Physician Assist. Omnibus/Team-based/Compact.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 672

Short Title: Physician Assist. Omnibus/Team-based/Compact. (Public)
Sponsors: Representatives Paré, Potts, Lambeth, and Chesser (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Health, if favorable, Finance, if favorable, Rules, Calendar, and Operations of the
House
April 3, 2025
*H672-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO ADJUST THE SUPERVISION ARRANGE MENT OF PHYSICIAN 2
ASSISTANTS AND TO MA KE VARIOUS CHANGES T O THE LICENSURE OF 3
PHYSICIAN ASSISTANTS. 4
The General Assembly of North Carolina enacts: 5
6
PART I. PHYSICIAN ASSISTANT TEAM-BASED PRACTICE 7
SECTION 1.1.(a) G.S. 90-1.1 is amended by adding a new subdivision to read: 8
"(4d) Team-based setting or team-based practice. – Any of the following: 9
a. A medical practice that meets all of the following requirements: 10
1. The majority of the practice is owned collectively by one or 11
more licensed physicians. 12
2. An owner who is a physician licensed under this Chapter has 13
consistent and meaningful participation in the design and 14
implementation of health services to patients , as defined by 15
rules adopted by the Board. 16
3. The physicians and team -based physician assistants who 17
provide services at the medical practice work in the same 18
clinical practice area. 19
b. Hospitals, clinics, nursing homes, and other health facilities with 20
active credentialing and quality programs where physicians have 21
consistent and meaningful participation in the design and 22
implementation of health services to patients , as defined by rules 23
adopted by the Board. 24
c. For the purposes of this Article, the term "team-based setting " or 25
"team-based practice " shall not include a medical practice that 26
specializes in pain management." 27
SECTION 1.1.(b) G.S. 90-9.3 reads as rewritten: 28
"§ 90-9.3. Requirements for licensure as a physician assistant. 29
(a) To be eligible for licensure as a phy sician assistant, an applicant shall submit proof 30
satisfactory to the Board that the applicant has met all of the following: 31
(1) The applicant has successfully completed an educational program for 32
physician assistants or surgeon assistants accredited by th e Accreditation 33
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Review Commission on Education for the Physician Assistant or its 1
predecessor or successor entities. 2
(2) The applicant has a current or previous certification issued by the National 3
Commission on Certification of Physician Assistants or its successor. 4
(3) The applicant is of good moral character. 5
(b) Before initiating practice of medical acts, tasks, or functions as a physician assistant, 6
the physician assistant shall provide the Board the name, address, and telephone number of the 7
physician who will supervise the physician assistant in the relevant medical setting. This 8
subsection shall not apply to physician assistants who meet the requirements for team -based 9
practice under G.S. 90-9.3A. 10
(c) The Board may, by rule, require an applicant to comply with other requirements or 11
submit additional information the Board deems appropriate." 12
SECTION 1.1.(c) Article 1 of Chapter 90 of the General Statutes is amended by 13
adding a new section to read: 14
"§ 90-9.3A. Requirements for team-based practice as a physician assistant. 15
(a) In order to practice as a team -based physician assistant, a physician assistant shall 16
meet all of the following conditions: 17
(1) Practice in team-based settings, as defined in G.S. 90-1.1(4d). 18
(2) Have more than 4,000 hours of clinical practice experience as a licensed 19
physician assistant and more than 1,000 hours of clinical practice experience 20
within the specific medical specialty of practice with a physician in that 21
specialty. 22
(3) Submit proof as the Board may deem satisfacto ry by rule that the individual 23
meets the requirements of subdivisions (1) and (2) of this subsection. The 24
Board may, by rule, require the physician assistant to comply with other 25
requirements or submit additional information the Board deems appropriate. 26
(b) Team-based p hysician assistants shall collaborate and consult with or refer to the 27
appropriate members of the health care team as required by the patient 's condition and as 28
indicated by the education, experience, and competencies of the physician assista nt and the 29
standard of care. The degree of collaboration must be determined by the practice which may 30
include decisions by the employer, group, hospital service, and the credentialing and privileging 31
systems of a licensed facility. The B oard may adopt rules to establish requirements for the 32
determination and enforcement of collab oration, consultation, and referral. Team-based 33
physician assistants are responsible for the care they provide. 34
(c) Notwithstanding any other provision of this Chapter, a team-based physician assistant 35
practicing in a perioperative setting, including the provision of surgical or anesthesia -related 36
services, shall be supervised by a physician." 37
SECTION 1.1.(d) G.S. 90-12.4 reads as rewritten: 38
"§ 90-12.4. Physician assistant limited volunteer license. 39
… 40
(d) Before initiating the performance of medical acts, tasks, or functions as a physician 41
assistant licensed under this section, the physician assistant shall provide submit to the Board 42
either an "Intent to Practice Notificati on Form ," which shall include the name, address, and 43
telephone number of the physician licensed under this Article who will supervise the physician 44
assistant in the clinic specializing in the care of indigent patients.patients, or meet the 45
requirements for team-based practice under G.S. 90-9.3A. 46
…." 47
SECTION 1.1.(e) G.S. 90-12.4B reads as rewritten: 48
"§ 90-12.4B. Physician Assistant assistant retired limited volunteer license. 49
…." 50
SECTION 1.1.(f) G.S. 90-18.1 reads as rewritten: 51
General Assembly Of North Carolina Session 2025
House Bill 672-First Edition Page 3
"§ 90-18.1. Limitations on physician assistants. 1
(a) Any person who is licensed under the provisions of G.S. 90-9.3 to perform medical 2
acts, tasks, and functions as a physician assistant may use the title "physician assistant" or "PA." 3
Any other person who uses the title in any for m or holds out to be a physician assistant or to be 4
so licensed, shall be deemed to be in violation of this Article. 5
(a1) Physician assistants shall clearly designate their credentials as a physician assistant in 6
all clinical settings. 7
(b) Physician assist ants are authorized to write prescriptions for drugs under the 8
following conditions: 9
(1) The North Carolina Medical Board has adopted regulations governing the 10
approval of individual physician assistants to write prescriptions with such 11
limitations as the Board may determine to be in the best interest of patient 12
health and safety. 13
(2) The physician assistant holds a current license issued by the Board. 14
(3) Repealed by Session Laws 2019-191, s. 35, effective October 1, 2019. 15
(4) The supervising physician has provided to the physician assistant written 16
instructions about indications and contraindications for prescribing drugs and 17
a written policy for periodic review by the physician of the drugs prescribed. 18
This subdivision shall not apply to individuals who a re practicing in a 19
team-based setting under G.S. 90-9.3A. 20
(5) A physician assistant shall personally consult with the supervising physician 21
prior to prescribing a targeted controlled substance as defined in Article 5 of 22
this Chapter when all of the following conditions apply: 23
a. The patient is being treated by a facility that primarily engages in the 24
treatment of pain by prescribing narcotic medications. 25
b. The therapeutic use of the targeted controlled substance will or is 26
expected to exceed a period of 30 days. 27
When a targeted controlled substance prescribed in accordance with this subdivision is 28
continuously prescribed to the same patient, the physician assistant shall consult with the 29
supervising physician at least once every 90 days to verify that the prescription remains medically 30
appropriate for the patient. 31
(c) Physician assistants are authorized to compound and dispense drugs under the 32
following conditions: 33
(1) The function is performed under the supervision of a licensed 34
pharmacist.physician. 35
(2) Rules and regulations of the North Carolina Board of Pharmacy and all 36
applicable State and federal laws governing this function compounding and 37
dispensing are complied with. 38
(3) The physician assistant holds a current license issued by the Board. 39
(4) The physician assistant registers with the Board of Pharmacy. 40
(d) Physician assistants are authorized to order medications, tests and treatments in 41
hospitals, clinics, nursing homes, and other health facilities under the following conditions: 42
(1) The North Caro lina Medical Board has adopted regulations governing the 43
approval of individual physician assistants to order medications, tests, and 44
treatments with such limitations as the Board may determine to be in the best 45
interest of patient health and safety. 46
(2) The physician assistant holds a current license issued by the Board. 47
(3) The If the p hysician assistant is subject to a supervisory arrangement, the 48
supervising physician has provided to the physician assistant written 49
instructions about ordering medication s, tests, and treatments, and when 50
appropriate, specific oral or written instructions for an individual patient, with 51
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provision for review by the physician of the order within a reasonable time, as 1
determined by the Board, after the medication, test, or treatment is ordered. 2
(4) The hospital or other health facility has adopted a written policy about 3
ordering medications, tests, and treatments, including procedures for 4
