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adopted, amended, readopted with amendments, or repealed many rules in Chapters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 defined 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)
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 orally, or in writing, to inspect
public records in person or by obtaining a photocopy of such records. A fee of $.25 per page shall be charged for
making photocopies of any document.
(b)
Requests for copies of public records should be addressed to the board's
administrator at the following address:
Board
of Medicine
Philbrook
Building
121
South Fruit Street
Concord,
(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.
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)
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 Draft Decisions.
(a)
Draft decisions shall not be binding upon the board. Changes in the form or the substance of a
draft decision may 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 may take action by telephone poll
or written ballot provided that such action is ratified at a subsequent meeting
of the board.
(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)
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 PRACTICE AND PROCEDURE
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 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. The source notes for rules renumbered by
these actions indicate the former rule number, and the document numbers and
effective dates apply to the rules under the former number.
PART
Med 201 INTRODUCTION AND DEFINITIONS
Med 201.01 Purpose. The board shall conduct various proceedings
for the purpose of acquiring sufficient information to make fair and reasoned
decisions on matters within its statutory jurisdiction, including decisions on applications
for licensure and complaints filed against licensees. These rules shall be construed to secure the
just, efficient and accurate resolution of all board proceedings.
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. #8944-A,
eff 7-18-07
Med
201.02 Definitions. Except where the context makes another
meaning manifest, the following words have the meanings indicated when used in
this chapter:
(a)
"Adjudicatory proceeding" means any proceeding in which the
rights, duties or privileges of a person are determined by the board, but does
not include nonadjudicatory investigations or rulemaking.
(b)
“Administrative prosecutions unit (APU)” means the administrative
prosecutions unit of the Office of the Attorney General.
(c)
“Board investigator” is a board employee or contractor who works with
the MRSC to conduct investigations.
(d)
"Complaint" means a written allegation of professional
misconduct against a licensee of the board.
(e)
"Data" means all information other than argument, including
oral or written descriptions, reports, maps, charts, drawings, photographs, audio
or video recordings, computer programs, or computer printouts.
(f)
“Disciplinary proceeding” means an adjudicative proceeding commenced by
the board for the purpose of examining alleged misconduct by a licensee.
(g)
“Expert reviewer” is a physician who is not a board of MRSC member who
is contracted to provide an expert review on a matter before the board.
(h)
"File" means to place a document in the actual possession of
the board.
(i)
"Hearing" means the receipt and consideration by the board of
data or argument, or both, by methods which are appropriate to the issues
presented and the position of the parties.
(j)
“Hearing counsel” means an individual appointed by the board to present
licensee misconduct allegations and denials of applications for licensure to
the board.
(k)
“Investigation” means a gathering of data by the board investigator or
MRSC concerning matters within its jurisdiction.
(l)
“Letter of concern” means a written letter from the board drawing the
licensee’s attention to specific acts or omissions that could place the
licensee at risk of future disciplinary action.
A letter of concern is non-disciplinary, confidential and is sent to the
licensee following a complaint and investigation pursuant to RSA 329:17, VII-a.
(m)
"Motion" means any request by a party to a proceeding for an
order relating to that proceeding.
(n)
"Order" means a document issued by the board:
(1) Establishing procedures to be followed in an
adjudicatory or nonadjudicatory proceeding;
(2) Granting or denying a petition or motion;
(3) Requiring a person to do, or to abstain from
doing, some thing; or
(4) Determining a person's rights to a license or
other privilege established by RSA 329 or the rules of this chapter.
(o)
"Petition" means any request to the board seeking an order or
any other action or relief, but does not include a license application, a
complaint against, or a motion.
(p)
“Physician investigator” means the physician appointed by the board,
subject to governor and council approval who works with the MRSC to assign and
investigate complaints as described in RSA 329:17, V-a.
(q) “Presiding officer” means the board member or
other individual to whom the board has delegated authority to preside over an
adjudicatory or other proceeding.
(r)
“Rulemaking” means the statutory procedures for the formulation of a
rule as set forth in RSA 541-A:3.
(s)
“Report of investigation (ROI)” is a report generated by the MRSC. The ROI contains a summary of the facts and
data gathered during the investigation and the recommendation of the MRSC for
resolution of the complaint.
(t)
“Settlement agreement” means a written order approved by the board
acknowledging consent of the licensee to enter stipulated facts and imposing
disciplinary actions consented to by the licensee to resolve certain
allegations of licensee misconduct. Once approved, a settlement agreement shall
become a public document in accordance with RSA 329:18-a, IV.
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. #8944-A,
eff 7-18-07; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 200); ss by #10125-A, eff 5-9-12
Med 201.03 Failure to Comply with Rules.
(a)
Failure to comply with the rules of this chapter shall be grounds for:
(1) Refusing to accept or admit a noncompliant
document for filing or refusing to consider a noncompliant oral petition or motion
where the document, petition or motion can not be amended to conform; or
(2) Accepting or admitting a noncompliant
application, petition or motion or exhibit on the condition that conformity with
specific procedural requirements be achieved by a specified date.
(b)
When a noncompliant pleading or other tendered information is not
accepted or admitted by the board, or when conditions for the acceptance or
admission of noncompliant information are not met, the board shall make a
decision on the pending matter without considering the noncompliant
information, unless the board notifies the parties that it has waived the rule
in accordance with Med 201.04.
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. #8944-A,
eff 7-18-07
Med 201.04 Waiver or Suspension of Procedural Rules.
The board, upon its own initiative or
upon the motion of any interested person, shall suspend or waive any procedural
requirement or limitation imposed by this chapter upon reasonable notice to
affected persons when it appears that the proposed waiver or suspension would
be lawful, and would be more likely to promote the fair, accurate and efficient
resolution of issues properly pending before the board than would adherence to
a particular procedural rule or rules.
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. #8944-A,
eff 7-18-07
PART
Med 202 APPEARANCES BEFORE THE BOARD
Med 202.01 Representatives.
