New Mexico 2025 Regular Session

New Mexico House Bill HB413 Compare Versions

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

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28	28	HOUSE BILL 413
29	29	57
30	30	TH LEGISLATURE
31	31	-
32	32
33	33	STATE
34	34
35	35	OF
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37	37	NEW
38	38
39	39	MEXICO
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41	41	-
42	42	FIRST SESSION
43	43	,
44	44
45	45	2025
46	46	INTRODUCED BY
47	47	Gail Armstrong and Harlan Vincent and Jenifer Jones
48	48	AN ACT
49	49	RELATING TO INTERGOVERNMENTAL AGREEMENTS; ENACTING THE
50	50	PHYSICIAN ASSISTANT LICENSURE INTERSTATE COMPACT.
51	51	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
52	52	SECTION 1. [NEW MATERIAL] SHORT TITLE.--This act may be
53	53	cited as the "Physician Assistant Licensure Interstate
54	54	Compact".
55	55	SECTION 2. [NEW MATERIAL] PURPOSE.--In order to
56	56	strengthen access to medical services, and in recognition of
57	57	the advances in the delivery of medical services, the
58	58	participating states of the Physician Assistant Licensure
59	59	Interstate Compact have allied in common purpose to develop a
60	60	comprehensive process that complements the existing authority
61	61	of state licensing boards to license and discipline physician
62	62	assistants and seeks to enhance the portability of a license to
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90	90	practice as a physician assistant while safeguarding the safety
91	91	of patients. This compact allows medical services to be
92	92	provided by physician assistants via the mutual recognition of
93	93	the licensee's qualifying license by other compact-
94	94	participating states. This compact also adopts the prevailing
95	95	standard for physician assistant licensure and affirms that the
96	96	practice and delivery of medical services by a licensed
97	97	physician assistant occurs where the patient is located at the
98	98	time of the patient encounter and therefore requires the
99	99	physician assistant to be under the jurisdiction of the state
100	100	licensing board where the patient is located. State licensing
101	101	boards that participate in this compact retain the jurisdiction
102	102	to impose adverse actions against a compact privilege in that
103	103	state issued to a physician assistant through the procedures of
104	104	this compact. The Physician Assistant Licensure Interstate
105	105	Compact will alleviate burdens for military families by
106	106	allowing active duty military personnel and their spouses to
107	107	obtain a compact privilege based on having an unrestricted
108	108	license in good standing from a participating state.
109	109	SECTION 3. [NEW MATERIAL] DEFINITIONS.--As used in the
110	110	Physician Assistant Licensure Interstate Compact:
111	111	A. "adverse action" means any administrative,
112	112	civil, equitable or criminal action permitted by a state's laws
113	113	that is imposed by a licensing board or other authority against
114	114	a physician assistant license or license application or compact
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143	143	privilege, including license denial, censure, revocation,
144	144	suspension, probation, monitoring of the licensee or
145	145	restriction on the licensee's practice;
146	146	B. "commission", "physician assistant licensure
147	147	compact commission" or "compact commission" means the national
148	148	administrative body created pursuant to Section 8 of this
149	149	compact;
150	150	C. "compact" means the Physician Assistant
151	151	Licensure Interstate Compact;
152	152	D. "compact privilege" means the authorization
153	153	granted by a remote state to allow a licensee from another
154	154	participating state to practice as a physician assistant to
155	155	provide medical services and other licensed activity to a
156	156	patient located in the remote state under the remote state's
157	157	laws and regulations;
158	158	E. "conviction" means a finding by a court that an
159	159	individual is guilty of a felony or misdemeanor offense through
160	160	adjudication or entry of a plea of guilt or no contest to the
161	161	charge by the offender;
162	162	F. "criminal background check" means the submission
163	163	of fingerprints or other biometric-based information for a
164	164	license applicant for the purpose of obtaining that applicant's
165	165	criminal history record information from the state's criminal
166	166	history record repository;
167	167	G. "data system" means the repository of
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196	196	information about licensees, including license status and
197	197	adverse actions, that is created and administered under the
198	198	terms of this compact;
199	199	H. "executive committee" means a group of directors
200	200	and ex-officio individuals elected or appointed pursuant to
201	201	Section 8 of this compact;
202	202	I. "impaired practitioner" means a physician
203	203	assistant whose practice is adversely affected by health-
204	204	related conditions that impact the physician assistant's
205	205	ability to practice;
206	206	J. "investigative information" means information,
207	207	records or documents received or generated by a licensing board
208	208	pursuant to an investigation;
209	209	K. "jurisprudence requirement" means the assessment
210	210	of an individual's knowledge of the laws and rules governing
211	211	the practice of a physician assistant in a state;
212	212	L. "license" means current authorization by a
213	213	state, other than authorization pursuant to a compact
214	214	privilege, for a physician assistant to provide medical
215	215	services that would be unlawful without current authorization;
216	216	M. "licensee" means an individual who holds a
217	217	license from a state to provide medical services as a physician
218	218	assistant;
219	219	N. "licensing board" means any state entity
220	220	authorized to license and otherwise regulate physician
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249	249	assistants;
250	250	O. "medical services" means health care services
251	251	provided for the diagnosis, prevention, treatment, cure or
252	252	relief of a health condition, injury or disease, as defined by
253	253	a state's laws and regulations;
254	254	P. "model compact" means the model for the
255	255	Physician Assistant Licensure Interstate Compact on file with
256	256	the council of state governments or other entity as designated
257	257	by the commission;
258	258	Q. "participating state" means a state that has
259	259	enacted this compact;
260	260	R. "physician assistant" means an individual who is
261	261	licensed as a physician assistant in a state. For purposes of
262	262	this compact, any other title or status adopted by a state to
263	263	replace the term "physician assistant" shall be deemed
264	264	synonymous with "physician assistant" and shall confer the same
265	265	rights and responsibilities to the licensee under the
266	266	provisions of this compact at the time of its enactment;
267	267	S. "qualifying license" means an unrestricted
268	268	license issued by a participating state to provide medical
269	269	services as a physician assistant;
270	270	T. "remote state" means a participating state where
271	271	a licensee who is not licensed as a physician assistant is
272	272	exercising or seeking to exercise the compact privilege;
273	273	U. "rule" means a regulation promulgated by an
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302	302	entity that has the force and effect of law;
303	303	V. "significant investigative information" means
304	304	investigative information that a licensing board, after an
305	305	inquiry or investigation that includes notification and an
306	306	opportunity for the physician assistant to respond if required
307	307	by state law, has reason to believe is not groundless and, if
308	308	proven true, would indicate more than a minor infraction; and
309	309	W. "state" means any state, commonwealth, district
310	310	or territory of the United States.