verification of the physician assistants' orders by nurses and other facility 5
employees and such other procedures as are in the interest of patient health 6
and safety. 7
(e) Any prescription written by a physician assistant or order given by a physician 8
assistant for medications, tests, or treatments shall be deemed to have been authorized by the 9
physician approved by the Board as the supervisor of the physician assistant and the supervising 10
physician shall be responsible for authorizing the prescription or order. This subsection shall not 11
apply to individuals who are practicing in a team -based setting under G.S. 90-9.3A who may 12
prescribe, order, administer, and procure drugs and medical devices without p hysician 13
authorization. Individuals who are practicing in a team -based setting under G.S. 90-9.3A may 14
also plan and initiate a therapeutic regim en that includes ordering and prescribing 15
non-pharmacological interventions, including durable medical equipment, nutrition, blood, blood 16
products, and diagnostic support services, including home health care, hospice, and physical and 17
occupational therapy. 18
(e1) Any medical certification completed by a physician assistant for a Physician assistants 19
may authen ticate any document, including death certificate shall be deemed to have been 20
authorized by the physician approved by the Board as the supervisor of the physician assistant, 21
and the supervising physician shall be responsible for authorizing the completion certificates with 22
their signature, certification, stamp, verification, affidavit, or endorsement , if it may be so 23
authenticated by the signature, certification, stamp, verification, affidavit, or endorsement of the 24
medical certification.a physician. 25
(e2) Physician assistants shall not perform final interpretations of diagnostic imaging 26
studies. For purposes of this subsection, "diagnostic imaging " shall include comp uted 27
tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron emission 28
tomography (PET), mammography, and ultra sound services. Final interpretation shall be 29
provided by a physician licensed under this Chapter. Notwithstanding any other provision of this 30
Chapter, physician assistants conducting final interpretation of plain film radiographs shall be 31
supervised by a physician. 32
… 33
(g) Any person who is licensed under G.S. 90-9.3 to perform medical acts, tasks, and 34
functions as a physician assistant shall comply with each of the following: 35
(1) Maintain a current and active license to practice in this State. 36
(2) Maintain an active registration with the Board. 37
(3) Have File a current Intent to Practice form filed with the Board.Board or meet 38
the requirements for team-based practice under G.S. 90-9.3A. 39
…." 40
SECTION 1.1.(g) G.S. 90-21.81(9) reads as rewritten: 41
"(9) Qualified technician. – A registered diagnostic medical sonographer who is 42
certified in obstetrics and gynecology by t he American Registry for 43
Diagnostic Medical Sonography (ARDMS) (ARDMS), a physician assistant 44
with certification in obstetrical ultrasonography, or a nurse midwife or 45
advanced practice nurse practitioner in obstetrics with certification in 46
obstetrical ultrasonography." 47
SECTION 1.1.(h) G.S. 58-3-169 reads as rewritten: 48
"§ 58-3-169. Required coverage for minimum hospital stay following birth. 49
(a) Definitions. – As used in this section: 50
(1) "Attending providers" includes: 51
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House Bill 672-First Edition Page 5
a. The obstetrician-gynecologists, pediatricians, family physicians, and 1
other physicians primarily responsible for the care of a mother and 2
newborn; and 3
b. The nurse midwives midwives, physician assistants, and nurse 4
practitioners primarily responsible for the care of a moth er and her 5
newborn child in accordance with State licensure and certification 6
laws. 7
…." 8
SECTION 1.1.(i) G.S. 110-91 reads as rewritten: 9
"§ 110-91. Mandatory standards for a license. 10
All child care facilities shall comply with all State laws and federal laws and local ordinances 11
that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the 12
standards in this section shall be complied with by all child care facilities. However, none of the 13
standards in this section appl y to the school-age children of the operator of a child care facility 14
but do apply to the preschool-age children of the operator. Children 13 years of age or older may 15
receive child care on a voluntary basis provided all applicable required standards are m et. The 16
standards in this section, along with any other applicable State laws and federal laws or local 17
ordinances, shall be the required standards for the issuance of a license by the Secretary under 18
the policies and procedures of the Commission except that the Commission may, in its discretion, 19
adopt less stringent standards for the licensing of facilities which provide care on a temporary, 20
part-time, drop-in, seasonal, after-school or other than a full-time basis. 21
(1) Medical Care and Sanitation. – The Commission for Public Health shall adopt 22
rules which establish minimum sanitation standards for child care centers and 23
their personnel. The sanitation rules adopted by the Commission for Public 24
Health shall cover such matters as the cleanliness of floors, w alls, ceilings, 25
storage spaces, utensils, and other facilities; adequacy of ventilation; 26
sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, 27
food protection facilities, bactericidal treatment of eating and drinking 28
utensils, and solid -waste storage and disposal; methods of food preparation 29
and serving; infectious disease control; sleeping facilities; and other items and 30
facilities as are necessary in the interest of the public health. The Commission 31
for Public Health shall a llow child care centers to use domestic kitchen 32
equipment, provided appropriate temperature levels for heating, cooling, and 33
storing are maintained. Child care centers that fry foods shall use commercial 34
hoods. These rules shall be developed in consultation with the Department. 35
The Commission shall adopt rules for child care facilities to establish 36
minimum requirements for child and staff health assessments and medical 37
care procedures. These rules shall be developed in consultation with the 38
Department. Each child shall have a health assessment before being admitted 39
or within 30 days following admission to a child care facility. The assessment 40
shall be done by: (i) a licensed physician, (ii) the physician's authorized agent 41
who is currently approved by the No rth Carolina Medical Board, or 42
comparable certifying board in any state contiguous to North Carolina, (iii) a 43
certified nurse practitioner, (iv) a licensed physician assistant, or (iv) (v) a 44
public health nurse meeting the Departments Standards for Early Periodic 45
Screening, Diagnosis, and Treatment Program. However, no health 46
assessment shall be required of any staff or child who is and has been in 47
normal health when the staff, or the child's parent, guardian, or full -time 48
custodian objects in writing to a health assessment on religious grounds which 49
conform to the teachings and practice of any recognized church or religious 50
denomination. 51
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Organizations that provide prepared meals to child care centers only are 1
considered child care centers for purposes of c ompliance with appropriate 2
sanitation standards. 3
…." 4
SECTION 1.2. The North Carolina Medical Board shall adopt permanent rules 5
necessary to implement the provisions of this act. 6
SECTION 1.3. Section 1.1 of this Part becomes effective when the North Carol ina 7
Medical Board adopts the permanent rules required under Section 1.2 of this Part or June 30, 8
2026, whichever occurs first. The North Carolina Medical Board shall notify the Revisor of 9
Statutes when the rules required under Section 1.2 of this Part have been adopted. The remainder 10
of this Part is effective when it becomes law. 11
12
PART II. PHYSICIAN ASSISTANT LICENSURE COMPACT 13
SECTION 2.1.(a) Chapter 90 of the General Statutes is amended by adding a new 14
Article to read: 15
"Article 18J. 16
"PA Licensure Compact. 17
"§ 90-270.200. Purpose. 18
In order to strengthen access to Medical Services, and in recognition of the advances in the 19
delivery of Medical Services, the Participating States of the PA Licensure Compact have allied 20
in common purpose to develop a comprehensive process that complements the existing authority 21
of State Licensing Boards to license and discipline PAs and seeks to enhance the portability of 22
License to practice as a PA while safeguarding the safety of patients. This Compact allows 23
Medical Services to be provided by PAs, via the mutual recognition of the Licensee's Qualifying 24
License by other Compact Participating States. This Compact also adopts the prevailing standard 25
for PA licensure and affirms that the practice and delivery of Medical Services by the PA occurs 26
where the patient is located at the time of the patient encounter, and therefore requires the PA to 27
be under the jurisdiction of the State Licensing Board where the patient is located. State Licensing 28
Boards that participate in this Compact retain the jurisdiction to impose Adverse Action against 29
a Compact Privilege in that State issued to a PA through the procedures of this Compact. The PA 30
Licensure Compact will alleviate burdens for military families by allowing active duty military 31
personnel and their spouses to obtain a Compact Privilege based on having an unrestricted 32
License in good standing from a Participating State. 33
"§ 90-270.201. Definitions. 34
The following definitions apply in this Compact: 35
(1) Adverse Action. – Any administr ative, civil, equitable, or criminal action 36
permitted by a State 's laws which is imposed by a Licensing Board or other 37
