 |
ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
physician assistants; licensure compact.
Purpose
Adopts the Physician Assistant Licensure Compact (Compact), allowing physician assistants (PAs) in participating states to obtain licensure in any other Compact state.
Background
PAs in Arizona are licensed and regulated by the Arizona Regulatory Board
of PAs. PAs may work under the supervision of a licensed physician in physician
offices, clinics, hospitals, surgical centers, patient homes, nursing homes or
other health care institutions. The duties of a PA include: 1) ordering,
prescribing, dispensing or administering drugs and medical devices;
2) pronouncing and authenticating deaths; 3) obtaining patient histories; 4)
performing physical examinations; 5) evaluating and diagnosing patients and
managing and providing medical treatment and therapeutic interventions; 6)
ordering and performing diagnostic studies and therapeutic procedures; 7)
assisting in surgery; 8) providing counseling and education; 9) making
appropriate referrals; 10) prescribing schedule II, III, IV or V controlled
substances;
11) performing minor surgery; and 12) performing other delegated nonsurgical
health care tasks (A.R.S.
Title 32, Ch. 25).
The Compact is an interstate licensure compact designed to facility the interstate practice of PAs. Under the Compact, PAs who are licensed in good standing in a Compact member state will be eligible to practice in other participating Compact states through Compact privilege, which is equivalent to a license. The Compact is formally enacted after seven states have officially enacted the model Compact into law through a state's legislative process. Currently, 20 states have adopted the Compact and implementation is in progress with an estimated timeframe of 18 to 24 months. Applications for Compact privileges will not be available until the Compact Commission (Commission) becomes fully operational (Compact).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
Purpose
1. States that the purpose of the Compact, in order to strengthen access to medical services and in recognition of the advances in the delivery of medical services, is to develop a comprehensive process that complements the existing authority of state licensing boards to license and discipline PAs and seek to enhance the portability of a license to practice as a PA while safeguarding the safety of patients.
2. States that the Compact allows medical services to be provided by PAs through the mutual recognition of the licensee's qualifying license by other Compact participating states.
3. States that the Compact 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, requiring the PA to be under the jurisdiction of the state licensing board where the patient is located.
4. States that state licensing boards participating in the Compact retain the jurisdiction to impose adverse action against a Compact privilege in that state issued to a PA through the procedures of the Compact.
5. States that the 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.
State Participation in the Compact
6. Requires a participating state to:
a) license PAs;
b) participate in the Commission's data system;
c) have a mechanism in place for receiving and investigating complaints against licensees and license applicants;
d) notify the Commission, in compliance with the terms of the 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;
e) fully implement a criminal background check requirement, within a time frame established by Commission rule, by the state's licensing board receiving the results of a criminal background check and reporting to the Commission whether the license applicant has been granted a license;
f) comply with Commission rules;
g) use passage of a recognized national exam such as the National Commission on Certification of PAs (NCCPA) national certifying examination as a requirement for PA licensure; and
h) grant the Compact privilege to a holder of a qualifying license in a participating state.
7. Specifies that the Compact does not prohibit a participating state from charging a fee for granting the Compact privilege.
Compact Privilege
8. Requires a licensee, to exercise the Compact privilege, to:
a) have graduated from a PA program accredited by the Accreditation Review Commission on Education for the PA or another program authorized by Commission rule;
b) hold current certification from the NCCPA;
c) have no felony or misdemeanor conviction;
d) have never had a controlled substance license, permit or registration suspended or revoked by a state or by the United States Drug Enforcement Administration;
e) have a unique identifier as determined by Commission rule;
f) hold a qualifying license;
g) have had no revocation of a license or limitation or restriction on any license currently held due to an adverse action;
h) if the licensee has had a limitation or restriction on a license or Compact privilege due to an adverse action, two years must have elapsed from the date on which the license or Compact privilege is no longer limited or restricted due to the adverse action;
i) if a Compact privilege has been revoked or is limited or restricted in a participating state for conduct that would not be a basis for disciplinary action in a participating state in which the licensee is practicing or applying to practice under a Compact privilege, that participating state has discretion not to consider such action as an adverse action requiring the denial or removal of a Compact privilege in that state;
j) notify the Commission that the licensee is seeking the Compact privilege in a remote state;
k) 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; and
l) report to the Commission any adverse action taken by a nonparticipating state within 30 days after the adverse action is taken.
