Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H2531 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 1
2	2	HOUSE DOCKET, NO. 2345 FILED ON: 1/16/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 2531
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Lindsay N. Sabadosa
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to physician assistant interstate compact.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Lindsay N. Sabadosa1st Hampshire1/16/2025Jacob R. OliveiraHampden, Hampshire and Worcester2/6/2025Christopher M. Markey9th Bristol2/13/2025John J. Marsi6th Worcester2/13/2025Patricia A. Duffy5th Hampden2/13/2025Jason M. LewisFifth Middlesex2/18/2025Michael J. Finn6th Hampden2/20/2025Joseph D. McKenna18th Worcester2/21/2025Steven George Xiarhos5th Barnstable2/23/2025Bruce E. TarrFirst Essex and Middlesex2/28/2025Judith A. Garcia11th Suffolk3/3/2025 1 of 34
16	16	HOUSE DOCKET, NO. 2345 FILED ON: 1/16/2025
17	17	HOUSE . . . . . . . . . . . . . . . No. 2531
18	18	By Representative Sabadosa of Northampton, a petition (accompanied by bill, House, No. 2531)
19	19	of Lindsay N. Sabadosa and others relative to physician assistant interstate compact. Public
20	20	Health.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Fourth General Court
24	24	(2025-2026)
25	25	_______________
26	26	An Act relative to physician assistant interstate compact.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. The General Laws are hereby amended by inserting after chapter 112A the
30	30	2following chapter:-
31	31	3 Chapter 112B. Physician Assistant Licensure Compact.
32	32	4 Section 1. In order to strengthen access to medical services, and in recognition of the
33	33	5advances in the delivery of medical services, the participating states of the physician assistant
34	34	6licensure compact have allied in common purpose to develop a comprehensive process that
35	35	7complements the existing authority of state licensing boards to license and discipline physician
36	36	8assistants and seeks to enhance the portability of a license to practice as a physician assistant
37	37	9while safeguarding the safety of patients. This compact allows medical services to be provided
38	38	10by physician assistants, via the mutual recognition of the licensee’s qualifying license by other
39	39	11compact participating states. This compact also adopts the prevailing standard for physician
40	40	12assistant licensure and affirms that the practice and delivery of medical services by the physician 2 of 34
41	41	13assistant occurs where the patient is located at the time of the patient encounter, and therefore
42	42	14requires the physician assistant to be under the jurisdiction of the state licensing board where the
43	43	15patient is located. State licensing boards that participate in this compact retain the jurisdiction to
44	44	16impose adverse action against a compact privilege in that state issued to a physician assistant
45	45	17through the procedures of this compact. The physician assistant licensure compact will alleviate
46	46	18burdens for military families by allowing active duty military personnel and their spouses to
47	47	19obtain a compact privilege based on having an unrestricted license in good standing from a
48	48	20participating state.
49	49	21 Section 2.
50	50	22 As used in this chapter, unless the context requires otherwise, the following words shall
51	51	23have the following meanings:
52	52	24 “Adverse action”, any administrative, civil, equitable, or criminal action permitted
53	53	25 by a state’s laws which is imposed by a licensing board or other authority against a
54	54	26physician assistant license or license application or compact privilege such as license denial,
55	55	27censure, revocation, suspension, probation, monitoring of the licensee, or restriction on the
56	56	28licensee’s practice.
57	57	29 “Compact privilege”, the authorization granted by a remote state to allow a licensee from
58	58	30another participating state to practice as a physician assistant to provide medical services and
59	59	31other licensed activity to a patient located in the remote state under the remote state’s laws and
60	60	32regulations. 3 of 34
61	61	33 “Conviction”, a finding by a court that an individual is guilty of a felony or misdemeanor
62	62	34offense through adjudication or entry of a plea of guilt or no contest to the charge by the
63	63	35offender.
64	64	36 “Criminal background check”, the submission of fingerprints or other biometric based
65	65	37information for a license applicant for the purpose of obtaining that applicant’s criminal history
66	66	38record information, as defined in 28 C.F.R. § 20.3(d), from the state’s criminal history record
67	67	39repository as defined in 28 C.F.R. § 20.3(f).
68	68	40 “Data system”, the repository of information about licensees, including but not limited to
69	69	41license status and adverse actions, which is created and administered under the terms of this
70	70	42compact.
71	71	43 “Executive committee”, a group of directors and ex-officio individuals elected or
72	72	44appointed pursuant to paragraph (2) of subsection (f) of section 7.
73	73	45 “Impaired practitioner”, a physician assistant whose practice is adversely affected by
74	74	46health related condition(s) that impact their ability to practice.
75	75	47 “Investigative information”, information, records, or documents received or
76	76	48 generated by a licensing board pursuant to an investigation.
77	77	49 “Jurisprudence requirement”, the assessment of an individual’s knowledge of the laws
78	78	50and rules governing the practice of a physician assistant in a state.
79	79	51 “License”, current authorization by a state, other than authorization pursuant to a compact
80	80	52privilege, for a physician assistant to provide medical services, which would be unlawful without
81	81	53current authorization. 4 of 34
82	82	54 “Licensee”, an individual who holds a license from a state to provide medical services as
83	83	55a physician assistant.
84	84	56 “Licensing board”, any state entity authorized to license and otherwise regulate physician
85	85	57assistants.
86	86	58 “Medical services”, health care services provided for the diagnosis, prevention, treatment,
87	87	59cure or relief of a health condition, injury, or disease, as defined by a state’s laws and
88	88	60regulations.
89	89	61 “Model compact”, the model for the physician assistant licensure compact on file with
90	90	62the Council of State Governments or other entity as designated by the commission.
91	91	63 “Participating state”, a state that has enacted this compact.
92	92	64 “Physician Assistant” means an individual who is licensed as a physician assistant in a
93	93	65state. For purposes of this compact, any other title or status adopted by a state to replace the term
94	94	66“Physician Assistant” shall be deemed synonymous with “physician assistant” and shall confer
95	95	67the same rights and responsibilities to the licensee under the provisions of this compact at the
96	96	68time of its enactment.