311	311	SECTION 4. [NEW MATERIAL] STATE PARTICIPATION IN
312	312	COMPACT.--
313	313	A. To participate in the compact, a participating
314	314	state shall:
315	315	(1) license physician assistants;
316	316	(2) participate in the commission's data
317	317	system;
318	318	(3) have a mechanism in place for receiving
319	319	and investigating complaints against licensees and license
320	320	applicants;
321	321	(4) notify the commission, in compliance with
322	322	the terms of the compact and commission rules, of any adverse
323	323	action against a licensee or license applicant and the
324	324	existence of significant investigative information regarding a
325	325	licensee or license applicant;
326	326	(5) fully implement a criminal background
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355	355	check requirement, within a time frame established by
356	356	commission rule, by requiring the state's licensing board to
357	357	receive the results of a criminal background check and report
358	358	to the commission whether the license applicant has been
359	359	granted a license;
360	360	(6) comply with the rules of the compact
361	361	commission;
362	362	(7) use passage of a recognized national exam,
363	363	such as the national commission on certification of physician
364	364	assistants' physician assistant national certifying
365	365	examination, as a requirement for physician assistant
366	366	licensure; and
367	367	(8) grant the compact privilege to a holder of
368	368	a qualifying license in a participating state.
369	369	B. Nothing in this compact prohibits a
370	370	participating state from charging a fee for granting the
371	371	compact privilege.
372	372	SECTION 5. [NEW MATERIAL] COMPACT PRIVILEGE.--
373	373	A. To exercise the compact privilege, a licensee
374	374	shall:
375	375	(1) have graduated from a physician assistant
376	376	program accredited by the accreditation review commission on
377	377	education for the physician assistant, inc. or other programs
378	378	authorized by commission rule;
379	379	(2) hold current national commission on
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408	408	certification of physician assistants certification;
409	409	(3) have no felony or misdemeanor conviction;
410	410	(4) have never had a controlled substance
411	411	license, permit or registration suspended or revoked by a state
412	412	or by the United States drug enforcement administration;
413	413	(5) have a unique identifier as determined by
414	414	commission rule;
415	415	(6) hold a qualifying license;
416	416	(7) have had no revocation of a license or
417	417	limitation or restriction on any license currently held due to
418	418	an adverse action;
419	419	(8) if the licensee has had a limitation or
420	420	restriction on a license or compact privilege due to an adverse
421	421	action, not exercise the compact privilege until two years have
422	422	elapsed from the date on which the license or compact privilege
423	423	is no longer limited or restricted due to the adverse action;
424	424	(9) notify the compact commission that the
425	425	licensee is seeking the compact privilege in a remote state;
426	426	(10) meet any jurisprudence requirement of a
427	427	remote state in which the licensee is seeking to practice under
428	428	the compact privilege and pay any fees applicable to satisfying
429	429	the jurisprudence requirement; and
430	430	(11) report to the commission any adverse
431	431	action taken by a nonparticipating state within thirty days
432	432	after the action is taken.
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461	461	B. The compact privilege is valid until the
462	462	expiration or revocation of the qualifying license unless
463	463	terminated pursuant to an adverse action. The licensee shall
464	464	also comply with all of the requirements of Subsection A of
465	465	this section to maintain the compact privilege in a remote
466	466	state. If the participating state takes adverse action against
467	467	a qualifying license, the licensee shall lose the compact
468	468	privilege in any remote state in which the licensee has a
469	469	compact privilege until all of the following occur:
470	470	(1) the license is no longer limited or
471	471	restricted; and
472	472	(2) two years have elapsed from the date on
473	473	which the license is no longer limited or restricted due to the
474	474	adverse action.
475	475	C. Once a restricted or limited license satisfies
476	476	the requirements of Subsection B of this section, the licensee
477	477	shall meet the requirements of Subsection A of this section to
478	478	re-obtain a compact privilege in any remote state.
479	479	D. For each remote state in which a physician
480	480	assistant seeks authority to prescribe controlled substances,
481	481	the physician assistant shall satisfy all requirements imposed
482	482	by the state in granting or renewing the authority.
483	483	E. If a compact privilege has been revoked or is
484	484	limited or restricted in a participating state for conduct that
485	485	would not be a basis for disciplinary action in a participating
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514	514	state in which the licensee is practicing or applying to
515	515	practice under a compact privilege, that participating state
516	516	shall have the discretion not to consider such action as an
517	517	adverse action requiring the denial or removal of a compact
518	518	privilege in that state.
519	519	SECTION 6. [NEW MATERIAL] DESIGNATION OF THE STATE FROM
520	520	WHICH A LICENSEE IS APPLYING FOR A COMPACT PRIVILEGE.--Upon a
521	521	licensee's application for a compact privilege, the licensee
522	522	shall identify to the commission the participating state from
523	523	which the licensee is applying, in accordance with applicable
524	524	rules adopted by the commission, and be subject to the
525	525	following requirements:
526	526	A. when applying for a compact privilege, the
527	527	licensee shall provide the commission with the address of the
528	528	licensee's primary residence and thereafter shall immediately
529	529	report to the commission any change in the address of the
530	530	licensee's primary residence; and
531	531	B. when applying for a compact privilege, the
532	532	licensee is required to consent to accept service of process by
533	533	mail at the licensee's primary residence on file with the
534	534	commission with respect to any action brought, or investigation
535	535	conducted, by the commission or a participating state,
536	536	including a subpoena.
537	537	SECTION 7. [NEW MATERIAL] ADVERSE ACTIONS.--
538	538	A. A participating state in which a licensee is
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567	567	licensed shall have exclusive power to impose adverse action
568	568	against the qualifying license issued by that participating
569	569	state.
570	570	B. In addition to the other powers conferred by
571	571	state law, a remote state shall have the authority, in
572	572	accordance with state due process law, to do all of the
573	573	following:
574	574	(1) take adverse action against a physician
575	575	assistant's compact privilege within that state to remove a
576	576	licensee's compact privilege or take other action necessary
577	577	under applicable law to protect the health and safety of the
578	578	state's residents; and
579	579	(2) issue subpoenas for hearings and
580	580	investigations that require the attendance and testimony of
581	581	witnesses as well as the production of evidence. Subpoenas
582	582	issued by a licensing board in a participating state for the
583	583	attendance and testimony of witnesses or the production of
584	584	evidence from another participating state shall be enforced in
585	585	the latter state by any court of competent jurisdiction,
586	586	according to the practice and procedure of that court
587	587	applicable to subpoenas issued in proceedings pending before
588	588	that court. The issuing authority shall pay any witness fees,
589	589	travel expenses, mileage and other fees required by the service
590	590	statutes of the state in which the witnesses or evidence are
591	591	located.
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620	620	C. Notwithstanding Paragraph (2) of Subsection B of
621	621	this section, subpoenas shall not be issued by a participating
622	622	state to gather evidence of conduct in another state that is
623	623	lawful in that other state for the purpose of taking adverse
624	624	action against a licensee's compact privilege or application
625	625	for a compact privilege in that participating state. Nothing
626	626	in this compact authorizes a participating state to impose
627	627	discipline against a physician assistant's compact privilege or
628	628	to deny an application for a compact privilege in that
629	629	participating state for the individual's otherwise lawful
630	630	practice in another state.
631	631	D. For purposes of taking adverse action, the
632	632	participating state that issued the qualifying license shall
633	633	give the same priority and effect to reported conduct received
634	634	from any other participating state as it would if the conduct
635	635	had occurred within the participating state that issued the
636	636	qualifying license. In so doing, that participating state
637	637	shall apply the state's own laws to determine appropriate
638	638	action.
639	639	E. A participating state, if otherwise permitted by
640	640	state law, may recover from the affected physician assistant
641	641	the costs of investigations and disposition of cases resulting
642	642	from any adverse action taken against that physician assistant.