9. Specifies that the Compact privilege is valid until the expiration or revocation of the qualifying license unless terminated in accordance with an adverse action.
10. Requires the licensee to also comply with all of the Compact privilege requirements to maintain the Compact privilege in a remote state.
11. Requires the licensee, if the participating state takes adverse action against a qualifying license, to lose the Compact privilege in any remote state in which the licensee has a Compact privilege until both of the following occur:
a) the license is no longer limited or restricted; and
b) two years have elapsed from the date on which the license is no longer limited or restricted due to the adverse action.
12. Requires the licensee, once a license is no longer restricted or limited and two years have elapsed from the date of the restriction or limitation, to meet the Compact privilege requirements to obtain a Compact privilege in any remote state.
13. Requires a PA, for each remote state in which a PA seeks authority to prescribe controlled substances, to satisfy all requirements imposed by that remote state in granting or renewing such authority.
State Designation for Compact Privilege
14. Requires a licensee, on application for a Compact privilege, to identify to the Commission the participating state from which the licensee is applying, in accordance with applicable rules adopted by the Commission.
15. Requires the licensee, when applying for a Compact privilege, to provide the Commission with the address of the licensee's primary residence.
16. Requires a licensee to immediately report to the Commission any change in the address of the licensee's primary residence.
17. Requires the licensee, when applying for a Compact privilege, 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.
Adverse Actions
18. Requires a participating state in which a licensee is licensed to have exclusive power to impose adverse action against the qualifying license issued by that participating state.
19. Requires a remote state, in addition to the other powers conferred by state law, to have the authority, in accordance with existing state due process law, to do the following:
a) take adverse action against a PA's Compact privilege within that state, remove a licensee's Compact privilege or take other action necessary under applicable law to protect the health and safety of its citizens; and
b) issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses as well as the production of evidence.
20. Requires 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 to 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.
21. Requires the issuing authority to pay any witness fees, travel expenses, mileage and other fees required by the service statutes of the state in which the witness or evidence is located.
22. Prohibits subpoenas from being 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.
23. States that the Compact does not authorize a participating state to impose discipline against a PA's Compact privilege or to deny an application for a Compact privilege in that participating state for the individual's otherwise lawful practice in another state.
24. Requires the participating state that issued the qualifying license, for the purposes of taking adverse action, to give the same priority and effect to reported conduct received from any other participating state as it would if the conduct had occurred within the participating state that issued the qualifying license and, in doing so, apply its own state laws to determine appropriate action.
25. Allows a participating state, if otherwise allowed by state law, to recover from the affected PA the costs of investigations and disposition of cases resulting from any adverse action taken against that PA.
26. Allows a participating state to take adverse action based on the factual findings of a remote state, if the participating state follows its own procedures for taking the adverse action.
27. Allows a participating state, in addition to the authority granted to a participating state by its respective state PA laws and regulations or other applicable state law, to participate with other participating states in joint investigations of licensees.
28. Requires participating states to share any investigative, litigation or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.
29. Requires the PA's Compact privilege in all remote state, if an adverse action is taken against a PA's qualifying license, to be deactivated until two years have elapsed after all restrictions have been removed from the state license.
30. Requires all disciplinary orders by the participating state that issued the qualifying license that impose adverse action against a PA's license to include a statement that the PA's Compact privilege is deactivated in all participating states during the pendency of the order.
31. Requires the participating state, if any participating state takes adverse action, to promptly notify the administrator of the data system.
Establishment of the Commission
32. Establishes a joint government agency and national administrative body known as the Commission.
33. States that the Commission is an instrumentality of the Compact states acting jointly and is not an instrumentality of any one state.
34. Requires the Commission to come into existence on or after the effective date of the Compact in accordance with Compact implementation requirements.
35. Requires each participating state to have and be limited to one delegate selected by that participating state's licensing board or, if the state has more than one licensing board, selected collectively by the participating state's licensing boards.
36. Requires the delegate to be either:
a) a current PA, physician or public member of a licensing board or PA council or committee; or
b) an administrator of a licensing board.
37. Allows any delegate to be removed or suspended from office as provided by the laws of the state from which the delegate is appointed.