97	97	69 “Physician Assistant Licensure Compact Commission”, “Compact Commission”, or
98	98	70“Commission”, the national administrative body created pursuant to subsection (a) of section 7.
99	99	71 “Qualifying license”, an unrestricted license issued by a participating state to provide
100	100	72medical services as a physician assistant.
101	101	73 “Remote state”, a participating state where a licensee who is not licensed as a physician
102	102	74assistant is exercising or seeking to exercise the compact privilege. 5 of 34
103	103	75 “Rule”, a regulation promulgated by an entity that has the force and effect of law.
104	104	76 “Significant investigative information”, investigative information that a licensing board,
105	105	77after an inquiry or investigation that includes notification and an opportunity for the physician
106	106	78assistant to respond if required by state law, has reason to believe is not groundless and, if
107	107	79proven true, would indicate more than a minor infraction.
108	108	80 “State”, any state, commonwealth, district, or territory of the United States.
109	109	81 Section 3. (a) To participate in this compact, a participating state shall:
110	110	82 (1) license physician assistants;
111	111	83 (2) participate in the compact commission’s data system;
112	112	84 (3) have a mechanism in place for receiving and investigating complaints against
113	113	85licensees and license applicants;
114	114	86 (4) notify the commission, in compliance with the terms of this compact and commission
115	115	87rules, of any adverse action against a licensee or license applicant and the existence of significant
116	116	88investigative information regarding a licensee or license applicant;
117	117	89 (5) fully implement a criminal background check requirement, within a time frame
118	118	90established by commission rule, by its licensing board receiving the results of a criminal
119	119	91background check and reporting to the commission whether the license applicant has been
120	120	92granted a license;
121	121	93 (6) comply with the rules of the compact commission; 6 of 34
122	122	94 (7) Utilize passage of a recognized national exam such as the NCCPA PANCE as a
123	123	95requirement for PA licensure; and
124	124	96 (8) grant the compact privilege to a holder of a qualifying license in a participating state.
125	125	97 (b) Nothing in this compact shall prohibit a participating state from charging a fee for
126	126	98granting the compact privilege.
127	127	99 Section 4. (a) To exercise the compact privilege, a licensee must:
128	128	100 (1) have graduated from a physician assistant program accredited by the Accreditation
129	129	101Review Commission on Education for the Physician Assistant, Inc. or other programs authorized
130	130	102by commission rule;
131	131	103 (2) hold current certification from the National Commission on Certification of Physician
132	132	104Assistants;
133	133	105 (3) have no felony or misdemeanor conviction;
134	134	106 (4) have never had a controlled substance license, permit, or registration suspended or
135	135	107revoked by a state or by the United States Drug Enforcement Administration;
136	136	108 (5) have a unique identifier as determined by commission rule;
137	137	109 (6) hold a qualifying license;
138	138	110 (7) have had no revocation of a license or limitation or restriction on any license currently
139	139	111held due to an adverse action; 7 of 34
140	140	112 (8) if a licensee has had a limitation or restriction on a license or compact privilege due to
141	141	113an adverse action, two years shall have elapsed from the date on which the license or compact
142	142	114privilege is no longer limited or restricted due to the adverse action;
143	143	115 (9) if a compact privilege has been revoked or is limited or restricted in a participating
144	144	116state for conduct that would not be a basis for disciplinary action in a participating state in which
145	145	117the licensee is practicing or applying to practice under a compact privilege, that participating
146	146	118state shall have the discretion not to consider such action as an adverse action requiring the
147	147	119denial or removal of a compact privilege in that state;
148	148	120 (10) notify the compact commission that the licensee is seeking the compact privilege in
149	149	121a remote state;
150	150	122 (11) meet any jurisprudence requirement of a remote state in which the licensee is
151	151	123seeking to practice under the compact privilege and pay any fees applicable to satisfying the
152	152	124jurisprudence requirement; and
153	153	125 (12) report to the commission any adverse action taken by a non-participating state within
154	154	12630 days after the action is taken.
155	155	127 (b) The compact privilege shall be valid until the expiration or revocation of the
156	156	128qualifying license unless terminated pursuant to an adverse action. The licensee must also
157	157	129comply with all of the requirements of subsection (a) to maintain the compact privilege in a
158	158	130remote state. If the participating state takes adverse action against a qualifying license, the
159	159	131licensee shall lose the compact privilege in any remote state in which the licensee has a compact
160	160	132privilege until all of the following occur: 8 of 34
161	161	133 (1) the license is no longer limited or restricted; and
162	162	134 (2) 2 years have elapsed from the date on which the license is no longer limited or
163	163	135restricted due to the adverse action.
164	164	136 (c) Once a restricted or limited license satisfies the requirements of paragraphs (1) and (2)
165	165	137of subsection (b), the licensee must meet the requirements of subsection (a) to obtain a compact
166	166	138privilege in any remote state.
167	167	139 (d) For each remote state in which a physician assistant seeks authority to prescribe
168	168	140controlled substances, the physician assistant shall satisfy all requirements imposed by such state
169	169	141in granting or renewing such authority.
170	170	142 Section 5. (a) Upon a licensee’s application for a compact privilege, the licensee shall
171	171	143identify to the commission the participating state from which the licensee is applying, in
172	172	144accordance with applicable rules adopted by the commission, and subject to the following
173	173	145requirements:
174	174	146 (1) when applying for a compact privilege, the licensee shall provide the commission
175	175	147with the address of the licensee’s primary residence and thereafter shall immediately report to the
176	176	148commission any change in the address of the licensee’s primary residence; and
177	177	149 (2) when applying for a compact privilege, the licensee shall consent to accept service of
178	178	150process by mail at the licensee’s primary residence on file with the commission with respect to
179	179	151any action brought against the licensee by the commission or a participating state, including a
180	180	152subpoena, with respect to any action brought or investigation conducted by the commission or a
181	181	153participating state. 9 of 34
182	182	154 Section 6. (a) A participating state in which a licensee is licensed shall have exclusive
183	183	155power to impose adverse action against the qualifying license issued by that participating state.
