North Carolina 2025-2026 Regular Session

North Carolina House Bill H672 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		GENERAL ASSEMBLY OF NORTH CAROLINA
2	2		SESSION 2025
3		-	H 1
4		-	HOUSE BILL 672
	3	+	H D
	4	+	HOUSE BILL DRH10292-NBf-127
	5	+
5	6
6	7
7	8		Short Title: Physician Assist. Omnibus/Team-based/Compact. (Public)
8		-	Sponsors: Representatives Paré, Potts, Lambeth, and Chesser (Primary Sponsors).
9		-	For a complete list of sponsors, refer to the North Carolina General Assembly web site.
10		-	Referred to: Health, if favorable, Finance, if favorable, Rules, Calendar, and Operations of the
11		-	House
12		-	April 3, 2025
13		-	H672 -v-1
	9	+	Sponsors: Representative Paré.
	10	+	Referred to:
	11	+
	12	+	DRH10292 -NBf-127
14	13		A BILL TO BE ENTITLED 1
15	14		AN ACT TO ADJUST THE SUPERVISION ARRANGEMENT OF PHYSICIAN 2
16	15		ASSISTANTS AND TO MAKE VARIOUS CHANGES TO THE LICENSURE OF 3
17	16		PHYSICIAN ASSISTANTS. 4
18	17		The General Assembly of North Carolina enacts: 5
19	18		6
20	19		PART I. PHYSICIAN ASSISTANT TEAM -BASED PRACTICE 7
21	20		SECTION 1.1.(a) G.S. 90-1.1 is amended by adding a new subdivision to read: 8
22	21		"(4d) Team-based setting or team-based practice. – Any of the following: 9
23	22		a. A medical practice that meets all of the following requirements: 10
24	23		1. The majority of the practice is owned collectively by one or 11
25	24		more licensed physicians. 12
26	25		2. An owner who is a physician licensed under this Chapter has 13
27	26		consistent and meaningful participation in the design and 14
28	27		implementation of health services to patients, as defined by 15
29	28		rules adopted by the Board. 16
30	29		3. The physicians and team-based physician assistants who 17
31	30		provide services at the medical practice work in the same 18
32	31		clinical practice area. 19
33	32		b. Hospitals, clinics, nursing homes, and other health facilities with 20
34	33		active credentialing and quality programs where physicians have 21
35	34		consistent and meaningful participation in the design and 22
36	35		implementation of health services to patients, as defined by rules 23
37	36		adopted by the Board. 24
38	37		c. For the purposes of this Article, the term "team-based setting" or 25
39	38		"team-based practice" shall not include a medical practice that 26
40	39		specializes in pain management." 27
41	40		SECTION 1.1.(b) G.S. 90-9.3 reads as rewritten: 28
42	41		"§ 90-9.3. Requirements for licensure as a physician assistant. 29
43	42		(a) To be eligible for licensure as a physician assistant, an applicant shall submit proof 30
44	43		satisfactory to the Board that the applicant has met all of the following: 31
45	44		(1) The applicant has successfully completed an educational program for 32
46		-	physician assistants or surgeon assistants accredited by the Accreditation 33 General Assembly Of North Carolina Session 2025
47		-	Page 2 House Bill 672-First Edition
48		-	Review Commission on Education for the Physician Assistant or its 1
49		-	predecessor or successor entities. 2
50		-	(2) The applicant has a current or previous certification issued by the National 3
51		-	Commission on Certification of Physician Assistants or its successor. 4
52		-	(3) The applicant is of good moral character. 5
53		-	(b) Before initiating practice of medical acts, tasks, or functions as a physician assistant, 6
54		-	the physician assistant shall provide the Board the name, address, and telephone number of the 7
55		-	physician who will supervise the physician assistant in the relevant medical setting. This 8
56		-	subsection shall not apply to physician assistants who meet the requirements for team-based 9
57		-	practice under G.S. 90-9.3A. 10
58		-	(c) The Board may, by rule, require an applicant to comply with other requirements or 11
59		-	submit additional information the Board deems appropriate." 12
60		-	SECTION 1.1.(c) Article 1 of Chapter 90 of the General Statutes is amended by 13
61		-	adding a new section to read: 14
62		-	"§ 90-9.3A. Requirements for team-based practice as a physician assistant. 15
63		-	(a) In order to practice as a team-based physician assistant, a physician assistant shall 16
64		-	meet all of the following conditions: 17
65		-	(1) Practice in team-based settings, as defined in G.S. 90-1.1(4d). 18
66		-	(2) Have more than 4,000 hours of clinical practice experience as a licensed 19
67		-	physician assistant and more than 1,000 hours of clinical practice experience 20
68		-	within the specific medical specialty of practice with a physician in that 21
69		-	specialty. 22
70		-	(3) Submit proof as the Board may deem satisfactory by rule that the individual 23
71		-	meets the requirements of subdivisions (1) and (2) of this subsection. The 24
72		-	Board may, by rule, require the physician assistant to comply with other 25
73		-	requirements or submit additional information the Board deems appropriate. 26
74		-	(b) Team-based physician assistants shall collaborate and consult with or refer to the 27
75		-	appropriate members of the health care team as required by the patient's condition and as 28
76		-	indicated by the education, experience, and competencies of the physician assistant and the 29
77		-	standard of care. The degree of collaboration must be determined by the practice which may 30
78		-	include decisions by the employer, group, hospital service, and the credentialing and privileging 31
79		-	systems of a licensed facility. The Board may adopt rules to establish requirements for the 32
80		-	determination and enforcement of collaboration, consultation, and referral. Team-based 33
81		-	physician assistants are responsible for the care they provide. 34
82		-	(c) Notwithstanding any other provision of this Chapter, a team-based physician assistant 35
83		-	practicing in a perioperative setting, including the provision of surgical or anesthesia-related 36
84		-	services, shall be supervised by a physician." 37
85		-	SECTION 1.1.(d) G.S. 90-12.4 reads as rewritten: 38
86		-	"§ 90-12.4. Physician assistant limited volunteer license. 39
87		-	… 40
88		-	(d) Before initiating the performance of medical acts, tasks, or functions as a physician 41
89		-	assistant licensed under this section, the physician assistant shall provide submit to the Board 42
90		-	either an "Intent to Practice Notification Form," which shall include the name, address, and 43
91		-	telephone number of the physician licensed under this Article who will supervise the physician 44
92		-	assistant in the clinic specializing in the care of indigent patients.patients, or meet the 45
93		-	requirements for team-based practice under G.S. 90-9.3A. 46
94		-	…." 47
95		-	SECTION 1.1.(e) G.S. 90-12.4B reads as rewritten: 48
96		-	"§ 90-12.4B. Physician Assistant assistant retired limited volunteer license. 49
97		-	…." 50
98		-	SECTION 1.1.(f) G.S. 90-18.1 reads as rewritten: 51 General Assembly Of North Carolina Session 2025
99		-	House Bill 672-First Edition Page 3
100		-	"§ 90-18.1. Limitations on physician assistants. 1
101		-	(a) Any person who is licensed under the provisions of G.S. 90-9.3 to perform medical 2
102		-	acts, tasks, and functions as a physician assistant may use the title "physician assistant" or "PA." 3
103		-	Any other person who uses the title in any form or holds out to be a physician assistant or to be 4
104		-	so licensed, shall be deemed to be in violation of this Article. 5
105		-	(a1) Physician assistants shall clearly designate their credentials as a physician assistant in 6
106		-	all clinical settings. 7
107		-	(b) Physician assistants are authorized to write prescriptions for drugs under the 8
108		-	following conditions: 9
109		-	(1) The North Carolina Medical Board has adopted regulations governing the 10
110		-	approval of individual physician assistants to write prescriptions with such 11
111		-	limitations as the Board may determine to be in the best interest of patient 12
112		-	health and safety. 13
113		-	(2) The physician assistant holds a current license issued by the Board. 14
114		-	(3) Repealed by Session Laws 2019-191, s. 35, effective October 1, 2019. 15
115		-	(4) The supervising physician has provided to the physician assistant written 16
116		-	instructions about indications and contraindications for prescribing drugs and 17
117		-	a written policy for periodic review by the physician of the drugs prescribed. 18
118		-	This subdivision shall not apply to individuals who are practicing in a 19
119		-	team-based setting under G.S. 90-9.3A. 20
120		-	(5) A physician assistant shall personally consult with the supervising physician 21
121		-	prior to prescribing a targeted controlled substance as defined in Article 5 of 22
122		-	this Chapter when all of the following conditions apply: 23
123		-	a. The patient is being treated by a facility that primarily engages in the 24
124		-	treatment of pain by prescribing narcotic medications. 25
125		-	b. The therapeutic use of the targeted controlled substance will or is 26
126		-	expected to exceed a period of 30 days. 27
127		-	When a targeted controlled substance prescribed in accordance with this subdivision is 28
128		-	continuously prescribed to the same patient, the physician assistant shall consult with the 29
129		-	supervising physician at least once every 90 days to verify that the prescription remains medically 30
130		-	appropriate for the patient. 31
131		-	(c) Physician assistants are authorized to compound and dispense drugs under the 32
132		-	following conditions: 33
133		-	(1) The function is performed under the supervision of a licensed 34
134		-	pharmacist.physician. 35
135		-	(2) Rules and regulations of the North Carolina Board of Pharmacy and all 36
136		-	applicable State and federal laws governing this function compounding and 37
137		-	dispensing are complied with. 38
138		-	(3) The physician assistant holds a current license issued by the Board. 39
139		-	(4) The physician assistant registers with the Board of Pharmacy. 40
140		-	(d) Physician assistants are authorized to order medications, tests and treatments in 41
141		-	hospitals, clinics, nursing homes, and other health facilities under the following conditions: 42
142		-	(1) The North Carolina Medical Board has adopted regulations governing the 43
143		-	approval of individual physician assistants to order medications, tests, and 44
144		-	treatments with such limitations as the Board may determine to be in the best 45
145		-	interest of patient health and safety. 46
146		-	(2) The physician assistant holds a current license issued by the Board. 47
147		-	(3) The If the physician assistant is subject to a supervisory arrangement, the 48
148		-	supervising physician has provided to the physician assistant written 49
149		-	instructions about ordering medications, tests, and treatments, and when 50
150		-	appropriate, specific oral or written instructions for an individual patient, with 51 General Assembly Of North Carolina Session 2025
151		-	Page 4 House Bill 672-First Edition
	45	+	physician assistants or surgeon assistants accredited by the Accreditation 33
	46	+	Review Commission on Education for the Physician Assistant or its 34
	47	+	predecessor or successor entities. 35
	48	+	H.B. 672
	49	+	Apr 1, 2025
	50	+	HOUSE PRINCIPAL CLERK General Assembly Of North Carolina Session 2025
	51	+	Page 2 DRH10292-NBf-127
	52	+	(2) The applicant has a current or previous certification issued by the National 1
	53	+	Commission on Certification of Physician Assistants or its successor. 2
	54	+	(3) The applicant is of good moral character. 3
	55	+	(b) Before initiating practice of medical acts, tasks, or functions as a physician assistant, 4
	56	+	the physician assistant shall provide the Board the name, address, and telephone number of the 5
	57	+	physician who will supervise the physician assistant in the relevant medical setting. This 6
	58	+	subsection shall not apply to physician assistants who meet the requirements for team-based 7
	59	+	practice under G.S. 90-9.3A. 8
	60	+	(c) The Board may, by rule, require an applicant to comply with other requirements or 9
	61	+	submit additional information the Board deems appropriate." 10
	62	+	SECTION 1.1.(c) Article 1 of Chapter 90 of the General Statutes is amended by 11
	63	+	adding a new section to read: 12
	64	+	"§ 90-9.3A. Requirements for team-based practice as a physician assistant. 13
	65	+	(a) In order to practice as a team-based physician assistant, a physician assistant shall 14