38. Requires the participating state licensing board to fill any vacancy occurring in the Commission within 60 days.
39. Entitles each delegate to one vote on all matters voted on by the Commission and to have an opportunity to participate in the business and affairs of the Commission.
40. Requires a delegate to vote in person or by such other means as provided in the bylaws.
41. Allows the bylaws to provide for delegates' participation in meetings by telecommunications, video conference or other means of communication.
42. Requires the Commission to meet at least once during each calendar year.
43. Requires additional meetings to be held as set forth in the Compact and the bylaws.
44. Requires the Commission to establish by rule a term of office for delegates.
45. Requires the Commission to have the following powers and duties:
a) establish a code of ethics for the Commission;
b) establish the fiscal year of the Commission;
c) establish fees;
d) establish bylaws;
e) maintain its financial records in accordance with the bylaws;
f) meet and take such actions as are consistent with the Compact and the bylaws;
g) promulgate rules to facilitate and coordinate implementation and administration of the Compact which have the force and effect of law and are binding in all participating states;
h) 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 will not be affected;
i) purchase and maintain insurance and bonds;
j) borrow, accept or contract for services of personnel, including employees of a participating state;
k) hire employees and engage contractors, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of the Compact and establish the Commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel and other related personnel matters;
l) accept any and all appropriate donations and grants of money, equipment, supplies, materials and services, and receive, use and dispose of the donations and grants, provided that at all times the Commission avoid any appearance of impropriety or conflict of interest;
m) lease, purchase, accept appropriate gifts or donations of, or otherwise own, hold, improve or use any property, whether real, personal or mixed, provided that at all times the Commission avoid any appearance of impropriety;
n) sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise dispose of any property, whether real, personal or mixed;
o) establish a budget and make expenditures;
p) borrow money;
q) 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 the Compact and the bylaws;
r) provide information to, receive information from and cooperate with law enforcement agencies;
s) elect a chair, vice chairperson, secretary and treasurer and such other officers of the Commission as provided in the Commission's bylaws;
t) reserve for itself, in addition to those reserved exclusively to the Commission under the Compact, powers that the executive committee may not exercise;
u) approve or disapprove a state's participation in the Compact based on the Commission's determination as to whether the state's Compact legislation departs in a material manner from the model Compact language;
v) prepare and provide to the participating states an annual report; and
w) perform such other functions as may be necessary or appropriate to achieve the purposes of the Compact consistent with the state regulation of PA licensure and practice.
46. Requires all meetings of the Commission that are not closed to be open to the public.
47. Requires notice of public meetings to be posted on the Commission's website at least 30 days before the public meeting.
48. Allows the Commission to convene a public meeting by providing at least 24 hours' prior notice on the Commission's website and any other means as provided in the Commission's rules and, for any of the reasons it may dispense with notice of proposed rulemaking under the Compact.
49. Allows the Commission to convene in a closed, nonpublic meeting or nonpublic part of a public meeting to receive legal advice or to discuss any of the following:
a) noncompliance of a participating state with its obligations under the Compact;
b) the employment, compensation, discipline or other matters, practices or procedures related to specific employees or other matters related to the Commission's internal personnel practices and procedures;
c) current, threatened or reasonably anticipated litigation;
d) negotiation of contracts for the purchase, lease or sale of goods, services or real estate;
e) accusations of any person of a crime or the formal censure of any person;
f) disclosure of trade secrets or commercial or financial information that is privileged or confidential;
g) disclosure of information of a personal nature if the disclosure would constitute a clearly unwarranted invasion of personal privacy;
h) disclosure of investigative records compiled for law enforcement purposes;
i) disclosure of information related to any investigative reports prepared by or on behalf of or for use by the Commission or other committee charged with responsibility of investigation or determination of compliance issues in accordance with the Compact;
j) legal advice; and
k) matters specifically exempt from disclosure by federal or participating states' statutes.
50. Requires the chairperson of the meeting or the chairperson's designee, if a meeting, or portion of a meeting, is closed, to certify that the meeting or portion of the meeting may be closed and reference each relevant exempting provision.
51. Requires the Commission to keep minutes that fully and clearly describe all matters discussed in a meeting and provide a full and accurate summary of actions taken, including a description of the views expressed.
