North Carolina House Bill H672 Amended / Bill

                    GENERAL ASSEMBLY OF NORTH CAROLINA 
SESSION 2025 
H 	1 
HOUSE BILL 672 
 
 
Short Title: Physician Assist. Omnibus/Team-based/Compact. 	(Public) 
Sponsors: Representatives Paré, Potts, Lambeth, and Chesser (Primary Sponsors). 
For a complete list of sponsors, refer to the North Carolina General Assembly web site. 
Referred to: Health, if favorable, Finance, if favorable, Rules, Calendar, and Operations of the 
House 
April 3, 2025 
*H672 -v-1* 
A BILL TO BE ENTITLED 1 
AN ACT TO ADJUST THE SUPERVISION ARRANGE MENT OF PHYSICIAN 2 
ASSISTANTS AND TO MA KE VARIOUS CHANGES T O THE LICENSURE OF 3 
PHYSICIAN ASSISTANTS. 4 
The General Assembly of North Carolina enacts: 5 
 6 
PART I. PHYSICIAN ASSISTANT TEAM-BASED PRACTICE 7 
SECTION 1.1.(a) G.S. 90-1.1 is amended by adding a new subdivision to read: 8 
"(4d) Team-based setting or team-based practice. – Any of the following: 9 
a. A medical practice that meets all of the following requirements: 10 
1. The majority of the practice is owned collectively by one or 11 
more licensed physicians. 12 
2. An owner who is a physician licensed under this Chapter has 13 
consistent and meaningful participation in the design and 14 
implementation of health services to patients, as defined by 15 
rules adopted by the Board. 16 
3. The physicians and team-based physician assistants who 17 
provide services at the medical practice work in the same 18 
clinical practice area. 19 
b. Hospitals, clinics, nursing homes, and other health facilities with 20 
active credentialing and quality programs where physicians have 21 
consistent and meaningful participation in the design and 22 
implementation of health services to patients, as defined by rules 23 
adopted by the Board. 24 
c. For the purposes of this Article, the term "team-based setting" or 25 
"team-based practice" shall not include a medical practice that 26 
specializes in pain management." 27 
SECTION 1.1.(b) G.S. 90-9.3 reads as rewritten: 28 
"§ 90-9.3.  Requirements for licensure as a physician assistant. 29 
(a) To be eligible for licensure as a physician assistant, an applicant shall submit proof 30 
satisfactory to the Board that the applicant has met all of the following: 31 
(1) The applicant has successfully completed an educational program for 32 
physician assistants or surgeon assistants accredited by the Accreditation 33  General Assembly Of North Carolina 	Session 2025 
Page 2  House Bill 672-First Edition 
Review Commission on Education for the Physician Assistant or its 1 
predecessor or successor entities. 2 
(2) The applicant has a current or previous certification issued by the National 3 
Commission on Certification of Physician Assistants or its successor. 4 
(3) The applicant is of good moral character. 5 
(b) Before initiating practice of medical acts, tasks, or functions as a physician assistant, 6 
the physician assistant shall provide the Board the name, address, and telephone number of the 7 
physician who will supervise the physician assistant in the relevant medical setting. This 8 
subsection shall not apply to physician assistants who meet the requirements for team-based 9 
practice under G.S. 90-9.3A. 10 
(c) The Board may, by rule, require an applicant to comply with other requirements or 11 
submit additional information the Board deems appropriate." 12 
SECTION 1.1.(c) Article 1 of Chapter 90 of the General Statutes is amended by 13 
adding a new section to read: 14 
"§ 90-9.3A.  Requirements for team-based practice as a physician assistant. 15 
(a) In order to practice as a team-based physician assistant, a physician assistant shall 16 
meet all of the following conditions: 17 
(1) Practice in team-based settings, as defined in G.S. 90-1.1(4d). 18 
(2) Have more than 4,000 hours of clinical practice experience as a licensed 19 
physician assistant and more than 1,000 hours of clinical practice experience 20 
within the specific medical specialty of practice with a physician in that 21 
specialty. 22 
(3) Submit proof as the Board may deem satisfactory by rule that the individual 23 
meets the requirements of subdivisions (1) and (2) of this subsection. The 24 
Board may, by rule, require the physician assistant to comply with other 25 
requirements or submit additional information the Board deems appropriate. 26 
(b) Team-based physician assistants shall collaborate and consult with or refer to the 27 
appropriate members of the health care team as required by the patient's condition and as 28 
indicated by the education, experience, and competencies of the physician assistant and the 29 
standard of care. The degree of collaboration must be determined by the practice which may 30 
include decisions by the employer, group, hospital service, and the credentialing and privileging 31 
systems of a licensed facility. The Board may adopt rules to establish requirements for the 32 
determination and enforcement of collaboration, consultation, and referral. Team-based 33 
physician assistants are responsible for the care they provide. 34 
(c) Notwithstanding any other provision of this Chapter, a team-based physician assistant 35 
practicing in a perioperative setting, including the provision of surgical or anesthesia-related 36 
services, shall be supervised by a physician." 37 
SECTION 1.1.(d) G.S. 90-12.4 reads as rewritten: 38 
"§ 90-12.4.  Physician assistant limited volunteer license. 39 
… 40 
(d) Before initiating the performance of medical acts, tasks, or functions as a physician 41 
assistant licensed under this section, the physician assistant shall provide submit to the Board 42 
either an "Intent to Practice Notification Form," which shall include the name, address, and 43 
telephone number of the physician licensed under this Article who will supervise the physician 44 
assistant in the clinic specializing in the care of indigent patients.patients, or meet the 45 
requirements for team-based practice under G.S. 90-9.3A. 46 
…." 47 
SECTION 1.1.(e) G.S. 90-12.4B reads as rewritten: 48 
"§ 90-12.4B.  Physician Assistant assistant retired limited volunteer license. 49 
…." 50 
SECTION 1.1.(f) G.S. 90-18.1 reads as rewritten: 51  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 3 
"§ 90-18.1.  Limitations on physician assistants. 1 
(a) Any person who is licensed under the provisions of G.S. 90-9.3 to perform medical 2 
acts, tasks, and functions as a physician assistant may use the title "physician assistant" or "PA." 3 
Any other person who uses the title in any form or holds out to be a physician assistant or to be 4 
so licensed, shall be deemed to be in violation of this Article. 5 
(a1) Physician assistants shall clearly designate their credentials as a physician assistant in 6 
all clinical settings. 7 
(b) Physician assistants are authorized to write prescriptions for drugs under the 8 
following conditions: 9 
(1) The North Carolina Medical Board has adopted regulations governing the 10 
approval of individual physician assistants to write prescriptions with such 11 
limitations as the Board may determine to be in the best interest of patient 12 
health and safety. 13 
(2) The physician assistant holds a current license issued by the Board. 14 
(3) Repealed by Session Laws 2019-191, s. 35, effective October 1, 2019. 15 
(4) The supervising physician has provided to the physician assistant written 16 
instructions about indications and contraindications for prescribing drugs and 17 
a written policy for periodic review by the physician of the drugs prescribed. 18 
This subdivision shall not apply to individuals who are practicing in a 19 
team-based setting under G.S. 90-9.3A. 20 
(5) A physician assistant shall personally consult with the supervising physician 21 
prior to prescribing a targeted controlled substance as defined in Article 5 of 22 
this Chapter when all of the following conditions apply: 23 
a. The patient is being treated by a facility that primarily engages in the 24 
treatment of pain by prescribing narcotic medications. 25 
b. The therapeutic use of the targeted controlled substance will or is 26 
expected to exceed a period of 30 days. 27 
When a targeted controlled substance prescribed in accordance with this subdivision is 28 
continuously prescribed to the same patient, the physician assistant shall consult with the 29 
supervising physician at least once every 90 days to verify that the prescription remains medically 30 
appropriate for the patient. 31 
(c) Physician assistants are authorized to compound and dispense drugs under the 32 
following conditions: 33 
(1) The function is performed under the supervision of a licensed 34 
pharmacist.physician. 35 
(2) Rules and regulations of the North Carolina Board of Pharmacy and all 36 
applicable State and federal laws governing this function compounding and 37 
dispensing are complied with. 38 
(3) The physician assistant holds a current license issued by the Board. 39 
(4) The physician assistant registers with the Board of Pharmacy. 40 
(d) Physician assistants are authorized to order medications, tests and treatments in 41 
hospitals, clinics, nursing homes, and other health facilities under the following conditions: 42 
(1) The North Carolina Medical Board has adopted regulations governing the 43 
approval of individual physician assistants to order medications, tests, and 44 
treatments with such limitations as the Board may determine to be in the best 45 
interest of patient health and safety. 46 
(2) The physician assistant holds a current license issued by the Board. 47 
(3) The If the physician assistant is subject to a supervisory arrangement, the 48 
supervising physician has provided to the physician assistant written 49 
instructions about ordering medications, tests, and treatments, and when 50 
appropriate, specific oral or written instructions for an individual patient, with 51  General Assembly Of North Carolina 	Session 2025 
Page 4  House Bill 672-First Edition 
provision for review by the physician of the order within a reasonable time, as 1 
determined by the Board, after the medication, test, or treatment is ordered. 2 
