CHAPTER Pod 100
ORGANIZATION, DEFINITIONS AND PUBLIC INFORMATION
PART Pod 101
PURPOSE AND SCOPE
Pod
101.01 Purpose and Scope. The rules of this title implement the
statutory responsibilities of the New Hampshire board of podiatry under RSA
315.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
PART Pod 102
DEFINITIONS
Pod
102.01 Terms Used. As used in these rules, the following terms
shall have the meanings indicated:
(a) "Administrative assistant" means
the board's staff director who assists the board in performing the functions
specified in RSA 315:5 and such other duties as the board prescribes.
(b) "Board" means the New Hampshire
board of podiatry created by RSA 315:1.
(c) "Clearance" means a verification
from another state board stating that the applicant's license is current and in
good standing.
(d) "Disciplinary proceeding" means an
adjudicatory proceeding commenced by the board for the purpose of examining
possible professional misconduct by a licensee.
(e) "Practice of podiatry" means the
diagnosis and treatment of ailments of the human foot and lower leg by any
medical, mechanical, electrical and surgical means available.
(f) "Podiatrist" means a doctor of
podiatric medicine holding a license to practice podiatry issued by the board
under RSA 315:8.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
PART Pod 103
AGENCY ORGANIZATION
Pod
103.01 Composition of the Board. The board consists of 5 members who meet the
eligibility requirements of RSA 315:1.
The board is made up of 4 licensed podiatrists and one member who is a
representative of the general public and is unconnected with the podiatry
profession.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
Pod
103.02 Duties of the Board. The duties of the board include, but are not
limited to:
(a) Examination and licensing of podiatrists;
(b) Oversight and discipline of licensees;
(c) Development of ethical and other professional
standards to be followed by licensees;
(d) Development of continuing professional
education requirements and other prerequisites for the renewal or reinstatement
of licenses;
(e) Study and preservation of information
concerning the practice of podiatry; and
(f) Identification and prevention of the
unauthorized practice of podiatry.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
Pod
103.03 Staff. The board employs an administrative assistant
and such other staff members as are necessary to assist with the record-keeping
and other statutory functions of the board and oversee the board's day-to-day
operations.
Source. #5391, eff
5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
Pod
103.04 Office Hours, Office Location,
Mailing Address and Telephone.
(a) The board's offices are located at:
Philbrook Building
121 South Fruit Street
Concord, New Hampshire 03301.
(b) The board’s offices are open to the public
Monday through Friday, excluding holidays, from 8:00 a.m. to 4:00 p.m.
(c) Correspondence shall be addressed to the
board's administrative assistant at the location stated in Pod 103.04(a).
(d) The board's telephone number is (603)
271-1203.
Source. #7816,
eff 1-7-03
PART Pod 104
PUBLIC INFORMATION
Pod
104.01 Record of Official Actions. Minutes shall be kept of all board meetings
and all official actions taken by the board.
These minutes shall record those members who participate in each vote
and shall separately record the position of any members who choose to dissent,
abstain or concur. Board minutes of actions which are not confidential under RSA 91-A:3, II or
RSA 91-A:5 shall be public records and shall be available for inspection during
the board's ordinary office hours within 144 hours from the close of the
meeting or vote in question.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
Pod
104.02 Custodian of Records. The board's administrative assistant shall be
the custodian of its records and shall respond to requests to examine those
portions of the board's records which are subject to public inspection or which
may otherwise be properly examined by the person requesting access.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
Pod
104.03 Copies of Records. Persons desiring
copies of board records shall make a request which identifies as particularly
as possible the information being sought and which agrees to pay the board's
copying fee of $.25 per page. If records
are requested which contain both public and confidential information, the board
shall delete the confidential information and provide the remaining
information.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
PART Pod 105
MEETINGS, DELIBERATIONS AND DECISIONS
Pod
105.01 Meetings. The board shall meet quarterly and schedule
such additional meetings as business requires.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
Pod
105.02 Necessary Quorum. No decision shall be made by the board nor
hearing conducted without a quorum present.
