HF 2623

as introduced - 93rd Legislature (2023 - 2024) Posted on 02/22/2024 04:13pm

A bill for an act
relating to health occupations; creating a physician assistant licensure compact;
proposing coding for new law in Minnesota Statutes, chapter 148.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [148.675] PHYSICIAN ASSISTANT LICENSURE COMPACT.
new text end

new text begin The physician assistant (PA) licensure compact is enacted into law and entered into with
all other jurisdictions legally joining in it in the form substantially specified in this section.
new text end

new text begin ARTICLE I
new text end

new text begin PURPOSE
new text end

new text begin In order to strengthen access to medical services, and in recognition of the advances in
the delivery of medical services, the participating states of the PA licensure compact have
allied in common purpose to develop a comprehensive process that complements the existing
authority of state licensing boards to license and discipline PAs and seek to enhance the
portability of a license to practice as a PA while safeguarding the safety of patients. This
compact allows medical services to be provided by PAs via the mutual recognition of the
licensee's qualifying license by other compact participating states. This compact also adopts
the prevailing standard for PA licensure and affirms that the practice and delivery of medical
services by the PA occurs where the patient is located at the time of the patient encounter,
and therefore requires the PA to be under the jurisdiction of the state licensing board where
the patient is located. State licensing boards that participate in this compact retain the
jurisdiction to impose adverse actions against a compact privilege in that state issued to a
PA through the procedures of this compact. The PA licensure compact will alleviate burdens
for military families by allowing active duty military personnel and their spouses to obtain
a compact privilege based on having an unrestricted license in good standing from a
participating state.
new text end

new text begin ARTICLE II
new text end

new text begin DEFINITIONS
new text end

new text begin As used in this compact, and except as otherwise provided, the following terms have
the meanings given them.
new text end

new text begin (a) "Adverse action" means any administrative, civil, equitable, or criminal action
permitted by a state's laws that is imposed by a licensing board or other authority against a
PA license, license application, or compact privilege such as license denial, censure,
revocation, suspension, probation, monitoring of the licensee, or restriction on the licensee's
practice.
new text end

new text begin (b) "Charter participating states" means the states that enacted the compact prior to the
commission convening.
new text end

new text begin (c) "Compact privilege" means the authorization granted by a remote state to allow a
licensee from another participating state to practice as a PA to provide medical services or
other licensed activities to a patient located in the remote state under the remote state's laws
and regulations.
new text end

new text begin (d) "Conviction" means a finding by a court that an individual is guilty of a felony or
misdemeanor offense through adjudication or entry of a plea of guilt or no contest to the
charge by the offender.
new text end

new text begin (e) "Criminal background check" means the submission of fingerprints or other
biometric-based information for a license applicant for the purpose of obtaining that
applicant's criminal history record information, as defined in Code of Federal Regulations,
title 28, part 20, subpart 20.3, clause (d), from the state's criminal history record repository,
as defined in Code of Federal Regulations, title 28, part 20, subpart 20.3, clause (f).
new text end

new text begin (f) "Data system" means the repository of information about licensees, including but not
limited to license status and adverse action, that is created and administered under the terms
of this compact.
new text end

new text begin (g) "Executive committee" means a group of directors and ex officio individuals elected
or appointed pursuant to article VII, paragraph (f), clause (2).
new text end

new text begin (h) "Impaired practitioner" means a PA whose practice is adversely affected by a
health-related condition that impacts the PA's ability to practice.
new text end

new text begin (i) "Investigative information" means information, records, and documents received or
generated by a licensing board pursuant to an investigation.
new text end

new text begin (j) "Jurisprudence requirement" means the assessment of an individual's knowledge of
the laws and rules governing the practice of a PA in a state.
new text end

new text begin (k) "License" means current authorization by a state, other than authorization pursuant
to a compact privilege, for a PA to provide medical services, which would be unlawful
without current authorization.
new text end

new text begin (l) "Licensee" means an individual who holds a license from a state to provide medical
services as a PA.
new text end

new text begin (m) "Licensing board" means any state entity authorized to license and otherwise regulate
PAs.
new text end

new text begin (n) "Medical services" means health care services provided for the diagnosis, prevention,
treatment, cure, or relief of a health condition, injury, or disease, as defined by a state's laws
and regulations.
new text end

