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HB-4309, As Passed Senate, July 3, 2026
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SENATE SUBSTITUTE FOR
HOUSE BILL NO. 4309
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 16337 and 18001 (MCL 333.16337 and 333.18001),
section 16337 as amended by 2006 PA 161 and section 18001 as
amended by 2018 PA 355, and by adding sections 16187d, 17011b,
17061a, 17511b, and 18011b.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
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Sec. 16187d. (1) The PA licensure compact is enacted into law
and entered into by this state as a party state with all other
jurisdictions that legally join in the compact, in the form
substantially as follows:
PA Licensure Compact
Section 1. Purpose
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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 from a Participating State.
Section 2. Definitions
In this Compact:
A. "Adverse Action" means any administrative, civil,
equitable, or criminal action permitted by a State's laws which is
imposed by a Licensing Board or other authority against a PA
License or License application or Compact Privilege such as License
denial, censure, revocation, suspension, probation, monitoring of
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the Licensee, or restriction on the Licensee's practice.
B. "Compact Privilege" means the authorization granted by a
Remote State to allow a Licensee from another Participating State
to practice as a PA to provide Medical Services and other licensed
activity to a patient located in the Remote State under the Remote
State's laws and regulations.
C. "Conviction" means a finding by a court that an individual
is guilty of a felony or misdemeanor offense through adjudication
or entry of a plea of guilt or no contest to the charge by the
offender.
D. "Criminal Background Check" means the submission of
fingerprints or other biometric-based information for a License
applicant for the purpose of obtaining that applicant's criminal
history record information, as defined in 28 CFR 20.3(d), from the
State's criminal history record repository as defined in 28 CFR
20.3(f).
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
Compact.
F. "Executive Committee" means a group of directors and ex-
officio individuals elected or appointed pursuant to Section 7.F.2.
G. "Impaired Practitioner" means a PA whose practice is
adversely affected by health-related condition(s) that impact their
ability to practice.
H. "Investigative Information" means information, records, or
documents received or generated by a Licensing Board pursuant to an
investigation.
I. "Jurisprudence Requirement" means the assessment of an
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individual's knowledge of the laws and Rules governing the practice
of a PA in a State.
J. "License" means current authorization by a State, other
than authorization pursuant to a Compact Privilege, for a PA to
provide Medical Services, which would be unlawful without current
authorization.
K. "Licensee" means an individual who holds a License from a
State to provide Medical Services as a PA.
L. "Licensing Board" means any State entity authorized to
license and otherwise regulate PAs.
M. "Medical Services" means health care services provided for
the diagnosis, prevention, treatment, cure or relief of a health
condition, injury, or disease, as defined by a State's laws and
regulations.
N. "Model Compact" means the model for the PA Licensure
Compact on file with The Council of State Governments or other
entity as designated by the Commission.
O. "Participating State" means a State that has enacted this
Compact.
P. "PA" means an individual who is licensed as a physician
assistant in a State. For purposes of this Compact, any other title
or status adopted by a State to replace the term "physician
assistant" shall be deemed synonymous with "physician assistant"
and shall confer the same rights and responsibilities to the
Licensee under the provisions of this Compact at the time of its
enactment.
Q. "PA Licensure Compact Commission," "Compact Commission," or
"Commission" means the national administrative body created
pursuant to Section 7.A of this Compact.
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R. "Qualifying License" means an unrestricted License issued
by a Participating State to provide Medical Services as a PA.
S. "Remote State" means a Participating State where a Licensee
who is not licensed as a PA is exercising or seeking to exercise
the Compact Privilege.
T. "Rule" means a regulation promulgated by an entity that has
the force and effect of law.
U. "Significant Investigative Information" means Investigative
Information that a Licensing Board, after an inquiry or
investigation that includes notification and an opportunity for the
PA to respond if required by State law, has reason to believe is
not groundless and, if proven true, would indicate more than a
minor infraction.
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
shall:
1. License PAs.
2. Participate in the Compact Commission's Data System.
3. Have a mechanism in place for receiving and investigating
complaints against Licensees and License applicants.
4. Notify the Commission, in compliance with the terms of this
Compact and Commission Rules, of any Adverse Action against a
Licensee or License applicant and the existence of Significant
Investigative Information regarding a Licensee or License
applicant.