(4) The hospital or other health facility has adopted a written policy about 3 
ordering medications, tests, and treatments, including procedures for 4 
verification of the physician assistants' orders by nurses and other facility 5 
employees and such other procedures as are in the interest of patient health 6 
and safety. 7 
(e) Any prescription written by a physician assistant or order given by a physician 8 
assistant for medications, tests, or treatments shall be deemed to have been authorized by the 9 
physician approved by the Board as the supervisor of the physician assistant and the supervising 10 
physician shall be responsible for authorizing the prescription or order. This subsection shall not 11 
apply to individuals who are practicing in a team-based setting under G.S. 90-9.3A who may 12 
prescribe, order, administer, and procure drugs and medical devices without physician 13 
authorization. Individuals who are practicing in a team-based setting under G.S. 90-9.3A may 14 
also plan and initiate a therapeutic regimen that includes ordering and prescribing 15 
non-pharmacological interventions, including durable medical equipment, nutrition, blood, blood 16 
products, and diagnostic support services, including home health care, hospice, and physical and 17 
occupational therapy. 18 
(e1) Any medical certification completed by a physician assistant for a Physician assistants 19 
may authenticate any document, including death certificate shall be deemed to have been 20 
authorized by the physician approved by the Board as the supervisor of the physician assistant, 21 
and the supervising physician shall be responsible for authorizing the completion certificates with 22 
their signature, certification, stamp, verification, affidavit, or endorsement, if it may be so 23 
authenticated by the signature, certification, stamp, verification, affidavit, or endorsement of the 24 
medical certification.a physician. 25 
(e2) Physician assistants shall not perform final interpretations of diagnostic imaging 26 
studies. For purposes of this subsection, "diagnostic imaging" shall include computed 27 
tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron emission 28 
tomography (PET), mammography, and ultrasound services. Final interpretation shall be 29 
provided by a physician licensed under this Chapter. Notwithstanding any other provision of this 30 
Chapter, physician assistants conducting final interpretation of plain film radiographs shall be 31 
supervised by a physician. 32 
… 33 
(g) Any person who is licensed under G.S. 90-9.3 to perform medical acts, tasks, and 34 
functions as a physician assistant shall comply with each of the following: 35 
(1) Maintain a current and active license to practice in this State. 36 
(2) Maintain an active registration with the Board. 37 
(3) Have File a current Intent to Practice form filed with the Board.Board or meet 38 
the requirements for team-based practice under G.S. 90-9.3A. 39 
…." 40 
SECTION 1.1.(g) G.S. 90-21.81(9) reads as rewritten: 41 
"(9) Qualified technician. – A registered diagnostic medical sonographer who is 42 
certified in obstetrics and gynecology by the American Registry for 43 
Diagnostic Medical Sonography (ARDMS) (ARDMS), a physician assistant 44 
with certification in obstetrical ultrasonography, or a nurse midwife or 45 
advanced practice nurse practitioner in obstetrics with certification in 46 
obstetrical ultrasonography." 47 
SECTION 1.1.(h) G.S. 58-3-169 reads as rewritten: 48 
"§ 58-3-169.  Required coverage for minimum hospital stay following birth. 49 
(a) Definitions. – As used in this section: 50 
(1) "Attending providers" includes: 51  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 5 
a. The obstetrician-gynecologists, pediatricians, family physicians, and 1 
other physicians primarily responsible for the care of a mother and 2 
newborn; and 3 
b. The nurse midwives midwives, physician assistants, and nurse 4 
practitioners primarily responsible for the care of a mother and her 5 
newborn child in accordance with State licensure and certification 6 
laws. 7 
…." 8 
SECTION 1.1.(i) G.S. 110-91 reads as rewritten: 9 
"§ 110-91.  Mandatory standards for a license. 10 
All child care facilities shall comply with all State laws and federal laws and local ordinances 11 
that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the 12 
standards in this section shall be complied with by all child care facilities. However, none of the 13 
standards in this section apply to the school-age children of the operator of a child care facility 14 
but do apply to the preschool-age children of the operator. Children 13 years of age or older may 15 
receive child care on a voluntary basis provided all applicable required standards are met. The 16 
standards in this section, along with any other applicable State laws and federal laws or local 17 
ordinances, shall be the required standards for the issuance of a license by the Secretary under 18 
the policies and procedures of the Commission except that the Commission may, in its discretion, 19 
adopt less stringent standards for the licensing of facilities which provide care on a temporary, 20 
part-time, drop-in, seasonal, after-school or other than a full-time basis. 21 
(1) Medical Care and Sanitation. – The Commission for Public Health shall adopt 22 
rules which establish minimum sanitation standards for child care centers and 23 
their personnel. The sanitation rules adopted by the Commission for Public 24 
Health shall cover such matters as the cleanliness of floors, walls, ceilings, 25 
storage spaces, utensils, and other facilities; adequacy of ventilation; 26 
sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, 27 
food protection facilities, bactericidal treatment of eating and drinking 28 
utensils, and solid-waste storage and disposal; methods of food preparation 29 
and serving; infectious disease control; sleeping facilities; and other items and 30 
facilities as are necessary in the interest of the public health. The Commission 31 
for Public Health shall allow child care centers to use domestic kitchen 32 
equipment, provided appropriate temperature levels for heating, cooling, and 33 
storing are maintained. Child care centers that fry foods shall use commercial 34 
hoods. These rules shall be developed in consultation with the Department. 35 
The Commission shall adopt rules for child care facilities to establish 36 
minimum requirements for child and staff health assessments and medical 37 
care procedures. These rules shall be developed in consultation with the 38 
Department. Each child shall have a health assessment before being admitted 39 
or within 30 days following admission to a child care facility. The assessment 40 
shall be done by: (i) a licensed physician, (ii) the physician's authorized agent 41 
who is currently approved by the North Carolina Medical Board, or 42 
comparable certifying board in any state contiguous to North Carolina, (iii) a 43 
certified nurse practitioner, (iv) a licensed physician assistant, or (iv) (v) a 44 
public health nurse meeting the Departments Standards for Early Periodic 45 
Screening, Diagnosis, and Treatment Program. However, no health 46 
assessment shall be required of any staff or child who is and has been in 47 
normal health when the staff, or the child's parent, guardian, or full-time 48 
custodian objects in writing to a health assessment on religious grounds which 49 
conform to the teachings and practice of any recognized church or religious 50 
denomination. 51  General Assembly Of North Carolina 	Session 2025 
Page 6  House Bill 672-First Edition 
Organizations that provide prepared meals to child care centers only are 1 
considered child care centers for purposes of compliance with appropriate 2 
sanitation standards. 3 
…." 4 
SECTION 1.2. The North Carolina Medical Board shall adopt permanent rules 5 
necessary to implement the provisions of this act. 6 
SECTION 1.3. Section 1.1 of this Part becomes effective when the North Carolina 7 
Medical Board adopts the permanent rules required under Section 1.2 of this Part or June 30, 8 
2026, whichever occurs first. The North Carolina Medical Board shall notify the Revisor of 9 
Statutes when the rules required under Section 1.2 of this Part have been adopted. The remainder 10 
of this Part is effective when it becomes law. 11 
 12 
PART II. PHYSICIAN ASSISTANT LICENSURE COMPACT 13 
SECTION 2.1.(a) Chapter 90 of the General Statutes is amended by adding a new 14 
Article to read: 15 
"Article 18J. 16 
"PA Licensure Compact. 17 
"§ 90-270.200.  Purpose. 18 
In order to strengthen access to Medical Services, and in recognition of the advances in the 19 
delivery of Medical Services, the Participating States of the PA Licensure Compact have allied 20 
in common purpose to develop a comprehensive process that complements the existing authority 21 
of State Licensing Boards to license and discipline PAs and seeks to enhance the portability of 22 
License to practice as a PA while safeguarding the safety of patients. This Compact allows 23 
Medical Services to be provided by PAs, via the mutual recognition of the Licensee's Qualifying 24 
License by other Compact Participating States. This Compact also adopts the prevailing standard 25 
for PA licensure and affirms that the practice and delivery of Medical Services by the PA occurs 26 
where the patient is located at the time of the patient encounter, and therefore requires the PA to 27 
be under the jurisdiction of the State Licensing Board where the patient is located. State Licensing 28 
Boards that participate in this Compact retain the jurisdiction to impose Adverse Action against 29 
a Compact Privilege in that State issued to a PA through the procedures of this Compact. The PA 30 
Licensure Compact will alleviate burdens for military families by allowing active duty military 31 
personnel and their spouses to obtain a Compact Privilege based on having an unrestricted 32 
License in good standing from a Participating State. 33 
"§ 90-270.201.  Definitions. 34 
The following definitions apply in this Compact: 35 