new text begin (o) "Model compact" means the model for the PA licensure compact on file with the
Council of State Governments or other entity as designated by the commission.
new text end

new text begin (p) "Participating state" means a state that has enacted this compact.
new text end

new text begin (q) "PA" means an individual who is licensed as a physician assistant in a state. For
purposes of this compact, any other title or status adopted by a state to replace the term
"physician assistant" shall be deemed synonymous with "physician assistant" and shall
confer the same rights and responsibilities to the licensee under the provisions of this compact
at the time of its enactment.
new text end

new text begin (r) "PA Licensure Compact Commission" or "compact commission" or "commission"
means the national administrative body created pursuant to article VII, paragraph (a).
new text end

new text begin (s) "Qualifying license" means an unrestricted license issued by a participating state to
provide medical services as a PA.
new text end

new text begin (t) "Remote state" means a participating state where a licensee who is not licensed as a
PA is exercising or seeking to exercise the compact privilege.
new text end

new text begin (u) "Rule" means a regulation promulgated by an entity that has the force and effect of
law.
new text end

new text begin (v) "Significant investigative information" means investigative information that a
licensing board, after an inquiry or investigation that includes notification and an opportunity
for the PA to respond if required by state law, has reason to believe is not groundless and,
if proven true, would indicate more than a minor infraction.
new text end

new text begin (w) "State" means any state, commonwealth, district, or territory of the United States.
new text end

new text begin ARTICLE III
new text end

new text begin STATE PARTICIPATION IN THE COMPACT
new text end

new text begin (a) To participate in this compact, a participating state must:
new text end

new text begin (1) license PAs;
new text end

new text begin (2) participate in the commission's data system;
new text end

new text begin (3) have a mechanism in place for receiving and investigating complaints against licensees
and license applicants;
new text end

new text begin (4) notify the commission, in compliance with the terms of this compact and commission
rules, of any adverse action against the licensee or license applicant and the existence of
significant investigative information regarding a licensee or license applicant;
new text end

new text begin (5) fully implement a criminal background check requirement, within a time frame
established by commission rule, by its licensing board receiving the results of a criminal
background check and reporting to the commission whether the license applicant has been
granted a license;
new text end

new text begin (6) fully comply with the rules of the compact commission;
new text end

new text begin (7) utilize a recognized national examination such as the National Commission on
Certification of Physician Assistants (NCCPA) physician assistant national certifying
examination as a requirement for PA licensure; and
new text end

new text begin (8) grant the compact privilege to a holder of a qualifying license in a participating state.
new text end

new text begin (b) Nothing in this compact prohibits a participating state from charging a fee for granting
the compact privilege.
new text end

new text begin ARTICLE IV
new text end

new text begin COMPACT PRIVILEGE
new text end

new text begin (a) To exercise the compact privilege, a licensee must:
new text end

new text begin (1) have graduated from a PA program accredited by the Accreditation Review
Commission on Education for the Physician Assistant, Inc. or other programs authorized
by commission rule;
new text end

new text begin (2) hold current NCCPA certification;
new text end

new text begin (3) have no felony or misdemeanor convictions;
new text end

new text begin (4) have never had a controlled substance license, permit, or registration suspended or
revoked by a state or by the United States Drug Enforcement Administration;
new text end

new text begin (5) have a unique identifier as determined by commission rule;
new text end

new text begin (6) hold a qualifying license;
new text end

new text begin (7) have had no revocation of a license or limitation or restriction due to an adverse
action on any currently held license;
new text end

new text begin (8) if a licensee has had a limitation or restriction on a license or compact privilege due
to an adverse action, two years must have elapsed from the date on which the license or
compact privilege is no longer limited or restricted due to the adverse action;
new text end

new text begin (9) if a compact privilege has been revoked or is limited or restricted in a participating
state for conduct that would not be a basis for disciplinary action in a participating state in
which the licensee is practicing or applying to practice under a compact privilege, that
participating state shall have the discretion not to consider such action as an adverse action
requiring the denial or removal of a compact privilege in that state;
new text end

new text begin (10) notify the compact commission that the licensee is seeking the compact privilege
in a remote state;
new text end

