Kansas 2025-2026 Regular Session

Kansas House Bill HB2219 Compare Versions

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1	1	Session of 2025
2	2	HOUSE BILL No. 2219
3	3	By Committee on Health and Human Services
4	4	Requested by Representative Buehler on behalf of the Kansas Chamber of
5	5	Commerce
6	6	2-3
7	7	AN ACT concerning the healing arts; relating to physician assistants;
8	8	enacting the physician assistant licensure compact to provide interstate
9	9	practice privileges.
10	10	Be it enacted by the Legislature of the State of Kansas:
11	11	Section 1. This act shall be known and may be cited as the physician
12	12	assistant licensure compact.
13	13	SECTION 1—PURPOSE
14	14	In order to strengthen access to medical services and in recognition of
15	15	the advances in the delivery of medical services, the participating states of
16	16	the PA licensure compact have allied in common purpose to develop a
17	17	comprehensive process that complements the existing authority of state
18	18	licensing boards to license and discipline PAs and seeks to enhance the
19	19	portability of a license to practice as a PA while safeguarding the safety of
20	20	patients. This compact allows medical services to be provided by PAs, via
21	21	the mutual recognition of the licensee's qualifying license by other
22	22	compact-participating states. This compact also adopts the prevailing
23	23	standard for PA licensure and affirms that the practice and delivery of
24	24	medical services by the PA occurs where the patient is located at the time
25	25	of the patient encounter and, therefore, requires the PA to be under the
26	26	jurisdiction of the state licensing board where the patient is located. State
27	27	licensing boards that participate in this compact retain the jurisdiction to
28	28	impose adverse action against a compact privilege in that state issued to a
29	29	PA through the procedures of this compact. The PA licensure compact will
30	30	alleviate burdens for military families by allowing active duty military
31	31	personnel and their spouses to obtain a compact privilege based on having
32	32	an unrestricted license in good standing from a participating state.
33	33	SECTION 2—DEFINITIONS
34	34	As used in this compact:
35	35	(a) "Adverse action" means any administrative, civil, equitable or
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70	70	criminal action permitted by a state's laws that is imposed by a licensing
71	71	board or other authority against a PA license, application for licensure or
72	72	compact privilege such as license denial, censure, revocation, suspension,
73	73	probation, monitoring of the licensee or restriction on the licensee's
74	74	practice.
75	75	(b) "Compact privilege" means the authorization granted by a remote
76	76	state to allow a licensee from another participating state to practice as a PA
77	77	to provide medical services and other licensed activity to a patient located
78	78	in the remote state under the remote state's laws and regulations.
79	79	(c) "Conviction" means a finding by a court that an individual is
80	80	guilty of a felony or misdemeanor offense through adjudication or entry of
81	81	a guilty plea or no contest to the charge by the offender.
82	82	(d) "Criminal background check" means the submission of
83	83	fingerprints or other biometric-based information for an applicant for
84	84	licensure for the purpose of obtaining that applicant's criminal history
85	85	record information, as defined in 28 C.F.R. § 20.3(d), from the state's
86	86	criminal history record repository as defined in 28 C.F.R. § 20.3(f).
87	87	(e) "Data system" means the repository of information concerning
88	88	licensees, including, but not limited to, license status and adverse actions,
89	89	that is created and administered under the terms of this compact.
90	90	(f) "Executive committee" means a group of directors and ex officio
91	91	individuals elected or appointed pursuant to section 7(f)(2).
92	92	(g) "Impaired practitioner" means a PA whose practice is adversely
93	93	affected by a health-related condition that impacts such PA's ability to
94	94	practice.
95	95	(h) "Investigative information" means information, records or
96	96	documents received or generated by a licensing board pursuant to an
97	97	investigation.
98	98	(i) "Jurisprudence requirement" means the assessment of an
99	99	individual's knowledge of the laws and rules governing the practice of a
100	100	PA in a state.
101	101	(j) "License" means current authorization by a state, other than
102	102	authorization pursuant to a compact privilege, for a PA to provide medical
103	103	services that would be unlawful without current authorization.
104	104	(k) "Licensee" means an individual who holds a license from a state
105	105	to provide medical services as a PA.
106	106	(l) "Licensing board" means any state entity authorized to license and
107	107	otherwise regulate PAs.
108	108	(m) "Medical services" means healthcare services provided for the
109	109	diagnosis, prevention, treatment, cure or relief of a health condition, injury
110	110	or disease, as defined by a state's laws and regulations.
111	111	(n) "Model compact" means the model for the PA licensure compact
112	112	on file with the council of state governments or other entity as designated
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156	156	by the commission.
157	157	(o) "PA" means an individual who is licensed as a physician assistant
158	158	in a state. For purposes of this compact, any other title or status adopted by
159	159	a state to replace the term "physician assistant" shall be deemed
160	160	synonymous with "physician assistant" and shall confer the same rights
161	161	and responsibilities to the licensee under the provisions of this compact at
162	162	the time of its enactment.
163	163	(p) "PA licensure compact commission," "compact commission" or
164	164	"commission" means the national administrative body created pursuant to
165	165	section 7(a).
166	166	(q) "Participating state" means a state that has enacted this compact.
167	167	(r) "Qualifying license" means an unrestricted license issued by a
168	168	participating state to provide medical services as a PA.
169	169	(s) "Remote state" means a participating state where a licensee who is
170	170	not licensed as a PA is exercising or seeking to exercise the compact
171	171	privilege.
172	172	(t) "Rule" means any rule or regulation adopted by an entity that has
173	173	the force and effect of law.
174	174	(u) "Significant investigative information" means investigative
175	175	information that a licensing board, after an inquiry or investigation that
176	176	includes notification and an opportunity for the PA to respond if required
177	177	by state law, has reason to believe is not groundless and, if proven true,
178	178	would indicate more than a minor infraction.
179	179	(v) "State" means any state, commonwealth, district or territory of the
180	180	United States.
