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SENATE FLOOR VERSION
February 8, 2024
SENATE BILL NO. 1654 By: Pugh
An Act relating to physician assistants; enacting the
Physician Assistant (PA) Licensure Compact and
authorizing Governor to enter into compac t with
certain jurisdictions; setting for th form of certain
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 Se ction 522.1 of Title 59, unless there
is created a duplication in numbering, reads as follows:
The Physician Assistant (PA) L icensure Compact is hereby enacted
into law and the Governor shall enter into a compact on behalf of
the State of Oklahoma with any jurisdiction legally joined therein,
in the form substantially as set forth in Section 2 of this act.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 522.2 of Title 59, unless there
is created a duplication in numbering, reads as follows:
Section 1. 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 PA Licensure Compact have all ied in
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common purpose to develop a comprehensive process that complements
the existing authority of State Licensing Boards to license and
discipline PAs and seeks to enhance the portability of a License to
practice as a PA while safeguarding the safety of patients. This
Compact allows Medical Services to b e provided by PAs, via the
mutual recognition of the Licensee ’s Qualifying License by other
Compact Participating States. This Compact also adopts the
prevailing standard for PA licensure and affirms tha t 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 this Compact retain the jurisdict ion to impose
Adverse Action against a Comp act Privilege in that State issued to a
PA through the procedures of this Compact. The PA Licensure Compact
will alleviate burdens for milita ry families by allowing active duty
military personnel and their spouses to obtain a Com pact Privilege
based on having an unrestricted License in g ood standing from a
Participating State.
Section 2. Definitions.
In this Compact:
A. “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;
B. “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 ;
C. “Conviction” means a finding by a court that an individual
is guilty of a felony or misdemeanor offense through adjudication o r
entry of a plea of guilt or no contest to the charge by the
offender;
D. “Criminal Background Check” means the submission of
fingerprints or other biometric-based information for a License
applicant for the pu rpose 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 repository as
defined in 28 C.F.R. , Section 20.3(f);
E. “Data System” means the repository of information about
Licensees, including but not li mited to License status and Adverse
Actions, which is created and administered under the terms of this
Compact;
F. “Executive Committee” means a group of directors and ex -
officio individuals elected or appointed pursuant to Section 7.F.2 ;
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G. “Impaired Practitioner” means a PA whose practice is
adversely affected by health -related condition(s) that impact their
ability to practice;
H. “Investigative Inform ation” means information, records, or
documents received or generated by a Licensing Board pursuant t o an
investigation;
I. “Jurisprudence Requirement ” means the assessment of an
individual’s knowledge of the laws and Rules governing the practice
of a PA in a State;
J. “License” means current authorization by a State, other than
authorization pursuant t o a Compact Privilege, for a PA to provide
Medical Services, which would be unlawful without current
authorization;
K. “Licensee” means an individual who holds a License from a
State to provide Medical Services as a PA ;
L. “Licensing Board” means any State entity authorized to
license and otherwise regulate PAs ;
M. “Medical Services” means health care services provided for
the diagnosis, preventio n, treatment, cure or relief of a health
condition, injury, or disease, as defined by a State ’s laws and
regulations;
N. “Model Compact” means the model for the PA Licensure Compact
on file with The Council of State Governments or other entity as
designated by the Commission;
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O. “Participating State” means a State that has enacted this
Compact;
P. “PA” 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 re place 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 ;
Q. “PA Licensure Compact Commission ,” “Compact Commission,” or
“Commission” mean the national administrative body created pursuant
to Section 7.A of this Compact ;
R. “Qualifying License” means an unrestricted License issued by
a Participating State to provide Medical Services as a PA;
S. “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;
T. “Rule” means a regulation promulgated by an entity that has
the force and effect of law ;
U. “Significant Investigative Information ” means Investigative
Information that a Licensing Board, after an inquiry or
investigation that includes notification and an opportunity for the
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
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V. “State” means any state, commo nwealth, district, or
territory of the United States.
Section 3. State Participation in this Compact .
A. To participate in this 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 this
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 Lice nsing
Board receiving the res ults of a Criminal Background Check and
reporting to the Commission whether the License applicant has been
granted a License;
6. Comply with the Rules of the Compact Commission ;
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 this Compact prohibits a Participating State from
charging a fee for granting the Compact Privilege.
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Section 4. Compact Privilege.
