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SENATE FLOOR VERSION
April 4, 2024
ENGROSSED HOUSE
BILL NO. 3781 By: Duel of the House
and
Pugh of the Senate
An Act relating to physician assistants; creating the
PA Licensure Compact; stating purpose; defining
terms; providing requirements f or state participation
in the Compact; providing for Compact privilege;
providing for state designation; providing for
adverse actions; establishing the PA Licensure
Compact Commission; providing for data and reporting
system; providing for rulemaking; pro viding for
oversight, dispute resolution, and enforcement;
providing for implementation of the Commission;
providing for construction and severability;
providing for binding effect of Compact; providing
for codification; and providing an effective date .
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.1 of Title 59, unless there
is created a duplication in numbering, reads as follow s:
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 PA Licensure Compact have allied in
common purpose to develop a comprehensive process that compl ements
the existing authority of state licensing boards to license and
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discipline physician assistants , or PAs, and seeks to enhance the
portability of a license to practice as a PA while safeguarding the
safety of patients. The Compact allows medical servic es to be
provided by PAs via the mutual recognition of the licensee 's
qualifying license by other Compact participating states. The
Compact also adopts the prevailing standard for PA licensure and
affirms that the practice and delivery of medical services by the PA
occurs where the patient is located at the time of the patient
encounter and therefore requires the PA to be under the jurisdiction
of the state licensing board where the patient is located. State
licensing boards that participate in th e Compact retain the
jurisdiction to impose adverse action against a Compact privilege in
that state issued to a PA through the procedures of th e Compact.
The PA Licensure Compact will alleviate burdens for military
families by allowing active duty military pe rsonnel and their
spouses to obtain a Compact privilege based on having an
unrestricted license in good standing from a participating state.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.2 of Title 59, unless there
is created a duplication in numbering, reads as follows:
As used in the Compact:
1. "Adverse action" means any administrative, civil, equitable,
or criminal action permitted by a state's laws which is imposed by a
licensing board or other authority against a PA license or license
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application or Compact privilege such as license denial, censure,
revocation, suspension, probation, monitoring of the licensee, or
restriction on the licensee's practice;
2. "Compact privilege" means the authorization granted by a
remote state to allow a licensee from another participating state to
practice as a PA to provide medical services and other licensed
activity to a patient located in the remote state under the remote
state's laws and regulations;
3. "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;
4. "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, as defined in 28 C.F.R. , Section
20.3(d), from the state's criminal history record repos itory as
defined in 28 C.F.R. , Section 20.3(f);
5. "Data system" means the repository of information about
licensees, including, but not limited to, license status and adverse
actions, which is created and administered under the terms of th e
Compact;
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6. "Executive committee" means a group of directors and ex
officio individuals elected or appointed pursuant to paragraph 2 of
subsection F of Section 7 of this Compact;
7. "Impaired practitioner" means a PA whose practice is
adversely affected by health -related conditions that impact his or
her ability to practice;
8. "Investigative information" means information, records, or
documents received or generated by a licensing board pursuant to an
investigation;
9. "Jurisprudence requirement" means the assessment of an
individual's knowledge of the laws and rules governing the practice
of a PA in a state;
10. "License" means current authorization by a state, other
than authorization pursuant to a Compact privilege, for a PA to
provide medical services, which would be unlawful without current
authorization;
11. "Licensee" means an individual who holds a license from a
state to provide medical services as a PA;
12. "Licensing board" means any state entity authorized to
license and otherwise regulate PAs ;
13. "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;
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14. "Model Compact" means the model for the PA Licensur e
Compact on file with The Council of State Governments or other
entity as designated by the Commission ;
15. "Participating state" means a state that has enacted th e
Compact;
16. "PA" means an individual who is licensed as a physician
assistant in a state. For purposes of the 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 the Compact at the time of its enactment ;
17. "PA Licensure Compact Commission", "Compact Commission", or
"Commission" means the national administrative body created pursuant
to subsection A of Section 7 of this Compact;
18. "Qualifying license" means an unrestricted license issued
by a participating state to provide medical services as a PA;
19. "Remote state" means a participating state where a licensee
who is not licensed as a PA is exercising or seeking to exercise the
Compact privilege;
20. "Rule" means a regulation promulgated by an entity that has
the force and effect of law ;
21. "Significant investigative information" means investigative
information that a licensing board, after an inquiry or
investigation that includes notification and an opportunity for the
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PA 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
22. "State" means any state, commonwealth, district, or
territory of the Unite d States.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.3 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. To participate in th e Compact, a participating state shall:
1. License PAs;
2. Participate in the Compact 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 check requirement
within a time frame established by Commission rule, by its licensing
board receiving the results of a criminal background check , and
reporting to the Commission whether the license applicant has been
granted a license;
6. Comply with the r ules of the Compact Commission;
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7. Utilize passage of a recognized national exam such as the
NCCPA PANCE as a requirement for PA licensure ; and
8. Grant the Compact privilege to a holder of a qualifying
license in a participating state .