643	643	F. A participating state may take adverse action
644	644	based on the factual findings of a remote state; provided that
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673	673	the participating state follows its own procedures for taking
674	674	the adverse action.
675	675	G. In addition to the authority granted to a
676	676	participating state by the state's physician assistant laws and
677	677	regulations or other applicable state law, any participating
678	678	state may participate with other participating states in joint
679	679	investigations of licensees. Participating states shall share
680	680	any investigative, litigation or compliance materials in
681	681	furtherance of any joint or individual investigation initiated
682	682	under this compact.
683	683	H. If an adverse action is taken against a
684	684	physician assistant's qualifying license, the physician
685	685	assistant's compact privilege in all remote states shall be
686	686	deactivated until two years have elapsed after all restrictions
687	687	have been removed from the state qualifying license. All
688	688	disciplinary orders by the participating state that issued the
689	689	qualifying license that impose adverse action against a
690	690	physician assistant's license shall include a statement that
691	691	the physician assistant's compact privilege is deactivated in
692	692	all participating states during the pendency of the order.
693	693	I. If any participating state takes adverse action,
694	694	the participating state shall promptly notify the administrator
695	695	of the data system.
696	696	SECTION 8. [NEW MATERIAL] PHYSICIAN ASSISTANT LICENSURE
697	697	COMPACT COMMISSION.--
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726	726	A. The participating states hereby create and
727	727	establish a joint government agency and national administrative
728	728	body known as "the physician assistant licensure compact
729	729	commission". The commission is an instrumentality of the
730	730	participating states acting jointly and not an instrumentality
731	731	of any one state. The commission shall come into existence on
732	732	or after the effective date of the compact as set forth in
733	733	Section 12 of this compact.
734	734	B. Membership, voting and meetings of the
735	735	commission shall proceed as follows:
736	736	(1) each participating state shall have and be
737	737	limited to one delegate selected by that participating state's
738	738	licensing board or, if the state has more than one licensing
739	739	board, selected collectively by the participating state's
740	740	licensing boards;
741	741	(2) a delegate shall be either:
742	742	(a) a current physician assistant,
743	743	physician or public member of a licensing board or physician
744	744	assistant council or committee; or
745	745	(b) an administrator of a licensing
746	746	board;
747	747	(3) a delegate may be removed or suspended
748	748	from office as provided by the laws of the state from which the
749	749	delegate is appointed;
750	750	(4) a participating state's licensing board
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779	779	shall fill any vacancy occurring in the commission within sixty
780	780	days;
781	781	(5) each delegate shall be entitled to one
782	782	vote on all matters voted on by the commission and shall
783	783	otherwise have an opportunity to participate in the business
784	784	and affairs of the commission. A delegate shall vote in person
785	785	or by such other means as provided in the commission's bylaws.
786	786	The bylaws may provide for delegates' participation in meetings
787	787	by telecommunications, video conference or other means of
788	788	communication;
789	789	(6) the commission shall meet at least once
790	790	per each calendar year. Additional meetings shall be held as
791	791	set forth in this compact and the commission's bylaws; and
792	792	(7) the commission shall establish by rule a
793	793	term of office for delegates.
794	794	C. The commission has the powers and duties to:
795	795	(1) establish a code of ethics for the
796	796	commission;
797	797	(2) establish the fiscal year of the
798	798	commission;
799	799	(3) establish fees;
800	800	(4) establish bylaws;
801	801	(5) maintain the commission's financial
802	802	records in accordance with the commission's bylaws;
803	803	(6) meet and take actions that are consistent
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832	832	with the provisions of this compact and the commission's
833	833	bylaws;
834	834	(7) promulgate rules to facilitate and
835	835	coordinate implementation and administration of this compact.
836	836	The rules shall have the force and effect of law and shall be
837	837	binding in all participating states;
838	838	(8) bring and prosecute legal proceedings or
839	839	actions in the name of the commission; provided that the
840	840	standing of any state licensing board to sue or be sued under
841	841	applicable law shall not be affected;
842	842	(9) purchase and maintain insurance and bonds;
843	843	(10) borrow, accept or contract for services
844	844	of personnel, including employees of a participating state;
845	845	(11) hire employees and engage contractors,
846	846	elect or appoint officers, fix compensation, define duties,
847	847	grant individuals appropriate authority to carry out the
848	848	purposes of this compact and establish the commission's
849	849	personnel policies and programs relating to conflicts of
850	850	interest, qualifications of personnel and other related
851	851	personnel matters;
852	852	(12) accept any and all appropriate donations
853	853	and grants of money, equipment, supplies, materials and
854	854	services and receive, use and dispose of the same; provided
855	855	that at all times the commission shall avoid any appearance of
856	856	impropriety or conflict of interest;
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885	885	(13) lease, purchase, accept appropriate gifts
886	886	or donations of or otherwise own, hold, improve or use any
887	887	property, real, personal or mixed; provided that at all times
888	888	the commission shall avoid any appearance of impropriety;
889	889	(14) sell, convey, mortgage, pledge, lease,
890	890	exchange, abandon or otherwise dispose of any property, real,
891	891	personal or mixed;
892	892	(15) establish a budget and make expenditures;
893	893	(16) borrow money;
894	894	(17) appoint committees, including standing
895	895	committees composed of members, state regulators, state
896	896	legislators or their representatives, consumer representatives
897	897	and other interested persons as may be designated in this
898	898	compact and the commission's bylaws;
899	899	(18) provide and receive information from, and
900	900	cooperate with, law enforcement agencies;
901	901	(19) elect a chair, vice chair, secretary,
902	902	treasurer and other officers of the commission as provided in
903	903	the commission's bylaws;
904	904	(20) in addition to powers reserved
905	905	exclusively to the commission under this compact, reserve
906	906	powers for the commission that the executive committee may not
907	907	exercise;
908	908	(21) approve or disapprove a state's
909	909	participation in this compact based on the commission's
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938	938	determination as to whether the state's compact legislation
939	939	departs in a material manner from the model compact language;
940	940	(22) prepare and provide to the participating
941	941	states an annual report; and
942	942	(23) perform other functions as may be
943	943	necessary or appropriate to achieve purposes of this compact
944	944	that are consistent with state regulation of physician
945	945	assistant licensure and practice.
