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General Assembly Raised Bill No. 6835
January Session, 2025
LCO No. 3782
Referred to Committee on PUBLIC HEALTH
Introduced by:
(PH)
AN ACT ADOPTING THE PHYSICIAN ASSISTANT LICENSURE
COMPACT.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective July 1, 2025) The Physician Assistant 1
Licensure Compact, hereinafter referred to as the "PA Licensure 2
Compact", is hereby enacted into law and entered into by the state of 3
Connecticut with any and all states legally joining therein in accordance 4
with its terms. The compact is substantially as follows: 5
PA LICENSURE COMPACT 6
Section 1. Purpose 7
In order to strengthen access to medical services, and in recognition 8
of the advances in the delivery of medical services, the participating 9
states of the PA Licensure Compact have allied in common purpose to 10
develop a comprehensive process that complements the existing 11
authority of state licensing boards to license and discipline PAs and 12
seeks to enhance the portability of a license to practice as a PA while 13
safeguarding the safety of patients. The compact allows medical services 14
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to be provided by PAs, via the mutual recognition of the licensee's 15
qualifying license by other compact participating states. The compact 16
adopts the prevailing standard for PA licensure and affirms that the 17
practice and delivery of medical services by the PA occurs where the 18
patient is located at the time of the patient encounter and requires the 19
PA to be under the jurisdiction of the state licensing board where the 20
patient is located. Each state licensing board that participates in the 21
compact shall retain the jurisdiction to impose adverse action against a 22
compact privilege in such board's state that was issued to a PA through 23
the procedures of the compact. The PA Licensure Compact will alleviate 24
burdens for military families by allowing active duty military personnel 25
and their spouses to obtain a compact privilege based on having an 26
unrestricted license in good standing from a participating state. 27
Section 2. Definitions 28
As used in the compact: 29
(1) "Adverse action" means any administrative, civil, equitable or 30
criminal action permitted by a state's laws that is imposed by a licensing 31
board or other authority against a PA license, PA license application or 32
compact privilege, including, but not limited to, license denial, censure, 33
revocation, suspension, probation, monitoring of the licensee or 34
restriction on the licensee's practice. 35
(2) "Compact privilege" means the authorization granted by a remote 36
state to allow a licensee from another participating state to practice as a 37
PA to provide medical services and other licensed activity to a patient 38
located in the remote state under the remote state's laws and 39
regulations. 40
(3) "Conviction" means a finding by a court that an individual is 41
guilty of a felony or misdemeanor offense through adjudication or entry 42
of a plea of guilt or no contest to the charge by the offender. 43
(4) "Criminal background check" means the submission of 44
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fingerprints or other biometric-based information for a license applicant 45
for the purpose of obtaining such applicant's criminal history record 46
information, as defined in 28 CFR 20.3(d), as amended from time to time, 47
from the state's criminal history record repository, as defined in 28 CFR 48
20.3(f), as amended from time to time. 49
(5) "Data system" means the repository of information about 50
licensees, including, but not limited to, license status and adverse 51
actions, that is created and administered under the terms of the compact. 52
(6) "Executive committee" means a group of directors and ex-officio 53
individuals elected or appointed pursuant to subdivision (2) of 54
subsection (f) of section 7 of the compact. 55
(7) "Impaired practitioner" means a PA whose practice is adversely 56
affected by a health-related condition that impacts the PA's ability to 57
practice. 58
(8) "Investigative information" means information, records or 59
documents received or generated by a licensing board pursuant to an 60
investigation. 61
(9) "Jurisprudence requirement" means the assessment of an 62
individual's knowledge of the laws and rules governing the practice of 63
a PA in a state. 64
(10) "License" means current authorization by a state, other than 65
authorization pursuant to a compact privilege, for a PA to provide 66
medical services that would be unlawful without such current 67
authorization. 68
(11) "Licensee" means an individual who holds a license from a state 69
to provide medical services as a PA. 70
(12) "Licensing board" means any state entity authorized to license 71
and otherwise regulate PAs. 72
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(13) "Medical services" means health care services provided for the 73
diagnosis, prevention, treatment, cure or relief of a health condition, 74
injury or disease, as defined by a state's laws and regulations. 75
(14) "Model compact" means the model for the PA Licensure 76
Compact on file with the Council of State Governments, or other entity 77
as designated by the commission. 78
(15) "Participating state" means a state that has enacted the compact. 79
(16) "PA" means an individual who is licensed as a physician assistant 80
in a state. For purposes of the compact, any other title or status adopted 81
by a state to replace the term "physician assistant" shall be deemed 82
synonymous with "physician assistant" and "PA" and shall confer the 83
same rights and responsibilities to the licensee under the provisions of 84
the compact at the time of the compact's enactment. 85
(17) "PA Licensure Compact Commission", "compact commission", or 86
"commission" means the national administrative body created pursuant 87
to subsection (a) of section 7 of the compact. 88
(18) "Qualifying license" means an unrestricted license issued by a 89
participating state to provide medical services as a PA. 90
(19) "Remote state" means a participating state where a licensee who 91
is not licensed as a PA is exercising or seeking to exercise the compact 92
privilege. 93
(20) "Rule" means a regulation promulgated by an entity that has the 94
force and effect of law. 95
(21) "Significant investigative information" means investigative 96
information that a licensing board, after an inquiry or investigation that 97
includes notification and an opportunity for the PA to respond if 98
required by state law, has reason to believe is not groundless and, if 99
proven true, would indicate more than a minor infraction. 100
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(22) "State" means any state, commonwealth, district or territory of 101
the United States. 102
Section 3. State Participation in the Compact 103
(a) To participate in the compact, a participating state shall: 104
(1) License PAs. 105
(2) Participate in the compact commission's data system. 106
(3) Have a mechanism in place for receiving and investigating 107
complaints against licensees and license applicants. 108
(4) Notify the commission, in compliance with the terms of the 109
compact and commission rules, of any adverse action against a licensee 110
or license applicant and the existence of significant investigative 111
information regarding a licensee or license applicant. 112
(5) Fully implement a criminal background check requirement, 113