Members who are recused because of a conflict of interest shall not be
counted in determining a quorum.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
Pod
105.03 Tentative Decisions.
(a) The board shall, during any meeting, as
appropriate under the circumstances of the case, instruct its staff or a committee of the board to prepare a document, subject to the
final review and approval of the board.
Such instructions shall be known as tentative decisions.
(b) Tentative decisions shall not be final
actions and shall not be binding upon the board. The board shall change its instructions and
shall modify the form or the substance of a tentative decision as often as is
required to produce a final document which satisfactorily sets forth the final
result the board intends to reach. The
board's final decision shall be issued only when the necessary majority has
voted in favor of the final form of the proposed action, allowing time for
printing the document in question.
(c) A member who was absent from the meeting at
which a tentative decision was made shall participate in the vote on a final
proposal prepared in accordance with the instructions given in the tentative
decision if the member is not recused because of a conflict of interest.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
PART Pod 106
APPOINTMENT OF SUBCOMMITTEES
Pod
106.01 Subcommittees.
(a) The board shall form subcommittees of one or
more of its members to investigate and make recommendations on matters which
could be handled by the full board.
(b) Subcommittees shall, with the express
approval of the board:
(1)
Enlist the assistance of qualified non-board members to serve as
advisory members of such a subcommittee; and
(2) Retain
advisors or consultants.
(c) Subcommittees shall be chaired by a member of
the board.
(d) The board shall appoint volunteers to
advisory committees which contain no members of the board for the purpose of
preparing special reports or projects of interest to the board, or both.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #7816,
eff 1-7-03
REVISION NOTE:
Document
#14261, effective 6-12-25, repealed Part Pod 201 through Part Pod 217 in
Chapter Pod 200, titled “Practice and Procedure”. Document #14261 also adopted a new Part Pod
201 titled “Rules of Practice and Procedures”, containing Pod 201.01 titled
“Applicability of Plc 200.”
Document
#14261 replaces all prior filings affecting the rules in the former Chapter Pod
200. The prior filings included the
following documents:
#5391,
eff 5-8-92
#7887-A,
eff 5-6-03
#7887-B,
eff 5-6-03
#10242-A,
eff 12-15-12
As
practice and procedure rules, the rules in Document #14261 will not expire
except pursuant to RSA 541-A:17, II.
PART Pod 201 RULES OF PRACTICE AND PROCEDURES
Pod 201.01 Applicability
of Plc 200. The Plc 200 rules shall govern with regards to all procedures for:
(a) The receipt and investigation of misconduct
complaints;
(b) The conduct of adjudicative and
non-adjudicative proceedings;
(c) Rulemaking submissions, considerations, and disposition of rulemaking
petitions;
(d) Public comment hearings;
(e) Declaratory rulings;
(f) Explanation of adopted rules;
(g) Voluntary surrender of licenses; and
(h) Waivers.
Source. #14261, eff 6-12-25
CHAPTER Pod
300 LICENSURE
Statutory
Authority: RSA 315:4
PART Pod 301 APPLICATION REQUIREMENTS
Pod
301.01 Application and Supporting
Documents.
(a) The applicant for licensure shall complete
and submit to the office of professional licensure and certification:
(1) The
“Universal Application for Initial Licensure” with the information described in
Plc 304.03; and
(2)
A 3 x 5 inch full face photograph of the applicant taken within 6 months
of submission of the application.
(b) The applicant shall sign and date the
application as described in Plc 304.05.
(c) Applicants shall include the application fee
required by Plc 1002.40.
(d) The applicant shall provide the following
with the application:
(1) A certified
copy of National Board scores submitted directly from the examining authority
to the OPLC;
(2) Certified
copies of American or foreign transcripts or diploma, which include podiatry
education and certification of completion of internship or residency;
(3) Original
letters of reference, addressed to the OPLC on professional letterhead, from 2
licensed podiatrists who have known the applicant for at least one year and can
attest to the applicant’s moral and professional character and shall state in
what context or capacity the individual has known the applicant; and
(4) A
curriculum vita showing a chronological list of the applicant’s work history
for the previous 10 years.
