Collaborative Practice Agreement · PA
New Hampshire Written Collaboration Agreement for Physician Assistants
Required. The Written Collaboration Agreement is the written instrument New Hampshire law names for a Physician Assistant working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
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 a New Hampshire Written Collaboration Agreement must contain
Governed by the New Hampshire Board of Medicine and the New Hampshire Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
Unless the Physician Assistant ("PA") has more than eight thousand (8,000) postgraduate clinical practice hours, or practices in a group, practice, or health system with at least one New Hampshire-licensed physician, the Physician Assistant shall practice pursuant to a written collaboration agreement with the Physician, who practices in a similar area of medicine, as required by N.H. Rev. Stat. Ann. § 328-D:3-b. Before January 1, 2027, a Physician Assistant with more than eight thousand (8,000) such hours who practices without a collaboration agreement in place must first obtain a waiver from the New Hampshire Board of Medicine; that waiver requirement sunsets on January 1, 2027, after which such a Physician Assistant may practice without a collaboration agreement and without a waiver.
Source: N.H. Rev. Stat. Ann. § 328-D:3-b
The collaboration agreement shall specify the process for collaboration and consultation with the Physician and other appropriate providers, based on the patient's condition and the Physician Assistant's education, training, and experience, and shall be signed by the Physician Assistant and the Physician and updated as necessary.
- The Written Collaboration Agreement on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- N.H. Rev. Stat. Ann. § 326-B:11statute
Authorizes Advanced Practice Registered Nurse independent diagnosis, prescribing, and dispensing under the nurse's own license.
- N.H. Rev. Stat. Ann. § 328-D:3-bstatute
Physician Assistant collaboration agreement requirement, the 8,000-hour experience threshold, and the Board of Medicine waiver process (which itself sunsets January 1, 2027).
- N.H. Rev. Stat. Ann. § 318:16-astatute
Standards for collaborative pharmacy practice agreements between a pharmacist, an attending practitioner, and a consenting patient.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
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 NH; the collaboration agreement governs the specifics. No schedule-specific quantity/duration limit for PAs was confirmed in this research pass (unlike NC's Schedule II 30-day-supply rule) — treat as unconfirmed rather than assuming no limit exists.
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 here: some (Permit Health) describe NH as requiring physician ownership/control of medical practices, while others (McLane Middleton) describe no CPOM prohibition at all and confirm physicians may be direct corporate employees. Treat entity-ownership structuring as an open item requiring counsel, not a settled fact.
Legal sources for these rules (4)
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.