946	946	D. Meetings of the commission shall proceed as
947	947	follows:
948	948	(1) all meetings of the commission that are
949	949	not closed pursuant to this subsection shall be open to the
950	950	public. Notice of public meetings shall be posted on the
951	951	commission's website at least thirty days prior to the public
952	952	meeting;
953	953	(2) notwithstanding Paragraph (1) of this
954	954	subsection, the commission may convene a public meeting by
955	955	providing at least twenty-four hours' prior notice on the
956	956	commission's website, and by any other means as provided in the
957	957	commission's rules, for any of the reasons that the commission
958	958	may dispense with notice of proposed rulemaking under
959	959	Subsection R of Section 10 of this compact;
960	960	(3) the commission may convene in a closed,
961	961	nonpublic meeting or nonpublic part of a public meeting to
962	962	receive legal advice or to discuss:
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991	991	(a) noncompliance of a participating
992	992	state with the state's obligations under this compact;
993	993	(b) the employment, compensation,
994	994	discipline or other matters, practices or procedures related to
995	995	specific employees or to the commission's internal personnel
996	996	practices and procedures;
997	997	(c) current, threatened or reasonably
998	998	anticipated litigation;
999	999	(d) negotiation of contracts for the
1000	1000	purchase, lease or sale of goods, services or real estate;
1001	1001	(e) accusing any person of a crime or
1002	1002	formally censuring any person;
1003	1003	(f) disclosure of trade secrets or
1004	1004	commercial or financial information that is privileged or
1005	1005	confidential;
1006	1006	(g) disclosure of information of a
1007	1007	personal nature where disclosure would constitute a clearly
1008	1008	unwarranted invasion of personal privacy;
1009	1009	(h) disclosure of investigative records
1010	1010	compiled for law enforcement purposes;
1011	1011	(i) disclosure of information related to
1012	1012	any investigative reports prepared by or on behalf of or for
1013	1013	use by the commission or other committee charged with the
1014	1014	responsibility of investigation or determination of compliance
1015	1015	issues pursuant to this compact;
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1044	1044	(j) legal advice; or
1045	1045	(k) matters specifically exempted from
1046	1046	disclosure by federal or participating states' statutes;
1047	1047	(4) if a meeting, or portion of a meeting, is
1048	1048	closed pursuant to this subsection, the chair of the meeting or
1049	1049	the chair's designee shall certify that the meeting or portion
1050	1050	of the meeting may be closed and shall reference each relevant
1051	1051	exempting provision; and
1052	1052	(5) the commission shall keep minutes that
1053	1053	fully and clearly describe all matters discussed in a meeting
1054	1054	and shall provide a full and accurate summary of actions taken,
1055	1055	including a description of the views expressed. All documents
1056	1056	considered in connection with an action shall be identified in
1057	1057	the minutes. All minutes and documents of a closed meeting
1058	1058	shall remain under seal, subject to release by a majority vote
1059	1059	of the commission or order of a court of competent
1060	1060	jurisdiction.
1061	1061	E. The commission shall be financed as follows:
1062	1062	(1) the commission shall pay, or provide for
1063	1063	the payment of, the reasonable expenses of its establishment,
1064	1064	organization and ongoing activities;
1065	1065	(2) the commission may accept any and all
1066	1066	appropriate revenue sources, donations and grants of money,
1067	1067	equipment, supplies, materials and services;
1068	1068	(3) the commission may levy and collect an
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1097	1097	annual assessment from each participating state and may impose
1098	1098	compact privilege fees on licensees of participating states to
1099	1099	whom a compact privilege is granted to cover the cost of the
1100	1100	operations and activities of the commission and its staff,
1101	1101	which shall be in a total amount sufficient to cover its annual
1102	1102	budget as approved by the commission each year for which
1103	1103	revenue is not provided by other sources. The aggregate annual
1104	1104	assessment amount levied on participating states shall be
1105	1105	allocated based upon a formula to be determined by commission
1106	1106	rule. A compact privilege expires when the licensee's
1107	1107	qualifying license in the participating state from which the
1108	1108	licensee applied for the compact privilege expires. If the
1109	1109	licensee terminates the qualifying license in the participating
1110	1110	state from which the licensee applied for the compact privilege
1111	1111	before its scheduled expiration, and the licensee has a
1112	1112	qualifying license in another participating state, the licensee
1113	1113	shall inform the commission that the licensee is changing to
1114	1114	that participating state for the purposes of applying for a
1115	1115	compact privilege and paying to the commission any compact
1116	1116	privilege fee required by commission rule;
1117	1117	(4) the commission shall not incur obligations
1118	1118	of any kind prior to securing the funds adequate to meet the
1119	1119	same; nor shall the commission pledge the credit of any of the
1120	1120	participating states, except by and with the authority of the
1121	1121	participating state; and
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1150	1150	(5) the commission shall keep accurate
1151	1151	accounts of all receipts and disbursements. The receipts and
1152	1152	disbursements of the commission shall be subject to the
1153	1153	financial review and accounting procedures established under
1154	1154	the commission's bylaws. All receipts and disbursements of
1155	1155	funds handled by the commission shall be subject to an annual
1156	1156	financial review by a certified or licensed public accountant,
1157	1157	and the report of the financial review shall be included in and
1158	1158	become part of the annual report of the commission.
1159	1159	F. The executive committee shall function as
1160	1160	follows:
1161	1161	(1) the executive committee has the power to
1162	1162	act on behalf of the commission according to the provisions of
1163	1163	this compact and commission rules;
1164	1164	(2) the executive committee is composed of the
1165	1165	following nine members:
1166	1166	(a) seven voting members who are elected
1167	1167	by the commission from the current membership of the
1168	1168	commission;
1169	1169	(b) one ex-officio, nonvoting member
1170	1170	from a recognized national physician assistant professional
1171	1171	association; and
1172	1172	(c) one ex-officio, nonvoting member
1173	1173	from a recognized national physician assistant certification
1174	1174	organization;
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1203	1203	(3) the ex-officio members of the executive
1204	1204	committee shall be selected by their respective organizations;
1205	1205	(4) the commission may remove any member of
1206	1206	the executive committee as provided in the commission's bylaws;
1207	1207	(5) the executive committee shall meet at
1208	1208	least annually;
1209	1209	(6) the executive committee has the following
1210	1210	duties and responsibilities:
1211	1211	(a) recommending to the commission
1212	1212	changes to the commission's rules or bylaws, changes to the
1213	1213	compact legislation, fees to be paid by participating states,
1214	1214	such as annual dues, and any compact privilege fee charged to
1215	1215	licensees;
1216	1216	(b) ensuring compact administration
1217	1217	services are appropriately provided, contractual or otherwise;
1218	1218	(c) preparing and recommending the
1219	1219	commission's budget;
1220	1220	(d) maintaining financial records on
1221	1221	behalf of the commission;
1222	1222	(e) monitoring compact compliance of
1223	1223	participating states and providing compliance reports to the
1224	1224	commission;
1225	1225	(f) establishing additional committees
1226	1226	as necessary;
1227	1227	(g) exercising the powers and duties of
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1256	1256	the commission during the interim between commission meetings,
1257	1257	except for issuing proposed rulemaking or adopting commission
1258	1258	rules or bylaws, or exercising any other powers and duties
1259	1259	exclusively reserved to the commission by the commission's
1260	1260	rules; and
1261	1261	(h) performing other duties as provided
1262	1262	by the commission's rules or bylaws;
1263	1263	(7) all meetings of the executive committee at
1264	1264	which the executive committee votes or plans to vote on matters
1265	1265	of exercising the powers and duties of the commission shall be
1266	1266	open to the public, and public notice of such meetings shall be
1267	1267	given in the same manner as notice of public meetings; and
1268	1268	(8) the executive committee may convene in a
1269	1269	closed, nonpublic meeting for the same reasons that the
1270	1270	commission may convene in a nonpublic meeting as provided in
1271	1271	this section and shall announce the closed meeting and keep
1272	1272	minutes of the closed meeting as the commission is required
1273	1273	pursuant to this section.