A. To exercise the Compact Privilege, a Licensee must:
1. Have graduated from a PA program accredited by the
Accreditation Review Commission on Education for the Physician
Assistant, Inc. or other programs authorized by Commission Ru le;
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 identi fier 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 years
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 r evoked or is limited or
restricted in a Participating State for conduct that would not b e 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 Sta te shall have the discretion not to
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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 ap plicable to satisfying the
Jurisprudence Requirement ; and
12. Report to the Commission any Adverse Action ta ken by a non-
participating 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 above to maintain the Compact Privilege
in a Remote State. If the Participating State takes Adver se 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 limited or restr icted due to the Adverse
Action.
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C. Once a restricted or limited License satisfies the
requirements of Subsection B .1 and 2, the Licensee must meet the
requirements of Subsec tion A to obtain a Compact Privilege in any
Remote State.
D. For each Remote State in which a PA seeks autho rity to
prescribe controlled substances, the PA shall satisfy all
requirements imposed by such State in granting or renewing such
authority.
Section 5. Designation of the State from Which Licensee is
Applying for a Compact Privilege.
Upon a Licensee’s application for a Compact Privilege, the
Licensee shall identify to the Commission the Part icipating State
from which the Licensee is applying, in acc ordance with applicable
Rules adopted by the Commission, and subject to the following
requirements:
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 s ervice 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
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action brought or investigation conducted by the Commission or a
Participating State.
Section 6. Adverse Actions.
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 Participa ting State.
B. In addition to the other po wers conferred by State law, a
Remote State shall have the authority, in accordance with existing
State due process law, to d o 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 a pplicable law to protect the health and
safety of its citizens ; and
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 competen t 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 which
the witnesses or evidence are located .
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3. Notwithstanding paragraph 2, 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 takin g Adverse
Action against a Licensee ’s Compact Privilege or application for a
Compact Privilege in that Participating State.
4. Nothing in this Compact authorizes a Participating State to
impose discipline against a PA ’s Compact Privilege or to deny an
application for a Compact Priv ilege 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
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 to
determine appropriate act ion.
D. A Participating State, if otherwise permitte d by State law,
may recover from the affected PA the cos ts 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 .
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1. In addition to the authority granted to a Participating
State by its respective State PA laws and regulations or other
applicable State law, any Participating State may participate wit h
other Participating States in joint investigations of Licensees.
2. Participating States shall share any investigative,
litigation, or compliance materials in furtherance of any joint or
individual investigation initiated under this 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
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. Establishment of the PA Licensure Compact
Commission.
A. The Participating States hereby create and establish a joint
government agency and n ational administrative body known as the PA
Licensure Compact Commission. The Commission is an instrumentality
of the Compact States acting joint ly and not an instrumentality of
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any one State. The Commission shall come into existence on or after
the effective date of the Compact as set forth in Section 11.A.
B. Membership, Voting, and Meet ings.
1. Each Participating State shall have and be limite d to one
(1) delegate selected by that Participating State ’s Licensing Board
or, if the State has more than o ne 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 .
3. Any delegate may be removed or suspended from office as
provided by the laws of th e 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 (1) 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 p erson 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 com munication.
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6. The Commission shall meet at least once during each calendar
year. Additional meetings shall be held as set forth in this
Compact and the bylaws.
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 ethi cs for 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;
6. Meet and take such actions as are consistent with the
provisions of this Compact and the 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 s ued under applicable law shall not be affected;
9. Purchase and maintain insurance and bonds;
10. Borrow, accept, or contract for services of personnel,
including, but not limited to, employees of a Participating State;
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11. Hire employees and engage contractors, elect or appoint
officers, fix compensation, define duties, grant such 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 ma tters;
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 donat ions of,
or otherwise own, hold, imp rove or use, any property, real, personal
or mixed; provided that at all times the Commi ssion 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 consu mer representatives, and such other
interested persons as may be designated in this Compact and the
bylaws;
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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 Commissi on 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 t he
Compact based upon its determination as to whether the State ’s
Compact legislation de parts in a material manner from the Model
Compact language;
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 this Compact consistent with
the State regulation of PA licensure and practice.
D. Meetings of the Commission .
1. All meetings of the Commission that are n ot closed pursuant
to this subsection shall be open to the public. Notice of public
meetings shall be posted on the Commiss ion’s website at least thirty
(30) days prior to the public meeting.
2. Notwithstanding subsection D.1 of this section, the
Commission may convene a public meeting by providing at least
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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 d ispense with notice of proposed rulemaking und er
Section 9.L.