	66	+	meet all of the following conditions: 15
	67	+	(1) Practice in team-based settings, as defined in G.S. 90-1.1(4d). 16
	68	+	(2) Have more than 4,000 hours of clinical practice experience as a licensed 17
	69	+	physician assistant and more than 1,000 hours of clinical practice experience 18
	70	+	within the specific medical specialty of practice with a physician in that 19
	71	+	specialty. 20
	72	+	(3) Submit proof as the Board may deem satisfactory by rule that the individual 21
	73	+	meets the requirements of subdivisions (1) and (2) of this subsection. The 22
	74	+	Board may, by rule, require the physician assistant to comply with other 23
	75	+	requirements or submit additional information the Board deems appropriate. 24
	76	+	(b) Team-based physician assistants shall collaborate and consult with or refer to the 25
	77	+	appropriate members of the health care team as required by the patient's condition and as 26
	78	+	indicated by the education, experience, and competencies of the physician assistant and the 27
	79	+	standard of care. The degree of collaboration must be determined by the practice which may 28
	80	+	include decisions by the employer, group, hospital service, and the credentialing and privileging 29
	81	+	systems of a licensed facility. The Board may adopt rules to establish requirements for the 30
	82	+	determination and enforcement of collaboration, consultation, and referral. Team-based 31
	83	+	physician assistants are responsible for the care they provide. 32
	84	+	(c) Notwithstanding any other provision of this Chapter, a team-based physician assistant 33
	85	+	practicing in a perioperative setting, including the provision of surgical or anesthesia-related 34
	86	+	services, shall be supervised by a physician." 35
	87	+	SECTION 1.1.(d) G.S. 90-12.4 reads as rewritten: 36
	88	+	"§ 90-12.4. Physician assistant limited volunteer license. 37
	89	+	… 38
	90	+	(d) Before initiating the performance of medical acts, tasks, or functions as a physician 39
	91	+	assistant licensed under this section, the physician assistant shall provide submit to the Board 40
	92	+	either an "Intent to Practice Notification Form," which shall include the name, address, and 41
	93	+	telephone number of the physician licensed under this Article who will supervise the physician 42
	94	+	assistant in the clinic specializing in the care of indigent patients.patients, or meet the 43
	95	+	requirements for team-based practice under G.S. 90-9.3A. 44
	96	+	…." 45
	97	+	SECTION 1.1.(e) G.S. 90-12.4B reads as rewritten: 46
	98	+	"§ 90-12.4B. Physician Assistant assistant retired limited volunteer license. 47
	99	+	…." 48
	100	+	SECTION 1.1.(f) G.S. 90-18.1 reads as rewritten: 49
	101	+	"§ 90-18.1. Limitations on physician assistants. 50 General Assembly Of North Carolina Session 2025
	102	+	DRH10292-NBf-127 Page 3
	103	+	(a) Any person who is licensed under the provisions of G.S. 90-9.3 to perform medical 1
	104	+	acts, tasks, and functions as a physician assistant may use the title "physician assistant" or "PA." 2
	105	+	Any other person who uses the title in any form or holds out to be a physician assistant or to be 3
	106	+	so licensed, shall be deemed to be in violation of this Article. 4
	107	+	(a1) Physician assistants shall clearly designate their credentials as a physician assistant in 5
	108	+	all clinical settings. 6
	109	+	(b) Physician assistants are authorized to write prescriptions for drugs under the 7
	110	+	following conditions: 8
	111	+	(1) The North Carolina Medical Board has adopted regulations governing the 9
	112	+	approval of individual physician assistants to write prescriptions with such 10
	113	+	limitations as the Board may determine to be in the best interest of patient 11
	114	+	health and safety. 12
	115	+	(2) The physician assistant holds a current license issued by the Board. 13
	116	+	(3) Repealed by Session Laws 2019-191, s. 35, effective October 1, 2019. 14
	117	+	(4) The supervising physician has provided to the physician assistant written 15
	118	+	instructions about indications and contraindications for prescribing drugs and 16
	119	+	a written policy for periodic review by the physician of the drugs prescribed. 17
	120	+	This subdivision shall not apply to individuals who are practicing in a 18
	121	+	team-based setting under G.S. 90-9.3A. 19
	122	+	(5) A physician assistant shall personally consult with the supervising physician 20
	123	+	prior to prescribing a targeted controlled substance as defined in Article 5 of 21
	124	+	this Chapter when all of the following conditions apply: 22
	125	+	a. The patient is being treated by a facility that primarily engages in the 23
	126	+	treatment of pain by prescribing narcotic medications. 24
	127	+	b. The therapeutic use of the targeted controlled substance will or is 25
	128	+	expected to exceed a period of 30 days. 26
	129	+	When a targeted controlled substance prescribed in accordance with this subdivision is 27
	130	+	continuously prescribed to the same patient, the physician assistant shall consult with the 28
	131	+	supervising physician at least once every 90 days to verify that the prescription remains medically 29
	132	+	appropriate for the patient. 30
	133	+	(c) Physician assistants are authorized to compound and dispense drugs under the 31
	134	+	following conditions: 32
	135	+	(1) The function is performed under the supervision of a licensed 33
	136	+	pharmacist.physician. 34
	137	+	(2) Rules and regulations of the North Carolina Board of Pharmacy and all 35
	138	+	applicable State and federal laws governing this function compounding and 36
	139	+	dispensing are complied with. 37
	140	+	(3) The physician assistant holds a current license issued by the Board. 38
	141	+	(4) The physician assistant registers with the Board of Pharmacy. 39
	142	+	(d) Physician assistants are authorized to order medications, tests and treatments in 40
	143	+	hospitals, clinics, nursing homes, and other health facilities under the following conditions: 41
	144	+	(1) The North Carolina Medical Board has adopted regulations governing the 42
	145	+	approval of individual physician assistants to order medications, tests, and 43
	146	+	treatments with such limitations as the Board may determine to be in the best 44
	147	+	interest of patient health and safety. 45
	148	+	(2) The physician assistant holds a current license issued by the Board. 46
	149	+	(3) The If the physician assistant is subject to a supervisory arrangement, the 47
	150	+	supervising physician has provided to the physician assistant written 48
	151	+	instructions about ordering medications, tests, and treatments, and when 49
	152	+	appropriate, specific oral or written instructions for an individual patient, with 50 General Assembly Of North Carolina Session 2025
	153	+	Page 4 DRH10292-NBf-127
152	154		provision for review by the physician of the order within a reasonable time, as 1
153	155		determined by the Board, after the medication, test, or treatment is ordered. 2
154	156		(4) The hospital or other health facility has adopted a written policy about 3
155	157		ordering medications, tests, and treatments, including procedures for 4
156	158		verification of the physician assistants' orders by nurses and other facility 5
157	159		employees and such other procedures as are in the interest of patient health 6
158	160		and safety. 7
159	161		(e) Any prescription written by a physician assistant or order given by a physician 8
160	162		assistant for medications, tests, or treatments shall be deemed to have been authorized by the 9
161	163		physician approved by the Board as the supervisor of the physician assistant and the supervising 10
162	164		physician shall be responsible for authorizing the prescription or order. This subsection shall not 11
163	165		apply to individuals who are practicing in a team-based setting under G.S. 90-9.3A who may 12
164	166		prescribe, order, administer, and procure drugs and medical devices without physician 13
165	167		authorization. Individuals who are practicing in a team-based setting under G.S. 90-9.3A may 14
166	168		also plan and initiate a therapeutic regimen that includes ordering and prescribing 15
167	169		non-pharmacological interventions, including durable medical equipment, nutrition, blood, blood 16
168	170		products, and diagnostic support services, including home health care, hospice, and physical and 17
169	171		occupational therapy. 18
170	172		(e1) Any medical certification completed by a physician assistant for a Physician assistants 19
171	173		may authenticate any document, including death certificate shall be deemed to have been 20
172	174		authorized by the physician approved by the Board as the supervisor of the physician assistant, 21
173	175		and the supervising physician shall be responsible for authorizing the completion certificates with 22
174	176		their signature, certification, stamp, verification, affidavit, or endorsement, if it may be so 23
175	177		authenticated by the signature, certification, stamp, verification, affidavit, or endorsement of the 24
176	178		medical certification.a physician. 25
177	179		(e2) Physician assistants shall not perform final interpretations of diagnostic imaging 26
178	180		studies. For purposes of this subsection, "diagnostic imaging" shall include computed 27
179	181		tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron emission 28
180	182		tomography (PET), mammography, and ultrasound services. Final interpretation shall be 29
181	183		provided by a physician licensed under this Chapter. Notwithstanding any other provision of this 30
182	184		Chapter, physician assistants conducting final interpretation of plain film radiographs shall be 31
183	185		supervised by a physician. 32
184	186		… 33
185	187		(g) Any person who is licensed under G.S. 90-9.3 to perform medical acts, tasks, and 34
186	188		functions as a physician assistant shall comply with each of the following: 35
187	189		(1) Maintain a current and active license to practice in this State. 36
188	190		(2) Maintain an active registration with the Board. 37
189	191		(3) Have File a current Intent to Practice form filed with the Board.Board or meet 38
190	192		the requirements for team-based practice under G.S. 90-9.3A. 39
191	193		…." 40
192	194		SECTION 1.1.(g) G.S. 90-21.81(9) reads as rewritten: 41
193	195		"(9) Qualified technician. – A registered diagnostic medical sonographer who is 42
194	196		certified in obstetrics and gynecology by the American Registry for 43
195	197		Diagnostic Medical Sonography (ARDMS) (ARDMS), a physician assistant 44
196	198		with certification in obstetrical ultrasonography, or a nurse midwife or 45
197	199		advanced practice nurse practitioner in obstetrics with certification in 46
198	200		obstetrical ultrasonography." 47
199	201		SECTION 1.1.(h) G.S. 58-3-169 reads as rewritten: 48
200	202		"§ 58-3-169. Required coverage for minimum hospital stay following birth. 49
201	203		(a) Definitions. – As used in this section: 50
202	204		(1) "Attending providers" includes: 51 General Assembly Of North Carolina Session 2025
203		-	~~House Bill 672-First Edition~~ Page 5
	205	+	DRH10292-NBf-127 Page 5
204	206		a. The obstetrician-gynecologists, pediatricians, family physicians, and 1
205	207		other physicians primarily responsible for the care of a mother and 2
206	208		newborn; and 3
207	209		b. The nurse midwives midwives, physician assistants, and nurse 4
208	210		practitioners primarily responsible for the care of a mother and her 5
209	211		newborn child in accordance with State licensure and certification 6
210	212		laws. 7
211	213		…." 8
212	214		SECTION 1.1.(i) G.S. 110-91 reads as rewritten: 9
213	215		"§ 110-91. Mandatory standards for a license. 10
214	216		All child care facilities shall comply with all State laws and federal laws and local ordinances 11
215	217		that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the 12
216	218		standards in this section shall be complied with by all child care facilities. However, none of the 13
217	219		standards in this section apply to the school-age children of the operator of a child care facility 14
218	220		but do apply to the preschool-age children of the operator. Children 13 years of age or older may 15
219	221		receive child care on a voluntary basis provided all applicable required standards are met. The 16