1274	1274	G. With respect to qualified immunity, defense and
1275	1275	indemnification:
1276	1276	(1) the members, officers, executive director,
1277	1277	employees and representatives of the commission shall be immune
1278	1278	from suit and liability, both personally and in their official
1279	1279	capacity, for any claim for damage to or loss of property or
1280	1280	personal injury or other civil liability caused by or arising
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1309	1309	from any actual or alleged act, error or omission that
1310	1310	occurred, or that the person against whom the claim is made had
1311	1311	a reasonable basis for believing occurred within the scope of
1312	1312	commission employment, duties or responsibilities; provided
1313	1313	that nothing in this paragraph shall be construed to protect
1314	1314	any such person from suit or liability for any damage, loss,
1315	1315	injury or liability caused by the intentional or willful or
1316	1316	wanton misconduct of that person. The procurement of insurance
1317	1317	of any type by the commission shall not in any way compromise
1318	1318	or limit the immunity granted by this compact;
1319	1319	(2) the commission shall defend any member,
1320	1320	officer, executive director, employee and representative of the
1321	1321	commission in any civil action seeking to impose liability
1322	1322	arising out of any actual or alleged act, error or omission
1323	1323	that occurred within the scope of commission employment, duties
1324	1324	or responsibilities, or as determined by the commission that
1325	1325	the person against whom the claim is made had a reasonable
1326	1326	basis for believing occurred within the scope of commission
1327	1327	employment, duties or responsibilities; provided that nothing
1328	1328	in this paragraph shall be construed to prohibit that person
1329	1329	from retaining counsel at the person's own expense; and
1330	1330	provided further that the actual or alleged act, error or
1331	1331	omission did not result from that person's intentional or
1332	1332	willful or wanton misconduct;
1333	1333	(3) the commission shall indemnify and hold
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1362	1362	harmless any member, officer, executive director, employee and
1363	1363	representative of the commission for the amount of any
1364	1364	settlement or judgment obtained against that person arising out
1365	1365	of any actual or alleged act, error or omission that occurred
1366	1366	within the scope of commission employment, duties or
1367	1367	responsibilities, or that the person had a reasonable basis for
1368	1368	believing occurred within the scope of commission employment,
1369	1369	duties or responsibilities; provided that the actual or alleged
1370	1370	act, error or omission did not result from the intentional or
1371	1371	willful or wanton misconduct of that person;
1372	1372	(4) venue is proper and judicial proceedings
1373	1373	by or against the commission shall be brought solely and
1374	1374	exclusively in a court of competent jurisdiction where the
1375	1375	principal office of the commission is located. The commission
1376	1376	may waive venue and jurisdictional defenses in any proceedings
1377	1377	as authorized by commission rules;
1378	1378	(5) nothing in this compact shall be construed
1379	1379	as a limitation on the liability of any licensee for
1380	1380	professional malpractice or misconduct, which shall be governed
1381	1381	solely by any other applicable state laws;
1382	1382	(6) nothing in this compact shall be construed
1383	1383	to designate the venue or jurisdiction to bring actions for
1384	1384	alleged acts of malpractice, professional misconduct,
1385	1385	negligence or other civil action pertaining to the practice of
1386	1386	a physician assistant. All such matters shall be determined
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1415	1415	exclusively by state law other than this compact;
1416	1416	(7) nothing in this compact shall be
1417	1417	interpreted to waive or otherwise abrogate a participating
1418	1418	state's state action immunity or state action affirmative
1419	1419	defense with respect to antitrust claims under the federal
1420	1420	Sherman Act, as amended, the federal Clayton Act, as amended,
1421	1421	or any other state or federal antitrust or anticompetitive law
1422	1422	or regulation; and
1423	1423	(8) nothing in this compact shall be construed
1424	1424	to be a waiver of sovereign immunity by the participating
1425	1425	states or by the commission.
1426	1426	SECTION 9. [NEW MATERIAL] DATA SYSTEM.--
1427	1427	A. The commission shall provide for the
1428	1428	development, maintenance, operation and utilization of a
1429	1429	coordinated data and reporting system containing licensure,
1430	1430	adverse actions and data on the existence of significant
1431	1431	investigative information on all licensed physician assistants
1432	1432	and applicants denied a license in participating states.
1433	1433	B. Notwithstanding any other state law to the
1434	1434	contrary, a participating state shall submit a uniform data set
1435	1435	to the data system on all physician assistants to whom this
1436	1436	compact is applicable, using a unique identifier, as required
1437	1437	by the rules of the commission, including:
1438	1438	(1) identifying information;
1439	1439	(2) licensure data;
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1468	1468	(3) adverse actions;
1469	1469	(4) any denial of application for licensure,
1470	1470	and the reason for such denial, excluding the reporting of any
1471	1471	criminal history record information where prohibited by law;
1472	1472	(5) the existence of significant investigative
1473	1473	information; and
1474	1474	(6) other information that may facilitate the
1475	1475	administration of this compact, as determined by the rules of
1476	1476	the commission.
1477	1477	C. Significant investigative information pertaining
1478	1478	to a licensee in any participating state shall only be
1479	1479	available to other participating states.
1480	1480	D. The commission shall promptly notify all
1481	1481	participating states of any adverse action that has been
1482	1482	reported to the commission. Adverse action information shall
1483	1483	be available to any participating state.
1484	1484	E. Participating states contributing information to
1485	1485	the data system may, in accordance with state or federal law,
1486	1486	designate information that may not be shared with the public
1487	1487	without the express permission of the contributing state.
1488	1488	Notwithstanding any such designation, the information shall be
1489	1489	reported to the commission through the data system.
1490	1490	F. Any information submitted to the data system
1491	1491	that is subsequently expunged pursuant to federal law or the
1492	1492	laws of the participating state contributing the information
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1521	1521	shall be removed from the data system upon reporting of the
1522	1522	expungement by the participating state to the commission.
1523	1523	G. The records and information provided to a
1524	1524	participating state pursuant to this compact or through the
1525	1525	data system, when certified by the commission or an agent of
1526	1526	the commission, shall constitute the authenticated business
1527	1527	records of the commission and shall be entitled to any
1528	1528	associated hearsay exception in any relevant judicial,
1529	1529	quasi-judicial or administrative proceedings in a participating
1530	1530	state.
1531	1531	SECTION 10. [NEW MATERIAL] RULEMAKING.--
1532	1532	A. The commission shall exercise rulemaking powers
1533	1533	pursuant to the criteria set forth in this section and the
1534	1534	rules promulgated pursuant to this section. Commission rules
1535	1535	shall become binding as of the date specified by the commission
1536	1536	for each rule.
1537	1537	B. The commission shall promulgate reasonable rules
1538	1538	in order to effectively and efficiently implement and
1539	1539	administer this compact and achieve the compact's purposes. A
1540	1540	commission rule shall be invalid and have no force or effect
1541	1541	only if a court of competent jurisdiction holds that the rule
1542	1542	is invalid because the commission exercised its rulemaking
1543	1543	authority in a manner that is beyond the scope of the purposes
1544	1544	of or the powers granted by this compact or based upon another
1545	1545	applicable standard of review.
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1574	1574	C. The rules of the commission shall have the force
1575	1575	of law in each participating state; provided that when the
1576	1576	rules of the commission conflict with the laws of the
1577	1577	participating state that establish the medical services a
1578	1578	physician assistant may perform in the participating state, as
1579	1579	held by a court of competent jurisdiction, the rules of the
1580	1580	commission shall be ineffective in that state to the extent of
1581	1581	the conflict.
