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HOUSE BILL 413
57
TH LEGISLATURE
-
STATE
OF
NEW
MEXICO
-
FIRST SESSION
,
2025
INTRODUCED BY
Gail Armstrong and Harlan Vincent and Jenifer Jones
AN ACT
RELATING TO INTERGOVERNMENTAL AGREEMENTS; ENACTING THE
PHYSICIAN ASSISTANT LICENSURE INTERSTATE COMPACT.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
SECTION 1. [NEW MATERIAL] SHORT TITLE.--This act may be
cited as the "Physician Assistant Licensure Interstate
Compact".
SECTION 2. [NEW MATERIAL] PURPOSE.--In order to
strengthen access to medical services, and in recognition of
the advances in the delivery of medical services, the
participating states of the Physician Assistant Licensure
Interstate Compact have allied in common purpose to develop a
comprehensive process that complements the existing authority
of state licensing boards to license and discipline physician
assistants and seeks to enhance the portability of a license to
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practice as a physician assistant while safeguarding the safety
of patients. This compact allows medical services to be
provided by physician assistants via the mutual recognition of
the licensee's qualifying license by other compact-
participating states. This compact also adopts the prevailing
standard for physician assistant licensure and affirms that the
practice and delivery of medical services by a licensed
physician assistant occurs where the patient is located at the
time of the patient encounter and therefore requires the
physician assistant to be under the jurisdiction of the state
licensing board where the patient is located. State licensing
boards that participate in this compact retain the jurisdiction
to impose adverse actions against a compact privilege in that
state issued to a physician assistant through the procedures of
this compact. The Physician Assistant Licensure Interstate
Compact will alleviate burdens for military families by
allowing active duty military personnel and their spouses to
obtain a compact privilege based on having an unrestricted
license in good standing from a participating state.
SECTION 3. [NEW MATERIAL] DEFINITIONS.--As used in the
Physician Assistant Licensure Interstate Compact:
A. "adverse action" means any administrative,
civil, equitable or criminal action permitted by a state's laws
that is imposed by a licensing board or other authority against
a physician assistant license or license application or compact
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privilege, including license denial, censure, revocation,
suspension, probation, monitoring of the licensee or
restriction on the licensee's practice;
B. "commission", "physician assistant licensure
compact commission" or "compact commission" means the national
administrative body created pursuant to Section 8 of this
compact;
C. "compact" means the Physician Assistant
Licensure Interstate Compact;
D. "compact privilege" means the authorization
granted by a remote state to allow a licensee from another
participating state to practice as a physician assistant to
provide medical services and other licensed activity to a
patient located in the remote state under the remote state's
laws and regulations;
E. "conviction" means a finding by a court that an
individual is guilty of a felony or misdemeanor offense through
adjudication or entry of a plea of guilt or no contest to the
charge by the offender;
F. "criminal background check" means the submission
of fingerprints or other biometric-based information for a
license applicant for the purpose of obtaining that applicant's
criminal history record information from the state's criminal
history record repository;
G. "data system" means the repository of
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information about licensees, including license status and
adverse actions, that is created and administered under the
terms of this compact;
H. "executive committee" means a group of directors
and ex-officio individuals elected or appointed pursuant to
Section 8 of this compact;
I. "impaired practitioner" means a physician
assistant whose practice is adversely affected by health-
related conditions that impact the physician assistant's
ability to practice;
J. "investigative information" means information,
records or documents received or generated by a licensing board
pursuant to an investigation;
K. "jurisprudence requirement" means the assessment
of an individual's knowledge of the laws and rules governing
the practice of a physician assistant in a state;
L. "license" means current authorization by a
state, other than authorization pursuant to a compact
privilege, for a physician assistant to provide medical
services that would be unlawful without current authorization;
M. "licensee" means an individual who holds a
license from a state to provide medical services as a physician
assistant;
N. "licensing board" means any state entity
authorized to license and otherwise regulate physician
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assistants;
O. "medical services" means health care services
provided for the diagnosis, prevention, treatment, cure or
relief of a health condition, injury or disease, as defined by
a state's laws and regulations;
P. "model compact" means the model for the
Physician Assistant Licensure Interstate Compact on file with
the council of state governments or other entity as designated
by the commission;
Q. "participating state" means a state that has
enacted this compact;
R. "physician assistant" means an individual who is
licensed as a physician assistant in a state. For purposes of
this compact, any other title or status adopted by a state to
replace the term "physician assistant" shall be deemed
synonymous with "physician assistant" and shall confer the same
rights and responsibilities to the licensee under the
provisions of this compact at the time of its enactment;
S. "qualifying license" means an unrestricted
license issued by a participating state to provide medical
services as a physician assistant;
T. "remote state" means a participating state where
a licensee who is not licensed as a physician assistant is
exercising or seeking to exercise the compact privilege;
U. "rule" means a regulation promulgated by an
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entity that has the force and effect of law;
V. "significant investigative information" means
investigative information that a licensing board, after an
inquiry or investigation that includes notification and an
opportunity for the physician assistant to respond if required
by state law, has reason to believe is not groundless and, if
proven true, would indicate more than a minor infraction; and
W. "state" means any state, commonwealth, district
or territory of the United States.