new text begin (11) meet any jurisprudence requirement of a remote state in which the licensee is seeking
to practice under the compact privilege and pay any fees applicable to satisfying the
jurisprudence requirement; and
new text end

new text begin (12) report to the commission any adverse action taken by any nonparticipating state
within 30 days after the date the action is taken.
new text end

new text begin (b) The compact privilege is valid until the expiration or revocation of the qualifying
license unless terminated pursuant to an adverse action. The licensee must also comply with
all of the requirements of paragraph (a) to maintain the compact privilege in a remote state.
If the participating state takes adverse action against a qualifying license, the licensee shall
lose the compact privilege in any remote state in which the licensee has a compact privilege
until all of the following occur:
new text end

new text begin (1) the license is no longer limited or restricted; and
new text end

new text begin (2) two years have elapsed from the date on which the license is no longer limited or
restricted due to the adverse action.
new text end

new text begin (c) Once a restricted or limited license satisfies the requirements of paragraph (b), the
licensee must meet the requirements of paragraph (a) to obtain a compact privilege in any
remote state.
new text end

new text begin (d) For each remote state in which a PA seeks authority to prescribe controlled substances,
the PA shall satisfy all requirements imposed by such state in granting or renewing such
authority.
new text end

new text begin ARTICLE V
new text end

new text begin DESIGNATION OF THE STATE FROM WHICH LICENSEE IS APPLYING FOR
COMPACT PRIVILEGE.
new text end

new text begin Upon a licensee's application for a compact privilege, the licensee must identify to the
commission the participating state from which the licensee is applying, in accordance with
applicable rules adopted by the commission, and subject to the following requirements:
new text end

new text begin (1) the licensee must provide the commission with the address of the licensee's primary
residence and thereafter shall immediately report to the commission any change in the
address of the licensee's primary residence; and
new text end

new text begin (2) the licensee must consent to accept service of process by mail at the licensee's primary
residence on file with the commission with respect to any action brought against the licensee
by the commission or a participating state, including a subpoena, with respect to any action
brought or investigation conducted by the commission or a participating state.
new text end

new text begin ARTICLE VI
new text end

new text begin ADVERSE ACTIONS
new text end

new text begin (a) A participating state in which a licensee is licensed shall have exclusive power to
impose adverse action against the qualifying license issued by that participating state.
new text end

new text begin (b) In addition to the other powers conferred by state law, a remote state shall have the
authority, in accordance with existing state due process law, to do the following:
new text end

new text begin (1) take adverse action against a PA's compact privilege in the state to remove a licensee's
compact privilege or take other action necessary under applicable law to protect the health
and safety of its citizens; and
new text end

new text begin (2) issue subpoenas for both hearings and investigations that require the attendance and
testimony of witnesses and the production of evidence. Subpoenas issued by a licensing
board in a participating state for the attendance and testimony of witnesses or the production
of evidence from another participating state shall be enforced in the latter state by any court
of competent jurisdiction, according to the practice and procedure of that court applicable
to subpoenas issued in proceedings pending before it. The issuing authority shall pay any
witness fees, travel expenses, mileage, and other fees required by the service statutes of the
state in which the witnesses or evidence are located.
new text end

new text begin (c) Notwithstanding paragraph (b), clause (1), subpoenas may not be issued by a
participating state to gather evidence of conduct in another state that is lawful in that other
state, for the purpose of taking adverse action against a licensee's compact privilege or
application for a compact privilege in that participating state.
new text end

new text begin (d) Nothing in this compact authorizes a participating state to impose discipline against
a PA's compact privilege or to deny an application for a compact privilege in that participating
state for the individual's otherwise lawful practice in another state.
new text end

