A summary of New Hampshire’s collaboration, agreement, filing, supervision, prescribing, and specialty rules for PAs and the physicians who collaborate with them.
Collaborating Physician Required? Yes, under a written collaboration agreement, until the PA has more than 8,000 post-graduate clinical practice hours.
Physician Involvement: Low
Agreement Name: Collaboration agreement
On-Site Requirements: None
Chart Review: None
Controlled Substances: Allowed. A PA who prescribes or dispenses controlled substances must register with the federal DEA and with any applicable state controlled substance regulatory authority. Prescribing a Schedule II through IV controlled drug by telemedicine triggers a follow-up evaluation requirement of at least once a year.
Reduced Supervision / Transition Requirements: More than 8,000 post-graduate clinical practice hours. A board waiver is required before practicing in a setting without at least one New Hampshire-licensed physician in the group, practice, or health system.
New Hampshire PA Collaboration Requirements Summary
New Hampshire requires a PA to enter into a written collaboration agreement with a New Hampshire-licensed physician who practices in a similar area of medicine. Physician involvement is low: no on-site presence, no chart review, no required meetings, and New Hampshire states plainly that PAs are solely responsible for the care they provide and their own medical decision making. The agreement is not filed with the board — it stays at the practice and the board will not request modifications to it. A PA with more than 8,000 post-graduate clinical practice hours can move past the agreement, but needs a board waiver first if the setting has no New Hampshire-licensed physician in the group, practice, or health system. This page covers New Hampshire’s rules on the collaborative relationship, the collaboration agreement, board filing, ongoing compliance, prescribing, and specialty and telehealth requirements.
Source: N.H. Rev. Stat. 328-D:3-b(I)(a)
Type of Collaborative Relationship
New Hampshire requires a written collaboration agreement with a New Hampshire-licensed physician, but keeps physician involvement low. PAs are solely responsible for the care they provide and for their own medical decision making, and a participating physician is not, by the existence of the collaboration agreement alone, legally liable for a PA’s actions or inactions — though that does not otherwise limit the physician’s liability. The path past the agreement runs through hours and setting: more than 8,000 post-graduate clinical practice hours, plus a board waiver if the practice setting has no New Hampshire-licensed physician. Note that New Hampshire’s statute refers to the profession as physician associates; the requirements are the same.
Source: N.H. Rev. Stat. 328-D:3-b(XVII)
What is a PA’s scope of practice in New Hampshire?
A PA’s scope in New Hampshire is limited to medical care within the PA’s own education, training, and experience. The collaboration agreement must contain an acknowledgment of that limit, and the PA is responsible for their own medical decision making within it.
Do PAs need a collaborating physician in New Hampshire?
Yes, until the PA has more than 8,000 post-graduate clinical practice hours. The agreement must be with a New Hampshire-licensed physician who practices in a similar area of medicine as the PA.
Can PAs practice independently in New Hampshire?
Yes, with more than 8,000 post-graduate clinical practice hours — but a board waiver is required first in some settings. A PA past that threshold who intends to practice where there is no New Hampshire-licensed physician in the group, practice, or health system may not do so without obtaining a waiver of the collaboration agreement requirement from the board of medicine.
How many PAs can a physician collaborate with in New Hampshire?
New Hampshire sets no limit on the number of PAs a physician may collaborate with.
Who can be a collaborating physician in New Hampshire?
A New Hampshire-licensed physician who practices in a similar area of medicine as the PA. New Hampshire sets no additional experience or continuing education requirement for that physician.
Are there proximity or in-person requirements in New Hampshire?
No, New Hampshire sets no distance, travel, or on-site presence requirement. The requirement is availability: a physician must be accessible for consultation in person, by telephone, or by electronic means at all times when the PA is practicing.
Collaboration Agreement Requirements
New Hampshire’s written agreement is called a collaboration agreement, and it must cover four things. The PA and the participating physician sign it, and New Hampshire specifies that no other signatures are required. It must be kept on file at the practice and made available to the board on request, and updated as necessary — but the board will not request or require any modifications to it. New Hampshire provides no template.
Source: N.H. Rev. Stat. 328-D:3-b(II)
What must be included in a PA collaborative agreement in New Hampshire?
Four things: processes for collaboration and consultation with the appropriate physician and other health care professionals, as indicated by the patient’s condition, the PA’s education, training, and experience, and applicable standards of care; an acknowledgment that the PA’s scope of practice is limited to medical care within the PA’s education, training, and experience; a statement that a physician will be accessible for consultation in person, by telephone, or electronically at all times the PA is practicing; and the signatures of the PA and the participating physician. New Hampshire provides no state template.
What is the collaborative agreement called in New Hampshire?
It is called a collaboration agreement. New Hampshire refers to the physician who signs it as the participating physician.
Who has to sign the collaborative agreement in New Hampshire?
The PA and the participating physician, and no one else — New Hampshire expressly states that no other signatures are required.
How often must the agreement be reviewed or renewed in New Hampshire?
New Hampshire sets no fixed schedule, but the collaboration agreement must be updated as necessary.
Is a backup physician required in New Hampshire?
