physician assistants; licensure compact

Chapter 0003 - 572R - H Ver of HB2190

House Engrossed

physician assistants;
licensure compact

State of Arizona

House of Representatives

Fifty-seventh Legislature

Second Regular Session

2026

CHAPTER 3

HOUSE BILL 2190

AN
ACT

Amending title 32, chapter 25, Arizona Revised
Statutes, by adding article 5; relating to the Arizona regulatory board of
physician assistants.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it enacted by the Legislature of
the State of Arizona:

Section 1. Title 32, chapter 25, Arizona
Revised Statutes, is amended by adding article 5, to read:

ARTICLE 5. PHYSICIAN ASSISTANT
LICENSURE COMPACT

START_STATUTE
32-2571.

Licensure compact

The physician assistant licensure compact is
adopted and enacted into law 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 physician assistant 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 physician assistants and seeks to enhance the portability of a
license to practice as a physician assistant while safeguarding the safety of
patients.� this compact allows medical services to be provided by physician
assistants via the mutual recognition of the licensee's qualifying license by
other compact participating states.� This compact also adopts the prevailing
standard for physician assistant licensure and affirms that the practice and
delivery of medical services by the physician assistant occurs where the
patient is located at the time of the patient encounter, and therefore requires
the physician assistant to be under the jurisdiction of the state licensing
board where the patient is located.� state licensing boards that participate in
this compact retain the jurisdiction to impose adverse action against a compact
privilege in that state issued to a physician assistant through the procedures
of this compact.� The physician assistant 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 from a participating state.

Section
2. Definitions

In this compact, unless the context otherwise
requires:

1. "Adverse action" means
any administrative, civil, equitable or criminal action allowed by a state's
laws that 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.

2. "Compact privilege"
means the authorization granted by a remote state to allow a licensee from
another participating state to practice as a PA to provide medical services and
other licensed activity to patients located in the remote state under the
remote state's laws and regulations.

3. "Conviction" means a
finding by a court that an individual is guilty of a felony or misdemeanor
offense through adjudication or entry of a plea of guilty or no contest to the
charge by the offender.

4. "Criminal background
check" means the submission of fingerprints or other biometric-based
information for a license applicant for the purpose of obtaining that
applicant's criminal history record information, as defined in 28 Code of
Federal Regulations section 20.3(
d
), from the state's
criminal history record repository as defined in 28 Code of Federal Regulations
section 20.3(
f
).

5. "Data system" means the
repository of information about licensees, including but not limited to license
status and adverse actions, that is created and administered under the terms of
this compact.

6. "Executive committee"
means a group of directors and ex officio individuals who are elected or
appointed pursuant to section 7, subsection F, paragraph 2 of this compact.

7. "Impaired practitioner"
means a PA whose practice is adversely affected by a health-related
condition that impacts the PA's ability to practice.

8. "Investigative
information" means information, records or documents received or generated
by a licensing board pursuant to an investigation.

9. "Jurisprudence
requirement" means the assessment of an individual's knowledge of the laws
and rules governing the practice of a PA in a state.

10. "License" means current
authorization by a state, other than authorization pursuant to a compact
privilege, for a PA to provide medical services that would be unlawful without
current authorization.

11. "Licensee" means an
individual who holds a license from a state to provide medical services as a
PA.

12. "Licensing board" means
any state entity that is authorized to license and otherwise regulate PAs.

13. "Medical services"
means health care services that are provided to diagnose, prevent, treat, cure
or relieve of a health condition, injury or disease, as defined by a state's
laws and regulations.

14. "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.

15. "PA" means an
individual who is licensed as a physician assistant in a state.� For the
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 this compact at the time of its
enactment.

16. "PA licensure compact
commission", "compact commission" or "commission"
means the national administrative body created pursuant to section 7,
subsection A of this compact.

17. "Participating state"
means a state that has enacted this compact.

18. "Qualifying license"
means an unrestricted license that is issued by a participating state to
provide medical services as a PA.

19. "Remote state" means a
participating state where a licensee who is not licensed as a PA is exercising
or seeking to exercise the compact privilege.

20. "Rule" means a
regulation promulgated by an entity that has the force and effect of law.

21. "Significant investigative
information" means investigative information that a licensing board, after
an inquiry or investigation that includes notification and an opportunity for
the 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.

22. "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 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 the state's licensing board receiving the results of a criminal
background check and reporting to the commission whether the license applicant
has been granted a license.