5. Fully implement a Criminal Background Check requirement,
within a time frame established by Commission Rule, by its
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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. Utilize passage of a recognized national exam such as the
NCCPA PANCE as a requirement for PA licensure.
8. Grant the Compact Privilege to a holder of a Qualifying
License in a Participating State.
B. Nothing in this Compact prohibits a Participating State
from charging a fee for granting the Compact Privilege.
Section 4. Compact Privilege
A. To exercise the Compact Privilege, a Licensee must:
1. Have graduated from a PA program accredited by the
Accreditation Review Commission on Education for the Physician
Assistant, Inc. or other programs authorized by Commission Rule.
2. Hold current NCCPA certification.
3. Have no felony or misdemeanor Conviction.
4. Have never had a controlled substance license, permit, or
registration suspended or revoked by a State or by the United
States Drug Enforcement Administration.
5. Have a unique identifier as determined by Commission Rule.
6. Hold a Qualifying License.
7. Have had no revocation of a License or limitation or
restriction on any License currently held due to an adverse action.
8. If a Licensee has had a limitation or restriction on a
License or Compact Privilege due to an Adverse Action, two 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.
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9. If a Compact Privilege has been revoked or is limited or
restricted in a Participating State for conduct that would not be a
basis for disciplinary action in a Participating State in which the
Licensee is practicing or applying to practice under a Compact
Privilege, that Participating State shall have the discretion not
to consider such action as an Adverse Action requiring the denial
or removal of a Compact Privilege in that State.
10. Notify the Compact Commission that the Licensee is seeking
the Compact Privilege in a Remote State.
11. Meet any Jurisprudence Requirement of a Remote State in
which the Licensee is seeking to practice under the Compact
Privilege and pay any fees applicable to satisfying the
Jurisprudence Requirement.
12. Report to the Commission any Adverse Action taken by a
non-participating State within thirty (30) days after the action is
taken.
B. The Compact Privilege is valid until the expiration or
revocation of the Qualifying License unless terminated pursuant to
an Adverse Action. The Licensee must also comply with all of the
requirements of Subsection A above to maintain the Compact
Privilege in a Remote State. If the Participating State takes
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
Action.
C. Once a restricted or limited License satisfies the
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requirements of Subsection B.1 and 2, the Licensee must meet the
requirements of Subsection A to obtain a Compact Privilege in any
Remote State.
D. For each Remote State in which a PA seeks authority to
prescribe controlled substances, the PA shall satisfy all
requirements imposed by such State in granting or renewing such
authority.
Section 5. 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 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.
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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 are located.
3. Notwithstanding paragraph 2, subpoenas may not be issued by
a Participating State to gather evidence of conduct in another
State that is lawful in that other State for the purpose of 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 State.
C. For purposes of taking Adverse Action, the Participating
State which issued the Qualifying License shall give the same
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priority and effect to reported conduct received from any other
Participating State as it would if the conduct had occurred within
the Participating State which issued the Qualifying License. In so
doing, that Participating State shall apply its own State laws to
determine appropriate action.
D. A Participating State, if otherwise permitted by State law,
may recover from the affected PA the costs of investigations and
disposition of cases resulting from any Adverse Action taken
against that PA.
E. A Participating State may take Adverse Action based on the
factual findings of a Remote State, provided that the Participating
State follows its own procedures for taking the Adverse Action.
F. Joint Investigations
1. In addition to the authority granted to a 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 (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
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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 in Section 11.A.
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 Boards.
2. The delegate shall be either:
a. A current PA, physician or public member of a Licensing
Board or PA Council/Committee; or
b. An administrator of a Licensing Board.
3. Any delegate may be removed or suspended from office as
provided by the laws of the State from which the delegate is
appointed.
4. The Participating State Licensing Board shall fill any
vacancy occurring in the Commission within sixty (60) days.