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

new text begin (f) A participating state, if otherwise permitted by state law, may recover from the
affected PA the costs of investigations and disposition of cases resulting from any adverse
action taken against that PA.
new text end

new text begin (g) A participating state may take adverse action based on the factual findings of a remote
state, provided that the participating state follows its own procedures for taking the adverse
action.
new text end

new text begin (h) Joint investigations:
new text end

new text begin (1) in addition to the authority granted to a participating state by its respective state PA
laws and regulations or other applicable state law, any participating state may participate
with other participating states in joint investigations of licensees; and
new text end

new text begin (2) participating states shall share any investigative, litigation, or compliance materials
in furtherance of any joint or individual investigation initiated under this compact.
new text end

new text begin (i) If an adverse action is taken against a PA's qualifying license, the PA's compact
privilege in all remote states shall be deactivated until two years have elapsed after all
restrictions have been removed from the state license. All disciplinary orders by the
participating state which issued the qualifying license that impose adverse action against a
PA's license shall include a statement that the PA's compact privilege is deactivated in all
participating states during the pendency of the order.
new text end

new text begin (j) If any participating state takes adverse action, it promptly shall notify the administrator
of the data system.
new text end

new text begin ARTICLE VII
new text end

new text begin ESTABLISHMENT OF THE PA LICENSURE COMPACT COMMISSION
new text end

new text begin (a) The participating states hereby create and establish a joint government agency and
national administrative body known as the PA Licensure Compact Commission. The
commission is an instrumentality of the compact states acting jointly, and is not an
instrumentality of any one state. The commission shall come into existence on or after the
effective date of the compact as set forth in article XI, paragraph (a).
new text end

new text begin (b) Membership, voting, and meetings:
new text end

new text begin (1) each participating state shall have and be limited to one delegate selected by that
participating state's licensing board or, if the state has more than one licensing board, selected
collectively by the participating state's licensing boards;
new text end

new text begin (2) the delegate shall be:
new text end

new text begin (i) a current PA, physician, or public member of a licensing board or PA council or
committee; or
new text end

new text begin (ii) an administrator of a licensing board;
new text end

new text begin (3) any delegate may be removed or suspended from office as provided by the laws of
the state from which the delegate is appointed;
new text end

new text begin (4) the participating state board shall fill any vacancy occurring in the commission within
60 days;
new text end

new text begin (5) each delegate shall be entitled to one vote on all matters voted on by the commission
and shall otherwise have an opportunity to participate in the business and affairs of the
commission;
new text end

new text begin (6) a delegate shall vote in person or by such other means as provided in the bylaws.
The bylaws may provide for delegates' participation in meetings by telecommunications,
video conference, or other means of communication;
new text end

new text begin (7) the commission shall meet at least once during each calendar year. Additional
meetings shall be held as set forth in this compact and the bylaws; and
new text end

new text begin (8) the commission shall establish by rule a term of office for delegates.
new text end

new text begin (c) The commission shall have the following powers and duties:
new text end

new text begin (1) establish a code of ethics for the commission;
new text end

new text begin (2) establish the fiscal year of the commission;
new text end

new text begin (3) establish fees;
new text end

new text begin (4) establish bylaws;
new text end

new text begin (5) maintain its financial records in accordance with the bylaws;
new text end

new text begin (6) meet and take such actions as are consistent with the provisions of this compact and
the bylaws;
new text end

new text begin (7) promulgate rules to facilitate and coordinate implementation and administration of
this compact. The rules shall have the force and effect of law and shall be binding in all
participating states;
new text end

new text begin (8) bring and prosecute legal proceedings or actions in the name of the commission,
provided that the standing of any state licensing board to sue or be sued under applicable
law shall not be affected;
new text end

new text begin (9) purchase and maintain insurance and bonds;
new text end

new text begin (10) borrow, accept, or contract for services of personnel, including but not limited to
employees of a participating state;
new text end

new text begin (11) hire employees and engage contractors, elect or appoint officers, fix compensation,
define duties, grant such individuals appropriate authority to carry out the purposes of this
compact, and establish the commission's personnel policies and programs relating to conflicts
of interest, qualifications of personnel, and other related personnel matters;
new text end

new text begin (12) accept any and all appropriate donations and grants of money, equipment, supplies,
materials, and services, and receive, utilize, and dispose of the same, provided that at all
times the commission shall avoid any appearance of impropriety or conflict of interest;
new text end

new text begin (13) lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold,
improve, or use, any property, real, personal, or mixed, provided that at all times the
commission shall avoid any appearance of impropriety;
new text end

new text begin (14) sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
any property real, personal, or mixed;
new text end