6. Comply with the rules of the
compact commission.

7. Use passage of a recognized
national exam such as the national commission on certification of physician
assistants physician assistant national certifying examination as a requirement
for PA licensure.

8. Grant the compact privilege to a
holder of a qualifying license in a participating state.

B. This Compact does not prohibit a
participating state from charging a fee for granting the compact privilege.

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 or another program authorized by commission rule.

2. Hold current certification from
the national commission on certification of PHYSICIAN assistants.

3. Have no felony or misdemeanor
conviction.

4. Have never had a controlled
substance license, permit or registration suspended or revoked by a state or by
the United States drug enforcement administration.

5. Have a unique identifier as
determined by commission rule.

6. Hold a qualifying license.

7. Have had no revocation of a
license or limitation or restriction on any license currently held due to an
adverse action.

8. If the licensee has had a
limitation or restriction on a license or compact privilege due to an adverse
action, 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
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 has discretion not to consider such action as an
adverse action requiring the denial or removal of a compact privilege in that
state.

10. Notify the compact commission
that the licensee is seeking the compact privilege in a remote state.

11. Meet any jurisprudence
requirement of a remote state in which the licensee is seeking to practice
under the compact privilege and pay any fees applicable to satisfying the
jurisprudence requirement.

12. Report to the commission any
adverse action taken by a nonparticipating state within thirty days after the
adverse action is taken.

B. The compact privilege is valid
until the expiration or revocation of the qualifying license unless terminated
pursuant to an adverse action. The licensee must also comply with
all of the requirements of subsection A of this section to maintain the compact
privilege in a remote state. If the participating state takes
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 both of the following occur:

1. The license is no longer limited
or restricted.

2. Two years have elapsed from the
date on which the license is no longer limited or restricted due to the adverse
action.

C. Once a restricted or limited
license satisfies the requirements of subsection B of this section, the
licensee must meet the requirements of subsection A of this section to obtain a
compact privilege in any remote state.

D. For each remote state in which a
PA seeks authority to prescribe controlled substances, the PA shall satisfy all
requirements imposed by that remote state in granting or renewing such
authority.

Section 5. Designation of State from Which Licensee

is Applying for a Compact Privilege

On a licensee's application for a compact
privilege, the licensee shall identify to the commission the participating
state from which the licensee is applying, in accordance with applicable rules
adopted by the commission and subject to the following requirements:

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.

2. When applying for a compact
privilege, the licensee is required to consent to accept service of process by
mail at the licensee's primary residence on file with the commission with
respect to any action brought against the licensee by the commission or a
participating state, including a subpoena, with respect to any action brought
or investigation conducted by the commission or a participating state.

Section
6. 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 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, 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 witness or evidence is located.

3. Notwithstanding paragraph 2 of
this subsection, subpoenas may not be issued by a participating state to gather
evidence of conduct in another state that is lawful in that other state for the
purpose of taking adverse action against a licensee's compact privilege or
application for a compact privilege in that participating state.

4. This compact does not authorize a
participating state to impose discipline against a PA's compact privilege or to
deny an application for a compact privilege in that participating state for the
individual's otherwise lawful practice in another state.

C. For the purposes of taking adverse
action, the participating state that issued the qualifying license shall give
the same priority and effect to reported conduct received from any other
participating state as it would if the conduct had occurred within the
participating state that issued the qualifying license. In so doing, that
participating state shall apply its own state laws to determine appropriate
action.

D. A participating state, if
otherwise allowed by state law, may recover from the affected PA the costs of
investigations and disposition of cases resulting from any adverse action taken
against that PA.

E. A participating state may take
adverse action based on the factual findings of a remote state, if the
participating state follows its own procedures for taking the adverse action.

F. Joint Investigations are as
follows:

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 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 years have elapsed after all restrictions
have been removed from the state license.� All disciplinary orders by the
participating state that 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, the participating state promptly shall notify the administrator
of the data system.

Section
7. Establishment of 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 is not an
instrumentality of any one state.� The commission shall come into existence on
or after the effective date of this compact as set forth in section 11,
subsection A of this compact.

B. Membership, Voting and Meetings of
the commission are as follows:

1. Each participating state shall
have and be limited to one delegate selected by that participating state's
licensing board or, if the state has more than one licensing board, selected
collectively by the participating state's licensing boards.

2. The delegate shall be either:

(
a
) A current
PA, physician or public member of a licensing board or PA council or committee.

(
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 is appointed.