220	222		standards in this section, along with any other applicable State laws and federal laws or local 17
221	223		ordinances, shall be the required standards for the issuance of a license by the Secretary under 18
222	224		the policies and procedures of the Commission except that the Commission may, in its discretion, 19
223	225		adopt less stringent standards for the licensing of facilities which provide care on a temporary, 20
224	226		part-time, drop-in, seasonal, after-school or other than a full-time basis. 21
225	227		(1) Medical Care and Sanitation. – The Commission for Public Health shall adopt 22
226	228		rules which establish minimum sanitation standards for child care centers and 23
227	229		their personnel. The sanitation rules adopted by the Commission for Public 24
228	230		Health shall cover such matters as the cleanliness of floors, walls, ceilings, 25
229	231		storage spaces, utensils, and other facilities; adequacy of ventilation; 26
230	232		sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, 27
231	233		food protection facilities, bactericidal treatment of eating and drinking 28
232	234		utensils, and solid-waste storage and disposal; methods of food preparation 29
233	235		and serving; infectious disease control; sleeping facilities; and other items and 30
234	236		facilities as are necessary in the interest of the public health. The Commission 31
235	237		for Public Health shall allow child care centers to use domestic kitchen 32
236	238		equipment, provided appropriate temperature levels for heating, cooling, and 33
237	239		storing are maintained. Child care centers that fry foods shall use commercial 34
238	240		hoods. These rules shall be developed in consultation with the Department. 35
239	241		The Commission shall adopt rules for child care facilities to establish 36
240	242		minimum requirements for child and staff health assessments and medical 37
241	243		care procedures. These rules shall be developed in consultation with the 38
242	244		Department. Each child shall have a health assessment before being admitted 39
243	245		or within 30 days following admission to a child care facility. The assessment 40
244	246		shall be done by: (i) a licensed physician, (ii) the physician's authorized agent 41
245	247		who is currently approved by the North Carolina Medical Board, or 42
246	248		comparable certifying board in any state contiguous to North Carolina, (iii) a 43
247	249		certified nurse practitioner, (iv) a licensed physician assistant, or (iv) (v) a 44
248	250		public health nurse meeting the Departments Standards for Early Periodic 45
249	251		Screening, Diagnosis, and Treatment Program. However, no health 46
250	252		assessment shall be required of any staff or child who is and has been in 47
251	253		normal health when the staff, or the child's parent, guardian, or full-time 48
252	254		custodian objects in writing to a health assessment on religious grounds which 49
253	255		conform to the teachings and practice of any recognized church or religious 50
254	256		denomination. 51 General Assembly Of North Carolina Session 2025
255		-	Page 6 ~~House Bill 672-First Edition~~
	257	+	Page 6 DRH10292-NBf-127
256	258		Organizations that provide prepared meals to child care centers only are 1
257	259		considered child care centers for purposes of compliance with appropriate 2
258	260		sanitation standards. 3
259	261		…." 4
260	262		SECTION 1.2. The North Carolina Medical Board shall adopt permanent rules 5
261	263		necessary to implement the provisions of this act. 6
262	264		SECTION 1.3. Section 1.1 of this Part becomes effective when the North Carolina 7
263	265		Medical Board adopts the permanent rules required under Section 1.2 of this Part or June 30, 8
264	266		2026, whichever occurs first. The North Carolina Medical Board shall notify the Revisor of 9
265	267		Statutes when the rules required under Section 1.2 of this Part have been adopted. The remainder 10
266	268		of this Part is effective when it becomes law. 11
267	269		12
268	270		PART II. PHYSICIAN ASSISTANT LICENSURE COMPACT 13
269	271		SECTION 2.1.(a) Chapter 90 of the General Statutes is amended by adding a new 14
270	272		Article to read: 15
271	273		"Article 18J. 16
272	274		"PA Licensure Compact. 17
273	275		"§ 90-270.200. Purpose. 18
274	276		In order to strengthen access to Medical Services, and in recognition of the advances in the 19
275	277		delivery of Medical Services, the Participating States of the PA Licensure Compact have allied 20
276	278		in common purpose to develop a comprehensive process that complements the existing authority 21
277	279		of State Licensing Boards to license and discipline PAs and seeks to enhance the portability of 22
278	280		License to practice as a PA while safeguarding the safety of patients. This Compact allows 23
279	281		Medical Services to be provided by PAs, via the mutual recognition of the Licensee's Qualifying 24
280	282		License by other Compact Participating States. This Compact also adopts the prevailing standard 25
281	283		for PA licensure and affirms that the practice and delivery of Medical Services by the PA occurs 26
282	284		where the patient is located at the time of the patient encounter, and therefore requires the PA to 27
283	285		be under the jurisdiction of the State Licensing Board where the patient is located. State Licensing 28
284	286		Boards that participate in this Compact retain the jurisdiction to impose Adverse Action against 29
285	287		a Compact Privilege in that State issued to a PA through the procedures of this Compact. The PA 30
286	288		Licensure Compact will alleviate burdens for military families by allowing active duty military 31
287	289		personnel and their spouses to obtain a Compact Privilege based on having an unrestricted 32
288	290		License in good standing from a Participating State. 33
289	291		"§ 90-270.201. Definitions. 34
290	292		The following definitions apply in this Compact: 35
291	293		(1) Adverse Action. – Any administrative, civil, equitable, or criminal action 36
292	294		permitted by a State's laws which is imposed by a Licensing Board or other 37
293	295		authority against a PA License or License application or Compact Privilege 38
294	296		such as License denial, censure, revocation, suspension, probation, 39
295	297		monitoring of the Licensee, or restriction on the Licensee's practice. 40
296	298		(2) Compact Privilege. – The authorization granted by a Remote State to allow a 41
297	299		Licensee from another Participating State to practice as a PA to provide 42
298	300		Medical Services and other licensed activity to a patient located in the Remote 43
299	301		State under the Remote State's laws and regulations. 44
300	302		(3) Conviction. – A finding by a court that an individual is guilty of a felony or 45
301	303		misdemeanor offense through adjudication or entry of a plea of guilt or no 46
302	304		contest to the charge by the offender. 47
303	305		(4) Criminal Background Check. – The submission of fingerprints or other 48
304	306		biometric-based information for a License applicant for the purpose of 49
305	307		obtaining that applicant's criminal history record information, as defined in 28 50 General Assembly Of North Carolina Session 2025
306		-	~~House Bill 672-First Edition~~ Page 7
	308	+	DRH10292-NBf-127 Page 7
307	309		C.F.R. § 20.3(d), from the State's criminal history record repository, as 1
308	310		defined in 28 C.F.R. § 20.3(f). 2
309	311		(5) Data System. – The repository of information about Licensees, including, but 3
310	312		not limited to, License status and Adverse Actions, which is created and 4
311	313		administered under the terms of this Compact. 5
312	314		(6) Executive Committee. – A group of directors and ex officio individuals 6
313	315		elected or appointed pursuant to G.S. 90-270.206(f)(2). 7
314	316		(7) Impaired Practitioner. – A PA whose practice is adversely affected by 8
315	317		health-related condition(s) that impact their ability to practice. 9
316	318		(8) Investigative Information. – Information, records, or documents received or 10
317	319		generated by a Licensing Board pursuant to an investigation. 11
318	320		(9) Jurisprudence Requirement. – The assessment of an individual's knowledge 12
319	321		of the laws and Rules governing the practice of a PA in a State. 13
320	322		(10) License. – Current authorization by a State, other than authorization pursuant 14
321	323		to a Compact Privilege, for a PA to provide Medical Services, which would 15
322	324		be unlawful without current authorization. 16
323	325		(11) Licensee. – An individual who holds a License from a State to provide 17
324	326		Medical Services as a PA. 18
325	327		(12) Licensing Board. – Any State entity authorized to license and otherwise 19
326	328		regulate PAs. 20
327	329		(13) Medical Services. – Health care services provided for the diagnosis, 21
328	330		prevention, treatment, cure, or relief of a health condition, injury, or disease, 22
329	331		as defined by a State's laws and regulations. 23
330	332		(14) Model Compact. – The model for the PA Licensure Compact on file with The 24
331	333		Council of State Governments or other entity as designated by the 25
332	334		Commission. 26
333	335		(15) Participating State. – A State that has enacted this Compact. 27
334	336		(16) PA. – An individual who is licensed as a physician assistant in a State. For 28
335	337		purposes of this Compact, any other title or status adopted by a State to replace 29
336	338		the term "physician assistant" shall be deemed synonymous with "physician 30
337	339		assistant" and shall confer the same rights and responsibilities to the Licensee 31
338	340		under the provisions of this Compact at the time of its enactment. 32
339	341		(17) PA Licensure Compact Commission, Compact Commission, or Commission. 33
340	342		– The national administrative body created pursuant to G.S. 90-270.206(f)(2) 34
341	343		of this Compact. 35
342	344		(18) Qualifying License. – An unrestricted License issued by a Participating State 36
343	345		to provide Medical Services as a PA. 37
344	346		(19) Remote State. – A Participating State where a Licensee who is not licensed as 38
345	347		a PA is exercising or seeking to exercise the Compact Privilege. 39
346	348		(20) Rule. – A regulation promulgated by an entity that has the force and effect of 40
347	349		law. 41
348	350		(21) Significant Investigative Information. – Investigative Information that a 42
349	351		Licensing Board, after an inquiry or investigation that includes notification 43
350	352		and an opportunity for the PA to respond if required by State law, has reason 44
351	353		to believe is not groundless and, if proven true, would indicate more than a 45
352	354		minor infraction. 46
353	355		(22) State. – Any state, commonwealth, district, or territory of the United States. 47
354	356		"§ 90-270.202. State participation in this Compact. 48
355	357		(a) To participate in this Compact, a Participating State shall: 49
356	358		(1) License PAs. 50
357	359		(2) Participate in the Compact Commission's Data System. 51 General Assembly Of North Carolina Session 2025
358		-	Page 8 ~~House Bill 672-First Edition~~
	360	+	Page 8 DRH10292-NBf-127
359	361		(3) Have a mechanism in place for receiving and investigating complaints against 1
360	362		Licensees and License applicants. 2
361	363		(4) Notify the Commission, in compliance with the terms of this Compact and 3
362	364		Commission Rules, of any Adverse Action against a Licensee or License 4
363	365		applicant and the existence of Significant Investigative Information regarding 5
364	366		a Licensee or License applicant. 6
365	367		(5) Fully implement a Criminal Background Check requirement, within a time 7
366	368		frame established by Commission Rule, by its Licensing Board receiving the 8
367	369		results of a Criminal Background Check and reporting to the Commission 9
368	370		whether the License applicant has been granted a License. 10
369	371		(6) Comply with the Rules of the Compact Commission. 11
370	372		(7) Utilize passage of a recognized national exam such as the NCCPA PANCE as 12
371	373		a requirement for PA licensure. 13
372	374		(8) Grant the Compact Privilege to a holder of a Qualifying License in a 14
373	375		Participating State. 15
374	376		(b) Nothing in this Compact prohibits a Participating State from charging a fee for 16
375	377		granting the Compact Privilege. 17