5. Each delegate shall be entitled to one (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'
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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 the
provisions of this Compact and the bylaws;
7. Promulgate Rules to facilitate and coordinate
implementation and administration of this Compact. The Rules shall
have the force and effect of law and shall be binding in all
Participating States;
8. Bring and prosecute legal proceedings or actions in the
name of the Commission, provided that the standing of any State
Licensing Board to sue or be 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, but not limited to, employees of a Participating State;
11. Hire employees and engage contractors, elect or appoint
officers, fix compensation, define duties, grant such individuals
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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 conflict of
interest;
13. Lease, purchase, accept appropriate gifts or donations of,
or otherwise own, hold, improve or use, any property, real,
personal or mixed; provided that at all times the Commission shall
avoid any appearance of impropriety;
14. Sell, convey, mortgage, pledge, lease, exchange, abandon,
or otherwise dispose of any property real, personal, or mixed;
15. Establish a budget and make expenditures;
16. Borrow money;
17. Appoint committees, including standing committees composed
of members, State regulators, State legislators or their
representatives, and consumer representatives, and such other
interested persons as may be designated in this Compact and the
bylaws;
18. Provide and receive information from, and cooperate with,
law enforcement agencies;
19. Elect a Chair, Vice Chair, Secretary and Treasurer and
such other officers of the Commission as provided in the
Commission's bylaws.
20. Reserve for itself, in addition to those reserved
exclusively to the Commission under the Compact, powers that the
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Executive Committee may not exercise;
21. Approve or disapprove a State's participation in the
Compact based upon its determination as to whether the State's
Compact legislation departs in a material manner from the Model
Compact language;
22. Prepare and provide to the Participating States an annual
report; and
23. Perform such other functions as may be necessary or
appropriate to achieve the purposes of this Compact consistent with
the State regulation of PA licensure and practice.
D. Meetings of the Commission
1. All meetings of the Commission that are 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
under Section 9.L.
3. The Commission may convene in a closed, non-public meeting
or non-public part of a public meeting to receive legal advice or
to discuss:
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
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and procedures;
c. Current, threatened, or reasonably anticipated litigation;
d. Negotiation of contracts for the purchase, lease, or sale
of goods, services, or real estate;
e. Accusing any person of a crime or formally censuring any
person;
f. Disclosure of trade secrets or commercial or financial
information that is privileged or confidential;
g. Disclosure of information of a personal nature where
disclosure would constitute a clearly unwarranted invasion of
personal privacy;
h. Disclosure of investigative records compiled for law
enforcement purposes;
i. Disclosure of information related to any investigative
reports prepared by or on behalf of or for use of the Commission or
other committee charged with responsibility of investigation or
determination of compliance issues pursuant to this Compact;
j. Legal advice; or
k. Matters specifically exempted from disclosure by federal or
Participating States' statutes.
4. If a meeting, or portion of a meeting, is closed pursuant
to this provision, the chair of the meeting or the chair's designee
shall certify that the meeting or portion of 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
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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 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 to that Participating State the
Participating State through which it applies for a Compact
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Privilege and pay to the Commission any Compact Privilege fee
required by Commission Rule.
4. The Commission shall not incur obligations of any kind
prior to securing the funds adequate to meet the same; nor shall
the Commission pledge the credit of any of the Participating
States, except by and with the authority of the Participating
State.
5. The Commission shall keep accurate accounts of all receipts
and disbursements. The receipts and disbursements of the Commission
shall be subject to the financial review and accounting procedures
established under its bylaws. All receipts and disbursements of
funds handled by the Commission shall be subject to an annual
financial review by a certified or licensed public accountant, and
the report of the financial review shall be included in and become
part of the annual report of the Commission.
F. The Executive Committee
1. The Executive Committee shall have the power to act on
behalf of the Commission according to the terms of this Compact and
Commission Rules.
2. The Executive Committee shall be composed of nine (9)
members:
a. Seven voting members who are elected by the Commission from
the current membership of the Commission;
b. One ex-officio, nonvoting member from a recognized national
PA professional association; and
c. One ex-officio, nonvoting member from a recognized national
PA certification organization.
3. The ex-officio members will be selected by their respective
organizations.
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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 Compact Participating States such as annual dues, and any
Commission Compact fee charged to Licensees for the Compact
Privilege;
b. Ensure Compact administration services are appropriately
provided, contractual or otherwise;
c. Prepare and recommend the budget;
d. Maintain financial records on behalf of the Commission;
e. Monitor Compact compliance of Participating States and
provide compliance reports to the Commission;
f. Establish additional 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 Commission's Rules
or bylaws.
7. All meetings of the Executive Committee at which it votes
or plans to vote on matters in exercising the powers and duties of
the Commission shall be open to the public and public notice of
such meetings shall be given as public meetings of the Commission
are given.