within a time frame established by commission rule, by the participating 114
state's licensing board receiving the results of a criminal background 115
check and reporting to the commission whether the license applicant 116
has been granted a license. 117
(6) Comply with the rules of the compact commission. 118
(7) Utilize passage of a recognized national licensure examination, 119
including, but not limited to, the Physician Assistant National 120
Certifying Examination administered by the National Commission on 121
Certification of Physician Assistants, as a requirement for PA licensure. 122
(8) Grant the compact privilege to a holder of a qualifying license in 123
a participating state. 124
(b) Nothing in the compact shall be construed to prohibit a 125
participating state from charging a fee for granting the compact 126
privilege. 127
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Section 4. Compact Privilege 128
(a) To exercise the compact privilege, a licensee shall: 129
(1) Have graduated from a PA program accredited by the 130
Accreditation Review Commission on Education for the Physician 131
Assistant, Inc., or any other PA program authorized by commission 132
rule. 133
(2) Hold current certification from the National Commission on 134
Certification of Physician Assistants. 135
(3) Have no felony or misdemeanor convictions. 136
(4) Have never had a controlled substance license, permit or 137
registration suspended or revoked by a state or by the United States 138
Drug Enforcement Administration. 139
(5) Have a unique identifier as determined by commission rule. 140
(6) Hold a qualifying license. 141
(7) Have had no revocation of a license or limitation or restriction on 142
any license currently held or compact privilege due to an adverse action, 143
provided (A) if a licensee had a limitation or restriction on a license or 144
compact privilege due to an adverse action, two years shall have elapsed 145
from the date on which the license or compact privilege is no longer 146
limited or restricted due to the adverse action, and (B) if a compact 147
privilege has been revoked or is limited or restricted in a participating 148
state for conduct that would not be a basis for disciplinary action in a 149
participating state in which the licensee is practicing or applying to 150
practice under a compact privilege, such participating state shall have 151
the discretion not to consider such action as an adverse action requiring 152
the denial or removal of a compact privilege in such state. 153
(8) Notify the compact commission that the licensee is seeking the 154
compact privilege in a remote state. 155
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(9) Meet any jurisprudence requirement of a remote state in which 156
the licensee is seeking to practice under the compact privilege and pay 157
any fees applicable to satisfying the jurisprudence requirement. 158
(10) Report to the commission any adverse action taken by a 159
nonparticipating state not later than thirty days after the adverse action 160
was taken. 161
(b) The compact privilege shall be valid until the expiration or 162
revocation of the qualifying license unless terminated pursuant to an 163
adverse action. The licensee shall comply with all of the requirements of 164
subsection (a) of this section of the compact to maintain the compact 165
privilege in a remote state. If the participating state takes adverse action 166
against a qualifying license, the licensee shall lose the compact privilege 167
in any remote state in which the licensee has a compact privilege until 168
both of the following occur: 169
(1) The license is no longer limited or restricted; and 170
(2) Two years have elapsed from the date on which the license is no 171
longer limited or restricted due to the adverse action. 172
(c) Once a restricted or limited license satisfies the requirements of 173
subdivisions (1) and (2) of subsection (b) of this section of the compact, 174
the licensee shall meet the requirements of subsection (a) of this section 175
of the compact to obtain a compact privilege in any remote state. 176
(d) For each remote state in which a PA seeks authority to prescribe 177
controlled substances, the PA shall satisfy all requirements imposed by 178
such state in granting or renewing such authority. 179
Section 5. Designation of the State from Which Licensee is Applying 180
for a Compact Privilege 181
(a) Upon a licensee's application for a compact privilege, the licensee 182
shall identify to the commission the participating state from which the 183
licensee is applying, in accordance with applicable rules adopted by the 184
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commission, and subject to the following requirements: 185
(1) When applying for a compact privilege, the licensee shall (A) 186
provide the commission with the address of the licensee's primary 187
residence, and (B) report to the commission any change in the address 188
of the licensee's primary residence immediately following such change. 189
(2) When applying for a compact privilege, the licensee shall be 190
required to consent to accept service of process by mail at the licensee's 191
primary residence on file with the commission with respect to any 192
action brought against the licensee by the commission or a participating 193
state, including, but not limited to, a subpoena. 194
Section 6. Adverse Actions 195
(a) A participating state in which a licensee is licensed shall have 196
exclusive power to impose adverse action against the qualifying license 197
issued by such participating state. 198
(b) In addition to the other powers conferred by state law, a remote 199
state shall have the authority, in accordance with existing state due 200
process requirements, to do all of the following: 201
(1) Take adverse action against a PA's compact privilege in such 202
remote state to remove a licensee's compact privilege or take other 203
action necessary under applicable law to protect the health and safety of 204
its citizens. 205
(2) Issue subpoenas for hearings or investigations that require the 206
attendance and testimony of witnesses and for the production of 207
evidence. Any subpoena issued by a licensing board in a participating 208
state for the attendance and testimony of witnesses or the production of 209
evidence from another participating state shall be enforced in such other 210
participating state by any court of competent jurisdiction according to 211
the practice and procedure of such court applicable to subpoenas issued 212
in proceedings pending before such court. The issuing authority shall 213
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pay any witness fees, travel expenses, mileage and other fees required 214
by the service statutes of the state in which the witnesses or evidence is 215
located. 216
(3) Notwithstanding the provisions of subdivision (2) of this 217
subsection, a participating state shall not issue a subpoena to gather 218
evidence of conduct in another state that is lawful in such other state for 219
the purpose of taking adverse action against a licensee's compact 220
privilege or application for a compact privilege in such participating 221
state. 222
(4) Nothing in the compact shall be construed to authorize a 223
participating state to impose discipline against a PA's compact privilege 224
or deny an application for a compact privilege in such participating state 225
for the PA's otherwise lawful practice in another state. 226