376	378		"§ 90-270.203. Compact Privilege. 18
377	379		(a) To exercise the Compact Privilege, a Licensee must: 19
378	380		(1) Have graduated from a PA program accredited by the Accreditation Review 20
379	381		Commission on Education for the Physician Assistant, Inc., or other programs 21
380	382		authorized by Commission Rule. 22
381	383		(2) Hold current NCCPA certification. 23
382	384		(3) Have no felony or misdemeanor conviction. 24
383	385		(4) Have never had a controlled substance license, permit, or registration 25
384	386		suspended or revoked by a State or by the United States Drug Enforcement 26
385	387		Administration. 27
386	388		(5) Have a unique identifier as determined by Commission Rule. 28
387	389		(6) Hold a Qualifying License. 29
388	390		(7) Have had no revocation of a License or limitation or restriction on any License 30
389	391		currently held due to an Adverse Action. 31
390	392		(8) If a Licensee has had a limitation or restriction on a License or Compact 32
391	393		Privilege due to an Adverse Action, two years must have elapsed from the 33
392	394		date on which the License or Compact Privilege is no longer limited or 34
393	395		restricted due to the Adverse Action. 35
394	396		(9) If a Compact Privilege has been revoked or is limited or restricted in a 36
395	397		Participating State for conduct that would not be a basis for disciplinary action 37
396	398		in a Participating State in which the Licensee is practicing or applying to 38
397	399		practice under a Compact Privilege, that Participating State shall have the 39
398	400		discretion not to consider such action as an Adverse Action requiring the 40
399	401		denial or removal of a Compact Privilege in that State. 41
400	402		(10) Notify the Compact Commission that the Licensee is seeking the Compact 42
401	403		Privilege in a Remote State. 43
402	404		(11) Meet any Jurisprudence Requirement of a Remote State in which the Licensee 44
403	405		is seeking to practice under the Compact Privilege and pay any fees applicable 45
404	406		to satisfying the Jurisprudence Requirement. 46
405	407		(12) Report to the Commission any Adverse Action taken by a non-participating 47
406	408		State within 30 days after the action is taken. 48
407	409		(b) The Compact Privilege is valid until the expiration or revocation of the Qualifying 49
408	410		License unless terminated pursuant to an Adverse Action. The Licensee must also comply with 50
409	411		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
410		-	~~House Bill 672-First Edition~~ Page 9
	412	+	DRH10292-NBf-127 Page 9
411	413		Remote State. If the Participating State takes Adverse Action against a Qualifying License, the 1
412	414		Licensee shall lose the Compact Privilege in any Remote State in which the Licensee has a 2
413	415		Compact Privilege until all of the following occur: 3
414	416		(1) The License is no longer limited or restricted; and 4
415	417		(2) Two years have elapsed from the date on which the License is no longer 5
416	418		limited or restricted due to the Adverse Action. 6
417	419		(c) Once a restricted or limited License satisfies the requirements of subdivisions (b)(1) 7
418	420		and (2) of this section, the Licensee must meet the requirements of subsection (a) of this section 8
419	421		to obtain a Compact Privilege in any Remote State. 9
420	422		(d) For each Remote State in which a PA seeks authority to prescribe controlled 10
421	423		substances, the PA shall satisfy all requirements imposed by such State in granting or renewing 11
422	424		such authority. 12
423	425		"§ 90-270.204. Designation of the State from which Licensee is applying for a Compact 13
424	426		Privilege. 14
425	427		Upon a Licensee's application for a Compact Privilege, the Licensee shall identify to the 15
426	428		Commission the Participating State from which the Licensee is applying, in accordance with 16
427	429		applicable Rules adopted by the Commission, and subject to the following requirements: 17
428	430		(1) When applying for a Compact Privilege, the Licensee shall provide the 18
429	431		Commission with the address of the Licensee's primary residence and 19
430	432		thereafter shall immediately report to the Commission any change in the 20
431	433		address of the Licensee's primary residence. 21
432	434		(2) When applying for a Compact Privilege, the Licensee is required to consent 22
433	435		to accept service of process by mail at the Licensee's primary residence on file 23
434	436		with the Commission with respect to any action brought against the Licensee 24
435	437		by the Commission or a Participating State, including a subpoena, with respect 25
436	438		to any action brought or investigation conducted by the Commission or a 26
437	439		Participating State. 27
438	440		"§ 90-270.205. Adverse Actions. 28
439	441		(a) A Participating State in which a Licensee is licensed shall have exclusive power to 29
440	442		impose Adverse Action against the Qualifying License issued by that Participating State. 30
441	443		(b) In addition to the other powers conferred by State law, a Remote State shall have the 31
442	444		authority, in accordance with existing State due process law, to do all of the following: 32
443	445		(1) Take Adverse Action against a PA's Compact Privilege within that State to 33
444	446		remove a Licensee's Compact Privilege or take other action necessary under 34
445	447		applicable law to protect the health and safety of its citizens. 35
446	448		(2) Issue subpoenas for both hearings and investigations that require the 36
447	449		attendance and testimony of witnesses as well as the production of evidence. 37
448	450		Subpoenas issued by a Licensing Board in a Participating State for the 38
449	451		attendance and testimony of witnesses or the production of evidence from 39
450	452		another Participating State shall be enforced in the latter State by any court of 40
451	453		competent jurisdiction, according to the practice and procedure of that court 41
452	454		applicable to subpoenas issued in proceedings pending before it. The issuing 42
453	455		authority shall pay any witness fees, travel expenses, mileage, and other fees 43
454	456		required by the service statutes of the State in which the witnesses or evidence 44
455	457		are located. 45
456	458		(3) Notwithstanding subdivision (2) of this subsection, subpoenas may not be 46
457	459		issued by a Participating State to gather evidence of conduct in another State 47
458	460		that is lawful in that other State for the purpose of taking Adverse Action 48
459	461		against a Licensee's Compact Privilege or application for a Compact Privilege 49
460	462		in that Participating State. 50 General Assembly Of North Carolina Session 2025
461		-	Page 10 ~~House Bill 672-First Edition~~
	463	+	Page 10 DRH10292-NBf-127
462	464		(4) Nothing in this Compact authorizes a Participating State to impose discipline 1
463	465		against a PA's Compact Privilege or to deny an application for a Compact 2
464	466		Privilege in that Participating State for the individual's otherwise lawful 3
465	467		practice in another State. 4
466	468		(c) For purposes of taking Adverse Action, the Participating State which issued the 5
467	469		Qualifying License shall give the same priority and effect to reported conduct received from any 6
468	470		other Participating State as it would if the conduct had occurred within the Participating State 7
469	471		which issued the Qualifying License. In so doing, that Participating State shall apply its own 8
470	472		State laws to determine appropriate action. 9
471	473		(d) A Participating State, if otherwise permitted by State law, may recover from the 10
472	474		affected PA the costs of investigations and disposition of cases resulting from any Adverse 11
473	475		Action taken against that PA. 12
474	476		(e) A Participating State may take Adverse Action based on the factual findings of a 13
475	477		Remote State, provided that the Participating State follows its own procedures for taking the 14
476	478		Adverse Action. 15
477	479		(f) Joint Investigations. – 16
478	480		(1) In addition to the authority granted to a Participating State by its respective 17
479	481		State PA laws and regulations or other applicable State law, any Participating 18
480	482		State may participate with other Participating States in joint investigations of 19
481	483		Licensees. 20
482	484		(2) Participating States shall share any investigative, litigation, or compliance 21
483	485		materials in furtherance of any joint or individual investigation initiated under 22
484	486		this Compact. 23
485	487		(g) If an Adverse Action is taken against a PA's Qualifying License, the PA's Compact 24
486	488		Privilege in all Remote States shall be deactivated until two years have elapsed after all 25
487	489		restrictions have been removed from the State License. All disciplinary orders by the 26
488	490		Participating State which issued the Qualifying License that impose Adverse Action against a 27
489	491		PA's License shall include a Statement that the PA's Compact Privilege is deactivated in all 28
490	492		Participating States during the pendency of the order. 29
491	493		(h) If any Participating State takes Adverse Action, it promptly shall notify the 30
492	494		administrator of the Data System. 31
493	495		"§ 90-270.206. Establishment of the PA Licensure Compact Commission. 32
494	496		(a) The Participating States hereby create and establish a joint government agency and 33
495	497		national administrative body known as the PA Licensure Compact Commission. The 34
496	498		Commission is an instrumentality of the Compact States acting jointly and not an instrumentality 35
497	499		of any one State. The Commission shall come into existence on or after the effective date of the 36
498	500		Compact as set forth in G.S. 90-270.210(a). 37
499	501		(b) Membership, Voting, and Meetings: 38
500	502		(1) Each Participating State shall have and be limited to one delegate selected by 39
501	503		that Participating State's Licensing Board or, if the State has more than one 40
502	504		Licensing Board, selected collectively by the Participating State's Licensing 41
503	505		Boards. 42
504	506		(2) The delegate shall be either: 43
505	507		a. A current PA, physician, or public member of a Licensing Board or 44
506	508		PA Council/Committee; or 45
507	509		b. An administrator of a Licensing Board. 46
508	510		(3) Any delegate may be removed or suspended from office as provided by the 47
509	511		laws of the State from which the delegate is appointed. 48
510	512		(4) The Participating State Licensing Board shall fill any vacancy occurring in the 49
511	513		Commission within 60 days. 50 General Assembly Of North Carolina Session 2025
512		-	~~House Bill 672-First Edition~~ Page 11
	514	+	DRH10292-NBf-127 Page 11
513	515		(5) Each delegate shall be entitled to one vote on all matters voted on by the 1
514	516		Commission and shall otherwise have an opportunity to participate in the 2
515	517		business and affairs of the Commission. A delegate shall vote in person or by 3
516	518		such other means as provided in the bylaws. The bylaws may provide for 4
517	519		delegates' participation in meetings by telecommunications, video conference, 5
518	520		or other means of communication. 6
519	521		(6) The Commission shall meet at least once during each calendar year. 7
520	522		Additional meetings shall be held as set forth in this Compact and the bylaws. 8
521	523		(7) The Commission shall establish by Rule a term of office for delegates. 9
522	524		(c) The Commission shall have the following powers and duties: 10
523	525		(1) Establish a code of ethics for the Commission; 11
524	526		(2) Establish the fiscal year of the Commission; 12
525	527		(3) Establish fees; 13
526	528		(4) Establish bylaws; 14
527	529		(5) Maintain its financial records in accordance with the bylaws; 15
528	530		(6) Meet and take such actions as are consistent with the provisions of this 16
529	531		Compact and the bylaws; 17
530	532		(7) Promulgate Rules to facilitate and coordinate implementation and 18
531	533		administration of this Compact. The Rules shall have the force and effect of 19
532	534		law and shall be binding in all Participating States; 20
533	535		(8) Bring and prosecute legal proceedings or actions in the name of the 21
534	536		Commission, provided that the standing of any State Licensing Board to sue 22