(a)
Persons appearing before the board shall represent themselves or be represented
by an individual of good character who:
(1) Is an attorney holding a current and active New
Hampshire license who has filed a written appearance with the board containing
his or her business address and telephone number; or
(2) Is not a
(b)
Motions for leave to appear before the board shall:
(1) Briefly describe the proposed
representative's professional and character qualifications;
(2) Describe any other occasions where the
proposed representative has acted as a representative for another;
(3) Provide the proposed representative's daytime
address and telephone number; and
(4) Be signed by both the proposed representative
and the party who would be represented.
(c)
Corporations, partnerships and other legal entities which are not natural
persons shall be represented only by:
(1) An attorney licensed in
(2) An officer, director, or managing partner
with express and unqualified written authority to act on behalf of the entity concerning
the matter in question.
(d)
Nothing in this section shall be construed to permit the unauthorized
practice of law.
(e)
The board shall, after notice and opportunity for hearing, prohibit an
individual from acting as a representative upon a finding that the individual
has engaged in willful misconduct relating to representation before the board,
has violated rules or orders of the board, disrupted board proceedings or made
material misrepresentations to the board or a party to the proceedings.
(f)
Any prohibition or restriction issued under (d), above, shall apply only
to the board's proceedings, either pending or in the future, or any combination
thereof, as warranted by the circumstances of the case.
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, EXPIRES:
12-13-06
New. #8944-A,
eff 7-18-07; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 200)
Med 202.02 Hearing Counsel.
(a)
When a proceeding warrants the participation of an investigator or
prosecutor, the board shall designate a member of the APU, a member of the
MRSC, or other qualified person to act as hearing counsel in an investigation
or adjudication.
(b)
Persons appointed to act as hearing counsel shall not perform
adjudicative functions in the same case in which they perform investigative or
prosecutorial functions.
(c)
Hearing counsel shall have the status of a party in adjudicative proceedings,
but shall not initiate judicial review of a final board action.
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, EXPIREd12-13-06
New. #8944-A,
eff 7-18-07; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 200)
PART
Med 203 TIME PERIODS
Med 203.01 Computation of Time.
(a)
Any time period specified in this chapter shall begin with the day
following the act, event, or default, and shall include the last day of the
period, unless it is Saturday, Sunday, or state legal holiday, in which event
the period shall run until the end of the next day which is not a Saturday,
Sunday, or state legal holiday.
(b)
When the period prescribed or allowed is less than 7 days, intermediate
Saturdays, Sundays, and state legal holidays shall be excluded from the
computation.
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, EXPIRED12-13-06
New. #8944-A,
eff 7-18-07
Med 203.02 Change in Allowed Times.
(a)
Except where a time period is fixed by statute, the board shall, upon
motion or upon its own initiative, enlarge or shorten the time provided for the
filing of any document, or advance or postpone the time provided for the filing
of any document, or advance or postpone the time set for any oral hearing,
prehearing conference, or other activity, for the purposes of efficiency and
due process.
(b)
A motion for a change of time shall be granted upon a finding of due
diligence and probable injury to the moving party which outweighs any detriment
likely to be suffered by any other party to the proceeding or the public interest
responsibilities of the board.
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. #8944-A,
eff 7-18-07
Med 203.03 Limitations. A motion to change time shall not be filed
within 3 business days of the event in question.
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. #8944-A,
eff 7-18-07
PART
Med 204 FILING AND SERVICE OF DOCUMENTS
Med 204.01 Filing of Documents with the Board.
(a)
A document shall be considered filed when it is actually received at the
board's office in
(b)
All correspondence, filings, and other communications to the board shall
be addressed to the board's office in care of its administrator.
(c)
All petitions, motions, exhibits, memoranda or other documents filed in
connection with a request for board action shall be filed with an original and
11 copies, unless the board directs that a lesser number of copies be
furnished;
(d)
Only a single copy shall be filed of:
(1) Transmittal letters, requests for public
information, or other routine correspondence not directed at formal board
action;
(2) License applications; and
(3) Complaints against licensees.
(e)
Failure to furnish the required number of copies may result in the
tendered document being returned as unacceptable for filing.
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. #8944-A,
eff 7-18-07; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 200)
Med
204.02 Subscription and Veracity of
Documents.
(a)
All complaints, petitions, motions, and replies filed with the board
shall be signed and dated by the proponent of the document or, if the party
appears by a representative, by the representative.
(b)
License applications shall be signed only by the applicant.
(c)
The signature on a document filed with the board shall constitute a
certification that:
(1) The signor has read the document;
(2) The signor is authorized to file it;
(3) To the best of the signor's knowledge, information
and belief, there are good grounds to support it; and
(4) The document has not been filed for purposes
of delay or harassment.
(d)
A violation of the representations of (c), above, shall to the extent
consistent with justice and the statutes administered by the board, be grounds
for entering an order adverse to the party committing the violation.
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. #8944-A,
eff 7-18-07
Med 204.03 Service of Documents.
(a)
Complaints against licensees shall be filed with the board without
service upon the licensee against whom the allegations are made.
(b)
Applications, petitions for rulemaking and petitions for declaratory
rulings shall be filed with the board without service upon other persons. Provided, however, that when the relief
sought by a petition for rulemaking or a petition for declaratory ruling would
clearly and directly affect the interests of a person or group of persons, the
board shall, by order, require service upon the affected person or persons.
(c)
All objections, motions, replies, exhibits, memoranda, or other documents
filed in connection with a request for board action shall be served by the
proponent upon all interested parties by:
(1) Depositing a copy of the document in the
United States mail, first class postage prepaid, addressed to the last address
given to the board by the party being served, no later than the day the
document is filed with the board;
(2) Delivering a copy of the document in hand on
or before the date it is filed with the board; or
(3) Such other means as the board shall order.
(d) All notices, orders, decisions or other
documents issued by the board in the course of an adjudicatory proceeding shall
be served by the board upon all parties to the proceeding by either:
(1) Depositing a copy of the document, first class
postage prepaid, in the United States mail, addressed to the last address given
to the board by the party being served; or
(2) Delivering a copy of the document in hand to
the party.