authority against a PA License or License application or Compact Privilege 38
such as License denial, censure, revocation, suspension, proba tion, 39
monitoring of the Licensee, or restriction on the Licensee's practice. 40
(2) Compact Privilege. – The authorization granted by a Remote State to allow a 41
Licensee from another Participating State to practice as a PA to provide 42
Medical Services and other licensed activity to a patient located in the Remote 43
State under the Remote State's laws and regulations. 44
(3) Conviction. – A finding by a court that an individual is guilty of a felony or 45
misdemeanor offense through adjudication or entry of a plea of guilt or no 46
contest to the charge by the offender. 47
(4) Criminal Background Check. – The submission of f ingerprints or other 48
biometric-based information for a License applicant for the purpose of 49
obtaining that applicant's criminal history record information, as defined in 28 50
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C.F.R. § 20.3(d), from the State's criminal history record repository, as 1
defined in 28 C.F.R. § 20.3(f). 2
(5) Data System. – The repository of information about Licensees, including, but 3
not limited to , License status and Adverse Action s, which is created and 4
administered under the terms of this Compact. 5
(6) Executive Committee. – A group of directors and ex officio individuals 6
elected or appointed pursuant to G.S. 90-270.206(f)(2). 7
(7) Impaired Pract itioner. – A PA whose practice is adversely affected by 8
health-related condition(s) that impact their ability to practice. 9
(8) Investigative Information. – Information, records, or documents received or 10
generated by a Licensing Board pursuant to an investigation. 11
(9) Jurisprudence Requirement. – The assessment of an individual 's knowledge 12
of the laws and Rules governing the practice of a PA in a State. 13
(10) License. – Current authorization by a State, other than authorization pursuant 14
to a Compact Privilege, for a PA to provide Medical Serv ices, which would 15
be unlawful without current authorization. 16
(11) Licensee. – An individual who holds a License from a State to provide 17
Medical Services as a PA. 18
(12) Licensing Board. – Any State entity authorized to license and otherwise 19
regulate PAs. 20
(13) Medical Services. – Health care services provided for the diagnosis, 21
prevention, treatment, cure, or relief of a health condition, injury, or disease, 22
as defined by a State's laws and regulations. 23
(14) Model Compact. – The model for the PA Licensure Compact on file with The 24
Council of State Go vernments or other entity as designated by the 25
Commission. 26
(15) Participating State. – A State that has enacted this Compact. 27
(16) PA. – An individual who is licensed as a physician assistant in a State. For 28
purposes of this Compact, any other title or status adopted by a State to replace 29
the term "physician assistant" shall be deemed synonymous with "physician 30
assistant" and shall confer the same rights and responsibilities to the Licensee 31
under the provisions of this Compact at the time of its enactment. 32
(17) PA Licensure Compact Commission, Compact Commission, or Commission. 33
– The national administrative body created pursuant to G.S. 90-270.206(f)(2) 34
of this Compact. 35
(18) Qualifying License. – An unrestricted License issued by a Participating State 36
to provide Medical Services as a PA. 37
(19) Remote State. – A Participating State where a Licensee who is not licensed as 38
a PA is exercising or seeking to exercise the Compact Privilege. 39
(20) Rule. – A regulation promulgated by an entity that has the force and effect of 40
law. 41
(21) Significant Investigative Information. – Investigative Information that a 42
Licensing Board, after an inquiry or investigation that includes notification 43
and an opportunity for the PA to respond if required by State law, has reason 44
to believe is not groundless and, if proven true, would indicate more than a 45
minor infraction. 46
(22) State. – Any state, commonwealth, district, or territory of the United States. 47
"§ 90-270.202. State participation in this Compact. 48
(a) To participate in this Compact, a Participating State shall: 49
(1) License PAs. 50
(2) Participate in the Compact Commission's Data System. 51
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(3) Have a mechanism in place for receiving and investigating complaints against 1
Licensees and License applicants. 2
(4) Notify the Commission, in compliance with the terms of this Compact and 3
Commission Rules, of any Adverse Action against a Licensee or License 4
applicant and the existence of Significant Investigative Information regarding 5
a Licensee or License applicant. 6
(5) Fully implement a Criminal Background Check requirement, within a time 7
frame established by Commission Rule, by its Licensing Board receiving the 8
results of a Criminal Background Check and reporting to the Commission 9
whether the License applicant has been granted a License. 10
(6) Comply with the Rules of the Compact Commission. 11
(7) Utilize passage of a recognized national exam such as the NCCPA PANCE as 12
a requirement for PA licensure. 13
(8) Grant the Compact Privilege to a holder of a Qualifying License in a 14
Participating State. 15
(b) Nothing in this Compact prohibits a Participating State from charging a fee for 16
granting the Compact Privilege. 17
"§ 90-270.203. Compact Privilege. 18
(a) To exercise the Compact Privilege, a Licensee must: 19
(1) Have graduated from a PA program accredited by the Accreditation Review 20
Commission on Education for the Physician Assistant, Inc., or other programs 21
authorized by Commission Rule. 22
(2) Hold current NCCPA certification. 23
(3) Have no felony or misdemeanor conviction. 24
(4) Have never had a controlled substance license, permit, or registration 25
suspended or revoked by a State or by the United States Drug Enforcement 26
Administration. 27
(5) Have a unique identifier as determined by Commission Rule. 28
(6) Hold a Qualifying License. 29
(7) Have had no revocation of a License or limitation or restriction on any License 30
currently held due to an Adverse Action. 31
(8) If a Licensee has had a limitation or restriction on a License or Compact 32
Privilege due to an Adverse Action, two years must have elapsed from the 33
date on which the License or Compact Privilege is no longer limited or 34
restricted due to the Adverse Action. 35
(9) If a Compact Privilege has been revoked or is limited or restricted in a 36
Participating State for conduct that would not be a basis for disciplinary action 37
in a Participating State in which the Licensee is practicing or applying to 38
practice under a Compact Privilege, that Participating State shall have the 39
discretion not to consider such action as an Adverse Actio n requiring the 40
denial or removal of a Compact Privilege in that State. 41
(10) Notify the Compact Commission that the Licensee is seeking the Compact 42
Privilege in a Remote State. 43
(11) Meet any Jurisprudence Requirement of a Remote State in which the Licensee 44
is seeking to practice under the Compact Privilege and pay any fees applicable 45
to satisfying the Jurisprudence Requirement. 46
(12) Report to the Commission any Adverse Action taken by a non -participating 47
State within 30 days after the action is taken. 48
(b) The Compact Privilege is valid until the expiration or revocation of the Qualifying 49
License unless terminated pursuant to an Adverse Action. The Licensee must also comply with 50
all of the requirements of subsection (a) of this section to maintain the Compact Privilege in a 51
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Remote State. If the Participating State takes Adverse Action against a Qualifying License, the 1
Licensee shall lose the Compact Privilege in any Remote State in which the Licensee has a 2
Compact Privilege until all of the following occur: 3
(1) The License is no longer limited or restricted; and 4
(2) Two years have elapsed from the date on which the License is no longer 5
limited or restricted due to the Adverse Action. 6
(c) Once a restricted or limited License satisfies the requirements of subdivisions (b)(1) 7
and (2) of this section, the Licensee must meet the requirements of subsection (a) of this section 8
to obtain a Compact Privilege in any Remote State. 9
(d) For each Remote State in which a PA seeks authority to prescribe controlled 10
substances, the PA shall satisfy all requirements imposed by such State in granting or renewing 11
such authority. 12
"§ 90-270.204. Designation of the State from which Licensee is applying for a Compact 13
Privilege. 14
Upon a Licensee 's application for a Compact Privilege, the Licensee shall identify to the 15
Commission the Participating State from which the Licensee is applying, in accordance with 16
applicable Rules adopted by the Commission, and subject to the following requirements: 17
(1) When applying for a Compact Privilege, the Licensee shall provide the 18
Commission with the address of the Licensee 's primary residence and 19
thereafter shall immediately report to the Commission any change in the 20
address of the Licensee's primary residence. 21
(2) When applying for a Compact Privilege, the Licensee is required to consent 22
to accept service of process by mail at the Licensee's primary residence on file 23
with the Commission with respect to any action brought against the Licensee 24
by the Commission or a Participating State, including a subpoena, with respect 25
to any action brought or investigation conducted by the Commission or a 26
Participating State. 27
"§ 90-270.205. Adverse Actions. 28
(a) A Participating State in which a Licensee is licensed shall have exclusive power to 29
impose Adverse Action against the Qualifying License issued by that Participating State. 30
(b) In addition to the other powers conferred by State law, a Remote State shall have the 31