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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;
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provided that nothing herein shall be construed to prohibit that
person from retaining their own counsel at their own expense; and
provided further, that the actual or alleged act, error, or
omission did not result from that person's intentional or willful
or wanton misconduct.
3. The Commission shall indemnify and hold harmless any
member, officer, executive director, employee, and representative
of the Commission for the amount of any settlement or judgment
obtained against that person arising out of any actual or alleged
act, error, or omission that occurred within the scope of
Commission employment, duties, or responsibilities, or that such
person had a reasonable basis for believing occurred within the
scope of Commission employment, duties, or responsibilities,
provided that the actual or alleged act, error, or omission did not
result from the intentional or willful or wanton misconduct of that
person.
4. Venue is proper and judicial proceedings by or against the
Commission shall be brought solely and exclusively in a court of
competent jurisdiction where the principal office of the Commission
is located. The Commission may waive venue and jurisdictional
defenses in any proceedings as authorized by Commission Rules.
5. Nothing herein shall be construed as a limitation on the
liability of any Licensee for professional malpractice or
misconduct, which shall be governed solely by any other applicable
State laws.
6. Nothing herein shall be construed to designate the venue or
jurisdiction to bring actions for alleged acts of malpractice,
professional misconduct, negligence, or other such civil action
pertaining to the practice of a PA. All such matters shall be
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determined exclusively by State law other than this Compact.
7. Nothing in this Compact shall be interpreted to waive or
otherwise abrogate a Participating State's state action immunity or
state action affirmative defense with respect to antitrust claims
under the 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
Commission.
Section 8. Data System
A. The Commission shall provide for the development,
maintenance, operation, and utilization of a coordinated data and
reporting system containing licensure, Adverse Action, and the
reporting of the existence of Significant Investigative Information
on all licensed PAs and applicants denied a License in
Participating States.
B. Notwithstanding any other State law to the contrary, a
Participating State shall submit a uniform data set to the Data
System on all PAs to whom this Compact is applicable (utilizing a
unique identifier) as required by the Rules of the Commission,
including:
1. Identifying information;
2. Licensure data;
3. Adverse Actions against a License or Compact Privilege;
4. Any denial of application for licensure, and the reason(s)
for such denial (excluding the reporting of any Criminal history
record information where prohibited by law);
5. The existence of Significant Investigative Information; and
6. Other information that may facilitate the administration of
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this Compact, as determined by the Rules of the Commission.
C. Significant Investigative Information pertaining to a
Licensee in any Participating State shall only be available to
other Participating States.
D. The Commission shall promptly notify all Participating
States of any Adverse Action taken against a Licensee or an
individual applying for a License that has been reported to it.
This Adverse Action information shall be available to any other
Participating State.
E. Participating States contributing information to the Data
System may, in accordance with State or federal law, designate
information that may not be shared with the public without the
express permission of the contributing State. Notwithstanding any
such designation, such information shall be reported to the
Commission through the Data System.
F. Any information submitted to the Data System that is
subsequently expunged pursuant to federal law or the laws of the
Participating State contributing the information shall be removed
from the Data System upon reporting of such by the Participating
State to the Commission.
G. The records and information provided to a Participating
State pursuant to 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
Participating State.
Section 9. Rulemaking
A. The Commission shall exercise its Rulemaking powers
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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
the extent of the conflict.
D. If a majority of the legislatures of the Participating
States rejects a Commission Rule, by enactment of a statute or
resolution in the same manner used to adopt this Compact within
four (4) years of the date of adoption of the Rule, then such Rule
shall have no further force and effect in any Participating State
or to any State applying to participate in the Compact.
E. Commission Rules shall be adopted at a regular or special
meeting of the Commission.
F. Prior to promulgation and adoption of a final Rule or Rules
by the Commission, and at least thirty (30) days in advance of the
meeting at which the Rule will be considered and voted upon, the
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Commission shall file a Notice of Proposed Rulemaking:
1. On the website of the Commission or other publicly
accessible platform; and
2. To persons who have requested notice of the Commission's
notices of proposed rulemaking, and
3. In such other way(s) as the Commission may by Rule specify.
G. The Notice of Proposed Rulemaking shall include:
1. The time, date, and location of the public hearing on the
proposed Rule and the proposed time, date and location of the
meeting in which the proposed Rule will be considered and voted
upon;
2. The text of the proposed Rule and the reason for the
proposed Rule;
3. A request for comments on the proposed Rule from any
interested person and the date by which written comments must be
received; and
4. The manner in which interested persons may submit notice to
the Commission of their intention to attend the public hearing or
provide any written comments.
