HB 1731

relating to the physician assistant licensure compact; authorizing
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Chapter 204, Occupations Code, is amended by
adding Subchapter I to read as follows:
SUBCHAPTER I. PHYSICIAN ASSISTANT LICENSURE COMPACT
Sec. 204.401.  PHYSICIAN ASSISTANT LICENSURE COMPACT.  The
Physician Assistant Licensure Compact is enacted and entered into
with all other jurisdictions that legally join in the compact,
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 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 be 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 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 this Compact retain the jurisdiction to impose
Adverse Action against a Compact Privilege in that State issued to a
PA through the procedures of this Compact. The PA Licensure Compact
will alleviate burdens for military families by allowing active
duty military personnel and their spouses to obtain a Compact
Privilege based on having an unrestricted License in good standing
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 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
C.  "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
D.  "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. § 20.3(d), from
the State's criminal history record repository as defined in 28
E.  "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 this
F.  "Executive Committee" means a group of directors and
ex-officio individuals elected or appointed pursuant to Section
G.  "Impaired Practitioner" means a PA whose practice is
adversely affected by health-related condition(s) that impact
H.  "Investigative Information" means information, records,
or documents received or generated by a Licensing Board pursuant to
I.  "Jurisprudence Requirement" means the assessment of an
individual's knowledge of the laws and Rules governing the practice
J.  "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
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, prevention, treatment, cure or relief of a
health condition, injury, or disease, as defined by a State's laws
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.
O.  "Participating State" means a State that has enacted this
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 replace the term "physician
assistant" shall be deemed synonymous with "physician assistant"
and shall confer the same rights and responsibilities to the
Licensee under the provisions of this Compact at the time of its
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
V.  "State" means any state, commonwealth, district, or
territory of the United States.
Section 3.  State Participation in this Compact
A.  To participate in this Compact, a Participating State
2.  Participate in the Compact Commission's Data
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
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
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.
8.  Require continuing education for License renewal.
9.  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.
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 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
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
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
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
12.  Report to the Commission any Adverse Action taken
by a non-participating State within thirty (30) days after the
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
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 limited or restricted due to the Adverse
C.  Once a restricted or limited License satisfies the
requirements of Subsection B.1 and 2, the Licensee must meet the
requirements of Subsection A to obtain a Compact Privilege in any
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
Section 5.  Designation of the State from Which Licensee is
Applying for a Compact Privilege
A.  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
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
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.
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 conferred 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.
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 which the witnesses or evidence
3.  Notwithstanding paragraph 1, 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 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 Privilege in that Participating
State for the individual's otherwise lawful practice in another
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
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
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
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 with other Participating States in joint
2.  Participating States shall share any
investigative, litigation, or compliance materials in furtherance
of any joint or individual investigation initiated under this
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 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
B.  Membership, Voting, and Meetings
1.  Each Participating State shall have and be limited
to one (1) 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
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 the State from which the delegate
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 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
7.  The Commission shall establish by Rule a term of
C.  The Commission shall have the following powers and
1.  Establish a code of ethics for the Commission;
2.  Establish the fiscal year of the Commission;
5.  Maintain its financial records in accordance with
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
8.  Bring and prosecute legal proceedings or actions in
the name of the Commission, provided that the standing of any State
Licensing Board to sue or be sued under applicable law shall not be
9.  Purchase and maintain insurance and bonds;
10.  Borrow, accept, or contract for services of
personnel, including, but not limited to, employees of a
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 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
13.  Lease, purchase, accept appropriate gifts or
donations of, or otherwise own, hold, improve or use, any property,
real, personal or mixed; provided that at all times the Commission
shall avoid any appearance of impropriety;
14.  Sell, convey, mortgage, pledge, lease, exchange,
abandon, or otherwise dispose ofany property real, personal, or
15.  Establish a budget and make expenditures;
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 this Compact and the
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
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
22.  Prepare and provide to the Participating States an
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.
