SESSION OF 2025
SUPPLEMENTAL NOTE ON HOUSE BILL NO. 2219
As Amended by House Committee on Health
and Human Services
Brief*
HB 2219, as amended, would enact the Physician
Assistant Licensure Compact (Compact). The Compact’s
uniform provisions are outlined below.
Purpose (Section 1)
The purpose of the Compact would be to facilitate the
interstate practice of physician assistants (PAs) with the goal
of improving public access to medical services and achieving
a number of objectives that reduce administrative burden
while increasing availability of licensed PAs as well as
cooperation among member state licensing bodies.
The Compact would preserve the regulatory authority of
states to safeguard the safety of patients through the current
system of state licensure while also providing license
portability for qualifying professionals.
The Compact would allow active duty military personnel
or their spouses to obtain a compact privilege by having an
unrestricted license in good standing from a participating
state.
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*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
https://klrd.gov/ Definitions (Section 2)
The Compact would define various terms used
throughout the Compact, including:
●“Compact privilege” would mean the authorization
granted by a remote state to allow a licensee from
another participating state to practice as a PA to
provide medical services and other licensed activity
to a patient located in a remote state under the
remote state’s laws and regulations; and
●“PA” would mean an individual who is licensed as a
PA in a state. For purposes of this compact, any
other title or status adopted by a state to replace
the term “physician assistant” shall be deemed
synonymous with “physician assistant” and shall
confer the same rights and responsibilities to the
licensee under the provisions of this compact at its
time of its enactment.
State Participation in the Compact (Section 3)
The Compact would require member states to:
●License PAs;
●Participate in the Compact Commission’s
(Commission) data system;
●Have a mechanism in place for receiving and
investigating complaints against licensees and
applicants for licensure;
●Notify the Commission of adverse actions and the
existence of significant investigative information
regarding a licensee or applicant for licensure;
●Implement and report a criminal background check,
which would include the submission of fingerprints
2- 2219 or other biometric-based information, per the
Commission;
●Comply with the rules of the Commission;
●Utilize passage of a recognized national
examination as a requirement for PA licensure; and
●Grant the Compact privilege to a qualifying
licensee in a participating state.
The Compact would authorize member states to charge
a fee for granting a Compact privilege.
Compact Privilege (Section 4)
The Compact would require PAs to meet certain
educational, credentialing, criminal history, and controlled
substances license, permit, or registration criteria to exercise
Compact privileges. The bill would align Compact privilege
with the underlying license’s adverse actions limitations or
restrictions unless a participating state does not have the
same basis for disciplinary action, and the participating state
would have the ability to exercise their discretion not to
consider such action as an adverse action requiring denial or
removal of a Compact privilege.
Designation of the State from which the Licensee is
Applying for Compact Privilege (Section 5)
The Compact would require a licensee to designate their
home state and the primary residential address to be used for
service of process by mail. The Compact would require a
licensee to consent to service of process by mail.
3- 2219 Adverse Actions (Section 6)
The Compact would allow a member state to take
adverse action against a licensee’s Compact privilege in such
member state and to issue subpoenas, except that a
subpoena could not be issued to gather evidence of conduct
that is lawful in another state for the purpose of taking
adverse action in the home state. Only the licensee’s home
state would have the power to take adverse action against
the license issued by the home state. However, a member
state would have the authority to take adverse action to
remove a Compact privilege or to protect the health and
safety of its citizens.
Member states would be permitted to recover costs of
investigations or dispositions if permitted by their state law.
The Compact would authorize joint investigations by member
states of licensees. The Compact would require that a
Compact privilege would be deactivated until two years have
elapsed after all restrictions have been removed from a state
license that has had adverse action taken. Member states
would have to report promptly any adverse action to the data
system.
Establishment of the Physician Assistant Licensure
Compact Commission (Section 7)
The Compact would create the Physician Assistant
Licensure Compact Commission and include provisions
relating to membership, voting, powers and duties, and
financing of the Commission. The Compact would establish
the Executive Committee, which would have the power to act
on behalf of the Commission according to the terms of the
Compact.
The Compact would provide for the Commission to pay
for the reasonable expenses of its establishment,
organization, and ongoing activities. The Commission would
be authorized to levy and collect an annual assessment from
4- 2219 each member state and impose fines on licensees of member
states to cover the cost of operations. The Compact would
require the Commission to establish a code of ethics for the
Commission; adopt an annual report, including a financial
review; and provide the report to member states.