52. Requires all documents considered in connection with an action to be identified in the Commission's minutes.
53. Requires all minutes and documents of a closed Commission meeting to remain under seal, subject to release by a majority vote of the Commission or order of a court of competent jurisdiction.
Financing of the Commission
54. Requires the Commission to pay, or provide for the payment of, the reasonable expenses of its establishment, organization and ongoing activities.
55. Allows the Commission to accept any and all appropriate revenue sources and donations and grants of money, equipment, supplies, materials and services.
56. Allows the Commission to levy on and collect an annual assessment from each participating state and 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.
57. Requires the assessment and fees levied and imposed by the Commission to be in a total amount sufficient to cover the Commission's annual budget as approved by the Commission each year for which revenue is not provided by other sources.
58. Requires the aggregate annual assessment amount levied on participating states to be allocated based on a formula to be determined by Commission rule.
59. Specifies that a Compact privilege expires when the licensee's qualifying license in the participating state from which the licensee applied for the Compact privilege expires.
60. Requires the licensee, 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, to:
a) inform the Commission that it is changing the participating state through which it applies for a Compact privilege to that participating state; and
b) pay to the Commission any Compact privilege fee required by Commission rule.
61. Prohibits the Commission from incurring obligations of any kind before securing the monies adequate to meet the same or pledge the credit of any participating state, except by and with the authority of the participating state.
62. Requires the Commission to keep accurate accounts of all receipts and disbursements.
63. Requires the receipts and disbursements of the Commission to be subject to the financial review and accounting procedures established under its bylaws.
64. Requires all receipts and disbursements of monies handled by the Commission to be subject to an annual financial review by a certified or licensed public accountant.
65. Requires the report of the annual financial review to be included in and become part of the annual report of the Commission.
Executive Committee
66. Requires the executive committee to have the power to act on behalf of the Commission according to the terms of the Compact and Commission rules.
67. Requires the executive committee to be composed of the following nine members:
a) seven voting members who are elected by the Commission from the current membership of the Commission;
b) one ex officio, nonvoting member from a recognized national PA professional association, selected by the association; and
c) one ex officio, nonvoting member from a recognized national PA certification organization, selected by the organization.
68. Allows the Commission to remove any member of the executive committee as provided in its bylaws.
69. Requires the executive committee to meet at least annually.
70. Requires the executive committee to have the following duties and responsibilities:
a) recommend to the Commission changes to the Commission's rules or bylaws, changes to the Compact legislation, fees to be paid by participating states, such as annual dues, and any Commission Compact fee charged to licensees for the Compact privilege;
b) ensure that Compact administration services are appropriately provided, contractual or otherwise;
c) prepare and recommend the Commission's budget;
d) maintain financial records on behalf of the Commission;
e) monitor Compact compliance of participating states and provide compliance reports to the Commission;
f) establish additional committees as necessary;
g) exercise the powers and duties of the Commission during the interim between Commission meetings, except for issuing proposed rulemaking or adopting Commission rules or bylaws, or exercising any other powers and duties exclusively reserved to the Commission by the Commission's rules; and
h) perform other duties as provided in the Commission's rules or bylaws.
71. Requires all meetings of the executive committee, at which the executive committee votes or plans to vote on matters in exercising the powers and duties of the Commission, to be open to the public.
72. Requires public notice of executive committee meetings to be given as public meetings of the Commission are given.
73. Allows the executive committee to convene in a closed, nonpublic meeting for the same reasons that the Commission may convene in a nonpublic meeting in accordance with the Compact.
74. Requires the executive committee to announce the closed meeting as the Commission is required to in accordance with the Compact.
75. Requires the executive committee to keep minutes of the closed meeting as the Commission is required to in accordance with the Compact.
Qualified Immunity, Defense and Indemnification
76. Requires the members, officers, executive director, employees and representatives of the Commission to 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.
77. States that the prescribed immunity does not protect any such person from suit or liability for any damage, loss or injury caused by the intentional or wilful or wanton misconduct of that person.
78. Prohibits the procurement of insurance of any type by the Commission from compromising or limiting, in any way, the prescribed immunity granted.