H. Prior to adoption of a proposed Rule, the Commission shall
allow persons to submit written data, facts, opinions, and
arguments, which shall be made available to the public.
I. If the hearing is to be held via electronic means, the
Commission shall publish the mechanism for access to the electronic
hearing.
1. All persons wishing to be heard at the hearing shall as
directed in the Notice of Proposed Rulemaking, not less than five
(5) business days before the scheduled date of the hearing, notify
the Commission of their desire to appear and testify at the
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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 required
by this section.
J. Following the public hearing the Commission shall consider
all written and oral comments timely received.
K. The Commission shall, by majority vote of all delegates,
take final action on the proposed Rule and shall determine the
effective date of the Rule, if adopted, based on the Rulemaking
record and the full text of the Rule.
1. If adopted, the Rule shall be posted on the Commission's
website.
2. The Commission may adopt changes to the proposed Rule
provided the changes do not enlarge the original purpose of the
proposed Rule.
3. The Commission shall provide on its website an explanation
of the reasons for substantive changes made to the proposed Rule as
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,
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the effective date of the Rule shall be no sooner than thirty (30)
days after the Commission issued the notice that it adopted the
Rule.
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, or
welfare;
2. Prevent a loss of Commission or Participating State funds;
3. Meet a deadline for the promulgation of a Commission Rule
that is established by federal law or Rule; or
4. Protect public health and safety.
M. The Commission or an authorized committee of the Commission
may direct revisions to a previously 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
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effect without further action. If the revision is challenged, the
revision may not take effect without the approval of the
Commission.
N. No Participating State's rulemaking requirements shall
apply under this Compact.
Section 10. Oversight, Dispute Resolution, and Enforcement
A. Oversight
1. The executive and judicial branches of State government in
each Participating State shall enforce this Compact and take all
actions necessary and appropriate to implement the 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 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
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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
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 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
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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 member
shall be awarded all costs of such litigation, including reasonable
attorney's fees.
7. Upon the termination of a State's participation in the
Compact, the State shall immediately provide notice to all
Licensees within that State of such termination:
a. Licensees who have been granted a Compact Privilege in that
State shall retain the Compact Privilege for one hundred eighty
(180) days following the effective date of such termination.
b. Licensees who are licensed in that State who have 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.
C. Dispute Resolution
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
appropriate.
D. Enforcement
1. The Commission, in the reasonable exercise of its
discretion, shall enforce the provisions of this Compact and Rules
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of the Commission.
2. If compliance is not secured after all means to secure
compliance have been exhausted, by majority vote, the Commission
may initiate legal action in the United States District Court for
the District of Columbia or the 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
attorney's fees.
3. The remedies herein shall not be the exclusive remedies of
the Commission. The Commission may pursue any other remedies
available under federal or State law.
E. Legal Action Against the Commission
1. A Participating State may initiate legal action against the
Commission in the United States District Court for the District of
Columbia or the federal district where the Commission has its
principal offices to enforce compliance with the provisions of 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
Commission
A. This Compact shall come into effect on the date on which
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this Compact statute is enacted into law in the seventh
Participating State.
1. On or after the effective date of the Compact, the
Commission shall convene and review the enactment of each of the
States that enacted the 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 participation in the
Compact.
2. Participating States enacting the Compact subsequent to the
seven initial Charter Participating States shall be subject to the
process set forth in Section 7.C.21 to determine if their
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
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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 hundred eighty (180) days.
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 of withdrawal.
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.
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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 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 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
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accordance with the requirements of Section 10.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 affected
as to all severable matters.
Section 13. Binding Effect of Compact
A. Nothing herein prevents the enforcement of any other law of
a Participating State that is not inconsistent with this Compact.
B. Any laws in a Participating State in conflict with this
Compact are superseded to the extent of the conflict.
C. All agreements between the Commission and the Participating
States are binding in accordance with their terms.
(2) Subsection (1) may be referred to as the "PA licensure
compact".