1.  All meetings of the Commission that are not closed
pursuant to this subsection shall be open to the public. Notice of
public meetings shall be posted on the Commission's website at
least thirty (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
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
3.  The Commission may convene in a closed, non-public
meeting or non-public part of a public meeting to receive legal
a.  Non-compliance of a Participating State with
its obligations under this Compact;
b.  The employment, compensation, discipline or
other 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
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
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
h.  Disclosure of investigative records compiled
i.  Disclosure of information related to any
investigative reports prepared byor on behalf of or for use of the
Commission or other committee charged with responsibility of
investigation or determination of compliance issues pursuant to
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 the meeting
may be closed and shall reference each relevant exempting
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.
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 to cover its annual budget as approved by the
Commission each year for which revenue is not provided by other
sources. The aggregate annual assessment amount levied on
Participating States shall be allocated based upon a formula to be
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.
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
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 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
5.  The Commission shall keep accurate accounts of all
receipts and disbursements. The receipts and disbursements of the
Commission shall be subject to the financial review and accounting
procedures established under 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.
1.  The Executive Committee shall have the power to act
on behalf of the Commission according to the terms of this Compact
2.  The Executive Committee shall be composed of nine
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
4.  The Commission may remove any member of the
Executive Committee as provided in its bylaws.
5.  The Executive Committee shall meet at least
6.  The Executive Committee shall have the following
a.  Recommend to the Commission changes to the
Commission's Rules or bylaws, changes to this 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
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
e.  Monitor Compact compliance of Participating
States and provide compliance reports to the Commission;
f.  Establish additional committees 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
reserved to the Commission by the Commission's Rules; and
h.  Perform other duties as provided in the
7.  All meeting 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 meetings shall be given as public meetings of the
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 injury or other civil liability caused by or arising out of
any actual or alleged act, error, or omission that occurred, or that
the person against whom the claim is made had a reasonable basis for
believing occurred within the scope of Commission employment,
duties or responsibilities; provided that nothing in this paragraph
shall be construed to protect any such person from suit or liability
for any damage, loss, injury, or liability caused by the
intentional or willful or wanton misconduct of that person. The
procurement of insurance of any type by the Commission shall not in
any way compromise or limit the immunity granted hereunder.
2.  The Commission shall defend any member, officer,
executive director, employee, and representative of the Commission
in any civil action seeking to impose liability arising out of any
actual or alleged act, error, or omission that occurred within the
scope of Commission employment, duties, or responsibilities, or as
determined by the commission that the person against whom the claim
is made had a reasonable basis for believing occurred within the
scope of Commission employment, duties, or responsibilities;
provided that nothing 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
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
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
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
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 this
7.  Nothing in this Compact shall be interpreted to
waive or otherwise person's intentional or willful or wanton
misconduct.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 anticompetitive law or regulation.
8.  Nothing in this Compact shall be construed to be a
waiver of sovereign immunity by the Participating States or by the
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 Investigative
Information on all licensed PAs and applicants denied a License in
B.  Notwithstanding any other State law to the contrary, a
Participating State shall submit a uniform data set to the Data
System on all PAs to whom this Compact is applicable (utilizing a
unique identifier) as required by the Rules of the Commission,
3.  Adverse Actions against a License or Compact
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
6.  Other information that may facilitate the
administration of this Compact, as determined by the Rules of the
C.  Significant Investigative Information pertaining to a
Licensee in any Participating State shall only be available to
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 information shall be available to any other
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
G.  The records and information provided to a Participating
State pursuant to this Compact or through the Data System, when
certified by the Commission or an agent 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
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 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
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
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 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
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
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
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
2.  The text of the proposed Rule and the reason for the
3.  A request for comments on the proposed Rule from any
interested person and the date by which written comments must be
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
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
arguments 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 Commission at hearings
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
2.  The Commission may adopt changes to the proposed
Rule provided the changes do not enlarge the original purpose of the
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 changes 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, the effective date of the Rule shall be no sooner than
thirty (30) days after the Commission issued the notice that it
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
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 Commission in order to:
1.  Meet an imminent threat to public health, safety,
2.  Prevent a loss of Commission or Participating State
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 adopted Commission
Rule for purposes of correcting typographical errors, errors in
format, errors in consistency, or grammatical errors. Public notice
of any revisions shall be posted on the website of the Commission.
