FILED SENATE
May 2, 2024
GENERAL ASSEMBLY OF NORTH CAROLINA
S.B. 879
SESSION 2023 PRINCIPAL CLERK
S D
SENATE BILL DRS15443-NBf-171
Short Title: PA Licensure Interstate Compact. (Public)
Sponsors: Senator Hise (Primary Sponsor).
Referred to:
1 A BILL TO BE ENTITLED
2 AN ACT TO ESTABLISH A PA LICENSURE COMPACT FOR THE LICENSURE OF
3 PHYSICIAN ASSISTANTS.
4 The General Assembly of North Carolina enacts:
5 SECTION 1. Chapter 90 of the General Statutes is amended by adding a new Article
6 to read:
7 "Article 18J.
8 "PA Licensure Compact.
9 "§ 90-270.200. Purpose.
10 In order to strengthen access to Medical Services, and in recognition of the advances in the
11 delivery of Medical Services, the Participating States of the PA Licensure Compact have allied
12 in common purpose to develop a comprehensive process that complements the existing authority
13 of State Licensing Boards to license and discipline PAs and seeks to enhance the portability of
14 License to practice as a PA while safeguarding the safety of patients. This Compact allows
15 Medical Services to be provided by PAs, via the mutual recognition of the Licensee's Qualifying
16 License by other Compact Participating States. This Compact also adopts the prevailing standard
17 for PA licensure and affirms that the practice and delivery of Medical Services by the PA occurs
18 where the patient is located at the time of the patient encounter, and therefore requires the PA to
19 be under the jurisdiction of the State Licensing Board where the patient is located. State Licensing
20 Boards that participate in this Compact retain the jurisdiction to impose Adverse Action against
21 a Compact Privilege in that State issued to a PA through the procedures of this Compact. The PA
22 Licensure Compact will alleviate burdens for military families by allowing active duty military
23 personnel and their spouses to obtain a Compact Privilege based on having an unrestricted
24 License in good standing from a Participating State.
25 "§ 90-270.201. Definitions.
26 The following definitions apply in this Compact:
27 (1) Adverse Action. – Any administrative, civil, equitable, or criminal action
28 permitted by a State's laws which is imposed by a Licensing Board or other
29 authority against a PA License or License application or Compact Privilege
30 such as License denial, censure, revocation, suspension, probation,
31 monitoring of the Licensee, or restriction on the Licensee's practice.
32 (2) Compact Privilege. – The authorization granted by a Remote State to allow a
33 Licensee from another Participating State to practice as a PA to provide
34 Medical Services and other licensed activity to a patient located in the Remote
35 State under the Remote State's laws and regulations.
36 (3) Conviction. – A finding by a court that an individual is guilty of a felony or
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 General Assembly Of North Carolina Session 2023
1 misdemeanor offense through adjudication or entry of a plea of guilt or no
2 contest to the charge by the offender
3 (4) Criminal Background Check. – The submission of fingerprints or other
4 biometric-based information for a License applicant for the purpose of
5 obtaining that applicant's criminal history record information, as defined in 28
6 C.F.R. § 20.3(d), from the State's criminal history record repository, as
7 defined in 28 C.F.R. § 20.3(f).
8 (5) Data System. – The repository of information about Licensees, including but
9 not limited to License status and Adverse Actions, which is created and
10 administered under the terms of this Compact.
11 (6) Executive Committee. – A group of directors and ex-officio individuals
12 elected or appointed pursuant to G.S. 90-270.206(f)(2).
13 (7) Impaired Practitioner. – A PA whose practice is adversely affected by
14 health-related condition(s) that impact their ability to practice.
15 (8) Investigative Information. – Information, records, or documents received or
16 generated by a Licensing Board pursuant to an investigation.
17 (9) Jurisprudence Requirement. – The assessment of an individual's knowledge
18 of the laws and Rules governing the practice of a PA in a State.
19 (10) License. – Current authorization by a State, other than authorization pursuant
20 to a Compact Privilege, for a PA to provide Medical Services, which would
21 be unlawful without current authorization.
22 (11) Licensee. – An individual who holds a License from a State to provide
23 Medical Services as a PA.
24 (12) Licensing Board. – Any State entity authorized to license and otherwise
25 regulate PAs.
