New Hampshire Management Services Agreement Guide: Avoiding Terms That Look Like Operational Control
New Hampshire has no fee-splitting provision that we found, but a 2026 bill that went to interim study would have counted a management services agreement as a change of control, so we avoid terms that confer operational or financial control.
Key Highlights
- We found no fee-splitting provision in the discipline statute or Board rules other than the AMA ethics code incorporated by reference.
- RSA 329:31-a voids any restriction on a physician's right to practice after a professional relationship ends.
- A rule puts record-release responsibility on the licensee if the practice is owned and controlled by a licensee and on the employer if the licensee is employed.
- Senate Bill 666 of 2026 was sent to interim study and is not law.
How to Price the Management Fee
The discipline statute and Board rules contain no fee-splitting ground other than the AMA code incorporated as a binding standard, whose text we did not read, and we found no authority on percentage fees. We use a fixed fee for defined services.
What the Practice Must Keep
The practice keeps clinical decisions and records, and no unlicensed person works in the physician's office outside the delegation rules, since the discipline statute covers a licensee who has employed or allowed an unlicensed person to practice in the licensee's office.
Terms to Avoid
Avoid arrangements conferring operational or financial control over the practice, since the 2026 bill would have defined change of control to include a management services agreement or any such arrangement, and avoid any unlicensed person practicing in the office.
Term, Records and Departing Clinicians
RSA 329:31-a voids any restriction on a physician's right to practice medicine in any area for any period after termination while other terms stay enforceable, and a separate statute requires disclosing a non-compete to a new hire before acceptance. We do not use non-competes for employed clinicians.
Filings, Notices and Watch Items
Senate Bill 666 would have required 60 days' notice to the Department of Justice with authority to prohibit transactions and barred MSOs from interfering with clinical judgment. The existing 180-day notice law covers health care charitable trusts only.
Drafting Checklist
- Fee: fixed for defined services.
- Control: no operational or financial control terms.
- Office: no unlicensed practice.
- Records: licensee responsible.
- Non-competes: none.
How We Draft It
Patients pay the physician-owned practice, the practice pays the management company a fixed monthly fee under the agreement, and the management company pays MedGrid a fixed monthly retainer for consulting. The management company never practices medicine, and the agreement never moves a clinical decision to it. Our template follows the same flat-fee design in every state, with the state-specific limits below layered on top.
Disclaimer
This article is general educational information, not legal advice. Management agreement rules change and differ by state, and this summary draws on our published state guide, parts of which rest on secondary sources, so have health care counsel in the state review any agreement before you sign.
MedGrid MSO provides management services to independently owned practices; it does not practise medicine and does not direct clinical decisions. Requirements vary by state and by service, and change over time — nothing on this page is legal or medical advice. Talk to us or your own counsel before making a structural decision for your clinic.