181	181	SECTION 3—STATE PARTICIPATION IN THIS COMPACT
182	182	(a) To participate in this compact, a participating state shall:
183	183	(1) License PAs;
184	184	(2) participate in the compact commission's data system;
185	185	(3) have a mechanism in place for receiving and investigating
186	186	complaints against licensees and applicants for licensure;
187	187	(4) notify the commission, in compliance with the terms of this
188	188	compact and commission rules, of any adverse action against a licensee or
189	189	applicant for licensure and the existence of significant investigative
190	190	information regarding a licensee or applicant for licensure;
191	191	(5) fully implement a criminal background check requirement, within
192	192	a time frame established by commission rule, examination the results of a
193	193	criminal background check and reporting to the commission whether the
194	194	applicant for licensure has been granted a license;
195	195	(6) comply with the rules of the compact commission;
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239	239	(7) utilize passage of a recognized national examination such as the
240	240	NCCPA PANCE as a requirement for PA licensure; and
241	241	(8) grant the compact privilege to a holder of a qualifying license in a
242	242	participating state.
243	243	(b) Nothing in this compact shall be construed to prohibit a
244	244	participating state from charging a fee for granting the compact privilege.
245	245	SECTION 4—COMPACT PRIVILEGE
246	246	(a) To exercise the compact privilege, a licensee shall:
247	247	(1) Have graduated from a PA program accredited by the
248	248	accreditation review commission on education for the physician assistant,
249	249	inc., or other programs authorized by commission rule;
250	250	(2) hold current NCCPA certification;
251	251	(3) have no felony or misdemeanor convictions;
252	252	(4) have never had a controlled substance license, permit or
253	253	registration suspended or revoked by a state or by the United States drug
254	254	enforcement administration;
255	255	(5) have a unique identifier as determined by commission rule;
256	256	(6) hold a qualifying license;
257	257	(7) have had no revocation of a license or limitation or restriction on
258	258	any license currently held due to an adverse action;
259	259	(A) if a licensee has had a limitation or restriction on a license or
260	260	compact privilege due to an adverse action, two years shall have elapsed
261	261	from the date on which the license or compact privilege is no longer
262	262	limited or restricted due to the adverse action;
263	263	(B) if a compact privilege has been revoked or is limited or restricted
264	264	in a participating state for conduct that would not be a basis for
265	265	disciplinary action in a participating state in which the licensee is
266	266	practicing or applying to practice under a compact privilege, that
267	267	participating state shall have the discretion not to consider such action as
268	268	an adverse action requiring the denial or removal of a compact privilege in
269	269	that state;
270	270	(8) notify the compact commission that the licensee is seeking the
271	271	compact privilege in a remote state;
272	272	(9) meet any jurisprudence requirement of a remote state in which the
273	273	licensee is seeking to practice under the compact privilege and pay any
274	274	fees applicable to satisfying the jurisprudence requirement; and
275	275	(10) report to the commission any adverse action taken by a
276	276	nonparticipating state within 30 days after such adverse action is taken.
277	277	(b) The compact privilege shall be valid until the expiration or
278	278	revocation of the qualifying license unless terminated pursuant to an
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322	322	adverse action. The licensee shall comply with the requirements of
323	323	subsection (a) to maintain the compact privilege in a remote state. If the
324	324	participating state takes adverse action against a qualifying license, the
325	325	licensee shall lose the compact privilege in any remote state in which the
326	326	licensee has a compact privilege until the licensee meets the following
327	327	conditions:
328	328	(1) The license is no longer limited or restricted; and
329	329	(2) two years have elapsed from the date on which the license is no
330	330	longer limited or restricted due to the adverse action.
331	331	(c) Once a restricted or limited license satisfies the requirements of
332	332	subsection (b), the licensee shall meet the requirements of subsection (a) to
333	333	obtain a compact privilege in any remote state.
334	334	(d) For each remote state in which a PA seeks authority to prescribe
335	335	controlled substances, the PA shall satisfy all the requirements imposed by
336	336	such state in granting or renewing such authority.
337	337	SECTION 5—DESIGNATION OF THE STATE FROM WHICH THE
338	338	LICENSEE IS APPLYING FOR A COMPACT PRIVILEGE
339	339	Upon a licensee's application for a compact privilege, the licensee shall
340	340	identify to the commission the participating state from which the licensee
341	341	is applying, in accordance with applicable rules adopted by the
342	342	commission and subject to the following requirements:
343	343	(a) When applying for a compact privilege, the licensee shall provide
344	344	the commission with the address of the licensee's primary residence and,
345	345	thereafter, shall immediately report to the commission any change in the
346	346	address of the licensee's primary residence; and
347	347	(b) when applying for a compact privilege, the licensee is required to
348	348	consent to accept service of process by mail at the licensee's primary
349	349	residence on file with the commission with respect to any action brought
350	350	against the licensee by the commission or a participating state, including a
351	351	subpoena, with respect to any action brought or investigation conducted by
352	352	the commission or a participating state.
353	353	SECTION 6—ADVERSE ACTIONS
354	354	(a) A participating state in which a licensee is licensed shall have
355	355	exclusive power to impose adverse action against the qualifying license
356	356	issued by that participating state.
357	357	(b) In addition to the other powers conferred by state law, a remote
358	358	state shall have the authority, in accordance with existing state due process
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402	402	law, to:
403	403	(1) Take adverse action against a PA's compact privilege within that
404	404	state to remove a licensee's compact privilege or take other action
405	405	necessary under applicable law to protect the health and safety of its
406	406	citizens; and
407	407	(2) issue subpoenas for both hearings and investigations that require
408	408	the attendance and testimony of witnesses as well as the production of
409	409	evidence. Subpoenas issued by a licensing board in a participating state for
410	410	the attendance and testimony of witnesses or the production of evidence
411	411	from another participating state shall be enforced in the latter state by any
412	412	court of competent jurisdiction, according to the practice and procedure of
413	413	such court applicable to subpoenas issued in proceedings pending before
414	414	it. The issuing authority shall pay any witness fees, travel expenses,
415	415	mileage and other fees required by the service statutes of the state in which
416	416	the witnesses or evidence is located.
417	417	(c) Notwithstanding subsection (b)(2), subpoenas shall not be issued
418	418	by a participating state to gather evidence of conduct in another state that
419	419	is lawful in such other state for the purpose of taking adverse action
420	420	against a licensee's compact privilege or application for a compact
421	421	privilege in the participating state.
422	422	(d) Nothing in this compact shall be deemed to authorize a
423	423	participating state to impose discipline against a PA's compact privilege or
424	424	to deny an application for a compact privilege in that participating state for
425	425	the individual's otherwise lawful practice in another state.