4. The participating state licensing
board shall fill any vacancy occurring in the commission within sixty days.

5. Each delegate is entitled to one
vote on all matters voted on by the commission and shall otherwise have an
opportunity to participate in the business and affairs of the commission.� A
delegate shall vote in person or by such other means as provided in the bylaws.
The bylaws may provide for delegates' participation in meetings by
telecommunications, video conference or other means of communication.

6. The commission shall meet at least
once during each calendar year. Additional meetings shall be held as set forth
in 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 ethics 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 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 sued under applicable law
shall not be affected.

9. Purchase and maintain insurance
and bonds.

10. Borrow, accept or contract for
services of personnel, including employees of a participating state.

11. Hire employees and engage
contractors, elect or appoint officers, fix compensation, define duties, grant
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, use and dispose of the same, provided that at all times the commission
shall avoid any appearance of impropriety or conflict of interest.

13. Lease, purchase, accept
appropriate gifts or donations of, or otherwise own, hold, improve or use any
property, whether real, personal or mixed, provided that at all times the
commission shall avoid any appearance of impropriety.

14. Sell, convey, mortgage, pledge,
lease, exchange, abandon or otherwise dispose of any property, whether real,
personal or mixed.

15. Establish a budget and make
expenditures.

16. Borrow money.

17. Appoint committees, including
standing committees composed of members, state regulators, state legislators or
their representatives, and consumer representatives, and such other interested
persons as may be designated in this compact and the bylaws.

18. Provide information to, receive
information from and cooperate with law enforcement agencies.

19. Elect a chair, vice chairperson,
secretary and treasurer and such other officers of the commission as provided
in the commission's bylaws.

20. Reserve for itself, in addition
to those reserved exclusively to the commission under this compact, powers that
the executive committee may not exercise.

21. Approve or disapprove a state's
participation in this compact based on the commission's determination as to
whether the state's compact legislation departs in a material manner from the
model compact language.

22. Prepare and provide to the
participating states an annual report.

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 are as
follows:

1. All meetings of the commission
that are not closed pursuant to this subsection shall be open to the public.�
Notice of public meetings shall be posted on the commission's website at least
thirty days before the public meeting.

2. Notwithstanding paragraph 1 of
this subsection, the commission may convene a public meeting by providing at
least twenty-four hours' prior notice on the commission's website, and
any other means as provided in the commission's rules, and for any of the
reasons it may dispense with notice of proposed rulemaking under section 9,
subsection L of this compact.

3. The commission may convene in a
closed, nonpublic meeting or nonpublic part of a public meeting to receive
legal advice or to discuss any of the following:

(
a
) Noncompliance
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 anticipated litigation.

(
d
) Negotiation
of contracts for the purchase, lease or sale of goods, services or real estate.

(
e
) Accusations
of any person of a crime or the formal censure of any person.

(
f
) Disclosure
of trade secrets or commercial or financial information that is privileged or
confidential.

(
g
) Disclosure
of information of a personal nature if the disclosure would constitute a
clearly unwarranted invasion of personal privacy.

(
h
) Disclosure
of investigative records compiled for law enforcement purposes.

(
i
) Disclosure
of information related to any investigative reports prepared by or on behalf of
or for use by the commission or other committee charged with responsibility of
investigation or determination of compliance issues pursuant to this compact.

(
j
) Legal
advice.

(
k
) Matters
specifically exempt from disclosure by federal or participating states'
statutes.

4. If
a meeting, or portion of a meeting, is closed pursuant to paragraph 3 of this
subsection, the chairperson of the meeting or the chairperson's designee shall
certify that the meeting or portion of the meeting may be closed and shall
reference each relevant exempting provision.

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 is as
follows:

1. The commission shall pay, or
provide for the payment of, the reasonable expenses of its establishment,
organization and ongoing activities.

2. The commission may accept any and
all appropriate revenue sources and 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.� The assessment and fees must be in a total amount
sufficient to cover the commission's 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 on a formula to be determined by commission rule.

(a)
A
compact privilege expires when the licensee's qualifying license in the
participating state from which the licensee applied for the compact privilege
expires.

(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 the participating state through
which it applies for a compact privilege to that participating state and pay to
the commission any compact privilege fee required by commission rule.

4. The commission shall not incur
obligations of any kind before securing the monies adequate to meet the same or
pledge the credit of any participating state, except by and with the authority
of the participating state.

5. The commission shall keep accurate
accounts of all receipts and disbursements.� The receipts and disbursements of
the commission shall be subject to the financial review and accounting
procedures established under its bylaws.� All receipts and disbursements of
monies handled by the commission are subject to an annual financial review by a
certified or licensed public accountant, and the report of the financial review
shall be included in and become part of the annual report of the commission.