1582	1582	D. If a majority of the legislatures of the
1583	1583	participating states rejects a commission rule by enactment of
1584	1584	a statute or resolution in the same manner used to adopt this
1585	1585	compact within four years of the date of adoption of the rule,
1586	1586	the rule shall have no further force and effect in any
1587	1587	participating state or to any state applying to participate in
1588	1588	the compact.
1589	1589	E. Commission rules shall be adopted at a regular
1590	1590	or special meeting of the commission.
1591	1591	F. Prior to promulgation and adoption of a final
1592	1592	rule by the commission, and at least thirty days in advance of
1593	1593	the meeting at which the rule will be considered and voted
1594	1594	upon, the commission shall file a notice of proposed
1595	1595	rulemaking:
1596	1596	(1) on the website of the commission or other
1597	1597	publicly accessible platform;
1598	1598	(2) to persons who have requested notice of
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1627	1627	the commission's notices of proposed rulemaking; and
1628	1628	(3) in other ways that the commission may
1629	1629	specify by rule.
1630	1630	G. The notice of proposed rulemaking shall include:
1631	1631	(1) the time, date and location of the public
1632	1632	hearing on the proposed rule and the proposed time, date and
1633	1633	location of the meeting in which the proposed rule will be
1634	1634	considered and voted upon;
1635	1635	(2) the text of the proposed rule and the
1636	1636	reason for the proposed rule;
1637	1637	(3) a request for comments on the proposed
1638	1638	rule from any interested person and the date by which written
1639	1639	comments must be received; and
1640	1640	(4) the manner in which interested persons may
1641	1641	submit notice to the commission of their intention to attend
1642	1642	the public hearing or provide written comments.
1643	1643	H. Prior to adoption of a proposed rule, the
1644	1644	commission shall allow persons to submit written data, facts,
1645	1645	opinions and arguments, which the commission shall make
1646	1646	available to the public.
1647	1647	I. If the hearing is to be held via electronic
1648	1648	means, the commission shall publish the mechanism for access to
1649	1649	the electronic hearing.
1650	1650	J. A person wishing to be heard at the hearing
1651	1651	shall, as directed in the notice of proposed rulemaking, no
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1680	1680	less than five business days before the scheduled date of the
1681	1681	hearing, notify the commission of the person's desire to appear
1682	1682	and testify at the hearing. Hearings shall be conducted in a
1683	1683	manner that provides each person who wishes to comment a fair
1684	1684	and reasonable opportunity to comment orally or in writing.
1685	1685	K. All hearings shall be recorded. A copy of the
1686	1686	recording and the written comments, data, facts, opinions and
1687	1687	arguments received in response to the proposed rulemaking shall
1688	1688	be made available upon request.
1689	1689	L. Nothing in this section shall be construed as
1690	1690	requiring a separate hearing on each proposed rule. Proposed
1691	1691	rules may be grouped for the convenience of the commission at
1692	1692	hearings required by this section.
1693	1693	M. Following a public hearing, the commission shall
1694	1694	consider all written and oral comments timely received.
1695	1695	N. The commission shall, by majority vote of all
1696	1696	delegates, take final action on a proposed rule and shall
1697	1697	determine the effective date of the rule, if adopted, based on
1698	1698	the rulemaking record and the full text of the rule. If
1699	1699	adopted, the rule shall be posted on the commission's website.
1700	1700	O. The commission may adopt changes to a proposed
1701	1701	rule; provided that the changes do not enlarge the original
1702	1702	purpose of the proposed rule.
1703	1703	P. The commission shall provide on the commission's
1704	1704	website an explanation of the reasons for substantive changes
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1733	1733	made to a proposed rule as well as reasons for substantive
1734	1734	changes not made that were recommended by commenters.
1735	1735	Q. The commission shall determine a reasonable
1736	1736	effective date for a rule. Except for an emergency as provided
1737	1737	in Subsection R of this section, the effective date of a rule
1738	1738	shall be no sooner than thirty days after the commission issued
1739	1739	the notice that the commission adopted the rule.
1740	1740	R. Upon determination that an emergency exists, the
1741	1741	commission may consider and adopt an emergency rule with
1742	1742	twenty-four hours' prior notice, without the opportunity for
1743	1743	comment or hearing; provided that the usual rulemaking
1744	1744	procedures provided in this compact and in this section shall
1745	1745	be retroactively applied to the rule as soon as reasonably
1746	1746	possible, but in no event later than ninety days after the
1747	1747	effective date of the rule. For the purposes of this compact,
1748	1748	an emergency rule is a rule that must be adopted immediately by
1749	1749	the commission in order to:
1750	1750	(1) meet an imminent threat to public health,
1751	1751	safety or welfare;
1752	1752	(2) prevent a loss of commission or
1753	1753	participating state funds;
1754	1754	(3) meet a deadline for the promulgation of a
1755	1755	commission rule that is established by federal law or rule; or
1756	1756	(4) protect public health and safety.
1757	1757	S. The commission or an authorized committee of the
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1786	1786	commission may direct revisions to a previously adopted
1787	1787	commission rule for purposes of correcting typographical
1788	1788	errors, errors in format, errors in consistency or grammatical
1789	1789	errors. Public notice of any revisions shall be posted on the
1790	1790	website of the commission. The revision shall be subject to
1791	1791	challenge by any person for a period of thirty days after
1792	1792	posting. The revision may be challenged only on grounds that
1793	1793	the revision results in a material change to a rule. A
1794	1794	challenge shall be made as set forth in the notice of revisions
1795	1795	and delivered to the commission prior to the end of the notice
1796	1796	period. If no challenge is made, the revision shall take
1797	1797	effect without further action. If the revision is challenged,
1798	1798	the revision shall not take effect without the approval of the
1799	1799	commission.
1800	1800	T. No participating state's rulemaking requirements
1801	1801	shall apply under this compact.
1802	1802	SECTION 11. [NEW MATERIAL] OVERSIGHT--DISPUTE
1803	1803	RESOLUTION--ENFORCEMENT.--
1804	1804	A. The executive and judicial branches of
1805	1805	government in each participating state shall enforce this
1806	1806	compact and take all actions necessary and appropriate to
1807	1807	implement the compact.
1808	1808	B. Venue is proper and judicial proceedings by or
1809	1809	against the commission shall be brought solely and exclusively
1810	1810	in a court of competent jurisdiction where the principal office
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1839	1839	of the commission is located. The commission may waive venue
1840	1840	and jurisdictional defenses to the extent the commission adopts
1841	1841	or consents to participate in alternative dispute resolution
1842	1842	proceedings. Nothing in this compact shall affect or limit the
1843	1843	selection or propriety of venue in any action against a
1844	1844	licensee for professional malpractice, misconduct or any
1845	1845	similar matter.
1846	1846	C. The commission is entitled to receive service of
1847	1847	process in any proceeding regarding the enforcement or
1848	1848	interpretation of this compact or the commission's rules and
1849	1849	has standing to intervene in the proceeding for all purposes.
1850	1850	Failure to provide the commission with service of process shall
1851	1851	render a judgment or order void as to the commission, this
1852	1852	compact or commission rules.
1853	1853	D. If the commission determines that a
1854	1854	participating state has defaulted in the performance of the
1855	1855	state's obligations or responsibilities under this compact or
1856	1856	commission rules, the commission shall provide written notice
1857	1857	to the defaulting state and other participating states. The
1858	1858	notice shall describe the default, the proposed means of curing
1859	1859	the default and any other action that the commission may take
1860	1860	and shall offer remedial training and specific technical
1861	1861	assistance regarding the default.