184	184	156 (b) In addition to the other powers conferred by state law, a remote state shall have the
185	185	157authority, in accordance with existing state due process law, to do all of the following:
186	186	158 (1) take adverse action against a physician assistant’s compact privilege within that state
187	187	159to remove a licensee’s compact privilege or take other action necessary under applicable law to
188	188	160protect the health and safety of its citizens;
189	189	161 (2) issue subpoenas for both hearings and investigations that require the attendance and
190	190	162testimony of witnesses as well as the production of evidence. Subpoenas issued by a licensing
191	191	163board in a participating state for the attendance and testimony of witnesses or the production of
192	192	164evidence from another participating state shall be enforced in the latter state by any court of
193	193	165competent jurisdiction, according to the practice and procedure of that court applicable to
194	194	166subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness
195	195	167fees, travel expenses, mileage and other fees required by the service statutes of the state in which
196	196	168the witnesses or evidence are located.
197	197	169 (3) notwithstanding paragraph (2), subpoenas may not be issued by a participating state to
198	198	170gather evidence of conduct in another state that is lawful in that other state for the purpose of
199	199	171taking adverse action against a licensee’s compact privilege or application for a compact
200	200	172privilege in that participating state; and
201	201	173 (4) nothing in this compact authorizes a participating state to impose discipline against a
202	202	174physician assistant’s compact privilege or to deny an application for a compact privilege in that
203	203	175participating state for the individual’s otherwise lawful practice in another state. 10 of 34
204	204	176 (c) For purposes of taking adverse action, the participating state which issued the
205	205	177qualifying license shall give the same priority and effect to reported conduct received from any
206	206	178other participating state as it would if the conduct had occurred within the participating state
207	207	179which issued the qualifying license. In so doing, that participating state shall apply its own state
208	208	180laws to determine appropriate action.
209	209	181 (d) A participating state, if otherwise permitted by state law, may recover from the
210	210	182affected physician assistant the costs of investigations and disposition of cases resulting from any
211	211	183adverse action taken against that physician assistant.
212	212	184 (e) A participating state may take adverse action based on the factual findings of a remote
213	213	185state, provided that the participating state follows its own procedures for taking the adverse
214	214	186action.
215	215	187 (f) (1) In addition to the authority granted to a participating state by its respective state
216	216	188physician assistant laws and regulations or other applicable state law, any participating state may
217	217	189participate with other participating states in joint investigations of licensees.
218	218	190 (2) Participating states shall share any investigative, litigation, or compliance materials in
219	219	191furtherance of any joint or individual investigation initiated under this compact.
220	220	192 (g) If an adverse action is taken against a physician assistant’s qualifying license, the
221	221	193physician assistant’s compact privilege in all remote states shall be deactivated until 2 years have
222	222	194elapsed after all restrictions have been removed from the state license. All disciplinary orders by
223	223	195the participating state which issued the qualifying license that impose adverse action against a
224	224	196physician assistant’s license shall include a statement that the physician assistant’s compact
225	225	197privilege is deactivated in all participating states during the pendency of the order. 11 of 34
226	226	198 (h) If any participating state takes adverse action, it promptly shall notify the
227	227	199administrator of the data system.
228	228	200 Section 7. (a) The participating states hereby establish a joint government agency and
229	229	201national administrative body known as the physician assistant licensure compact commission.
230	230	202The commission is an instrumentality of the compact states acting jointly and not an
231	231	203instrumentality of any 1 state. The commission shall come into existence on or after the effective
232	232	204date of the compact as set forth in subsection (a) of section 11.
233	233	205 (b)(1) Each participating state shall have and be limited to 1 delegate selected by that
234	234	206participating state’s licensing board or, if the state has more than one licensing board, selected
235	235	207collectively by the participating state’s licensing boards.
236	236	208 (2) The delegate shall be:
237	237	209 (i) a current physician assistant, physician or public member of a licensing board or
238	238	210physician assistant council/committee; or
239	239	211 (ii) an administrator of a licensing board.
240	240	212 (3) Any delegate may be removed or suspended from office as provided by the laws of
241	241	213the state from which the delegate is appointed.
242	242	214 (4) The participating state licensing board shall fill any vacancy occurring in the
243	243	215commission within 60 days.
244	244	216 (5) Each delegate shall be entitled to 1 vote on all matters voted on by the commission
245	245	217and shall otherwise have an opportunity to participate in the business and affairs of the
246	246	218commission. A delegate shall vote in person or by such other means as provided in the bylaws. 12 of 34
247	247	219The bylaws may provide for delegates’ participation in meetings by telecommunications, video
248	248	220conference, or other means of communication.
249	249	221 (6) The commission shall meet at least once during each calendar year. Additional
250	250	222meetings shall be held as set forth in this compact and the bylaws.
251	251	223 (7) The commission shall establish by rule a term of office for delegates.