(1) Adverse Action. – Any administrative, civil, equitable, or criminal action 36 
permitted by a State's laws which is imposed by a Licensing Board or other 37 
authority against a PA License or License application or Compact Privilege 38 
such as License denial, censure, revocation, suspension, probation, 39 
monitoring of the Licensee, or restriction on the Licensee's practice. 40 
(2) Compact Privilege. – The authorization granted by a Remote State to allow a 41 
Licensee from another Participating State to practice as a PA to provide 42 
Medical Services and other licensed activity to a patient located in the Remote 43 
State under the Remote State's laws and regulations. 44 
(3) Conviction. – A finding by a court that an individual is guilty of a felony or 45 
misdemeanor offense through adjudication or entry of a plea of guilt or no 46 
contest to the charge by the offender. 47 
(4) Criminal Background Check. – The submission of fingerprints or other 48 
biometric-based information for a License applicant for the purpose of 49 
obtaining that applicant's criminal history record information, as defined in 28 50  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 7 
C.F.R. § 20.3(d), from the State's criminal history record repository, as 1 
defined in 28 C.F.R. § 20.3(f). 2 
(5) Data System. – The repository of information about Licensees, including, but 3 
not limited to, License status and Adverse Actions, which is created and 4 
administered under the terms of this Compact. 5 
(6) Executive Committee. – A group of directors and ex officio individuals 6 
elected or appointed pursuant to G.S. 90-270.206(f)(2). 7 
(7) Impaired Practitioner. – A PA whose practice is adversely affected by 8 
health-related condition(s) that impact their ability to practice. 9 
(8) Investigative Information. – Information, records, or documents received or 10 
generated by a Licensing Board pursuant to an investigation. 11 
(9) Jurisprudence Requirement. – The assessment of an individual's knowledge 12 
of the laws and Rules governing the practice of a PA in a State. 13 
(10) License. – Current authorization by a State, other than authorization pursuant 14 
to a Compact Privilege, for a PA to provide Medical Services, which would 15 
be unlawful without current authorization. 16 
(11) Licensee. – An individual who holds a License from a State to provide 17 
Medical Services as a PA. 18 
(12) Licensing Board. – Any State entity authorized to license and otherwise 19 
regulate PAs. 20 
(13) Medical Services. – Health care services provided for the diagnosis, 21 
prevention, treatment, cure, or relief of a health condition, injury, or disease, 22 
as defined by a State's laws and regulations. 23 
(14) Model Compact. – The model for the PA Licensure Compact on file with The 24 
Council of State Governments or other entity as designated by the 25 
Commission. 26 
(15) Participating State. – A State that has enacted this Compact. 27 
(16) PA. – An individual who is licensed as a physician assistant in a State. For 28 
purposes of this Compact, any other title or status adopted by a State to replace 29 
the term "physician assistant" shall be deemed synonymous with "physician 30 
assistant" and shall confer the same rights and responsibilities to the Licensee 31 
under the provisions of this Compact at the time of its enactment. 32 
(17) PA Licensure Compact Commission, Compact Commission, or Commission. 33 
– The national administrative body created pursuant to G.S. 90-270.206(f)(2) 34 
of this Compact. 35 
(18) Qualifying License. – An unrestricted License issued by a Participating State 36 
to provide Medical Services as a PA. 37 
(19) Remote State. – A Participating State where a Licensee who is not licensed as 38 
a PA is exercising or seeking to exercise the Compact Privilege. 39 
(20) Rule. – A regulation promulgated by an entity that has the force and effect of 40 
law. 41 
(21) Significant Investigative Information. – Investigative Information that a 42 
Licensing Board, after an inquiry or investigation that includes notification 43 
and an opportunity for the PA to respond if required by State law, has reason 44 
to believe is not groundless and, if proven true, would indicate more than a 45 
minor infraction. 46 
(22) State. – Any state, commonwealth, district, or territory of the United States. 47 
"§ 90-270.202.  State participation in this Compact. 48 
(a) To participate in this Compact, a Participating State shall: 49 
(1) License PAs. 50 
(2) Participate in the Compact Commission's Data System. 51  General Assembly Of North Carolina 	Session 2025 
Page 8  House Bill 672-First Edition 
(3) Have a mechanism in place for receiving and investigating complaints against 1 
Licensees and License applicants. 2 
(4) Notify the Commission, in compliance with the terms of this Compact and 3 
Commission Rules, of any Adverse Action against a Licensee or License 4 
applicant and the existence of Significant Investigative Information regarding 5 
a Licensee or License applicant. 6 
(5) Fully implement a Criminal Background Check requirement, within a time 7 
frame established by Commission Rule, by its Licensing Board receiving the 8 
results of a Criminal Background Check and reporting to the Commission 9 
whether the License applicant has been granted a License. 10 
(6) Comply with the Rules of the Compact Commission. 11 
(7) Utilize passage of a recognized national exam such as the NCCPA PANCE as 12 
a requirement for PA licensure. 13 
(8) Grant the Compact Privilege to a holder of a Qualifying License in a 14 
Participating State. 15 
(b) Nothing in this Compact prohibits a Participating State from charging a fee for 16 
granting the Compact Privilege. 17 
"§ 90-270.203.  Compact Privilege. 18 
(a) To exercise the Compact Privilege, a Licensee must: 19 
(1) Have graduated from a PA program accredited by the Accreditation Review 20 
Commission on Education for the Physician Assistant, Inc., or other programs 21 
authorized by Commission Rule. 22 
(2) Hold current NCCPA certification. 23 
(3) Have no felony or misdemeanor conviction. 24 
(4) Have never had a controlled substance license, permit, or registration 25 
suspended or revoked by a State or by the United States Drug Enforcement 26 
Administration. 27 
(5) Have a unique identifier as determined by Commission Rule. 28 
(6) Hold a Qualifying License. 29 
(7) Have had no revocation of a License or limitation or restriction on any License 30 
currently held due to an Adverse Action. 31 
(8) If a Licensee has had a limitation or restriction on a License or Compact 32 
Privilege due to an Adverse Action, two years must have elapsed from the 33 
date on which the License or Compact Privilege is no longer limited or 34 
restricted due to the Adverse Action. 35 
(9) If a Compact Privilege has been revoked or is limited or restricted in a 36 
Participating State for conduct that would not be a basis for disciplinary action 37 
in a Participating State in which the Licensee is practicing or applying to 38 
practice under a Compact Privilege, that Participating State shall have the 39 
discretion not to consider such action as an Adverse Action requiring the 40 
denial or removal of a Compact Privilege in that State. 41 
(10) Notify the Compact Commission that the Licensee is seeking the Compact 42 
Privilege in a Remote State. 43 
(11) Meet any Jurisprudence Requirement of a Remote State in which the Licensee 44 
is seeking to practice under the Compact Privilege and pay any fees applicable 45 
to satisfying the Jurisprudence Requirement. 46 
(12) Report to the Commission any Adverse Action taken by a non-participating 47 
State within 30 days after the action is taken. 48 
(b) The Compact Privilege is valid until the expiration or revocation of the Qualifying 49 
License unless terminated pursuant to an Adverse Action. The Licensee must also comply with 50 
all of the requirements of subsection (a) of this section to maintain the Compact Privilege in a 51  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 9 
Remote State. If the Participating State takes Adverse Action against a Qualifying License, the 1 
Licensee shall lose the Compact Privilege in any Remote State in which the Licensee has a 2 
Compact Privilege until all of the following occur: 3 
(1) The License is no longer limited or restricted; and 4 
(2) Two years have elapsed from the date on which the License is no longer 5 
limited or restricted due to the Adverse Action. 6 
(c) Once a restricted or limited License satisfies the requirements of subdivisions (b)(1) 7 
and (2) of this section, the Licensee must meet the requirements of subsection (a) of this section 8 
to obtain a Compact Privilege in any Remote State. 9 
(d) For each Remote State in which a PA seeks authority to prescribe controlled 10 
substances, the PA shall satisfy all requirements imposed by such State in granting or renewing 11 
such authority. 12 
"§ 90-270.204.  Designation of the State from which Licensee is applying for a Compact 13 
Privilege. 14 
Upon a Licensee's application for a Compact Privilege, the Licensee shall identify to the 15 
Commission the Participating State from which the Licensee is applying, in accordance with 16 
applicable Rules adopted by the Commission, and subject to the following requirements: 17 
(1) When applying for a Compact Privilege, the Licensee shall provide the 18 
Commission with the address of the Licensee's primary residence and 19 
thereafter shall immediately report to the Commission any change in the 20 
address of the Licensee's primary residence. 21 
(2) When applying for a Compact Privilege, the Licensee is required to consent 22 
to accept service of process by mail at the Licensee's primary residence on file 23 
with the Commission with respect to any action brought against the Licensee 24 
by the Commission or a Participating State, including a subpoena, with respect 25 
to any action brought or investigation conducted by the Commission or a 26 
Participating State. 27 
"§ 90-270.205.  Adverse Actions. 28 
(a) A Participating State in which a Licensee is licensed shall have exclusive power to 29 