79. Requires the Commission to defend any member, officer, executive director, employee and representative of the Commission in any civil action seeking to impose liability arising out of any actual or alleged act, error or omission that occurred within the scope of Commission employment, duties or responsibilities, or as determined by the Commission that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities, provided that:
a) a person may retain their own counsel at their own expense; and
b) the actual or alleged act, error or omission did not result from the person's intentional or wilful or wanton misconduct.
80. Requires the Commission to 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
81. States that the prescribed indemnification does not apply if the actual or alleged act, error or omission did not result from the intentional or wilful or wanton misconduct of that person.
82. Requires judicial proceedings by or against the Commission to be brough solely and exclusively, as proper venue, in a court of competent jurisdiction where the principal office of the Commission is located.
83. Allows the Commission to waive venue and jurisdictional defenses in any proceedings as authorized by Commission rules.
84. States that the Compact does not limit the liability of any licensee for professional malpractice or misconduct, which is governed solely by any other applicable state laws.
85. States that the Compact does not designate the venue or jurisdiction to bring actions for alleged acts of malpractice, professional misconduct or negligence or other such civil action pertaining to the practice of a PA.
86. Requires all matters, for alleged acts of malpractice, professional misconduct or negligence or other such civil action pertaining to the practice of a PA, to be determined exclusively by state law other than the Compact.
87. States that the Compact does not waive or otherwise abrogate a participating state's state action immunity or state action affirmative defense with respect to antitrust claims under the federal Sherman Act, the federal Clayton Act or any other state or federal antitrust or anticompetitive law or regulation.
88. States that the Compact is not a waiver of sovereign immunity by the participating states or by the Commission.
Data System
89. Requires the Commission to provide for the development, maintenance, operation and utilization of a coordinated data and reporting system containing licensure, adverse action and significant investigative information on all licensed PAs and applicants who are denied a license in participating states.
90. Requires a participating state to submit a uniform data set to the data system on all PAs to whom the Compact is applicable using a unique identifier, as required by Commission rules, that includes:
a) identifying information;
b) licensure data;
c) adverse actions against a license or Compact privilege;
d) any denial of an application for licensure and the reasons for such denial, excluding the reporting of any criminal history record information where prohibited by law;
e) the existence of significant investigative information; and
f) other information that may facilitate the administration of the Compact, as determined by Commission rules.
91. Requires significant investigative information pertaining to a licensee in any participating state to be available only to other participating states.
92. Requires the Commission to promptly notify all participating states of any adverse action taken against a licensee or an individual applying for a license that has been reported to the Commission.
93. Requires reported adverse action information to be available to any other participating state.
94. Allows participating states contributing information to the data system, in accordance with state or federal law, to designate information that may not be shared with the public without the express permission of the contributing state.
95. Requires information from a participating state that is not designated as needing express permission to be reported to the Commission through the data system.
96. Requires any information submitted to the data system that is subsequently expunged in accordance with federal law or the laws of the participating state contributing the information to be removed from the data system on a report of the expungement by the participating state to the Commission.
97. States that the records and information provided to a participating state in accordance with the Compact or through the data system, when certified by the Commission or the Commission's agent:
a) constitute the authenticated business records of the Commission; and
b) are entitled to any associated hearsay exception in any relevant judicial, quasi-judicial or administrative proceedings in a participating state.
Rulemaking
98. Requires the Commission to exercise its rulemaking powers in accordance with the criteria set forth in the Compact and the adopted Commission rules.
99. Requires the Commission rules to become binding as of the date specified by the Commission for each rule.
100. Requires the Commission to promulgate reasonable rules in order to effectively and efficiently implement and administer the Compact and achieve its purposes.
101. Requires a Commission rule to be invalid and not have force or effect only if a court of competent jurisdiction holds that the rule is invalid because the Commission exercised its rulemaking authority in a manner that is beyond the scope of the purposes of the Compact, or the rulemakings powers granted in the Compact, or based on another applicable standard of review.
102. Requires the Commission's rules to have the force of law in each participating state.
103. Requires the Commission's rules, where the Commission's rules conflict with the laws of the participating state as held by a court of competent jurisdiction, to be ineffective in that state to the extent of the conflict.
104. States that, if a majority of the legislatures of the participating states rejects a Commission rule by enacting a statute or resolution in the same manner used to adopt the Compact within four years after the date of adoption of the rule, the rule has no further force and effect in any participating state or to any state applying to participate in the Compact.