252	252	224 (c) The commission shall have the following powers and duties:
253	253	225 (1) establish a code of ethics for the commission;
254	254	226 (2) establish the fiscal year of the commission;
255	255	227 (3) establish fees;
256	256	228 (4) establish bylaws;
257	257	229 (5) maintain its financial records in accordance with the bylaws;
258	258	230 (6) meet and take such actions as are consistent with the provisions of this compact and
259	259	231the bylaws;
260	260	232 (7) promulgate rules to facilitate and coordinate implementation and administration of
261	261	233this compact. The rules shall have the force and effect of law and shall be binding in all
262	262	234participating states;
263	263	235 (8) bring and prosecute legal proceedings or actions in the name of the commission,
264	264	236provided that the standing of any state licensing board to sue or be sued under applicable law
265	265	237shall not be affected; 13 of 34
266	266	238 (9) purchase and maintain insurance and bonds;
267	267	239 (10) borrow, accept, or contract for services of personnel, including, but not limited to,
268	268	240employees of a participating state;
269	269	241 (11) hire employees and engage contractors, elect or appoint officers, fix compensation,
270	270	242define duties, grant such individuals appropriate authority to carry out the purposes of this
271	271	243compact, and establish the commission’s personnel policies and programs relating to conflicts of
272	272	244interest, qualifications of personnel,and other related personnel matters;
273	273	245 (12) accept any and all appropriate donations and grants of money, equipment, supplies,
274	274	246materials and services, and receive, utilize and dispose of the same; provided that at all times the
275	275	247commission shall avoid any appearance of impropriety or conflict of interest;
276	276	248 (13) lease, purchase, accept appropriate gifts or donations of, or otherwise own, hold,
277	277	249improve or use, any property, real, personal or mixed; provided, that at all times the commission
278	278	250shall avoid any appearance of impropriety;
279	279	251 (14) sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
280	280	252any property real, personal, or mixed;
281	281	253 (15) establish a budget and make expenditures;
282	282	254 (16) borrow money;
283	283	255 (17) appoint committees, including standing committees composed of members, state
284	284	256regulators, state legislators or their representatives, and consumer representatives, and such other
285	285	257interested persons as may be designated in this compact and the bylaws; 14 of 34
286	286	258 (18) provide and receive information from, and cooperate with, law enforcement
287	287	259agencies;
288	288	260 (19) elect a chair, vice chair, secretary and treasurer and such other officers of the
289	289	261commission as provided in the commission’s bylaws;
290	290	262 (20) reserve for itself, in addition to those reserved exclusively to the commission under
291	291	263the compact, powers that the executive committee may not exercise;
292	292	264 (21) approve or disapprove a state’s participation in the compact based upon its
293	293	265determination as to whether the state’s compact legislation departs in a material manner from the
294	294	266model compact language;
295	295	267 (22) prepare and provide to the participating states an annual report; and
296	296	268 (23) perform such other functions as may be necessary or appropriate to achieve the
297	297	269purposes of this compact consistent with the state regulation of physician assistant licensure and
298	298	270practice.
299	299	271 (d) (1) All meetings of the commission that are not closed pursuant to this subsection
300	300	272shall be open to the public. Notice of public meetings shall be posted on the commission’s
301	301	273website at least 30 days prior to the public meeting.
302	302	274 (2) Notwithstanding paragraph (1) of subsection (d), the commission may convene a
303	303	275public meeting by providing at least 24 hours prior notice on the commission’s website, and any
304	304	276other means as provided in the commission’s rules, for any of the reasons it may dispense with
305	305	277notice of proposed rulemaking under subsection (I) of section 9. 15 of 34
306	306	278 (3) The commission may convene in a closed, non-public meeting or non-public part of a
307	307	279public meeting to receive legal advice or to discuss:
308	308	280 (i) non-compliance of a participating state with its obligations under this compact;
309	309	281 (ii) the employment, compensation, discipline or other matters, practices or procedures
310	310	282related to specific employees or other matters related to the commission’s internal personnel
311	311	283practices and procedures;
312	312	284 (iii) current, threatened, or reasonably anticipated litigation;
313	313	285 (iv) negotiation of contracts for the purchase, lease, or sale of goods, services, or real
314	314	286estate;
315	315	287 (v) accusing any person of a crime or formally censuring any person;
316	316	288 (vi) disclosure of trade secrets or commercial or financial information that is privileged or
317	317	289confidential;
318	318	290 (vii) disclosure of information of a personal nature where disclosure would constitute a
319	319	291clearly unwarranted invasion of personal privacy;
320	320	292 (viii) disclosure of investigative records compiled for law enforcement purposes;
321	321	293 (ix) disclosure of information related to any investigative reports prepared by or on behalf
322	322	294of or for use of the commission or other committee charged with responsibility of investigation
323	323	295or determination of compliance issues pursuant to this compact;
324	324	296 (x) legal advice; or 16 of 34
325	325	297 (xi) matters specifically exempted from disclosure by federal or participating states’
326	326	298statutes.
327	327	299 (4) If a meeting, or portion of a meeting, is closed pursuant to this provision, the chair of
328	328	300the meeting or the chair’s designee shall certify that the meeting or portion of the meeting may
329	329	301be closed and shall reference each relevant exempting provision.
330	330	302 (5) The commission shall keep minutes that fully and clearly describe all matters
331	331	303discussed in a meeting and shall provide a full and accurate summary of actions taken, including
332	332	304a description of the views expressed. All documents considered in connection with an action
333	333	305shall be identified in such minutes. All minutes and documents of a closed meeting shall remain
334	334	306under seal, subject to release by a majority vote of the commission or order of a court of
335	335	307competent jurisdiction.
336	336	308 (e)(1) The commission shall pay, or provide for the payment of, the reasonable expenses
337	337	309of its establishment, organization, and ongoing activities.
338	338	310 (2) The commission may accept any and all appropriate revenue sources, donations, and
339	339	311grants of money, equipment, supplies, materials, and services.
340	340	312 (3) The commission may levy on and collect an annual assessment from each
341	341	313participating state and may impose compact privilege fees on licensees of participating states to
342	342	314whom a compact privilege is granted to cover the cost of the operations and activities of the
343	343	315commission and its staff, which must be in a total amount sufficient to cover its annual budget as
344	344	316approved by the commission each year for which revenue is not provided by other sources. The
345	345	317aggregate annual assessment amount levied on participating states shall be allocated based upon
346	346	318a formula to be determined by commission rule. 17 of 34
347	347	319 (i) A compact privilege expires when the licensee’s qualifying license in the participating
348	348	320state from which the licensee applied for the compact privilege expires.
349	349	321 (ii) If the licensee terminates the qualifying license through which the licensee applied for
350	350	322the compact privilege before its scheduled expiration, and the licensee has a qualifying license in
351	351	323another participating state, the licensee shall inform the commission that it is changing to that
352	352	324participating state the participating state through which it applies for a compact privilege and pay
353	353	325to the commission any compact privilege fee required by commission rule.
354	354	326 (4) The commission shall not incur obligations of any kind prior to securing the funds
355	355	327adequate to meet the same; nor shall the commission pledge the credit of any of the participating
356	356	328states, except by and with the authority of the participating state.
357	357	329 (5) The commission shall keep accurate accounts of all receipts and disbursements. The
358	358	330receipts and disbursements of the commission shall be subject to the financial review and
359	359	331accounting procedures established under its bylaws. All receipts and disbursements of funds
360	360	332handled by the commission shall be subject to an annual financial review by a certified or
361	361	333licensed public accountant, and the report of the financial review shall be included in and
362	362	334become part of the annual report of the commission.