SECTION 4. [NEW MATERIAL] STATE PARTICIPATION IN
COMPACT.--
A. To participate in the compact, a participating
state shall:
(1) license physician assistants;
(2) participate in the commission's data
system;
(3) have a mechanism in place for receiving
and investigating complaints against licensees and license
applicants;
(4) notify the commission, in compliance with
the terms of the compact and commission rules, of any adverse
action against a licensee or license applicant and the
existence of significant investigative information regarding a
licensee or license applicant;
(5) fully implement a criminal background
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check requirement, within a time frame established by
commission rule, by requiring the state's licensing board to
receive the results of a criminal background check and report
to the commission whether the license applicant has been
granted a license;
(6) comply with the rules of the compact
commission;
(7) use passage of a recognized national exam,
such as the national commission on certification of physician
assistants' physician assistant national certifying
examination, as a requirement for physician assistant
licensure; and
(8) grant the compact privilege to a holder of
a qualifying license in a participating state.
B. Nothing in this compact prohibits a
participating state from charging a fee for granting the
compact privilege.
SECTION 5. [NEW MATERIAL] COMPACT PRIVILEGE.--
A. To exercise the compact privilege, a licensee
shall:
(1) have graduated from a physician assistant
program accredited by the accreditation review commission on
education for the physician assistant, inc. or other programs
authorized by commission rule;
(2) hold current national commission on
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certification of physician assistants certification;
(3) have no felony or misdemeanor conviction;
(4) have never had a controlled substance
license, permit or registration suspended or revoked by a state
or by the United States drug enforcement administration;
(5) have a unique identifier as determined by
commission rule;
(6) hold a qualifying license;
(7) have had no revocation of a license or
limitation or restriction on any license currently held due to
an adverse action;
(8) if the licensee has had a limitation or
restriction on a license or compact privilege due to an adverse
action, not exercise the compact privilege until two years have
elapsed from the date on which the license or compact privilege
is no longer limited or restricted due to the adverse action;
(9) notify the compact commission that the
licensee is seeking the compact privilege in a remote state;
(10) meet any jurisprudence requirement of a
remote state in which the licensee is seeking to practice under
the compact privilege and pay any fees applicable to satisfying
the jurisprudence requirement; and
(11) report to the commission any adverse
action taken by a nonparticipating state within thirty days
after the action is taken.
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B. The compact privilege is valid until the
expiration or revocation of the qualifying license unless
terminated pursuant to an adverse action. The licensee shall
also comply with all of the requirements of Subsection A of
this section to maintain the compact privilege in a remote
state. If the participating state takes adverse action against
a qualifying license, the licensee shall lose the compact
privilege in any remote state in which the licensee has a
compact privilege until all of the following occur:
(1) the license is no longer limited or
restricted; and
(2) two years have elapsed from the date on
which the license is no longer limited or restricted due to the
adverse action.
C. Once a restricted or limited license satisfies
the requirements of Subsection B of this section, the licensee
shall meet the requirements of Subsection A of this section to
re-obtain a compact privilege in any remote state.
D. For each remote state in which a physician
assistant seeks authority to prescribe controlled substances,
the physician assistant shall satisfy all requirements imposed
by the state in granting or renewing the authority.
E. If a compact privilege has been revoked or is
limited or restricted in a participating state for conduct that
would not be a basis for disciplinary action in a participating
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state in which the licensee is practicing or applying to
practice under a compact privilege, that participating state
shall have the discretion not to consider such action as an
adverse action requiring the denial or removal of a compact
privilege in that state.
SECTION 6. [NEW MATERIAL] DESIGNATION OF THE STATE FROM
WHICH A LICENSEE IS APPLYING FOR A COMPACT PRIVILEGE.--Upon a
licensee's application for a compact privilege, the licensee
shall identify to the commission the participating state from
which the licensee is applying, in accordance with applicable
rules adopted by the commission, and be subject to the
following requirements:
A. when applying for a compact privilege, the
licensee shall provide the commission with the address of the
licensee's primary residence and thereafter shall immediately
report to the commission any change in the address of the
licensee's primary residence; and
B. when applying for a compact privilege, the
licensee is required to consent to accept service of process by
mail at the licensee's primary residence on file with the
commission with respect to any action brought, or investigation
conducted, by the commission or a participating state,
including a subpoena.
SECTION 7. [NEW MATERIAL] ADVERSE ACTIONS.--
A. A participating state in which a licensee is
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licensed shall have exclusive power to impose adverse action
against the qualifying license issued by that participating
state.
B. In addition to the other powers conferred by
state law, a remote state shall have the authority, in
accordance with state due process law, to do all of the
following:
(1) take adverse action against a physician
assistant's compact privilege within that state to remove a
licensee's compact privilege or take other action necessary
under applicable law to protect the health and safety of the
state's residents; and
(2) issue subpoenas for hearings and
investigations that require the attendance and testimony of
witnesses as well as the production of evidence. Subpoenas
issued by a licensing board in a participating state for the
attendance and testimony of witnesses or the production of
evidence from another participating state shall be enforced in
the latter state by any court of competent jurisdiction,
according to the practice and procedure of that court
applicable to subpoenas issued in proceedings pending before
that court. The issuing authority shall pay any witness fees,
travel expenses, mileage and other fees required by the service
statutes of the state in which the witnesses or evidence are
located.