535	537		or be sued under applicable law shall not be affected; 23
536	538		(9) Purchase and maintain insurance and bonds; 24
537	539		(10) Borrow, accept, or contract for services of personnel, including, but not 25
538	540		limited to, employees of a Participating State; 26
539	541		(11) Hire employees and engage contractors, elect or appoint officers, fix 27
540	542		compensation, define duties, grant such individuals appropriate authority to 28
541	543		carry out the purposes of this Compact, and establish the Commission's 29
542	544		personnel policies and programs relating to conflicts of interest, qualifications 30
543	545		of personnel, and other related personnel matters; 31
544	546		(12) Accept any and all appropriate donations and grants of money, equipment, 32
545	547		supplies, materials, and services and receive, utilize, and dispose of the same; 33
546	548		provided that at all times the Commission shall avoid any appearance of 34
547	549		impropriety or conflict of interest; 35
548	550		(13) Lease, purchase, accept appropriate gifts or donations of, or otherwise own, 36
549	551		hold, improve, or use any property, real, personal, or mixed; provided that at 37
550	552		all times the Commission shall avoid any appearance of impropriety; 38
551	553		(14) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise 39
552	554		dispose of any property real, personal, or mixed; 40
553	555		(15) Establish a budget and make expenditures; 41
554	556		(16) Borrow money; 42
555	557		(17) Appoint committees, including standing committees composed of members, 43
556	558		State regulators, State legislators or their representatives, and consumer 44
557	559		representatives, and such other interested persons as may be designated in this 45
558	560		Compact and the bylaws; 46
559	561		(18) Provide and receive information from, and cooperate with, law enforcement 47
560	562		agencies; 48
561	563		(19) Elect a Chair, Vice-Chair, Secretary, and Treasurer and such other officers of 49
562	564		the Commission as provided in the Commission's bylaws; 50 General Assembly Of North Carolina Session 2025
563		-	Page 12 ~~House Bill 672-First Edition~~
	565	+	Page 12 DRH10292-NBf-127
564	566		(20) Reserve for itself, in addition to those reserved exclusively to the Commission 1
565	567		under the Compact, powers that the Executive Committee may not exercise; 2
566	568		(21) Approve or disapprove a State's participation in the Compact based upon its 3
567	569		determination as to whether the State's Compact legislation departs in a 4
568	570		material manner from the Model Compact language; 5
569	571		(22) Prepare and provide to the Participating States an annual report; and 6
570	572		(23) Perform such other functions as may be necessary or appropriate to achieve 7
571	573		the purposes of this Compact consistent with the State regulation of PA 8
572	574		licensure and practice. 9
573	575		(d) Meetings of the Commission: 10
574	576		(1) All meetings of the Commission that are not closed pursuant to this subsection 11
575	577		shall be open to the public. Notice of public meetings shall be posted on the 12
576	578		Commission's website at least 30 days prior to the public meeting. 13
577	579		(2) Notwithstanding subdivision (1) of this subsection, the Commission may 14
578	580		convene a public meeting by providing at least 24 hours' prior notice on the 15
579	581		Commission's website, and any other means as provided in the Commission's 16
580	582		Rules, for any of the reasons it may dispense with notice of proposed 17
581	583		rulemaking under G.S. 90-270.208(l). 18
582	584		(3) The Commission may convene in a closed, nonpublic meeting or nonpublic 19
583	585		part of a public meeting to receive legal advice or to discuss: 20
584	586		a. Noncompliance of a Participating State with its obligations under this 21
585	587		Compact; 22
586	588		b. The employment, compensation, discipline or other matters, practices 23
587	589		or procedures related to specific employees or other matters related to 24
588	590		the Commission's internal personnel practices and procedures; 25
589	591		c. Current, threatened, or reasonably anticipated litigation; 26
590	592		d. Negotiation of contracts for the purchase, lease, or sale of goods, 27
591	593		services, or real estate; 28
592	594		e. Accusing any person of a crime or formally censuring any person; 29
593	595		f. Disclosure of trade secrets or commercial or financial information that 30
594	596		is privileged or confidential; 31
595	597		g. Disclosure of information of a personal nature where disclosure would 32
596	598		constitute a clearly unwarranted invasion of personal privacy; 33
597	599		h. Disclosure of investigative records compiled for law enforcement 34
598	600		purposes; 35
599	601		i. Disclosure of information related to any investigative reports prepared 36
600	602		by or on behalf of or for use of the Commission or other committee 37
601	603		charged with responsibility of investigation or determination of 38
602	604		compliance issues pursuant to this Compact; 39
603	605		j. Legal advice; or 40
604	606		k. Matters specifically exempted from disclosure by federal or 41
605	607		Participating States' statutes. 42
606	608		(4) If a meeting, or portion of a meeting, is closed pursuant to this provision, the 43
607	609		chair of the meeting or the chair's designee shall certify that the meeting or 44
608	610		portion of the meeting may be closed and shall reference each relevant 45
609	611		exempting provision. 46
610	612		(5) The Commission shall keep minutes that fully and clearly describe all matters 47
611	613		discussed in a meeting and shall provide a full and accurate summary of 48
612	614		actions taken, including a description of the views expressed. All documents 49
613	615		considered in connection with an action shall be identified in such minutes. 50
614	616		All minutes and documents of a closed meeting shall remain under seal, 51 General Assembly Of North Carolina Session 2025
615		-	~~House Bill 672-First Edition~~ Page 13
	617	+	DRH10292-NBf-127 Page 13
616	618		subject to release by a majority vote of the Commission or order of a court of 1
617	619		competent jurisdiction. 2
618	620		(e) Financing of the Commission: 3
619	621		(1) The Commission shall pay, or provide for the payment of, the reasonable 4
620	622		expenses of its establishment, organization, and ongoing activities. 5
621	623		(2) The Commission may accept any and all appropriate revenue sources, 6
622	624		donations, and grants of money, equipment, supplies, materials, and services. 7
623	625		(3) The Commission may levy on and collect an annual assessment from each 8
624	626		Participating State and may impose Compact Privilege fees on Licensees of 9
625	627		Participating States to whom a Compact Privilege is granted to cover the cost 10
626	628		of the operations and activities of the Commission and its staff, which must 11
627	629		be in a total amount sufficient to cover its annual budget as approved by the 12
628	630		Commission each year for which revenue is not provided by other sources. 13
629	631		The aggregate annual assessment amount levied on Participating States shall 14
630	632		be allocated based upon a formula to be determined by Commission Rule. 15
631	633		a. A Compact Privilege expires when the Licensee's Qualifying License 16
632	634		in the Participating State from which the Licensee applied for the 17
633	635		Compact Privilege expires. 18
634	636		b. If the Licensee terminates the Qualifying License through which the 19
635	637		Licensee applied for the Compact Privilege before its scheduled 20
636	638		expiration, and the Licensee has a Qualifying License in another 21
637	639		Participating State, the Licensee shall inform the Commission that it 22
638	640		is changing to that Participating State the Participating State through 23
639	641		which it applies for a Compact Privilege and pay to the Commission 24
640	642		any Compact Privilege fee required by Commission Rule. 25
641	643		(4) The Commission shall not incur obligations of any kind prior to securing the 26
642	644		funds adequate to meet the same nor shall the Commission pledge the credit 27
643	645		of any of the Participating States, except by and with the authority of the 28
644	646		Participating State. 29
645	647		(5) The Commission shall keep accurate accounts of all receipts and 30
646	648		disbursements. The receipts and disbursements of the Commission shall be 31
647	649		subject to the financial review and accounting procedures established under 32
648	650		its bylaws. All receipts and disbursements of funds handled by the 33
649	651		Commission shall be subject to an annual financial review by a certified or 34
650	652		licensed public accountant, and the report of the financial review shall be 35
651	653		included in and become part of the annual report of the Commission. 36
652	654		(f) The Executive Committee: 37
653	655		(1) The Executive Committee shall have the power to act on behalf of the 38
654	656		Commission according to the terms of this Compact and Commission Rules. 39
655	657		(2) The Executive Committee shall be composed of nine members: 40
656	658		a. Seven voting members who are elected by the Commission from the 41
657	659		current membership of the Commission; 42
658	660		b. One ex officio, nonvoting member from a recognized national PA 43
659	661		professional association; and 44
660	662		c. One ex officio, nonvoting member from a recognized national PA 45
661	663		certification organization. 46
662	664		(3) The ex officio members will be selected by their respective organizations. 47
663	665		(4) The Commission may remove any member of the Executive Committee as 48
664	666		provided in its bylaws. 49
665	667		(5) The Executive Committee shall meet at least annually. 50
666	668		(6) The Executive Committee shall have the following duties and responsibilities: 51 General Assembly Of North Carolina Session 2025
667		-	Page 14 ~~House Bill 672-First Edition~~
	669	+	Page 14 DRH10292-NBf-127
668	670		a. Recommend to the Commission changes to the Commission's Rules 1
669	671		or bylaws, changes to this Compact legislation, fees to be paid by 2
670	672		Compact Participating States such as annual dues, and any 3
671	673		Commission Compact fee charged to Licensees for the Compact 4
672	674		Privilege; 5
673	675		b. Ensure Compact administration services are appropriately provided, 6
674	676		contractual or otherwise; 7
675	677		c. Prepare and recommend the budget; 8
676	678		d. Maintain financial records on behalf of the Commission; 9
677	679		e. Monitor Compact compliance of Participating States and provide 10
678	680		compliance reports to the Commission; 11
679	681		f. Establish additional committees as necessary; 12
680	682		g. Exercise the powers and duties of the Commission during the interim 13
681	683		between Commission meetings, except for issuing proposed 14
682	684		rulemaking or adopting Commission Rules or bylaws, or exercising 15
683	685		any other powers and duties exclusively reserved to the Commission 16
684	686		by the Commission's Rules; and 17
685	687		h. Perform other duties as provided in the Commission's Rules or bylaws. 18
686	688		(7) All meetings of the Executive Committee at which it votes or plans to vote on 19
687	689		matters in exercising the powers and duties of the Commission shall be open 20
688	690		to the public and public notice of such meetings shall be given as public 21
689	691		meetings of the Commission are given. 22
690	692		(8) The Executive Committee may convene in a closed, nonpublic meeting for 23
691	693		the same reasons that the Commission may convene in a nonpublic meeting 24
692	694		as set forth in G.S. 90-270.206(d)(3) and shall announce the closed meeting 25
693	695		as the Commission is required to under G.S. 90-270.206(d)(3) and keep 26
694	696		minutes of the closed meeting as the Commission is required to under 27
695	697		G.S. 90-270.206(d)(3). 28
696	698		(g) Qualified Immunity, Defense, and Indemnification: 29
697	699		(1) The members, officers, executive director, employees, and representatives of 30
698	700		the Commission shall be immune from suit and liability, both personally and 31
699	701		in their official capacity, for any claim for damage to or loss of property or 32
700	702		personal injury or other civil liability caused by or arising out of any actual or 33