363	363	335 (f) (1) The executive committee shall have the power to act on behalf of the commission
364	364	336according to the terms of this compact and commission rules.
365	365	337 (2) The executive committee shall be composed of 9 members:
366	366	338 (i) 7 voting members who are elected by the commission from the current membership of
367	367	339the commission; 18 of 34
368	368	340 (ii) 1 ex-officio, nonvoting member from a recognized national physician assistant
369	369	341professional association; and
370	370	342 (iii) 1 ex-officio, nonvoting member from a recognized national physician assistant
371	371	343certification organization.
372	372	344 (3) The ex-officio members will be selected by their respective organizations.
373	373	345 (4) The commission may remove any member of the executive committee as provided in
374	374	346its bylaws.
375	375	347 (5) The executive committee shall meet at least annually.
376	376	348 (6) The executive committee shall have the following duties and responsibilities:
377	377	349 (i) recommend to the commission changes to the commission’s rules or bylaws, changes
378	378	350to this compact legislation, fees to be paid by compact participating states such as annual dues,
379	379	351and any commission compact fee charged to licensees for the compact privilege;
380	380	352 (ii) ensure compact administration services are appropriately provided, contractual or
381	381	353otherwise;
382	382	354 (iii) prepare and recommend the budget;
383	383	355 (iv) maintain financial records on behalf of the commission;
384	384	356 (v) monitor compact compliance of participating states and provide compliance reports to
385	385	357the commission;
386	386	358 (vi) establish additional committees as necessary; 19 of 34
387	387	359 (vii) exercise the powers and duties of the commission during the interim between
388	388	360commission meetings, except for issuing proposed rulemaking or adopting commission rules or
389	389	361bylaws, or exercising any other powers and duties exclusively reserved to the commission by the
390	390	362commission’s rules; and
391	391	363 (viii) perform other duties as provided in the commission’s rules or bylaws.
392	392	364 (7) All meetings of the executive committee at which it votes or plans to vote on matters
393	393	365in exercising the powers and duties of the commission shall be open to the public and public
394	394	366notice of such meetings shall be given as public meetings of the commission are given.
395	395	367 (8) The executive committee may convene in a closed, non-public meeting for the same
396	396	368reasons that the commission may convene in a non-public meeting as set forth in paragraph (3)
397	397	369of subsection (d) of section 7 and shall announce the closed meeting as the commission is
398	398	370required to under paragraph (4) of said subsection (d) and keep minutes of the closed meeting as
399	399	371the commission is required to under paragraph (5) of said subsection (d).
400	400	372 (g)(1) The members, officers, executive director, employees and representatives of the
401	401	373commission shall be immune from suit and liability, both personally and in their official
402	402	374capacity, for any claim for damage to or loss of property or personal injury or other civil liability
403	403	375caused by or arising out of any actual or alleged act, error, or omission that occurred, or that the
404	404	376person against whom the claim is made had a reasonable basis for believing occurred within the
405	405	377scope of commission employment, duties or responsibilities; provided that nothing in this
406	406	378paragraph shall be construed to protect any such person from suit or liability for any damage,
407	407	379loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person. 20 of 34
408	408	380The procurement of insurance of any type by the commission shall not in any way compromise
409	409	381or limit the immunity granted hereunder.
410	410	382 (2) The commission shall defend any member, officer, executive director, employee, and
411	411	383representative of the commission in any civil action seeking to impose liability arising out of any
412	412	384actual or alleged act, error, or omission that occurred within the scope of commission
413	413	385employment, duties, or responsibilities, or as determined by the commission that the person
414	414	386against whom the claim is made had a reasonable basis for believing occurred within the scope
415	415	387of commission employment, duties, or responsibilities; provided that nothing herein shall be
416	416	388construed to prohibit that person from retaining their own counsel at their own expense; and
417	417	389provided further, that the actual or alleged act, error, or omission did not result from that
418	418	390person’s intentional or willful or wanton misconduct.
419	419	391 (3) The commission shall indemnify and hold harmless any member, officer, executive
420	420	392director, employee, and representative of the commission for the amount of any settlement or
421	421	393judgment obtained against that person arising out of any actual or alleged act, error, or omission
422	422	394that occurred within the scope of commission employment, duties, or responsibilities, or that
423	423	395such person had a reasonable basis for believing occurred within the scope of commission
424	424	396employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission
425	425	397did not result from the intentional or willful or wanton misconduct of that person.
426	426	398 (4) Venue is proper and judicial proceedings by or against the commission shall be
427	427	399brought solely and exclusively in a court of competent jurisdiction where the principal office of
428	428	400the commission is located. The commission may waive venue and jurisdictional defenses in any
429	429	401proceedings as authorized by commission rules. 21 of 34
430	430	402 (5) Nothing herein shall be construed as a limitation on the liability of any licensee for
431	431	403professional malpractice or misconduct, which shall be governed solely by any other applicable
432	432	404state laws.
433	433	405 (6) Nothing herein shall be construed to designate the venue or jurisdiction to bring
434	434	406actions for alleged acts of malpractice, professional misconduct, negligence, or other such civil
435	435	407action pertaining to the practice of a physician assistant. All such matters shall be determined
436	436	408exclusively by state law other than this compact.
437	437	409 (7) Nothing in this compact shall be interpreted to waive or otherwise abrogate a
438	438	410participating state’s state action immunity or state action affirmative defense with respect to
439	439	411antitrust claims under the Sherman Act, Clayton Act, or any other state or federal antitrust or
440	440	412anticompetitive law or regulation.
441	441	413 (8) Nothing in this compact shall be construed to be a waiver of sovereign immunity by
442	442	414the participating states or by the commission.
443	443	415 Section 8. (a) The commission shall provide for the development, maintenance,
444	444	416operation, and utilization of a coordinated data and reporting system containing licensure,
445	445	417adverse action, and the reporting of the existence of significant investigative information on all
446	446	418licensed physician assistants and applicants denied a license in participating states.