impose Adverse Action against the Qualifying License issued by that Participating State. 30 
(b) In addition to the other powers conferred by State law, a Remote State shall have the 31 
authority, in accordance with existing State due process law, to do all of the following: 32 
(1) Take Adverse Action against a PA's Compact Privilege within that State to 33 
remove a Licensee's Compact Privilege or take other action necessary under 34 
applicable law to protect the health and safety of its citizens. 35 
(2) Issue subpoenas for both hearings and investigations that require the 36 
attendance and testimony of witnesses as well as the production of evidence. 37 
Subpoenas issued by a Licensing Board in a Participating State for the 38 
attendance and testimony of witnesses or the production of evidence from 39 
another Participating State shall be enforced in the latter State by any court of 40 
competent jurisdiction, according to the practice and procedure of that court 41 
applicable to subpoenas issued in proceedings pending before it. The issuing 42 
authority shall pay any witness fees, travel expenses, mileage, and other fees 43 
required by the service statutes of the State in which the witnesses or evidence 44 
are located. 45 
(3) Notwithstanding subdivision (2) of this subsection, subpoenas may not be 46 
issued by a Participating State to gather evidence of conduct in another State 47 
that is lawful in that other State for the purpose of taking Adverse Action 48 
against a Licensee's Compact Privilege or application for a Compact Privilege 49 
in that Participating State. 50  General Assembly Of North Carolina 	Session 2025 
Page 10  House Bill 672-First Edition 
(4) Nothing in this Compact authorizes a Participating State to impose discipline 1 
against a PA's Compact Privilege or to deny an application for a Compact 2 
Privilege in that Participating State for the individual's otherwise lawful 3 
practice in another State. 4 
(c) For purposes of taking Adverse Action, the Participating State which issued the 5 
Qualifying License shall give the same priority and effect to reported conduct received from any 6 
other Participating State as it would if the conduct had occurred within the Participating State 7 
which issued the Qualifying License. In so doing, that Participating State shall apply its own 8 
State laws to determine appropriate action. 9 
(d) A Participating State, if otherwise permitted by State law, may recover from the 10 
affected PA the costs of investigations and disposition of cases resulting from any Adverse 11 
Action taken against that PA. 12 
(e) A Participating State may take Adverse Action based on the factual findings of a 13 
Remote State, provided that the Participating State follows its own procedures for taking the 14 
Adverse Action. 15 
(f) Joint Investigations. – 16 
(1) In addition to the authority granted to a Participating State by its respective 17 
State PA laws and regulations or other applicable State law, any Participating 18 
State may participate with other Participating States in joint investigations of 19 
Licensees. 20 
(2) Participating States shall share any investigative, litigation, or compliance 21 
materials in furtherance of any joint or individual investigation initiated under 22 
this Compact. 23 
(g) If an Adverse Action is taken against a PA's Qualifying License, the PA's Compact 24 
Privilege in all Remote States shall be deactivated until two years have elapsed after all 25 
restrictions have been removed from the State License. All disciplinary orders by the 26 
Participating State which issued the Qualifying License that impose Adverse Action against a 27 
PA's License shall include a Statement that the PA's Compact Privilege is deactivated in all 28 
Participating States during the pendency of the order. 29 
(h) If any Participating State takes Adverse Action, it promptly shall notify the 30 
administrator of the Data System. 31 
"§ 90-270.206.  Establishment of the PA Licensure Compact Commission. 32 
(a) The Participating States hereby create and establish a joint government agency and 33 
national administrative body known as the PA Licensure Compact Commission. The 34 
Commission is an instrumentality of the Compact States acting jointly and not an instrumentality 35 
of any one State. The Commission shall come into existence on or after the effective date of the 36 
Compact as set forth in G.S. 90-270.210(a). 37 
(b) Membership, Voting, and Meetings: 38 
(1) Each Participating State shall have and be limited to one delegate selected by 39 
that Participating State's Licensing Board or, if the State has more than one 40 
Licensing Board, selected collectively by the Participating State's Licensing 41 
Boards. 42 
(2) The delegate shall be either: 43 
a. A current PA, physician, or public member of a Licensing Board or 44 
PA Council/Committee; or 45 
b. An administrator of a Licensing Board. 46 
(3) Any delegate may be removed or suspended from office as provided by the 47 
laws of the State from which the delegate is appointed. 48 
(4) The Participating State Licensing Board shall fill any vacancy occurring in the 49 
Commission within 60 days. 50  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 11 
(5) Each delegate shall be entitled to one vote on all matters voted on by the 1 
Commission and shall otherwise have an opportunity to participate in the 2 
business and affairs of the Commission. A delegate shall vote in person or by 3 
such other means as provided in the bylaws. The bylaws may provide for 4 
delegates' participation in meetings by telecommunications, video conference, 5 
or other means of communication. 6 
(6) The Commission shall meet at least once during each calendar year. 7 
Additional meetings shall be held as set forth in this Compact and the bylaws. 8 
(7) The Commission shall establish by Rule a term of office for delegates. 9 
(c) The Commission shall have the following powers and duties: 10 
(1) Establish a code of ethics for the Commission; 11 
(2) Establish the fiscal year of the Commission; 12 
(3) Establish fees; 13 
(4) Establish bylaws; 14 
(5) Maintain its financial records in accordance with the bylaws; 15 
(6) Meet and take such actions as are consistent with the provisions of this 16 
Compact and the bylaws; 17 
(7) Promulgate Rules to facilitate and coordinate implementation and 18 
administration of this Compact. The Rules shall have the force and effect of 19 
law and shall be binding in all Participating States; 20 
(8) Bring and prosecute legal proceedings or actions in the name of the 21 
Commission, provided that the standing of any State Licensing Board to sue 22 
or be sued under applicable law shall not be affected; 23 
(9) Purchase and maintain insurance and bonds; 24 
(10) Borrow, accept, or contract for services of personnel, including, but not 25 
limited to, employees of a Participating State; 26 
(11) Hire employees and engage contractors, elect or appoint officers, fix 27 
compensation, define duties, grant such individuals appropriate authority to 28 
carry out the purposes of this Compact, and establish the Commission's 29 
personnel policies and programs relating to conflicts of interest, qualifications 30 
of personnel, and other related personnel matters; 31 
(12) Accept any and all appropriate donations and grants of money, equipment, 32 
supplies, materials, and services and receive, utilize, and dispose of the same; 33 
provided that at all times the Commission shall avoid any appearance of 34 
impropriety or conflict of interest; 35 
(13) Lease, purchase, accept appropriate gifts or donations of, or otherwise own, 36 
hold, improve, or use any property, real, personal, or mixed; provided that at 37 
all times the Commission shall avoid any appearance of impropriety; 38 
(14) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise 39 
dispose of any property real, personal, or mixed; 40 
(15) Establish a budget and make expenditures; 41 
(16) Borrow money; 42 
(17) Appoint committees, including standing committees composed of members, 43 
State regulators, State legislators or their representatives, and consumer 44 
representatives, and such other interested persons as may be designated in this 45 
Compact and the bylaws; 46 
(18) Provide and receive information from, and cooperate with, law enforcement 47 
agencies; 48 
(19) Elect a Chair, Vice-Chair, Secretary, and Treasurer and such other officers of 49 
the Commission as provided in the Commission's bylaws; 50  General Assembly Of North Carolina 	Session 2025 
Page 12  House Bill 672-First Edition 
(20) Reserve for itself, in addition to those reserved exclusively to the Commission 1 
under the Compact, powers that the Executive Committee may not exercise; 2 
(21) Approve or disapprove a State's participation in the Compact based upon its 3 
determination as to whether the State's Compact legislation departs in a 4 
material manner from the Model Compact language; 5 
(22) Prepare and provide to the Participating States an annual report; and 6 
(23) Perform such other functions as may be necessary or appropriate to achieve 7 
the purposes of this Compact consistent with the State regulation of PA 8 
licensure and practice. 9 
(d) Meetings of the Commission: 10 
(1) All meetings of the Commission that are not closed pursuant to this subsection 11 
shall be open to the public. Notice of public meetings shall be posted on the 12 
Commission's website at least 30 days prior to the public meeting. 13 
(2) Notwithstanding subdivision (1) of this subsection, the Commission may 14 
convene a public meeting by providing at least 24 hours' prior notice on the 15 
Commission's website, and any other means as provided in the Commission's 16 
Rules, for any of the reasons it may dispense with notice of proposed 17 
rulemaking under G.S. 90-270.208(l). 18 
(3) The Commission may convene in a closed, nonpublic meeting or nonpublic 19 
part of a public meeting to receive legal advice or to discuss: 20 
a. Noncompliance of a Participating State with its obligations under this 21 
Compact; 22 
b. The employment, compensation, discipline or other matters, practices 23 