new text begin (15) establish a budget and make expenditures;
new text end

new text begin (16) borrow money;
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new text begin (17) appoint committees, including standing committees composed of members, state
regulators, state legislators or their representatives, and consumer representatives, and such
other interested persons as may be designated in this compact and the bylaws;
new text end

new text begin (18) provide and receive information from, and cooperate with, law enforcement agencies;
new text end

new text begin (19) elect a chair, vice chair, secretary, and treasurer and such other officers of the
commission as provided in the commission's bylaws;
new text end

new text begin (20) reserve for itself, in addition to those reserved exclusively to the commission under
the compact, powers that the executive committee may not exercise;
new text end

new text begin (21) approve or disapprove a state's participation in the compact based upon its
determination as to whether the state's compact legislation departs in a material manner
from the model compact language;
new text end

new text begin (22) prepare and provide to the participating states an annual report; and
new text end

new text begin (23) perform such other functions as may be necessary or appropriate to achieve the
purposes of this compact consistent with the state regulation of PA licensure and practice.
new text end

new text begin (d) Meetings of the commission:
new text end

new text begin (1) all meetings of the commission that are not closed pursuant to this paragraph shall
be open to the public. Notice of public meetings shall be posted on the commission's website
at least 30 days prior to the public meeting;
new text end

new text begin (2) notwithstanding clause (1), the commission may 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, for any of the reasons it may dispense with notice of
proposed rulemaking under article IX, paragraph (l);
new text end

new text begin (3) the commission may convene in a closed, nonpublic meeting or nonpublic part of a
public meeting to receive legal advice or to discuss:
new text end

new text begin (i) noncompliance of a participating state with its obligations under this compact;
new text end

new text begin (ii) 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;
new text end

new text begin (iii) current, threatened, or reasonably anticipated litigation;
new text end

new text begin (iv) negotiation of contracts for the purchase, lease, or sale of goods, services, or real
estate;
new text end

new text begin (v) accusing any person of a crime or formally censuring any person;
new text end

new text begin (vi) disclosure of trade secrets or commercial or financial information that is privileged
or confidential;
new text end

new text begin (vii) disclosure of information of a personal nature where disclosure would constitute a
clearly unwarranted invasion of personal privacy;
new text end

new text begin (viii) disclosure of investigative records compiled for law enforcement purposes;
new text end

new text begin (ix) disclosure of information related to any investigative reports prepared by or on
behalf of, or for use of, the commission or other committee charged with responsibility of
investigation or determination of compliance issues pursuant to this compact;
new text end

new text begin (x) legal advice; or
new text end

new text begin (xi) matters specifically exempted from disclosure by federal or participating states'
statutes;
new text end

new text begin (4) if a meeting, or portion of a meeting, is closed pursuant to clause (3), the chair of
the meeting or the chair's designee shall certify that the meeting or portion of the meeting
may be closed and shall reference each relevant exempting provision; and
new text end

new text begin (5) the commission shall keep minutes that fully and clearly describe all matters discussed
in a meeting and shall provide a full and accurate summary of actions taken, including a
description of the views expressed. All documents considered in connection with an action
shall be identified in such minutes. All minutes and documents of a closed meeting shall
remain under seal, subject to release by a majority vote of the commission or order of a
court of competent jurisdiction.
new text end

new text begin (e) Financing of the commission:
new text end

new text begin (1) the commission shall pay, or provide for the payment of, the reasonable expenses of
its establishment, organization, and ongoing activities;
new text end

new text begin (2) the commission may accept any and all appropriate revenue sources, donations, and
grants of money, equipment, supplies, materials, and services;
new text end

new text begin (3) the commission may levy on and collect an annual assessment from each participating
state and may impose compact privilege fees on licensees of participating states to whom
a compact privilege is granted, to cover the cost of the operations and activities of the
commission and its staff. The cost of the operations and activities of the commission and
its staff must be in a total amount sufficient to cover its annual budget as approved by the
commission each year for which revenue is not provided by other sources. The aggregate
annual assessment amount levied on participating states shall be allocated based upon a
formula to be determined by commission rule:
new text end

new text begin (i) a compact privilege expires when the licensee's qualifying license in the participating
state from which the licensee applied for the compact privilege expires; and
new text end

new text begin (ii) if the licensee terminates the qualifying license through which the licensee applied
for the compact privilege before its scheduled expiration, and the licensee has a qualifying
license in another participating state, the licensee shall inform the commission that it is
changing the participating state through which it applies for a compact privilege to the other
participating state and pay to the commission any compact privilege fee required by
commission rule;
new text end

new text begin (4) the commission shall not incur obligations of any kind prior to securing the funds
adequate to meet the same, nor shall the commission pledge the credit of any of the
participating states, except by and with the authority of the participating state; and
new text end