(c) For purposes of taking adverse action, the participating state that 227
issued the qualifying license shall give the same priority and effect to 228
reported conduct received from any other participating state as it would 229
if the conduct had occurred within the participating state that issued the 230
qualifying license and shall apply its own state laws to determine 231
appropriate action. 232
(d) A participating state, if otherwise permitted by state law, may 233
recover from the affected PA the costs of any investigation or disposition 234
of a case resulting from any adverse action taken against such PA. 235
(e) A participating state may take adverse action based on the factual 236
findings of a remote state, provided the participating state follows its 237
own procedures for taking the adverse action. 238
(f) Joint Investigations 239
(1) In addition to the authority granted to a participating state by its 240
respective state statutes and regulations concerning PAs, or other 241
applicable state law, any participating state may participate with any 242
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other participating state in a joint investigation of a licensee. 243
(2) A participating state shall share any investigative, litigation or 244
compliance materials in furtherance of any joint or individual 245
investigation initiated under the compact. 246
(g) If an adverse action is taken against a PA's qualifying license, the 247
PA's compact privilege in all remote states shall be deactivated until two 248
years have elapsed from the date on which all restrictions were removed 249
from the state license. All disciplinary orders by the participating state 250
that issued the qualifying license that impose one or more adverse 251
actions against a PA's license shall include a statement that the PA's 252
compact privilege is deactivated in all participating states during the 253
pendency of the order. 254
(h) If any participating state takes adverse action, it shall promptly 255
notify the administrator of the data system. 256
Section 7. Establishment of the PA Licensure Compact Commission 257
(a) The participating states hereby create and establish a joint 258
government agency and national administrative body known as the PA 259
Licensure Compact Commission. The commission shall be an 260
instrumentality of the compact states acting jointly and not an 261
instrumentality of any one state. The commission shall come into 262
existence on or after the effective date of the compact as set forth in 263
subsection (a) of section 11 of the compact. 264
(b) Membership, Voting and Meetings 265
(1) Each participating state shall have and be limited to one delegate 266
selected by such participating state's licensing board or, if the state has 267
more than one licensing board, selected collectively by the participating 268
state's licensing boards. 269
(2) The delegate shall be either: 270
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(A) A current PA, physician or public member of a licensing board or 271
a PA council or committee; or 272
(B) An administrator of a licensing board. 273
(3) Any delegate may be removed or suspended from office as 274
provided by the laws of the state from which the delegate is appointed. 275
(4) The participating state licensing board shall fill any vacancy 276
occurring in the commission not later than sixty days after the date on 277
which the vacancy occurred. 278
(5) Each delegate shall be entitled to one vote on all matters voted on 279
by the commission and shall otherwise have an opportunity to 280
participate in the business and affairs of the commission. A delegate 281
shall vote in person or by such other means as provided in the bylaws. 282
The bylaws may provide for delegates' participation in meetings by 283
telecommunications, video conference or other means of 284
communication. 285
(6) The commission shall meet at least once during each calendar 286
year. Additional meetings shall be held as set forth in the compact and 287
the bylaws. 288
(7) The commission shall establish by rule a term of office for 289
delegates. 290
(c) The commission shall have the following powers and duties: 291
(1) Establish a code of ethics for the commission; 292
(2) Establish the fiscal year of the commission; 293
(3) Establish fees; 294
(4) Establish bylaws; 295
(5) Maintain its financial records in accordance with the bylaws; 296
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(6) Meet and take such actions as are consistent with the provisions 297
of the compact and the bylaws; 298
(7) Promulgate rules to facilitate and coordinate implementation and 299
administration of the compact. The rules shall have the force and effect 300
of law and shall be binding in all participating states; 301
(8) Bring and prosecute legal proceedings or actions in the name of 302
the commission, provided the standing of any state licensing board to 303
sue or be sued under applicable law shall not be affected; 304
(9) Purchase and maintain insurance and bonds; 305
(10) Borrow, accept or contract for services of personnel, including, 306
but not limited to, employees of a participating state; 307
(11) Hire employees and engage contractors, elect or appoint officers, 308
fix compensation, define duties, grant such individuals appropriate 309
authority to carry out the purposes of the compact and establish the 310
commission's personnel policies and programs relating to conflicts of 311
interest, qualifications of personnel and other related personnel matters; 312
(12) Accept any and all appropriate donations and grants of money, 313
equipment, supplies, materials and services, and receive, utilize and 314
dispose of such money, equipment, supplies material and services, 315
provided the commission shall avoid any appearance of impropriety or 316
conflict of interest at all times; 317
(13) Lease, purchase, accept appropriate gifts or donations of, or 318
otherwise own, hold, improve or use, any property, real, personal or 319
mixed, provided the commission shall avoid any appearance of 320
impropriety at all times; 321
(14) Sell, convey, mortgage, pledge, lease, exchange, abandon or 322
otherwise dispose of any property real, personal or mixed; 323
(15) Establish a budget and make expenditures; 324
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(16) Borrow money; 325
(17) Appoint committees, including standing committees composed 326
of members, state regulators, state legislators or their representatives 327
and consumer representatives, and such other interested persons as 328
may be designated in the compact and the bylaws; 329
(18) Provide and receive information from, and cooperate with, law 330
enforcement agencies; 331
(19) Elect a chair, vice chair, secretary and treasurer and such other 332
officers of the commission as provided in the commission's bylaws; 333
(20) Reserve for itself, in addition to those reserved exclusively to the 334
commission under the compact, powers that the executive committee 335
may not exercise; 336
(21) Approve or disapprove a state's participation in the compact 337
based upon its determination as to whether the state's compact 338
legislation departs in a material manner from the model compact 339
language; 340
(22) Prepare and provide to the participating states an annual report; 341
and 342
(23) Perform such other functions as may be necessary or appropriate 343
to achieve the purposes of the compact consistent with the state 344
regulation of PA licensure and practice. 345
(d) Meetings of the Commission 346