(e)
When a party has appeared by a representative, service shall be upon the
representative. Provided, however, that
the board may order additional service upon a finding that such service would
facilitate the fair and efficient conduct of the proceeding.
(f)
Except for exhibits distributed at a prehearing conference or hearing, every
document filed with the board, and required to be served upon the parties to an
adjudicatory proceeding, shall be accompanied by a certificate of service,
signed by the person making service, attesting to the method and date of service,
and the persons served.
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. #8944-A,
eff 7-18-07
PART
Med 205 PLEADINGS
Med 205.01 Petitions.
(a)
The only pleadings permitted shall be petitions and replies to
petitions. Complaints against licensees
are a particular type of petition and shall be subject to the additional requirements
of Med 205.02. Application for license
shall not be considered petitions.
(b)
Petitions shall contain:
(1) The name and address of the petitioner;
(2) The name and address of the petitioner's
representative, if any;
(3) A concise statement of the facts which
warrant the relief requested from the board;
(4) The description of the action which the
petitioner wishes the board to take;
(5) A citation to any statutes, rules, orders, or
other authority which entitles the petitioner to have the board act as
requested; and
(6) The signature and date required by Med
204.02(a).
(c)
All replies to petitions shall contain:
(1) The name and address of the respondent;
(2) The name and address of the representative of
the respondent, if any;
(3) A statement admitting or denying each fact
alleged in the petition pursuant to Med 205.01(b)(3);
(4) A statement admitting or denying the
authority identified by the petitioner pursuant to Med 205.01(b)(5);
(5) A concise statement of any additional or
different facts which warrant the board acting in the manner requested by
the respondent;
(6) A citation to any statutes, rules, orders or
other authority, not identified in the petition, having a bearing upon the
subject matter of the petition;
(7) The action which the respondent wishes the
board to take; and
(8) The signature and date required by Med
204.02(a).
(d)
Replies shall be filed within 10 days from the date of the petition
unless otherwise ordered by the board pursuant to a request that due process
requires a longer period.
(e)
Any fact contained in the petition which is not denied in the reply,
shall be deemed admitted by the respondent.
A statement that the respondent lacks sufficient knowledge to admit or
deny shall be treated as a denial. The
petitioner shall be presumed to deny all allegations in the objection, and no
response shall be permitted to the reply.
(f)
In the case of a petition by a licensee for removal of a letter of
concern from his or her file, the board shall not consider removal of letter
unless presented with clear and convincing evidence that counters the board’s
basis for issuing the letter of concern.
Such evidence shall be included with the licensee’s petition. If petition is denied, a copy of the petition
shall remain in his or her file.
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. #8944-A,
eff 7-18-07; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 200)
Med 205.02 Complaints of Licensee Misconduct.
(a)
Complaints alleging misconduct by licensees in violation of RSA 329:17,
II or Med 500 shall be in writing and filed at the board's offices in Concord,
New Hampshire.
(b)
A complaint shall contain the following:
(1) The name and address of the complainant;
(2) The name and business address of the licensee
against whom the complaint is directed;
(3)
The specific facts and circumstances which are believed to constitute
professional misconduct; and
(4) The signature and date required by Med
204.02(a).
(c)
A complaint shall be treated as a
request for the initiation of disciplinary proceedings by the board. Complaints shall be exempt from public
disclosure provisions in accordance with RSA 329:18, I. However, should the board find that a threat
to public health, safety or welfare exists, the board may seek an emergency
suspension of license pursuant to Med 409 and shall notify the licensee’s
employer, administrator or hospital chief where the licensee holds hospital
privileges.
Source. #4970, eff 11-8-90; ss by #5223, eff 9-12-91;
ss by #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED 12-13-06
New. #8944-A,
eff 7-18-07; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 200)
Med 205.03
Investigations.
(a)
Upon receipt of a complaint, the board’s investigator shall review the
complaint as follows:
(1) If the complaint does not comply with Med 205.02(b),
is facially invalid or fails to allege misconduct, it shall be forwarded to the
board for a decision; and
(2)
If the complaint is in compliance with
Med 205.02(b) and makes an allegation of misconduct:
a. The board investigator shall forward the
complaint to any licensee who is identified in the complaint to request a
response and any other data that is necessary based on the initial review of
the complaint;
b. The licensee(s) shall respond to the request
for information within 30 days of receipt of the request, unless an extension
is granted for good cause;
c. The board investigator shall obtain any
necessary records;
d. If deemed necessary by the MRSC,
investigations in which there is a contemporaneous criminal investigation,
imminent danger to patient safety, or concern about the destruction of
evidence, shall be conducted on an ex parte basis; and
e. Should the MRSC be unable to gather
information during the course of an informal investigation, a motion may be
made to the board to authorize a formal investigation. The motion shall avoid disclosure of any
facts other than those necessary to explain the inability of the MRSC to gather
the needed information.
(b)
Upon receipt of the licensee’s response, the board investigator shall
forward the complaint and response to the MRSC.
The physician investigator in consultation with the chair of the MRSC
shall assign the case to a member of the MRSC for review and further
investigation. If no member of the MRSC
is able to review the complaint, the MRSC shall appoint another qualified
person to conduct an investigation. The
MRSC shall make inquiry of any person and otherwise gather data in order to
fully investigate the possible violation of any board rule or statute. The type, form and extent of an investigation
shall be determined by the need to examine acts of possible misconduct.
(c)
The MRSC shall conduct regular meetings to address the investigation of
complaints. In December of each year, the MRSC shall
elect one of its members to chair the MRSC meetings for the coming year.
Source. #9900, eff 4-12-11
(see Revision Note at chapter heading for Med 200); ss by #10125-A, eff 5-9-12
Med 205.04 Motions and Objections Thereto.
(a)
Unless presented during an oral session of a proceeding, all motions and
objections shall be in writing.