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

new text begin (f) The executive committee:
new text end

new text begin (1) the executive committee shall have the power to act on behalf of the commission
according to the terms of this compact and commission rules;
new text end

new text begin (2) the executive committee shall be composed of nine members as follows:
new text end

new text begin (i) seven voting members who are elected by the commission from the current
membership of the commission;
new text end

new text begin (ii) one ex officio, nonvoting member from a recognized national PA professional
association; and
new text end

new text begin (iii) one ex officio, nonvoting member from a recognized national PA certification
organization;
new text end

new text begin (3) the ex officio members will be selected by their respective organizations;
new text end

new text begin (4) the commission may remove any member of the executive committee as provided
in its bylaws;
new text end

new text begin (5) the executive committee shall meet at least annually;
new text end

new text begin (6) the executive committee shall have the following duties and responsibilities:
new text end

new text begin (i) recommend to the entire commission changes to the commission's rules or bylaws,
changes to this compact legislation, fees paid by compact participating states such as annual
dues, and any commission compact fee charged to licensees for the compact privilege;
new text end

new text begin (ii) ensure compact administration services are appropriately provided, contractual or
otherwise;
new text end

new text begin (iii) prepare and recommend the budget;
new text end

new text begin (iv) maintain financial records on behalf of the commission;
new text end

new text begin (v) monitor compact compliance of participating states and provide compliance reports
to the commission;
new text end

new text begin (vi) establish additional committees as necessary;
new text end

new text begin (vii) 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
new text end

new text begin (viii) perform other duties as provided in commission's rules or bylaws;
new text end

new text begin (7) all meetings of the executive committee at which it votes or plans to vote on matters
in exercising the powers and duties of the commission shall be open to the public, and public
notice of such meetings shall be given as public meetings of the commission are given; and
new text end

new text begin (8) the executive committee may convene in a closed, nonpublic meeting for the same
reasons that the commission may convene in a nonpublic meeting as set forth in paragraph
(d), clause (3), and shall announce the closed meeting as the commission is required to
under paragraph (d), clause (4), and keep minutes of the closed meeting as the commission
is required to under paragraph (d), clause (5).
new text end

new text begin (g) Qualified immunity, defense, and indemnification:
new text end

new text begin (1) the members, officers, executive director, employees, and representatives of the
commission shall be immune from suit and liability, both personally and in their official
capacity, for any claim for damage to or loss of property or personal injury or other civil
liability caused by or arising out of any actual or alleged act, error, or omission that occurred,
or that the person against whom the claim is made had a reasonable basis for believing
occurred, within the scope of commission employment, duties, or responsibilities, provided
that nothing in this paragraph shall be construed to protect any such person from suit or
liability for any damage, loss, injury, or liability caused by the intentional or willful or
wanton misconduct of that person. The procurement of insurance of any type by the
commission shall not in any way compromise or limit the immunity granted hereunder;
new text end

new text begin (2) the commission shall defend any member, officer, executive director, employee, or
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 that the person against whom the claim is made
had a reasonable basis for believing occurred within the scope of commission employment,
duties, or responsibilities, provided that nothing herein shall be construed to prohibit that
person from retaining their own counsel at their own expense, and provided further that the
actual or alleged act, error, or omission did not result from that person's intentional or willful
or wanton misconduct;
new text end