1862	1862	E. If a state in default fails to cure the default,
1863	1863	the defaulting state may be terminated from this compact upon
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1892	1892	an affirmative vote of a majority of the delegates of the
1893	1893	participating states, and all rights, privileges and benefits
1894	1894	conferred by this compact upon the state may be terminated on
1895	1895	the effective date of termination. A cure of the default does
1896	1896	not relieve the offending state of obligations or liabilities
1897	1897	incurred during the period of default.
1898	1898	F. Termination of participation in this compact
1899	1899	shall be imposed only after all other means of securing
1900	1900	compliance have been exhausted. Notice of intent to suspend or
1901	1901	terminate shall be given by the commission to the governor, the
1902	1902	majority and minority leaders of the defaulting state's
1903	1903	legislature and the licensing boards of each of the
1904	1904	participating states.
1905	1905	G. A state that has been terminated is responsible
1906	1906	for all assessments, obligations and liabilities incurred
1907	1907	through the effective date of termination, including
1908	1908	obligations that extend beyond the effective date of
1909	1909	termination.
1910	1910	H. The commission shall not bear any cost related
1911	1911	to a state that is found to be in default or that has been
1912	1912	terminated from the compact, unless agreed upon in writing
1913	1913	between the commission and the defaulting state.
1914	1914	I. The defaulting state may appeal the state's
1915	1915	termination from this compact by the commission by petitioning
1916	1916	the United States district court for the District of Columbia
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1945	1945	or the federal district where the commission has its principal
1946	1946	offices. The prevailing party shall be awarded all costs of
1947	1947	the litigation, including reasonable attorney fees.
1948	1948	J. Upon the termination of a state's participation
1949	1949	in this compact, the state shall immediately provide notice to
1950	1950	all licensees within that state of the termination. Licensees
1951	1951	who:
1952	1952	(1) have been granted a compact privilege in
1953	1953	that state shall retain the compact privilege for one hundred
1954	1954	eighty days following the effective date of the termination;
1955	1955	and
1956	1956	(2) are licensed in that state who have been
1957	1957	granted a compact privilege in a participating state shall
1958	1958	retain the compact privilege for one hundred eighty days unless
1959	1959	the licensee also has a qualifying license in a participating
1960	1960	state or obtains a qualifying license in a participating state
1961	1961	before the one-hundred-eighty-day period ends, in which case
1962	1962	the compact privilege shall continue.
1963	1963	K. Upon request by a participating state, the
1964	1964	commission shall attempt to resolve disputes related to this
1965	1965	compact that arise among participating states and between
1966	1966	participating and nonparticipating states. The commission
1967	1967	shall promulgate a rule providing for both mediation and
1968	1968	binding dispute resolution for disputes as appropriate.
1969	1969	L. The commission, in the reasonable exercise of
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1976	1976	4
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1978	1978	6
1979	1979	7
1980	1980	8
1981	1981	9
1982	1982	10
1983	1983	11
1984	1984	12
1985	1985	13
1986	1986	14
1987	1987	15
1988	1988	16
1989	1989	17
1990	1990	18
1991	1991	19
1992	1992	20
1993	1993	21
1994	1994	22
1995	1995	23
1996	1996	24
1997	1997	25
1998	1998	the commission's discretion, shall enforce the provisions of
1999	1999	this compact and rules of the commission. If compliance is not
2000	2000	secured after all means to secure compliance have been
2001	2001	exhausted, by majority vote, the commission may initiate legal
2002	2002	action in the United States district court for the District of
2003	2003	Columbia or the federal district where the commission has its
2004	2004	principal offices, against a participating state in default to
2005	2005	enforce compliance with the provisions of this compact and the
2006	2006	commission's promulgated rules and bylaws. The relief sought
2007	2007	may include both injunctive relief and damages. In the event
2008	2008	that judicial enforcement is necessary, the prevailing party
2009	2009	shall be awarded all costs of such litigation, including
2010	2010	reasonable attorney fees.
2011	2011	M. The remedies provided in this compact shall not
2012	2012	be the exclusive remedies of the commission. The commission
2013	2013	may pursue any other remedies available under federal or state
2014	2014	law.
2015	2015	N. A participating state may initiate legal action
2016	2016	against the commission in the United States district court for
2017	2017	the District of Columbia or the federal district where the
2018	2018	commission has its principal offices to enforce compliance with
2019	2019	the provisions of this compact and the commission's rules. The
2020	2020	relief sought may include both injunctive relief and damages.
2021	2021	In the event judicial enforcement is necessary, the prevailing
2022	2022	party shall be awarded all costs of such litigation, including
2023	2023	.230663.1
2024	2024	- 38 - underscored material = new
2025	2025	[bracketed material] = delete
2026	2026	1
2027	2027	2
2028	2028	3
2029	2029	4
2030	2030	5
2031	2031	6
2032	2032	7
2033	2033	8
2034	2034	9
2035	2035	10
2036	2036	11
2037	2037	12
2038	2038	13
2039	2039	14
2040	2040	15
2041	2041	16
2042	2042	17
2043	2043	18
2044	2044	19
2045	2045	20
2046	2046	21
2047	2047	22
2048	2048	23
2049	2049	24
2050	2050	25
2051	2051	reasonable attorney fees. No entity other than a participating
2052	2052	state shall enforce this compact against the commission.
2053	2053	SECTION 12. [NEW MATERIAL] EFFECTIVE DATE OF THE
2054	2054	PHYSICIAN ASSISTANT LICENSURE INTERSTATE COMPACT.--
2055	2055	A. This compact shall come into effect on the date
2056	2056	on which this compact statute is enacted into law in the
2057	2057	seventh participating state.
2058	2058	B. On or after the effective date of this compact,
2059	2059	the commission shall convene and review the enactment of each
2060	2060	of the participating state statutes that enacted the compact
2061	2061	prior to the commission convening to determine if the statute
2062	2062	enacted by each participating state is materially different
2063	2063	than the model compact.
2064	2064	C. A charter participating state whose enactment is
2065	2065	found to be materially different from the model compact shall
2066	2066	be entitled to the default process set forth in Section 11 of
2067	2067	this compact. If any participating state later withdraws from
2068	2068	this compact or its participation is terminated, the commission
2069	2069	shall remain in existence and the compact shall remain in
2070	2070	effect even if the number of participating states is fewer than
2071	2071	seven. Participating states enacting this compact subsequent
2072	2072	to the commission convening shall be subject to the process set
2073	2073	forth in Paragraph (21) of Subsection C of Section 8 of this
2074	2074	compact to determine if the enactments are materially different
2075	2075	from the model compact and whether those states qualify for
2076	2076	.230663.1
2077	2077	- 39 - underscored material = new
2078	2078	[bracketed material] = delete
2079	2079	1
2080	2080	2
2081	2081	3
2082	2082	4
2083	2083	5
2084	2084	6
2085	2085	7
2086	2086	8
2087	2087	9
2088	2088	10
2089	2089	11
2090	2090	12
2091	2091	13
2092	2092	14
2093	2093	15
2094	2094	16
2095	2095	17
2096	2096	18
2097	2097	19
2098	2098	20
2099	2099	21
2100	2100	22
2101	2101	23
2102	2102	24
2103	2103	25
2104	2104	participation in the compact.