B. Nothing in the Compact prohibits a participating state from
charging a fee for granting the Compact privilege.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.4 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. To exercise the Compact privilege, a licensee shall:
1. Have graduated from a PA program accredited by the
Accreditation Review Commission on Education for the Physician
Assistant, Inc., or other programs au thorized by Commission rule;
2. Hold current NCCPA 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 a licensee has had a limitation or restriction on a
license or Compact privilege due to an adverse action, two (2) years
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must have elapsed from the date on which the license or Compact
privilege is no longer limited or restricted due to the adverse
action;
9. 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 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;
10. Notify the Compact Commission that the licensee is seeking
the Compact privilege in a remote state;
11. 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
12. Report to the Commission any adverse action taken by a
nonparticipating state within thirty (30) days after the action is
taken.
B. The Compact privilege is valid until the expiration or
revocation of the qualifying license unless terminated pursuant to
an adverse action. The licensee must 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
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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 (2) years have elapsed from the date on which the
license is no longer lim ited or restricted due to the adverse
action.
C. Once a restricted or limited license satisfies the
requirements of paragraphs 1 and 2 of s ubsection B of this section,
the licensee must meet the requirements of subsection A of this
section to obtain a Compact privilege in any remote state.
D. For each remote state in which a PA seeks authority to
prescribe controlled substances, the PA shall satisfy all
requirements imposed by such state in granting or renewing such
authority.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.5 of Title 59, unless there
is created a duplication in numbering, reads as follows:
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 subject to the following
requirements:
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1. 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
2. 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 against the licensee by the Commission
or a participating state, including a subpoena, with respect to any
action brought or investigation conducted by the Commission or a
participating state.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.6 of Title 59, unless there
is created a duplicat ion in numbering, reads as follows:
A. A participating state in which a licensee is 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 conf erred by state law, a
remote state shall have the authority, in accordance with existing
state due process law, to do all of the following :
1. Take adverse action against a PA'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 its citizens;
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2. Issue subpoenas for both 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 it. The issuing
authority shall pay any witness fees, travel expenses, mileage , and
other fees required by the service statutes of the state in whi ch
the witnesses or evidence are located;
3. Notwithstanding paragraph 2 of this subsection, subpoenas
may 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 adve rse action against a licensee 's Compact
privilege or application for a Compact privilege in that
participating state; and
4. Nothing in the Compact authorizes a participating state to
impose discipline against a PA '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 .
C. For purposes of taking adverse action, the participating
state which issued the qualifying license shall give the same
priority and effect to reported conduct received from any other
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participating state as it would if the conduct had occurred within
the participating state which issued the qualifying license. In so
doing, that participating state shall apply its own state laws t o
determine appropriate action.
D. A participating state, if otherwise permitted by state law,
may recover from the affected PA the costs of investigations and
disposition of cases resulting from any adverse action taken against
that PA.
E. A participating state may take adverse action based on the
factual findings of a remote state, provided that the participating
state follows its own procedures for taking the adverse action.
F. Joint investigations:
1. In addition to the authority granted to a partic ipating
state by its respective state PA laws and regulations or other
applicable state law, any participating state may participate with
other participating states in joint investigations of licensees ; and
2. Participating states shall share any investigati ve,
litigation, or compliance materials in furtherance of any joint or
individual investigation initiated under th e Compact.
G. If an adverse action is taken against a PA's qualifying
license, the PA's Compact privilege in all remote states shall be
deactivated until two (2) years have elapsed after all restrictions
have been removed from the state license . All disciplinary orders
by the participating state which issued the qualifying license that
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impose adverse action against a PA's license shall include a
statement that the PA's Compact privilege is deactivated in all
participating states during the pendency of the order .
H. If any participating state takes adverse action, it promptly
shall notify the administrator of the data system .
SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.7 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. The participating states hereby create and establish a joint
government agency and national administrative body known as the PA
Licensure Compact Commission. The Commission is an instrumentality
of the Compact 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 subsection A of
Section 11.
B. Membership, voting, and meetings:
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. The delegate shall be either:
a. a current PA, physician , or public member of a
licensing board or PA council/committee, or
b. an administrator of a licensing board;
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3. Any delegate may be removed or suspended from office as
provided by the laws of the state from which the delegate is
appointed;
4. The participating state licensing board shall fill any
vacancy occurring in the Commission within sixty (60) 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 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 during each calendar
year. Additional meetings shall be held as set forth in th e Compact
and the bylaws; and
7. The Commission shall establish by rule a term of office for
delegates.
C. The Commission shall have the following powers and duties:
1. Establish a code of ethics fo r the Commission;
2. Establish the fiscal year of the Commission;
3. Establish fees;
4. Establish bylaws;
5. Maintain its financial records in accordance with the
bylaws;
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6. Meet and take such actions as are consistent with the
provisions of the Compact and the bylaws;
7. Promulgate rules to facilitate and coordinate implementation
and administration of th e Compact. The rules shall have the force
and effect of law and shall be binding in all participating states ;
8. Bring and prosecute legal proceed ings 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 o f personnel,
including, but not limited to, employees of a participating state;
11. Hire employees and engage contractors, elect or appoint
officers, fix compensation, define duties, grant such individuals
appropriate authority to carry out the purpose s of the 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,
utilize, and dispose of the same , provided that at all times the
Commission shall avoid any appearance of impropriety or conflict of
interest;
13. Lease, purchase, accept appropriate gifts or donations o f,
or otherwise own, hold, improve , or use, any property, real,
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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, and consumer representatives and such other
interested persons as may be designated in th e Compact and the
bylaws;
18. Provide and receive information from, and cooperate with,
law enforcement agencies;
19. Elect a chair, vice-chair, secretary and treasurer , and
such other officers of the Commission as provided in the
Commission's bylaws;
20. Reserve for itself, in addition to those reserved
exclusively to the Commission under the Compact, powers that the
executive committee may not exercise;
21. Approve or disapprove a state's participation in the
Compact based upon its determination as to whether the state's
Compact legislation departs in a material manner from the model
Compact language;
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22. Prepare and provide to the participating states an annual
report; and
23. Perform such other functions as may be necessary or
appropriate to achieve the purposes of th e Compact consistent with
the state regulation of PA licensure and practice.
D. Meetings of the Commission :
1. All meetings of the Commission that are not cl osed 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
(30) 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 (24) hours prior notice on the Commission 's website, and
any other means as provided in the Commission 's rules, for any of
the reasons it may dispense with notice of proposed rulemaking under
subsection L of Section 9 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:
a. noncompliance of a participating state with its
obligations under th e Compact,
b. the employment, compensation, discipline , or other
matters, practices, or procedures, related to specific
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employees or other matters related to the Commission 's
internal personnel practices and procedures,
c. current, threatened, or reasonably ant icipated
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 of the
Commission or other committee charged with
responsibility of investigation or determination of
compliance issues pursuant to th e Compact,
j. legal advice, or
k. matters specifically exempted from disclosure by
federal or participating states ' statutes;
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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 such 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. Financing of the Commission :
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 ; and
3. The Commission may levy on and collect an 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 must be in a total amount sufficient
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to cover its annual budge t 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. a Compact privilege expires when the licensee 's
qualifying license in the participating state from
which the licensee applied for the Compact privilege
expires, and
b. if the licensee terminates the qualifying license
through 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 it is changing to that participating
state the participating state through which it appl ies
for a Compact privilege and pay 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;
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
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established under its 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:
1. The executive committee shall have the power to act on
behalf of the Commission according to the terms of th e Compact and
Commission rules;
2. The executive committee shall be composed of nine (9)
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 PA professional association , and
c. one ex officio, nonvoting member from a recognized
national PA certification organization;
3. The ex officio members will be selected by their respective
organizations;
4. The Commission may remove any member of the executive
committee as provided in its bylaws;
5. The executive committee shall meet at least annually ;
6. The executive committee shall have the following duties and
responsibilities:
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a. recommend to the Commission changes to the
Commission's rules or bylaws, changes to the Compact
legislation, fees to be paid by Compact participating
states such as annual dues, and any Commission Compact
fee charged to licensees for the Compact privilege,
b. ensure Compact administration services are
appropriately provided, contractual or otherwise ,
c. prepare and recommend the budget ,
d. maintain financial records on behalf of the
Commission,
e. monitor Compact compliance of participating states and
provide compliance reports to the Commission ,
f. establish additional committee s as necessary,
g. exercise the powers and duties of 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 rese rved to the Commission by the
Commission's rules, and
h. perform other duties as provided in the Commission 's
rules or bylaws;
7. All meetings of the executive committee at which it votes or
plans to vote on matters in exercising the powers and duties of the
Commission shall be open to the public , and public notice of such
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meetings shall be given as public meetings of the Commission are
given; and
8. The executive committee may convene in a closed, nonpublic
meeting for the same reasons that the Commissio n may convene in a
nonpublic meeting as set forth in paragraph 3 of subsection D of
this section and shall announce the closed meeting as the Commission
is required to under paragraph 4 of subsection D of this section and
keep minutes of the closed meeting as the Commission is required to
under paragraph 5 of subsection D of this section.