3. The Commission may convene in a closed, non -public meeting
or non-public part of a public meeting to rec eive legal advice or to
discuss:
a. non-compliance of a Participating State with its
obligations under this Compact,
b. the employment, compensation, discipline or othe r
matters, practices or procedures related to specific
employees or other matters related to the Commission ’s
internal personnel practices and procedures ,
c. current, threatened, or reasonably anticipated
litigation,
d. negotiation of contracts for the pur chase, lease, or
sale of goods, services, or real estate ,
e. accusing any person of a cr ime or formally censuring
any person,
f. disclosure of trade secrets or commercial or financial
information that is privileged or confidential ,
g. disclosure of informa tion of a personal nature where
disclosure would constitute a clearly unwarranted
invasion of personal priv acy,
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h. disclosure of investigative records compiled for law
enforcement purposes ,
i. disclosure of information r elated 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 this Compact ,
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 provision, the chair of the meeting or the chair ’s designee
shall certify that the meeting or portion of t he meeting may be
closed and shall reference each relevant exempting provision.
5. The Commission shall keep minutes that f ully and clearly
describe all matters discussed in a meetin g and shall provide a full
and accurate summary of actio ns 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 Commis sion or order of a court of
competent jurisdiction.
E. Financing of the Commission .
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1. The Commission shall pay, or provid e for the payment of, the
reasonable expenses of its establ ishment, 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 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 activitie s of the
Commission and its staff, which must be in a total amount sufficient
to cover its annual budget as approved by the Commission each year
for which revenue is no t provided by other sources. The aggregate
annual assessment amount levied on Participating States shall be
allocated based upon a formula to be determined by Comm ission Rule.
a. A Compact Privilege expires when the Lic ensee’s
Qualifying License in the Pa rticipating State from
which the Licensee applie d for the Compact Privilege
expires.
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
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Commission that it is changing to that Participating
State the Participating State through which it applies
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 a ny kind prior
to securing the funds adequate to meet the sa me; nor shall the
Commission pledge the credit of any of the Participating States,
except by and with the aut hority 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 account ing procedures
established under its bylaws. All receipts and disburseme nts of
funds handled by the Commission shall be sub ject to an annual
financial review by a certified or licens ed 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 this 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 ,
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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 s hall meet at least annually.
6. The Executive Committee shall have the following duties and
responsibilities:
a. recommend to the Commission chang es to the
Commission’s Rules or bylaws, changes to this Compact
legislation, fees to be paid by Compact Parti cipating
States such as annual dues, and any Commission C ompact
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 Par ticipating States and
provide compliance reports to the Com mission,
f. establish additional committees as necessary ,
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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 reserved to the Commission by the
Commission’s Rules, and
h. perform other duties as provided in the Commission ’s
Rules or bylaws.
7. All meeting of the Executiv e Committee at which it votes or
plans to vote on matters i n exercising the powers and duties of the
Commission shall be open to the public and public notice of such
meetings shall be given as public meetings of the Commissio n are
given.
8. The Executive Committee may convene in a closed, non -public
meeting for the same reasons that the Commission may convene in a
non-public meeting as set forth in Section 7.D .3 and shall announce
the closed meeting as the Commission is required to under Section
7.D.4 and keep minutes of the closed meeting as the Commission is
required to under Section 7.D.5.
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 i njury or other
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civil liability cause d by or arising out of any actual or al leged
act, error, or omission that occurred, or t hat the person against
whom the claim is made had a reasona ble basis for believing occurred
within the scope of Commission employment, duties or
responsibilities; provi ded 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 a ny way
compromise or limit the immunity granted h ereunder.
2. The Commission shall defend any member, offic er, 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 respo nsibilities; provided that
nothing herein shall be construe d to prohibit that person from
retaining their own counsel at their own expense; an d provided
further, that the actual or alleged act, error, or omission did not
result from that person ’s intentional or willful or wanton
misconduct.
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3. The Commission shall indemnify and hold harmless any member,
officer, executive director, em ployee, and representative of the
Commission for the amount of any settlement or judgment obtained
against that person arisi ng 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 th e 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 wa ive venue and jurisdiction al
defenses in any proceedings as authorized by Commission Rules.
5. Nothing herein 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 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 sha ll be
determined exclusively by State law other than this Compact.
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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 c laims
under the Sherman Act, Clayton Act, or any other State or federal
antitrust or anticompetitive law or regulation.
8. Nothing in this Compact shall be construed to be a waiver of
sovereign immunity by the Participating State s or by the Commission.
Section 8. Data System.
