GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2025 S 1 SENATE BILL 396 Short Title: Medical Board Licensing Efficiency Act. (Public) Sponsors: Senators Britt, Sawrey, and Galey (Primary Sponsors). Referred to: Rules and Operations of the Senate March 25, 2025 *S396 -v-1* A BILL TO BE ENTITLED 1 AN ACT TO MAKE MODIF ICATIONS TO THE LAWS PERTAINING TO THE NORTH 2 CAROLINA MEDICAL BOA RD. 3 The General Assembly of North Carolina enacts: 4 SECTION 1. Article 1 of Chapter 90 of the General Statutes is amended by adding 5 a new section to read: 6 "§ 90-12.2B. Licensure by endorsement. 7 (a) The Board may issue a license as a physician, physician assistant, or anesthesiologist 8 assistant in North Carolina to an applicant who submits an application for licensure by 9 endorsement to the Board and satisfies all of the following, as applicable to the applicant's 10 licensure: 11 (1) Has held an active, full, and unrestricted license in at least one other United 12 States jurisdiction, including any state, territory, or district, for at least five 13 years. Physicians applying for a license to practice medicine must have 14 practiced with an active, full, and unrestricted license for at least two years 15 after completing training after graduating from medical school in a residency 16 program approved by any of the following: 17 a. The Accreditation Council for Graduate Medical Education. 18 b. The American Osteopathic Association. 19 c. The Royal College of Physicians and Surgeons of Canada. 20 d. The College of Family Physicians of Canada. 21 (2) An employer submits a letter to the Board verifying that the applicant has 22 accepted an offer of full-time employment to practice consistent with the 23 applicant's respective licensure in person at a physical location in this State 24 rendering care to individuals in this State. 25 (3) Provides to the Board sufficient proof of identification, including the 26 applicant's social security number, certified or official copy of birth certificate, 27 copy of drivers license, United States passport, or other government-issued 28 identification. The applicant shall include documentation of any legal name 29 change. 30 (4) Provides an attestation that the applicant meets all of the following: 31 a. Is in good standing in all jurisdictions of licensure where the applicant 32 holds an active license, has not been disciplined in the last five years 33 by any occupational licensing board preceding the application by 34 endorsement, and has no pending investigations by any occupational 35 licensing board. 36 General Assembly Of North Carolina Session 2025 Page 2 Senate Bill 396-First Edition b. Is not the subject to any adverse action taken by any regulatory board 1 or agency overseeing the applicant's respective licensure in the last 2 five years preceding the application for licensure by endorsement. 3 c. Has actively practiced as a physician, physician assistant, or 4 anesthesiologist assistant for an average of 20 hours or more per week 5 during the two years immediately preceding the application for 6 licensure by endorsement. 7 d. Has no misdemeanor or felony convictions in the last five years 8 preceding the application for licensure by endorsement. 9 e. Meets the licensure requirements of physicians under G.S. 90-9.1 or 10 G.S. 90-9.2, physician assistants under G.S. 90-9.3, or 11 anesthesiologist assistants under G.S. 90-9.4. 12 f. Meets the examination requirements of G.S. 90-10.1 for physician 13 licensure. 14 g. Is able to satisfy all licensing requirements of any applicable Board 15 rule, including 21 NCAC 32B .1303, 21 NCAC 32S .0202, and 21 16 NCAC 32W .0103, as amended, for physicians, physician assistants, 17 and anesthesiologist assistants, respectively. 18 (b) Licensees who have received a licensure in accordance with subsection (a) of this 19 section shall submit to the Board any additional licensure information for a license as required 20 by any applicable Board rule, including 21 NCAC 32B .1303, as amended, within 120 days of 21 receipt of licensure by endorsement under this section. Failure to provide the necessary 22 information under this section shall constitute a basis for the Board to investigate that failure and 23 take appropriate action. The Board has the authority to investigate and take appropriate action 24 against an applicant or licensee who applied for or received licensure by endorsement under this 25 section. The Board shall retain jurisdiction over the holder of any inactive license issued by the 26 Board. 27 (c) A license issued under this section shall become inactive after 180 days unless the 28 applicant meets all of the requirements of subsection (b) of this section. 29 (d) An applicant for licensure by endorsement shall pay the applicable license fees under 30 G.S. 90-13.1 and applicable criminal background check fees under G.S. 90-11." 31 SECTION 2. G.S. 90-13.1 reads as rewritten: 32 "§ 90-13.1. License fees. 33 (a) Each applicant for a license to practice medicine and surgery in this State under 34 G.S. 90-9.1, 90-9.2, or 90-12.02 shall pay to the North Carolina Medical Board an application 35 fee of four hundred dollars ($400.00).not to exceed five hundred fifty dollars ($550.00). 36 (a1) Physicians applying for licensure by endorsement under G.S. 90-12.2B shall pay to 37 the Board an application fee not to exceed eight hundred twenty-five dollars ($825.00). 