(b)
All motions shall state clearly and concisely:
(1) The purpose of the motion;
(2) The relief sought by the motion;
(3) The statutes, rules, orders, or other
authority authorizing the relief sought by the motion;
(4) The facts claimed to constitute grounds for
the relief requested by the motion; and
(5) The signature and date required in Med
204.01(a).
(c)
Objections to motions shall state clearly and concisely:
(1) The defense of the party filing the
objections;
(2) The action which the party filing the
objection wishes the board to take on the motion;
(3) The statutes, rules, orders, or other
authority relied upon in defense of the motion;
(4) Any facts which are additional to or different
from the facts states in the motion; and
(5) The signature and date required by Med
204.01(a).
(d)
An objection to a motion shall specifically admit or deny each fact
contained in the motion. Failure to deny
a fact contained in a motion shall constitute the admission of that fact for
the purposes of the motion. In the event
a party filing an objection to a motion lacks sufficient information to either
admit or deny a fact contained in the motion, the party shall so state,
specifically identifying such fact.
(e)
Unless otherwise ordered by the board, motions shall be decided upon the
writings submitted. Repetitious motions
shall not be submitted.
(f)
Unless otherwise ordered by the board, objections to motions shall be
filed within 10 days after the filing of the motion. Failure to object to a motion within the time
allowed shall constitute a waiver of objection to the motion.
Source. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED 12-13-06
New. #8944-A,
eff 7-18-07;
renumbered by #9900 (from Med 205.03) (see Revision Note at chapter heading for
Med 200)
PART
Med 206 ADJUDICATORY PROCEEDINGS
Med 206.01 Applicability. This part shall govern all proceedings
conducted by the board except rulemaking and investigations.
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. #8944-A,
eff 7-18-07; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 200)
Med 206.02 Commencement.
(a)
The board shall commence an adjudicatory proceeding by issuing a notice
of hearing to the respondent, respondent’s counsel if an appearance has been
filed, hearing counsel, the board’s counsel at the Department of Justice, and,
in the case where a complaint was received in compliance with Med 205.02(b), to
the complainant at least 15 days before the first scheduled hearing date or
first prehearing conference.
(b)
The adjudicatory proceeding shall be heard by the board or a panel of
the board with a minimum of 3 members appointed by the board president. The panel for a hearing on a physician
licensee shall consist of a minimum of 2 physicians and one public member. The panel for a hearing on a physician
assistant licensee shall consist of a minimum of one physician, one public
member, and, if possible, one physician assistant.
(c)
The notice commencing an adjudicatory proceeding shall:
(1) Identify the parties to the proceeding as of
the date of the order and specify a deadline for the submission of petitions to
intervene;
(2) Briefly summarize the subject matter of the
proceeding, and identify the issues to be resolved;
(3) Specify the legislative authority for the
proposed action, and identify any applicable board rules;
(4) Specify the date by which, and the address
where, appearances or motions by representatives shall be filed;
(5) Specify the date, time, and location of an
initial prehearing conference or dates for an oral hearing;
(6) Identify the presiding officer for the
proceeding, if other than the president of the board;
(7) Identify any special procedures to be
followed;
(8) Identify any confidentiality requirements
applicable to the proceeding;
(9) Include a statement that each party has the
right to have an attorney present to represent the party at the party’s expense;
(10) Include a statement that each party has the
right to have the agency provide a certified shorthand court reporter at the
party’s expense and that any such request be submitted in writing at least 10
days prior to the proceeding; and
(11) Contain such other information or attachments
as the circumstances of the case may warrant including, but not limited to,
orders consolidating or severing issues in the proceeding with other
proceedings, and orders directing the production or exchange of documents.
Source. #4970, eff 11-8-90; amd by #5838, eff
6-17-94; ss by #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED 12-13-06
New. #8944-A,
eff 7-18-07; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 200)
Med 206.03 Docketing, Service of Notice, Public
Notice.
(a)
The board shall assign each adjudicatory proceeding a docket number, and
serve the hearing notice upon all parties to the proceeding and the board's
legal counsel in the civil bureau, department of justice. The hearing notice shall be served upon the
respondent, and the complainant, if any, by means of certified mail.
(b)
Service of all subsequent orders, decisions and notices issued by the
board, including any amendments to the hearing notice, shall be served upon the
parties, and any intervenors, by regular mail.
(c)
Orders, notices, and decisions of the board, and motions, memoranda,
exhibits, and other documents and data submitted to the board in a docketed
case shall be kept in a docket file and made available for public inspection in
the board's office except to the extent that confidentiality has been otherwise
provided for by law.
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. #8944-A,
eff 7-18-07
Med 206.04 Intervention.
(a)
Petitions for intervention shall state with particularity:
(1) The petitioner's interest in the subject
matter of the hearing;
(2) The petitioner's position with respect to the
subject matter of the hearing;
(3) Why the interests of the parties and the
orderly and prompt conduct of the proceeding would not be impaired; and
(4) Any other reasons why the petitioner should
be permitted to intervene.
(b)
Petitions for intervention shall be granted if the petitioner has a
substantial interest in the proceeding and has been diligent with respect to
requesting intervention, and if the petitioner's participation will not
prejudice a party or unduly delay the proceeding.
(c)
Petitions for intervention shall be granted subject to appropriate conditions
or limitations which shall be subject to modification by the board at any time
during the proceeding.
(d)
Once granted leave to intervene, an intervenor shall take the proceeding
as he or she finds it and no portion of the proceeding shall be repeated
because of the fact of intervention.
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. #8944-A,
eff 7-18-07
Med 206.05 Right to Counsel. Any party in an adjudicatory proceeding may
be represented by counsel, but an attorney appearing on behalf of a party shall
first file a letter announcing the fact of representation at the earliest date
practical. Parties shall retain counsel
at their own expense and requests for appointment of counsel shall not be
entertained.
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. #8944-A,
eff 7-18-07
Med 206.06 Prehearing and Other Informal Conferences.
(a) At any time following the commencement of an
adjudicatory proceeding, the presiding officer, upon motion, or upon his or her
own initiative, direct all interested parties to attend one or more prehearing
conference to aid in the disposition of the proceeding.