426	426	(e) For purposes of taking adverse action, the participating state that
427	427	issued the qualifying license shall give the same priority and effect to
428	428	reported conduct received from any other participating state as it would if
429	429	the conduct had occurred within the participating state that issued the
430	430	qualifying license. The participating state shall apply its own state laws to
431	431	determine appropriate action.
432	432	(f) A participating state, if otherwise permitted by state law, may
433	433	recover from the affected PA the costs of investigations and disposition of
434	434	cases resulting from any adverse action taken against that PA.
435	435	(g) A participating state may take adverse action based on the factual
436	436	findings of a remote state if the participating state follows its own
437	437	procedures for taking the adverse action.
438	438	(h) Joint investigations.
439	439	(1) In addition to the authority granted to a participating state by such
440	440	state's PA laws and regulations or other applicable state law, any
441	441	participating state may participate with other participating states in joint
442	442	investigations of licensees.
443	443	(2) Participating states shall share any investigative, litigation or
444	444	compliance materials in furtherance of any joint or individual investigation
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488	488	initiated under this compact.
489	489	(i) If an adverse action is taken against a PA's qualifying license, the
490	490	PA's compact privilege in all remote states shall be deactivated until two
491	491	years have elapsed after all restrictions have been removed from the state
492	492	license. All disciplinary orders by the participating state that issued the
493	493	qualifying license that impose adverse action against a PA's license shall
494	494	include a statement that the PA's compact privilege is deactivated in all
495	495	participating states during the pendency of the order.
496	496	(j) If any participating state takes adverse action, it promptly shall
497	497	notify the administrator of the data system.
498	498	SECTION 7—ESTABLISHMENT OF THE PA LICENSURE COMPACT
499	499	COMMISSION
500	500	(a) The participating states hereby create and establish a joint
501	501	government agency and national administrative body known as the PA
502	502	licensure compact commission. The commission is an instrumentality of
503	503	the compact states acting jointly and not an instrumentality of any one
504	504	state. The commission shall come into existence on or after the effective
505	505	date of the compact as set forth in section 11(a).
506	506	(b) Membership, voting and meetings.
507	507	(1) Each participating state shall have and be limited to one delegate
508	508	selected by such participating state's licensing board or, if such
509	509	participating state has more than one licensing board, selected collectively
510	510	by the participating state's licensing boards.
511	511	(2) A delegate shall be either:
512	512	(A) A current PA, physician or public member of a licensing board or
513	513	PA council or committee; or
514	514	(B) an administrator of a licensing board.
515	515	(3) Any delegate may be removed or suspended from office as
516	516	provided by the laws of the state from which the delegate is appointed.
517	517	(4) The participating state licensing board shall fill any vacancy
518	518	occurring in the commission within 60 days.
519	519	(5) Each delegate shall be entitled to one vote on all matters voted on
520	520	by the commission and shall otherwise have an opportunity to participate
521	521	in the commission's business and affairs. A delegate shall vote in person or
522	522	by such other means as provided in the bylaws. The bylaws may provide
523	523	for delegates' participation in meetings by telecommunications, video
524	524	conference or other means of communication.
525	525	(6) The commission shall meet at least once during each calendar
526	526	year. Additional meetings shall be held as set forth in this compact and the
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571	571	(7) The commission shall establish by rule a term of office for
572	572	delegates.
573	573	(c) The commission shall have the following powers and duties:
574	574	(1) Establish a code of ethics for the commission;
575	575	(2) establish the fiscal year of the commission;
576	576	(3) establish fees;
577	577	(4) establish bylaws;
578	578	(5) maintain its financial records in accordance with the bylaws;
579	579	(6) meet and take such actions as are consistent with the provisions of
580	580	this compact and the bylaws;
581	581	(7) adopt rules to facilitate and coordinate implementation and
582	582	administration of this compact, and such rules shall have the force and
583	583	effect of law and shall be binding in all participating states;
584	584	(8) bring and prosecute legal proceedings or actions in the name of
585	585	the commission, except that the standing of any state licensing board to
586	586	sue or be sued under applicable law shall not be affected;
587	587	(9) purchase and maintain insurance and bonds;
588	588	(10) borrow, accept or contract for services of personnel, including,
589	589	but not limited to, employees of a participating state;
590	590	(11) hire employees and engage contractors, elect or appoint officers,
591	591	fix compensation, define duties, grant such individuals appropriate
592	592	authority to carry out the purposes of this compact and establish the
593	593	commission's personnel policies and programs relating to conflicts of
594	594	interest, qualifications of personnel and other related personnel matters;
595	595	(12) accept any and all appropriate donations and grants of money,
596	596	equipment, supplies, materials and services and receive, utilize and
597	597	dispose of the same. At all times the commission shall avoid any
598	598	appearance of impropriety or conflict of interest;
599	599	(13) lease, purchase, accept appropriate gifts or donations of or
600	600	otherwise own, hold, improve or use any property real, personal or mixed.
601	601	In performing these actions, the commission shall avoid the appearance of
602	602	impropriety at all times;
603	603	(14) sell, convey, mortgage, pledge, lease, exchange, abandon or
604	604	otherwise dispose of any property real, personal or mixed;
605	605	(15) establish a budget and make expenditures;
606	606	(16) borrow money;
607	607	(17) appoint committees, including standing committees composed of
608	608	members, state regulators, state legislators or their representatives,
609	609	consumer representatives and such other interested persons as may be
610	610	designated in this compact and the bylaws;
611	611	(18) provide and receive information from, and cooperate with, law
612	612	enforcement agencies;
613	613	(19) elect a chairperson, vice chairperson, secretary and treasurer and
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657	657	such other officers of the commission as provided in the commission's
658	658	bylaws;
659	659	(20) reserve for itself, in addition to those reserved exclusively to the
660	660	commission under the compact, powers that the executive committee shall
661	661	not exercise;
662	662	(21) approve or disapprove a state's participation in the compact
663	663	based upon its determination as to whether the state's compact legislation
664	664	materially departs from the model compact language;
665	665	(22) prepare and provide to the participating states an annual report;
666	666	and
667	667	(23) perform such other functions as may be necessary or appropriate
668	668	to achieve the purposes of this compact, consistent with the state
669	669	regulation of PA licensure and practice.
670	670	(d) Meetings of the commission.