(1) All meetings of the commission that are not closed pursuant to 347
subdivision (3) of this subsection shall be open to the public. Notice of 348
public meetings shall be posted on the commission's Internet web site 349
not later than thirty days prior to the public meeting. 350
(2) Notwithstanding the provisions of subdivision (1) of this 351
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subsection, the commission may convene a public meeting by providing 352
notice of the meeting at least twenty-four hours prior to the meeting on 353
the commission's Internet web site, and any other means as provided in 354
the commission's rules, for any of the reasons it may dispense with 355
notice of proposed rulemaking under subsection (l) of section 9 of the 356
compact. 357
(3) The commission may convene in a closed, nonpublic meeting or 358
nonpublic part of a public meeting to receive legal advice or to discuss: 359
(A) Noncompliance of a participating state with its obligations under 360
the compact; 361
(B) The employment, compensation, discipline or other matters, 362
practices or procedures related to specific employees or other matters 363
related to the commission's internal personnel practices and procedures; 364
(C) Current, threatened or reasonably anticipated litigation; 365
(D) Negotiation of contracts for the purchase, lease or sale of goods, 366
services or real estate; 367
(E) Accusing any person of a crime or formally censuring any person; 368
(F) Disclosure of trade secrets or commercial or financial information 369
that is privileged or confidential; 370
(G) Disclosure of information of a personal nature where disclosure 371
would constitute a clearly unwarranted invasion of personal privacy; 372
(H) Disclosure of investigative records compiled for law enforcement 373
purposes; 374
(I) Disclosure of information related to any investigative reports 375
prepared by or on behalf of or for use of the commission or other 376
committee charged with responsibility of investigation or determination 377
of compliance issues pursuant to the compact; 378
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(J) Legal advice; or 379
(K) Matters specifically exempted from disclosure by federal or 380
participating states' statutes. 381
(4) If a meeting, or portion of a meeting, is closed pursuant to 382
subdivision (3) of this subsection, the chair of the meeting, or the chair's 383
designee, shall certify that the meeting or portion of the meeting may be 384
closed and shall reference each relevant exempting provision. 385
(5) The commission shall keep minutes that fully and clearly describe 386
all matters discussed in a meeting and shall provide a full and accurate 387
summary of actions taken, including, but not limited to, a description of 388
the views expressed at the meeting. All documents considered in 389
connection with an action shall be identified in such minutes. All 390
minutes and documents of a closed meeting shall remain under seal, 391
subject to release by a majority vote of the commission or order of a 392
court of competent jurisdiction. 393
(e) Financing of the Commission 394
(1) The commission shall pay, or provide for the payment of, the 395
reasonable expenses of its establishment, organization and ongoing 396
activities. 397
(2) The commission may accept any and all appropriate revenue 398
sources, donations and grants of money, equipment, supplies, materials 399
and services. 400
(3) The commission may levy on and collect an annual assessment 401
from each participating state and may impose compact privilege fees on 402
licensees of participating states to whom a compact privilege is granted 403
to cover the cost of the operations and activities of the commission and 404
its staff. Such fees shall be in a total amount that is sufficient to cover its 405
annual budget as approved by the commission each year for which 406
revenue is not provided by other sources. The aggregate annual 407
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assessment amount levied on participating states shall be allocated 408
based upon a formula to be determined by commission rule. 409
(A) A compact privilege expires when the licensee's qualifying 410
license in the participating state from which the licensee applied for the 411
compact privilege expires. 412
(B) If the licensee terminates the qualifying license through which the 413
licensee applied for the compact privilege before its scheduled 414
expiration and the licensee has a qualifying license in another 415
participating state, the licensee shall inform the commission that it is 416
changing to such participating state the participating state through 417
which it applies for a compact privilege and pay to the commission any 418
compact privilege fee required by commission rule. 419
(4) The commission shall not (A) incur an obligation of any kind prior 420
to securing the funds adequate to meet the same, or (B) pledge the credit 421
of any of the participating states, except by and with the authority of the 422
participating state. 423
(5) The commission shall keep accurate accounts of all receipts and 424
disbursements. The receipts and disbursements of the commission shall 425
be subject to the financial review and accounting procedures established 426
under its bylaws. All receipts and disbursements of funds handled by 427
the commission shall be subject to an annual financial review by a 428
certified or licensed public accountant, and the report of the financial 429
review shall be included in and become part of the annual report of the 430
commission. 431
(f) The Executive Committee 432
(1) The executive committee shall have the power to act on behalf of 433
the commission according to the terms of the compact and commission 434
rules. 435
(2) The executive committee shall be composed of the following nine 436
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members: 437
(A) Seven voting members who shall be elected by the commission 438
from the current membership of the commission; 439
(B) One ex-officio, nonvoting member from a recognized national PA 440
professional association; and 441
(C) One ex-officio, nonvoting member from a recognized national PA 442
certification organization. 443
(3) The ex-officio members shall be selected by their respective 444
organizations. 445
(4) The commission may remove any member of the executive 446
committee as provided in its bylaws. 447
(5) The executive committee shall meet at least annually. 448
(6) The executive committee shall have the following duties and 449
responsibilities: 450
(A) Recommend to the commission changes to the commission's rules 451
or bylaws, changes to the compact legislation, fees to be paid by compact 452
participating states, including, but not limited to, annual dues, and any 453
commission compact fee charged to licensees for the compact privilege; 454
(B) Ensure compact administration services are appropriately 455
provided, contractual or otherwise; 456
(C) Prepare and recommend the budget; 457
(D) Maintain financial records on behalf of the commission; 458
(E) Monitor compact compliance of participating states and provide 459
compliance reports to the commission; 460
(F) Establish additional committees as necessary; 461
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(G) Exercise the powers and duties of the commission during the 462
interim between commission meetings, except the issuance of proposed 463
rulemaking, the adoption of commission rules or bylaws or the exercise 464