authority, in accordance with existing State due process law, to do all of the following: 32
(1) Take Adverse Action against a PA 's Compact Privilege within that State to 33
remove a Licensee's Compact Privilege or take other action necessary under 34
applicable law to protect the health and safety of its citizens. 35
(2) Issue subpoenas for both hearings and investigations that require the 36
attendance and testimony of witnesses as well as the production of evidence. 37
Subpoenas issued by a Licensing Board in a Participating State for the 38
attendance and testimony of witnesses or the production of evidence from 39
another Participating State shall be enforced in the latter State by any court of 40
competent jurisdiction, according to the practice and procedure of that court 41
applicable to subpoenas issued in proceedings pending before it. The issuing 42
authority shall pay any witness fees, travel expenses, mileage , and other fees 43
required by the service statutes of the State in which the witnesses or evidence 44
are located. 45
(3) Notwithstanding subdivision (2) of this subsection, subpoenas may not be 46
issued by a Participating State to gather evidence of conduct in another State 47
that is lawful in that other State for the purpose of taking Adverse Action 48
against a Licensee's Compact Privilege or application for a Compact Privilege 49
in that Participating State. 50
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(4) Nothing in this Compact authorizes a Participating State to impose discipline 1
against a PA 's Compact Privilege or to deny an application for a Compact 2
Privilege in that Participating State for the individual 's otherwise lawful 3
practice in another State. 4
(c) For purposes of taking Adverse Action, the Participating State which issued the 5
Qualifying License shall give the same priority and effect to reported conduct received from any 6
other Participating State as it would if the conduct had occurred within the Participating State 7
which issued the Qualifying License. In so doing, that Participating State shall apply its own 8
State laws to determine appropriate action. 9
(d) A Participating State, if otherwise permitted by State law, may recover from the 10
affected PA the costs of investigations and disposition of cases resulting from any Adverse 11
Action taken against that PA. 12
(e) A Participating State may take Adverse Action based on the factual findings of a 13
Remote State, provided that the Participating State follows i ts own procedures for taking the 14
Adverse Action. 15
(f) Joint Investigations. – 16
(1) In addition to the authority granted to a Participating State by its respective 17
State PA laws and regulations or other applicable State law, any Participating 18
State may participate with other Participating States in joint investigations of 19
Licensees. 20
(2) Participating States shall share any investigative, litigation, or compliance 21
materials in furtherance of any joint or individual investigation initiated under 22
this Compact. 23
(g) If an Adverse Action is taken against a PA 's Qualifying License, the PA 's Compact 24
Privilege in all Remote States shall be deactivated until two years have elapsed after all 25
restrictions have been removed from the State License. All disciplinary orders by the 26
Participating State which issued the Qualifying License that impose Adverse Action against a 27
PA's License shall include a Statement that the PA 's Compact Privilege is deactivated in all 28
Participating States during the pendency of the order. 29
(h) If any Participating State takes Adverse Action, it promptly shall notify the 30
administrator of the Data System. 31
"§ 90-270.206. Establishment of the PA Licensure Compact Commission. 32
(a) The Participating States hereby create and establish a joint government agen cy and 33
national administrative body known as the PA Licensure Compact Commission. The 34
Commission is an instrumentality of the Compact States acting jointly and not an instrumentality 35
of any one State. The Commission shall come into existence on or after the effective date of the 36
Compact as set forth in G.S. 90-270.210(a). 37
(b) Membership, Voting, and Meetings: 38
(1) Each Participating State shall have and be limited to one delegate selected by 39
that Participating State 's Licensing Board or, if the State has mor e than one 40
Licensing Board, selected collectively by the Participating State 's Licensing 41
Boards. 42
(2) The delegate shall be either: 43
a. A current PA, physician , or public member of a Licensing Board or 44
PA Council/Committee; or 45
b. An administrator of a Licensing Board. 46
(3) Any delegate may be removed or suspended from office as provided by the 47
laws of the State from which the delegate is appointed. 48
(4) The Participating State Licensing Board shall fill any vacancy occurring in the 49
Commission within 60 days. 50
General Assembly Of North Carolina Session 2025
House Bill 672-First Edition Page 11
(5) Each delegate shall be entitled to one vote on all matters voted on by the 1
Commission and shall otherwise have an opportunity to participate in the 2
business and affairs of the Commission. A delegate shall vote in person or by 3
such other means as pr ovided in the bylaws. The bylaws may provide for 4
delegates' participation in meetings by telecommunications, video conference, 5
or other means of communication. 6
(6) The Commission shall meet at least once during each calendar year. 7
Additional meetings shall be held as set forth in this Compact and the bylaws. 8
(7) The Commission shall establish by Rule a term of office for delegates. 9
(c) The Commission shall have the following powers and duties: 10
(1) Establish a code of ethics for the Commission; 11
(2) Establish the fiscal year of the Commission; 12
(3) Establish fees; 13
(4) Establish bylaws; 14
(5) Maintain its financial records in accordance with the bylaws; 15
(6) Meet and take such actions as are consistent with the provisions of this 16
Compact and the bylaws; 17
(7) Promulgate Rules to facilitate and coordinate implementation and 18
administration of this Compact. The Rules shall have the force and effect of 19
law and shall be binding in all Participating States; 20
(8) Bring and prosecute legal proceedings or actions in the name of the 21
Commission, provided that the standing of any State Licensing Board to sue 22
or be sued under applicable law shall not be affected; 23
(9) Purchase and maintain insurance and bonds; 24
(10) Borrow, accept, or contract for services of personnel, includi ng, but not 25
limited to, employees of a Participating State; 26
(11) Hire employees and engage contractors, elect or appoint officers, fix 27
compensation, define duties, grant such individuals appropriate authority to 28
carry out the purposes of this Compact, and establish the Commission 's 29
personnel policies and programs relating to conflicts of interest, qualifications 30
of personnel, and other related personnel matters; 31
(12) Accept any and all appropriate donations and grants of money, equipment, 32
supplies, materials, and services and receive, utilize, and dispose of the same; 33
provided that at all times the Commission shall avoid any appearance of 34
impropriety or conflict of interest; 35
(13) Lease, purchase, accept appropriate gifts or donations of, or otherwise own, 36
hold, improve, or use any property, real, personal, or mixed; provided that at 37
all times the Commission shall avoid any appearance of impropriety; 38
(14) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise 39
dispose of any property real, personal, or mixed; 40
(15) Establish a budget and make expenditures; 41
(16) Borrow money; 42
(17) Appoint committees, including standing committees composed of members, 43
State regulators, State legislators or their representatives, and consumer 44
representatives, and such other interested persons as may be designated in this 45
Compact and the bylaws; 46
(18) Provide and receive information from, and cooperate with, law enforcement 47
agencies; 48
(19) Elect a Chair, Vice-Chair, Secretary, and Treasurer and such other officers of 49
the Commission as provided in the Commission's bylaws; 50
General Assembly Of North Carolina Session 2025
Page 12 House Bill 672-First Edition
(20) Reserve for itself, in addition to those reserved exclusively to the Commission 1
under the Compact, powers that the Executive Committee may not exercise; 2
(21) Approve or disapprove a State 's participation in the Compact based upon its 3
determination as to whether the State 's Compact legislation departs in a 4
material manner from the Model Compact language; 5
(22) Prepare and provide to the Participating States an annual report; and 6
(23) Perform such other functions as may be necessary or appropriate to achieve 7
the purposes of this Compact consistent with the State regulation of PA 8
licensure and practice. 9
(d) Meetings of the Commission: 10
(1) All meetings of the Commission that are not closed pursuant to this subsection 11
shall be open to the public. Notice of public meetings shall be posted on the 12
Commission's website at least 30 days prior to the public meeting. 13
(2) Notwithstanding subdivision (1) of this subsection, the Commission may 14
convene a public me eting by providing at least 24 hours ' prior notice on the 15
Commission's website, and any other means as provided in the Commission's 16
Rules, for any of the reasons it may dispense with notice of proposed 17
rulemaking under G.S. 90-270.208(l). 18
(3) The Commission may convene in a closed, nonpublic meeting or nonpublic 19
part of a public meeting to receive legal advice or to discuss: 20
a. Noncompliance of a Participating State with its obligations under this 21
Compact; 22
b. The employment, compensation, discipline or other matters, practices 23
or procedures related to specific employees or other matters related to 24
the Commission's internal personnel practices and procedures; 25