(e) The application shall be processed, and an
approval or denial issued in accordance with Plc 304.06 through Plc 304.13.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; amd
by #9901-A, eff 4-15-11, (para (a)); amd by #9901-B, eff
4-15-11, (para (b)) (formerly Pod 301.01, 301.04, & 301.08), EXPIRED:
4-15-19 in para (a); ss by #12811,
INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13900, eff 5-12-24
Pod
301.02 Time Limit of Application. An application shall remain on current status
for a period not to exceed 12 months.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-A, eff
4-15-11 (formerly Pod 301.05), EXPIRED: 4-15-19
New. #12811,
INTERIM, eff 6-14-19, EXPIRED: 12-11-19
New. #13900, eff 5-12-24
Pod
301.03 Timeliness of Credentials. An applicant who has been inactive from
practice for more than 36 months shall meet all current licensure requirements
and attend a minimum of 40 hours of continuing podiatry education as specified
in Pod 402.01 for the 2 years prior to the date of application.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-A, eff
4-15-11 (formerly Pod 301.06), EXPIRED: 4-15-19
New. #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13900, eff 5-12-24
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-A, eff
4-15-11 (formerly Pod 301.09), EXPIRED: 4-15-19
New. #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13900, eff 5-12-24 (formerly Pod 301.05)
PART Pod 302 QUALIFICATIONS
Pod
302.01 Educational Requirements.
(a) Applicants for licensure shall have graduated
from a college of podiatry or podiatric medicine which is accredited by the
American Podiatric Medical Association.
(b) Applicants shall have completed one year of
internship or residency training that meets the requirements of the Council on
Podiatric Medical Education (CPME) of the American Podiatric Medical
Association. An internship or residency
shall be at a hospital maintaining standards of the American Podiatric Medical
Association.
Source. #1046, eff l0-19-77; ss by #2983, eff 3-7-85,
EXPIRED: 3-7-91
New. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04, EXPIRED: 3-12-12
New. #10242-B, eff 12-15-12, EXPIRED: 12-15-22
New. #13900, ef 5-12-24
Pod
303.01 Type of Examination. Examination of candidates for licensure in
New Hampshire shall be by the National Board of Podiatric Medical Examiners.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-A, eff
4-15-11, EXPIRED: 4-15-19
New. #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13900, ef 5-12-24
Pod
303.02 Passing Grade. Each candidate shall have a score of at least
75.0%. Candidates who fail to obtain
such average shall only be required to repeat that portion of the examination
for which they did not receive an average of at least 75.0%.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-A, eff
4-15-11, EXPIRED: 4-15-19
New. #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13900, ef 5-12-24
PART Pod 304
FEES
Pod
304.01 Fees. The fees shall be as set forth in Plc
1002.40.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-A, eff
4-15-11, EXPIRED: 4-15-19
New. #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13900, ef 5-12-24
CHAPTER Pod
400 RENEWAL, CONTINUING EDUCATION/CEU
AND ONGOING REQUIREMENTS
PART Pod 401 RENEWAL OF LICENSE
Pod
401.01 Expiration of License. Licenses governed under this chapter 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 the
license by June 30 of the year in which the licensee’s renewal is set to occur.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-A, eff
4-15-11, EXPIRED: 4-15-19
New. #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13819, eff 2-9-24
Pod
401.02 Renewal of License.
(a) At least 60 days prior to the expiration of
license, the board shall provide to each licensee a
renewal application.
(b) Any licensee wishing to renew a license shall
submit:
(1) The
completed renewal application supplied by the board on or before June 30 of the
year in which the licensee’s renewal is set to occur;
(2) The fee as
specified in Plc 1002.40; and
(3) Proof of
completion of the continuing education requirements of Pod 402.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-A, eff
4-15-11, EXPIRED: 4-15-19
New. #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13819, eff 2-9-24
Pod
401.03 Renewal Application.
(a) The applicant for renewal of licensure shall
provide the information described in Plc 308.06.
(b) The applicant shall sign and date the
application below the statement described in Plc 308.08.
