Evidence status: CURRENT STATUTORY PATIENT-PROTECTION FRAMEWORK. New Hampshire’s chronic-pain statute does more than require treatment agreements. It also contains unusually explicit protections for individualized pain treatment.

Treating practitioner controls the clinical decision

RSA 318-B:41 states that decisions about treatment of chronic pain are to be made by the treating practitioner, including when treatment requires opioid analgesics. Practitioners are directed to provide care sufficient to treat chronic pain based on ongoing objective evaluation without fear of reprimand or discipline.

No predetermined MME ceiling

The statute states that ordering, prescribing, dispensing, administering, or paying for controlled substances, including opioid analgesics, may not be predetermined by specific morphine-milligram-equivalent guidelines.

Continuation when treatment is working

For a patient on a managed and monitored opioid regimen who has increased functionality and quality of life as a result of treatment, the statute states that treatment is to continue when there is no indication of misuse or diversion.

Good-faith clinical judgment

The rules implementing the chronic-pain statute must account for individualized patient needs and provide for practitioners acting in good faith and in the course of their profession to use their best judgment, notwithstanding contrary statutes or rules within the boundaries of the governing law.

Dignity and access

The statute also directs that patients covered by the chronic-pain section be treated with dignity and not be unduly denied medications needed to treat their conditions.

Why this matters to Contract for Care

The written treatment agreement is mandatory, but New Hampshire’s broader statutory framework does not treat the agreement as permission to replace individualized clinical care with rigid dose ceilings or automatic denial. This page preserves that countervailing legal context.

Primary source

• RSA 318-B:41, especially paragraph II(d)

Reviewed: October 4, 2026.

Evidence boundary: These protections do not eliminate the written-agreement requirement. They define the individualized clinical framework within which that requirement operates.