c. Current, threatened, or reasonably anticipated litigation; 26
d. Negotiation of contracts for the purchase, lease, or sale of goods, 27
services, or real estate; 28
e. Accusing any person of a crime or formally censuring any person; 29
f. Disclosure of trade secrets or commercial or financial information that 30
is privileged or confidential; 31
g. Disclosure of information of a personal nature where disclosure would 32
constitute a clearly unwarranted invasion of personal privacy; 33
h. Disclosure of investigative records compiled for law enforcement 34
purposes; 35
i. Disclosure of information related to any investigative reports prepared 36
by or on behalf of or for use of the Commission or other committee 37
charged with responsibility of investigation or determination of 38
compliance issues pursuant to this Compact; 39
j. Legal advice; or 40
k. Matters specifically exempted from disclosure by federal or 41
Participating States' statutes. 42
(4) If a meeting, or portion of a meeting, is closed pursuant to this provision, the 43
chair of the meeting or the chair 's designee shall certify that the meeting or 44
portion of the meeting may be closed and shal l reference each relevant 45
exempting provision. 46
(5) The Commission shall keep minutes that fully and clearly describe all matters 47
discussed in a meeting and shall provide a full and accurate summary of 48
actions taken, including a description of the views exp ressed. All documents 49
considered in connection with an action shall be identified in such minutes. 50
All minutes and documents of a closed meeting shall remain under seal, 51
General Assembly Of North Carolina Session 2025
House Bill 672-First Edition Page 13
subject to release by a majority vote of the Commission or order of a court of 1
competent jurisdiction. 2
(e) Financing of the Commission: 3
(1) The Commission shall pay, or provide for the payment of, the reasonable 4
expenses of its establishment, organization, and ongoing activities. 5
(2) The Commission may accept any and all appropriate revenue sources, 6
donations, and grants of money, equipment, supplies, materials, and services. 7
(3) The Commission may levy on and collect an annual assessment from each 8
Participating State and may impose Compact Privilege fees on Licensees of 9
Participating States to whom a Compact Privilege is granted to cover the cost 10
of the operations and activities of the Commission and its staff, which must 11
be in a total amount sufficient to cover its annual budget as approved by the 12
Commission each year for which revenue is n ot provided by other sources. 13
The aggregate annual assessment amount levied on Participating States shall 14
be allocated based upon a formula to be determined by Commission Rule. 15
a. A Compact Privilege expires when the Licensee's Qualifying License 16
in the Pa rticipating State from which the Licensee applied for the 17
Compact Privilege expires. 18
b. If the Licensee terminates the Qualifying License through which the 19
Licensee applied for the Compact Privilege before its scheduled 20
expiration, and the Licensee has a Q ualifying License in another 21
Participating State, the Licensee shall inform the Commission that it 22
is changing to that Participating State the Participating State through 23
which it applies for a Compact Privilege and pay to the Commission 24
any Compact Privilege fee required by Commission Rule. 25
(4) The Commission shall not incur obligations of any kind prior to securing the 26
funds adequate to meet the same nor shall the Commission pledge the credit 27
of any of the Participating States, except by and with the auth ority of the 28
Participating State. 29
(5) The Commission shall keep accurate accounts of all receipts and 30
disbursements. The receipts and disbursements of the Commission shall be 31
subject to the financial review and accounting procedures established under 32
its b ylaws. All receipts and disbursements of funds handled by the 33
Commission shall be subject to an annual financial review by a certified or 34
licensed public accountant, and the report of the financial review shall be 35
included in and become part of the annual report of the Commission. 36
(f) The Executive Committee: 37
(1) The Executive Committee shall have the power to act on behalf of the 38
Commission according to the terms of this Compact and Commission Rules. 39
(2) The Executive Committee shall be composed of nine members: 40
a. Seven voting members who are elected by the Commission from the 41
current membership of the Commission; 42
b. One ex officio, nonvoting member from a recognized national PA 43
professional association; and 44
c. One ex officio, nonvoting member from a recognized national PA 45
certification organization. 46
(3) The ex officio members will be selected by their respective organizations. 47
(4) The Commission may remove any member of the Executive Committee as 48
provided in its bylaws. 49
(5) The Executive Committee shall meet at least annually. 50
(6) The Executive Committee shall have the following duties and responsibilities: 51
General Assembly Of North Carolina Session 2025
Page 14 House Bill 672-First Edition
a. Recommend to the Commission changes to the Commission 's Rules 1
or bylaws, changes to this Compact legislation, fees to be paid by 2
Compact Participating States such as annual dues, and any 3
Commission Compact fee charged to Licensees for the Compact 4
Privilege; 5
b. Ensure Compact administration services are appropriately provided, 6
contractual or otherwise; 7
c. Prepare and recommend the budget; 8
d. Maintain financial records on behalf of the Commission; 9
e. Monitor Compact compliance of Participating States and provide 10
compliance reports to the Commission; 11
f. Establish additional committees as necessary; 12
g. Exercise the powers and duties of the Commission during the interim 13
between Commission meetings, except for issuing proposed 14
rulemaking or adopting Commission Rules or bylaws, or exercising 15
any other powers and duties exclusively reserved to the Commission 16
by the Commission's Rules; and 17
h. Perform other duties as provided in the Commission's Rules or bylaws. 18
(7) All meetings of the Executive Committee at which it votes or plans to vote on 19
matters in exercising the powers and duties of the Commission shall be open 20
to the public and public notice of such meetings shall be given as public 21
meetings of the Commission are given. 22
(8) The Executive Committee may convene in a closed, nonpublic meeting for 23
the same reasons that the Commission may convene in a nonpublic meeting 24
as set forth in G.S. 90-270.206(d)(3) and shall announce the closed meeting 25
as the Commission is required to under G.S. 90-270.206(d)(3) and keep 26
minutes of the closed meeting as the Commission is required to under 27
G.S. 90-270.206(d)(3). 28
(g) Qualified Immunity, Defense, and Indemnification: 29
(1) The members, officers, executive director, employees, and representatives of 30
the Commission shall be immune from suit and liability, both personally and 31
in their official capacity, for any claim for damage to or loss of property or 32
personal injury or other civil liability caused by or arising out of any actual or 33
alleged act, error, or omission that occurred, or that the person against whom 34
the claim is made had a reasonable basis for believing occurred within the 35
scope of Commission em ployment, duties, or responsibilities; provided that 36
nothing in this paragraph shall be construed to protect any such person from 37
suit or liability for any damage, loss, injury, or liability caused by the 38
intentional or willful or wanton misconduct of that person. The procurement 39
of insurance of any type by the Commission shall not in any way compromise 40
or limit the immunity granted hereunder. 41
(2) The Commission shall defend any member, officer, executive director, 42
employee, and representative of the Commis sion in any civil action seeking 43
to impose liability arising out of any actual or alleged act, error, or omission 44
that occurred within the scope of Commission employment, duties, or 45
responsibilities, or as determined by the Commission that the person again st 46
whom the claim is made had a reasonable basis for believing occurred within 47
the scope of Commission employment, duties, or responsibilities; provided 48
that nothing herein shall be construed to prohibit that person from retaining 49
their own counsel at thei r own expense; and provided further, that the actual 50
General Assembly Of North Carolina Session 2025
House Bill 672-First Edition Page 15
or alleged act, error, or omission did not result from that person 's intentional 1
or willful or wanton misconduct. 2
(3) The Commission shall indemnify and hold harmless any member, officer, 3
executive director, employee, and representative of the Commission for the 4
amount of any settlement or judgment obtained against that person arising out 5
of any actual or alleged act, error, or omission that occurred within the scope 6
of Commission employment, duties, or r esponsibilities, or that such person 7
had a reasonable basis for believing occurred within the scope of Commission 8
employment, duties, or responsibilities, provided that the actual or alleged act, 9
error, or omission did not result from the intentional or wi llful or wanton 10
misconduct of that person. 11
(4) Venue is proper and judicial proceedings by or against the Commission shall 12
be brought solely and exclusively in a court of competent jurisdiction where 13
the principal office of the Commission is located. The Commission may waive 14
venue and jurisdictional defenses in any proceedings as authorized by 15
Commission Rules. 16
(5) Nothing herein shall be construed as a limitation on the liability of any 17
Licensee for professional malpractice or misconduct, which shall be governed 18
solely by any other applicable State laws. 19
(6) Nothing herein shall be construed to designate the venue or jurisdiction to 20