of any other powers and duties exclusively reserved to the commission 465
by the commission's rules; and 466
(H) Perform other duties as provided in the commission's rules or 467
bylaws. 468
(7) All meetings of the executive committee at which it votes or plans 469
to vote on matters in exercising the powers and duties of the 470
commission shall be open to the public and public notice of such 471
meetings shall be given as public meetings of the commission are given. 472
(8) The executive committee may convene in a closed, nonpublic 473
meeting for the same reasons that the commission may convene in a 474
nonpublic meeting as set forth in subdivision (3) of subsection (d) of this 475
section of the compact and shall announce the closed meeting as the 476
commission is required to under subdivision (4) of subsection (d) of this 477
section of the compact and keep minutes of the closed meeting as the 478
commission is required to under subdivision (5) of subsection (d) of this 479
section of the compact. 480
(g) Qualified Immunity, Defense and Indemnification 481
(1) The members, officers, executive director, employees and 482
representatives of the commission shall be immune from suit and 483
liability, both personally and in their official capacity, for any claim for 484
damage to or loss of property or personal injury or other civil liability 485
caused by or arising out of any actual or alleged act, error or omission 486
that occurred, or that the person against whom the claim is made had a 487
reasonable basis for believing occurred, within the scope of commission 488
employment, duties or responsibilities, provided nothing in this 489
subdivision shall be construed to protect any such person from suit or 490
liability for any damage, loss, injury or liability caused by the intentional 491
or wilful or wanton misconduct of that person. The procurement of 492
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insurance of any type by the commission shall not in any way 493
compromise or limit the immunity granted under this subdivision. 494
(2) The commission shall defend any member, officer, executive 495
director, employee and representative of the commission in any civil 496
action seeking to impose liability arising out of any actual or alleged act, 497
error or omission that occurred within the scope of commission 498
employment, duties or responsibilities, or as determined by the 499
commission that the person against whom the claim is made had a 500
reasonable basis for believing occurred within the scope of commission 501
employment, duties or responsibilities, provided (A) nothing in this 502
subdivision shall be construed to prohibit such person from retaining 503
such person's own counsel at such person's own expense, and (B) the 504
actual or alleged act, error or omission did not result from such person's 505
intentional or wilful or wanton misconduct. 506
(3) The commission shall indemnify and hold harmless any member, 507
officer, executive director, employee or representative of the 508
commission for the amount of any settlement or judgment obtained 509
against such person arising out of any actual or alleged act, error or 510
omission that occurred within the scope of commission employment, 511
duties or responsibilities, or that such person had a reasonable basis for 512
believing occurred within the scope of commission employment, duties 513
or responsibilities, provided the actual or alleged act, error or omission 514
did not result from the intentional or wilful or wanton misconduct of 515
such person. 516
(4) Venue shall be proper and judicial proceedings by or against the 517
commission shall be brought solely and exclusively in a court of 518
competent jurisdiction where the principal office of the commission is 519
located. The commission may waive venue and jurisdictional defenses 520
in any proceedings as authorized by commission rules. 521
(5) Nothing in the compact shall be construed as a limitation on the 522
liability of any licensee for professional malpractice or misconduct, 523
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which shall be governed solely by any other applicable state laws. 524
(6) Nothing in the compact shall be construed to designate the venue 525
or jurisdiction to bring actions for alleged acts of malpractice, 526
professional misconduct, negligence or other such civil action 527
pertaining to the practice of a PA. All such matters shall be determined 528
exclusively by state law other than the compact. 529
(7) Nothing in the compact shall be construed to waive or otherwise 530
abrogate a participating state's state action immunity or state action 531
affirmative defense with respect to antitrust claims under the Sherman 532
Act, 15 USC 1 et seq., as amended from time to time, Clayton Antitrust 533
Act, 15 USC 12-27, as amended from time to time, or any other state or 534
federal antitrust or anticompetitive law or regulation. 535
(8) Nothing in the compact shall be construed to be a waiver of 536
sovereign immunity by the participating states or by the commission. 537
Section 8. Data System 538
(a) The commission shall provide for the development, maintenance, 539
operation and utilization of a coordinated data and reporting system 540
containing licensure, adverse action and the reporting of the existence 541
of significant investigative information on all licensed PAs and 542
applicants denied a license in participating states. 543
(b) Notwithstanding any other state law, each participating state shall 544
submit a uniform data set to the data system, utilizing a unique 545
identifier for such state, on all PAs to whom the compact is applicable 546
as required by the rules of the commission, including the following: 547
(1) Identifying information; 548
(2) Licensure data; 549
(3) Adverse actions against a license or compact privilege; 550
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(4) Any denial of application for licensure, except any criminal 551
history record information where the reporting of such information is 552
prohibited by law, and the reason or reasons for such denial; 553
(5) The existence of significant investigative information; and 554
(6) Any other information that may facilitate the administration of the 555
compact, as determined by the rules of the commission. 556
(c) Significant investigative information pertaining to a licensee in 557
any participating state shall only be available to other participating 558
states. 559
(d) The commission shall promptly notify all participating states of 560
any adverse action taken against a licensee or an individual applying for 561
a license that has been reported to the commission. Such adverse action 562
information shall be available to any other participating state. 563
(e) Each participating state contributing information to the data 564
system may, in accordance with state or federal law, designate 565
information that may not be shared with the public without the express 566
permission of the contributing state. Notwithstanding any such 567
designation, such information shall be reported to the commission 568
through the data system. 569
(f) Any information submitted to the data system that is subsequently 570
expunged pursuant to federal law or the laws of the participating state 571
contributing the information shall be removed from the data system 572
upon the reporting of such expungement by the participating state to 573
the commission. 574
(g) The records and information provided to a participating state 575