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C. Notwithstanding Paragraph (2) of Subsection B of
this section, subpoenas shall not be issued by a participating
state to gather evidence of conduct in another state that is
lawful in that other state for the purpose of taking adverse
action against a licensee's compact privilege or application
for a compact privilege in that participating state. Nothing
in this compact authorizes a participating state to impose
discipline against a physician assistant's compact privilege or
to deny an application for a compact privilege in that
participating state for the individual's otherwise lawful
practice in another state.
D. For purposes of taking adverse action, the
participating state that issued the qualifying license shall
give the same priority and effect to reported conduct received
from any other participating state as it would if the conduct
had occurred within the participating state that issued the
qualifying license. In so doing, that participating state
shall apply the state's own laws to determine appropriate
action.
E. A participating state, if otherwise permitted by
state law, may recover from the affected physician assistant
the costs of investigations and disposition of cases resulting
from any adverse action taken against that physician assistant.
F. A participating state may take adverse action
based on the factual findings of a remote state; provided that
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the participating state follows its own procedures for taking
the adverse action.
G. In addition to the authority granted to a
participating state by the state's physician assistant laws and
regulations or other applicable state law, any participating
state may participate with other participating states in joint
investigations of licensees. Participating states shall share
any investigative, litigation or compliance materials in
furtherance of any joint or individual investigation initiated
under this compact.
H. If an adverse action is taken against a
physician assistant's qualifying license, the physician
assistant's compact privilege in all remote states shall be
deactivated until two years have elapsed after all restrictions
have been removed from the state qualifying license. All
disciplinary orders by the participating state that issued the
qualifying license that impose adverse action against a
physician assistant's license shall include a statement that
the physician assistant's compact privilege is deactivated in
all participating states during the pendency of the order.
I. If any participating state takes adverse action,
the participating state shall promptly notify the administrator
of the data system.
SECTION 8. [NEW MATERIAL] PHYSICIAN ASSISTANT LICENSURE
COMPACT COMMISSION.--
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A. The participating states hereby create and
establish a joint government agency and national administrative
body known as "the physician assistant licensure compact
commission". The commission is an instrumentality of the
participating states acting jointly and not an instrumentality
of any one state. The commission shall come into existence on
or after the effective date of the compact as set forth in
Section 12 of this compact.
B. Membership, voting and meetings of the
commission shall proceed as follows:
(1) each participating state shall have and be
limited to one delegate selected by that participating state's
licensing board or, if the state has more than one licensing
board, selected collectively by the participating state's
licensing boards;
(2) a delegate shall be either:
(a) a current physician assistant,
physician or public member of a licensing board or physician
assistant council or committee; or
(b) an administrator of a licensing
board;
(3) a delegate may be removed or suspended
from office as provided by the laws of the state from which the
delegate is appointed;
(4) a participating state's licensing board
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shall fill any vacancy occurring in the commission within sixty
days;
(5) each delegate shall be entitled to one
vote on all matters voted on by the commission and shall
otherwise have an opportunity to participate in the business
and affairs of the commission. A delegate shall vote in person
or by such other means as provided in the commission's bylaws.
The bylaws may provide for delegates' participation in meetings
by telecommunications, video conference or other means of
communication;
(6) the commission shall meet at least once
per each calendar year. Additional meetings shall be held as
set forth in this compact and the commission's bylaws; and
(7) the commission shall establish by rule a
term of office for delegates.
C. The commission has the powers and duties to:
(1) establish a code of ethics for the
commission;
(2) establish the fiscal year of the
commission;
(3) establish fees;
(4) establish bylaws;
(5) maintain the commission's financial
records in accordance with the commission's bylaws;
(6) meet and take actions that are consistent
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with the provisions of this compact and the commission's
bylaws;
(7) promulgate rules to facilitate and
coordinate implementation and administration of this compact.
The rules shall have the force and effect of law and shall be
binding in all participating states;
(8) bring and prosecute legal proceedings or
actions in the name of the commission; provided that the
standing of any state licensing board to sue or be sued under
applicable law shall not be affected;
(9) purchase and maintain insurance and bonds;
(10) borrow, accept or contract for services
of personnel, including employees of a participating state;
(11) hire employees and engage contractors,
elect or appoint officers, fix compensation, define duties,
grant individuals appropriate authority to carry out the
purposes of this compact and establish the commission's
personnel policies and programs relating to conflicts of
interest, qualifications of personnel and other related
personnel matters;
(12) accept any and all appropriate donations
and grants of money, equipment, supplies, materials and
services and receive, use and dispose of the same; provided
that at all times the commission shall avoid any appearance of
impropriety or conflict of interest;
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(13) lease, purchase, accept appropriate gifts
or donations of or otherwise own, hold, improve or use any
property, real, personal or mixed; provided that at all times
the commission shall avoid any appearance of impropriety;
(14) sell, convey, mortgage, pledge, lease,
exchange, abandon or otherwise dispose of any property, real,
personal or mixed;
(15) establish a budget and make expenditures;
(16) borrow money;
(17) appoint committees, including standing
committees composed of members, state regulators, state
legislators or their representatives, consumer representatives
and other interested persons as may be designated in this
compact and the commission's bylaws;
(18) provide and receive information from, and
cooperate with, law enforcement agencies;
(19) elect a chair, vice chair, secretary,
treasurer and other officers of the commission as provided in
the commission's bylaws;
(20) in addition to powers reserved
exclusively to the commission under this compact, reserve
powers for the commission that the executive committee may not
exercise;
(21) approve or disapprove a state's
participation in this compact based on the commission's
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determination as to whether the state's compact legislation
departs in a material manner from the model compact language;
(22) prepare and provide to the participating
states an annual report; and
(23) perform other functions as may be
necessary or appropriate to achieve purposes of this compact
that are consistent with state regulation of physician
assistant licensure and practice.