or procedures related to specific employees or other matters related to 24 
the Commission's internal personnel practices and procedures; 25 
c. Current, threatened, or reasonably anticipated litigation; 26 
d. Negotiation of contracts for the purchase, lease, or sale of goods, 27 
services, or real estate; 28 
e. Accusing any person of a crime or formally censuring any person; 29 
f. Disclosure of trade secrets or commercial or financial information that 30 
is privileged or confidential; 31 
g. Disclosure of information of a personal nature where disclosure would 32 
constitute a clearly unwarranted invasion of personal privacy; 33 
h. Disclosure of investigative records compiled for law enforcement 34 
purposes; 35 
i. Disclosure of information related to any investigative reports prepared 36 
by or on behalf of or for use of the Commission or other committee 37 
charged with responsibility of investigation or determination of 38 
compliance issues pursuant to this Compact; 39 
j. Legal advice; or 40 
k. Matters specifically exempted from disclosure by federal or 41 
Participating States' statutes. 42 
(4) If a meeting, or portion of a meeting, is closed pursuant to this provision, the 43 
chair of the meeting or the chair's designee shall certify that the meeting or 44 
portion of the meeting may be closed and shall reference each relevant 45 
exempting provision. 46 
(5) The Commission shall keep minutes that fully and clearly describe all matters 47 
discussed in a meeting and shall provide a full and accurate summary of 48 
actions taken, including a description of the views expressed. All documents 49 
considered in connection with an action shall be identified in such minutes. 50 
All minutes and documents of a closed meeting shall remain under seal, 51  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 13 
subject to release by a majority vote of the Commission or order of a court of 1 
competent jurisdiction. 2 
(e) Financing of the Commission: 3 
(1) The Commission shall pay, or provide for the payment of, the reasonable 4 
expenses of its establishment, organization, and ongoing activities. 5 
(2) The Commission may accept any and all appropriate revenue sources, 6 
donations, and grants of money, equipment, supplies, materials, and services. 7 
(3) The Commission may levy on and collect an annual assessment from each 8 
Participating State and may impose Compact Privilege fees on Licensees of 9 
Participating States to whom a Compact Privilege is granted to cover the cost 10 
of the operations and activities of the Commission and its staff, which must 11 
be in a total amount sufficient to cover its annual budget as approved by the 12 
Commission each year for which revenue is not provided by other sources. 13 
The aggregate annual assessment amount levied on Participating States shall 14 
be allocated based upon a formula to be determined by Commission Rule. 15 
a. A Compact Privilege expires when the Licensee's Qualifying License 16 
in the Participating State from which the Licensee applied for the 17 
Compact Privilege expires. 18 
b. If the Licensee terminates the Qualifying License through which the 19 
Licensee applied for the Compact Privilege before its scheduled 20 
expiration, and the Licensee has a Qualifying License in another 21 
Participating State, the Licensee shall inform the Commission that it 22 
is changing to that Participating State the Participating State through 23 
which it applies for a Compact Privilege and pay to the Commission 24 
any Compact Privilege fee required by Commission Rule. 25 
(4) The Commission shall not incur obligations of any kind prior to securing the 26 
funds adequate to meet the same nor shall the Commission pledge the credit 27 
of any of the Participating States, except by and with the authority of the 28 
Participating State. 29 
(5) The Commission shall keep accurate accounts of all receipts and 30 
disbursements. The receipts and disbursements of the Commission shall be 31 
subject to the financial review and accounting procedures established under 32 
its bylaws. All receipts and disbursements of funds handled by the 33 
Commission shall be subject to an annual financial review by a certified or 34 
licensed public accountant, and the report of the financial review shall be 35 
included in and become part of the annual report of the Commission. 36 
(f) The Executive Committee: 37 
(1) The Executive Committee shall have the power to act on behalf of the 38 
Commission according to the terms of this Compact and Commission Rules. 39 
(2) The Executive Committee shall be composed of nine members: 40 
a. Seven voting members who are elected by the Commission from the 41 
current membership of the Commission; 42 
b. One ex officio, nonvoting member from a recognized national PA 43 
professional association; and 44 
c. One ex officio, nonvoting member from a recognized national PA 45 
certification organization. 46 
(3) The ex officio members will be selected by their respective organizations. 47 
(4) The Commission may remove any member of the Executive Committee as 48 
provided in its bylaws. 49 
(5) The Executive Committee shall meet at least annually. 50 
(6) The Executive Committee shall have the following duties and responsibilities: 51  General Assembly Of North Carolina 	Session 2025 
Page 14  House Bill 672-First Edition 
a. Recommend to the Commission changes to the Commission's Rules 1 
or bylaws, changes to this Compact legislation, fees to be paid by 2 
Compact Participating States such as annual dues, and any 3 
Commission Compact fee charged to Licensees for the Compact 4 
Privilege; 5 
b. Ensure Compact administration services are appropriately provided, 6 
contractual or otherwise; 7 
c. Prepare and recommend the budget; 8 
d. Maintain financial records on behalf of the Commission; 9 
e. Monitor Compact compliance of Participating States and provide 10 
compliance reports to the Commission; 11 
f. Establish additional committees as necessary; 12 
g. Exercise the powers and duties of the Commission during the interim 13 
between Commission meetings, except for issuing proposed 14 
rulemaking or adopting Commission Rules or bylaws, or exercising 15 
any other powers and duties exclusively reserved to the Commission 16 
by the Commission's Rules; and 17 
h. Perform other duties as provided in the Commission's Rules or bylaws. 18 
(7) All meetings of the Executive Committee at which it votes or plans to vote on 19 
matters in exercising the powers and duties of the Commission shall be open 20 
to the public and public notice of such meetings shall be given as public 21 
meetings of the Commission are given. 22 
(8) The Executive Committee may convene in a closed, nonpublic meeting for 23 
the same reasons that the Commission may convene in a nonpublic meeting 24 
as set forth in G.S. 90-270.206(d)(3) and shall announce the closed meeting 25 
as the Commission is required to under G.S. 90-270.206(d)(3) and keep 26 
minutes of the closed meeting as the Commission is required to under 27 
G.S. 90-270.206(d)(3). 28 
(g) Qualified Immunity, Defense, and Indemnification: 29 
(1) The members, officers, executive director, employees, and representatives of 30 
the Commission shall be immune from suit and liability, both personally and 31 
in their official capacity, for any claim for damage to or loss of property or 32 
personal injury or other civil liability caused by or arising out of any actual or 33 
alleged act, error, or omission that occurred, or that the person against whom 34 
the claim is made had a reasonable basis for believing occurred within the 35 
scope of Commission employment, duties, or responsibilities; provided that 36 
nothing in this paragraph shall be construed to protect any such person from 37 
suit or liability for any damage, loss, injury, or liability caused by the 38 
intentional or willful or wanton misconduct of that person. The procurement 39 
of insurance of any type by the Commission shall not in any way compromise 40 
or limit the immunity granted hereunder. 41 
(2) The Commission shall defend any member, officer, executive director, 42 
employee, and representative of the Commission in any civil action seeking 43 
to impose liability arising out of any actual or alleged act, error, or omission 44 
that occurred within the scope of Commission employment, duties, or 45 
responsibilities, or as determined by the Commission that the person against 46 
whom the claim is made had a reasonable basis for believing occurred within 47 
the scope of Commission employment, duties, or responsibilities; provided 48 
that nothing herein shall be construed to prohibit that person from retaining 49 
their own counsel at their own expense; and provided further, that the actual 50  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 15 
or alleged act, error, or omission did not result from that person's intentional 1 
or willful or wanton misconduct. 2 
(3) The Commission shall indemnify and hold harmless any member, officer, 3 
executive director, employee, and representative of the Commission for the 4 
amount of any settlement or judgment obtained against that person arising out 5 
of any actual or alleged act, error, or omission that occurred within the scope 6 
of Commission employment, duties, or responsibilities, or that such person 7 
had a reasonable basis for believing occurred within the scope of Commission 8 
employment, duties, or responsibilities, provided that the actual or alleged act, 9 
error, or omission did not result from the intentional or willful or wanton 10 
misconduct of that person. 11 
(4) Venue is proper and judicial proceedings by or against the Commission shall 12 
be brought solely and exclusively in a court of competent jurisdiction where 13 
the principal office of the Commission is located. The Commission may waive 14 
venue and jurisdictional defenses in any proceedings as authorized by 15 
Commission Rules. 16 
(5) Nothing herein shall be construed as a limitation on the liability of any 17 
Licensee for professional malpractice or misconduct, which shall be governed 18 