G. 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 out of any actual or alleged
act, error, or omission that occurred, or that th e person against
whom the claim is made had a reasonable basis for believing it
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 s uit 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 her eunder;
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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 wi thin 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 respons ibilities, provided that
nothing herein shall be construed to prohibit that person from
retaining their own counsel at their 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 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 such 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 ;
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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 herein sh all 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 herein shall be construed to designate the venue or
jurisdiction to bring actions for alleged acts of malpractice,
professional misconduct, negligence, or other such civil action
pertaining to the practice of a PA. All such matters shall be
determined exclusively by state law other than th e Compact;
7. Nothing in the 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 Sherman Act, Clayton Act, or any other state or federal
antitrust or anticom petitive law or regulation ; and
8. Nothing in the Compact shall be construed to be a waiver of
sovereign immunity by the participating states or by the Commission.
SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.8 of Title 59, unless there
is created a duplication in numbering, reads as follows:
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A. The Commission shall provide for the development,
maintenance, operation, and utilization of a coordinated data and
reporting system contai ning licensure, adverse action, and the
reporting of the existence of significant investigative information
on all licensed PAs and applicants denied a license in participating
states.
B. Notwithstanding an y other state law to the contrary, a
participating state shall submit a uniform data set to the data
system on all PAs to whom the Compact is applicable (utilizing a
unique identifier) as required by the rules of the Commission,
including:
1. Identifying information;
2. Licensure data;
3. Adverse actions against a license or Compact privilege; and
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
the Compact, as determined by the rules of the Commission.
C. Significant investigative information pertaining to a
licensee in any participating state shall only be a vailable to other
participating states .
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D. The Commission shall promptly notify all participating
states of any adverse action taken against a licensee or an
individual applying for a license that has been reported to it .
This adverse action informati on shall be available to any other
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, such 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 shall be removed
from the data system upon reporting of such by the participating
state to the Commission.
G. The records and information provided to a participating
state pursuant to the Compact or through the data system, when
certified by the Commission or an agent thereof, 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.
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SECTION 9. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.9 of Title 59, unless there
is created a duplication in numbering, reads as follo ws:
A. The Commission shall exercise its rulemaking powers pursuant
to the criteria set forth in this section and the rules adopted
thereunder. 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 th e Compact and
achieve its 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 the Compact, or the powers granted hereunder, or based
upon another applicable standard of review.
C. The rules of the Commission shall have the force of law in
each participating state; provided, however, that where the rules of
the Commission conflict with the laws of the participating state
that establish the medical services a PA 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
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resolution in the same manner used to adopt th e Compact within four
(4) years of the date of adoption of the rule, then such 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 or rules
by the Commission, and at least thirty (30) 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 the Commission 's
notices of proposed rulemaking ; and
3. In such other way(s) as the Commission may by rule specify.
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;
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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 any written comments.
H. Prior to adoption of a proposed rule, the Commission shall
allow persons to submit written data, facts, opinions, and
arguments, which shall be made 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.
1. All persons wishing to be heard at the hearing shall , as
directed in the notice of proposed rulemaking, not less than five
(5) business days before the scheduled date of the hearing, notify
the Commission of their desire to appear and testify at the hearing .
2. Hearings shall be conducted in a manner providing each
person who wishes to comment a fair and reasonable opportunity to
comment orally or in writing .
3. All hearings shall be recorded. A copy of the recording and
the written comments, data, facts, opinions, and argum ents received
in response to the proposed rulemaking shall be made available to a
person upon request.