bring actions for alleged acts of malpractice, professional misconduct, 21
negligence, or other such civil action pertaining to the practice of a PA. All 22
such matters shall be determined exclusively by State law other than this 23
Compact. 24
(7) Nothing in this Compact shall be interpreted to waive or otherwise abrogate a 25
Participating State's state action immunity or state action affir mative defense 26
with respect to antitrust claims under the Sherman Act, Clayton Act, or any 27
other State or federal antitrust or anticompetitive law or regulation. 28
(8) Nothing in this Compact shall be construed to be a waiver of sovereign 29
immunity by the Participating States or by the Commission. 30
"§ 90-270.207. Data System. 31
(a) The Commission shall provide for the development, maintenance, operation, and 32
utilization of a coordinated data and reporting system containing licensure, Adverse Action, and 33
the reporting of the existence of Significant Investigative Information on all licensed PAs and 34
applicants denied a License in Participating States. 35
(b) Notwithstanding any other State law to the contrary, a Participating State shall submit 36
a uniform data set to t he Data System on all PAs to whom this Compact is applicable (utilizing 37
a unique identifier) as required by the Rules of the Commission, including: 38
(1) Identifying information; 39
(2) Licensure data; 40
(3) Adverse Actions against a License or Compact Privilege; 41
(4) Any denial of application for licensure, and the reason(s) f or such denial 42
(excluding the reporting of any criminal history record information where 43
prohibited by law); 44
(5) The existence of Significant Investigative Information; and 45
(6) Other information that may facilitate the administration of this Compact, as 46
determined by the Rules of the Commission. 47
(c) Significant Investigative Information pertaining to a Licensee in any Participating 48
State shall only be available to other Participating States. 49
General Assembly Of North Carolina Session 2025
Page 16 House Bill 672-First Edition
(d) The Commission shall promptly notify all Participating States of any Adverse Action 1
taken against a Licensee or an individual applying for a License that has been reported to it. This 2
Adverse Action information shall be available to any other Participating State. 3
(e) Participating States contributing information to the Data System may, in accordance 4
with State or federal law, designate information that may not be shared with the public without 5
the express permission of the contributing State. Not withstanding any such designation, such 6
information shall be reported to the Commission through the Data System. 7
(f) Any information submitted to the Data System that is subsequently expunged 8
pursuant to federal law or the laws of the Participating State c ontributing the information shall 9
be removed from the Data System upon reporting of such by the Participating State to the 10
Commission. 11
(g) The records and information provided to a Participating State pursuant to this 12
Compact or through the Data System, wh en certified by the Commission or an agent thereof, 13
shall constitute the authenticated business records of the Commission and shall be entitled to any 14
associated hearsay exception in any relevant judicial, quasi -judicial, or administrative 15
proceedings in a Participating State. 16
"§ 90-270.208. Rulemaking. 17
(a) The Commission shall exercise its Rulemaking powers pursuant to the criteria set 18
forth in this section and the Rules adopted thereunder. Commission Rules shall become binding 19
as of the date specified by the Commission for each Rule. 20
(b) The Commission shall promulgate reasonable Rules in order to effectively and 21
efficiently implement and administer this Compact and achieve its purposes. A Commission Rule 22
shall be invalid and have not force or effect only if a court of competent jurisdiction holds that 23
the Rule is invalid because the Commission exercised its rulemaking authority in a manner that 24
is beyond the scope of the purposes of this Compact, or the powers granted hereunder, or based 25
upon another applicable standard of review. 26
(c) The Rules of the Commission shall have the force of law in each Participating State, 27
provided, however, that where the Rules of the Commission conflict with the laws of the 28
Participating State that establish the Medical Services a PA may perform in the Participating 29
State, as held by a court of competent jurisdiction, the Rules of the Commission shall be 30
ineffective in that State to the extent of the conflict. The Rules of the Commission shall not 31
modify or expand, in any way, the scope of practice of a PA as established by the laws of the 32
Participating State. 33
(d) If a majority of the legislatures of the Participating States rejects a Commission Rule, 34
by enactment of a statute or resolution in the same manner used to adopt thi s Compact within 35
four years of the date of adoption of the Rule, then such Rule shall have no further force and 36
effect in any Participating State or to any State applying to participate in the Compact. 37
(e) Commission Rules shall be adopted at a regular or special meeting of the 38
Commission. 39
(f) Prior to promulgation and adoption of a final Rule or Rules by the Commission, and 40
at least 30 days in advance of the meeting at which the Rule will be considered and voted upon, 41
the Commission shall file a Notice of Proposed Rulemaking: 42
(1) On the website of the Commission or other publicly accessible platform; 43
(2) To persons who have requested notice of the Commission 's notices of 44
proposed rulemaking; and 45
(3) In such other way(s) as the Commission may by Rule specify. 46
(g) The Notice of Proposed Rulemaking shall include: 47
(1) The time, date, and location of the public hearing on the proposed Rule and 48
the proposed time, date , and location of the meeting in which the proposed 49
Rule will be considered and voted upon; 50
(2) The text of the proposed Rule and the reason for the proposed Rule; 51
General Assembly Of North Carolina Session 2025
House Bill 672-First Edition Page 17
(3) A request for comments on the proposed Rule from any interested person and 1
the date by which written comments must be received; and 2
(4) The manner in which interested persons may submit notice to the Commission 3
of their intention to attend the public hearing or provide any written 4
comments. 5
(h) Prior to adoption of a proposed Rule, the Commission shall allow persons to submit 6
written data, facts, opinions, and arguments, which shall be made available to the public. 7
(i) If the hearing is to be held via electronic means, the Commission shall publish the 8
mechanism for access to the electronic hearing. 9
(1) All persons wishing to be heard at the hearing shall as directed in the Notice 10
of Proposed Rulemaking, not less than five business days before the scheduled 11
date of the hearing, notify the Commission of their desire to appear and testify 12
at the hearing. 13
(2) Hearings shall be conducted in a manner providing each person who wishes 14
to comment a fair and reasonable opportunity to comment orally or in writing. 15
(3) All hearings shall be recorded. A copy of the recording and the written 16
comments, data, facts, opinions, and arguments received in response to the 17
proposed rulemaking shall be made available to a person upon request. 18
(4) Nothing in this section shall be construed as requiring a separate hearing on 19
each proposed Rule. Proposed Rules may be grouped for the convenience of 20
the Commission at hearings required by this section. 21
(j) Following the public hearing , the Commission shall consider all written and oral 22
comments timely received. 23
(k) The Commission shall, by majority vote of all delegates, take final action on the 24
proposed Rule and shall determine the effective date of the Rul e, if adopted, based on the 25
Rulemaking record and the full text of the Rule. 26
(1) If adopted, the Rule shall be posted on the Commission's website. 27
(2) The Commission may adopt changes to the proposed Rule provided the 28
changes do not enlarge the original purpose of the proposed Rule. 29
(3) The Commission shall provide on its website an explanation of the reasons for 30
substantive changes made to the proposed Rule as well as reasons for 31
substantive changes not made that were recommended by commenters. 32
(4) The Com mission shall determine a reasonable effective date for the Rule. 33
Except for an emergency as provided in subsection ( l) of this section, the 34
effective date of the Rule shall be no sooner than 30 days after the Commission 35
issued the notice that it adopted the Rule. 36
(l) Upon determination that an emergency exists, the Commission may consider and 37
adopt an emergency Rule with 24 hours ' prior notice, without the opportunity for comment, or 38
hearing, provided that the usual Rulemaking procedures provided in this Compact and in this 39
section shall be retroactively applied to the Rule as soon as reasonably possible, in no event later 40
than 90 days after the effective date of the Rule. For the purposes of this provision, an emergency 41
Rule is one that must be adopted immediately by the Commission in order to: 42
(1) Meet an imminent threat to public health, safety, or welfare; 43
(2) Prevent a loss of Commission or Participating State funds; 44
(3) Meet a deadline for the promulgation of a Commission Rule that is established 45
by federal law or Rule; or 46
(4) Protect public health and safety. 47
(m) The Commission or an authorized committee of the Commission may direct revisions 48
to a previously adopted Commission Rule for purposes of correcting typographical errors, errors 49
in format, err ors in consistency, or grammatical errors. Public notice of any revisions shall be 50
posted on the website of the Commission. The revision shall be subject to challenge by any 51
General Assembly Of North Carolina Session 2025