D. Meetings of the commission shall proceed as
follows:
(1) all meetings of the commission that are
not closed pursuant to this subsection shall be open to the
public. Notice of public meetings shall be posted on the
commission's website at least thirty days prior to the public
meeting;
(2) notwithstanding Paragraph (1) of this
subsection, the commission may convene a public meeting by
providing at least twenty-four hours' prior notice on the
commission's website, and by any other means as provided in the
commission's rules, for any of the reasons that the commission
may dispense with notice of proposed rulemaking under
Subsection R of Section 10 of this compact;
(3) the commission may convene in a closed,
nonpublic meeting or nonpublic part of a public meeting to
receive legal advice or to discuss:
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(a) noncompliance of a participating
state with the state's obligations under this compact;
(b) the employment, compensation,
discipline or other matters, practices or procedures related to
specific employees or to the commission's internal personnel
practices and procedures;
(c) current, threatened or reasonably
anticipated litigation;
(d) negotiation of contracts for the
purchase, lease or sale of goods, services or real estate;
(e) accusing any person of a crime or
formally censuring any person;
(f) disclosure of trade secrets or
commercial or financial information that is privileged or
confidential;
(g) disclosure of information of a
personal nature where disclosure would constitute a clearly
unwarranted invasion of personal privacy;
(h) disclosure of investigative records
compiled for law enforcement purposes;
(i) disclosure of information related to
any investigative reports prepared by or on behalf of or for
use by the commission or other committee charged with the
responsibility of investigation or determination of compliance
issues pursuant to this compact;
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(j) legal advice; or
(k) matters specifically exempted from
disclosure by federal or participating states' statutes;
(4) if a meeting, or portion of a meeting, is
closed pursuant to this subsection, the chair of the meeting or
the chair's designee shall certify that the meeting or portion
of the meeting may be closed and shall reference each relevant
exempting provision; and
(5) the commission shall keep minutes that
fully and clearly describe all matters discussed in a meeting
and shall provide a full and accurate summary of actions taken,
including a description of the views expressed. All documents
considered in connection with an action shall be identified in
the minutes. All minutes and documents of a closed meeting
shall remain under seal, subject to release by a majority vote
of the commission or order of a court of competent
jurisdiction.
E. The commission shall be financed as follows:
(1) the commission shall pay, or provide for
the payment of, the reasonable expenses of its establishment,
organization and ongoing activities;
(2) the commission may accept any and all
appropriate revenue sources, donations and grants of money,
equipment, supplies, materials and services;
(3) the commission may levy and collect an
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annual assessment from each participating state and may impose
compact privilege fees on licensees of participating states to
whom a compact privilege is granted to cover the cost of the
operations and activities of the commission and its staff,
which shall be in a total amount sufficient to cover its annual
budget as approved by the commission each year for which
revenue is not provided by other sources. The aggregate annual
assessment amount levied on participating states shall be
allocated based upon a formula to be determined by commission
rule. A compact privilege expires when the licensee's
qualifying license in the participating state from which the
licensee applied for the compact privilege expires. If the
licensee terminates the qualifying license in the participating
state from which the licensee applied for the compact privilege
before its scheduled expiration, and the licensee has a
qualifying license in another participating state, the licensee
shall inform the commission that the licensee is changing to
that participating state for the purposes of applying for a
compact privilege and paying to the commission any compact
privilege fee required by commission rule;
(4) the commission shall not incur obligations
of any kind prior to securing the funds adequate to meet the
same; nor shall the commission pledge the credit of any of the
participating states, except by and with the authority of the
participating state; and
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(5) the commission shall keep accurate
accounts of all receipts and disbursements. The receipts and
disbursements of the commission shall be subject to the
financial review and accounting procedures established under
the commission's bylaws. All receipts and disbursements of
funds handled by the commission shall be subject to an annual
financial review by a certified or licensed public accountant,
and the report of the financial review shall be included in and
become part of the annual report of the commission.