F. Powers, duties and membership of
the Executive Committee are as follows:

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 the following nine members:

(
a
) Seven
voting members who are elected by the commission from the current membership of
the commission.

(
b
) One ex
officio, nonvoting member from a recognized national PA professional
association.

(
c
) One ex
officio, nonvoting member from a recognized national PA certification
organization.

3. The ex officio members will be
selected by their respective organizations.

4. The commission may remove any
member of the executive committee as provided in its bylaws.

5. The executive committee shall meet
at least annually.

6. The executive committee shall have
the following duties and responsibilities:

(
a
) Recommend
to the commission changes to the commission's rules or bylaws, changes to this
compact legislation, fees to be paid by participating states, such as annual
dues, and any commission compact fee charged to licensees for the compact privilege.

(
b
) Ensure that
compact administration services are appropriately provided, contractual or
otherwise.

(
c
) Prepare and
recommend the commission's budget.

(
d
) Maintain
financial records on behalf of the commission.

(
e
) Monitor
compact compliance of participating states and provide compliance reports to
the commission.

(
f
) Establish
additional 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.

(
h
) Perform
other duties as provided in the commission's rules or bylaws.

7. All
meetings of the executive committee at which the executive committee votes or
plans to vote on matters 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 commission are given.

8. The executive committee may
convene in a closed, nonpublic meeting for the same reasons that the commission
may convene in a nonpublic meeting as set forth in subsection D, paragraph 3 of
this
section.� The executive committee shall announce the
closed meeting as the commission is required to under subsection D, paragraph 4
of this�
section and shall keep minutes of the closed
meeting as the commission is required to under subsection D, paragraph 5 of
this
Section.

G. Qualified Immunity, Defense and
Indemnification of the commission are as follows:

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.� This paragraph does not protect any such person
from suit or liability for any damage, loss or injury caused by the intentional
or wilful 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 under this paragraph.

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 this paragraph does not prohibit that person
from retaining the person's own counsel at the person's own expense; and
provided further, that the actual or alleged act, error or omission did not
result from that person's intentional or wilful or wanton misconduct.

3. The commission shall indemnify and
hold harmless any member, officer, executive director, employee and
representative of the commission for the amount of any settlement or judgment
obtained against that person arising out of any actual or alleged act, error or
omission that occurred within the scope of commission employment, duties or
responsibilities, or that such person had a reasonable basis for believing
occurred within the scope of commission employment, duties or responsibilities
if the actual or alleged act, error or omission did not result from the
intentional or wilful or wanton misconduct of that person.

4. Venue is proper and judicial
proceedings by or against the commission shall be brought solely and
exclusively in a court of competent jurisdiction where the principal office of
the commission is located.� The commission may waive venue and jurisdictional
defenses in any proceedings as authorized by commission rules.

5. This compact does not limit the
liability of any licensee for professional malpractice or misconduct, which
shall be governed solely by any other applicable state laws.

6. This compact does not designate
the venue or jurisdiction to bring actions for alleged acts of malpractice,
professional misconduct or 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 compact.

7. this compact does not waive or
otherwise abrogate a participating state's state action immunity or state
action affirmative defense with respect to antitrust claims under the Sherman
Act, the Clayton Act or any other state or federal antitrust or anticompetitive
law or regulation.

8. THis compact is not a waiver of
sovereign immunity by the participating states 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 significant
investigative information on all licensed PAs and applicants who are denied a
license in participating states.

B. Notwithstanding any other state
law to the contrary, a participating state shall submit a uniform data set to
the data system on all PAs to whom this compact is applicable using a unique
identifier, as required by the rules of the commission, that includes:

1. Identifying information.

2. Licensure data.

3. Adverse actions against a license
or compact privilege.

4. Any denial of an application for
licensure and the reasons for such denial, excluding the reporting of any
criminal history record information where prohibited by law.

5. The existence of significant
investigative information.

6. Other information that may
facilitate the administration of this compact, as determined by the rules of
the commission.

C. Significant investigative
information pertaining to a licensee in any participating state shall be
available only to other participating states.

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 the commission. This adverse action information shall be available
to any other participating state.

E. Participating states contributing
information to the data system may, in accordance with state or federal law,
designate information that may not be shared with the public without the
express permission of the contributing state. Notwithstanding any
such designation, such information shall be reported to the commission through
the data system.