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-B, eff 4-15-11; ss by #13819, eff 2-9-24
Pod
401.04 Late Filing.
(a) Pursuant to RSA 315:12, a licensee who fails
to renew their license before July 1 of the year in which the licensee’s
renewal is set to occur may renew within 90 days of license expiration by
submitting a completed renewal application and the renewal fee.
(b) A licensee who fails to renew their license
more than 90 days after such license has expired may file an application for
reinstatement pursuant to Pod 401.05(b).
Source. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04; ss by #9901-A, eff
4-15-11, EXPIRED: 4-15-19
New. #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13819, eff
2-9-24
Pod 401.05 Reinstatement
of License.
(a)
Any licensee whose license has expired by reason of error, omission, or
neglect to pay the annual renewal fee beyond 90 days after expiration of the
license 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 (c) below.
(b)
Applicants for reinstatement shall provide, pursuant to (a) above, or
cause to be provided, on a form described in Plc 308.06(b) which includes proof
of completion of continuing education for
the 2 years immediately preceding the date of application which meets the
requirements of Pod 402.
(c)
Applicants for reinstatement shall pay the reinstatement fee specified
in Plc 1002.40.
Source. #9901-A, eff
4-15-11, (paras (a) & (c)); amd by #9901-B, eff 4-15-11, (para (b), EXPIRED:
4-15-19 in (paras (a) & (c)); ss by #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13819, eff 2-9-24
PART Pod 402
CONTINUING EDUCATION
Pod 402.01 Continuing Podiatry Education.
(a)
When the licensee applies for renewal of licensure, he or she shall
provide documentation of involvement in activities updating competency in
podiatry. The licensee shall obtain a
minimum of 40 hours biennially, with at least 30 hours obtained through in
person or simultaneously interactive remote learning attendance in courses
approved pursuant to (c) below and no more than 10 hours of instructional media
certified by the Council on Podiatric Medical Education (CPME).
(b)
All continuing education activities shall be completed between January 1
of the first year of the biennial period and December 31 of the second year.
(c)
Instructional media may include one or more of the following passive
prerecorded learning activities:
(1) Video presentations;
(2) Audio presentations;
(3) Computer-assisted instruction; and
(4) Written educational programs.
(d)
Credit hours accumulated through participation in formal courses given
by an accredited American school or college of podiatry or medicine, or by a
state or regional podiatric association recognized by the Council on Podiatric
Medical Education or by the American Medical Association, shall be approved.
(e)
Licensees who possess a “United States Drug Enforcement Administration”
(DEA) number shall complete 3 hours of containing education in the area of pain
management, addiction disorders, or a combination of both. The 3 hours of continuing education shall
count toward the 40 continuing education credits required under this paragraph.
Source. #5391, eff
5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04, EXPIRED: 3-12-12
New. #10242-B, eff 12-15-12; amd
in paragraph (a) by #13272, EMERGENCY RULE, eff 10-4-21, EXPIRES: 4-2-22; rpld in paragraph (a) by #13321, STATEMENT OF REPEAL, eff
12-29-21
New. #13819, eff 2-9-24
Pod
402.02 Reporting Requirements and
Continuing Education Reporting Form.
(a) The applicant shall report the hours on the
“Continuing Education Audit Reporting” form provided by the board by April 1 of
even-numbered years. Documentation of
attendance shall be attached to the form.
Such documentation shall include the name of
the applicant, the title of the course, the number of hours of the course, and
the date the course was taken.
(b) The applicant shall provide the following
information on the “Continuing Education Audit Reporting Form”:
(1) The
applicant's name;
(2) The
applicant’s license number;
(3) The
applicant's home address;
(4) The
applicant's personal phone number;
(5) The
applicant's place of employment;
(6) The
applicant's address of employment;
(7) The
applicant's business phone;
(8) The total
number of podiatric continuing education hours obtained;
(9) The total number of hours obtained for pain
management, addiction disorders, or a combination of both as required by Pod
402.01(d); and
(10) The
applicant’s signature and date of signing below the following preprinted
statement:
“To the best of my knowledge and belief the
information provided on the continuing education reporting form and supporting
documentation are true, complete, and not misleading. I understand that any material misrepresentation
shall be subject to disciplinary action by the board.”