701	703		alleged act, error, or omission that occurred, or that the person against whom 34
702	704		the claim is made had a reasonable basis for believing occurred within the 35
703	705		scope of Commission employment, duties, or responsibilities; provided that 36
704	706		nothing in this paragraph shall be construed to protect any such person from 37
705	707		suit or liability for any damage, loss, injury, or liability caused by the 38
706	708		intentional or willful or wanton misconduct of that person. The procurement 39
707	709		of insurance of any type by the Commission shall not in any way compromise 40
708	710		or limit the immunity granted hereunder. 41
709	711		(2) The Commission shall defend any member, officer, executive director, 42
710	712		employee, and representative of the Commission in any civil action seeking 43
711	713		to impose liability arising out of any actual or alleged act, error, or omission 44
712	714		that occurred within the scope of Commission employment, duties, or 45
713	715		responsibilities, or as determined by the Commission that the person against 46
714	716		whom the claim is made had a reasonable basis for believing occurred within 47
715	717		the scope of Commission employment, duties, or responsibilities; provided 48
716	718		that nothing herein shall be construed to prohibit that person from retaining 49
717	719		their own counsel at their own expense; and provided further, that the actual 50 General Assembly Of North Carolina Session 2025
718		-	~~House Bill 672-First Edition~~ Page 15
	720	+	DRH10292-NBf-127 Page 15
719	721		or alleged act, error, or omission did not result from that person's intentional 1
720	722		or willful or wanton misconduct. 2
721	723		(3) The Commission shall indemnify and hold harmless any member, officer, 3
722	724		executive director, employee, and representative of the Commission for the 4
723	725		amount of any settlement or judgment obtained against that person arising out 5
724	726		of any actual or alleged act, error, or omission that occurred within the scope 6
725	727		of Commission employment, duties, or responsibilities, or that such person 7
726	728		had a reasonable basis for believing occurred within the scope of Commission 8
727	729		employment, duties, or responsibilities, provided that the actual or alleged act, 9
728	730		error, or omission did not result from the intentional or willful or wanton 10
729	731		misconduct of that person. 11
730	732		(4) Venue is proper and judicial proceedings by or against the Commission shall 12
731	733		be brought solely and exclusively in a court of competent jurisdiction where 13
732	734		the principal office of the Commission is located. The Commission may waive 14
733	735		venue and jurisdictional defenses in any proceedings as authorized by 15
734	736		Commission Rules. 16
735	737		(5) Nothing herein shall be construed as a limitation on the liability of any 17
736	738		Licensee for professional malpractice or misconduct, which shall be governed 18
737	739		solely by any other applicable State laws. 19
738	740		(6) Nothing herein shall be construed to designate the venue or jurisdiction to 20
739	741		bring actions for alleged acts of malpractice, professional misconduct, 21
740	742		negligence, or other such civil action pertaining to the practice of a PA. All 22
741	743		such matters shall be determined exclusively by State law other than this 23
742	744		Compact. 24
743	745		(7) Nothing in this Compact shall be interpreted to waive or otherwise abrogate a 25
744	746		Participating State's state action immunity or state action affirmative defense 26
745	747		with respect to antitrust claims under the Sherman Act, Clayton Act, or any 27
746	748		other State or federal antitrust or anticompetitive law or regulation. 28
747	749		(8) Nothing in this Compact shall be construed to be a waiver of sovereign 29
748	750		immunity by the Participating States or by the Commission. 30
749	751		"§ 90-270.207. Data System. 31
750	752		(a) The Commission shall provide for the development, maintenance, operation, and 32
751	753		utilization of a coordinated data and reporting system containing licensure, Adverse Action, and 33
752	754		the reporting of the existence of Significant Investigative Information on all licensed PAs and 34
753	755		applicants denied a License in Participating States. 35
754	756		(b) Notwithstanding any other State law to the contrary, a Participating State shall submit 36
755	757		a uniform data set to the Data System on all PAs to whom this Compact is applicable (utilizing 37
756	758		a unique identifier) as required by the Rules of the Commission, including: 38
757	759		(1) Identifying information; 39
758	760		(2) Licensure data; 40
759	761		(3) Adverse Actions against a License or Compact Privilege; 41
760	762		(4) Any denial of application for licensure, and the reason(s) for such denial 42
761	763		(excluding the reporting of any criminal history record information where 43
762	764		prohibited by law); 44
763	765		(5) The existence of Significant Investigative Information; and 45
764	766		(6) Other information that may facilitate the administration of this Compact, as 46
765	767		determined by the Rules of the Commission. 47
766	768		(c) Significant Investigative Information pertaining to a Licensee in any Participating 48
767	769		State shall only be available to other Participating States. 49 General Assembly Of North Carolina Session 2025
768		-	Page 16 ~~House Bill 672-First Edition~~
	770	+	Page 16 DRH10292-NBf-127
769	771		(d) The Commission shall promptly notify all Participating States of any Adverse Action 1
770	772		taken against a Licensee or an individual applying for a License that has been reported to it. This 2
771	773		Adverse Action information shall be available to any other Participating State. 3
772	774		(e) Participating States contributing information to the Data System may, in accordance 4
773	775		with State or federal law, designate information that may not be shared with the public without 5
774	776		the express permission of the contributing State. Notwithstanding any such designation, such 6
775	777		information shall be reported to the Commission through the Data System. 7
776	778		(f) Any information submitted to the Data System that is subsequently expunged 8
777	779		pursuant to federal law or the laws of the Participating State contributing the information shall 9
778	780		be removed from the Data System upon reporting of such by the Participating State to the 10
779	781		Commission. 11
780	782		(g) The records and information provided to a Participating State pursuant to this 12
781	783		Compact or through the Data System, when certified by the Commission or an agent thereof, 13
782	784		shall constitute the authenticated business records of the Commission and shall be entitled to any 14
783	785		associated hearsay exception in any relevant judicial, quasi-judicial, or administrative 15
784	786		proceedings in a Participating State. 16
785	787		"§ 90-270.208. Rulemaking. 17
786	788		(a) The Commission shall exercise its Rulemaking powers pursuant to the criteria set 18
787	789		forth in this section and the Rules adopted thereunder. Commission Rules shall become binding 19
788	790		as of the date specified by the Commission for each Rule. 20
789	791		(b) The Commission shall promulgate reasonable Rules in order to effectively and 21
790	792		efficiently implement and administer this Compact and achieve its purposes. A Commission Rule 22
791	793		shall be invalid and have not force or effect only if a court of competent jurisdiction holds that 23
792	794		the Rule is invalid because the Commission exercised its rulemaking authority in a manner that 24
793	795		is beyond the scope of the purposes of this Compact, or the powers granted hereunder, or based 25
794	796		upon another applicable standard of review. 26
795	797		(c) The Rules of the Commission shall have the force of law in each Participating State, 27
796	798		provided, however, that where the Rules of the Commission conflict with the laws of the 28
797	799		Participating State that establish the Medical Services a PA may perform in the Participating 29
798	800		State, as held by a court of competent jurisdiction, the Rules of the Commission shall be 30
799	801		ineffective in that State to the extent of the conflict. The Rules of the Commission shall not 31
800	802		modify or expand, in any way, the scope of practice of a PA as established by the laws of the 32
801	803		Participating State. 33
802	804		(d) If a majority of the legislatures of the Participating States rejects a Commission Rule, 34
803	805		by enactment of a statute or resolution in the same manner used to adopt this Compact within 35
804	806		four years of the date of adoption of the Rule, then such Rule shall have no further force and 36
805	807		effect in any Participating State or to any State applying to participate in the Compact. 37
806	808		(e) Commission Rules shall be adopted at a regular or special meeting of the 38
807	809		Commission. 39
808	810		(f) Prior to promulgation and adoption of a final Rule or Rules by the Commission, and 40
809	811		at least 30 days in advance of the meeting at which the Rule will be considered and voted upon, 41
810	812		the Commission shall file a Notice of Proposed Rulemaking: 42
811	813		(1) On the website of the Commission or other publicly accessible platform; 43
812	814		(2) To persons who have requested notice of the Commission's notices of 44
813	815		proposed rulemaking; and 45
814	816		(3) In such other way(s) as the Commission may by Rule specify. 46
815	817		(g) The Notice of Proposed Rulemaking shall include: 47
816	818		(1) The time, date, and location of the public hearing on the proposed Rule and 48
817	819		the proposed time, date, and location of the meeting in which the proposed 49
818	820		Rule will be considered and voted upon; 50
819	821		(2) The text of the proposed Rule and the reason for the proposed Rule; 51 General Assembly Of North Carolina Session 2025
820		-	~~House Bill 672-First Edition~~ Page 17
	822	+	DRH10292-NBf-127 Page 17
821	823		(3) A request for comments on the proposed Rule from any interested person and 1
822	824		the date by which written comments must be received; and 2
823	825		(4) The manner in which interested persons may submit notice to the Commission 3
824	826		of their intention to attend the public hearing or provide any written 4
825	827		comments. 5
826	828		(h) Prior to adoption of a proposed Rule, the Commission shall allow persons to submit 6
827	829		written data, facts, opinions, and arguments, which shall be made available to the public. 7
828	830		(i) If the hearing is to be held via electronic means, the Commission shall publish the 8
829	831		mechanism for access to the electronic hearing. 9
830	832		(1) All persons wishing to be heard at the hearing shall as directed in the Notice 10
831	833		of Proposed Rulemaking, not less than five business days before the scheduled 11
832	834		date of the hearing, notify the Commission of their desire to appear and testify 12
833	835		at the hearing. 13
834	836		(2) Hearings shall be conducted in a manner providing each person who wishes 14
835	837		to comment a fair and reasonable opportunity to comment orally or in writing. 15
836	838		(3) All hearings shall be recorded. A copy of the recording and the written 16
837	839		comments, data, facts, opinions, and arguments received in response to the 17
838	840		proposed rulemaking shall be made available to a person upon request. 18
839	841		(4) Nothing in this section shall be construed as requiring a separate hearing on 19
840	842		each proposed Rule. Proposed Rules may be grouped for the convenience of 20
841	843		the Commission at hearings required by this section. 21
842	844		(j) Following the public hearing, the Commission shall consider all written and oral 22
843	845		comments timely received. 23
844	846		(k) The Commission shall, by majority vote of all delegates, take final action on the 24
845	847		proposed Rule and shall determine the effective date of the Rule, if adopted, based on the 25
846	848		Rulemaking record and the full text of the Rule. 26
847	849		(1) If adopted, the Rule shall be posted on the Commission's website. 27
848	850		(2) The Commission may adopt changes to the proposed Rule provided the 28
849	851		changes do not enlarge the original purpose of the proposed Rule. 29