F. The executive committee shall function as
follows:
(1) the executive committee has the power to
act on behalf of the commission according to the provisions of
this compact and commission rules;
(2) the executive committee is composed of the
following nine members:
(a) seven voting members who are elected
by the commission from the current membership of the
commission;
(b) one ex-officio, nonvoting member
from a recognized national physician assistant professional
association; and
(c) one ex-officio, nonvoting member
from a recognized national physician assistant certification
organization;
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(3) the ex-officio members of the executive
committee shall be selected by their respective organizations;
(4) the commission may remove any member of
the executive committee as provided in the commission's bylaws;
(5) the executive committee shall meet at
least annually;
(6) the executive committee has the following
duties and responsibilities:
(a) recommending to the commission
changes to the commission's rules or bylaws, changes to the
compact legislation, fees to be paid by participating states,
such as annual dues, and any compact privilege fee charged to
licensees;
(b) ensuring compact administration
services are appropriately provided, contractual or otherwise;
(c) preparing and recommending the
commission's budget;
(d) maintaining financial records on
behalf of the commission;
(e) monitoring compact compliance of
participating states and providing compliance reports to the
commission;
(f) establishing additional committees
as necessary;
(g) exercising the powers and duties of
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the commission during the interim between commission meetings,
except for issuing proposed rulemaking or adopting commission
rules or bylaws, or exercising any other powers and duties
exclusively reserved to the commission by the commission's
rules; and
(h) performing other duties as provided
by the commission's rules or bylaws;
(7) all meetings of the executive committee at
which the executive committee votes or plans to vote on matters
of exercising the powers and duties of the commission shall be
open to the public, and public notice of such meetings shall be
given in the same manner as notice of public meetings; and
(8) the executive committee may convene in a
closed, nonpublic meeting for the same reasons that the
commission may convene in a nonpublic meeting as provided in
this section and shall announce the closed meeting and keep
minutes of the closed meeting as the commission is required
pursuant to this section.
G. With respect to qualified immunity, defense and
indemnification:
(1) the members, officers, executive director,
employees and representatives of the commission shall be immune
from suit and liability, both personally and in their official
capacity, for any claim for damage to or loss of property or
personal injury or other civil liability caused by or arising
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from any actual or alleged act, error or omission that
occurred, or that the person against whom the claim is made had
a reasonable basis for believing occurred within the scope of
commission employment, duties or responsibilities; provided
that nothing in this paragraph shall be construed to protect
any such person from suit or liability for any damage, loss,
injury or liability caused by the intentional or willful or
wanton misconduct of that person. The procurement of insurance
of any type by the commission shall not in any way compromise
or limit the immunity granted by this compact;
(2) the commission shall defend any member,
officer, executive director, employee and representative of the
commission in any civil action seeking to impose liability
arising out of any actual or alleged act, error or omission
that occurred within the scope of commission employment, duties
or responsibilities, or as determined by the commission that
the person against whom the claim is made had a reasonable
basis for believing occurred within the scope of commission
employment, duties or responsibilities; provided that nothing
in this paragraph shall be construed to prohibit that person
from retaining counsel at the person's own expense; and
provided further that the actual or alleged act, error or
omission did not result from that person's intentional or
willful or wanton misconduct;
(3) the commission shall indemnify and hold
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harmless any member, officer, executive director, employee and
representative of the commission for the amount of any
settlement or judgment obtained against that person arising out
of any actual or alleged act, error or omission that occurred
within the scope of commission employment, duties or
responsibilities, or that the person had a reasonable basis for
believing occurred within the scope of commission employment,
duties or responsibilities; provided that the actual or alleged
act, error or omission did not result from the intentional or
willful or wanton misconduct of that person;
(4) venue is proper and judicial proceedings
by or against the commission shall be brought solely and
exclusively in a court of competent jurisdiction where the
principal office of the commission is located. The commission
may waive venue and jurisdictional defenses in any proceedings
as authorized by commission rules;
(5) nothing in this compact shall be construed
as a limitation on the liability of any licensee for
professional malpractice or misconduct, which shall be governed
solely by any other applicable state laws;
(6) nothing in this compact shall be construed
to designate the venue or jurisdiction to bring actions for
alleged acts of malpractice, professional misconduct,
negligence or other civil action pertaining to the practice of
a physician assistant. All such matters shall be determined
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exclusively by state law other than this compact;
(7) nothing in this compact shall be
interpreted to waive or otherwise abrogate a participating
state's state action immunity or state action affirmative
defense with respect to antitrust claims under the federal
Sherman Act, as amended, the federal Clayton Act, as amended,
or any other state or federal antitrust or anticompetitive law
or regulation; and
(8) nothing in this compact shall be construed
to be a waiver of sovereign immunity by the participating
states or by the commission.
SECTION 9. [NEW MATERIAL] DATA SYSTEM.--
A. The commission shall provide for the
development, maintenance, operation and utilization of a
coordinated data and reporting system containing licensure,
adverse actions and data on the existence of significant
investigative information on all licensed physician assistants
and applicants denied a license in participating states.
B. Notwithstanding any other state law to the
contrary, a participating state shall submit a uniform data set
to the data system on all physician assistants to whom this
compact is applicable, using a unique identifier, as required
by the rules of the commission, including:
(1) identifying information;
(2) licensure data;
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(3) adverse actions;
(4) any denial of application for licensure,
and the reason for such denial, excluding the reporting of any
criminal history record information where prohibited by law;
(5) the existence of significant investigative
information; and
(6) other information that may facilitate the
administration of this compact, as determined by the rules of
the commission.
