As of January 1, 2025, this bill requires that in order to participate in the Compact, a Participating State must satisfy the following conditions:
(1) License Physician Assistants;
(2) Participate in the PA Licensure Compact Commission's ("Commission") Data System;
(3) Have a mechanism in place for receiving and investigating complaints against Licensees and License applicants;
(4) Notify the Commission, in compliance with the terms of this Compact and Commission Rules, of any Adverse Action against a Licensee or License applicant and the existence of Significant Investigative Information regarding a Licensee or License applicant;
(5) Fully implement a Criminal Background Check requirement, within a time frame established by Commission Rule, by its Licensing Board receiving the results of a Criminal Background Check and reporting to the Commission whether the License applicant has been granted a License;
(6) Comply with the Rules of the Compact Commission;
(7) Utilize passage of a recognized national exam such as the National Commission on the Certification of Physician Assistants (NCCPA) Physician Assistant National Certifying Examination (PANCE) as a requirement for Physician Assistant licensure; and
(8) Grant the Compact Privilege to a holder of a Qualifying License in a Participating State.
COMPACT PRIVILEGE
This bill requires that in order to exercise the Compact Privilege, a Licensee must meet the following criteria:
(1) Licensee must have graduated from a Physician Assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant, Inc., or other programs authorized by Commission Rule;
(2) Licensee must hold current NCCPA certification;
(3) Licensee must have no felony or misdemeanor Conviction;
(4) Licensee must have never had a controlled substance license, permit, or registration suspended or revoked by a State or by the U.S. Drug Enforcement Administration;
(5) Licensee must have a unique identifier as determined by Commission Rule;
(6) Licensee must hold a Qualifying License;
(7) Licensee must have had no revocation of a License or limitation or restriction on any License currently held due to an adverse action;
(8) If a Licensee has had a limitation or restriction on a License or Compact Privilege due to an Adverse Action, then two years must have elapsed from the date on which the License or Compact Privilege is no longer limited or restricted due to the Adverse Action;
(9) If a Compact Privilege has been revoked or is limited or restricted in a Participating State for conduct that would not be a basis for disciplinary action in a Participating State in which the Licensee is practicing or applying to practice under a Compact Privilege, then that Participating State has the discretion not to consider such action as an Adverse Action requiring the denial or removal of a Compact Privilege in that State;
(10) Licensee must notify the Compact Commission that the Licensee is seeking the Compact Privilege in a Remote State;
(11) Licensee must meet any Jurisprudence Requirement of a Remote State in which the Licensee is seeking to practice under the Compact Privilege and pay any fees applicable to satisfying the Jurisprudence Requirement; and
(12) Licensee must report to the Commission any Adverse Action taken by a non-participating State within 30 days after the action is taken.
This bill provides that the Compact Privilege is valid until the expiration or revocation of the Qualifying License unless terminated pursuant to an Adverse Action. The Licensee must also comply with all of the requirements of the above provision to maintain the Compact Privilege in a Remote State. If the Participating State takes Adverse Action against a Qualifying License, then the Licensee must lose the Compact Privilege in any Remote State in which the Licensee has a Compact Privilege until the License is no longer limited or restricted and two years have elapsed from the date on which the License is no longer limited or restricted due to the Adverse Action.
Once a restricted or limited License is no longer limited or restricted and two years have elapsed from the date on which the License is no longer limited or restricted due to the Adverse Action, the Licensee must meet the requirements of (1)–(12) above to obtain a Compact Privilege in any Remote State.
This bill requires that for each Remote State in which a Physician Assistant seeks authority to prescribe controlled substances, the Physician Assistant must satisfy all requirements imposed by such State in granting or renewing such authority.
DESIGNATION OF THE STATE
This bill requires that upon a Licensee's application for a Compact Privilege, the Licensee must identify to the Commission the Participating State from which the Licensee is applying, in accordance with applicable Rules adopted by the Commission, and subject to the following requirements:
(1) The Licensee must provide the Commission with the address of the Licensee's primary residence and thereafter must immediately report to the Commission any change in the address of the Licensee's primary residence; and
(2) The Licensee must consent to accept service of process by mail at the Licensee's primary residence on file with the Commission with respect to any action brought against the Licensee by the Commission or a Participating State, with respect to any action brought or investigation conducted by the Commission or a Participating State.
