1 STATE OF OKLAHOMA
1
2 2nd Session of the 59th Legislature (2024)
2
3 HOUSE BILL 3781 By: Duel
3
4
4
5
5
6 AS INTRODUCED
6
7 An Act relating to physician assistants; creating the
7 PA Licensure Compact; stating the purpose; providing
8 definitions; providing requirements for state
8 participation in the Compact; providing for Compact
9 privilege; providing for state designation; providing
9 for adverse actions; establishing the Compact
10 Commission; providing for the data system; providing
10 for rulemaking; providing for oversight, dispute
11 resolution, and enforcement; providing for data
11 implementation of the Compact Commission; providing
12 for construction and severability; providing for
12 binding effect of Compact; providing for
13 codification; and providing an effective date.
13
14
14
15
15
16 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
16
17 SECTION 1. NEW LAW A new section of law to be codified
17
18 in the Oklahoma Statutes as Section 545.1 of Title 59, unless there
18
19 is created a duplication in numbering, reads as follows:
19
20 In order to strengthen access to medical services and in
20
21 recognition of the advances in the delivery of medical services the
21
22 participating states of the PA Licensure Compact have allied in
22
23 common purpose to develop a comprehensive process that complements
23
24 the existing authority of state licensing boards to license and
24
Req. No. 8711 Page 1
 1 discipline physician assistants or PAs and seeks to enhance the
1
2 portability of a license to practice as a PA while safeguarding the
2
3 safety of patients. This Compact allows medical services to be
3
4 provided by PAs, via the mutual recognition of the licensee's
4
5 qualifying license by other compact participating states. This
5
6 Compact also adopts the prevailing standard for PA licensure and
6
7 affirms that the practice and delivery of medical services by the PA
7
8 occurs where the patient is located at the time of the patient
8
9 encounter and therefore requires the PA to be under the jurisdiction
9
10 of the state licensing board where the patient is located. State
10
11 licensing boards that participate in this Compact retain the
11
12 jurisdiction to impose adverse action against a compact privilege in
12
13 that state issued to a PA through the procedures of this Compact.
13
14 The PA Licensure Compact will alleviate burdens for military
14
15 families by allowing active duty military personnel and their
15
16 spouses to obtain a compact privilege based on having an
16
17 unrestricted license in good standing from a participating state.
17
18 SECTION 2. NEW LAW A new section of law to be codified
18
19 in the Oklahoma Statutes as Section 545.2 of Title 59, unless there
19
20 is created a duplication in numbering, reads as follows:
20
21 As used in this Compact:
21
22 1. "Adverse action" means any administrative, civil, equitable,
22
23 or criminal action permitted by a state's laws which is imposed by a
23
24 licensing board or other authority against a PA license or license
24
Req. No. 8711 Page 2
 1 application or compact privilege such as license denial, censure,
1
2 revocation, suspension, probation, monitoring of the licensee, or
2
3 restriction on the licensee's practice;
3
4 2. "Compact privilege" means the authorization granted by a
4
5 remote state to allow a licensee from another participating state to
5
6 practice as a PA to provide medical services and other licensed
6
7 activity to a patient located in the remote state under the remote
7
8 state's laws and regulations;
8
9 3. "Conviction" means a finding by a court that an individual
9
10 is guilty of a felony or misdemeanor offense through adjudication or
10
11 entry of a plea of guilt or no contest to the charge by the
11
12 offender;
12
13 4. "Criminal background check" means the submission of
13
14 fingerprints or other biometric-based information for a license
14
15 applicant for the purpose of obtaining that applicant's criminal
15
16 history record information, as defined in 28 C.F.R., Section
16
17 20.3(d), from the state's criminal history record repository as
17
18 defined in 28 C.F.R., Section 20.3(f);
18
19 5. "Data system" means the repository of information about
19
20 licensees, including, but not limited to, license status and adverse
20
21 actions, which is created and administered under the terms of this
21
22 Compact;
22
23
23
24
24
Req. No. 8711 Page 3
 1 6. "Executive committee" means a group of directors and ex-
1