Sec. 16337. (1) Fees for a person an individual licensed or
seeking licensure to engage in practice as a physician's assistant
under part 170, part 175, or part 180 are as follows:
(a) Application processing fee $ 30.00
(b) License fee, per year 50.00
(c) Temporary license 35.00
(d) Limited license, per year 25.00
(2) In addition to the fees required under subsection (1) and
any fee charged by the compact commission for a compact privilege
under the PA licensure compact enacted in section 16187d, this
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state's fee for an individual seeking to hold a compact privilege
in this state under the PA licensure compact is $50.00 per year.
Sec. 17011b. (1) An individual who holds a compact privilege
under the PA licensure compact is authorized to engage in the
practice as a physician's assistant under this article.
(2) For purposes of this article, including the obligations of
an individual who is licensed to engage in the practice as a
physician's assistant, an individual who holds a compact privilege
under the PA licensure compact is considered a physician's
assistant who is licensed under this part.
(3) This section does not apply until 12 months after the
implementation of the data system under the PA licensure compact.
(4) As used in this section, "PA licensure compact" means the
PA licensure compact enacted in section 16187d.
Sec. 17061a. The task force shall select the director to act
as this state's delegate for purposes of the PA licensure compact
enacted in section 16187d.
Sec. 17511b. (1) An individual who holds a compact privilege
under the PA licensure compact is authorized to engage in the
practice as a physician's assistant under this article.
(2) For purposes of this article, including the obligations of
an individual who is licensed to engage in the practice as a
physician's assistant, an individual who holds a compact privilege
under the PA licensure compact is considered a physician's
assistant who is licensed under this part.
(3) This section does not apply until 12 months after the
implementation of the data system under the PA licensure compact.
(4) As used in this section, "PA licensure compact" means the
PA licensure compact enacted in section 16187d.
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Sec. 18001. (1) As used in this part:
(a) "Medical care services" means those services within the
scope of practice of podiatric physicians licensed by the board,
except those services that the board prohibits or otherwise
restricts within a practice agreement or determines shall not be
delegated by a podiatric physician without endangering the health
and safety of patients as provided for in section 18048.
(b) "Participating podiatrist" means a podiatric physician or
a podiatric physician designated by a group of podiatric physicians
under section 18049 to represent that group.
(c) "Podiatric physician" or "podiatrist" means an individual
who is licensed under this article to engage in the practice of
podiatric medicine and podiatric surgery.
(d) "Practice agreement" means an agreement described in
section 18047.
(e) "Practice as a physician's assistant" means the practice
of podiatric medicine and podiatric surgery with a participating
podiatric physician podiatrist under a practice agreement.
(f) Except as otherwise provided in subdivision (g), "practice
of podiatric medicine and podiatric surgery" or "practice of
podiatry" means any of the following:
(i) The evaluation, diagnosis, management, and prevention of
conditions of the lower extremities, including local manifestations
of systemic disease in the human foot and ankle, by attending to
and advising patients and through the use of devices, diagnostic
tests, drugs and biologicals, surgical procedures, or other means.
The evaluation, diagnosis, management, and prevention of conditions
of the lower extremities may include osseous and soft tissue
procedures that address the pathology of the foot, ankle, and the
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contiguous attachments below the tibial tuberosity.
(ii) The treatment of ulcerations below the tibial tuberosity
and of human nail diseases, callosities, and verruca.
(g) "Practice of podiatric medicine and podiatric surgery"
does not include amputations proximal to the tibiotalar joint,
proximal osseous procedures that do not involve the tibiotalar
joint, or the administration of intravenous sedation or general
anesthesia.
(h) "Task force" means the joint task force created in section
17025.
(2) In addition to the definitions in this part, article 1
contains general definitions and principles of construction
applicable to all articles in this code and part 161 contains
definitions applicable to this part.
Sec. 18011b. (1) An individual who holds a compact privilege
under the PA licensure compact is authorized to engage in the
practice as a physician's assistant under this article.
(2) For purposes of this article, including the obligations of
an individual who is licensed to engage in the practice as a
physician's assistant, an individual who holds a compact privilege
under the PA licensure compact is considered a physician's
assistant who is licensed under this part.
(3) This section does not apply until 12 months after the
implementation of the data system under the PA licensure compact.
(4) As used in this section, "PA licensure compact" means the
PA licensure compact enacted in section 16187d.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.