No, New Hampshire sets no backup or alternate physician requirement. The agreement must state that a physician will be accessible for consultation at all times when the PA is practicing.
Board Filing Requirements
New Hampshire does not require the collaboration agreement to be filed, and a participating physician is not required to submit a written acceptance of collaboration to the board. The agreement instead stays on file at the practice and is produced to the board on request, and the board will not request or require modifications to it. A PA may practice as soon as the agreement is in place, and no notice is required when the relationship ends.
Source: N.H. Rev. Stat. 328-D:3-b(VI)
Do you have to file the collaborative agreement with the board in New Hampshire?
No. The collaboration agreement is kept on file at the practice and made available to the board on request, and a participating physician is not required to submit a written acceptance of collaboration. The board does provide a notification of collaboration form for the physician to submit.
Can a PA start practicing as soon as they file in New Hampshire?
Yes. There is no board approval step for the collaboration agreement, and the board will not request or require modifications to it.
What are the termination and notice requirements in New Hampshire?
New Hampshire sets no termination or notice requirement when a collaborative relationship ends. If a participating physician practicing as a sole practitioner becomes unexpectedly unavailable because of serious illness or death, the PA may continue practicing for up to 30 days without entering into a new collaboration agreement.
Collaboration Compliance
New Hampshire’s only ongoing obligation is availability. A physician must be accessible for consultation in person, by telephone, or by electronic means at all times when the PA is practicing, and the collaboration agreement must say so. There is no chart review requirement, no meeting cadence, no chart co-signature requirement, no supervision documentation, and no records retention period.
Source: N.H. Rev. Stat. 328-D:3-b(II)(c)
How many charts must a collaborating physician review in New Hampshire?
None — New Hampshire requires no chart review. There is no chart co-signature requirement and no supervision documentation requirement either.
How often must a PA and collaborating physician meet in New Hampshire?
New Hampshire sets no required meeting cadence. A physician must be accessible for consultation in person, by telephone, or electronically at all times the PA is practicing, and the agreement’s collaboration and consultation processes govern beyond that.
How long must collaboration records be kept in New Hampshire?
New Hampshire sets no retention period for collaboration records. The collaboration agreement itself must be kept on file at the practice and made available to the board on request.
Prescribing Rules
PAs in New Hampshire who prescribe or dispense controlled substances must register with the federal DEA and with any applicable state controlled substance regulatory authority. New Hampshire adds no other conditions on prescriptive authority and sets no prescription form requirements. One rule applies specifically to remote prescribing: a Schedule II through IV controlled drug prescribed by telemedicine requires a follow-up evaluation.
Source: N.H. Rev. Stat. 328-D:3-b(XVI)
Can a PA prescribe controlled substances in New Hampshire?
Yes, with registration from the federal DEA and any applicable state controlled substance regulatory authority. New Hampshire adds no heightened supervision requirement specific to controlled substances.
Can a PA prescribe Schedule II drugs in New Hampshire?
New Hampshire’s master regulatory data does not set schedule-specific limits on what a PA may prescribe. Where a Schedule II through IV controlled drug is prescribed by telemedicine, a practitioner licensed to prescribe it must conduct a subsequent evaluation at intervals appropriate to the patient, condition, and drug, and at least annually.
What schedule drugs can a PA prescribe in New Hampshire?
New Hampshire’s master regulatory data sets no schedule-by-schedule limits on PA prescribing. The registration requirement covers controlled substances generally, and the telemedicine follow-up rule applies to Schedules II through IV.
Does a PA need a DEA license in New Hampshire?
Yes, a PA who prescribes or dispenses controlled substances must register with the federal DEA, and with any applicable state controlled substance regulatory authority. New Hampshire sets no prescription form or prescription pad requirements.
Can a PA prescribe independently (without physician sign-off) in New Hampshire?
New Hampshire requires no physician sign-off, co-signature, or prescription-level review. Prescribing must stay within the PA’s education, training, and experience, and a physician must remain accessible for consultation while the PA is practicing.
Specialty & Telehealth Requirements
New Hampshire sets no specialty-specific requirements for PAs but does regulate one aspect of telemedicine: prescribing a controlled drug in Schedules II through IV by telemedicine triggers a follow-up evaluation requirement. Otherwise the standard collaboration, agreement, and prescribing rules apply across settings.
Source: N.H. Rev. Stat. 328-D:3-b(XIII)
Are there telehealth or telemedicine requirements for PAs in New Hampshire?
Yes, for controlled-substance prescribing by telemedicine. When a non-opioid or opioid controlled drug in Schedules II through IV is prescribed by telemedicine, a practitioner licensed to prescribe that drug must conduct a subsequent evaluation at intervals appropriate for the patient, the medical condition, and the drug — and not less than annually. Telephone and electronic contact also satisfy the general requirement that a physician be accessible for consultation.
Are there specialty-specific requirements for PAs in New Hampshire?
New Hampshire sets no specialty-specific requirements for PAs in the master regulatory data. Specialty does govern matching: the physician signing the collaboration agreement must practice in a similar area of medicine as the PA.
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