Source. #8061, eff 3-12-04, EXPIRED: 3-12-12
New. #10242-B, eff 12-15-12
PART Pod 403 ONGOING REQUIREMENTS
Pod
403.01 Severance of Connection. Each licensee shall notify the board in
writing within 5 days after he or she severs connection with any commitment to
practice podiatry for any reason, either personal, professional, or
disciplinary.
Source. #1046, eff l0-19-77; ss by #2983, eff 3-7-85,
EXPIRED: 3-7-91
New. #5391, eff 5-8-92, EXPIRED: 5-6-98
New. #8061, eff 3-12-04, EXPIRED: 3-12-12
New. #10242-B eff 12-15-12, EXPIRED: 12-15-22
New. #13819, eff 2-9-24
Pod 403.02 Replacement of Wall Certificates. If the original wall certificate of any
registered podiatrist is lost or damaged, the licensee may apply to the board
in writing for replacement of such wall certificate. A replacement wall certificate shall be
issued, but the podiatrist shall retain his or her original license
number. There shall be a charge of $25
for this service.
Source. #8061, eff 3-12-04, EXPIRED: 3-12-12
New. #10242-B, eff 12-15-12
Source. #9901-A, eff 4-15-11, EXPIRED: 4-15-19
New. #12811, INTERIM, eff 6-14-19, EXPIRED:
12-11-19
New. #13819, eff 2-9-24
CHAPTER Pod
500 UNETHICAL CONDUCT
PART Pod 501 UNETHICAL CONDUCT
Pod
501.01 Violations of APMA Ethical
Guidelines. Violations of the
American Podiatric Medical Association, Inc. Code of Ethics, March 2022, shall
constitute unprofessional conduct
within the meaning of RSA 315:9, II(c).
Source. #1046, eff l0-19-77; ss by #2983, eff 3-7-85,
EXPIRED: 3-7-91
New. #5391, eff 5-8-92, EXPIRED: 5-8-98
New. #8061, eff 3-12-04, EXPIRED: 3-12-12
New. #10242-B, eff 12-15-12, EXPIRED: 12-15-22
New. #13820, eff 2-9-24
PART Pod 502
OPIOID PRESCRIBING
Pod 502.01 Applicability. This part shall apply to the prescribing of
opioids for the treatment of non-cancer and non-terminal pain, and shall not
apply to the supervised administration of opioids in a health care setting.
Source. #12149, eff
3-25-17
Pod 502.02 Noncompliance with Standards as
Unprofessional Conduct. The ethical
standards set forth in this part shall bind all licensees, and noncompliance
with these standards shall constitute unprofessional conduct as used in NH RSA
315:9, I(c). The board shall investigate
violations of these standards and impose disciplinary sanctions for such
violations by following the disciplinary procedures set forth in Pod 200.