850	852		(3) The Commission shall provide on its website an explanation of the reasons for 30
851	853		substantive changes made to the proposed Rule as well as reasons for 31
852	854		substantive changes not made that were recommended by commenters. 32
853	855		(4) The Commission shall determine a reasonable effective date for the Rule. 33
854	856		Except for an emergency as provided in subsection (l) of this section, the 34
855	857		effective date of the Rule shall be no sooner than 30 days after the Commission 35
856	858		issued the notice that it adopted the Rule. 36
857	859		(l) Upon determination that an emergency exists, the Commission may consider and 37
858	860		adopt an emergency Rule with 24 hours' prior notice, without the opportunity for comment, or 38
859	861		hearing, provided that the usual Rulemaking procedures provided in this Compact and in this 39
860	862		section shall be retroactively applied to the Rule as soon as reasonably possible, in no event later 40
861	863		than 90 days after the effective date of the Rule. For the purposes of this provision, an emergency 41
862	864		Rule is one that must be adopted immediately by the Commission in order to: 42
863	865		(1) Meet an imminent threat to public health, safety, or welfare; 43
864	866		(2) Prevent a loss of Commission or Participating State funds; 44
865	867		(3) Meet a deadline for the promulgation of a Commission Rule that is established 45
866	868		by federal law or Rule; or 46
867	869		(4) Protect public health and safety. 47
868	870		(m) The Commission or an authorized committee of the Commission may direct revisions 48
869	871		to a previously adopted Commission Rule for purposes of correcting typographical errors, errors 49
870	872		in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be 50
871	873		posted on the website of the Commission. The revision shall be subject to challenge by any 51 General Assembly Of North Carolina Session 2025
872		-	Page 18 ~~House Bill 672-First Edition~~
	874	+	Page 18 DRH10292-NBf-127
873	875		person for a period of 30 days after posting. The revision may be challenged only on grounds 1
874	876		that the revision results in a material change to a Rule. A challenge shall be made as set forth in 2
875	877		the notice of revisions and delivered to the Commission prior to the end of the notice period. If 3
876	878		no challenge is made, the revision will take effect without further action. If the revision is 4
877	879		challenged, the revision may not take effect without the approval of the Commission. 5
878	880		(n) No Participating State's rulemaking requirements shall apply under this Compact. 6
879	881		"§ 90-270.209. Oversight, dispute resolution, and enforcement. 7
880	882		(a) Oversight: 8
881	883		(1) The executive and judicial branches of State government in each Participating 9
882	884		State shall enforce this Compact and take all actions necessary and appropriate 10
883	885		to implement the Compact. 11
884	886		(2) Venue is proper and judicial proceedings by or against the Commission shall 12
885	887		be brought solely and exclusively in a court of competent jurisdiction where 13
886	888		the principal office of the Commission is located. The Commission may waive 14
887	889		venue and jurisdictional defenses to the extent it adopts or consents to 15
888	890		participate in alternative dispute resolution proceedings. Nothing herein shall 16
889	891		affect or limit the selection or propriety of venue in any action against a 17
890	892		Licensee for professional malpractice, misconduct, or any such similar matter. 18
891	893		(3) The Commission shall be entitled to receive service of process in any 19
892	894		proceeding regarding the enforcement or interpretation of the Compact or the 20
893	895		Commission's Rules and shall have standing to intervene in such a proceeding 21
894	896		for all purposes. Failure to provide the Commission with service of process 22
895	897		shall render a judgment or order in such proceeding void as to the 23
896	898		Commission, this Compact, or Commission Rules. 24
897	899		(b) Default, Technical Assistance, and Termination: 25
898	900		(1) If the Commission determines that a Participating State has defaulted in the 26
899	901		performance of its obligations or responsibilities under this Compact or the 27
900	902		Commission Rules, the Commission shall provide written notice to the 28
901	903		defaulting State and other Participating States. The notice shall describe the 29
902	904		default, the proposed means of curing the default, and any other action that 30
903	905		the Commission may take and shall offer remedial training and specific 31
904	906		technical assistance regarding the default. 32
905	907		(2) If a State in default fails to cure the default, the defaulting State may be 33
906	908		terminated from this Compact upon an affirmative vote of a majority of the 34
907	909		delegates of the Participating States, and all rights, privileges, and benefits 35
908	910		conferred by this Compact upon such State may be terminated on the effective 36
909	911		date of termination. A cure of the default does not relieve the offending State 37
910	912		of obligations or liabilities incurred during the period of default. 38
911	913		(3) Termination of participation in this Compact shall be imposed only after all 39
912	914		other means of securing compliance have been exhausted. Notice of intent to 40
913	915		suspend or terminate shall be given by the Commission to the governor, the 41
914	916		majority and minority leaders of the defaulting State's legislature, and to the 42
915	917		Licensing Board(s) of each of the Participating States. 43
916	918		(4) A State that has been terminated is responsible for all assessments, 44
917	919		obligations, and liabilities incurred through the effective date of termination, 45
918	920		including obligations that extend beyond the effective date of termination. 46
919	921		(5) The Commission shall not bear any costs related to a State that is found to be 47
920	922		in default or that has been terminated from this Compact, unless agreed upon 48
921	923		in writing between the Commission and the defaulting State. 49
922	924		(6) The defaulting State may appeal its termination from the Compact by the 50
923	925		Commission by petitioning the United States District Court for the District of 51 General Assembly Of North Carolina Session 2025
924		-	~~House Bill 672-First Edition~~ Page 19
	926	+	DRH10292-NBf-127 Page 19
925	927		Columbia or the federal district where the Commission has its principal 1
926	928		offices. The prevailing member shall be awarded all costs of such litigation, 2
927	929		including reasonable attorneys' fees. 3
928	930		(7) Upon the termination of a State's participation in the Compact, the State shall 4
929	931		immediately provide notice to all Licensees within that State of such 5
930	932		termination: 6
931	933		a. Licensees who have been granted a Compact Privilege in that State 7
932	934		shall retain the Compact Privilege for 180 days following the effective 8
933	935		date of such termination. 9
934	936		b. Licensees who are licensed in that State who have been granted a 10
935	937		Compact Privilege in a Participating State shall retain the Compact 11
936	938		Privilege for 180 days unless the Licensee also has a Qualifying 12
937	939		License in a Participating State or obtains a Qualifying License in a 13
938	940		Participating State before the 180-day period ends, in which case the 14
939	941		Compact Privilege shall continue. 15
940	942		(c) Dispute Resolution: 16
941	943		(1) Upon request by a Participating State, the Commission shall attempt to resolve 17
942	944		disputes related to this Compact that arise among Participating States and 18
943	945		between Participating and non-Participating States. 19
944	946		(2) The Commission shall promulgate a Rule providing for both mediation and 20
945	947		binding dispute resolution for disputes as appropriate. 21
946	948		(d) Enforcement: 22
947	949		(1) The Commission, in the reasonable exercise of its discretion, shall enforce the 23
948	950		provisions of this Compact and Rules of the Commission. 24
949	951		(2) If compliance is not secured after all means to secure compliance have been 25
950	952		exhausted, by majority vote, the Commission may initiate legal action in the 26
951	953		United States District Court for the District of Columbia or the federal district 27
952	954		where the Commission has its principal offices, against a Participating State 28
953	955		in default to enforce compliance with the provisions of this Compact and the 29
954	956		Commission's promulgated Rules and bylaws. The relief sought may include 30
955	957		both injunctive relief and damages. In the event judicial enforcement is 31
956	958		necessary, the prevailing party shall be awarded all costs of such litigation, 32
957	959		including reasonable attorneys' fees. 33
958	960		(3) The remedies herein shall not be the exclusive remedies of the Commission. 34
959	961		The Commission may pursue any other remedies available under federal or 35
960	962		State law. 36
961	963		(e) Legal Action Against the Commission: 37
962	964		(1) A Participating State may initiate legal action against the Commission in the 38
963	965		United States District Court for the District of Columbia or the federal district 39
964	966		where the Commission has its principal offices to enforce compliance with the 40
965	967		provisions of the Compact and its Rules. The relief sought may include both 41
966	968		injunctive relief and damages. In the event judicial enforcement is necessary, 42
967	969		the prevailing party shall be awarded all costs of such litigation, including 43
968	970		reasonable attorneys' fees. 44
969	971		(2) No person other than a Participating State shall enforce this Compact against 45
970	972		the Commission. 46
971	973		"§ 90-270.210. Date of implementation of the PA Licensure Compact Commission. 47
972	974		(a) This Compact shall come into effect on the date on which this Compact statute is 48
973	975		enacted into law in the seventh Participating State. 49
974	976		(1) On or after the effective date of the Compact, the Commission shall convene 50
975	977		and review the enactment of each of the States that enacted the Compact prior 51 General Assembly Of North Carolina Session 2025
976		-	Page 20 ~~House Bill 672-First Edition~~
	978	+	Page 20 DRH10292-NBf-127
977	979		to the Commission convening ("Charter Participating States") to determine if 1
978	980		the statute enacted by each such Charter Participating State is materially 2
979	981		different than the Model Compact. 3
980	982		a. A Charter Participating State whose enactment is found to be 4
981	983		materially different from the Model Compact shall be entitled to the 5
982	984		default process set forth in G.S. 90-270.209(b). 6
983	985		b. If any Participating State later withdraws from the Compact or its 7
984	986		participation is terminated, the Commission shall remain in existence 8
985	987		and the Compact shall remain in effect even if the number of 9
986	988		Participating States should be less than seven. Participating States 10
987	989		enacting the Compact subsequent to the Commission convening shall 11
988	990		be subject to the process set forth in G.S. 90-270.206(c)(21) to 12
989	991		determine if their enactments are materially different from the Model 13
990	992		Compact and whether they qualify for participation in the Compact. 14
991	993		(2) Participating States enacting the Compact subsequent to the seven initial 15
992	994		Charter Participating States shall be subject to the process set forth in 16
993	995		G.S. 90-270.206(c)(21) to determine if their enactments are materially 17
994	996		different from the Model Compact and whether they qualify for participation 18
995	997		in the Compact. 19
996	998		(3) All actions taken for the benefit of the Commission or in furtherance of the 20
997	999		purposes of the administration of the Compact prior to the effective date of 21
998	1000		the Compact or the Commission coming into existence shall be considered to 22
999	1001		be actions of the Commission unless specifically repudiated by the 23
1000	1002		Commission. 24
1001	1003		(b) Any State that joins this Compact shall be subject to the Commission's Rules and 25
1002	1004		bylaws as they exist on the date on which this Compact becomes law in that State. Any Rule that 26