671	671	(1) All meetings of the commission that are not closed pursuant to
672	672	this subsection shall be open to the public. Notice of public meetings shall
673	673	be posted on the commission's website at least 30 days prior to the public
674	674	meeting.
675	675	(2) Notwithstanding subsection (d)(1), the commission may convene
676	676	a public meeting by providing at least 24 hours' prior notice on the
677	677	commission's website and any other means as provided in the
678	678	commission's rules for any of the reasons it may dispense, with notice of
679	679	proposed rulemaking under section 9(l).
680	680	(3) The commission may convene in a closed, nonpublic meeting or
681	681	nonpublic part of a public meeting to receive legal advice or to discuss:
682	682	(A) Noncompliance of a participating state with its obligations under
683	683	this compact;
684	684	(B) the employment, compensation, discipline or other matters,
685	685	practices or procedures related to specific employees or other matters
686	686	related to the commission's internal personnel practices and procedures;
687	687	(C) any current, threatened or reasonably anticipated litigation;
688	688	(D) the negotiation of contracts for the purchase, lease or sale of
689	689	goods, services or real estate;
690	690	(E) the accusation of any individual of a crime or the formal censure
691	691	any individual;
692	692	(F) the disclosure of trade secrets or commercial or financial
693	693	information that is privileged or confidential;
694	694	(G) the disclosure of information of a personal nature, if disclosure
695	695	would constitute a clearly unwarranted invasion of personal privacy;
696	696	(H) the disclosure of investigative records compiled for law
697	697	enforcement purposes;
698	698	(I) the disclosure of information related to any investigative reports
699	699	prepared by or on behalf of or for use of the commission or other
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743	743	committee charged with the responsibility of investigation or
744	744	determination of compliance issues pursuant to this compact;
745	745	(J) legal advice; or
746	746	(K) any matters specifically exempted from disclosure by federal or a
747	747	participating state's statutes.
748	748	(4) If a meeting, or portion of a meeting, is closed pursuant to
749	749	subsection (d)(3), the chairperson of the meeting or the chairperson's
750	750	designee shall certify that the meeting or portion of the meeting may be
751	751	closed and shall reference each relevant exempting provision.
752	752	(5) The commission shall keep minutes that fully and clearly describe
753	753	all matters discussed in a meeting and shall provide a full and accurate
754	754	summary of actions taken, including a description of the views expressed.
755	755	All documents considered in connection with an action shall be identified
756	756	in such minutes. All minutes and documents of a closed meeting shall
757	757	remain under seal, subject to release by a majority vote of the commission
758	758	or order of a court of competent jurisdiction.
759	759	(e) Financing of the commission.
760	760	(1) The commission shall pay, or provide for the payment of, the
761	761	reasonable expenses of its establishment, organization and ongoing
762	762	activities.
763	763	(2) The commission may accept any and all appropriate revenue
764	764	sources, donations and grants of money, equipment, supplies, materials
765	765	and services.
766	766	(3) The commission may levy on and collect an annual assessment
767	767	from each participating state and may impose compact privilege fees on
768	768	licensees of participating states to which a compact privilege is granted to
769	769	cover the cost of the operations and activities of the commission and its
770	770	staff. Such assessment shall be in a total amount sufficient to cover the
771	771	commission's annual budget as approved by the commission each year for
772	772	which revenue is not provided by other sources. The aggregate annual
773	773	assessment amount levied on participating states shall be allocated based
774	774	upon a formula to be determined by commission rule. Compact privileges
775	775	and such contract privilege's associated fees shall be governed as follows:
776	776	(A) A compact privilege expires when the licensee's qualifying
777	777	license in the participating state from which the licensee applied for the
778	778	compact privilege expires; and
779	779	(B) if the licensee terminates the qualifying license through which the
780	780	licensee applied for the compact privilege before its scheduled expiration
781	781	and the licensee has a qualifying license in another participating state, the
782	782	licensee shall inform the commission that it is changing to that
783	783	participating state through which it applies for a compact privilege to that
784	784	participating state and pay to the commission any compact privilege fee
785	785	required by commission rule.
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829	829	(4) The commission shall not incur obligations of any kind prior to
830	830	securing the funds adequate to meet such obligations, nor shall the
831	831	commission pledge the credit of any of the participating states, except by
832	832	and with the authority of the participating state.
833	833	(5) The commission shall keep accurate accounts of all receipts and
834	834	disbursements. The receipts and disbursements of the commission shall be
835	835	subject to the financial review and accounting procedures established
836	836	under its bylaws. All receipts and disbursements of funds handled by the
837	837	commission shall be subject to an annual financial review by a certified or
838	838	licensed public accountant, and the report of the financial review shall be
839	839	included in and become part of the annual report of the commission.
840	840	(f) The executive committee.
841	841	(1) The executive committee shall have to power to act on behalf of
842	842	the commission according to the terms of this compact and commission
843	843	rules.
844	844	(2) The executive committee shall be composed of nine members
845	845	described as follows:
846	846	(A) Seven voting members who are elected by the commission from
847	847	the current membership of the commission;
848	848	(B)(i)(a) one ex officio, nonvoting member from a recognized
849	849	national PA professional association; and
850	850	(b) one ex officio, nonvoting member from a recognized national PA
851	851	certification organization.
852	852	(ii) The ex officio members shall be selected by their respective
853	853	organizations.
854	854	(3) The commission may remove any member of the executive
855	855	committee as provided in its bylaws.
856	856	(4) The executive committee shall meet at least annually.
857	857	(5) The executive committee shall have the following duties and
858	858	responsibilities:
859	859	(A) Recommend to the commission changes to the commission's
860	860	rules or bylaws, changes to this compact legislation, fees to be paid by
861	861	compact-participating states such as annual dues and any commission
862	862	compact fee charged to licensees for the compact privilege;
863	863	(B) ensure that compact administration services are appropriately
864	864	provided, whether
865	865	contractual or otherwise;
866	866	(C) prepare and recommend the budget;
867	867	(D) maintain financial records on behalf of the commission;
868	868	(E) monitor compact compliance of participating states and provide
869	869	compliance reports to the commission;
870	870	(F) establish additional committees as necessary;
871	871	(G) exercise the powers and duties of the commission during the
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915	915	interim between commission meetings, except for issuing proposed
916	916	rulemaking or adopting commission rules or bylaws or exercising any
917	917	other powers and duties exclusively reserved to the commission by the
918	918	commission's rules; and
919	919	(H) perform other duties as provided in the commission's rules or
920	920	bylaws.