ADVERSE ACTION
This bill provides that a Participating State in which a Licensee is licensed may impose Adverse Action against the Qualifying License issued by that Participating State. In addition to the other powers conferred by State law, a Remote State has the authority, in accordance with existing State due process law, to do all of the following:
(1) Take Adverse Action against a Physician Assistant's Compact Privilege within that State to remove a Licensee's Compact Privilege or take other action necessary under applicable law to protect the health and safety of its citizens;
(2) Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses as well as the production of evidence. Subpoenas issued by a Licensing Board in a Participating State for the attendance and testimony of witnesses or the production of evidence from another Participating State must be enforced in the latter State by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority is required to pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the State in which the witnesses or evidence are located; and
(3) Subpoenas may not be issued by a Participating State to gather evidence of conduct in another State that is lawful in that other State for the purpose of taking Adverse Action against a Licensee's Compact Privilege or application for a Compact Privilege in that Participating State.
This bill requires the Participating State that issued the Qualifying License to give the same priority and effect to reported conduct received from any other Participating State as it would if the conduct had occurred within the Participating State which issued the Qualifying License. In so doing, that Participating State must apply its own State laws to determine appropriate action.
This bill authorizes a Participating State to recover from the affected Physician Assistant the costs of investigations and disposition of cases resulting from any Adverse Action taken against that Physician Assistant. A Participating State may take Adverse Action based on the factual findings of a Remote State, so long as the Participating State follows its own procedures for taking the Adverse Action. This bill authorizes any Participating State to participate with other Participating States in joint investigations of Licensees.
If an Adverse Action is taken against a Physician Assistant's Qualifying License, then the Physician Assistant's Compact Privilege in all Remote States must be deactivated until two years have elapsed after all restrictions have been removed from the State License. All disciplinary orders by the Participating State that issued the Qualifying License that impose Adverse Action against a Physician Assistant's License must include a Statement that the Physician Assistant's Compact Privilege is deactivated in all Participating States during the pendency of the order. This bill requires any Participating State to notify the administrator of the Data System if it takes Adverse Action
ESTABLISHMENT OF THE COMMISSION
This bill provides that the Participating States hereby create and establish a joint government agency and national administrative body known as the PA Licensure Compact Commission ("Commission"). The Commission is an instrumentality of the Compact States acting jointly and not an instrumentality of any one State. The Commission comes into existence on or after the effective date of the Compact.
DELEGATES
This bill requires each Participating State to have one delegate selected by that Participating State's Licensing Board. The delegate must be a current Physician Assistant, physician, or public member of a Licensing Board or Physician Assistant Council/Committee, or an administrator of a Licensing Board.
Each delegate is entitled to one vote on all matters voted on by the Commission and must otherwise have an opportunity to participate in the business and affairs of the Commission. A delegate must vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates' participation in meetings by telecommunications, video conference, or other means of communication.
This bill requires the Commission to meet at least once during each calendar year. Additional meetings must be held as set forth in this Compact and the bylaws. The Commission must establish by Rule a term of office for delegates.
POWERS AND DUTIES
This bill lists the various powers and duties of the Commission, which include, amongst others, establishing a code of ethics for the Commission; establishing the fiscal year of the Commission; establishing fees; establishing bylaws; maintaining financial records; promulgating Rules; bringing and prosecuting legal proceedings or actions in the name of the Commission; hiring employees and engaging contractors; electing or appointing officers; establishing a budget and making expenditures; and preparing and providing to the Participating States an annual report.
MEETINGS OF THE COMMISSION
This bill requires all meetings of the Commission that are not closed to be open to the public. Notice of public meetings must be posted on the Commission's website at least 30 days prior to the public meeting. This bill authorizes the Commission to convene a public meeting by providing at least 24 hours' prior notice on the Commission's website, and any other means as provided in the Commission's Rules, for any of the reasons it may dispense with notice of proposed rulemaking under this bill. Additionally, this bill authorizes the Commission to convene in a closed, nonpublic meeting or non-public part of a public meeting to receive legal advice or to discuss any of the following:
(1) Non-compliance of a Participating State with its obligations under this Compact;
(2) The employment, compensation, discipline or other matters, practices, or procedures related to specific employees or other matters related to the Commission's internal personnel practices and procedures;
(3) Current, threatened, or reasonably anticipated litigation;
(4) Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate;
(5) Accusing any person of a crime or formally censuring any person;
(6) Disclosure of trade secrets or commercial or financial information that is privileged or confidential;
(7) Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
(8) Disclosure of investigative records compiled for law enforcement purposes;
(9) Disclosure of information related to any investigative reports prepared by or on behalf of or for use of the Commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to this Compact;
(10) Legal advice; or
(11) Matters specifically exempted from disclosure by federal or Participating States' statutes.