Source. #12149, eff 3-25-17
Pod 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 is generally 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 non-cancer pain persists beyond the usual course of an acute disease
or healing of an injury, or that may or may not be associated with an acute or
chronic pathologic process that causes continuous or intermittent pain over months
or years. For the purposes of these
rules, chronic pain does not include pain from cancer or terminal care;
(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 equivalent dose (MED)”
means a conversion of various opioids to a morphine equivalent dose by the use
of accepted conversion tables;
(i) “Prescription”
means a verbal, written, 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 physician 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. #12149, eff
3-25-17
Pod 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;
(d)
Ensure that the patient has been provided
information that contains the following:
(1) Risk of side effects, including addiction and
overdose resulting in death;
(2) Risks of keeping unused medication;
(3) Options for safely securing and disposing of
unused medication; and
(4) Danger in operating motor vehicle
or heavy machinery;
(e)
Comply with all federal and state controlled substances laws, rules, and
regulations;
(f)
Complete a board-approved risk assessment tool, such as the Screener and
Opioid Assessment for Patients with Pain (SOAPP);
(g)
Document an appropriate pain treatment plan and consideration of
non-pharmacological modalities and non-opioid therapy;
(h)
Utilize a written informed consent that explains the following risks
associated with opioids:
(1) Addiction;
(2) Overdose and death;
(3) Physical dependence;
(4) Physical side effects;
(5) Hyperalgesia;
(6) Tolerance; and
(7) Crime victimization;
(i) In an emergency department, urgent care
setting, or walk-in clinic:
(1) Not prescribe more than the minimum amount of
opioids medically necessary to treat the patient’s medical condition. In most
cases, an opioid prescription of 3 or fewer days is sufficient, but a licensee
shall not prescribe for more than 7 days; and
(2) If prescribing an opioid for acute pain that
exceeds a board-approved limit, document the medical condition and appropriate
clinical rationale in the patient’s medical record; and
(j)
Not be obligated to prescribe opioids for more
than 30 days, but if opioids are indicated and appropriate for persistent,
unresolved acute pain that extends beyond a period of 30 days, the licensee
shall conduct an in-office follow-up with the patient prior to issuing a new
opioid prescription.
Source. #12149, eff 3-25-17
Pod 502.05 Chronic Pain. If opioids are indicated and clinically
appropriate for chronic pain, prescribing licensees shall:
(a)
Conduct and document a history and physical examination;
(b)
Conduct and document a risk assessment, including, but not limited to,
the use of an evidence based screening tool such as the Screener and Opioid
Assessment for Patients with Pain (SOAPP);
(c)
Document the prescription and rationale for all opioids;
(d)
Prescribe the lowest effective dose for a limited duration;
(e)
Comply with all federal and state controlled substances laws, rules, and
regulations;
(f)
Utilize a written informed consent that explains the following risks
associated with opioids:
(1) Addiction;
(2) Overdose and death;
(3) Physical dependence;
(4) Physical side effects;
(5) Hyperalgesia;
(6) Tolerance; and
(7) Crime victimization;
(g)
Create and discuss a treatment plan with the patient. This shall include, but not be limited to the
goals of treatment, in terms of pain management, restoration of function,
safety, time course for treatment, and consideration of non-pharmacological
modalities and non-opioid therapy.
Informed consent documents and treatment agreements may be part of one
document for the sake of convenience;
(h)
Utilize a written treatment agreement that is included in the medical
record, and specifies conduct that triggers the discontinuation or tapering of
opioids;
(i) The treatment agreement shall also address,
at a minimum, the following:
(1) The requirement for safe medication use and
storage;
(2) The requirement of obtaining opioids from
only one prescriber or practice;
(3) The consent to periodic and random drug
testing; and
(4) The prescriber’s responsibility to be
available or to have clinical coverage available;
(j)
Document the consideration of a consultation with an appropriate
specialist in the following circumstances:
(1) When the patient receives a 100 mg morphine
equivalent dose for longer than 90 days;
(2) When a patient is at high risk for abuse or
addiction; or
(3) When a patient has a co-morbid psychiatric
disorder;
(k)
Reevaluate treatment plans and use of opioids at least twice a year;
(l)
Require random and periodic urine drug testing at least annually for all
patients using opioids for longer than 90 days.
Unanticipated findings shall be addressed in a manner that supports the
health of the patient; and
(m) Have clinical coverage available for 24 hours
per day, 7 days per week, to assist in the management of patients; and
(n)
The prescriber may forego the requirements for a written treatment
agreement and for periodic drug testing for patients:
(1) Who are residents in a long-term,
non-rehabilitative nursing home facility where medications are administered by
licensed staff; or
(2) Who are being treated for episodic
intermittent pain and receiving no more than 50 dose units of opioids in a 3
month period.
Source. #12149, eff 3-25-17
Pod 502.06 Prescription Drug Monitoring Program.