921	921	(6) All meetings of the executive committee at which it votes or plans
922	922	to vote on matters in exercising the powers and duties of the commission
923	923	shall be open to the public and public notice of such meetings shall be
924	924	given as public meetings of the commission are given.
925	925	(7) The executive committee may convene in a closed, nonpublic
926	926	meeting for the same reasons that the commission may convene in a
927	927	nonpublic meeting as set forth in subsection (d)(3), and shall announce the
928	928	closed meeting as the commission is required to do under subsection (d)(4)
929	929	and keep minutes of the closed meeting as the commission is required to
930	930	do under subsection (d)(5).
931	931	(g) Qualified immunity, defense and indemnification.
932	932	(1) The members, officers, executive director, employees and
933	933	representatives of the commission shall be immune from suit and liability,
934	934	both personally and in their official capacity, for any claim for damage to
935	935	or loss of property or personal injury or other civil liability caused by or
936	936	arising out of any actual or alleged act, error or omission that occurred or
937	937	that the individual against whom the claim is made had a reasonable basis
938	938	for believing occurred within the scope of commission employment, duties
939	939	or responsibilities. Nothing in this paragraph shall be construed to protect
940	940	any such individual from suit or liability for any damage, loss, injury or
941	941	liability caused by the intentional or willful or wanton misconduct of such
942	942	individual. The procurement of insurance of any type by the commission
943	943	shall not in any way compromise or limit the immunity granted hereunder.
944	944	(2) The commission shall defend any member, officer, executive
945	945	director, employee, and representative of the commission in any civil
946	946	action seeking to impose liability arising out of any actual or alleged act,
947	947	error or omission that occurred within the scope of commission
948	948	employment, duties or responsibilities or as determined by the commission
949	949	that the individual against whom the claim is made had a reasonable basis
950	950	for believing occurred within the scope of commission employment, duties
951	951	or responsibilities. Nothing herein shall be construed to prohibit such
952	952	individual from retaining such individual's own counsel at the individual's
953	953	own expense or that the actual or alleged act, error or omission did not
954	954	result from the individual's intentional, willful or wanton misconduct.
955	955	(3) The commission shall indemnify and hold harmless any member,
956	956	officer, executive director, employee or representative of the commission
957	957	for the amount of any settlement or judgment obtained against that
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1001	1001	individual arising out of any actual or alleged act, error or omission that
1002	1002	occurred within the scope of commission employment, duties or
1003	1003	responsibilities or that such individual had a reasonable basis for believing
1004	1004	occurred within the scope of commission employment, duties or
1005	1005	responsibilities, if the actual or alleged act, error or omission did not result
1006	1006	from the intentional or willful or wanton misconduct of that individual.
1007	1007	(4) Venue is proper and judicial proceedings by or against the
1008	1008	commission shall be brought solely and exclusively in a court of
1009	1009	competent jurisdiction where the principal office of the commission is
1010	1010	located. The commission may waive venue and jurisdictional defenses in
1011	1011	any proceedings as authorized by commission rules.
1012	1012	(5) Nothing herein shall be construed as a limitation on the liability of
1013	1013	any licensee for professional malpractice or misconduct, which shall be
1014	1014	governed solely by any other applicable state laws.
1015	1015	(6) Nothing herein shall be construed to designate the venue or
1016	1016	jurisdiction to bring actions for alleged acts of malpractice, professional
1017	1017	misconduct, negligence or other such civil action pertaining to the practice
1018	1018	of a PA. All such matters shall be determined exclusively by state law
1019	1019	other than this compact.
1020	1020	(7) Nothing in this compact shall be interpreted to waive or otherwise
1021	1021	abrogate a participating state's state action immunity or state action
1022	1022	affirmative defense with respect to antitrust claims under the Sherman act,
1023	1023	Clayton act or any other state or federal antitrust or anticompetitive law or
1024	1024	regulation.
1025	1025	(8) Nothing in this compact shall be construed to be a waiver of
1026	1026	sovereign immunity by the participating states or by the commission.
1027	1027	SECTION 8—DATA SYSTEM
1028	1028	(a) The commission shall provide for the development, maintenance,
1029	1029	operation and utilization of a coordinated data and reporting system
1030	1030	containing licensure, adverse action and the reporting of the existence of
1031	1031	significant investigative information on all licensed PAs and applicants
1032	1032	that are denied a license in participating states.
1033	1033	(b) Notwithstanding any other state law to the contrary, a
1034	1034	participating state shall submit a uniform data set to the data system on all
1035	1035	PAs to whom this compact is applicable, utilizing a unique identifier, as
1036	1036	required by the rules of the commission, including:
1037	1037	(1) Identifying information;
1038	1038	(2) licensure data;
1039	1039	(3) adverse actions against a license or compact privilege;
1040	1040	(4) any denial of application for licensure and the reason for such
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1084	1084	denial, excluding the reporting of any criminal history record information
1085	1085	where such reporting is prohibited by law;
1086	1086	(5) the existence of significant investigative information; and
1087	1087	(6) other information that may facilitate the administration of this
1088	1088	compact, as determined by the rules of the commission.
1089	1089	(c) Significant investigative information pertaining to a licensee in
1090	1090	any participating state shall only be available to other participating states.
1091	1091	(d) The commission shall promptly notify all participating states of
1092	1092	any adverse action taken against a licensee or an individual applying for a
1093	1093	license that has been reported to such commission. Such adverse action
1094	1094	information shall be available to any other participating state.
1095	1095	(e) Participating states contributing information to the data system
1096	1096	may, in accordance with state or federal law, designate information that
1097	1097	shall not be shared with the public without the express permission of the
1098	1098	contributing state. Notwithstanding any such designation, such information
1099	1099	shall be reported to the commission through the data system.
1100	1100	(f) Any information submitted to the data system that is subsequently
1101	1101	expunged pursuant to federal law or the laws of the participating state
1102	1102	contributing the information shall be removed from the data system upon
1103	1103	reporting of such by the participating state to the commission.
1104	1104	(g) The records and information provided to a participating state
1105	1105	pursuant to this compact or through the data system, when certified by the
1106	1106	commission or an agent thereof, shall constitute the authenticated business
1107	1107	records of the commission and shall be entitled to any associated hearsay
1108	1108	exception in any relevant judicial, quasi-judicial or administrative
1109	1109	proceedings in a participating state.