This bill requires the Commission to keep minutes that fully and clearly describe all matters discussed in a meeting and to provide a full and accurate summary of actions taken, including a description of the views expressed. All documents considered in connection with an action must be identified in such minutes. All minutes and documents of a closed meeting must remain under seal, subject to release by a majority vote of the Commission or order of a court of competent jurisdiction.
FINANCING THE COMMISSION
This bill requires the Commission to pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities. The Commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.
This bill authorizes the Commission to levy on and collect an annual assessment from each Participating State and to impose Compact Privilege fees on Licensees of Participating States to whom a Compact Privilege is granted to cover the cost of the operations and activities of the Commission and its staff, which must be in a total amount sufficient to cover its annual budget as approved by the Commission each year for which revenue is not provided by other sources. The aggregate annual assessment amount levied on Participating States must be allocated based upon a formula to be determined by Commission Rule.
This bill requires the Commission to keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the Commission are subject to the financial review and accounting procedures established under its bylaws. All receipts and disbursements of funds handled by the Commission are also subject to an annual financial review by a certified or licensed public accountant, and the report of the financial review must be included in and become part of the annual report of the Commission.
EXECUTIVE COMMITTEE
This bill provides that the Executive Committee has the power to act on behalf of the Commission according to the terms of this Compact and Commission Rules. This bill requires the Executive Committee to be composed of nine members, seven voting members who are elected by the Commission from the current membership of the Commission, one ex officio, nonvoting member from a recognized national Physician Assistant professional association, and one ex officio, nonvoting member from a recognized national Physician Assistant certification organization. The ex officio members must be selected by their respective organizations. The Commission may remove any member as provided in the Commission's bylaws.
This bill requires the Executive Committee to meet at least annually and provides that the Executive Committee has the following duties and responsibilities:
(1) Recommend to the Commission changes to the Commission's Rules or bylaws, changes to this Compact legislation, fees to be paid by Compact Participating States such as annual dues, and any Commission Compact fee charged to Licensees for the Compact Privilege;
(2) Ensure Compact administration services are appropriately provided;
(3) Prepare and recommend the budget;
(4) Maintain financial records on behalf of the Commission;
(5) Monitor Compact compliance of Participating States and provide compliance reports to the Commission;
(6) Establish additional committees as necessary;
(7) Exercise the powers and duties of the Commission during the interim between Commission meetings, except for issuing proposed rulemaking or adopting Commission Rules or bylaws, or exercising any other powers and duties exclusively reserved to the Commission by the Commission's Rules; and
(8) Perform other duties as provided in the Commission's Rules or bylaws.
This bill generally requires all meetings of the Executive Committee at which it votes or plans to vote on matters in exercising the powers and duties of the Commission to be open to the public and public notice of such meetings must be given as public meetings of the Commission are given.
However, this bill authorizes the Executive Committee to convene in a closed, nonpublic meeting for the same reasons that the Commission may convene in a nonpublic meeting as set forth in the above provisions of this bill and must announce the closed meeting as the Commission is required to under the above provisions of this bill and keep minutes of the closed meeting as the Commission is required to under this bill.
QUALIFIED IMMUNITY, DEFENSE, AND INDEMNIFICATION
This bill provides that the members, officers, executive director, employees, and representatives of the Commission are immune from suit and liability, both personally and in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities; however, this provision does not protect any such person from suit or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person.
DATA SYSTEM
This bill requires the Commission to provide for the development, maintenance, operation, and utilization of a coordinated data and reporting system containing licensure, Adverse Action, and the reporting of the existence of Significant Investigative Information on all licensed Physician Assistants and applicants denied a License in Participating States. A Participating State must submit a uniform data set to the Data System on all Physician Assistants to whom this Compact is applicable (utilizing a unique identifier) as required by the Rules of the Commission. This bill clarifies that significant Investigative Information pertaining to a Licensee in any Participating State must only be available to other Participating States. This bill requires the Commission to promptly notify all Participating States of any Adverse Action taken against a Licensee or an individual applying for a License that has been reported to it. This Adverse Action information must be available to any other Participating State.
COMMISSION RULES APPLICABILITY
This bill requires the Commission to exercise its Rulemaking powers pursuant to the criteria set forth in this bill and the Rules adopted