1003	1005		has been previously adopted by the Commission shall have the full force and effect of law on the 27
1004	1006		day this Compact becomes law in that State. 28
1005	1007		(c) Any Participating State may withdraw from this Compact by enacting a statute 29
1006	1008		repealing the same. 30
1007	1009		(1) A Participating State's withdrawal shall not take effect until 180 days after 31
1008	1010		enactment of the repealing statute. During this 180-day period, all Compact 32
1009	1011		Privileges that were in effect in the withdrawing State and were granted to 33
1010	1012		Licensees licensed in the withdrawing State shall remain in effect. If any 34
1011	1013		Licensee licensed in the withdrawing State is also licensed in another 35
1012	1014		Participating State or obtains a license in another Participating State within 36
1013	1015		the 180 days, the Licensee's Compact Privileges in other Participating States 37
1014	1016		shall not be affected by the passage of the 180 days. 38
1015	1017		(2) Withdrawal shall not affect the continuing requirement of the State Licensing 39
1016	1018		Board(s) of the withdrawing State to comply with the investigative and 40
1017	1019		Adverse Action reporting requirements of this Compact prior to the effective 41
1018	1020		date of withdrawal. 42
1019	1021		(3) Upon the enactment of a statute withdrawing a State from this Compact, the 43
1020	1022		State shall immediately provide notice of such withdrawal to all Licensees 44
1021	1023		within that State. Such withdrawing State shall continue to recognize all 45
1022	1024		Licenses granted pursuant to this Compact for a minimum of 180 days after 46
1023	1025		the date of such notice of withdrawal. 47
1024	1026		(d) Nothing contained in this Compact shall be construed to invalidate or prevent any PA 48
1025	1027		licensure agreement or other cooperative arrangement between Participating States and between 49
1026	1028		a Participating State and non-Participating State that does not conflict with the provisions of this 50
1027	1029		Compact. 51 General Assembly Of North Carolina Session 2025
1028		-	~~House Bill 672-First Edition~~ Page 21
	1030	+	DRH10292-NBf-127 Page 21
1029	1031		(e) This Compact may be amended by the Participating States. No amendment to this 1
1030	1032		Compact shall become effective and binding upon any Participating State until it is enacted 2
1031	1033		materially in the same manner into the laws of all Participating States as determined by the 3
1032	1034		Commission. 4
1033	1035		"§ 90-270.211. Construction and severability. 5
1034	1036		(a) This Compact and the Commission's rulemaking authority shall be liberally construed 6
1035	1037		so as to effectuate the purposes and the implementation and administration of the Compact. 7
1036	1038		Provisions of the Compact expressly authorizing or requiring the promulgation of Rules shall not 8
1037	1039		be construed to limit the Commission's rulemaking authority solely for those purposes. 9
1038	1040		(b) The provisions of this Compact shall be severable and if any phrase, clause, sentence, 10
1039	1041		or provision of this Compact is held by a court of competent jurisdiction to be contrary to the 11
1040	1042		constitution of any Participating State, a State seeking participation in the Compact, or of the 12
1041	1043		United States, or the applicability thereof to any government, agency, person, or circumstance is 13
1042	1044		held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of 14
1043	1045		this Compact and the applicability thereof to any other government, agency, person, or 15
1044	1046		circumstance shall not be affected thereby. 16
1045	1047		(c) Notwithstanding subsection (b) of this section, the Commission may deny a State's 17
1046	1048		participation in the Compact or, in accordance with the requirements of G.S. 90-270.209(b), 18
1047	1049		terminate a Participating State's participation in the Compact, if it determines that a constitutional 19
1048	1050		requirement of a Participating State is, or would be with respect to a State seeking to participate 20
1049	1051		in the Compact, a material departure from the Compact. Otherwise, if this Compact shall be held 21
1050	1052		to be contrary to the constitution of any Participating State, the Compact shall remain in full force 22
1051	1053		and effect as to the remaining Participating States and in full force and effect as to the 23
1052	1054		Participating State affected as to all severable matters. 24
1053	1055		"§ 90-270.212. Binding effect of Compact. 25
1054	1056		(a) Nothing herein prevents the enforcement of any other law of a Participating State that 26
1055	1057		is not inconsistent with this Compact. 27
1056	1058		(b) Any laws in a Participating State in conflict with this Compact are superseded to the 28
1057	1059		extent of the conflict. 29
1058	1060		(c) All agreements between the Commission and the Participating States are binding in 30
1059	1061		accordance with their terms." 31
1060	1062		SECTION 2.1.(b) G.S. 90-9.3 reads as rewritten: 32
1061	1063		"§ 90-9.3. Requirements for licensure as a physician assistant. 33
1062	1064		(a) To be eligible for licensure as a physician assistant, an applicant shall submit proof 34
1063	1065		satisfactory to the Board that the applicant has met all of the following: 35
1064	1066		(1) The applicant has successfully completed an educational program for 36
1065	1067		physician assistants or surgeon assistants accredited by the Accreditation 37
1066	1068		Review Commission on Education for the Physician Assistant or its 38
1067	1069		predecessor or successor entities. 39
1068	1070		(2) The applicant has a current or previous certification issued by the National 40
1069	1071		Commission on Certification of Physician Assistants or its successor. 41
1070	1072		(3) The applicant is of good moral character. 42
1071	1073		(a1) A physician assistant applying for licensure under Article 18J of this Chapter shall be 43
1072	1074		in compliance with that Article. 44
1073	1075		(b) Before initiating practice of medical acts, tasks, or functions as a physician assistant, 45
1074	1076		the physician assistant shall provide the Board the name, address, and telephone number of the 46
1075	1077		physician who will supervise the physician assistant in the relevant medical setting. 47
1076	1078		(c) The Board may, by rule, require an applicant to comply with other requirements or 48
1077	1079		submit additional information the Board deems appropriate." 49
1078	1080		SECTION 2.1.(c) G.S. 90-13.2 reads as rewritten: 50
1079	1081		"§ 90-13.2. Registration every year with Board. 51 General Assembly Of North Carolina Session 2025
1080		-	Page 22 ~~House Bill 672-First Edition~~
	1082	+	Page 22 DRH10292-NBf-127
1081	1083		(a) Every licensee shall register annually with the Board no later than 30 days after the 1
1082	1084		person's birthday. Every privilege holder shall register annually with the Board in accordance 2
1083	1085		with the Physician Assistant Licensure Compact, Article 18J of this Chapter. 3
1084	1086		… 4
1085	1087		(b1) Physician assistants shall pay an annual registration fee of one hundred forty dollars 5
1086	1088		($140.00). A physician assistant who fails to register as required by this section shall pay an 6
1087	1089		additional fee of twenty-five dollars ($25.00) to the Board. 7
1088	1090		…." 8
1089	1091		SECTION 2.1.(d) G.S. 90-13.1 is amended by adding a new subsection to read: 9
1090	1092		"(g) For the initial licensure or privilege of a physician assistant, the Board shall require 10
1091	1093		the payment of two hundred thirty dollars ($230.00)." 11
1092	1094		SECTION 2.1.(e) G.S. 90-1.1 reads as rewritten: 12
1093	1095		"§ 90-1.1. Definitions. 13
1094	1096		The following definitions apply in this Article: 14
1095	1097		… 15
1096	1098		(4) License. – An authorization issued by the Board to a physician, physician 16
1097	1099		assistant, or anesthesiologist assistant to perform medical acts, tasks, or 17
1098	1100		functions. License shall include any physician assistant compact privilege 18
1099	1101		granted under Article 18J of this Chapter. 19
1100	1102		(4a) Licensee. – Any person issued a license by the Board, whether the license is 20
1101	1103		active or inactive, including an inactive license by means of surrender. 21
1102	1104		Licensee shall include any compact privilege issued to a holder of a qualifying 22
1103	1105		license in a participating state pursuant to Article 18J of this Chapter. 23
1104	1106		…." 24
1105	1107		SECTION 2.1.(f) G.S. 90-5.1 reads as rewritten: 25
1106	1108		"§ 90-5.1. Powers and duties of the Board. 26
1107	1109		(a) The Board shall have the following powers and duties: 27
1108	1110		… 28
1109	1111		(11) Implement the Physician Assistant Licensure Compact under Article 18J of 29
1110	1112		this Chapter, including issuing compact privileges. 30
1111	1113		(12) Appoint a delegate to serve on the Physician Assistant Licensure Compact 31
1112	1114		Commission under G.S. 90-270.206. The delegate shall be either (i) a current 32
1113	1115		physician assistant, physician, or public member of the Board, or (ii) an 33
1114	1116		administrator of the Board. 34
1115	1117		…." 35
1116	1118		SECTION 2.1.(g) G.S. 90-11 reads as rewritten: 36
1117	1119		"§ 90-11. Criminal background checks. 37
1118	1120		(a) Repealed by Session Laws 2007-346, s. 11, effective October 1, 2007. 38
1119	1121		(a1) Repealed by Session Laws 2007-346, s. 9.1, effective October 1, 2007. 39
1120	1122		(b) The Department of Public Safety may provide a criminal record check to the Board 40
1121	1123		for a person who has applied for a license through the Board. Board and for purposes of Article 41
1122	1124		18J of this Chapter. The Board shall provide to the Department of Public Safety, along with the 42
1123	1125		request, the fingerprints of the applicant, any additional information required by the Department 43
1124	1126		of Public Safety, and a form signed by the applicant consenting to the check of the criminal 44
1125	1127		record and to the use of the fingerprints and other identifying information required by the State 45
1126	1128		or national repositories. The applicant's fingerprints shall be forwarded to the State Bureau of 46
1127	1129		Investigation for a search of the State's criminal history record file, and the State Bureau of 47
1128	1130		Investigation shall forward a set of the fingerprints to the Federal Bureau of Investigation for a 48
1129	1131		national criminal history check. The Board shall keep all information pursuant to this subsection 49
1130	1132		privileged, in accordance with applicable State law and federal guidelines, and the information 50
1131	1133		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
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	1134	+	DRH10292-NBf-127 Page 23
1133	1135		The Department of Public Safety may charge each applicant a fee for conducting the checks 1
1134	1136		of criminal history records authorized by this subsection. The Board has the authority to collect 2
1135	1137		this fee from each applicant and remit it to the Department of Public Safety." 3
1136	1138		SECTION 2.1.(h) G.S. 90-14 reads as rewritten: 4
1137	1139		"§ 90-14. Disciplinary Authority. 5
1138	1140		(a) The Board shall have the power to place on probation with or without conditions, 6
1139	1141		impose limitations and conditions on, publicly reprimand, assess monetary redress, issue public 7
1140	1142		letters of concern, mandate free medical services, require satisfactory completion of treatment 8
1141	1143		programs or remedial or educational training, fine, deny, annul, suspend, or revoke a license, or 9
1142	1144		other authority to practice medicine in this State, issued by the Board to any person who has been 10
1143	1145		found by the Board to have committed any of the following acts or conduct, or for any of the 11
1144	1146		following reasons: 12
1145	1147		… 13
1146	1148		(18) A violation of Article 18J of this Chapter, consistent with the provisions of 14
1147	1149		that Article for compact privilege holders. 15
1148	1150		…." 16
1149	1151		SECTION 2.2. Section 2.1 of this Part is effective nine months after it becomes law. 17
1150	1152		18
1151	1153		PART III. EFFECTIVE DATE 19
1152	1154		SECTION 3.1. Except as otherwise provided, this act is effective when it becomes 20
1153	1155		law. 21