1110	1110	SECTION 9—RULEMAKING
1111	1111	(a) The commission shall exercise its rulemaking powers pursuant to
1112	1112	the criteria set forth in this section and the rules adopted thereunder.
1113	1113	Commission rules shall become binding as of the date specified by the
1114	1114	commission for each rule.
1115	1115	(b) The commission shall adopt reasonable rules in order to
1116	1116	effectively and efficiently implement and administer this compact and
1117	1117	achieve its purposes. A commission rule shall be invalid and have no force
1118	1118	or effect only if a court of competent jurisdiction holds that the rule is
1119	1119	invalid because the commission exercised its rulemaking authority in a
1120	1120	manner that is beyond the scope of the purposes of this compact, the
1121	1121	powers granted hereunder or based upon another applicable standard of
1122	1122	review.
1123	1123	(c) The rules of the commission shall have the force of law in each
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1167	1167	participating state, except that where the rules of the commission conflict
1168	1168	with the laws of the participating state that establish the medical services, a
1169	1169	PA may perform in the participating state, as held by a court of competent
1170	1170	jurisdiction, and the rules of the commission shall be ineffective in that
1171	1171	state to the extent of the conflict.
1172	1172	(d) If a majority of the legislatures of the participating states rejects a
1173	1173	commission rule, by enactment of a statute or resolution in the same
1174	1174	manner used to adopt this compact within four years of the date of
1175	1175	adoption of the rule, then such rule shall have no further force and effect in
1176	1176	any participating state or to any state applying to participate in the
1177	1177	compact.
1178	1178	(e) Commission rules shall be adopted at a regular or special meeting
1179	1179	of the commission.
1180	1180	(f) Prior to promulgation and adoption of a final rule by the
1181	1181	commission and at least 30 days in advance of the meeting at which the
1182	1182	rule will be considered and voted upon, the commission shall file a notice
1183	1183	of proposed rulemaking:
1184	1184	(1) On the commission's website or other publicly accessible
1185	1185	platform;
1186	1186	(2) to persons who have requested notice of the commission's notices
1187	1187	of proposed rulemaking; and
1188	1188	(3) in such other ways as the commission may specify by rule.
1189	1189	(g) The notice of proposed rulemaking shall include:
1190	1190	(1) The time, date and location of the public hearing on the proposed
1191	1191	rule and the proposed time, date and location of the meeting in which the
1192	1192	proposed rule will be considered and voted upon;
1193	1193	(2) the text of and the reason for the proposed rule;
1194	1194	(3) a request for comments on the proposed rule from any interested
1195	1195	person and the date by which written comments must be received; and
1196	1196	(4) the manner in which interested persons may submit notice to the
1197	1197	commission of their intention to attend the public hearing or provide any
1198	1198	written comments.
1199	1199	(h) Prior to adoption of a proposed rule, the commission shall allow
1200	1200	persons to submit written data, facts, opinions and arguments, which shall
1201	1201	be made available to the public.
1202	1202	(i) If the hearing is to be held via electronic means, the commission
1203	1203	shall publish the mechanism for access to the electronic hearing.
1204	1204	(1) All persons wishing to be heard at the hearing shall, as directed in
1205	1205	the notice of proposed rulemaking published not less than five business
1206	1206	days before the scheduled date of the hearing, notify the commission of
1207	1207	their desire to appear and testify at the hearing.
1208	1208	(2) Hearings shall be conducted in a manner that provides each
1209	1209	person who wishes to comment a fair and reasonable opportunity to
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1253	1253	comment orally or in writing.
1254	1254	(3) All hearings shall be recorded. A copy of the recording and the
1255	1255	written comments, data, facts, opinions and arguments received in
1256	1256	response to the proposed rulemaking shall be made available to a person
1257	1257	upon request.
1258	1258	(4) Nothing in this section shall be construed as requiring a separate
1259	1259	hearing on each proposed rule. Proposed rules may be grouped for the
1260	1260	convenience of the commission at hearings required by this section.
1261	1261	(j) Following the public hearing, the commission shall consider all
1262	1262	written and oral comments timely received.
1263	1263	(k) The commission shall, by majority vote of all delegates, take final
1264	1264	action on the proposed rule and shall determine the effective date of the
1265	1265	rule, if adopted, based on the rulemaking record and the full text of the
1266	1266	rule.
1267	1267	(1) If adopted, the rule shall be posted on the commission's website.
1268	1268	(2) The commission may adopt changes to the proposed rule if the
1269	1269	changes do not expand the original purpose of the proposed rule.
1270	1270	(3) The commission shall provide an explanation on its website of the
1271	1271	reasons for any substantive changes made to the proposed rule as well as
1272	1272	reasons for any substantive changes not made that were recommended by
1273	1273	commenters.
1274	1274	(4) The commission shall determine a reasonable effective date for
1275	1275	the rule. Except for an emergency as provided in subsection (l), the
1276	1276	effective date of the rule shall be not sooner than 30 days after the
1277	1277	commission issued the notice that it adopted the rule.
1278	1278	(l) Upon the determination that an emergency exists, the commission
1279	1279	may consider and adopt an emergency rule with 24 hours' prior notice,
1280	1280	without the opportunity for comment or hearing, expect that the usual
1281	1281	rulemaking procedures provided in this compact and in this section shall
1282	1282	be retroactively applied to the rule as soon as reasonably possible but in no
1283	1283	event later than 90 days after the effective date of the rule. For the
1284	1284	purposes of this provision, an emergency rule is one that shall be adopted
1285	1285	immediately by the commission in order to:
1286	1286	(1) Address an imminent threat to public health, safety or welfare;
1287	1287	(2) prevent a loss of commission or participating state funds;
1288	1288	(3) meet a deadline for the promulgation of a commission rule that is
1289	1289	established by federal law or rule; or
1290	1290	(4) protect public health and safety.