(b)
Matters which can be addressed at a prehearing conference shall include:
(1) Opportunities and procedures for settlement;
(2) Opportunities and procedures for
simplification of the issues;
(3) Possible admissions of fact and of documents to
avoid unnecessary proof;
(4) Possible limitations on the number of
witnesses;
(5) Possible changes to the standard procedures
which would otherwise govern the proceeding;
(6) The distribution of written testimony, if
any, and exhibits to the parties;
(7) Possible consolidation of the examination of
witnesses by the parties; and
(8) Any other matters which might contribute to
the prompt, fair and orderly conduct of the proceeding.
(c)
The board shall cause prehearing conferences to be recorded unless all
parties wish to discuss possible settlement off the record. Matters decided at
a prehearing conference shall be reflected in an appropriate order.
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. #8944-A,
eff 7-18-07
Med 206.07 Discovery and Disclosure.
(a)
Upon the written request of a party, the board shall disclose to the
parties to a proceeding, any information, not privileged, in the possession of
the board, which is related to the subject matter of the proceeding. Privileged information shall be disclosed
when required by RSA 329:18, I. Neither
the board nor any officer or employee thereof, shall be subject to further
discovery.
(b)
Any party wishing discovery against another party, shall, by motion,
seek leave to do so and shall identify the exact type of discovery requested.
(c)
Discovery shall be permitted when it appears that:
(1) The parties cannot adequately address the
factual issues at the time fixed for the presentation of evidence without an
opportunity to acquire data pursuant to discovery;
(2) The requested method of discovery is
reasonable and will not cause material unfairness or unreasonable expenses to
any party; and
(3) The requested discovery will not unreasonably
delay the proceeding.
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. #8944-A,
eff 7-18-07
Med 206.08 Subpoenas.
(a)
Subpoenas for the attendance of witnesses or the production of evidence
in board investigations or adjudicatory proceedings shall be issued by the
MRSC, the board investigator, or upon the order of the board. In adjudicatory proceedings, a party
requesting the board, the MRSC, or the board investigator to authorize a subpoena
shall attach a copy of the proposed subpoena to its motion. If the motion is granted, the requesting
party shall be responsible for the service of the subpoena and payment of any
applicable witness fee and mileage expenses.
(b)
The person to whom the subpoena is directed may, within 7 days after
service of the subpoena, or before the date specified in the subpoena for
compliance therewith, whichever is later, file a motion to quash or modify the
subpoena. If the board denies the motion
to quash or modify, in whole or in part, the person to whom the subpoena is
directed shall comply with the subpoena, or any modification thereof, within
the balance of time prescribed in the subpoena or within 3 days from the date
of the board's order, whichever is greater, unless the board expressly provides
additional time to comply as due process requires.
(c)
A subpoena shall be served in any manner authorized by law. The date, time, and method of service shall
be written on the reverse of the original copy of the subpoena by the person
making service who shall then file that copy with the board.
(d)
Should any person fail to comply with a subpoena issued pursuant to this
section, the board shall take one or more of the following actions:
(1) Impose sanctions specific to any pending proceeding
or investigation, including, but not limited to, entry of a default judgment as
to some or all of the pending issues which is adverse to the noncompliant
party;
(2) Institute a separate investigation against
any noncompliant individual who is subject to the board's jurisdiction; or
(3) Direct an interested party to seek judicial
enforcement of some or all of the subpoena.
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. #8944-A,
eff 7-18-07; ss by #9900, eff
4-12-11 (see Revision Note at chapter heading for Med 200)
Med 206.09 Evidence.
(a)
Proceedings shall not be conducted under the rules of evidence, but the
evidentiary privileges recognized by the law of
(b)
All data which will reasonably assist the board to arrive at the truth
shall be admissible, but data which is irrelevant or immaterial; unduly
repetitious or cumulative; or needlessly insulting or scandalous shall be
excluded.
(c)
The board shall permit that some or all of the evidence be submitted in
written form, but oral testimony shall be required when necessary to allow
appropriate cross examination, to avoid material prejudice or to permit full
and fair disclosure of disputed material facts.
(d)
If the board officially notices a fact, it shall so state, and permit
any party, upon timely request, the opportunity to show the contrary.
(e)
Witnesses appearing before the board shall testify under oath or
affirmation.
(f)
The board shall cause an audio tape or stenographic record to be made of
hearings and prehearing conferences. This
record shall be transcribed upon the request of a party who pays the estimated
cost of transcription in advance. Provided, however, that if the board elects
to transcribe some or all of the record for its own use, the transcribed
portions shall be included in the public docket file. The record of the proceeding shall be made by
a certified shorthand court reporter, if requested, pursuant to RSA 541-A:31,
VII-a.
Source. #4970, eff 11-8-90, amd by #5223, eff
9-12-91; ss by #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED 12-13-06
New. #8944-A,
eff 7-18-07
Med 206.10 Burden of Proof.
(a)
The party asserting the affirmative of a proposition shall have the
burden of proving the truth of that proposition by a preponderance of the
evidence.
(b)
Without limiting the generality of paragraph (a), above, all moving
parties and all petitioners shall have the burden of persuading the board that
their motion or petition should be granted.
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. #8944-A,
eff 7-18-07
Med 206.11 Methods of Proceeding.
(a)
Where facts material to the subject matter of the proceeding are in
dispute, and personal observation of witnesses or the immediate opportunity for
cross-examination of witnesses is necessary or desirable, the proceeding shall,
to that extent, consist of a trial-type evidentiary hearing with the subsequent
submission of memoranda;
(b)
Where facts material to the subject matter
of the proceeding are in dispute, but personal observation of the
witnesses or the immediate opportunity for cross-examination of witnesses is
not required, some or all of the proceeding may, to that extent, consist of the
subsequent submission of affidavits and memoranda;
(c)
Where no facts material to the subject matter of the proceeding are in
dispute, the proceeding shall to that extent be limited to the submission of
memoranda wherein are argued the conclusions the parties wish the board to draw
from said facts.