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

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

new text begin (5) nothing herein shall be construed as a limitation on the liability of any licensee for
professional malpractice or misconduct, which shall be governed solely by any other
applicable state laws;
new text end

new text begin (6) nothing herein shall be construed to designate the venue or jurisdiction to bring
actions for alleged acts of malpractice, professional misconduct, negligence, or other such
civil action pertaining to the practice of a PA. All such matters shall be determined
exclusively by state law other than this compact;
new text end

new text begin (7) nothing in this compact shall be interpreted to waive or otherwise abrogate a
participating state's state action immunity or state action affirmative defense with respect
to antitrust claims under the federal Sherman Act, Clayton Act, or any other state or federal
antitrust or anticompetitive law or regulation; and
new text end

new text begin (8) nothing in this compact shall be construed to be a waiver of sovereign immunity by
the participating states or by the commission.
new text end

new text begin ARTICLE VIII
new text end

new text begin DATA SYSTEM
new text end

new text begin (a) The commission shall provide for the development, maintenance, and utilization of
a coordinated database and reporting system containing licensure and adverse action
information, and the reporting of significant investigative information on all licensed PAs
and applicants denied a license in participating states.
new text end

new text begin (b) Notwithstanding any other state law to the contrary, a participating state shall submit
a uniform data set to the data system on all PAs to whom this compact is applicable, using
a unique identifier, as required by the rules of the commission, including:
new text end

new text begin (1) identifying information;
new text end

new text begin (2) licensure data;
new text end

new text begin (3) adverse actions against a license or compact privilege;
new text end

new text begin (4) any denial of application for licensure and the reason or reasons for the denial,
excluding the reporting of any criminal history record information where prohibited by law;
new text end

new text begin (5) the existence of significant investigative information; and
new text end

new text begin (6) other information that may facilitate the administration of this compact, as determined
by the rules of the commission.
new text end

new text begin (c) Significant investigative information pertaining to a licensee in any participating
state shall only be available to other participating states.
new text end

new text begin (d) The commission shall promptly notify all participating states of any reports it receives
of any adverse action taken against a licensee or an individual applying for a license. This
adverse action information shall be available to any other participating state.
new text end

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

new text begin (f) Any information submitted to the data system that is subsequently expunged by
federal law or the laws of the participating state contributing the information shall be removed
from the data system upon reporting of such by the participating state to the commission.
new text end

new text begin (g) The records and information provided to a participating state pursuant to this compact
or through the data system, when certified by the commission or an agent thereof, shall
constitute the authenticated business records of the commission and shall be entitled to any
associated hearsay exception in any relevant judicial, quasi-judicial, or administrative
proceedings in a participating state.
new text end

new text begin ARTICLE IX
new text end

new text begin RULEMAKING
new text end

new text begin (a) The commission shall exercise its rulemaking powers pursuant to the criteria set
forth in this article and the rules adopted thereunder. Commission rules shall become binding
as of the date specified by the commission for each rule.
new text end

new text begin (b) The commission shall promulgate reasonable rules in order to effectively and
efficiently implement and administer this compact and achieve its purposes. A commission
rule shall be invalid and have no force or effect only if a court of competent jurisdiction
holds that the rule is invalid because the commission exercised its rulemaking authority in
a manner that is beyond the scope of the purposes of this compact, or the powers granted
hereunder, or based upon another applicable standard of review.
new text end

new text begin (c) The rules of the commission shall have the force of law in each participating state,
provided however that where the rules of the commission conflict with the laws of the
participating state that establish the medical services a PA may perform in the participating
state, as held by a court of competent jurisdiction, the rules of the commission shall be
ineffective in that state to the extent of the conflict.
new text end

new text begin (d) If a majority of the legislatures of the participating states rejects a commission rule,
by enactment of a statute or resolution in the same manner used to adopt the compact within
four years of the date of adoption of the rule, then such rule shall have no further force and
effect in any participating state or in any state applying to participate in the compact.
new text end

new text begin (e) Rules or amendments to the rules shall be adopted at a regular or special meeting of
the commission.
new text end

new text begin (f) Prior to promulgation and adoption of a final rule or rules by the commission and at
least 30 days in advance of the meeting at which the rule will be considered and voted upon,
the commission shall file a notice of proposed rulemaking:
new text end

new text begin (1) on the website of the commission or other publicly accessible platform;
new text end

new text begin (2) to persons who have requested notice of the commission's notices of proposed
rulemaking; and
new text end

new text begin (3) in such other ways as the commission may specify by rule.
new text end

new text begin (g) The notice of proposed rulemaking shall include:
new text end

new text begin (1) the time, date, and location of the public hearing on the proposed rule;
new text end