Page 18 House Bill 672-First Edition
person for a period of 30 days after posting. The revision may be challenged only on grounds 1
that the revision results in a material change to a Rule. A challenge shall be made as set forth in 2
the notice of revisions and delivered to the Commission prior to the end of the notice period. If 3
no challenge is made, the revision will take ef fect without further action. If the revision is 4
challenged, the revision may not take effect without the approval of the Commission. 5
(n) No Participating State's rulemaking requirements shall apply under this Compact. 6
"§ 90-270.209. Oversight, dispute resolution, and enforcement. 7
(a) Oversight: 8
(1) The executive and judicial branches of State government in each Participating 9
State shall enforce this Compact and take all actions necessary and appropriate 10
to implement the Compact. 11
(2) Venue is proper and judicial proceedings by or against the Commission shall 12
be brought solely and exclusively in a court of competent jurisdiction where 13
the principal office of the Commission is located. The Commission may waive 14
venue and jurisdictional defenses to the extent it adopts or consents to 15
participate in alternative dispute resolution proceedings. Nothing herein shall 16
affect or limit the selection or propriety of venue in any action against a 17
Licensee for professional malpractice, misconduct, or any such similar matter. 18
(3) The Commission shall be entitled to receive service of process in any 19
proceeding regarding the enforcement or interpretation of the Compact or the 20
Commission's Rules and shall have standing to intervene in such a proceeding 21
for all purposes. Failur e to provide the Commission with service of process 22
shall render a judgment or order in such proceeding void as to the 23
Commission, this Compact, or Commission Rules. 24
(b) Default, Technical Assistance, and Termination: 25
(1) If the Commission determines that a Participating State has defaulted in the 26
performance of its obligations or responsibilities under this Compact or the 27
Commission Rules, the Commission shall provide written notice to the 28
defaulting State and other Participating States. The notice shall d escribe the 29
default, the proposed means of curing the default , and any other action that 30
the Commission may take and shall offer remedial training and specific 31
technical assistance regarding the default. 32
(2) If a State in default fails to cure the default, the defaulting State may be 33
terminated from this Compact upon an affirmative vote of a majority of the 34
delegates of the Participating States, and all rights, privileges , and benefits 35
conferred by this Compact upon such State may be terminated on the effective 36
date of termination. A cure of the default does not relieve the offending State 37
of obligations or liabilities incurred during the period of default. 38
(3) Termination of participation in this Compact shall be imposed only after all 39
other means of securing compliance have been exhausted. Notice of intent to 40
suspend or terminate shall be given by the Commission to the governor, the 41
majority and minority leaders of the defaulting State 's legislature, and to the 42
Licensing Board(s) of each of the Participating States. 43
(4) A State that has been terminated is responsible for all assessments, 44
obligations, and liabilities incurred through the effective date of termination, 45
including obligations that extend beyond the effective date of termination. 46
(5) The Commission shall not bear any costs related to a State that is found to be 47
in default or that has been terminated from this Compact, unless agreed upon 48
in writing between the Commission and the defaulting State. 49
(6) The defaulting State may appeal its termination from the Compact by the 50
Commission by petitioning the United States District Court for the District of 51
General Assembly Of North Carolina Session 2025
House Bill 672-First Edition Page 19
Columbia or the federal district where the Commission has its principal 1
offices. The prevailing member shall be awarded all costs of such litigation, 2
including reasonable attorneys' fees. 3
(7) Upon the termination of a State's participation in the Compact, the State shall 4
immediately provide notice to all Licensees within that State of such 5
termination: 6
a. Licensees who have been granted a Compact Privilege in that State 7
shall retain the Compact Privilege for 180 days following the effective 8
date of such termination. 9
b. Licensees who are licensed in that State who have been granted a 10
Compact Privilege in a Participating State shall retain the Compact 11
Privilege for 180 days unless the Licensee also has a Qualifying 12
License in a Participating State or obtains a Qualifying License in a 13
Participating State before the 180 -day period ends, in which case the 14
Compact Privilege shall continue. 15
(c) Dispute Resolution: 16
(1) Upon request by a Participating State, the Commission shall attempt to resolve 17
disputes related to this Compact that arise among Participating States and 18
between Participating and non-Participating States. 19
(2) The Commission shall promulgate a R ule providing for both mediation and 20
binding dispute resolution for disputes as appropriate. 21
(d) Enforcement: 22
(1) The Commission, in the reasonable exercise of its discretion, shall enforce the 23
provisions of this Compact and Rules of the Commission. 24
(2) If compliance is not secured after all means to secure compliance have been 25
exhausted, by majority vote, the Commission may initiate legal action in the 26
United States District Court for the District of Columbia or the federal district 27
where the Commission ha s its principal offices, against a Participating State 28
in default to enforce compliance with the provisions of this Compact and the 29
Commission's promulgated Rules and bylaws. The relief sought may include 30
both injunctive relief and damages. In the event ju dicial enforcement is 31
necessary, the prevailing party shall be awarded all costs of such litigation, 32
including reasonable attorneys' fees. 33
(3) The remedies herein shall not be the exclusive remedies of the Commission. 34
The Commission may pursue any other re medies available under federal or 35
State law. 36
(e) Legal Action Against the Commission: 37
(1) A Participating State may initiate legal action against the Commission in the 38
United States District Court for the District of Columbia or the federal district 39
where the Commission has its principal offices to enforce compliance with the 40
provisions of the Compact and its Rules. The relief sought may include both 41
injunctive relief and damages. In the event judicial enforcement is necessary, 42
the prevailing party shall be awarded all costs of such litigation, including 43
reasonable attorneys' fees. 44
(2) No person other than a Participating State shall enforce this Compact against 45
the Commission. 46
"§ 90-270.210. Date of implementation of the PA Licensure Compact Commission. 47
(a) This Compact shall come into effect on the date on which this Compact statute is 48
enacted into law in the seventh Participating State. 49
(1) On or after the effective date of the Com pact, the Commission shall convene 50
and review the enactment of each of the States that enacted the Compact prior 51
General Assembly Of North Carolina Session 2025
Page 20 House Bill 672-First Edition
to the Commission convening ("Charter Participating States") to determine if 1
the statute enacted by each such Charter Participating State is ma terially 2
different than the Model Compact. 3
a. A Charter Participating State whose enactment is found to be 4
materially different from the Model Compact shall be entitled to the 5
default process set forth in G.S. 90-270.209(b). 6
b. If any Participating State later withdraws from the Compact or its 7
participation is terminated, the Commission shall remain in existence 8
and the Compact shall remain in effect even if the number of 9
Participating States should be less than seven. Participat ing States 10
enacting the Compact subsequent to the Commission convening shall 11
be subject to the process set forth in G.S. 90-270.206(c)(21) to 12
determine if their enactments are materially different from the Model 13
Compact and whether they qualify for participation in the Compact. 14
(2) Participating States enacting the Compact subsequent to the seven initial 15
Charter Participating States shall be subject to the process set forth in 16
G.S. 90-270.206(c)(21) to determine if their enactments are materially 17
different from the Model Compact and whether they qualify for participation 18
in the Compact. 19
(3) All actions taken for the benefit of the Commission or in furtherance of the 20
purposes of the administration of the Compact prior to the effective date of 21
the Compact or the Commission coming into existence shall be considered to 22
be actions of the Commission unless specifically repudiated by the 23
Commission. 24
(b) Any State that joins this Compact shall be subject to the Commission 's Rules and 25
bylaws as they exist on the date on which this Compact becomes law in that State. Any Rule that 26
has been previously adopted by the Commission shall have the full force and effect of law on the 27
day this Compact becomes law in that State. 28
(c) Any Participating State may withdraw from this C ompact by enacting a statute 29
repealing the same. 30
(1) A Participating State 's withdrawal shall not take effect until 180 days after 31
enactment of the repealing statute. During this 180 -day period, all Compact 32
Privileges that were in effect in the withdrawing State and were granted to 33
Licensees licensed in the withdrawing State shall remain in effect. If any 34
Licensee licensed in the withdrawing State is also licensed in another 35
Participating State or obtains a license in another Participating State within 36