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4. Nothing in this section shall be construed as requiring a
separate hearing on each proposed rule. Proposed rules may be
grouped for the convenien ce of the Commission at hearings required
by this section.
J. Following the public hearing , the Commission shall consider
all written and oral comments timely received.
K. The Commission shall, by majority vote of all delegates,
take final action on the 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 .
1. If adopted, the rule shall be posted on the Commission 's
website.
2. The Commission may adopt changes to the pr oposed rule
provided the changes do not enlarge the original purpose of the
proposed rule.
3. The Commission shall provide on its website an explanation
of the reasons for substantive changes made to the proposed rule, as
well as reasons for substantive chan ges not made that were
recommended by commenters .
4. The Commission shall determine a reasonable effective date
for the rule. Except for an emergency as provided in subsection L
of this section, the effective date of the rule shall be no sooner
than thirty (30) days after the Commission issued the notice that it
adopted the rule.
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L. Upon determination that an emergency exists, the Commission
may consider and adopt an emergency rule with twenty-four (24) hours
prior notice, without the opportunity for com ment or hearing,
provided that the usual rulemaking procedures provided in th e
Compact and in this section shall be retroactively applied to the
rule as soon as reasonably possible, in no event later than ninety
(90) days after the effective date of the rule. For the purposes of
this subsection, an emergency rule is one 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.
M. The Commission or an authorized committee of the Commission
may direct revisions to a previously a dopted 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 challen ge by any person for a period of
thirty (30) 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
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and delivered to the Commission prior to the end of the notice
period. If no challenge is made, the revision will take effect
without further action. If the revision is challenged, the revision
may not take effect without the approval of the Commission.
N. No participating state's rulemaking requirements shall apply
under the Compact.
SECTION 10. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.10 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. Oversight:
1. The executive and judicial branches of state government in
each participating state shall enforce th e Compact and take all
actions necessary and appropriate to implement the Compact;
2. Venue is proper and judicial procee dings 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 to the extent it adopts or consents to participate in
alternative dispute resolution proceedings. Nothing herein shall
affect or limit the selection or propriety of venue in any action
against a licensee for professional malpractice, misconduct , or any
such similar matter; and
3. The Commission shall be entitled to receive service of
process in any proceeding regarding the enforcement or
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interpretation of the Compact or the Commission's rules and shall
have standing to intervene in such a proceeding for all purposes.
Failure to provide the Commission with service of process shall
render a judgment or order in such proceeding void as to the
Commission, the Compact, or Commission rules.
B. Default, technical assistance, and termination:
1. If the Commission determines that a partic ipating state has
defaulted in the performance of its obligations or responsibilities
under the Compact or the Commission rules, the Commission shall
provide written notice to the defaulting state and other
participating states. The notice shall descri be 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;
2. If a state in default fails to cure the default, the
defaulting state may be terminated from th e Compact upon an
affirmative vote of a majority of the delegates of the participating
states, and all rights, privileges , and benefits conferred by th e
Compact upon such state may be terminated on the effective da te of
termination. A cure of the default does not relieve the offending
state of obligations or liabilities incurred during the period of
default;
3. Termination of participation in th e Compact shall be imposed
only after all other means of securing complia nce have been
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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 to the licensing boards
of each of the participating states ;
4. 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 ;
5. The Commission shall no t bear any costs related to a state
that is found to be in default or that has been terminated from th e
Compact, unless agreed upon in writing between the Commission and
the defaulting state;
6. The defaulting state may appeal its termination from the
Compact by the Commission by petitioning the U.S. District Court for
the District of Columbia or the federal district where the
Commission has its principal offices. The prevailing member shall
be awarded all costs of such litigation, including reasonable
attorney fees; and
7. Upon the termination of a state's participation in the
Compact, the state shall immediately provide notice to all licensees
within that state of such termination:
a. licensees who have been granted a Compact privilege in
that state shall retain the Compact privilege for one
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hundred eighty (180) days following the effective date
of such termination, and
b. licensees who 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 (180) 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.
C. Dispute resolution:
1. Upon request by a participating state, the Commission shall
attempt to resolve disputes related to th e Compact that arise among
participating states and between participating and nonparticipating
states; and
2. The Commission shall promulgate a rule providing for both
mediation and binding dispute resolution for disputes as
appropriate.