105. Requires Commission rules to be adopted at a regular or special meeting of the Commission.
106. Requires the Commission, before adopting a final rule or rules, and at least 30 days in advance of the meeting at which the rule or rules will be considered and voted on, to file a notice of proposed rulemaking in the following manner:
a) on the website of the Commission or other publicly accessible platform;
b) to persons who have requested notice of the Commission's notices of proposed rulemaking; and
c) in such other way as the Commission may by rule specify.
107. Requires the notice of proposed rulemaking to include all of the following:
a) the time, date and location of the public hearing on the proposed rule and the proposed time, date and location of the meeting in which the proposed rule will be considered and voted on;
b) the text of the proposed rule and the reason for the proposed rule;
c) a request for comments on the proposed rule from any interested person and the date by which written comments must be received; and
d) 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.
108. Requires the Commission, before adopting a proposed rule, to allow persons to submit written data, facts, opinions and arguments,
109. Requires the Commission to make the submitted written data, facts opinions and arguments available to the public.
110. Requires the Commission, if the hearing is to be held via electronic means, to publish the mechanism for access to the electronic hearing.
111. Requires all persons wishing to be heard at a hearing to notify the Commission, as directed in the notice of proposed rulemaking no less than five business days before the scheduled date of the hearing, of their desire to appear and testify at the hearing.
112. Requires hearings to be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.
113. Requires all hearings to be recorded.
114. Requires a copy of the hearing recording and the written comments, data, facts, opinions and arguments received in response to the proposed rulemaking to be made available to a person on request.
115. States that the Compact does not require a separate hearing on each proposed rule.
116. Allows proposed rules to be grouped for the convenience of the Commission at hearings required in accordance with the Compact.
117. Requires the Commission, following the public hearing, to consider all written and oral comments timely received.
118. Requires the Commission, by a majority vote of all delegates, to take final action on the proposed rule and determine the effective date of the rule, if adopted, based on the rulemaking record and the full text of the rule.
119. Requires adopted rules to be posted on the Commission's website.
120. Allows the Commission to adopt changes to a proposed rule if the changes do not enlarge the original purpose of the proposed rule.
121. Requires the Commission to provide on its website an explanation of the reasons for substantive changes that are made to a proposed rule as well as reasons for substantive changes that are not made and that were recommended by commenters.
122. Requires the Commission to determine a reasonable effective date for the rule.
123. Requires the effective date of the rule, except for an emergency, to be no sooner than 30 days after the Commission issued the notice that it adopted the rule.
124. Allows the Commission, on determination that an emergency exists, to consider and adopt an emergency rule with 24 hours' prior notice, without the opportunity for comment or hearing, if the usual rulemaking procedures provided in the Compact and adopted Commission rules are retroactively applied to the rule as soon as reasonably possible, but no later than 90 days after the effective date of the rule.
125. States that an emergency rule is one that is adopted immediately by the Commission to accomplish any of the following:
a) meet an imminent threat to public health, safety or welfare;
b) prevent a loss of Commission or participating state monies;
c) meet a deadline for the promulgation of a Commission rule that is established by federal law or regulation; or
d) protect public health and safety.
126. Allows the Commission or an authorized committee of the Commission to direct revisions to a previously adopted Commission rule for the purposes of correcting typographical errors, errors in format, errors in consistency or grammatical errors.
127. Requires public notice of any revisions to a previously adopted Commission rule to be posted on the website of the Commission.
128. Subjects any revision to a previously adopted Commission rule to challenge by any person for a period of 30 days after posting.
129. Allows any revision to a previously adopted Commission rule to be challenged only on grounds that the revision results in a material change to a rule.
130. Requires a challenge to any revision to a previously adopted Commission rule to be made as set forth in the notice of revisions and delivered to the Commission before the end of the notice period.
131. States that, if no challenge is made, the revision to a previously adopted Commission rule will take effect without further action.
132. Prohibits the revision of a previously adopted Commission rule, if the revision is challenged, from taking effect without the approval of the Commission.
133. States that a participating state's rulemaking requirements do not apply under the Compact.
Oversight
134. Requires the executive and judicial branches of state government in each participating state to enforce the Compact and take all actions necessary and appropriate to implement the Compact.