2 officio individuals elected or appointed pursuant to paragraph 2 of
2
3 subsection F of Section 7;
3
4 7. "Impaired practitioner" means a PA whose practice is
4
5 adversely affected by health-related conditions that impact his or
5
6 her ability to practice;
6
7 8. "Investigative information" means information, records, or
7
8 documents received or generated by a licensing board pursuant to an
8
9 investigation;
9
10 9. "Jurisprudence requirement" means the assessment of an
10
11 individual's knowledge of the laws and rules governing the practice
11
12 of a PA in a state;
12
13 10. "License" means current authorization by a state, other
13
14 than authorization pursuant to a compact privilege, for a PA to
14
15 provide medical services, which would be unlawful without current
15
16 authorization;
16
17 11. "Licensee" means an individual who holds a license from a
17
18 state to provide medical services as a PA;
18
19 12. "Licensing board" means any state entity authorized to
19
20 license and otherwise regulate PAs;
20
21 13. "Medical services" means health care services provided for
21
22 the diagnosis, prevention, treatment, cure, or relief of a health
22
23 condition, injury, or disease, as defined by a state's laws and
23
24 regulations;
24
Req. No. 8711 Page 4
 1 14. "Model compact" means the model for the PA Licensure
1
2 Compact on file with The Council of State Governments or other
2
3 entity as designated by the Commission;
3
4 15. "Participating state" means a state that has enacted this
4
5 Compact;
5
6 16. "PA" means an individual who is licensed as a physician
6
7 assistant in a state. For purposes of this Compact, any other title
7
8 or status adopted by a state to replace the term "physician
8
9 assistant" shall be deemed synonymous with "physician assistant" and
9
10 shall confer the same rights and responsibilities to the licensee
10
11 under the provisions of this Compact at the time of its enactment;
11
12 17. "PA Licensure Compact Commission," "Compact Commission," or
12
13 "Commission" means the national administrative body created pursuant
13
14 to subsection A of section 7 of this Compact;
14
15 18. "Qualifying license" means an unrestricted license issued
15
16 by a participating state to provide medical services as a PA;
16
17 19. "Remote state" means a participating state where a licensee
17
18 who is not licensed as a PA is exercising or seeking to exercise the
18
19 compact privilege;
19
20 20. "Rule" means a regulation promulgated by an entity that has
20
21 the force and effect of law;
21
22 21. "Significant investigative information" means investigative
22
23 information that a licensing board, after an inquiry or
23
24 investigation that includes notification and an opportunity for the
24
Req. No. 8711 Page 5
 1 PA to respond if required by state law, has reason to believe is not
1
2 groundless, and if proven true, would indicate more than a minor
2
3 infraction; and
3
4 22. "State" means any state, commonwealth, district, or
4
5 territory of the United States.
5
6 SECTION 3. NEW LAW A new section of law to be codified
6
7 in the Oklahoma Statutes as Section 545.3 of Title 59, unless there
7
8 is created a duplication in numbering, reads as follows:
8
9 A. To participate in this Compact, a participating state shall:
9
10 1. License PAs;
10
11 2. Participate in the Compact Commission's data system;
11
12 3. Have a mechanism in place for receiving and investigating
12
13 complaints against licensees and license applicants;
13
14 4. Notify the Commission, in compliance with the terms of this
14
15 Compact and Commission rules, of any adverse action against a
15
16 licensee or license applicant and the existence of significant
16
17 investigative information regarding a licensee or license applicant;
17
18 5. Fully implement a criminal background check requirement
18
19 within a time frame established by Commission rule, by its licensing
19
20 board receiving the results of a criminal background check, and
20
21 reporting to the Commission whether the license applicant has been
21
22 granted a license;
22
23 6. Comply with the rules of the Compact Commission;
23
24
24
Req. No. 8711 Page 6
 1 7. Utilize passage of a recognized national exam such as the
1
2 NCCPA PANCE as a requirement for PA licensure; and
2
3 8. Grant the compact privilege to a holder of a qualifying
3
4 license in a participating state.
4
5 B. Nothing in this Compact prohibits a participating state
5
6 from charging a fee for granting the compact privilege.