447	447	419 (b) Notwithstanding any other state law to the contrary, a participating state shall submit
448	448	420a uniform data set to the data system on all physician assistants to whom this compact is
449	449	421applicable, utilizing a unique identifier as required by the rules of the commission, including:
450	450	422 (1) identifying information; 22 of 34
451	451	423 (2) licensure data;
452	452	424 (3) adverse actions against a license or compact privilege;
453	453	425 (4) any denial of application for licensure, and the reason or reasons for such denial,
454	454	426excluding the reporting of any criminal history record information where prohibited by law;
455	455	427 (5) the existence of significant investigative information; and
456	456	428 (6) other information that may facilitate the administration of this compact, as determined
457	457	429by the rules of the commission.
458	458	430 (c) Significant investigative information pertaining to a licensee in any participating state
459	459	431shall only be available to other participating states.
460	460	432 (d) The commission shall promptly notify all participating states of any adverse action
461	461	433taken against a licensee or an individual applying for a license that has been reported to it. This
462	462	434adverse action information shall be available to any other participating state.
463	463	435 (e) Participating states contributing information to the data system may, in accordance
464	464	436with state or federal law, designate information that may not be shared with the public without
465	465	437the express permission of the contributing state. Notwithstanding any such designation, such
466	466	438information shall be reported to the commission through the data system.
467	467	439 (f) Any information submitted to the data system that is subsequently expunged pursuant
468	468	440to federal law or the laws of the participating state contributing the information shall be removed
469	469	441from the data system upon reporting of such by the participating state to the commission. 23 of 34
470	470	442 (g) The records and information provided to a participating state pursuant to this compact
471	471	443or through the data system, when certified by the commission or an agent thereof, shall constitute
472	472	444the authenticated business records of the commission, and shall be entitled to any associated
473	473	445hearsay exception in any relevant judicial, quasi-judicial or administrative
474	474	446 proceedings in a participating state.
475	475	447 Section 9. (a) The commission shall exercise its rulemaking powers pursuant to the
476	476	448criteria in this section and the rules adopted thereunder. Commission rules shall become binding
477	477	449as of the date specified by the commission for each rule.
478	478	450 (b) The commission shall promulgate reasonable rules in order to effectively and
479	479	451efficiently implement and administer this compact and achieve its purposes. A commission rule
480	480	452shall be invalid and not have force or effect only if a court of competent jurisdiction holds that
481	481	453the rule is invalid because the commission exercised its rulemaking authority in a manner that is
482	482	454beyond the scope of the purposes of this compact, or the powers granted hereunder, or based
483	483	455upon another applicable standard of review.
484	484	456 (c) The rules of the commission shall have the force of law in each participating state,
485	485	457provided however that where the rules of the commission conflict with the laws of the
486	486	458participating state that establish the medical services a physician assistant may perform in the
487	487	459participating state, as held by a court of competent jurisdiction, the rules of the commission shall
488	488	460be ineffective in that state to the extent of the conflict.
489	489	461 (d) If a majority of the legislatures of the participating states rejects a commission rule,
490	490	462by enactment of a statute or resolution in the same manner used to adopt this compact within 4 24 of 34
491	491	463years of the date of adoption of the rule, then such rule shall have no further force and effect in
492	492	464any participating state or to any state applying to participate in the compact.
493	493	465 (e) Commission rules shall be adopted at a regular or special meeting of the commission.
494	494	466 (f) Prior to promulgation and adoption of a final rule or rules by the commission, and at
495	495	467least 30 days in advance of the meeting at which the rule will be considered and voted upon, the
496	496	468commission shall file a notice of proposed rulemaking:
497	497	469 (1) on the website of the commission or other publicly accessible platform;
498	498	470 (2) to persons who have requested notice of the commission’s notices of proposed
499	499	471rulemaking; and
500	500	472 (3) in such other ways as the commission may by rule specify.
501	501	473 (g) The notice of proposed rulemaking shall include:
502	502	474 (1) the time, date, and location of the public hearing on the proposed rule and the
503	503	475proposed time, date and location of the meeting in which the proposed rule will be considered
504	504	476and voted upon;
505	505	477 (2) the text of the proposed rule and the reason for the proposed rule;
506	506	478 (3) a request for comments on the proposed rule from any interested person and the date
507	507	479by which written comments must be received; and
508	508	480 (4) the manner in which interested persons may submit notice to the commission of their
509	509	481intention to attend the public hearing or provide any written comments. 25 of 34
510	510	482 (h) Prior to adoption of a proposed rule, the commission shall allow persons to submit
511	511	483written data, facts, opinions, and arguments, which shall be made available to the public.
512	512	484 (i) If the hearing is to be held via electronic means, the commission shall publish the
513	513	485mechanism for access to the electronic hearing.
514	514	486 (1) All persons wishing to be heard at the hearing shall as directed in the notice of
515	515	487proposed rulemaking, not less than 5 business days before the scheduled date of the hearing,
516	516	488notify the commission of their desire to appear and testify at the hearing.
517	517	489 (2) Hearings shall be conducted in a manner providing each person who wishes to
518	518	490comment a fair and reasonable opportunity to comment orally or in writing.
519	519	491 (3) All hearings shall be recorded. A copy of the recording and the written comments,
520	520	492data, facts, opinions, and arguments received in response to the proposed rulemaking shall be
521	521	493made available to a person upon request.
522	522	494 (4) Nothing in this section shall be construed as requiring a separate hearing on each
523	523	495proposed rule. Proposed rules may be grouped for the convenience of the commission at hearings
524	524	496required by this section.
525	525	497 (j) Following the public hearing the commission shall consider all written and oral
526	526	498comments timely received.
527	527	499 (k) The commission shall, by majority vote of all delegates, take final action on the
528	528	500proposed rule and shall determine the effective date of the rule, if adopted, based on the
529	529	501rulemaking record and the full text of the rule.
530	530	502 (1) If adopted, the rule shall be posted on the commission’s website. 26 of 34
531	531	503 (2) The commission may adopt changes to the proposed rule provided the changes do not
532	532	504enlarge the original purpose of the proposed rule.
533	533	505 (3) The commission shall provide on its website an explanation of the reasons for
534	534	506substantive changes made to the proposed rule as well as reasons for substantive changes not
535	535	507made that were recommended by commenters.