2105	2105	D. Participating states enacting this compact
2106	2106	subsequent to the seven initial participating states shall be
2107	2107	subject to the process set forth in Paragraph (21) of
2108	2108	Subsection C of Section 8 of this compact to determine if the
2109	2109	enactments are materially different from the model compact and
2110	2110	whether the states qualify for participation in the compact.
2111	2111	E. All actions taken for the benefit of the
2112	2112	commission or in furtherance of the purposes of the
2113	2113	administration of this compact prior to the effective date of
2114	2114	the compact or the commission coming into existence shall be
2115	2115	considered to be actions of the commission unless specifically
2116	2116	repudiated by the commission.
2117	2117	F. Any state that joins this compact shall be
2118	2118	subject to the commission's rules and bylaws as they exist on
2119	2119	the date on which the compact becomes law in that state. Any
2120	2120	rule that has been previously adopted by the commission shall
2121	2121	have the full force and effect of law on the day the compact
2122	2122	becomes law in that state.
2123	2123	G. Any participating state may withdraw from this
2124	2124	compact by enacting a statute repealing the same.
2125	2125	H. A participating state's withdrawal shall not
2126	2126	take effect until one hundred eighty days after enactment of
2127	2127	the repealing statute. During this one-hundred-eighty-day
2128	2128	period, all compact privileges that were in effect in the
2129	2129	.230663.1
2130	2130	- 40 - underscored material = new
2131	2131	[bracketed material] = delete
2132	2132	1
2133	2133	2
2134	2134	3
2135	2135	4
2136	2136	5
2137	2137	6
2138	2138	7
2139	2139	8
2140	2140	9
2141	2141	10
2142	2142	11
2143	2143	12
2144	2144	13
2145	2145	14
2146	2146	15
2147	2147	16
2148	2148	17
2149	2149	18
2150	2150	19
2151	2151	20
2152	2152	21
2153	2153	22
2154	2154	23
2155	2155	24
2156	2156	25
2157	2157	withdrawing state and were granted to licensees licensed in the
2158	2158	withdrawing state shall remain in effect. If any licensee
2159	2159	licensed in the withdrawing state is also licensed in another
2160	2160	participating state or obtains a license in another
2161	2161	participating state within the one-hundred-eighty-day period,
2162	2162	the licensee's compact privileges in other participating states
2163	2163	shall not be affected.
2164	2164	I. Withdrawal of a participating state shall not
2165	2165	affect the continuing requirement of the state licensing board
2166	2166	or boards of the withdrawing state to comply with the
2167	2167	investigative and adverse action reporting requirements of the
2168	2168	compact prior to the effective date of withdrawal.
2169	2169	J. Upon the enactment of a statute withdrawing a
2170	2170	participating state from this compact, the withdrawing state
2171	2171	shall immediately provide notice of the withdrawal to all
2172	2172	licensees within that state. The withdrawing state shall
2173	2173	continue to recognize all licenses granted pursuant to this
2174	2174	compact for a minimum of one hundred eighty days after the date
2175	2175	of the notice of withdrawal.
2176	2176	K. Nothing contained in this compact shall be
2177	2177	construed to invalidate or prevent any physician assistant
2178	2178	licensure agreement or other cooperative arrangement between
2179	2179	participating states and between a participating state and
2180	2180	nonparticipating state that does not conflict with the
2181	2181	provisions of this compact.
2182	2182	.230663.1
2183	2183	- 41 - underscored material = new
2184	2184	[bracketed material] = delete
2185	2185	1
2186	2186	2
2187	2187	3
2188	2188	4
2189	2189	5
2190	2190	6
2191	2191	7
2192	2192	8
2193	2193	9
2194	2194	10
2195	2195	11
2196	2196	12
2197	2197	13
2198	2198	14
2199	2199	15
2200	2200	16
2201	2201	17
2202	2202	18
2203	2203	19
2204	2204	20
2205	2205	21
2206	2206	22
2207	2207	23
2208	2208	24
2209	2209	25
2210	2210	L. This compact may be amended by the participating
2211	2211	states. No amendment to this compact shall become effective
2212	2212	and binding upon any participating state until it is enacted
2213	2213	materially in the same manner into the laws of all
2214	2214	participating states as determined by the commission.
2215	2215	SECTION 13. [NEW MATERIAL] CONSTRUCTION AND
2216	2216	SEVERABILITY.--
2217	2217	A. This compact and the commission's rulemaking
2218	2218	authority shall be liberally construed so as to effectuate the
2219	2219	purposes and the implementation and administration of the
2220	2220	compact. Provisions of this compact expressly authorizing or
2221	2221	requiring the promulgation of rules shall not be construed to
2222	2222	limit the commission's rulemaking authority solely for those
2223	2223	purposes.
2224	2224	B. The provisions of this compact shall be
2225	2225	severable, and if any phrase, clause, sentence or provision of
2226	2226	this compact is held by a court of competent jurisdiction to be
2227	2227	contrary to the constitution of any participating state, a
2228	2228	state seeking participation in the compact or the United
2229	2229	States, or if the applicability of the compact to any
2230	2230	government, agency, person or circumstance is held to be
2231	2231	unconstitutional by a court of competent jurisdiction, the
2232	2232	validity of the remainder of the compact and the applicability
2233	2233	thereof to any other government, agency, person or circumstance
2234	2234	shall not be affected.
2235	2235	.230663.1
2236	2236	- 42 - underscored material = new
2237	2237	[bracketed material] = delete
2238	2238	1
2239	2239	2
2240	2240	3
2241	2241	4
2242	2242	5
2243	2243	6
2244	2244	7
2245	2245	8
2246	2246	9
2247	2247	10
2248	2248	11
2249	2249	12
2250	2250	13
2251	2251	14
2252	2252	15
2253	2253	16
2254	2254	17
2255	2255	18
2256	2256	19
2257	2257	20
2258	2258	21
2259	2259	22
2260	2260	23
2261	2261	24
2262	2262	25
2263	2263	C. Notwithstanding Subsection B of this section,
2264	2264	the commission may deny a state's participation in this compact
2265	2265	or, in accordance with the requirements of Section 11 of this
2266	2266	compact, terminate a participating state's participation in the
2267	2267	compact, if it determines that a constitutional requirement of
2268	2268	a participating state is, or would be with respect to a state
2269	2269	seeking to participate in the compact, a material departure
2270	2270	from the compact. Otherwise, if this compact shall be held to
2271	2271	be contrary to the constitution of any participating state, the
2272	2272	compact shall remain in full force and effect as to the
2273	2273	remaining participating states and in full force and effect as
2274	2274	to the participating state affected as to all severable
2275	2275	matters.
2276	2276	SECTION 14. [NEW MATERIAL] BINDING EFFECT OF COMPACT.--
2277	2277	A. Nothing in this compact prevents the enforcement
2278	2278	of any other law of a participating state that is not
2279	2279	inconsistent with this compact.
2280	2280	B. Any laws in a participating state in conflict
2281	2281	with this compact are superseded to the extent of the conflict.
2282	2282	C. All agreements between the commission and the
2283	2283	participating states are binding in accordance with their
2284	2284	terms.
2285	2285	- 43 -
2286	2286	.230663.1