solely by any other applicable State laws. 19 
(6) Nothing herein shall be construed to designate the venue or jurisdiction to 20 
bring actions for alleged acts of malpractice, professional misconduct, 21 
negligence, or other such civil action pertaining to the practice of a PA. All 22 
such matters shall be determined exclusively by State law other than this 23 
Compact. 24 
(7) Nothing in this Compact shall be interpreted to waive or otherwise abrogate a 25 
Participating State's state action immunity or state action affirmative defense 26 
with respect to antitrust claims under the Sherman Act, Clayton Act, or any 27 
other State or federal antitrust or anticompetitive law or regulation. 28 
(8) Nothing in this Compact shall be construed to be a waiver of sovereign 29 
immunity by the Participating States or by the Commission. 30 
"§ 90-270.207.  Data System. 31 
(a) The Commission shall provide for the development, maintenance, operation, and 32 
utilization of a coordinated data and reporting system containing licensure, Adverse Action, and 33 
the reporting of the existence of Significant Investigative Information on all licensed PAs and 34 
applicants denied a License in Participating States. 35 
(b) Notwithstanding any other State law to the contrary, a Participating State shall submit 36 
a uniform data set to the Data System on all PAs to whom this Compact is applicable (utilizing 37 
a unique identifier) as required by the Rules of the Commission, including: 38 
(1) Identifying information; 39 
(2) Licensure data; 40 
(3) Adverse Actions against a License or Compact Privilege; 41 
(4) Any denial of application for licensure, and the reason(s) for such denial 42 
(excluding the reporting of any criminal history record information where 43 
prohibited by law); 44 
(5) The existence of Significant Investigative Information; and 45 
(6) Other information that may facilitate the administration of this Compact, as 46 
determined by the Rules of the Commission. 47 
(c) Significant Investigative Information pertaining to a Licensee in any Participating 48 
State shall only be available to other Participating States. 49  General Assembly Of North Carolina 	Session 2025 
Page 16  House Bill 672-First Edition 
(d) The Commission shall promptly notify all Participating States of any Adverse Action 1 
taken against a Licensee or an individual applying for a License that has been reported to it. This 2 
Adverse Action information shall be available to any other Participating State. 3 
(e) Participating States contributing information to the Data System may, in accordance 4 
with State or federal law, designate information that may not be shared with the public without 5 
the express permission of the contributing State. Notwithstanding any such designation, such 6 
information shall be reported to the Commission through the Data System. 7 
(f) Any information submitted to the Data System that is subsequently expunged 8 
pursuant to federal law or the laws of the Participating State contributing the information shall 9 
be removed from the Data System upon reporting of such by the Participating State to the 10 
Commission. 11 
(g) The records and information provided to a Participating State pursuant to this 12 
Compact or through the Data System, when certified by the Commission or an agent thereof, 13 
shall constitute the authenticated business records of the Commission and shall be entitled to any 14 
associated hearsay exception in any relevant judicial, quasi-judicial, or administrative 15 
proceedings in a Participating State. 16 
"§ 90-270.208.  Rulemaking. 17 
(a) The Commission shall exercise its Rulemaking powers pursuant to the criteria set 18 
forth in this section and the Rules adopted thereunder. Commission Rules shall become binding 19 
as of the date specified by the Commission for each Rule. 20 
(b) The Commission shall promulgate reasonable Rules in order to effectively and 21 
efficiently implement and administer this Compact and achieve its purposes. A Commission Rule 22 
shall be invalid and have not force or effect only if a court of competent jurisdiction holds that 23 
the Rule is invalid because the Commission exercised its rulemaking authority in a manner that 24 
is beyond the scope of the purposes of this Compact, or the powers granted hereunder, or based 25 
upon another applicable standard of review. 26 
(c) The Rules of the Commission shall have the force of law in each Participating State, 27 
provided, however, that where the Rules of the Commission conflict with the laws of the 28 
Participating State that establish the Medical Services a PA may perform in the Participating 29 
State, as held by a court of competent jurisdiction, the Rules of the Commission shall be 30 
ineffective in that State to the extent of the conflict. The Rules of the Commission shall not 31 
modify or expand, in any way, the scope of practice of a PA as established by the laws of the 32 
Participating State.  33 
(d) If a majority of the legislatures of the Participating States rejects a Commission Rule, 34 
by enactment of a statute or resolution in the same manner used to adopt this Compact within 35 
four years of the date of adoption of the Rule, then such Rule shall have no further force and 36 
effect in any Participating State or to any State applying to participate in the Compact. 37 
(e) Commission Rules shall be adopted at a regular or special meeting of the 38 
Commission. 39 
(f) Prior to promulgation and adoption of a final Rule or Rules by the Commission, and 40 
at least 30 days in advance of the meeting at which the Rule will be considered and voted upon, 41 
the Commission shall file a Notice of Proposed Rulemaking: 42 
(1) On the website of the Commission or other publicly accessible platform; 43 
(2) To persons who have requested notice of the Commission's notices of 44 
proposed rulemaking; and 45 
(3) In such other way(s) as the Commission may by Rule specify. 46 
(g) The Notice of Proposed Rulemaking shall include: 47 
(1) The time, date, and location of the public hearing on the proposed Rule and 48 
the proposed time, date, and location of the meeting in which the proposed 49 
Rule will be considered and voted upon; 50 
(2) The text of the proposed Rule and the reason for the proposed Rule; 51  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 17 
(3) A request for comments on the proposed Rule from any interested person and 1 
the date by which written comments must be received; and 2 
(4) The manner in which interested persons may submit notice to the Commission 3 
of their intention to attend the public hearing or provide any written 4 
comments. 5 
(h) Prior to adoption of a proposed Rule, the Commission shall allow persons to submit 6 
written data, facts, opinions, and arguments, which shall be made available to the public. 7 
(i) If the hearing is to be held via electronic means, the Commission shall publish the 8 
mechanism for access to the electronic hearing. 9 
(1) All persons wishing to be heard at the hearing shall as directed in the Notice 10 
of Proposed Rulemaking, not less than five business days before the scheduled 11 
date of the hearing, notify the Commission of their desire to appear and testify 12 
at the hearing. 13 
(2) Hearings shall be conducted in a manner providing each person who wishes 14 
to comment a fair and reasonable opportunity to comment orally or in writing. 15 
(3) All hearings shall be recorded. A copy of the recording and the written 16 
comments, data, facts, opinions, and arguments received in response to the 17 
proposed rulemaking shall be made available to a person upon request. 18 
(4) Nothing in this section shall be construed as requiring a separate hearing on 19 
each proposed Rule. Proposed Rules may be grouped for the convenience of 20 
the Commission at hearings required by this section. 21 
(j) Following the public hearing, the Commission shall consider all written and oral 22 
comments timely received. 23 
(k) The Commission shall, by majority vote of all delegates, take final action on the 24 
proposed Rule and shall determine the effective date of the Rule, if adopted, based on the 25 
Rulemaking record and the full text of the Rule. 26 
(1) If adopted, the Rule shall be posted on the Commission's website. 27 
(2) The Commission may adopt changes to the proposed Rule provided the 28 
changes do not enlarge the original purpose of the proposed Rule. 29 
(3) The Commission shall provide on its website an explanation of the reasons for 30 
substantive changes made to the proposed Rule as well as reasons for 31 
substantive changes not made that were recommended by commenters. 32 
(4) The Commission shall determine a reasonable effective date for the Rule. 33 
Except for an emergency as provided in subsection (l) of this section, the 34 
effective date of the Rule shall be no sooner than 30 days after the Commission 35 
issued the notice that it adopted the Rule. 36 
(l) Upon determination that an emergency exists, the Commission may consider and 37 
adopt an emergency Rule with 24 hours' prior notice, without the opportunity for comment, or 38 
hearing, provided that the usual Rulemaking procedures provided in this Compact and in this 39 
section shall be retroactively applied to the Rule as soon as reasonably possible, in no event later 40 
than 90 days after the effective date of the Rule. For the purposes of this provision, an emergency 41 
Rule is one that must be adopted immediately by the Commission in order to: 42 
(1) Meet an imminent threat to public health, safety, or welfare; 43 
(2) Prevent a loss of Commission or Participating State funds; 44 
(3) Meet a deadline for the promulgation of a Commission Rule that is established 45 
by federal law or Rule; or 46 
(4) Protect public health and safety. 47 
(m) The Commission or an authorized committee of the Commission may direct revisions 48 
to a previously adopted Commission Rule for purposes of correcting typographical errors, errors 49 
in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be 50 