135. Requires judicial proceedings by or against the Commission to be brought solely and exclusively, as prover venue, in a court of competent jurisdiction where the principal office of the Commission is located.
136. Allows the Commission to waive venue and jurisdictional defenses to the extent the Commission adopts or consents to participate in alternative dispute resolution proceedings.
137. States that the Compact does not affect or limit the selection or propriety of venue in any action against a licensee for professional malpractice or misconduct or any such similar matter.
138. Requires the Commission to be entitled to receive service of process in any proceeding regarding the enforcement or interpretation of the Compact or the Commission's rules and have standing to intervene in such a proceeding for all purposes.
139. States that failure to provide service of process to the Commission renders a judgment or order void as to the Commission, the Compact or Commission rules.
Default, Technical Assistance and Termination
140. Requires the Commission, if it determines that a participating state has defaulted in the performance of its obligations or responsibilities under the Compact or Commission rules, to provide written notice to the defaulting state and other participating states.
141. Requires the default notice to:
a) describe the default, the proposed means of curing the default and any other action that the Commission may take; and
b) offer remedial training and specific technical assistance regarding the default.
142. Allows the defaulting state, if it fails to cure the default, to be terminated from the Compact on an affirmative vote of a majority of the delegates of the participating states and all rights, privileges and benefits conferred by the Compact on that state may be terminated on the effective date of termination.
143. States that a cure of a default does not relieve the offending state of obligations or liabilities incurred during the period of default.
144. Requires termination of participation in the Compact to be imposed only after all other means of securing compliance have been exhausted.
145. Requires a notice of intent to suspend or terminate to be given by the Commission to the Governor, the majority and minority leaders of the defaulting state's legislature and the licensing boards of each participating state.
146. Stipulates that 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.
147. Prohibits the Commission from bearing any costs related to a state that is found to be in default or that has been terminated from the Compact, unless agreed on in writing between the Commission and the defaulting state.
148. Allows the defaulting state to appeal its termination from the Compact by the Commission by petitioning the U.S. District Court for the District of Columbia or the federal district where the Commission has its principal offices.
149. Requires the prevailing party to be awarded all costs of such litigation, including reasonable attorney fees.
150. Requires the defaulting state, on the termination of a state's participation in the Compact, to immediately provide notice of the termination to all licensees within that state that includes the following information:
a) licensees who have been granted a Compact privilege in that state retain the Compact privilege for 180 days following the effective date of the termination; and
b) licensees who are licensed in that state and who have been granted a Compact privilege in a participating state retain the Compact privilege for 180 unless the licensee also has a qualifying license in a participating state or obtains a qualifying license in a participating state before the 180 period ends, in which case the Compact privilege continues.
Dispute Resolution
151. Requires the Commission, on request by a participating state, to attempt to resolve disputes related to the Compact that arise among participating states and between participating states and nonparticipating states.
152. Requires the Commission to promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.
Enforcement
153. Requires the Commission, in the reasonable exercise of its discretion, to enforce the Compact and rules of the Commission.
154. Allows the Commission by majority vote, if compliance is not secured after all means to secure compliance have been exhausted, to initiate legal action in the U.S. District Court for the District of Columbia or the federal district where the Commission has its principal offices against a participating state that is in default to enforce compliance with the Compact and the Commission's promulgated rules and bylaws.
155. Allows the relief sought by the Commission to include both injunctive relief and damages.
156. Allows the prevailing party, if judicial enforcement is necessary, to be awarded all costs of such litigation, including reasonable attorney fees.
157. States that the enforcement remedies prescribed in the Compact are not the exclusive remedies of the Commission.
158. Allows the Commission to pursue any other remedies available under federal or state law.
Legal Action Against the Commission
159. Allows a participating state to initiate legal action against the Commission in the U.S. District Court for the District of Columbia or the federal district where the Commission has its principal offices to enforce compliance with the Compact and its rules.
160. Allows the relief sought by a participating state to include both injunctive relief and damages.
161. Requires a prevailing party, if judicial enforcement is necessary, to be awarded all costs of such litigation, including reasonable attorney fees.
162. Allows only a participating state to enforce the Compact against the Commission.
Implementation Date of the Compact
163. Requires the Compact to come into effect on the date on which the Compact statute is enacted into law in the seventh participating state.