C. Significant investigative information pertaining
to a licensee in any participating state shall only be
available to other participating states.
D. The commission shall promptly notify all
participating states of any adverse action that has been
reported to the commission. Adverse action information shall
be available to any participating state.
E. Participating states contributing information to
the data system may, in accordance with state or federal law,
designate information that may not be shared with the public
without the express permission of the contributing state.
Notwithstanding any such designation, the information shall be
reported to the commission through the data system.
F. Any information submitted to the data system
that is subsequently expunged pursuant to federal law or the
laws of the participating state contributing the information
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shall be removed from the data system upon reporting of the
expungement by the participating state to the commission.
G. The records and information provided to a
participating state pursuant to this compact or through the
data system, when certified by the commission or an agent of
the commission, shall constitute the authenticated business
records of the commission and shall be entitled to any
associated hearsay exception in any relevant judicial,
quasi-judicial or administrative proceedings in a participating
state.
SECTION 10. [NEW MATERIAL] RULEMAKING.--
A. The commission shall exercise rulemaking powers
pursuant to the criteria set forth in this section and the
rules promulgated pursuant to this section. Commission rules
shall become binding as of the date specified by the commission
for each rule.
B. The commission shall promulgate reasonable rules
in order to effectively and efficiently implement and
administer this compact and achieve the compact's purposes. A
commission rule shall be invalid and have no force or effect
only if a court of competent jurisdiction holds that the rule
is invalid because the commission exercised its rulemaking
authority in a manner that is beyond the scope of the purposes
of or the powers granted by this compact or based upon another
applicable standard of review.
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C. The rules of the commission shall have the force
of law in each participating state; provided that when the
rules of the commission conflict with the laws of the
participating state that establish the medical services a
physician assistant may perform in the participating state, as
held by a court of competent jurisdiction, the rules of the
commission shall be ineffective in that state to the extent of
the conflict.
D. If a majority of the legislatures of the
participating states rejects a commission rule by enactment of
a statute or resolution in the same manner used to adopt this
compact within four years of the date of adoption of the rule,
the rule shall have no further force and effect in any
participating state or to any state applying to participate in
the compact.
E. Commission rules shall be adopted at a regular
or special meeting of the commission.
F. Prior to promulgation and adoption of a final
rule by the commission, and at least thirty days in advance of
the meeting at which the rule will be considered and voted
upon, the commission shall file a notice of proposed
rulemaking:
(1) on the website of the commission or other
publicly accessible platform;
(2) to persons who have requested notice of
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the commission's notices of proposed rulemaking; and
(3) in other ways that the commission may
specify by rule.
G. The notice of proposed rulemaking shall include:
(1) the time, date and location of the public
hearing on the proposed rule and the proposed time, date and
location of the meeting in which the proposed rule will be
considered and voted upon;
(2) the text of the proposed rule and the
reason for the proposed rule;
(3) a request for comments on the proposed
rule from any interested person and the date by which written
comments must be received; and
(4) the manner in which interested persons may
submit notice to the commission of their intention to attend
the public hearing or provide written comments.
H. Prior to adoption of a proposed rule, the
commission shall allow persons to submit written data, facts,
opinions and arguments, which the commission shall make
available to the public.
I. If the hearing is to be held via electronic
means, the commission shall publish the mechanism for access to
the electronic hearing.
J. A person wishing to be heard at the hearing
shall, as directed in the notice of proposed rulemaking, no
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less than five business days before the scheduled date of the
hearing, notify the commission of the person's desire to appear
and testify at the hearing. Hearings shall be conducted in a
manner that provides each person who wishes to comment a fair
and reasonable opportunity to comment orally or in writing.
K. All hearings shall be recorded. A copy of the
recording and the written comments, data, facts, opinions and
arguments received in response to the proposed rulemaking shall
be made available upon request.
L. Nothing in this section shall be construed as
requiring a separate hearing on each proposed rule. Proposed
rules may be grouped for the convenience of the commission at
hearings required by this section.
M. Following a public hearing, the commission shall
consider all written and oral comments timely received.
N. The commission shall, by majority vote of all
delegates, take final action on a proposed rule and shall
determine the effective date of the rule, if adopted, based on
the rulemaking record and the full text of the rule. If
adopted, the rule shall be posted on the commission's website.
O. The commission may adopt changes to a proposed
rule; provided that the changes do not enlarge the original
purpose of the proposed rule.
P. The commission shall provide on the commission's
website an explanation of the reasons for substantive changes
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made to a proposed rule as well as reasons for substantive
changes not made that were recommended by commenters.
Q. The commission shall determine a reasonable
effective date for a rule. Except for an emergency as provided
in Subsection R of this section, the effective date of a rule
shall be no sooner than thirty days after the commission issued
the notice that the commission adopted the rule.