26 (13) Medical Services. – Health care services provided for the diagnosis,
27 prevention, treatment, cure, or relief of a health condition, injury, or disease,
28 as defined by a State's laws and regulations.
29 (14) Model Compact. – The model for the PA Licensure Compact on file with The
30 Council of State Governments or other entity as designated by the
31 Commission.
32 (15) Participating State. – A State that has enacted this Compact.
33 (16) PA. – An individual who is licensed as a physician assistant in a State. For
34 purposes of this Compact, any other title or status adopted by a State to replace
35 the term "physician assistant" shall be deemed synonymous with "physician
36 assistant" and shall confer the same rights and responsibilities to the Licensee
37 under the provisions of this Compact at the time of its enactment.
38 (17) PA Licensure Compact Commission, Compact Commission, or Commission.
39 – The national administrative body created pursuant to G.S. 90-270.206(f)(2)
40 of this Compact.
41 (18) Qualifying License. – An unrestricted License issued by a Participating State
42 to provide Medical Services as a PA.
43 (19) Remote State. – A Participating State where a Licensee who is not licensed as
44 a PA is exercising or seeking to exercise the Compact Privilege.
45 (20) Rule. – A regulation promulgated by an entity that has the force and effect of
46 law.
47 (21) Significant Investigative Information. – Investigative Information that a
48 Licensing Board, after an inquiry or investigation that includes notification
49 and an opportunity for the PA to respond if required by State law, has reason
50 to believe is not groundless and, if proven true, would indicate more than a
51 minor infraction.
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1 (22) State. – Any state, commonwealth, district, or territory of the United States.
2 "§ 90-270.202. State Participation in this Compact.
3 (a) To participate in this Compact, a Participating State shall:
4 (1) License PAs.
5 (2) Participate in the Compact Commission's Data System.
6 (3) Have a mechanism in place for receiving and investigating complaints against
7 Licensees and License applicants.
8 (4) Notify the Commission, in compliance with the terms of this Compact and
9 Commission Rules, of any Adverse Action against a Licensee or License
10 applicant and the existence of Significant Investigative Information regarding
11 a Licensee or License applicant.
12 (5) Fully implement a Criminal Background Check requirement, within a time
13 frame established by Commission Rule, by its Licensing Board receiving the
14 results of a Criminal Background Check and reporting to the Commission
15 whether the License applicant has been granted a License.
16 (6) Comply with the Rules of the Compact Commission.
17 (7) Utilize passage of a recognized national exam such as the NCCPA PANCE as
18 a requirement for PA licensure.
19 (8) Grant the Compact Privilege to a holder of a Qualifying License in a
20 Participating State.
21 (b) Nothing in this Compact prohibits a Participating State from charging a fee for
22 granting the Compact Privilege.
23 "§ 90-270.203. Compact Privilege.
24 (a) To exercise the Compact Privilege, a Licensee must:
25 (1) Have graduated from a PA program accredited by the Accreditation Review
26 Commission on Education for the Physician Assistant, Inc. or other programs
27 authorized by Commission Rule.
28 (2) Hold current NCCPA certification.
29 (3) Have no felony or misdemeanor Conviction.
30 (4) Have never had a controlled substance license, permit, or registration
31 suspended or revoked by a State or by the United States Drug Enforcement
32 Administration.
33 (5) Have a unique identifier as determined by Commission Rule.
34 (6) Hold a Qualifying License.
35 (7) Have had no revocation of a License or limitation or restriction on any License
36 currently held due to an adverse action.
37 (8) If a Licensee has had a limitation or restriction on a License or Compact
38 Privilege due to an Adverse Action, two years must have elapsed from the
39 date on which the License or Compact Privilege is no longer limited or
40 restricted due to the Adverse Action.
41 (9) If a Compact Privilege has been revoked or is limited or restricted in a
42 Participating State for conduct that would not be a basis for disciplinary action
43 in a Participating State in which the Licensee is practicing or applying to
44 practice under a Compact Privilege, that Participating State shall have the
45 discretion not to consider such action as an Adverse Action requiring the
46 denial or removal of a Compact Privilege in that State.
47 (10) Notify the Compact Commission that the Licensee is seeking the Compact
48 Privilege in a Remote State.
49 (11) Meet any Jurisprudence Requirement of a Remote State in which the Licensee
50 is seeking to practice under the Compact Privilege and pay any fees applicable
51 to satisfying the Jurisprudence Requirement.