posted on the website of the Commission. The revision shall be subject to challenge by any 51  General Assembly Of North Carolina 	Session 2025 
Page 18  House Bill 672-First Edition 
person for a period of 30 days after posting. The revision may be challenged only on grounds 1 
that the revision results in a material change to a Rule. A challenge shall be made as set forth in 2 
the notice of revisions and delivered to the Commission prior to the end of the notice period. If 3 
no challenge is made, the revision will take effect without further action. If the revision is 4 
challenged, the revision may not take effect without the approval of the Commission. 5 
(n) No Participating State's rulemaking requirements shall apply under this Compact. 6 
"§ 90-270.209.  Oversight, dispute resolution, and enforcement. 7 
(a) Oversight: 8 
(1) The executive and judicial branches of State government in each Participating 9 
State shall enforce this Compact and take all actions necessary and appropriate 10 
to implement the Compact. 11 
(2) Venue is proper and judicial proceedings by or against the Commission shall 12 
be brought solely and exclusively in a court of competent jurisdiction where 13 
the principal office of the Commission is located. The Commission may waive 14 
venue and jurisdictional defenses to the extent it adopts or consents to 15 
participate in alternative dispute resolution proceedings. Nothing herein shall 16 
affect or limit the selection or propriety of venue in any action against a 17 
Licensee for professional malpractice, misconduct, or any such similar matter. 18 
(3) The Commission shall be entitled to receive service of process in any 19 
proceeding regarding the enforcement or interpretation of the Compact or the 20 
Commission's Rules and shall have standing to intervene in such a proceeding 21 
for all purposes. Failure to provide the Commission with service of process 22 
shall render a judgment or order in such proceeding void as to the 23 
Commission, this Compact, or Commission Rules. 24 
(b) Default, Technical Assistance, and Termination: 25 
(1) If the Commission determines that a Participating State has defaulted in the 26 
performance of its obligations or responsibilities under this Compact or the 27 
Commission Rules, the Commission shall provide written notice to the 28 
defaulting State and other Participating States. The notice shall describe the 29 
default, the proposed means of curing the default, and any other action that 30 
the Commission may take and shall offer remedial training and specific 31 
technical assistance regarding the default. 32 
(2) If a State in default fails to cure the default, the defaulting State may be 33 
terminated from this Compact upon an affirmative vote of a majority of the 34 
delegates of the Participating States, and all rights, privileges, and benefits 35 
conferred by this Compact upon such State may be terminated on the effective 36 
date of termination. A cure of the default does not relieve the offending State 37 
of obligations or liabilities incurred during the period of default. 38 
(3) Termination of participation in this Compact shall be imposed only after all 39 
other means of securing compliance have been exhausted. Notice of intent to 40 
suspend or terminate shall be given by the Commission to the governor, the 41 
majority and minority leaders of the defaulting State's legislature, and to the 42 
Licensing Board(s) of each of the Participating States. 43 
(4) A State that has been terminated is responsible for all assessments, 44 
obligations, and liabilities incurred through the effective date of termination, 45 
including obligations that extend beyond the effective date of termination. 46 
(5) The Commission shall not bear any costs related to a State that is found to be 47 
in default or that has been terminated from this Compact, unless agreed upon 48 
in writing between the Commission and the defaulting State. 49 
(6) The defaulting State may appeal its termination from the Compact by the 50 
Commission by petitioning the United States District Court for the District of 51  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 19 
Columbia or the federal district where the Commission has its principal 1 
offices. The prevailing member shall be awarded all costs of such litigation, 2 
including reasonable attorneys' fees. 3 
(7) Upon the termination of a State's participation in the Compact, the State shall 4 
immediately provide notice to all Licensees within that State of such 5 
termination: 6 
a. Licensees who have been granted a Compact Privilege in that State 7 
shall retain the Compact Privilege for 180 days following the effective 8 
date of such termination. 9 
b. Licensees who are licensed in that State who have been granted a 10 
Compact Privilege in a Participating State shall retain the Compact 11 
Privilege for 180 days unless the Licensee also has a Qualifying 12 
License in a Participating State or obtains a Qualifying License in a 13 
Participating State before the 180-day period ends, in which case the 14 
Compact Privilege shall continue. 15 
(c) Dispute Resolution: 16 
(1) Upon request by a Participating State, the Commission shall attempt to resolve 17 
disputes related to this Compact that arise among Participating States and 18 
between Participating and non-Participating States. 19 
(2) The Commission shall promulgate a Rule providing for both mediation and 20 
binding dispute resolution for disputes as appropriate. 21 
(d) Enforcement: 22 
(1) The Commission, in the reasonable exercise of its discretion, shall enforce the 23 
provisions of this Compact and Rules of the Commission. 24 
(2) If compliance is not secured after all means to secure compliance have been 25 
exhausted, by majority vote, the Commission may initiate legal action in the 26 
United States District Court for the District of Columbia or the federal district 27 
where the Commission has its principal offices, against a Participating State 28 
in default to enforce compliance with the provisions of this Compact and the 29 
Commission's promulgated Rules and bylaws. The relief sought may include 30 
both injunctive relief and damages. In the event judicial enforcement is 31 
necessary, the prevailing party shall be awarded all costs of such litigation, 32 
including reasonable attorneys' fees. 33 
(3) The remedies herein shall not be the exclusive remedies of the Commission. 34 
The Commission may pursue any other remedies available under federal or 35 
State law. 36 
(e) Legal Action Against the Commission: 37 
(1) A Participating State may initiate legal action against the Commission in the 38 
United States District Court for the District of Columbia or the federal district 39 
where the Commission has its principal offices to enforce compliance with the 40 
provisions of the Compact and its Rules. The relief sought may include both 41 
injunctive relief and damages. In the event judicial enforcement is necessary, 42 
the prevailing party shall be awarded all costs of such litigation, including 43 
reasonable attorneys' fees. 44 
(2) No person other than a Participating State shall enforce this Compact against 45 
the Commission. 46 
"§ 90-270.210.  Date of implementation of the PA Licensure Compact Commission. 47 
(a) This Compact shall come into effect on the date on which this Compact statute is 48 
enacted into law in the seventh Participating State. 49 
(1) On or after the effective date of the Compact, the Commission shall convene 50 
and review the enactment of each of the States that enacted the Compact prior 51  General Assembly Of North Carolina 	Session 2025 
Page 20  House Bill 672-First Edition 
to the Commission convening ("Charter Participating States") to determine if 1 
the statute enacted by each such Charter Participating State is materially 2 
different than the Model Compact. 3 
a. A Charter Participating State whose enactment is found to be 4 
materially different from the Model Compact shall be entitled to the 5 
default process set forth in G.S. 90-270.209(b). 6 
b. If any Participating State later withdraws from the Compact or its 7 
participation is terminated, the Commission shall remain in existence 8 
and the Compact shall remain in effect even if the number of 9 
Participating States should be less than seven. Participating States 10 
enacting the Compact subsequent to the Commission convening shall 11 
be subject to the process set forth in G.S. 90-270.206(c)(21) to 12 
determine if their enactments are materially different from the Model 13 
Compact and whether they qualify for participation in the Compact. 14 
(2) Participating States enacting the Compact subsequent to the seven initial 15 
Charter Participating States shall be subject to the process set forth in 16 
G.S. 90-270.206(c)(21) to determine if their enactments are materially 17 
different from the Model Compact and whether they qualify for participation 18 
in the Compact. 19 
(3) All actions taken for the benefit of the Commission or in furtherance of the 20 
purposes of the administration of the Compact prior to the effective date of 21 
the Compact or the Commission coming into existence shall be considered to 22 
be actions of the Commission unless specifically repudiated by the 23 
Commission. 24 
(b) Any State that joins this Compact shall be subject to the Commission's Rules and 25 
bylaws as they exist on the date on which this Compact becomes law in that State. Any Rule that 26 
has been previously adopted by the Commission shall have the full force and effect of law on the 27 
day this Compact becomes law in that State. 28 
(c) Any Participating State may withdraw from this Compact by enacting a statute 29 
repealing the same. 30 
(1) A Participating State's withdrawal shall not take effect until 180 days after 31 
enactment of the repealing statute. During this 180-day period, all Compact 32 
Privileges that were in effect in the withdrawing State and were granted to 33 
Licensees licensed in the withdrawing State shall remain in effect. If any 34 
Licensee licensed in the withdrawing State is also licensed in another 35 
Participating State or obtains a license in another Participating State within 36 