(d) Oral argument other than a brief opening and a closing statement shall be permitted only when requested in a written motion which demonstrates a substantial need for
such a procedure. Written argument in the form of legal briefs or memorandum shall be permitted
subject to such filing schedules established by the board.
(e)
The foregoing paragraphs shall not limit the board's authority to
structure a proceeding in a manner suitable to its subject matter and
recognized due process requirements, or to require the submission of additional
data at any time.
(f)
As applicable, an order scheduling a supplemental hearing shall be issued
by the presiding officer or board at any time prior to the issuance of a final
order in the proceeding.
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. #8944-A,
eff 7-18-07
Med 206.12 Inquiry By Presiding Officer. The presiding officer, and board members or
board advisors recognized by the presiding officer, shall question witnesses
and make such inquiry of witnesses, parties or counsel, as he or she believes
necessary to develop a sound record for decision.
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. #8944-A,
eff 7-18-07
Med 206.13 Proposed Findings of Fact and Conclusions
of Law.
(a)
Any party may request leave to submit proposed findings of fact and
conclusions of law, but the submission of such findings shall be reserved to
the presiding officer's discretion.
(b)
The presiding officer shall direct any party to submit proposed findings
of fact and conclusions of law if the presiding officer believes proposed
findings or conclusions would be helpful in deciding the case. If such an order is issued, the board shall
include individual rulings upon such proposed findings or conclusions as part
of its final decision.
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. #8944-A,
eff 7-18-07
Med 206.14 Exparte Communications. Once a notice of hearing has been issued
commencing an adjudicatory proceeding, no party shall communicate with any
participating board member, the presiding officer, or any advisor to these
persons, concerning the merits of the case except upon notice to all parties
and in accordance with the rules of this chapter. Nor shall any party cause another person to
make such communications or otherwise engage in conduct prohibited by RSA 541-A:36.
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. #8944-A,
eff 7-18-07
Med 206.15 Disciplinary Hearings.
(a)
The board, or the presiding officer, shall also set forth the particular
scheduling and filing requirements applicable to each case and include them in
a hearing order, prehearing order, or other appropriate order served upon the
parties.
(b)
Misconduct allegations set forth in a hearing notice may be amended at
any time prior to the issuance of a final order. Provided, however, the parties shall receive
at least 15 days notice and an opportunity to be heard on any amended issues.
(c)
If ordered to do so by the presiding officer or board, the licensee
shall respond in writing to stated misconduct allegations by admitting or
denying each allegation within a reasonable time period specified by the
board. Failure to respond shall result
in an order of default, including disciplinary sanctions, against the licensee,
unless the licensee can show that the failure to respond was due to reasons
beyond their control, such as accident, illness or death of an immediate family
member.
(d)
The board shall, when necessary, at any time during the course of a
disciplinary hearing, appoint an attorney to investigate and prosecute misconduct
allegations in furtherance of the public protection features of RSA 329. The decision to appoint an attorney to
investigate and prosecute misconduct allegations to the discretion of the board
and shall not be the subject of a motion by any party.
(e)
Notices of hearing and other procedural orders of the board in
disciplinary proceedings shall be public documents, and prehearing conferences
in disciplinary proceedings shall be open to the public except to the extent
that settlement discussions or other matters entitled to confidentiality are
addressed.
Source. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8944-A,
eff 7-18-07
PART
Med 207 PRESIDING OFFICER
Med 207.01 Designation.
(a)
Adjudicatory proceedings commenced by the board shall be conducted by a
presiding officer.
(b)
The board president shall serve as presiding officer or shall designate
another qualified person to so serve.
(c)
The board may, at any time, and without notice or hearing, replace the
presiding officer.
Source. #4970, eff 11-8-90, EXPIRED: 11-8-96
New. #6517, eff 5-30-97
New. #8662, INTERIM, eff 6-16-06, EXPIRED: 12-13-06
New. #8944-A,
eff 7-18-07
Med 207.02 Authority of Presiding Officer.
(a)
Except as otherwise provided by the board, the presiding officer shall
possess all authority with respect to the procedural aspects of adjudicatory
proceedings which would be possessed by the board itself, including, but not
limited to, the power to administer oaths and affirmations, direct the course
of the proceeding, and decide procedural and discovery issues.
(b)
Except as provided by Med 207.04, the presiding officer shall receive no
testimony or oral argument on the merits
of the case unless a majority of the board members eligible to participate in
the proceeding, including the presiding officer, are present. Board members need not be present during
prehearing conferences or arguments on procedural or discovery motions.
(c)
Except in proceedings conducted pursuant to Med 207.04, the presiding
officer shall be consistent with the fair and orderly conduct of the
proceeding, permit board members who are present during any stage of an
adjudicatory proceeding to make reasonable inquiries of the parties and the witnesses.
(d)
The presiding officer shall not accept final offers of settlement or
impose consent decrees, but may assist the parties in reaching settlements. When a settlement has been proposed in
writing, the presiding officer shall refer it to the board for decision, but
shall not stay the proceeding while the board is deliberating on the settlement
proposal.
(e)
The presiding officer shall not decide motions or enter orders which
finally resolve the proceeding or stay the proceeding for more than 60
days. Potentially dispositive motions
may be referred to the board immediately or deferred until the close of the
record, in the sole discretion of the presiding officer.
(f)
If the presiding officer believes that a default or similar final order
should enter against a party, the presiding officer shall issue a written recommendation
to the board, with service on the parties, and the board shall take appropriate
action after allowing the parties 10 days to file objections thereto.
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. #8944-A,
eff 7-18-07
Med 207.03 Exceptions to Interlocutory Rulings by the
Presiding Officer.
(a)
There shall be no interlocutory appeal to the board of procedural or
discovery orders made by the presiding officer.
Contemporaneous exceptions to such rulings shall be unnecessary to
preserve the objections of any party adversely affected.