D. Enforcement:
1. The Commission, in the reasonable exercise of its
discretion, shall enforce the provisions of th e Compact and rules of
the Commission;
2. If compliance is not secured after all means to secure
compliance have been exhausted, by majority vote, the Commission may
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initiate legal action in the U.S. District Court for the District of
Columbia or the federal dist rict where the Commission has its
principal offices against a participating state in default to
enforce compliance with the provisions of th e Compact and the
Commission's promulgated rules and bylaws. The relief sought may
include both injunctive relie f and damages. In the event judicial
enforcement is necessary, the prevailing party shall be awarded all
costs of such litigation, including reasonable attorney fees ; and
3. The remedies herein shall not be the exclusive remedies of
the Commission. The Commission may pursue any other remedies
available under federal or state law.
E. Legal action against the Commission:
1. A participating state may initiate legal action against the
Commission in the U.S. 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 the Compact and
its 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 reasonable attorney fees.
2. No person other than a participating state shall enforce th e
Compact against the Commission.
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SECTION 11. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.11 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. The Compact shall come into effect on the date on which th e
Compact statute is enacted into law in the seve nth participating
state.
1. On or after the effective date of the Compact, the
Commission shall convene and review the enactment of each of the
states that enacted the Compact prior to the Commission convening
"Charter Participating States " to determine if the statute enacted
by each such Charter Participating State is materially different
than the model Compact:
a. A Charter Participating State whose enactment is found
to be materially different from the model Compact
shall be entitled to the default proc ess set forth in
subsection B of Section 10 of this Compact, and
b. If any participating state later withdraws from the
Compact or its participation is terminated, the
Commission shall remain in existence and the Compact
shall remain in effect even if t he number of
participating states should be less than seven.
Participating states enacting the Compact subsequent
to the Commission convening shall be subject to the
process set forth in paragraph 21 of subsection C of
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Section 7 of this Compact to determine if their
enactments are materially different from the model
Compact and whether they qualify for participation in
the Compact;
2. Participating states enacting the Compact subsequent to the
seven initial Charter Participating States shall be subject to the
process set forth in paragraph 21 of subsection C of Section 7 of
this Compact to determine if their enactments are materially
different from the model Compact and whether they qualify for
participation in the Compact; and
3. All actions taken for the b enefit of the Commission or in
furtherance of the purposes of the administration of the 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 re pudiated by the Commission.
B. Any state that joins the Compact shall be subject to the
Commission's rules and bylaws as they exist on the date on which th e
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 th e Compact becomes law in that state.
C. Any participating state may withdraw from the Compact by
enacting a statute repealing the same.
1. A participating state's withdrawal shall not take effect
until one hundred eighty (180) days after enactment of the repealing
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statute. During this one-hundred-eighty-day period, all Compact
privileges that were in effect in the withdrawing state and were
granted to licensees licensed in the withdrawing state shall re main
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 (180)
days, the licensee's Compact privileges in other p articipating
states shall not be affected by the passage of the one hundred
eighty (180) days.
2. Withdrawal shall not affect the continuing requirement of
the state licensing boards of the withdrawing state to comply with
the investigative and adverse actio n reporting requirements of the
Compact prior to the effective date of withdrawal.
3. Upon the enactment of a statute withdrawing a state from the
Compact, the state shall immediately provide notice of such
withdrawal to all licensees within that state. Such withdrawing
state shall continue to recognize all licenses granted pursuant to
the Compact for a minimum of one hundred eighty (180) days after the
date of such notice of withdrawal.
D. Nothing contained in th e Compact shall be construed to
invalidate or prevent any PA 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 th e Compact.
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E. The Compact may be amended by the participating states. No
amendment to the 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 12. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.12 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. The Compact and the Commission's rulemaking authority sh all
be liberally construed so as to effectuate the purposes and the
implementation and administration of the Compact. Provisions of the
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 th e Compact shall be severable, and if any
phrase, clause, sentence , or provision of the 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 of the United States, or the applicability thereof 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 thereby.
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C. Notwithstanding subsection B o f this section, the Commission
may deny a state's participation in the Compact or, in accordance
with the requirements of subsection B of Section 10 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 t o a state seeking to participate
in the Compact, a material departure from the Compact. Otherwise,
if the 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 13. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 545.13 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. Nothing herein prevents the enforcement of any other law of
a participating state that is not inconsistent with th e Compact.
B. Any laws in a participating state in conflict w ith the
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.
SECTION 14. This act shall become effective November 1, 2024.
COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES
April 4, 2024 - DO PASS