantity or duration limit in statute (contrast North Carolina's Schedule II 30-day-supply rule); check the agreement and Board rules.
Written agreement
Required
True for the default case (under 8,000 hours, or no Board of Medicine waiver). A PA with ≥8,000 hours who has obtained a Board of Medicine waiver may practice in a setting with no NH-licensed physician at all, without a collaboration agreement.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — New Hampshire has no independent corporate-practice-of-medicine doctrine — RSA 329 contains no prohibition on corporate employment of physicians/PAs, and the former fee-splitting statute (RSA 329:23) was repealed in 1996 (secondary-sourced: McLane Middleton). A practice MAY instead be organized as a Professional Corporation under RSA 294-A, in which case ownership is restricted to 'qualified persons' (RSA 294-A:1, :8) — but PAs are not clearly enumerated among the licensee categories eligible to hold PC shares, an unresolved gap similar to Virginia's PA-ownership question.
Secondary sources conflict: some describe New Hampshire as requiring physician ownership or control of medical practices, while others describe no corporate-practice prohibition at all and confirm physicians may be direct corporate employees. Entity-ownership structuring needs counsel.
Sources for the supervision rules (4)
What a collaborating physician costs here
Typical monthly cost in New Hampshire
$500 – $600
Estimate for one Physician Assistant. Standard-tier state.
About New Hampshire's rules
RSA 326-B:11 gives all APRN categories (NP/CRNA/CNM/CNS) plenary, independent practice authority with no supervising-physician or collaborative-agreement requirement and no experience-based transition period — unlike NC/VA. PA title changes to 'physician associate' effective 1/1/2027 (not yet live). NH has no independent corporate-practice-of-medicine doctrine; secondary sources disagree on how far that extends — verify before relying on any CPOM entry below.
Other clinicians in New Hampshire: see the state overview.