F. Any information submitted to the
data system that is subsequently expunged pursuant to federal law or the laws
of the participating state contributing the information shall be removed from
the data system on a report of the expungement by the participating state to
the commission.

G. The records and information
provided to a participating state pursuant to this compact or through the data
system, when certified by the commission or an agent thereof, constitute the
authenticated business records of the commission and are 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 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 not have 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 on another applicable standard of
review.

C. The rules of the commission shall
have the force of law in each participating state, except that where the rules
of the commission conflict with the laws of the participating state that
establish the medical services a PA may perform in the participating state, as
held by a court of competent jurisdiction, the rules of the commission shall be
ineffective in that state to the extent of the conflict.

D. If a majority of the legislatures
of the participating states rejects a commission rule by enacting a statute or
resolution in the same manner used to adopt this compact within four years
after the date of adoption of the rule, that rule has no further force and
effect in any participating state or to any state applying to participate in
the compact.

E. Commission rules shall be adopted
at a regular or special meeting of the commission.

F. Before the commission adopts a
final rule or rules, and at least thirty days in advance of the meeting at
which the rule will be considered and voted on, the commission shall file a
notice of proposed rulemaking in the following manner:

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.

3. In such other way as the
commission may by rule specify.

G. The notice of proposed rulemaking
shall include all of the following:

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 on.

2. The text of the proposed rule and
the reason for the proposed rule.

3. A request for comments on the
proposed rule from any interested person and the date by which written comments
must be received.

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. Before adopting 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.� The following apply to hearings:

1. All persons wishing to be heard at
a hearing shall notify the commission, as directed in the notice of proposed
rulemaking not less than five business days before the scheduled date of the
hearing, 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 on request.

4. This section does not require a
separate hearing on each proposed rule.� Proposed rules may be grouped for the
convenience of the commission at hearings required by this section.

J. Following the public hearing, the
commission shall consider all written and oral comments timely received.

K. The commission, by a majority vote
of all delegates, shall 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.� The following apply to rules:

1. If adopted, the rule shall be
posted on the commission's website.

2. The commission may adopt changes
to the proposed rule if 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 that are made
to the proposed rule as well as reasons for substantive changes that are not
made and that were recommended by commenters.

4. The Commission shall determine a
reasonable effective date for the rule. Except for an emergency as
provided in subsection L of this section, the effective date of the rule shall
be not sooner than thirty days after the commission issued the notice that it
adopted the rule.

L. On determination that an emergency
exists, the commission may consider and adopt an emergency rule with twenty-four
hours' prior notice, without the opportunity for comment or hearing, if the
usual rulemaking procedures provided in this compact and this section are
retroactively applied to the rule as soon as reasonably possible, but not later
than ninety days after the effective date of the rule. For the
purposes of this subsection, an emergency rule is one that must be adopted
immediately by the commission in order to accomplish any of the following:

1. Meet an imminent threat to public
health, safety or welfare.

2. Prevent a loss of commission or
participating state monies.

3. Meet a deadline for the
promulgation of a commission rule that is established by federal law or
regulation.

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 the 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 is subject to challenge by any person for a period of thirty days
after posting.� The revision may be challenged only on grounds that the
revision results in a material change to a rule.� A challenge shall be made as
set forth in the notice of revisions and delivered to the commission before the
end of the notice period. If no challenge is made, the revision will
take effect without further action.� If the revision is challenged, the
revision may not take effect without the approval of the commission.

N. A participating state's rulemaking
requirements do not apply under this compact.

Section
10. Oversight, Dispute Resolution and Enforcement

A. Oversight of this compact is as
follows:

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 this
compact.

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 the commission adopts or consents to
participate in alternative dispute resolution proceedings. This
compact does not affect or limit the selection or propriety of venue in any
action against a licensee for professional malpractice or 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 this 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 renders a judgment or order
in such a proceeding void as to the commission, this compact or commission
rules.

B. Default,
Technical Assistance and Termination are as follows:

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 on
an affirmative vote of a majority of the delegates of the participating states,
and all rights, privileges and benefits conferred by this compact on that state
may be terminated on the effective date of termination. A cure of the default
does not relieve the offending state of obligations or liabilities incurred
during the period of default.

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 the licensing boards of each participating
state.

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 on in writing between the
commission and the defaulting state.

6. The defaulting state may appeal
its termination from this compact by the commission by petitioning the United
States district court for the District of Columbia or the federal district
where the commission has its principal offices. The prevailing party
shall be awarded all costs of such litigation, including reasonable attorney
fees.