536	536	508 (4) The commission shall determine a reasonable effective date for the rule. Except for an
537	537	509emergency as provided in subsection (l), the effective date of the rule shall be no sooner than 30
538	538	510days after the commission issued the notice that it adopted the rule.
539	539	511 (l) Upon determination that an emergency exists, the commission may consider and adopt
540	540	512an emergency rule with 24 hours prior notice, without the opportunity for comment, or hearing,
541	541	513provided that the usual rulemaking procedures provided in this compact and in this section shall
542	542	514be retroactively applied to the rule as soon as reasonably possible, in no event later than 90 days
543	543	515after the effective date of the rule. For the purposes of this provision, an emergency rule is one
544	544	516that must be adopted immediately by the commission in order to:
545	545	517 (1) meet an imminent threat to public health, safety, or welfare;
546	546	518 (2) prevent a loss of commission or participating state funds;
547	547	519 (3) meet a deadline for the promulgation of a commission rule that is established by
548	548	520federal law or rule; or
549	549	521 (4) protect public health and safety.
550	550	522 (m) The commission or an authorized committee of the commission may direct revisions
551	551	523to a previously adopted commission rule for purposes of correcting typographical errors, errors 27 of 34
552	552	524in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be
553	553	525posted on the website of the commission. The revision shall be subject to challenge by any
554	554	526person for a period of 30 days after posting. The revision may be challenged only on grounds
555	555	527that the revision results in a material change to a rule. A challenge shall be made as set forth in
556	556	528the notice of revisions and delivered to the commission prior to the end of the notice period. If no
557	557	529challenge is made, the revision will take effect without further action. If the revision is
558	558	530challenged, the revision may not take effect without the approval of the commission.
559	559	531 (n) No participating state’s rulemaking requirements shall apply under this compact.
560	560	532 Section 10. (a)(1) The executive and judicial branches of state government in each
561	561	533participating state shall enforce this compact and take all actions necessary and appropriate to
562	562	534implement the compact.
563	563	535 (2) Venue is proper and judicial proceedings by or against the commission shall be
564	564	536brought solely and exclusively in a court of competent jurisdiction where the principal office of
565	565	537the commission is located. The commission may waive venue and jurisdictional defenses to the
566	566	538extent it adopts or consents to participate in alternative dispute resolution proceedings. Nothing
567	567	539herein shall affect or limit the selection or propriety of venue in any action against a licensee for
568	568	540professional malpractice, misconduct or any such similar matter.
569	569	541 (3) The commission shall be entitled to receive service of process in any proceeding
570	570	542regarding the enforcement or interpretation of the compact or the commission’s rules and shall
571	571	543have standing to intervene in such a proceeding for all purposes. Failure to provide the
572	572	544commission with service of process shall render a judgment or order in such proceeding void as
573	573	545to the commission, this compact, or commission rules. 28 of 34
574	574	546 (b) (1) If the commission determines that a participating state has defaulted in the
575	575	547performance of its obligations or responsibilities under this compact or the commission rules, the
576	576	548commission shall provide written notice to the defaulting state and other participating states. The
577	577	549notice shall describe the default, the proposed means of curing the default and any other action
578	578	550that the commission may take and shall offer remedial training and specific technical assistance
579	579	551regarding the default.
580	580	552 (2) If a state in default fails to cure the default, the defaulting state may be terminated
581	581	553from this compact upon an affirmative vote of a majority of the delegates of the participating
582	582	554states, and all rights, privileges and benefits conferred by this compact upon such state may be
583	583	555terminated on the effective date of termination. A cure of the default does not relieve the
584	584	556offending state of obligations or liabilities incurred during the period of default.
585	585	557 (3) Termination of participation in this compact shall be imposed only after all other
586	586	558means of securing compliance have been exhausted. Notice of intent to suspend or terminate
587	587	559shall be given by the commission to the governor, the majority and minority leaders of the
588	588	560defaulting state’s legislature, and to the licensing board of each of the participating states.
589	589	561 (4) A state that has been terminated is responsible for all assessments, obligations, and
590	590	562liabilities incurred through the effective date of termination, including obligations that extend
591	591	563beyond the effective date of termination.
592	592	564 (5) The commission shall not bear any costs related to a state that is found to be in default
593	593	565or that has been terminated from this compact, unless agreed upon in writing between the
594	594	566commission and the defaulting state. 29 of 34
595	595	567 (6) The defaulting state may appeal its termination from the compact by the commission
596	596	568by petitioning the U.S. District Court for the District of Columbia or the federal district where
597	597	569the commission has its principal offices. The prevailing member shall be awarded all costs of
598	598	570such litigation, including reasonable attorney’s fees.
599	599	571 (7) Upon the termination of a state’s participation in the compact, the state shall
600	600	572immediately provide notice to all licensees within that state of such termination:
601	601	573 (i) licensees who have been granted a compact privilege in that state shall retain the
602	602	574compact privilege for 180 days following the effective date of such termination.
603	603	575 (ii) licensees who are licensed in that state who have been granted a compact privilege in
604	604	576a participating state shall retain the compact privilege for 180 days unless the licensee also has a
605	605	577qualifying license in a participating state or obtains a qualifying license in a participating state
606	606	578before the 180-day period ends, in which case the compact privilege shall continue.
607	607	579 (c) (1) Upon request by a participating state, the commission shall attempt to resolve
608	608	580disputes related to this compact that arise among participating states and between participating
609	609	581and non-participating states.
610	610	582 (2) The commission shall promulgate a rule providing for both mediation and binding
611	611	583dispute resolution for disputes as appropriate.
612	612	584 (d)(1) The commission, in the reasonable exercise of its discretion, shall enforce the
613	613	585provisions of this compact and rules of the commission.
614	614	586 (2) If compliance is not secured after all means to secure compliance have been
615	615	587exhausted, by majority vote, the commission may initiate legal action in the United States 30 of 34
616	616	588District Court for the District of Columbia or the federal district where the commission has its
617	617	589principal offices, against a participating state in default to enforce compliance with the
618	618	590provisions of this compact and the commission’s promulgated rules and bylaws. The relief
619	619	591sought may include both injunctive relief and damages. In the event judicial enforcement is
620	620	592necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable
621	621	593attorney’s fees.