38 (b) Each applicant for a limited license to practice in a medical education and training 39 program under G.S. 90-12.01 shall pay to the Board a fee of one hundred dollars ($100.00).one 40 hundred twenty-five dollars ($125.00). 41 (c) An applicant for a limited volunteer license under G.S. 90-12.1A or G.S. 90-12.1B 42 shall not pay a fee. 43 (d) A fee of twenty-five dollars ($25.00) shall be paid for the issuance of a duplicate 44 license. 45 (e) All fees shall be paid in advance to the North Carolina Medical Board, to be held in 46 a fund for the use of the Board. 47 (f) For the initial and annual licensure of an anesthesiologist assistant, the Board may 48 require the payment of a fee not to exceed one hundred fifty dollars ($150.00).two hundred 49 dollars ($200.00). 50 General Assembly Of North Carolina Session 2025 Senate Bill 396-First Edition Page 3 (g) Anesthesiologist assistants applying for licensure by endorsement under 1 G.S. 90-12.2B shall pay to the Board an application fee not to exceed three hundred dollars 2 ($300.00). 3 (h) For the initial licensure of a physician assistant, the Board shall require the payment 4 of a fee not to exceed three hundred twenty-five dollars ($325.00). 5 (i) Physician assistants applying for licensure by endorsement under G.S. 90-12.2B shall 6 pay to the Board an application fee not to exceed five hundred dollars ($500.00)." 7 SECTION 3. G.S. 90-13.2 reads as rewritten: 8 "§ 90-13.2. Registration every year with Board. 9 (a) Every licensee shall register annually with the Board no later than 30 days after the 10 person's birthday. 11 (b) A person who registers with the Board shall report to the Board the person's name and 12 office and residence address and any other information required by the Board, and shall pay an 13 annual registration fee of two hundred fifty dollars ($250.00), not to exceed three hundred fifty 14 dollars ($350.00), except those who have a limited license to practice in a medical education and 15 training program approved by the Board for the purpose of education or training shall pay a 16 registration fee of one hundred twenty-five dollars ($125.00), one hundred fifty dollars 17 ($150.00), and those who have a retired limited volunteer license pursuant to G.S. 90-12.1B or a 18 limited volunteer license pursuant to G.S. 90-12.1A shall pay no annual registration fee. 19 However, licensees who have a limited license to practice for the purpose of education and 20 training under G.S. 90-12.01 shall not be required to pay more than one annual registration fee 21 for each year of training. 22 (b1) Physician assistants shall pay an annual registration fee not to exceed two hundred 23 dollars ($200.00). A physician assistant who fails to register as required by this section shall pay 24 an additional fee of twenty-five dollars ($25.00) to the Board. 25 (c) Repealed by Session Laws 2016-117, s. 2(i), effective October 1, 2016. 26 (d) A licensee who is not actively engaged in the performance of medical acts, tasks, or 27 functions in North Carolina and who does not wish to register the license may direct the Board 28 to place the license on inactive status. 29 (e) A physician who fails to register as required by this section shall pay an additional 30 fee of fifty dollars ($50.00) to the Board. The license of any physician who fails to register and 31 who remains unregistered for a period of 30 days after certified notice of the failure is 32 automatically inactive. The Board shall retain jurisdiction over the holder of the inactive license. 33 (f) Except as provided in G.S. 90-12.1B, a person whose license is inactive shall not 34 practice medicine in North Carolina nor be required to pay the annual registration fee. 35 (g) Upon payment of all accumulated fees and penalties, the license of the licensee may 36 be reinstated, subject to the Board requiring the licensee to appear before the Board for an 37 interview and to comply with other licensing requirements. The penalty may not exceed the 38 applicable maximum fee for a license under G.S. 90-13.1. 39 (h) The Board shall not deny a licensee's annual registration based solely on the licensee's 40 failure to become board certified." 41 SECTION 4. G.S. 90-689 reads as rewritten: 42 "§ 90-689. Expenses; fees. 43 (a) All fees shall be payable to the Medical Board and deposited in the name of the 44 Medical Board in financial institutions designated by the Medical Board as official depositories. 45 These fees shall be used to carry out the purposes of this Article. 46 (b) All salaries, compensation, and expenses incurred or allowed to carry out the purposes 47 of this Article shall be paid by the Medical Board exclusively out of the fees received by the 48 Medical Board as authorized by this Article or funds received from other sources. In no case shall 49 any salary, expense, or other obligation authorized by this Article be charged against the State 50 treasury. 51 General Assembly Of North Carolina Session 2025 Page 4 Senate Bill 396-First Edition (c) The Committee, upon the approval of the Medical Board, shall establish fees not 1 exceeding the following amounts: 2 (1) License application $350.00$400.00 3 (2) Biennial renewal of license $350.00$400.00 4 (3) Late renewal of license $100.00 5 (4) Provisional license $175.00$200.00 6 (5) Copies of rules Cost." 7 SECTION 5. The North Carolina Medical Board may adopt temporary rules to 8 implement the provisions of this act. 9 SECTION 6. This act becomes effective October 1, 2025. 10