7. On the termination of a state's
participation in this compact, that state shall immediately provide notice of
the termination to all licensees within that state that includes the following
information:

(
a
) Licensees
who have been granted a compact privilege in that state shall retain the
compact privilege for one hundred eighty days following the effective date of
the termination.

(
b
) Licensees
who are licensed in that state and who have been granted a compact privilege in
a participating state shall retain the compact privilege for one hundred eighty
days unless the licensee also has a qualifying license in a participating state
or obtains a qualifying license in a participating state before the one hundred
eighty-day period ends, in which case the compact privilege shall
continue.

C. Dispute Resolution is as follows:

1. On request by a participating
state, the commission shall attempt to resolve disputes related to this compact
that arise among participating states and between participating states and
nonparticipating states.

2. The commission shall promulgate a
rule providing for both mediation and binding dispute resolution for disputes
as appropriate.

D. Enforcement is as follows:

1. The commission, in the reasonable
exercise of its discretion, shall enforce this compact and rules of the
commission.

2. If compliance is not secured after
all means to secure compliance have been exhausted, the commission, by majority
vote, 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 that is in default to enforce
compliance with this compact and the commission's promulgated rules and
bylaws.� The relief sought may include both injunctive relief and damages.� If
judicial enforcement is necessary, the prevailing party shall be awarded all
costs of such litigation, including reasonable attorney fees.

3. The remedies prescribed in this
subsection are not 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 is as follows:

1. A participating state may initiate
legal action against the commission in the United States district court for the
District of Columbia or the federal district where the commission has its
principal offices to enforce compliance with this compact and its rules.� The
relief sought may include both injunctive relief and damages. if
judicial enforcement is necessary, the prevailing party shall be awarded all
costs of such litigation, including reasonable attorney fees.

2. Only a participating state may
enforce this compact against the commission.

Section 11. Date of Implementation of 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 as follows:

1. On or after the effective date of
the compact, the commission shall convene and review the enactment of each
state that enacted the compact prior to the commission convening, to be known
as the charter participating states, to determine if the statute enacted by
each charter participating state is materially different than the model
compact.� if:

(
a
) A charter
participating state's enactment is found to be materially different from the
model compact, the charter participating state is entitled to the default
process set forth in section 10, subsection B of this compact.

(
b
) 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 is less than seven.
Participating states enacting the compact subsequent to the commission
convening are subject to the process set forth in section 7, subsection C,
paragraph 21 of this compact to determine if their enactments are materially
different from the model compact and whether they qualify for participation in
the compact.

2. Participating states enacting this
compact after the seven initial charter participating states are subject to the
process set forth in section 7, subsection C, paragraph 21 of this compact 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 administering this
compact before 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
is 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, and:

1. A participating state's withdrawal
does not take effect until one hundred eighty days after enactment of the
repealing statute.� During this one hundred eighty day-period, all
compact privileges that were in effect in the withdrawing state and that 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 days, the licensee's compact privileges in other
participating states is not affected by the passage of the one hundred eighty
days.

2. Withdrawal does not affect the
continuing requirement of the licensing board of the withdrawing state to
comply with the investigative and adverse action reporting requirements of this
compact before the effective date of withdrawal.

3. On the enactment of a statute
withdrawing a state from this compact, the state shall immediately provide
notice of the withdrawal to all licensees within that state.� The withdrawing
state shall continue to recognize all licenses granted pursuant to this compact
for at least one hundred eighty days after the date of the notice of
withdrawal.

D. This compact does not invalidate
or prevent any PA licensure agreement or other cooperative arrangement between
participating states and between a participating state and nonparticipating
state that does not conflict with this compact.

E. This compact may be amended by the
participating states.� An amendment to this compact may not become effective
and binding on any participating state until it is enacted materially in the
same manner into the laws of all participating states as determined by the
commission.

Section
12. 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 this compact. Provisions
of this compact that expressly authorize or require 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, any state seeking participation in the
compact or 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 section 10, subsection B of this
compact, terminate a participating state's participation in the compact, if the
commission 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 this compact.� Otherwise, if this compact is
held to be contrary to the constitution of any participating state, this
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. This
compact does not prevent the enforcement of any other law of a participating
state that is not inconsistent with this compact.

B. Any laws in a participating state
that are 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.
END_STATUTE

APPROVED BY THE GOVERNOR FEBRUARY 20, 2026.

FILED IN THE OFFICE OF THE SECRETARY OF STATE FEBRUARY 20,
2026.