622	622	594 (3) The remedies herein shall not be the exclusive remedies of the commission. The
623	623	595commission may pursue any other remedies available under federal or state law.
624	624	596 (e)(1) A participating state may initiate legal action against the commission in the U.S.
625	625	597District Court for the District of Columbia or the federal district where the commission has its
626	626	598principal offices to enforce compliance with the provisions of the compact and its rules. The
627	627	599relief sought may include both injunctive relief and damages. In the event judicial enforcement is
628	628	600necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable
629	629	601attorney’s fees.
630	630	602 (2) No person other than a participating state shall enforce this compact against the
631	631	603commission.
632	632	604 Section 11. (a) This compact shall come into effect on the date on which this compact
633	633	605statute is enacted into law in the seventh participating state.
634	634	606 (1) On or after the effective date of the compact, the commission shall convene and
635	635	607review the enactment of each of the states that enacted the compact prior to the commission
636	636	608convening referred to as charter participating states, to determine if the statute enacted by each
637	637	609such charter participating state is materially different than the model compact. 31 of 34
638	638	610 (i) a charter participating state whose enactment is found to be materially different from
639	639	611the model compact shall be entitled to the default process set forth in subsection (b) of section
640	640	61210.
641	641	613 (ii) if any participating state later withdraws from the compact or its participation is
642	642	614terminated, the commission shall remain in existence and the compact shall remain in effect even
643	643	615if the number of participating states should be less than seven. Participating states enacting the
644	644	616compact subsequent to the commission convening shall be subject to the process set forth in
645	645	617paragraph (21) of subsection (c) of section 7 to determine if their enactments are materially
646	646	618different from the model compact and whether they qualify for participation in the compact.
647	647	619 (2) Participating states enacting the compact subsequent to the seven initial charter
648	648	620participating states shall be subject to the process set forth in paragraph (21) of subsection (c) of
649	649	621section 7 to determine if their enactments are materially different from the model compact and
650	650	622whether they qualify for participation in the compact.
651	651	623 (3) All actions taken for the benefit of the commission or in furtherance of the purposes
652	652	624of the administration of the compact prior to the effective date of the compact or the commission
653	653	625coming into existence shall be considered to be actions of the commission unless specifically
654	654	626repudiated by the commission.
655	655	627 (b) Any state that joins this compact shall be subject to the commission’s rules and
656	656	628bylaws as they exist on the date on which this compact becomes law in that state. Any rule that
657	657	629has been previously adopted by the commission shall have the full force and effect of law on the
658	658	630day this compact becomes law in that state. 32 of 34
659	659	631 (c) Any participating state may withdraw from this compact by enacting a statute
660	660	632repealing the same.
661	661	633 (1) A participating state’s withdrawal shall not take effect until 180 days after enactment
662	662	634of the repealing statute. During this 180 day-period, all compact privileges that were in effect in
663	663	635the withdrawing state and were granted to licensees licensed in the withdrawing state shall
664	664	636remain in effect. If any licensee licensed in the withdrawing state is also licensed in another
665	665	637participating state or obtains a license in another participating state within the 180 days, the
666	666	638licensee’s compact privileges in other participating states shall not be affected by the passage of
667	667	639the 180 days.
668	668	640 (2) Withdrawal shall not affect the continuing requirement of the state licensing board of
669	669	641the withdrawing state to comply with the investigative, and adverse action reporting
670	670	642requirements of this compact prior to the effective date of withdrawal.
671	671	643 (3) Upon the enactment of a statute withdrawing a state from this compact, the state shall
672	672	644immediately provide notice of such withdrawal to all licensees within that state. Such
673	673	645withdrawing state shall continue to recognize all licenses granted pursuant to this compact for a
674	674	646minimum of 180days after the date of such notice of withdrawal.
675	675	647 (d) Nothing contained in this compact shall be construed to invalidate or prevent any
676	676	648physician assistant licensure agreement or other cooperative arrangement between participating
677	677	649states and between a participating state and non-participating state that does not conflict with the
678	678	650provisions of this compact.
679	679	651 (e) This compact may be amended by the participating states. No amendment to this
680	680	652compact shall become effective and binding upon any participating state until it is enacted 33 of 34
681	681	653materially in the same manner into the laws of all participating states as determined by the
682	682	654commission.
683	683	655 Section 12. (a) This compact and the commission’s rulemaking authority shall be
684	684	656liberally construed so as to effectuate the purposes, and the implementation and administration of
685	685	657the compact. Provisions of the compact expressly authorizing or requiring the promulgation of
686	686	658rules shall not be construed to limit the commission’s rulemaking authority solely for those
687	687	659purposes.
688	688	660 (b) The provisions of this compact shall be severable and if any phrase, clause, sentence
689	689	661or provision of this compact is held by a court of competent jurisdiction to be contrary to the
690	690	662constitution of any participating state, a state seeking participation in the compact, or of the
691	691	663United States, or the applicability thereof to any government, agency, person or circumstance is
692	692	664held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of
693	693	665this compact and the applicability thereof to any other government, agency, person or
694	694	666circumstance shall not be affected thereby.
695	695	667 (c) Notwithstanding subsection (b) or this subsection, the commission may deny a state’s
696	696	668participation in the compact or, in accordance with the requirements of subsection (b) of section
697	697	669(10), terminate a participating state’s participation in the compact, if it determines that a
698	698	670constitutional requirement of a participating state is, or would be with respect to a state seeking
699	699	671to participate in the compact, a material departure from the compact. Otherwise, if this compact
700	700	672shall be held to be contrary to the constitution of any participating state, the compact shall
701	701	673remain in full force and effect as to the remaining participating states and in full force and effect
702	702	674as to the participating state affected as to all severable matters. 34 of 34
703	703	675 Section 13. (a) Nothing herein prevents the enforcement of any other law of a
704	704	676participating state that is not inconsistent with this compact.
705	705	677 (b) Any laws in a participating state in conflict with this compact are superseded to the
706	706	678extent of the conflict.
707	707	679 (c) All agreements between the commission and the participating states are binding in
708	708	680accordance with their terms.