A. The Commission shall provide for the development,
maintenance, operation, and utilization of a coordinated data and
reporting system containing licensure, Adverse Action, and the
reporting of the existence of Significant Investig ative Information
on all licensed PAs and applicants denied a License in Participating
States.
B. Notwithstanding any other State law to the contr ary, a
Participating State shall submit a uniform data set to the Data
System on all PAs to whom this Compact is applicable (utiliz ing 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;
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4. Any denial of application for licensure, and the reason(s)
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 deter mined by the Rules of the Commission.
C. Significant Investigative Information pertaining to a
Licensee in any Participating State shall only be av ailable to other
Participating States.
D. The Commission shall promptly notify all Pa rticipating
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 information shall be available to any other
Participating State.
E. Participating States contribut ing 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 submitt ed to the Data System that is
subsequently expunged pursuan t to federal law or the laws of the
Participating State contributing the information shall be removed
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from the Data System upon rep orting of such by the Participating
State to the Commission.
G. The records and information provided to a Participating
State pursuant to this Comp act 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.
Section 9. Rulemaking.
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 bindi ng 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 admin ister this Compact
and achieve its purposes. A Commission Rule shall be invalid and
have not 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 this Compact, or the powers granted hereun der, or based
upon another applicable standard of review.
C. The Rules of the Commis sion shall have the force of law in
each Participating State, provided however that wher e the Rules of
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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
resolution in the same manner used to adopt this Compact within four
(4) years of the dat e 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 Compac t.
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 consid ered 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:
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1. The time, date, and location of the public hearing on the
proposed Rule and the proposed time, date an d location of the
meeting in which the proposed Rule will be considered and voted
upon;
2. The text of the proposed Rule an d 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 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 h earing.
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2. Hearings shall be conduc ted in a manner providing each
person who wishes to comment a fair and reasonable opport unity to
comment orally or in writing.
3. All hearings shall be recorded. A copy of the recording and
the written comments, d ata, facts, opinions, and argument s received
in response to the proposed rulemaking shall be made available to a
person upon request.
4. 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 Com mission at hearings required
by this section.
J. Following the public hearing the Commi ssion shall consider
all written and oral comments timely r eceived.
K. The Commission shall, by majority vote of all delegates ,
take final action on the propose d 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 a dopt changes to the proposed 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
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well as reasons for substantive changes n ot 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,
the effective date of the Rule shall be no sooner t han thirty (30)
days after the Commi ssion issued the notice that it adopted the
Rule.
L. Upon determination that an emergen cy exists, the Commission
may consider and adopt an emergen cy Rule with twenty-four (24) 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, in no event later than ninety
(90) days after the effective date of the Rule. For the purposes of
this provision, an emergency Rule is one that must be adopted
immediately by the Commissi on in order to:
1. Meet an imminent threat to public healt h, 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 Commissi on
may direct revisions to a previo usly adopted Commission Rule for
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purposes of correcting typographical errors, errors in format,
errors in consistency, or gr ammatical 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 (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 i n the notice of revisions
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 revis ion
may not take effect without the approval of the Commission.
N. No Participating State ’s rulemaking requirements shall apply
under this Compact.
Section 10. Oversight, Dispute Resolution, and Enforcement .
A. Oversight.
1. The executive and judicial branches of State government in
each Participating State shall enforce th is Compact and take all
actions necessary and appropriate to implement the Compact.
2. Venue is proper and judicial proceed ings by or against the
Commission shall be brought solely a nd exclusively in a court of
competent jurisdiction where the principal office of the Commiss ion
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
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affect or limit the selection or proprie ty of venue in any action
against a licensee for professional malpractice, misconduct or any
such similar matter.
3. The Commission shall be entitled to receive service of
process in any proceeding regarding the enforcement or
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, this Compact, or Commission Rules.
B. Default, Technical Assistance, and Termination .
1. If the Commission determines that a Participati ng State has
defaulted in the performance of its obligation s or responsibilities
under this Compact or the 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 trainin g 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 this Compact upon an
affirmative vote of a majority of the delegates of the Participating
States, and all rights, privileges and benefit s conferred by this
Compact upon such State may be terminated on the effective date of
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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 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 St ate’s legislature, and to the Licensing Board(s)
of each of the Participating States.
4. A State that has been terminated is responsible for all
assessments, obligations, and liabilities incurred t hrough the
effective date of termination, including obliga tions that extend
beyond the effective date of termination.
5. The Commission shall not bear any costs related to a State
that is found to be in d efault or that has been terminated from this
Compact, unless agreed upon in writing between the Commission an d
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 dist rict where the
Commission has its principal offices. The prevailing member shall
be awarded all costs of such litigation, including reasonable
attorney’s fees.