pursuant to the compact or through the data system, when certified by 576
the commission or an agent thereof, shall constitute the authenticated 577
business records of the commission and shall be entitled to any 578
associated hearsay exception in any relevant judicial, quasi-judicial or 579
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administrative proceedings in a participating state. 580
Section 9. Rulemaking 581
(a) The commission shall exercise its rulemaking powers pursuant to 582
the criteria set forth in this section of the compact and the rules adopted 583
under the compact. A commission rule shall become binding as of the 584
date specified by the commission for each rule. 585
(b) The commission shall promulgate reasonable rules to effectively 586
and efficiently implement and administer the compact and achieve the 587
compact's purposes. A commission rule shall be invalid and have no 588
force or effect only if a court of competent jurisdiction holds that the rule 589
is invalid because the commission exercised its rulemaking authority in 590
a manner that is beyond the scope of the purposes of the compact, or the 591
powers granted under the compact, or based upon another applicable 592
standard of review. 593
(c) The rules of the commission shall have the force of law in each 594
participating state, provided where the rules of the commission conflict 595
with the laws of the participating state that establish the medical 596
services a PA may perform in the participating state, as held by a court 597
of competent jurisdiction, the rules of the commission shall be 598
ineffective in such state to the extent of the conflict. 599
(d) If a majority of the legislatures of the participating states rejects a 600
commission rule by enactment of a statute or resolution in the same 601
manner used to adopt the compact not later than four years after the 602
date of adoption of the commission rule, such rule shall have no further 603
force and effect in any participating state or to any state applying to 604
participate in the compact. 605
(e) Commission rules shall be adopted at a regular or special meeting 606
of the commission. 607
(f) Prior to promulgation and adoption of a final rule or rules by the 608
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commission, and at least thirty days prior to the meeting at which the 609
rule will be considered and voted upon, the commission shall file a 610
notice of proposed rulemaking: 611
(1) On the Internet web site of the commission or other publicly 612
accessible platform; 613
(2) To persons who have requested notice of the commission's notices 614
of proposed rulemaking; and 615
(3) In such other manners as the commission may by rule specify. 616
(g) The notice of proposed rulemaking shall include the following: 617
(1) The time, date and location of the public hearing on the proposed 618
rule and the proposed time, date and location of the meeting in which 619
the proposed rule will be considered and voted upon; 620
(2) The text of the proposed rule and the reason for the proposed rule; 621
(3) A request for comments on the proposed rule from any interested 622
person and the date by which written comments must be received; and 623
(4) The manner in which interested persons may submit notice to the 624
commission of their intention to attend the public hearing or provide 625
any written comments. 626
(h) Prior to adoption of a proposed rule, the commission shall allow 627
persons to submit written data, facts, opinions and arguments, which 628
shall be made available to the public. 629
(i) If the hearing is to be held via electronic means, the commission 630
shall publish the mechanism for access to the electronic hearing. 631
(1) All persons wishing to be heard at the hearing shall, as directed in 632
the notice of proposed rulemaking, notify the commission of their desire 633
to appear and testify at the hearing not less than five business days prior 634
to the scheduled date of the hearing. 635
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(2) Hearings shall be conducted in a manner providing each person 636
who wishes to comment a fair and reasonable opportunity to comment 637
orally or in writing. 638
(3) All hearings shall be recorded. A copy of the recording and the 639
written comments, data, facts, opinions and arguments received in 640
response to the proposed rulemaking shall be made available to a 641
person upon request. 642
(4) Nothing in this section of the compact shall be construed to 643
require a separate hearing on each proposed rule. Proposed rules may 644
be grouped for the convenience of the commission at hearings required 645
by this section of the compact. 646
(j) Following the public hearing, the commission shall consider all 647
written and oral comments timely received. 648
(k) The commission shall, by majority vote of all delegates, take final 649
action on the proposed rule and determine the effective date of the rule, 650
if adopted, based on the rulemaking record and the full text of the rule. 651
(1) If adopted, the rule shall be posted on the commission's Internet 652
web site. 653
(2) The commission may adopt changes to the proposed rule, 654
provided the changes do not expand the original purpose of the 655
proposed rule. 656
(3) The commission shall post on its Internet web site an explanation 657
of the reasons for substantive changes made to the proposed rule and 658
the reasons for any substantive changes that were recommended by 659
commenters but not made. 660
(4) The commission shall determine a reasonable effective date for the 661
rule. Except for an emergency as provided in subsection (l) of this 662
section of the compact, the effective date of the rule shall be no sooner 663
than thirty days after the commission issued the notice that it adopted 664
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the rule. 665
(l) Upon determination that an emergency exists, the commission 666
may consider and adopt an emergency rule with twenty-four hours' 667
prior notice, without the opportunity for comment or hearing, provided 668
the usual rulemaking procedures provided in the compact and in this 669
section of the compact shall be retroactively applied to the rule as soon 670
as reasonably possible, but in no event later than ninety days after the 671
effective date of the rule. For the purposes of this subsection, 672
"emergency rule" means a rule that shall be adopted immediately by the 673
commission to: 674
(1) Meet an imminent threat to public health, safety or welfare; 675
(2) Prevent a loss of commission or participating state funds; 676
(3) Meet a deadline for the promulgation of a commission rule that is 677
established by federal law or rule; or 678
(4) Protect public health or safety. 679
(m) The commission or an authorized committee of the commission 680
may direct revisions to a previously adopted commission rule for 681
purposes of correcting typographical errors, errors in format, errors in 682
consistency or grammatical errors. Public notice of any revisions shall 683
be posted on the Internet web site of the commission. The revision shall 684
be subject to challenge by any person for a period of thirty days after 685
posting. The revision may be challenged only on grounds that the 686
revision results in a material change to a rule. A challenge shall be made 687
as set forth in the notice of revisions and delivered to the commission 688
prior to the end of the notice period. If no challenge is made, the revision 689