the 180 days, the Licensee's Compact Privileges in other Participating States 37
shall not be affected by the passage of the 180 days. 38
(2) Withdrawal shall not affect the continuing requirement of the State Licensing 39
Board(s) of the withdrawing State to comply with the investigative and 40
Adverse Action reporting requirements of this Compact prior to the effective 41
date of withdrawal. 42
(3) Upon the enactment of a statute withdrawing a State from this Compact, the 43
State shall immediately provide notice of such withdr awal to all Licensees 44
within that State. Such withdrawing State shall continue to recognize all 45
Licenses granted pursuant to this Compact for a minimum of 180 days after 46
the date of such notice of withdrawal. 47
(d) Nothing contained in this Compact shall be construed to invalidate or prevent any PA 48
licensure agreement or other cooperative arrangement between Participating States and between 49
a Participating State and non-Participating State that does not conflict with the provisions of this 50
Compact. 51
General Assembly Of North Carolina Session 2025
House Bill 672-First Edition Page 21
(e) This Compact may be amended by the Participating States. No amendment to this 1
Compact shall become effective and binding upon any Participating State until it is enacted 2
materially in the same manner into the laws of all Participating States as determined by the 3
Commission. 4
"§ 90-270.211. Construction and severability. 5
(a) This Compact and the Commission's rulemaking authority shall be liberally construed 6
so as to effectuate the purposes and the implementation and administration of the Compact. 7
Provisions of the Compact expressly authorizing or requiring the promulgation of Rules shall not 8
be construed to limit the Commission's rulemaking authority solely for those purposes. 9
(b) The provisions of this Compact shall be severable and if any phrase, clause, sentence, 10
or provision of this Compact is held by a court of competent jurisdiction to be contrary to the 11
constitution of any Participating State, a State seeking participation in the Compact, or of the 12
United States, or the applicability thereof to any government, agency, person, or circumstance is 13
held to be unconstitutional by a court of competent jurisdiction, the validity of the remainder of 14
this Compact and the applicability thereof to any other government, agency, person , or 15
circumstance shall not be affected thereby. 16
(c) Notwithstanding subsection (b) of this section, the Commission may deny a State 's 17
participation in the Compact or, in accordance with the requirements of G.S. 90-270.209(b), 18
terminate a Participating State's participation in the Compact, if it determines that a constitutional 19
requirement of a Participating State is, or would be with respect to a State seeking to participate 20
in the Compact, a material departure from the Compact. Otherwise, if this Compact shall be held 21
to be contrary to the constitution of any Participating State, the Compact shall remain in full force 22
and effect as to the remaining Participating States and in full force and effect as to the 23
Participating State affected as to all severable matters. 24
"§ 90-270.212. Binding effect of Compact. 25
(a) Nothing herein prevents the enforcement of any other law of a Participating State that 26
is not inconsistent with this Compact. 27
(b) Any laws in a Participating State in conflict with this Compact are sup erseded to the 28
extent of the conflict. 29
(c) All agreements between the Commission and the Participating States are binding in 30
accordance with their terms." 31
SECTION 2.1.(b) G.S. 90-9.3 reads as rewritten: 32
"§ 90-9.3. Requirements for licensure as a physician assistant. 33
(a) To be eligible for licensure as a physician assistant, an applicant shall submit proof 34
satisfactory to the Board that the applicant has met all of the following: 35
(1) The applicant has successfully completed an educational program f or 36
physician assistants or surgeon assistants accredited by the Accreditation 37
Review Commission on Education for the Physician Assistant or its 38
predecessor or successor entities. 39
(2) The applicant has a current or previous certification issued by the Natio nal 40
Commission on Certification of Physician Assistants or its successor. 41
(3) The applicant is of good moral character. 42
(a1) A physician assistant applying for licensure under Article 18J of this Chapter shall be 43
in compliance with that Article. 44
(b) Before initiating practice of medical acts, tasks, or functions as a physician assistant, 45
the physician assistant shall provide the Board the name, address, and telephone number of the 46
physician who will supervise the physician assistant in the relevant medical setting. 47
(c) The Board may, by rule, require an applicant to comply with other requirements or 48
submit additional information the Board deems appropriate." 49
SECTION 2.1.(c) G.S. 90-13.2 reads as rewritten: 50
"§ 90-13.2. Registration every year with Board. 51
General Assembly Of North Carolina Session 2025
Page 22 House Bill 672-First Edition
(a) Every licensee shall register annually with the Board no later than 30 days after the 1
person's birthday. Every privilege holder shall register annually with the Board in accordance 2
with the Physician Assistant Licensure Compact, Article 18J of this Chapter. 3
… 4
(b1) Physician assistants shall pay an annual registration fee of one hundred forty dollars 5
($140.00). A physician assistant who fails to register as required by this section shall pay an 6
additional fee of twenty-five dollars ($25.00) to the Board. 7
…." 8
SECTION 2.1.(d) G.S. 90-13.1 is amended by adding a new subsection to read: 9
"(g) For the initial licensure or privilege of a physician assistant, the Board shall require 10
the payment of two hundred thirty dollars ($230.00)." 11
SECTION 2.1.(e) G.S. 90-1.1 reads as rewritten: 12
"§ 90-1.1. Definitions. 13
The following definitions apply in this Article: 14
… 15
(4) License. – An authorization issued by the Board to a physician, physician 16
assistant, or anesthesiologist assistant to perform medical acts, tasks, or 17
functions. License shall include any physician assistant compact privilege 18
granted under Article 18J of this Chapter. 19
(4a) Licensee. – Any person issued a license by the Board, whether the license is 20
active or inactive, including an inactive license by means of surrender. 21
Licensee shall include any compact privilege issued to a holder of a qualifying 22
license in a participating state pursuant to Article 18J of this Chapter. 23
…." 24
SECTION 2.1.(f) G.S. 90-5.1 reads as rewritten: 25
"§ 90-5.1. Powers and duties of the Board. 26
(a) The Board shall have the following powers and duties: 27
… 28
(11) Implement the Physician Assistant Licensure Compact under Article 18J of 29
this Chapter, including issuing compact privileges. 30
(12) Appoint a delegate to serve on the Physician A ssistant Licensure Compact 31
Commission under G.S. 90-270.206. The delegate shall be either (i) a current 32
physician assistant, physician, or public member of the Board, or (ii) an 33
administrator of the Board. 34
…." 35
SECTION 2.1.(g) G.S. 90-11 reads as rewritten: 36
"§ 90-11. Criminal background checks. 37
(a) Repealed by Session Laws 2007-346, s. 11, effective October 1, 2007. 38
(a1) Repealed by Session Laws 2007-346, s. 9.1, effective October 1, 2007. 39
(b) The Department of Public Safety may provide a criminal record check to the Board 40
for a person who has applied for a license through the Board. Board and for purposes of Article 41
18J of this Chapter. The Board shall provide to the Department of Public Safety, along with the 42
request, the fingerprints of the applicant, any additional information required by the Department 43
of Public Safety, and a form signed by the applicant consenting to the check of the criminal 44
record and to the use of the fingerprints and other identifying information required by the State 45
or national repositories. The applicant's fingerprints shall be forwarded to the State Bureau of 46
Investigation for a search of the State's criminal history record file, and the State Bureau of 47
Investigation shall forward a set of the fingerprints to the Federa l Bureau of Investigation for a 48
national criminal history check. The Board shall keep all information pursuant to this subsection 49
privileged, in accordance with applicable State law and federal guidelines, and the information 50
shall be confidential and shall not be a public record under Chapter 132 of the General Statutes. 51
General Assembly Of North Carolina Session 2025
House Bill 672-First Edition Page 23
The Department of Public Safety may charge each applicant a fee for conducting the checks 1
of criminal history records authorized by this subsection. The Board has the authority to collect 2
this fee from each applicant and remit it to the Department of Public Safety." 3
SECTION 2.1.(h) G.S. 90-14 reads as rewritten: 4
"§ 90-14. Disciplinary Authority. 5
(a) The Board shall have the power to place on probation with or without conditions, 6
impose limitations and conditions on, publicly reprimand, assess monetary redress, issue public 7
letters of concern, mandate free medical services, require satisfactory completion of treatment 8
programs or remedial or educational training, fine, deny, annul, suspend, or revoke a license, or 9
other authority to practice medicine in this State, issued by the Board to any person who has been 10
found by the Board to have committed any of the following acts or conduct, or for any of the 11
following reasons: 12
… 13
(18) A violation of Article 18J of this Chapter, consistent with the provisions of 14
that Article for compact privilege holders. 15
…." 16
SECTION 2.2. Section 2.1 of this Part is effective nine months after it becomes law. 17
18
PART III. EFFECTIVE DATE 19
SECTION 3.1. Except as otherwise provided, this act is effective when it becomes 20
law. 21