The Compact would provide for the qualified immunity,
defense, and indemnity of its members, officers, employees,
and representatives acting within the scope of Commission
employment, duties, or responsibilities. The protections would
not apply for damage, loss, injury, or liability caused by the
individual’s intentional, willful, or wanton misconduct. The
Compact would not limit the liability of any licensee for
professional malpractice or misconduct governed by
applicable state laws.
Data Systems (Section 8)
The Compact would require the Commission to develop,
maintain, operate, and utilize a coordinated data system. The
Compact would govern how the information would be
provided to the data system by member states and the use of
the data by member states, as well as its designation of
information that could not be shared with the public without
the express permission of the contributing state. The
Compact would also require removal of expunged information
from the data system.
Rulemaking (Section 9)
The Compact would authorize the Commission to
exercise rulemaking powers. The bill would require notice of
proposed rules to specified persons and locations to be
provided at least 30 days prior to the meeting where the
Commission will consider such rules. Additionally, the
Commission would be required to provide notice of the public
hearing and provide access to the meeting and record all
hearings. The Compact would state a majority of legislatures
5- 2219 of the member states could reject a rule by enactment of a
statute or resolution within four years of adoption of the rule.
The Compact would also provide for emergency rulemaking
procedures.
Oversight, Dispute Resolution, and Enforcement
(Section 10)
The Compact would provide that the executive and
judicial branches in each member state would enforce and
implement the Compact. The Compact would establish
judicial venue and service of process for the Commission.
The Compact would also establish a process to be followed
by member states regarding default, requesting technical
assistance, or termination from the Compact. The Compact
would require the Commission, upon member request, to
attempt to resolve disputes arising among member states and
between member states and non-member states. In addition,
the Commission would be authorized to enforce the
provisions of the Compact, and, by majority vote, could
initiate legal action in federal court against a member state in
default.
Effective Date, Withdrawal, and Amendment (Section 11)
The Compact would be effective on the date on which
the Compact statute is enacted into law in the seventh
member state. Any member state would be allowed to
withdraw from the Compact by enacting a statute that would
repeal the Compact, but this would not take effect until 180
days after the enactment of the repealing statute. Member
states could amend the Compact, but any amendment would
not be effective until it is enacted by all member states.
Additionally, the Compact would not invalidate or prevent any
licensure agreement or cooperative arrangement between a
member state and non-member state that did not conflict with
the Compact. [Note: As of May 2024, the Compact met the
threshold of seven states participating. It is projected that the
6- 2219 Compact Commission will begin granting Compact privileges
to practice in early 2026.]
Construction and Severability (Section 12)
The Compact would state the Compact and the
Commission’s rulemaking authority shall be liberally
construed, and the provisions of the Compact would be
severable.
Binding Effect of Compact (Section 13)
The Compact would not prevent the enforcement of any
other law of a member state not inconsistent with the
Compact. Laws in conflict with the Compact would be
superseded to the extent of the conflict, and all lawful actions
of the Commission would be binding upon member states.
Background
The bill was introduced by the House Committee on
Health and Human Services at the request of Representative
Buehler on behalf of the Kansas Chamber of Commerce.
[Note: A companion bill, SB 126, has been introduced in
the Senate.]
House Committee on Health and Human Services
In the House Committee hearing, proponent testimony
was provided by representatives of the Kansas Academy of
Physician Associates, Kansas Adjutant General’s
Department, Kansas Chamber of Commerce, and U.S.
Department of Defense. The conferees noted the portability
of licensing across states for the profession as well as
assisting military families in their relocations.
No other testimony was provided.
7- 2219 The House Committee amended the bill to make a
technical change.
Fiscal Information
According to the fiscal note prepared by the Division of
the Budget on the bill, as introduced, the State Board of
Healing Arts states enactment of the bill would increase
agency fee fund expenditures by $65,500 beginning in FY
2025, which would include $55,000 for 1.0 licensing staff
position. The agency also estimates $8,000 to $10,000 for
office and computer expenses. Most of the expenses would
be ongoing. The agency reports this position would be
necessary as the bill includes new requirements for the
agency with set timelines for completion of tasks.
The agency reports it has absorbed costs for similar
requirements in the past but is now at capacity and cannot
continue to do so. The agency states PAs that participate in
the Compact would continue to pay a state fee for their
license, but there is no mechanism to measure the number of
licensees that would utilize the Compact for a Kansas license.
The Compact would allow for the Compact Commission
to levy fees for participating states; however, the agency
notes the Compact would be new and not fully active at this
time so it is unclear if states would be charged and what the
fee would be.
Any fiscal effect associated with the bill is not reflected
in The FY 2026 Governor’s Budget Report.
Physician assistants; Physician Assistant Licensure Compact; health; health care;
licensing; Board of Healing Arts
8- 2219