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1 (12) Report to the Commission any Adverse Action taken by a non-participating
2 State within thirty (30) days after the action is taken.
3 (b) The Compact Privilege is valid until the expiration or revocation of the Qualifying
4 License unless terminated pursuant to an Adverse Action. The Licensee must also comply with
5 all of the requirements of Subsection A above to maintain the Compact Privilege in a Remote
6 State. If the Participating State takes Adverse Action against a Qualifying License, the Licensee
7 shall lose the Compact Privilege in any Remote State in which the Licensee has a Compact
8 Privilege until all of the following occur:
9 (1) The License is no longer limited or restricted; and
10 (2) Two (2) years have elapsed from the date on which the License is no longer
11 limited or restricted due to the Adverse Action.
12 (c) Once a restricted or limited License satisfies the requirements of subdivisions (b)(1)
13 and (2) of this section, the Licensee must meet the requirements of subsection (a) of this section
14 to obtain a Compact Privilege in any Remote State.
15 (d) For each Remote State in which a PA seeks authority to prescribe controlled
16 substances, the PA shall satisfy all requirements imposed by such State in granting or renewing
17 such authority.
18 "§ 90-270.204. Designation of the State from Which Licensee is Applying for a Compact
19 Privilege.
20 (a) Upon a Licensee's application for a Compact Privilege, the Licensee shall identify to
21 the Commission the Participating State from which the Licensee is applying, in accordance with
22 applicable Rules adopted by the Commission, and subject to the following requirements:
23 (1) When applying for a Compact Privilege, the Licensee shall provide the
24 Commission with the address of the Licensee's primary residence and
25 thereafter shall immediately report to the Commission any change in the
26 address of the Licensee's primary residence.
27 (2) When applying for a Compact Privilege, the Licensee is required to consent
28 to accept service of process by mail at the Licensee's primary residence on file
29 with the Commission with respect to any action brought against the Licensee
30 by the Commission or a Participating State, including a subpoena, with respect
31 to any action brought or investigation conducted by the Commission or a
32 Participating State.
33 "§ 90-270.205. Adverse Actions.
34 (a) A Participating State in which a Licensee is licensed shall have exclusive power to
35 impose Adverse Action against the Qualifying License issued by that Participating State.
36 (b) In addition to the other powers conferred by State law, a Remote State shall have the
37 authority, in accordance with existing State due process law, to do all of the following:
38 (1) Take Adverse Action against a PA's Compact Privilege within that State to
39 remove a Licensee's Compact Privilege or take other action necessary under
40 applicable law to protect the health and safety of its citizens.
41 (2) Issue subpoenas for both hearings and investigations that require the
42 attendance and testimony of witnesses as well as the production of evidence.
43 Subpoenas issued by a Licensing Board in a Participating State for the
44 attendance and testimony of witnesses or the production of evidence from
45 another Participating State shall be enforced in the latter State by any court of
46 competent jurisdiction, according to the practice and procedure of that court
47 applicable to subpoenas issued in proceedings pending before it. The issuing
48 authority shall pay any witness fees, travel expenses, mileage and other fees
49 required by the service statutes of the State in which the witnesses or evidence
50 are located.
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1 (3) Notwithstanding subdivision (2) of this subsection, subpoenas may not be
2 issued by a Participating State to gather evidence of conduct in another State
3 that is lawful in that other State for the purpose of taking Adverse Action
4 against a Licensee's Compact Privilege or application for a Compact Privilege
5 in that Participating State.
6 (4) Nothing in this Compact authorizes a Participating State to impose discipline
7 against a PA's Compact Privilege or to deny an application for a Compact
8 Privilege in that Participating State for the individual's otherwise lawful
9 practice in another State.
10 (c) For purposes of taking Adverse Action, the Participating State which issued the
11 Qualifying License shall give the same priority and effect to reported conduct received from any
12 other Participating State as it would if the conduct had occurred within the Participating State
13 which issued the Qualifying License. In so doing, that Participating State shall apply its own
14 State laws to determine appropriate action.
15 (d) A Participating State, if otherwise permitted by State law, may recover from the
16 affected PA the costs of