1291	1291	(m) The commission, or an authorized committee of the commission,
1292	1292	may direct revisions to a previously adopted commission rule for purposes
1293	1293	of correcting typographical errors, errors in format, errors in consistency
1294	1294	or grammatical errors. Public notice of any revisions shall be posted on the
1295	1295	commission's website. The revision shall be subject to challenge by any
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1339	1339	person for a period of 30 days after posting. The revision may be
1340	1340	challenged only on grounds that the revision results in a material change to
1341	1341	a rule. A challenge shall be made as set forth in the notice of revisions and
1342	1342	delivered to the commission prior to the end of the notice period. If no
1343	1343	challenge is made, the revision shall take effect without further action. If
1344	1344	the revision is challenged, the revision shall not take effect without the
1345	1345	approval of the commission.
1346	1346	(n) No participating state's rulemaking requirements shall apply under
1347	1347	this compact.
1348	1348	SECTION 10—OVERSIGHT, DISPUTE RESOLUTION AND
1349	1349	ENFORCEMENT
1350	1350	(a) Oversight.
1351	1351	(1) The executive and judicial branches of state government in each
1352	1352	participating state shall enforce this compact and take all actions necessary
1353	1353	and appropriate to implement the compact.
1354	1354	(2) Venue is proper and judicial proceedings by or against the
1355	1355	commission shall be brought solely and exclusively in a court of
1356	1356	competent jurisdiction where the principal office of the commission is
1357	1357	located. The commission may waive venue and jurisdictional defenses to
1358	1358	the extent that it adopts or consents to participate in alternative dispute
1359	1359	resolution proceedings. Nothing herein shall affect or limit the selection or
1360	1360	propriety of venue in any action against a licensee for professional
1361	1361	malpractice, misconduct or any such similar matter.
1362	1362	(3) The commission shall be entitled to receive service of process in
1363	1363	any proceeding regarding the enforcement or interpretation of the compact
1364	1364	or the commission's rules and shall have standing to intervene in such a
1365	1365	proceeding for all purposes. Failure to provide the commission with
1366	1366	service of process shall render a judgment or order in such proceeding
1367	1367	void as to the commission, this compact or commission rules.
1368	1368	(b) Default, technical assistance and termination.
1369	1369	(1) If the commission determines that a participating state has
1370	1370	defaulted in the performance of its obligations or responsibilities under
1371	1371	this compact or the commission rules, the commission shall provide
1372	1372	written notice to the defaulting state and other participating states. The
1373	1373	notice shall describe the default, the proposed means of curing the default
1374	1374	and any other action that the commission may take and shall offer remedial
1375	1375	training and specific technical assistance regarding the default.
1376	1376	(2) If a state in default fails to cure the default, the defaulting state
1377	1377	may be terminated from this compact upon an affirmative vote of a
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1421	1421	majority of the delegates of the participating states, and all rights,
1422	1422	privileges and benefits conferred by this compact upon such state may be
1423	1423	terminated on the effective date of termination. A cure of the default shall
1424	1424	not relieve the offending state of obligations or liabilities incurred during
1425	1425	the period of default.
1426	1426	(3) Termination of participation in this compact shall be imposed only
1427	1427	after all other means of securing compliance have been exhausted. Notice
1428	1428	of intent to suspend or terminate shall be given by the commission to the
1429	1429	governor, the majority and minority leaders of the defaulting state's
1430	1430	legislature and to the licensing board of each of the participating states.
1431	1431	(4) A state that has been terminated is responsible for all assessments,
1432	1432	obligations and liabilities incurred through the effective date of
1433	1433	termination, including obligations that extend beyond the effective date of
1434	1434	termination.
1435	1435	(5) The commission shall not bear any costs related to a state that is
1436	1436	found to be in default or that has been terminated from this compact,
1437	1437	unless agreed upon in writing between the commission and the defaulting
1438	1438	state.
1439	1439	(6) The defaulting state may appeal its termination from the compact
1440	1440	by the commission by petitioning the United States district court for the
1441	1441	District of Columbia or the federal district where the commission has its
1442	1442	principal offices. The prevailing member shall be awarded all costs of such
1443	1443	litigation, including reasonable attorney fees.
1444	1444	(7) Upon the termination of a state's participation in the compact, the
1445	1445	state shall immediately provide notice to all licensees within that state of
1446	1446	such termination:
1447	1447	(A) Licensees who have been granted a compact privilege in that
1448	1448	state shall retain the compact privilege for 180 days following the effective
1449	1449	date of such termination; and
1450	1450	(B) licensees who are licensed in that state who have been granted a
1451	1451	compact privilege in a participating state shall retain the compact privilege
1452	1452	for 180 days unless the licensee also has a qualifying license in a
1453	1453	participating state or obtains a qualifying license in a participating state
1454	1454	before the 180-day period ends, in which case, the compact privilege shall
1455	1455	continue.
1456	1456	(c) Dispute resolution.
1457	1457	(1) Upon request by a participating state, the commission shall
1458	1458	attempt to resolve disputes related to this compact that arise among
1459	1459	participating states and between participating and nonparticipating states.
1460	1460	(2) The commission shall adopt a rule providing for both mediation
1461	1461	and binding dispute resolution for disputes as appropriate.
1462	1462	(d) Enforcement.
1463	1463	(1) The commission, in the reasonable exercise of its discretion, shall
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1507	1507	enforce the provisions of this compact and rules of the commission.
1508	1508	(2) If compliance is not secured after all means to secure compliance
1509	1509	have been exhausted, by majority vote, the commission may initiate legal
1510	1510	action in the United States district court for the District of Columbia or the
1511	1511	federal district where the commission has its principal offices against a
1512	1512	participating state in default to enforce compliance with the provisions of
1513	1513	this compact and the commission's promulgated rules and bylaws. The
1514	1514	relief sought may include both injunctive relief and damages. In the event
1515	1515	that judicial enforcement is necessary, the prevailing party shall be
1516	1516	awarded all costs of such litigation, including reasonable attorney fees.
1517	1517	(3) The remedies herein shall not be the exclusive remedies of the
1518	1518	commission. The commission may pursue any other remedies available
1519	1519	under federal or state law.
1520	1520	(e) Legal action against the commission.
1521	1521	(1) A participating state may initiate legal action against the
1522	1522	commission in the United States district court for the District of Columbia
1523	1523	or the federal district where the commission has its principal offices to
1524	1524	enforce compliance with the provisions of the compact and its rules. The
1525	1525	relief sought may include both injunctive relief and damages. In the event
1526	1526	that judicial enforcement is necessary, the prevailing party shall be
1527	1527	awarded all costs of such litigation, including reasonable attorney fees.