shall take effect without further action. If the revision is challenged, the 690
revision may not take effect without the approval of the commission. 691
(n) No participating state's rulemaking requirements shall apply 692
under the compact. 693
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Section 10. Oversight, Dispute Resolution and Enforcement 694
(a) Oversight 695
(1) The executive and judicial branches of state government in each 696
participating state shall enforce the compact and take all actions 697
necessary and appropriate to implement the compact. 698
(2) Venue shall be proper and judicial proceedings by or against the 699
commission shall be brought solely and exclusively in a court of 700
competent jurisdiction where the principal office of the commission is 701
located. The commission may waive venue and jurisdictional defenses 702
to the extent it adopts or consents to participate in alternative dispute 703
resolution proceedings. Nothing in this subdivision shall be construed 704
to affect or limit the selection or propriety of venue in any action against 705
a licensee for professional malpractice, misconduct or any such similar 706
matter. 707
(3) The commission shall be entitled to receive service of process in 708
any proceeding regarding the enforcement or interpretation of the 709
compact or the commission's rules and shall have standing to intervene 710
in such a proceeding for all purposes. Failure to provide the commission 711
with service of process shall render a judgment or order in such 712
proceeding void as to the commission, the compact or commission rules. 713
(b) Default, Technical Assistance and Termination 714
(1) If the commission determines that a participating state has 715
defaulted in the performance of its obligations or responsibilities under 716
the compact or the commission rules, the commission shall provide 717
written notice to the defaulting state and other participating states. The 718
notice shall describe the default, the proposed means of curing the 719
default and any other action that the commission may take and shall 720
offer remedial training and specific technical assistance regarding the 721
default. 722
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(2) If a state in default fails to cure the default, the defaulting state 723
may be terminated from the compact upon an affirmative vote of a 724
majority of the delegates of the participating states, and all rights, 725
privileges and benefits conferred by the compact upon such state may 726
be terminated on the effective date of termination. A cure of the default 727
shall not relieve the offending state of obligations or liabilities incurred 728
during the period of default. 729
(3) Termination of participation in the compact shall be imposed only 730
after all other means of securing compliance have been exhausted. The 731
commission shall provide notice of intent to suspend or terminate to the 732
governor and majority and minority leaders of the defaulting state's 733
legislature and the licensing board or boards of each of the participating 734
states. 735
(4) A state that has been terminated shall be responsible for all 736
assessments, obligations and liabilities incurred through the effective 737
date of termination, including, but not limited to, obligations that extend 738
beyond the effective date of termination. 739
(5) The commission shall not bear any costs related to a state that is 740
found to be in default or that has been terminated from the compact, 741
unless agreed upon in writing between the commission and the 742
defaulting state. 743
(6) The defaulting state may appeal its termination from the compact 744
by the commission by petitioning the United States District Court for 745
the District of Columbia or the federal district where the commission 746
has its principal offices. The prevailing member shall be awarded all 747
costs of such litigation, including, but not limited to, reasonable 748
attorney's fees. 749
(7) Upon the termination of a state's participation in the compact, the 750
state shall immediately provide notice to all licensees within such state 751
of such termination. 752
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(A) Licensees who have been granted a compact privilege in such 753
state shall retain the compact privilege for one hundred eighty days 754
following the effective date of such termination. 755
(B) Licensees who are licensed in such state who have been granted a 756
compact privilege in a participating state shall retain the compact 757
privilege for one hundred eighty days unless the licensee also has a 758
qualifying license in a participating state or obtains a qualifying license 759
in a participating state before the one-hundred-eighty-day period ends, 760
in which case the compact privilege shall continue. 761
(c) Dispute Resolution 762
(1) Upon request by a participating state, the commission shall 763
attempt to resolve disputes related to the compact that arise among 764
participating states and between participating and nonparticipating 765
states. 766
(2) The commission shall promulgate a rule providing for both 767
mediation and binding dispute resolution for disputes as appropriate. 768
(d) Enforcement 769
(1) The commission, in the reasonable exercise of its discretion, shall 770
enforce the provisions of the compact and rules of the commission. 771
(2) If compliance is not secured after all means to secure compliance 772
have been exhausted, the commission may, by majority vote, initiate 773
legal action in the United States District Court for the District of 774
Columbia, or the federal district where the commission has its principal 775
offices, against a participating state in default to enforce compliance 776
with the provisions of the compact and the commission's promulgated 777
rules and bylaws. The relief sought may include both injunctive relief 778
and damages. If judicial enforcement is necessary, the prevailing party 779
shall be awarded all costs of such litigation, including reasonable 780
attorney's fees. 781
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(3) The remedies set forth in subdivision (2) of this subsection shall 782
not be the exclusive remedies of the commission. The commission may 783
pursue any other remedies available under federal or state law. 784
(e) Legal Action Against the Commission 785
(1) A participating state may initiate legal action against the 786
commission in the United States District Court for the District of 787
Columbia, or the federal district where the commission has its principal 788
offices, to enforce compliance with the provisions of the compact and its 789
rules. The relief sought may include both injunctive relief and damages. 790
If judicial enforcement is necessary, the prevailing party shall be 791
awarded all costs of such litigation, including reasonable attorney's fees. 792
(2) No person other than a participating state shall enforce the 793
compact against the commission. 794
Section 11. Date of Implementation of the PA Licensure Compact 795
Commission 796
(a) The compact shall come into effect on the date on which this 797
compact statute is enacted into law in the seventh participating state. 798
(1) On or after the effective date of the compact, the commission shall 799
convene and review the enactment of each of the states that enacted the 800
compact prior to the commission convening, which shall be known as 801
the charter participating states, to determine if the statute enacted by 802