The revision shall be subject to challenge by any person for a
period of thirty (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 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
N.  No Participating State's rulemaking requirements shall
Section 10.  Oversight, Dispute Resolution, and Enforcement
1.  The executive and judicial branches of State
government in each Participating State shall enforce this Compact
and take all actions necessary and appropriate to implement the
2.  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 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.
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 Participating
State has defaulted in the performance of its obligations 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 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 this Compact upon an
affirmative vote of a majority of the delegates of the
Participating States, and all rights, privileges and benefits
conferred by this Compact upon such State may be terminated on the
effective date of termination. A cure of the default does not
relieve the offending State of obligations or liabilities incurred
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 State'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 through the
effective date of termination, including obligations 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 default or that has been terminated
from this 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
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
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 (180)-day period
ends, in which case the Compact Privilege shall continue.
1.  Upon request by a Participating State, the
Commission shall attempt to resolve disputes related to this
Compact that arise among Participating States and between
participating and non-Participating States.
2.  The Commission shall promulgate a Rule providing
for both mediation and binding dispute resolution for disputes as
1.  The Commission, in the reasonable exercise of its
discretion, shall enforce the provisions of this Compact and Rules
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 federal district where the
Commission has its principal offices, against a Participating State
in default to enforce compliance with the provisions of this
Compact and the Commission's promulgated Rules and bylaws. The
relief sought may include both injunctive relief and damages. In
the event judicial enforcement is necessary, the prevailing party
shall be awarded all costs of such litigation, including reasonable
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's fees.
2.  No person other than a Participating State shall
enforce this Compact against the Commission.
Section 11.  Date of Implementation of the PA Licensure Compact
A.  This Compact shall come into effect on the date on which
this Compact statute is enacted into law in the seventh
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 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 and the Compact shall remain in effect
even if the 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
Section 7.C.21 to determine if their enactments are materially
different from the Model Compact and whether they qualify for
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 enactments are materially different from the Model Compact
and whether they qualify for participation in the Compact.
3.  All actions taken for the benefit 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 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 which
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.
1.  A Participating State's withdrawal shall not take
effect until one hundred eighty (180) days after enactment of the
repealing statute. During this one hundred eighty (180) day-period,
all Compact Privileges that 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 Participating State or obtains a
license in another Participating State within the one hundred
eighty (180) days, the Licensee's Compact Privileges in other
Participating States shall not be affected by the passage of the one
2.  Withdrawal shall not affect the continuing
requirement 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
3.  Upon the enactment of a statute withdrawing a State
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 (180)
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 States and between a
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 States.
No amendment to this Compact shall become effective and binding
upon any Participating State until it is enacted materially in the
same manner into the laws of all Participating States as determined
Section 12.  Construction and Severability
A.  This Compact and the Commission's rulemaking authority
shall be liberally construed so as to effectuate the purposes, and
the implementation and administration of the Compact. Provisions of
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 this Compact shall be severable and if
any phrase, clause, sentence or provision of this Compact is held by
a court of competent jurisdiction to be contrary to the
constitution of any Participating State, a State seeking
participation in the Compact, or 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.
C.  Notwithstanding subsection B or this section, the
Commission may deny a State's participation in the Compact or, in
accordance with the requirements of Section10.B, terminate a
Participating State's participation in the Compact, if it
determines that a constitutional requirement of a Participating
State is, or would be with respect to a State seeking to participate
in the Compact, a material departure from the Compact. Otherwise,
if this Compact shall be held to be contrary to the constitution of
any Participating State, the Compact shall remain in full force and
effect as to the remaining Participating States and in full force
and effect as to the Participating State affect