1528	1528	(2) No person other than a participating state shall enforce this
1529	1529	compact against the commission.
1530	1530	SECTION 11—DATE OF IMPLEMENTATION OF THE PA
1531	1531	LICENSURE COMPACT COMMISSION
1532	1532	(a) This compact shall come into effect on the date that this compact
1533	1533	statute is enacted into law in the seventh participating state.
1534	1534	(1) On or after the effective date of the compact, the commission
1535	1535	shall convene and review the enactment of each of the states that enacted
1536	1536	the compact prior to the commission convening, called charter-
1537	1537	participating states, to determine if the statute enacted by each such
1538	1538	charter-participating state is materially different than the model compact.
1539	1539	(A) A charter-participating state whose enactment is found to be
1540	1540	materially different from the model compact shall be entitled to the default
1541	1541	process set forth in section 10(b).
1542	1542	(B) If any participating state later withdraws from the compact or its
1543	1543	participation is terminated, the commission shall remain in existence and
1544	1544	the compact shall remain in effect even if the number of participating
1545	1545	states should be fewer than seven. Participating states enacting the
1546	1546	compact subsequent to the commission convening shall be subject to the
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1590	1590	process set forth in section 7(c)(21) to determine if their enactments are
1591	1591	materially different from the model compact and whether they qualify for
1592	1592	participation in the compact.
1593	1593	(2) Participating states enacting the compact subsequent to the seven
1594	1594	initial charter-participating states shall be subject to the process set forth in
1595	1595	section 7(c)(21) to determine if their enactments are materially different
1596	1596	from the model compact and whether they qualify for participation in the
1597	1597	compact.
1598	1598	(3) All actions taken for the benefit of the commission or in
1599	1599	furtherance of the purposes of the administration of the compact prior to
1600	1600	the effective date of the compact or the commission coming into existence
1601	1601	shall be considered to be actions of the commission unless specifically
1602	1602	repudiated by the commission.
1603	1603	(b) Any state that joins this compact shall be subject to the
1604	1604	commission's rules and bylaws as they exist on the date that this compact
1605	1605	becomes law in that state. Any rule that has been previously adopted by
1606	1606	the commission shall have the full force and effect of law on the day that
1607	1607	this compact becomes law in that state.
1608	1608	(c) Any participating state may withdraw from this compact by
1609	1609	enacting a statute repealing the same.
1610	1610	(1) A participating state's withdrawal shall not take effect until 180
1611	1611	days after enactment of the repealing statute. During the 180-day period,
1612	1612	all compact privileges that were in effect in the withdrawing state and were
1613	1613	granted to licensees licensed in the withdrawing state shall remain in
1614	1614	effect. If any licensee licensed in the withdrawing state is also licensed in
1615	1615	another participating state or obtains a license in another participating state
1616	1616	within the 180 days, the licensee's compact privileges in other participating
1617	1617	states shall not be affected by the passage of the 180 days.
1618	1618	(2) Withdrawal shall not affect the continuing requirement of the state
1619	1619	licensing board of the withdrawing state to comply with the investigative
1620	1620	and adverse action reporting requirements of this compact prior to the
1621	1621	effective date of withdrawal.
1622	1622	(3) Upon the enactment of a statute withdrawing a state from this
1623	1623	compact, the state shall immediately provide notice of such withdrawal to
1624	1624	all licensees within that state. Such withdrawing state shall continue to
1625	1625	recognize all licenses granted pursuant to this compact for a minimum of
1626	1626	180 days after the date of such notice of withdrawal.
1627	1627	(d) Nothing contained in this compact shall be construed to invalidate
1628	1628	or prevent any PA licensure agreement or other cooperative arrangement
1629	1629	between participating states and between a participating state and
1630	1630	nonparticipating state that does not conflict with the provisions of this
1631	1631	compact.
1632	1632	(e) This compact may be amended by the participating states. No
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1676	1676	amendment to this compact shall become effective and binding upon any
1677	1677	participating state until it is enacted materially in the same manner into the
1678	1678	laws of all participating states as determined by the commission.
1679	1679	SECTION 12—CONSTRUCTION AND SEVERABILITY
1680	1680	(a) This compact and the commission's rulemaking authority shall be
1681	1681	liberally construed so as to effectuate the purposes and the implementation
1682	1682	and administration of the compact. Provisions of the compact expressly
1683	1683	authorizing or requiring the adoption of rules shall not be construed to
1684	1684	limit the commission's rulemaking authority solely for those purposes.
1685	1685	(b) The provisions of this compact shall be severable, and if any
1686	1686	phrase, clause, sentence or provision of this compact is held by a court of
1687	1687	competent jurisdiction to be contrary to the constitution of any
1688	1688	participating state, a state seeking participation in the compact or of the
1689	1689	United States, or the applicability thereof to any government, agency,
1690	1690	person or circumstance is held to be unconstitutional by a court of
1691	1691	competent jurisdiction, the validity of the remainder of this compact and
1692	1692	the applicability thereof to any other government, agency, person or
1693	1693	circumstance shall not be affected thereby.
1694	1694	(c) Notwithstanding the provisions of this subsection or subsection
1695	1695	(b), the commission may deny a state's participation in the compact or, in
1696	1696	accordance with the requirements of section 10(b), terminate a
1697	1697	participating state's participation in the compact, if it determines that a
1698	1698	constitutional requirement of a participating state is, or would be with
1699	1699	respect to a state seeking to participate in the compact, a material departure
1700	1700	from the compact. Otherwise, if this compact shall be held to be contrary
1701	1701	to the constitution of any participating state, the compact shall remain in
1702	1702	full force and effect as to the remaining participating states and in full
1703	1703	force and effect as to the participating state affected as to all severable
1704	1704	matters.
1705	1705	SECTION 13—BINDING EFFECT OF COMPACT
1706	1706	(a) Nothing herein prevents the enforcement of any other law of a
1707	1707	participating state that is not inconsistent with this compact.
1708	1708	(b) Any laws in a participating state in conflict with this compact are
1709	1709	superseded to the extent of the conflict.
1710	1710	(c) All agreements between the commission and the participating
1711	1711	states are binding in accordance with their terms.
1712	1712	Sec. 2. This act shall take effect and be in force from and after its
1713	1713	publication in the statute book.
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