(b)
The parties may include objections to an adverse ruling of a presiding
officer in any exceptions they may take to a proposed decision under Med
207.04. When a proposed decision is not
issued, such objections shall be presented to the board as a motion or as part
of a closing memorandum submitted within 10 days from the close of the hearing
or such further period as the presiding officer may allow.
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. #8944-A,
eff 7-18-07
Med 207.04 Proposed Decisions By Presiding Officer.
(a)
The board may direct that evidence be received solely by a presiding
officer who shall be charged with preparing a written decision with
recommendations for the final disposition of the case and any pending
motions. Such decision shall be known as
proposed decision, and shall be served upon the parties and the board.
(b)
The parties may file exceptions and supporting memoranda of law for
review by the board within 30 days from the date the proposed decision was
served. Replies to exceptions and reply
memoranda may be filed within 15 days from the date of the document being replied
to.
(c)
If a party wishes to present oral argument to the board it shall file a
separate motion for oral argument within the time allowed for filing exceptions
or replies to exceptions.
(d)
If no exceptions are filed to a proposed decision, the board may, within
10 days following the deadline for filing exceptions, issue an order announcing
that the proposed decision shall be reviewed by the board on its own
motion. If no exceptions are filed and
the board does not take such action, the proposed decision shall automatically
become the final decision of the board on the 41st day following the date it
was served upon the parties.
(e)
When the board has directed a presiding officer to receive evidence and
enter a proposed decision, there shall be no communications between the
presiding officer and the board members concerning the merits of the case, and
the board members shall not participate in the questioning of witnesses at the
hearing, as would otherwise be permitted by Med 206.12.
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. #8944-A,
eff 7-18-07
PART
Med 208 RECONSIDERATION AND STAY
Med 208.01 Motion for Reconsideration or Rehearing.
(a)
An adjudicatory order of the board, or, an order denying a petition for declaratory
ruling or rulemaking, shall not be final until the date it is served upon the
parties pursuant to Med 204.03(d).
(b)
Within 30 days after service of a final adjudicatory order, any party
may file a motion for reconsideration which, if the action is subject to
judicial review under RSA 541, shall serve as a petition for rehearing under
that statute. No distinction shall be
made between the terms "reconsideration" and "rehearing."
(c)
A motion for reconsideration of a proposed board rule shall be filed
within 30 days after the filing of a final proposal under RSA 541-A:12. Motions for reconsideration shall not be
accepted for orders adopting emergency or interim rules filed under RSA
541-A:18 or RSA 541-A:19, or for final rules modified in response to
legislative committee objections pursuant to RSA 541-A:13, V(b).
(d)
A motion for reconsideration shall:
(1) Include any memorandum of law the moving
party wishes to submit;
(2) Identify each error of fact, error of
reasoning, or erroneous conclusion contained in the final order which the
moving party wishes reconsidered; and
(3) Concisely state the correct factual finding,
correct reasoning, and correct conclusion urged by the moving party.
(e)
The board shall grant or deny the motion, or any part thereof, on its
merits, to the extent the motion has revealed errors of law, fact or policy in
the board's prior decision. The board shall
also treat the motion as one for reopening and order the receipt of such
additional data or additional argument when necessary to consider newly
discovered evidence or cure alleged procedural errors.
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. #8944-A,
eff 7-18-07; amd by #9900, eff
4-12-11
Med 208.02 Reconsideration on the Board's Own Motion.
(a)
Within the time frame specified in Med 208.01(b), the board may
reconsider, revise or reverse any final action on its own motion. If such action is based upon the existing
record, prior notice shall not be given to the parties.
(b)
If the board believes further argument or data should be considered, an
appropriate order providing the parties with notice and an opportunity to be
heard shall be issued before any revision is made in the board's previous
action.
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. #8944-A,
eff 7-18-07
Med 208.03 Stay of Board Orders.
(a)
A stay of board action shall be specifically requested. The mere filing of a motion for
reconsideration shall not operate as a stay of any order, but a motion for stay
may be combined with a motion for reconsideration.
(b)
A motion for stay shall be considered only if it is filed within the
time period for requesting reconsideration specified by Med 208.01(a), and
shall demonstrate good cause sufficient to warrant the stay of an action by the
(c)
The board, acting on its own motion, may stay the effect of any final
order within the time period specified in subparagraph (b), above, with or
without issuing a corresponding order to reconsider or reopen the proceeding.
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. #8944-A,
eff 7-18-07
PART
Med 209 CONSOLIDATION AND SEVERANCE
Med 209.01 Consolidation. Whenever it shall appear to the board, upon motion
or its own initiative, that 2 or more proceedings involve substantially similar
or substantially related issues, the board shall, as fairness and efficiency
permit, consolidate those proceedings for hearing, or decision, or both.
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. #8944-A,
eff 7-18-07
Med 209.02 Severance. Whenever it shall appear to the board, upon
motion or its own initiative, that injury to the substantial rights of a party
or undue delay may be thereby avoided, the board shall, as fairness, accuracy
and efficiency permit, sever one or more issues from a proceeding, and dispose
of those issues in another proceeding.
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. #8944-A,
eff 7-18-07
PART
Med 210 RULEMAKING
Med 210.01 How Adopted. A board rule, or any amendment or repeal thereof,
shall be adopted by order after notice and opportunity for a legislative-type
hearing as provided by RSA 541-A11.
Rules shall be proposed by petition or by the board acting on its own motion.
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. #8944-A,
eff 7-18-07;
renumbered by #9900 (from Med 211.01) (see Revision Note at chapter heading for
Med 200)
Med 210.02 Petition for Rulemaking.
(a)
Any person may request the board to commence a proceeding for the
purpose of adopting, amending, or repealing a rule by filing a petition which
contains:
(1)
A statement of the petitioner's interest
in the subject matter of the proposed rule;
(2) The text of the proposed rule or a statement
of the particular results intended by the petitioner to flow from the implementation
of the proposed rule;
(3) If the petitioner proposes to amend or repeal
an existing rule, an identification of the particular rule sought to be amended
or repealed; and
(4) Any data or argument the petitioner believes
would be useful to the board in deciding whether to commence a rulemaking
proceeding.