the 180 days, the Licensee's Compact Privileges in other Participating States 37 
shall not be affected by the passage of the 180 days. 38 
(2) Withdrawal shall not affect the continuing requirement of the State Licensing 39 
Board(s) of the withdrawing State to comply with the investigative and 40 
Adverse Action reporting requirements of this Compact prior to the effective 41 
date of withdrawal. 42 
(3) Upon the enactment of a statute withdrawing a State from this Compact, the 43 
State shall immediately provide notice of such withdrawal to all Licensees 44 
within that State. Such withdrawing State shall continue to recognize all 45 
Licenses granted pursuant to this Compact for a minimum of 180 days after 46 
the date of such notice of withdrawal. 47 
(d) Nothing contained in this Compact shall be construed to invalidate or prevent any PA 48 
licensure agreement or other cooperative arrangement between Participating States and between 49 
a Participating State and non-Participating State that does not conflict with the provisions of this 50 
Compact. 51  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 21 
(e) This Compact may be amended by the Participating States. No amendment to this 1 
Compact shall become effective and binding upon any Participating State until it is enacted 2 
materially in the same manner into the laws of all Participating States as determined by the 3 
Commission. 4 
"§ 90-270.211.  Construction and severability. 5 
(a) This Compact and the Commission's rulemaking authority shall be liberally construed 6 
so as to effectuate the purposes and the implementation and administration of the Compact. 7 
Provisions of the Compact expressly authorizing or requiring the promulgation of Rules shall not 8 
be construed to limit the Commission's rulemaking authority solely for those purposes. 9 
(b) The provisions of this Compact shall be severable and if any phrase, clause, sentence, 10 
or provision of this Compact is held by a court of competent jurisdiction to be contrary to the 11 
constitution of any Participating State, a State seeking participation in the Compact, or of the 12 
United States, or the applicability thereof to any government, agency, person, or circumstance is 13 
held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of 14 
this Compact and the applicability thereof to any other government, agency, person, or 15 
circumstance shall not be affected thereby. 16 
(c) Notwithstanding subsection (b) of this section, the Commission may deny a State's 17 
participation in the Compact or, in accordance with the requirements of G.S. 90-270.209(b), 18 
terminate a Participating State's participation in the Compact, if it determines that a constitutional 19 
requirement of a Participating State is, or would be with respect to a State seeking to participate 20 
in the Compact, a material departure from the Compact. Otherwise, if this Compact shall be held 21 
to be contrary to the constitution of any Participating State, the Compact shall remain in full force 22 
and effect as to the remaining Participating States and in full force and effect as to the 23 
Participating State affected as to all severable matters. 24 
"§ 90-270.212.  Binding effect of Compact. 25 
(a) Nothing herein prevents the enforcement of any other law of a Participating State that 26 
is not inconsistent with this Compact. 27 
(b) Any laws in a Participating State in conflict with this Compact are superseded to the 28 
extent of the conflict. 29 
(c) All agreements between the Commission and the Participating States are binding in 30 
accordance with their terms." 31 
SECTION 2.1.(b) G.S. 90-9.3 reads as rewritten: 32 
"§ 90-9.3.  Requirements for licensure as a physician assistant. 33 
(a) To be eligible for licensure as a physician assistant, an applicant shall submit proof 34 
satisfactory to the Board that the applicant has met all of the following: 35 
(1) The applicant has successfully completed an educational program for 36 
physician assistants or surgeon assistants accredited by the Accreditation 37 
Review Commission on Education for the Physician Assistant or its 38 
predecessor or successor entities. 39 
(2) The applicant has a current or previous certification issued by the National 40 
Commission on Certification of Physician Assistants or its successor. 41 
(3) The applicant is of good moral character. 42 
(a1) A physician assistant applying for licensure under Article 18J of this Chapter shall be 43 
in compliance with that Article. 44 
(b) Before initiating practice of medical acts, tasks, or functions as a physician assistant, 45 
the physician assistant shall provide the Board the name, address, and telephone number of the 46 
physician who will supervise the physician assistant in the relevant medical setting. 47 
(c) The Board may, by rule, require an applicant to comply with other requirements or 48 
submit additional information the Board deems appropriate." 49 
SECTION 2.1.(c) G.S. 90-13.2 reads as rewritten: 50 
"§ 90-13.2.  Registration every year with Board. 51  General Assembly Of North Carolina 	Session 2025 
Page 22  House Bill 672-First Edition 
(a) Every licensee shall register annually with the Board no later than 30 days after the 1 
person's birthday. Every privilege holder shall register annually with the Board in accordance 2 
with the Physician Assistant Licensure Compact, Article 18J of this Chapter. 3 
… 4 
(b1) Physician assistants shall pay an annual registration fee of one hundred forty dollars 5 
($140.00). A physician assistant who fails to register as required by this section shall pay an 6 
additional fee of twenty-five dollars ($25.00) to the Board. 7 
…." 8 
SECTION 2.1.(d) G.S. 90-13.1 is amended by adding a new subsection to read: 9 
"(g) For the initial licensure or privilege of a physician assistant, the Board shall require 10 
the payment of two hundred thirty dollars ($230.00)." 11 
SECTION 2.1.(e) G.S. 90-1.1 reads as rewritten: 12 
"§ 90-1.1.  Definitions. 13 
The following definitions apply in this Article: 14 
… 15 
(4) License. – An authorization issued by the Board to a physician, physician 16 
assistant, or anesthesiologist assistant to perform medical acts, tasks, or 17 
functions. License shall include any physician assistant compact privilege 18 
granted under Article 18J of this Chapter. 19 
(4a) Licensee. – Any person issued a license by the Board, whether the license is 20 
active or inactive, including an inactive license by means of surrender. 21 
Licensee shall include any compact privilege issued to a holder of a qualifying 22 
license in a participating state pursuant to Article 18J of this Chapter. 23 
…." 24 
SECTION 2.1.(f) G.S. 90-5.1 reads as rewritten: 25 
"§ 90-5.1.  Powers and duties of the Board. 26 
(a) The Board shall have the following powers and duties: 27 
… 28 
(11) Implement the Physician Assistant Licensure Compact under Article 18J of 29 
this Chapter, including issuing compact privileges. 30 
(12) Appoint a delegate to serve on the Physician Assistant Licensure Compact 31 
Commission under G.S. 90-270.206. The delegate shall be either (i) a current 32 
physician assistant, physician, or public member of the Board, or (ii) an 33 
administrator of the Board. 34 
…." 35 
SECTION 2.1.(g) G.S. 90-11 reads as rewritten: 36 
"§ 90-11.  Criminal background checks. 37 
(a) Repealed by Session Laws 2007-346, s. 11, effective October 1, 2007. 38 
(a1) Repealed by Session Laws 2007-346, s. 9.1, effective October 1, 2007. 39 
(b) The Department of Public Safety may provide a criminal record check to the Board 40 
for a person who has applied for a license through the Board. Board and for purposes of Article 41 
18J of this Chapter. The Board shall provide to the Department of Public Safety, along with the 42 
request, the fingerprints of the applicant, any additional information required by the Department 43 
of Public Safety, and a form signed by the applicant consenting to the check of the criminal 44 
record and to the use of the fingerprints and other identifying information required by the State 45 
or national repositories. The applicant's fingerprints shall be forwarded to the State Bureau of 46 
Investigation for a search of the State's criminal history record file, and the State Bureau of 47 
Investigation shall forward a set of the fingerprints to the Federal Bureau of Investigation for a 48 
national criminal history check. The Board shall keep all information pursuant to this subsection 49 
privileged, in accordance with applicable State law and federal guidelines, and the information 50 
shall be confidential and shall not be a public record under Chapter 132 of the General Statutes. 51  General Assembly Of North Carolina 	Session 2025 
House Bill 672-First Edition  	Page 23 
The Department of Public Safety may charge each applicant a fee for conducting the checks 1 
of criminal history records authorized by this subsection. The Board has the authority to collect 2 
this fee from each applicant and remit it to the Department of Public Safety." 3 
SECTION 2.1.(h) G.S. 90-14 reads as rewritten: 4 
"§ 90-14.  Disciplinary Authority. 5 
(a) The Board shall have the power to place on probation with or without  conditions, 6 
impose limitations and conditions on, publicly reprimand, assess monetary redress, issue public 7 
letters of concern, mandate free medical services, require satisfactory completion of treatment 8 
programs or remedial or educational training, fine, deny, annul, suspend, or revoke a license, or 9 
other authority to practice medicine in this State, issued by the Board to any person who has been 10 
found by the Board to have committed any of the following acts or conduct, or for any of the 11 
following reasons: 12 
… 13 
(18) A violation of Article 18J of this Chapter, consistent with the provisions of 14 
that Article for compact privilege holders. 15 
…." 16 
SECTION 2.2. Section 2.1 of this Part is effective nine months after it becomes law. 17 
 18 
PART III. EFFECTIVE DATE 19 
SECTION 3.1. Except as otherwise provided, this act is effective when it becomes 20 
law. 21