R. Upon determination that an emergency exists, the
commission may consider and adopt an emergency rule with
twenty-four hours' prior notice, without the opportunity for
comment or hearing; provided that the usual rulemaking
procedures provided in this compact and in this section shall
be retroactively applied to the rule as soon as reasonably
possible, but in no event later than ninety days after the
effective date of the rule. For the purposes of this compact,
an emergency rule is a rule that must be adopted immediately by
the commission in order to:
(1) meet an imminent threat to public health,
safety or welfare;
(2) prevent a loss of commission or
participating state funds;
(3) meet a deadline for the promulgation of a
commission rule that is established by federal law or rule; or
(4) protect public health and safety.
S. The commission or an authorized committee of the
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commission may direct revisions to a previously adopted
commission rule for purposes of correcting typographical
errors, errors in format, errors in consistency or grammatical
errors. Public notice of any revisions shall be posted on the
website of the commission. The revision shall be subject to
challenge by any person for a period of thirty days after
posting. The revision may be challenged only on grounds that
the revision results in a material change to a rule. A
challenge shall be made as set forth in the notice of revisions
and delivered to the commission prior to the end of the notice
period. If no challenge is made, the revision shall take
effect without further action. If the revision is challenged,
the revision shall not take effect without the approval of the
commission.
T. No participating state's rulemaking requirements
shall apply under this compact.
SECTION 11. [NEW MATERIAL] OVERSIGHT--DISPUTE
RESOLUTION--ENFORCEMENT.--
A. The executive and judicial branches of
government in each participating state shall enforce this
compact and take all actions necessary and appropriate to
implement the compact.
B. Venue is proper and judicial proceedings by or
against the commission shall be brought solely and exclusively
in a court of competent jurisdiction where the principal office
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of the commission is located. The commission may waive venue
and jurisdictional defenses to the extent the commission adopts
or consents to participate in alternative dispute resolution
proceedings. Nothing in this compact shall affect or limit the
selection or propriety of venue in any action against a
licensee for professional malpractice, misconduct or any
similar matter.
C. The commission is entitled to receive service of
process in any proceeding regarding the enforcement or
interpretation of this compact or the commission's rules and
has standing to intervene in the proceeding for all purposes.
Failure to provide the commission with service of process shall
render a judgment or order void as to the commission, this
compact or commission rules.
D. If the commission determines that a
participating state has defaulted in the performance of the
state's obligations or responsibilities under this compact or
commission rules, the commission shall provide written notice
to the defaulting state and other participating states. The
notice shall describe the default, the proposed means of curing
the default and any other action that the commission may take
and shall offer remedial training and specific technical
assistance regarding the default.
E. If a state in default fails to cure the default,
the defaulting state may be terminated from this compact upon
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an affirmative vote of a majority of the delegates of the
participating states, and all rights, privileges and benefits
conferred by this compact upon the state may be terminated on
the effective date of termination. A cure of the default does
not relieve the offending state of obligations or liabilities
incurred during the period of default.
F. Termination of participation in this compact
shall be imposed only after all other means of securing
compliance have been exhausted. Notice of intent to suspend or
terminate shall be given by the commission to the governor, the
majority and minority leaders of the defaulting state's
legislature and the licensing boards of each of the
participating states.
G. A state that has been terminated is responsible
for all assessments, obligations and liabilities incurred
through the effective date of termination, including
obligations that extend beyond the effective date of
termination.
H. The commission shall not bear any cost related
to a state that is found to be in default or that has been
terminated from the compact, unless agreed upon in writing
between the commission and the defaulting state.
I. The defaulting state may appeal the state's
termination from this compact by the commission by petitioning
the United States district court for the District of Columbia
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or the federal district where the commission has its principal
offices. The prevailing party shall be awarded all costs of
the litigation, including reasonable attorney fees.
J. Upon the termination of a state's participation
in this compact, the state shall immediately provide notice to
all licensees within that state of the termination. Licensees
who:
(1) have been granted a compact privilege in
that state shall retain the compact privilege for one hundred
eighty days following the effective date of the termination;
and
(2) are licensed in that state who have been
granted a compact privilege in a participating state shall
retain the compact privilege for one hundred eighty days unless
the licensee also has a qualifying license in a participating
state or obtains a qualifying license in a participating state
before the one-hundred-eighty-day period ends, in which case
the compact privilege shall continue.
K. Upon request by a participating state, the
commission shall attempt to resolve disputes related to this
compact that arise among participating states and between
participating and nonparticipating states. The commission
shall promulgate a rule providing for both mediation and
binding dispute resolution for disputes as appropriate.
L. The commission, in the reasonable exercise of
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the commission's discretion, shall enforce the provisions of
this compact and rules of the commission. If compliance is not
secured after all means to secure compliance have been
exhausted, by majority vote, the commission may initiate legal
action in the United States district court for the District of
Columbia or the federal district where the commission has its
principal offices, against a participating state in default to
enforce compliance with the provisions of this compact and the
commission's promulgated rules and bylaws. The relief sought
may include both injunctive relief and damages. In the event
that judicial enforcement is necessary, the prevailing party
shall be awarded all costs of such litigation, including
reasonable attorney fees.
M. The remedies provided in this compact shall not
be the exclusive remedies of the commission. The commission
may pursue any other remedies available under federal or state
law.
N. A participating state may initiate legal action
against the commission in the United States district court for
the District of Columbia or the federal district where the
commission has its principal offices to enforce compliance with
the provisions of this compact and the commission's rules. The
relief sought may include both injunctive relief and damages.