6
7 SECTION 4. NEW LAW A new section of law to be codified
7
8 in the Oklahoma Statutes as Section 545.4 of Title 59, unless there
8
9 is created a duplication in numbering, reads as follows:
9
10 A. To exercise the compact privilege, a licensee shall:
10
11 1. Have graduated from a PA program accredited by the
11
12 Accreditation Review Commission on Education for the Physician
12
13 Assistant, Inc., or other programs authorized by Commission rule;
13
14 2. Hold current NCCPA certification;
14
15 3. Have no felony or misdemeanor conviction;
15
16 4. Have never had a controlled substance license, permit, or
16
17 registration suspended or revoked by a state or by the United States
17
18 Drug Enforcement Administration;
18
19 5. Have a unique identifier as determined by Commission rule;
19
20 6. Hold a qualifying license;
20
21 7. Have had no revocation of a license or limitation or
21
22 restriction on any license currently held due to an adverse action;
22
23 8. If a licensee has had a limitation or restriction on a
23
24 license or compact privilege due to an adverse action, two (2) years
24
Req. No. 8711 Page 7
 1 must have elapsed from the date on which the license or compact
1
2 privilege is no longer limited or restricted due to the adverse
2
3 action;
3
4 9. If a compact privilege has been revoked or is limited or
4
5 restricted in a participating state for conduct that would not be a
5
6 basis for disciplinary action in a participating state in which the
6
7 licensee is practicing or applying to practice under a compact
7
8 privilege, that participating state shall have the discretion not to
8
9 consider such action as an adverse action requiring the denial or
9
10 removal of a compact privilege in that state;
10
11 10. Notify the Compact Commission that the licensee is seeking
11
12 the compact privilege in a remote state;
12
13 11. Meet any jurisprudence requirement of a remote state in
13
14 which the licensee is seeking to practice under the compact
14
15 privilege and pay any fees applicable to satisfying the
15
16 jurisprudence requirement; and
16
17 12. Report to the Commission any adverse action taken by a non-
17
18 participating state within thirty (30) days after the action is
18
19 taken.
19
20 B. The compact privilege is valid until the expiration or
20
21 revocation of the qualifying license unless terminated pursuant to
21
22 an adverse action. The licensee must also comply with all of the
22
23 requirements of subsection A above to maintain the compact privilege
23
24 in a remote state. If the participating state takes adverse action
24
Req. No. 8711 Page 8
 1 against a qualifying license, the licensee shall lose the compact
1
2 privilege in any remote state in which the licensee has a compact
2
3 privilege until all of the following occur:
3
4 1. The license is no longer limited or restricted; and
4
5 2. Two (2) years have elapsed from the date on which the
5
6 license is no longer limited or restricted due to the adverse
6
7 action.
7
8 C. Once a restricted or limited license satisfies the
8
9 requirements of paragraphs 1 and 2 of subsection B, the licensee
9
10 must meet the requirements of subsection A above to obtain a compact
10
11 privilege in any remote state.
11
12 D. For each remote state in which a PA seeks authority to
12
13 prescribe controlled substances, the PA shall satisfy all
13
14 requirements imposed by such state in granting or renewing such
14
15 authority.
15
16 SECTION 5. NEW LAW A new section of law to be codified
16
17 in the Oklahoma Statutes as Section 545.5 of Title 59, unless there
17
18 is created a duplication in numbering, reads as follows:
18
19 A. Upon a licensee's application for a compact privilege, the
19
20 licensee shall identify to the Commission the participating state
20
21 from which the licensee is applying, in accordance with applicable
21
22 rules adopted by the Commission, and subject to the following
22
23 requirements:
23
24
24
Req. No. 8711 Page 9
 1 1. When applying for a compact privilege, the licensee shall
1
2 provide the Commission with the address of the licensee's primary
2
3 residence and thereafter shall immediately report to the Commission
3
4 any change in the address of the licensee's primary residence; and
4
5 2. When applying for a compact privilege, the licensee is
5
6 required to consent to accept service of process by mail at the
6
7 licensee's primary residence on file with the Commission with
7
8 respect to any action brought against the licensee by the Commission
8
9 or a participating state, including a subpoena, with respect to any
9
10 action brought or investigation conducted by the Commission or a
10
11 participating state.
11
12 SECTION 6. NEW LAW A new section of law to be codified
12
13 in the Oklahoma Statutes as Section 545.6 of Title 59, unless there
13
14 is created a duplication in numbering, reads as follows:
14
15 A. A participating state in which a licensee is licensed shall
15
16 have exclusive power to impose adverse action against the qualifying
16
17 license issued by that participating state.
17
18 B. In addition to the other powers conferred by state law, a
18
19 remote state shall have the authority, in accordance with existing
19
20 state due process law, to do all of the following:
20
21 1. Take adverse action against a PA's compact privilege within
21
22 that state to remove a licensee's compact privilege or take other
22
23 action necessary under applicable law to protect the health and
23
24 safety of its citizens;
24
Req. No. 8711 Page 10
 1 2. Issue subpoenas for both hearings and investigations that
1
2 require the attendance and testimony of witnesses, as well as the
2
3 production of evidence. Subpoenas issued by a licensing board in a
3
4 participating state for the attendance and testimony of witnesses or
4
5 the production of evidence from another participating state shall be
5
6 enforced in the latter state by any court of competent jurisdiction,
6
7 according to the practi