164. Requires the Commission, on or after the effective date of the Compact, to convene and review the enactment of each state that enacted the Compact prior to the Commission convening, to be known as the charter participating states, to determine if the statute enacted by each charter participating state is materially different than the model Compact.
165. Entitles a charter participating state, if its enactment is found to be materially different from the model Compact, to the default process set forth in the Compact.
166. Requires the Commission to remain in existence and the Compact to remain in effect, if any participating state later withdraws from the Compact or its participation is terminated, even if the number of participating states is less than seven.
167. Subjects participating states that enact the Compact to the Commission's determination of whether the state's enactments are materially different from the model Compact and whether they qualify for participation in the Compact.
168. Requires all actions taken for the benefit of the Commission or in furtherance of the purposes of administering the Compact before the effective date of the Compact or the Commission coming into existence to be considered actions of the Commission unless specifically repudiated by the Commission.
169. Subjects any state that joins the Compact to the Commission's rules and bylaws as they exist on the date on which the Compact becomes law in that state.
170. Requires any rule that has been previously adopted by the Commission to have the full force and effect of law on the day the Compact becomes law in that state.
171. Allows any participating state to withdraw from the Compact by enacting a statute repealing the Compact.
172. States that a participating state's withdrawal does not take effect until 180 days after enactment of the repealing statute.
173. States that during the 180-day period after the enactment of a repealing statute, all Compact privileges that were in effect in the withdrawing state and that were granted to licensees licensed in the withdrawing state remain in effect.
174. States that, 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 180 days after the enactment of a repealing statute, the licensee's Compact privileges in other participating states is not affected by the passage of the 180 days.
175. States that a participating state's withdrawal does not affect the continuing requirement of the licensing board of the withdrawing state to comply with the investigative and adverse action reporting requirements of the Compact before the effective date of withdrawal.
176. Requires a state, on the enactment of a statute withdrawing from the Compact, to immediately provide notice of the withdrawal to all licensees within that state.
177. Requires the withdrawing state to continue to recognize all licenses granted in accordance with the Compact for at least 180 days after the date of the notice of withdrawal.
178. States that the Compact does not invalidate or prevent any PA licensure agreement or other cooperative arrangement between participating states and between a participating state and nonparticipating state that does not conflict with the Compact.
179. Allows the Compact to be amended by the participating states.
180. Prohibits an amendment to the Compact from become effective and binding on any participating state until it is enacted materially in the same manner into the laws of all participating states as determined by the Commission.
Construction and Severability
181. Requires the Compact and the Commission's rulemaking authority to be liberally construed so as to effectuate the purposes and the implementation and administration of the Compact.
182. Prohibits the provisions of the Compact that expressly authorize or require the promulgation of rules from being construed to limit the Commission's rulemaking authority solely for those purposes.
183. Requires the provisions of the Compact to be severable.
184. Asserts that if any phrase, clause, sentence or provision of the Compact is held by a court of competent jurisdiction to be contrary to the constitution of any participating state, any state seeking participation in the Compact or the United States, or its applicability to any government, agency, person or circumstance is held to be unconstitutional, the validity of the remainder of the Compact and its applicability to any other government, agency, person or circumstance is not affected.
185. Requires the Commission to deny a state's participation in the Compact or terminate a participating state's participation in the Compact in accordance with the Compact, if the Commission determines that a constitutional requirement of a participating state is or would be with respect to a state seeking to participate in the Compact, a material departure from the Compact.
186. Requires the Compact, if it is held to be contrary to the constitution of any participating state, to remain in full force and effect as to:
a) the remaining participating states; and
b) the participating state affected as to all severable matters.
Binding Effect of the Compact
187. States that the Compact does not prevent the enforcement of any other law of a participating state that is not inconsistent with the Compact.
188. States that any laws in a participating state that conflict with the Compact are superseded to the extent of the conflict.
189. States that all agreements between the Commission and the participating states are binding in accordance with their terms.
Miscellaneous
190. Defines terms.
191. Becomes effective on the general effective date.
Amendments Adopted by Committee of the Whole
· Makes technical and conforming changes.
Senate Action
RAGE 1/28/26 DP 7-0-0
Prepared by Senate Research
February 13, 2026
JT/ci