In the event judicial enforcement is necessary, the prevailing
party shall be awarded all costs of such litigation, including
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reasonable attorney fees. No entity other than a participating
state shall enforce this compact against the commission.
SECTION 12. [NEW MATERIAL] EFFECTIVE DATE OF THE
PHYSICIAN ASSISTANT LICENSURE INTERSTATE COMPACT.--
A. This compact shall come into effect on the date
on which this compact statute is enacted into law in the
seventh participating state.
B. On or after the effective date of this compact,
the commission shall convene and review the enactment of each
of the participating state statutes that enacted the compact
prior to the commission convening to determine if the statute
enacted by each participating state is materially different
than the model compact.
C. A charter participating state whose enactment is
found to be materially different from the model compact shall
be entitled to the default process set forth in Section 11 of
this compact. If any participating state later withdraws from
this compact or its participation is terminated, the commission
shall remain in existence and the compact shall remain in
effect even if the number of participating states is fewer than
seven. Participating states enacting this compact subsequent
to the commission convening shall be subject to the process set
forth in Paragraph (21) of Subsection C of Section 8 of this
compact to determine if the enactments are materially different
from the model compact and whether those states qualify for
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participation in the compact.
D. Participating states enacting this compact
subsequent to the seven initial participating states shall be
subject to the process set forth in Paragraph (21) of
Subsection C of Section 8 of this compact to determine if the
enactments are materially different from the model compact and
whether the states qualify for participation in the compact.
E. All actions taken for the benefit of the
commission or in furtherance of the purposes of the
administration of this compact prior to the effective date of
the compact or the commission coming into existence shall be
considered to be actions of the commission unless specifically
repudiated by the commission.
F. Any state that joins this compact shall be
subject to the commission's rules and bylaws as they exist on
the date on which the compact becomes law in that state. Any
rule that has been previously adopted by the commission shall
have the full force and effect of law on the day the compact
becomes law in that state.
G. Any participating state may withdraw from this
compact by enacting a statute repealing the same.
H. A participating state's withdrawal shall not
take effect until one hundred eighty days after enactment of
the repealing statute. During this one-hundred-eighty-day
period, all compact privileges that were in effect in the
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withdrawing state and were granted to licensees licensed in the
withdrawing state shall remain in effect. If any licensee
licensed in the withdrawing state is also licensed in another
participating state or obtains a license in another
participating state within the one-hundred-eighty-day period,
the licensee's compact privileges in other participating states
shall not be affected.
I. Withdrawal of a participating state shall not
affect the continuing requirement of the state licensing board
or boards of the withdrawing state to comply with the
investigative and adverse action reporting requirements of the
compact prior to the effective date of withdrawal.
J. Upon the enactment of a statute withdrawing a
participating state from this compact, the withdrawing state
shall immediately provide notice of the withdrawal to all
licensees within that state. The withdrawing state shall
continue to recognize all licenses granted pursuant to this
compact for a minimum of one hundred eighty days after the date
of the notice of withdrawal.
K. Nothing contained in this compact shall be
construed to invalidate or prevent any physician assistant
licensure agreement or other cooperative arrangement between
participating states and between a participating state and
nonparticipating state that does not conflict with the
provisions of this compact.
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L. This compact may be amended by the participating
states. No amendment to this compact shall become effective
and binding upon any participating state until it is enacted
materially in the same manner into the laws of all
participating states as determined by the commission.
SECTION 13. [NEW MATERIAL] CONSTRUCTION AND
SEVERABILITY.--
A. This compact and the commission's rulemaking
authority shall be liberally construed so as to effectuate the
purposes and the implementation and administration of the
compact. Provisions of this compact expressly authorizing or
requiring the promulgation of rules shall not be construed to
limit the commission's rulemaking authority solely for those
purposes.
B. The provisions of this compact shall be
severable, and if any phrase, clause, sentence or provision of
this compact is held by a court of competent jurisdiction to be
contrary to the constitution of any participating state, a
state seeking participation in the compact or the United
States, or if the applicability of the compact to any
government, agency, person or circumstance is held to be
unconstitutional by a court of competent jurisdiction, the
validity of the remainder of the compact and the applicability
thereof to any other government, agency, person or circumstance
shall not be affected.
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C. Notwithstanding Subsection B of this section,
the commission may deny a state's participation in this compact
or, in accordance with the requirements of Section 11 of this
compact, terminate a participating state's participation in the
compact, if it determines that a constitutional requirement of
a participating state is, or would be with respect to a state
seeking to participate in the compact, a material departure
from the compact. Otherwise, if this compact shall be held to
be contrary to the constitution of any participating state, the
compact shall remain in full force and effect as to the
remaining participating states and in full force and effect as
to the participating state affected as to all severable
matters.
SECTION 14. [NEW MATERIAL] BINDING EFFECT OF COMPACT.--
A. Nothing in this compact prevents the enforcement
of any other law of a participating state that is not
inconsistent with this compact.
B. Any laws in a participating state in conflict
with this compact are superseded to the extent of the conflict.
C. All agreements between the commission and the
participating states are binding in accordance with their
terms.
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