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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
hundred eighty (180) days following the effective date
of such termination.
b. Licensees who are licensed in that State who have b een
granted a Compact Privilege in a Participating State
shall retain the Compact Privil ege for one hundred
eighty (180) days unless the Li censee also has a
Qualifying License in a Participating State or obtains
a Qualifying License in a Participating Stat e before
the one hundred eighty (180) -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 disput es related to this Compact that aris e among
Participating States and between participating and non -Participating
States.
2. The Commission shall promulgate a Rule providing fo r both
mediation and binding dispute resolution for disputes as
appropriate.
D. Enforcement.
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1. The Commission, in the reasonable exercise of its
discretion, shall enforce the provisions of this 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
initiate legal action in the United States District Court for the
District of Columbia or the fede ral district where the Commission
has its principal offices, against a Participating State in default
to enforce compliance with the provisions o f this Compact and the
Commission’s promulgated Rules and bylaws. 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 ’s fees.
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 lega l 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 in clude both injunctive relief and
damages. In the event judicial enforcement is necessar y, the
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prevailing party shall be awarded all costs of such litigation,
including reasonable attorney ’s fees.
2. No person other than a Participating State shall enforc e
this Compact against the Commission.
Section 11. Date of Implementation of the PA Licensure Compact
Commission.
A. This Compact shall come into effect on the date on which
this Compact statute is enacted into law in the seventh
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 Compac t 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 St ate whose enactment is found
to be materially different from the Model Compact
shall be entitled to the de fault process set forth in
Section 10.B.
b. If any Participating State later withdraws from the
Compact or its participation is terminated, the
Commission shall remain in existence an d the Compact
shall remain in effect even if the number of
Participating States should be less than seven.
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Participating States enacting the Compact subsequent
to the Commission convening shall be subject to the
process set forth in Section 7.C.21 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 Section 7.C.21 to determine if their e nactments
are materially different from th e Model Compact and whether they
qualify for participation in the Compact.
3. All actions taken for the benefit o f the Commission or in
furtherance of the purposes of the administration of the Compact
prior to the effective date of the Compact or the Comm ission coming
into existence shall be considered to be actions of the Commission
unless specifically repudiated by the Commission.
B. Any State that joins this Compact shall be subject to the
Commission’s Rules and bylaws as they exist on the date on whic h
this 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 this Compact becomes law in that State.
C. Any Participating State may withdraw from this Compact by
enacting a statute repealing the same.
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1. A Participating State ’s withdrawal shall not take effect
until one hundred eighty (180) days after e nactment of the repealing
statute. During this one hundred eighty (180) day -period, all
Compact Privileges t hat were in effect in the 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 Participa ting State or obtains a license
in another Participating State within the one hundr ed eighty (180)
days, the Licensee’s Compact Privileges in other Participating
States shall not be a ffected by the passage of the one hundred
eighty (180) days.
2. Withdrawal shall not affect the continuing r equirement of
the State Licensing Board(s) of the withdrawing State to comply with
the investigative, and Adverse Action reporting requirements of this
Compact prior to the effective date of withdrawal.
3. Upon the enactment of a statute withdrawing a Sta te from
this 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
this Compact for a minimum of one hundred eighty (1 80) days after
the date of such notice of withdrawal.
D. Nothing contained in this Compact shall be construed to
invalidate or prevent any PA licensure agreement or other
cooperative arrangement between Participating St ates and between a
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Participating State and non-Participating State that does not
conflict with the provisions of this Compact.
E. This Compact may be amended by the Participating Sta tes. No
amendment to this Compact shall become effective and binding upon
any Participating State until it i s enacted materially in the same
manner into the laws of all Participating States as determined by
the Commission.
Section 12. Construction and Severability .
A. This 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 th e promulgation of Rules
shall not be construed to limit the Commission ’s rulemaking
authority solely for thos e 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 p articipation 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 this 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 or this section, the Commission
may deny a State’s participation in the Compac t or, in accordance
with the requirements of Section 10.B, terminate a Participating
State’s participation in the Compact, i f it determines that a
constitutional requirement of a Part icipating 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 13. Binding Effect of Compact.
A. Nothing herein prevents the enforcement of any other law of
a Participating State that is not inconsistent with this Compact.
B. Any laws in a Partic ipating 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.
SECTION 3. This act shall become e ffective November 1, 2024.
COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES
February 8, 2024 - DO PASS