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. #8944-A,
eff 7-18-07;
renumbered by #9900 (from Med 211.02) (see Revision Note at chapter heading for
Med 200)
Med 210.03 Disposition of Petition.
(a)
The board shall, by order, grant or deny a petition for rulemaking. Before issuing that order, however, the board
may require additional data or argument from the petitioner or other interested
persons.
(b)
The board shall grant the petition for rulemaking unless the adoption,
amendment or repeal sought would result in:
(1) A rule that is not within the rulemaking
authority of the board;
(2) Duplication of a rule or of a statutory
provision;
(3) Inconsistency between the existing rules and
the statutory mandate of the board;
(4) Inconsistency of one administrative rule with
another; or
(5) Negatively impacting the board’s ability to
carry out the mandates of RSA 329.
(c) If the petition is denied, the board shall
state the reason therefore in the order.
If the petition is granted, the board shall undertake to commence a
rulemaking proceeding in accordance with RSA 541-A:3.
(d)
Within 30 days of receipt of a sufficient petition the board shall
dispose of it in the following manner:
(1) By notifying the petitioner that the petition
is granted and beginning rulemaking proceedings as required by RSA 541-A:4; or
(2) By notifying the petitioner in writing that
the petition is denied and the reasons for its denial.
(e)
The denial of a petition for rulemaking shall not entitle the petitioner
to a hearing.
Source. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8944-A,
eff 7-18-07;
renumbered by #9900 (from Med 211.03) (see Revision Note at chapter heading for
Med 200)
Med 210.04 Commencement of Rulemaking Proceeding.
The board shall commence a rulemaking
proceeding by following the procedures set forth in RSA 541-A: 3 et seq.
Source. #6517, eff 5-30-97, EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8944-A,
eff 7-18-07;
renumbered by #9900 (from Med 211.04) (see Revision Note at chapter heading for
Med 200)
PART
Med 211 WAIVER OF SUBSTANTIVE RULES
Med 211.01 Petitions for Waiver.
(a)
Any interested person may request the board to waive any rule not
covered by Med 201.04 by filing an original and two copies of a petition
pursuant to Med 205.01(b) which clearly identifies the rule in question and
sets forth specific facts and arguments which support the requested
waiver. No statutory requirements shall
be waived.
(b)
Petitions for waivers of substantive rules shall address whether:
(1) Adherence to the rule would cause the petitioner
hardship;
(2) The requested waiver is necessary because of
any neglect or misfeasance on the part of the petitioner;
(3) Waiver of the rule would be consistent with
the statues and regulatory programs administered by the board;
(4) Waiver of the rule would injure third
persons; and
(c)
If examination of the petition reveals that the proposed relief might
substantially affect other persons, the board shall require service of the
petition on such persons and advise them that they may file a reply to the
petition pursuant to Med 205.01(c).
(d)
The petitioner shall provide such further information or participate in
such evidentiary or other proceedings, as ordered by the board after reviewing
the petition and any replies received.
(e)
A petition for waiver of a rule which does not allege material facts,
which, if true, would be sufficient to support the requested waiver, shall be
denied without prior notice or further hearing.
(f)
The board shall initiate a waiver or suspension of a substantive rule
upon its own motion by providing affected parties with notice and an
opportunity to be heard, and issuing an order which finds that waiver would be
consistent with the criteria of (b), above.
(g)
For the purposes of this section, good cause shall be deemed to exist
if, at a minimum, the petitioner has demonstrated that:
(1) Adherence to the rule would cause the
petitioner hardship;
(2) Waiver or suspension of the rule would be
consistent with the statutes and regulatory programs administered by the
department;
(3) Waiver or suspension of the rule would not
injure third persons; and
(4) Waiver or suspension is necessary due to
factors outside the control of the petitioner.
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. #8944-B, eff 7-18-07; renumbered by #9900 (from
Med 212.01) (see Revision Note at chapter heading for Med 200)
PART
Med 212 DECLARATORY RULINGS
Med 212.01 Petitions for Declaratory Rulings.
(a)
Any interested person may request a declaratory ruling from the board on
matters within its jurisdiction by filing an original and 10 copies of a
petition pursuant to Med 205.01(b).
(b)
Such a petition shall also set forth the following information:
(1) The exact ruling being requested;
(2) The statutory and factual basis for the
ruling;
(3) A statement as to how and why the issuance of
a ruling on this subject would benefit the petitioner, other interested persons,
and the public at large, and
(4) The identity, including mailing addresses
when reasonably available, of specific persons whose interests would be
affected by the issuance or nonissuance of the ruling in question.
Source. #5785, eff 2-4-94; ss by #6517, eff 5-30-97,
EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED:
12-13-06
New. #8944-A,
eff 7-18-07;
renumbered by #9900 (from Med 213.01) (see Revision Note at chapter heading for
Med 200)
Med 212.02 Action on Petitions for Declaratory
Rulings.
(a)
If examination of a petition for declaratory ruling reveals that other
persons would be substantially affected by the proposed ruling, the board shall
require service of the petition on such persons and advise them that they may
file a reply pursuant to Med 205.01(b).
(b)
The petitioner and any persons served with notice of the petition shall
provide such further information or participate in such evidentiary or other
proceedings as the board may direct after reviewing the petition and any
replies received.
(c)
The board shall have no obligation to issue a declaratory ruling in response
to a particular petition.
(d)
Petitions shall be denied when:
(1) The ruling would inappropriately impact upon
pending administrative, judicial or legislative proceedings; or
(2) Other procedural options are available to the
interested parties or the board.
Source. #5785, eff 2-4-94; ss by #6517, eff 5-30-97,
EXPIRED: 5-30-05
New. #8662, INTERIM, eff 6-16-06, EXPIRED: 12-13-06
New. #8944-A,
eff 7-18-07;
renumbered by #9900 (from Med 213.02) (see Revision Note at chapter heading for
Med 200)
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 5 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
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
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 f