each such charter participating state is materially different from the 803
compact. 804
(A) A charter participating state whose enactment is found to be 805
materially different from the compact shall be entitled to the default 806
process set forth in subsection (b) of section 10 of the compact. 807
(B) If any participating state later withdraws from the compact or its 808
participation is terminated, the commission shall remain in existence 809
and the compact shall remain in effect even if the number of 810
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participating states is less than seven after such withdrawal. 811
Participating states enacting the compact subsequent to the commission 812
convening shall be subject to the process set forth in subdivision (21) of 813
subsection (c) of section 7 of the compact to determine if such 814
enactments are materially different from the compact and whether such 815
participating states qualify for participation in the compact. 816
(2) Participating states enacting the compact subsequent to the seven 817
initial charter participating states shall be subject to the process set forth 818
in subdivision (21) of subsection (c) of section 7 of the compact to 819
determine if such enactments are materially different from the compact 820
and whether such participating states qualify for participation in the 821
compact. 822
(3) All actions taken for the benefit of the commission or in 823
furtherance of the purposes of the administration of the compact prior 824
to the effective date of the compact or the commission coming into 825
existence shall be considered to be actions of the commission unless 826
specifically repudiated by the commission. 827
(b) Any state that joins the compact shall be subject to the 828
commission's rules and bylaws as such rules and bylaws exist on the 829
date on which the compact becomes law in such state. Any rule that has 830
been previously adopted by the commission shall have the full force and 831
effect of law on the day the compact becomes law in such state. 832
(c) Any participating state may withdraw from the compact by 833
enacting a statute repealing the compact. 834
(1) A participating state's withdrawal from the compact shall not take 835
effect until one hundred eighty days after enactment of the repealing 836
statute. During such one-hundred-eighty-day period, all compact 837
privileges that were in effect in the withdrawing state and were granted 838
to licensees licensed in the withdrawing state shall remain in effect. If 839
any licensee licensed in the withdrawing state is also licensed in another 840
participating state or obtains a license in another participating state on 841
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or before one hundred eighty days after such withdrawal, the licensee's 842
compact privileges in other participating states shall not be affected by 843
the passage of such one hundred eighty days. 844
(2) Withdrawal under subsection (d) of this section of the compact 845
shall not affect the continuing requirement of the state licensing board 846
or boards of the withdrawing state to comply with the investigative and 847
adverse action reporting requirements of the compact prior to the 848
effective date of withdrawal. 849
(3) Upon the enactment of a statute withdrawing a state from the 850
compact, the state shall immediately provide notice of such withdrawal 851
to all licensees in such state. Such withdrawing state shall continue to 852
recognize all licenses granted pursuant to the compact for a minimum 853
of one hundred eighty days after the date of such notice of withdrawal. 854
(d) Nothing in the compact shall be construed to invalidate or prevent 855
any PA licensure agreement or other cooperative arrangement between 856
participating states and between a participating state and 857
nonparticipating state that does not conflict with the provisions of the 858
compact. 859
(e) The compact may be amended by the participating states. No 860
amendment to the compact shall become effective and binding upon 861
any participating state until it is enacted materially in the same manner 862
into the laws of all participating states as determined by the 863
commission. 864
Section 12. Construction and Severability 865
(a) The compact and the commission's rulemaking authority shall be 866
liberally construed to effectuate the purposes and the implementation 867
and administration of the compact. Provisions of the compact expressly 868
authorizing or requiring the promulgation of rules shall not be 869
construed to limit the commission's rulemaking authority solely for 870
those purposes. 871
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(b) The provisions of the compact shall be severable and if any phrase, 872
clause, sentence or provision of the compact is held by a court of 873
competent jurisdiction to be contrary to the constitution of any 874
participating state, a state seeking participation in the compact or of the 875
United States, or the applicability of the compact to any government, 876
agency, person or circumstance is held to be unconstitutional by a court 877
of competent jurisdiction, the validity of the remainder of the compact 878
and the applicability thereof to any other government, agency, person 879
or circumstance shall not be affected thereby. 880
(c) Notwithstanding the provisions of subsection (b) of this section of 881
the compact, the commission may deny a state's participation in the 882
compact or, in accordance with the requirements of subsection (b) of 883
section 10 of the compact, terminate a participating state's participation 884
in the compact if it determines that a constitutional requirement of a 885
participating state is, or would be with respect to a state seeking to 886
participate in the compact, a material departure from the compact. 887
Otherwise, if the compact is held to be contrary to the constitution of 888
any participating state, the compact shall remain in full force and effect 889
as to the remaining participating states and in full force and effect as to 890
the participating state affected as to all severable matters. 891
Section 13. Binding Effect of Compact 892
(a) Nothing in the compact shall prevent the enforcement of any other 893
law of a participating state that is not inconsistent with the compact. 894
(b) Any laws in a participating state in conflict with the compact are 895
superseded to the extent of the conflict. 896
(c) All agreements between the commission and the participating 897
states are binding in accordance with the terms of such agreements. 898
Sec. 2. (NEW) (Effective July 1, 2025) The Commissioner of Public 899
Health shall require each person applying for licensure as a physician 900
assistant to submit to a state and national fingerprint-based criminal 901
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history records check pursuant to section 29-17a of the general statutes. 902
As used in this section, (1) "physician assistant" means an individual 903
licensed to practice as a physician assistant, and (2) "licensure" means 904
authorization by a state physician assistant regulatory authority to 905
practice as a physician assistant, the practice of which would be 906
unlawful without such authorization. 907
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2025 New section
Sec. 2 July 1, 2025 New section
Statement of Purpose:
To adopt the Physician Assistant Licensure Compact.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
underlined.]