Section 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; andc. 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.N.H. Admin. Code § Med 305.02
#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)
Amended by Volume XL Number 7, Filed February 13, 2020, Proposed by #12972, Effective 1/10/2020, Expires 1/10/2030