(a)
Prescribers required to register with the program under RSA 318-B:31-40,
or his or her delegate, shall query the prescription drug monitoring program to
obtain a history of schedule II-IV controlled substances dispensed to a
patient, prior to prescribing an initial schedule II, III, and IV opioids for the management or treatment of this patient’s
pain and then periodically and at least twice per year, except when:
(1) Controlled medications are to be administered
to patients in a health care setting; or
(2) The program is inaccessible or not
functioning properly, due to an internal or external electronic issue; or
(3) An emergency department is experiencing a
higher than normal patient volume such that querying the program database would
materially delay care.
(b)
A licensee shall document the exceptions described in (a)(2) and (3)
above in the patient’s medical record.
Source. #12149, eff 3-25-17
Pod 502.07 Medication Assisted Treatment. Licensees who prescribe medication assisted
treatment shall adhere to the principles outlined in the American Society of
Addiction Medicine’s National Practice Guideline For the Use of Medications in
the Treatment of Addiction Involving Opioid Use (2015) found at http://www.asam.org/quality-practice/guidelines-and-consensus-documents/npg/complete-guideline as
cited in Appendix II.
Source. #12149, eff 3-25-17
APPENDIX I
|
Rule |
Specific State Statute which the Rule
Implements |
|
|
|
|
Pod
101.01 |
RSA
315:1; 315:2; 315:4 |
|
Pod
102 |
RSA
541-A:7 |
|
Pod
103.01 |
RSA
315:1 |
|
Pod
103.02 |
RSA
541-A:16, I(a) |
|
Pod
103.03 |
RSA
541-A:16, I(a) |
|
Pod
104 |
RSA
541-A:16, I(a) |
|
Pod
105 |
RSA
541-A:16, I(a), 315:1 |
|
Pod
106 |
RSA
315:10, II |
|
|
|
|
Pod
200 |
RSA
541-A:16,I(b)-(d) |
|
|
|
|
Pod 301 |
RSA 315:2, 315:4, I-II |
|
Pod 301.01 |
RSA 315:2; RSA 315:4, I, III, VII; RSA 315:7; RSA
315:15 |
|
Pod 301.02 |
RSA 315:4, I |
|
Pod 301.03 |
RSA 315:4, I |
|
Pod 301.04 |
RSA 315:4, I |
|
Pod
301.05 |
RSA
315:8, I |
|
Pod
302 |
RSA
315:2; RSA 315:4, II |
|
Pod 303 |
RSA 315:4, I, II; RSA 315:7 |
|
Pod 304 |
RSA 310:6, I |
|
|
|
|
Pod 401.01 - 401.02 |
RSA 315:2, II; RSA 315:4, I, V, VII; RSA 315:11; RSA
315:12 |
|
Pod 401.03 |
RSA 315:11 |
|
Pod 401.04 |
RSA 315:12 |
|
Pod 401.04 |
RSA 315:12 |
|
Pod 401.05 |
RSA 315:13-a |
|
Pod 402 |
RSA 315:2, II; RSA 315:4, X |
|
Pod
402.01 |
RSA
315:2, II; RSA 315:4, II |
|
Pod
402.02 |
RSA
315:2, II; RSA 315:4, II |
|
Pod
403.01 |
RSA
315:4, XI |
|
Pod
403.02 |
RSA
315:4, VI, X |
|
Pod 403.03 |
RSA 315:4, VI, X |
|
Pod
501 |
RSA
315:9, II(c) |
|
Pod 501.01 |
RSA 315:9, II(c), RSA 315:4 |
|
Pod 502 |
RSA 315:4, V, VI, XII |
APPENDIX II
|
Rule |
Reference |
Obtain at: |
|
Pod 501.01 |
The American Podiatric Medical
Association Inc., Code of Ethics March 2022 |
No cost to download from: https://www.apma.org/files/Code%20of%20Ethics_FINAL_1669749709677_2.pdf |
|
Pod
502.07 |
The
American Society of Addiction Medicine’s “National Practice Guideline For the
Use of Medications in the Treatment of Addiction Involving Opioid Use,”
adopted on June 1, 2015. |
No
cost to download from: http://www.asam.org/quality-practice/guidelines-and-consensus-documents/npg/complete-guideline |