new text begin (2) the time, date, and location of the public hearing in which the proposed rule will be
considered and voted upon;
new text end

new text begin (3) the text of the proposed rule and the reason for the proposed rule;
new text end

new text begin (4) a request for comments on the proposed rule from any interested person and the date
by which written comments must be received; and
new text end

new text begin (5) the manner in which interested persons may submit notice to the commission of their
intention to attend the public hearing and any written comments.
new text end

new text begin (h) Prior to adoption of a proposed rule, the commission shall allow persons to submit
written data, facts, opinions, and arguments, which shall be made available to the public.
new text end

new text begin (i) If the hearing is held via electronic means, the commission shall publish the mechanism
for access to the electronic hearing:
new text end

new text begin (1) all persons wishing to be heard at the hearing shall notify the commission of their
desire to appear and testify at the hearing, not less than five business days before the
scheduled date of the hearing, as directed in the notice of proposed rulemaking;
new text end

new text begin (2) hearings shall be conducted in a manner providing each person who wishes to
comment a fair and reasonable opportunity to comment orally or in writing;
new text end

new text begin (3) all hearings shall be recorded. A copy of the recording and the written comments,
data, facts, opinions, and arguments received in response to the proposed rulemaking shall
be made available to a person on request; and
new text end

new text begin (4) nothing in this section shall be construed as requiring a separate hearing on each
rule. Proposed rules may be grouped for the convenience of the commission at hearings
required by this article.
new text end

new text begin (j) Following the public hearing, the commission shall consider all written and oral
comments timely received.
new text end

new text begin (k) The commission shall, by majority vote of all delegates, take final action on the
proposed rule and shall determine the effective date of the rule, if adopted, based on the
rulemaking record and the full text of the rule. The commission:
new text end

new text begin (1) shall, if adopted, post the rule on the commission's website;
new text end

new text begin (2) may adopt changes to the proposed rule provided the changes do not expand the
original purpose of the proposed rule;
new text end

new text begin (3) shall provide on its website an explanation of the reasons for substantive changes
made to the proposed rule as well as reasons for substantive changes not made that were
recommended by commenters; and
new text end

new text begin (4) shall determine a reasonable effective date for the rule. Except for an emergency as
provided in paragraph (l), the effective date of the rule shall be no sooner than 30 days after
the commission issued the notice that it adopted the rule.
new text end

new text begin (l) Upon determination that an emergency exists, the commission may consider and
adopt an emergency rule with 24 hours' prior notice, without the opportunity for comment
or hearing, provided that the usual rulemaking procedures provided in the compact and in
this article shall be retroactively applied to the rule as soon as reasonably possible, in no
event later than 90 days after the effective date of the rule. For the purposes of this provision,
an emergency rule is one that must be adopted immediately by the commission in order to:
new text end

new text begin (1) meet an imminent threat to public health, safety, or welfare;
new text end

new text begin (2) prevent a loss of commission or participating state funds;
new text end

new text begin (3) meet a deadline for the promulgation of a commission rule that is established by
federal law or rule; or
new text end

new text begin (4) protect public health and safety.
new text end

new text begin (m) The commission or an authorized committee of the commission may direct revisions
to a previously adopted commission rule for purposes of correcting typographical errors,
errors in format, errors in consistency, or grammatical errors. Public notice of any revisions
shall be posted on the website of the commission. The revision shall be subject to challenge
by any person for a period of 30 days after posting. The revision may be challenged only
on grounds that the revision results in a material change to a rule. A challenge shall be made
as set forth in the notice of revisions and delivered to the commission prior to the end of
the notice period. If no challenge is made, the revision will take effect without further action.
If the revision is challenged, the revision may not take effect without the approval of the
commission.
new text end

new text begin (n) No participating state's rulemaking requirements shall apply under this compact.
new text end

new text begin ARTICLE X
new text end

new text begin OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT
new text end

new text begin (a) Oversight:
new text end

new text begin (1) the executive and judicial branches of state government in each participating state
shall enforce this compact and take all actions necessary and appropriate to implement the
compact;
new text end

new text begin (2) venue is proper and judicial proceedings by or against the commission shall be
brought solely and exclusively in a court of competent jurisdiction where the principal office
of the commission is located. The commission may waive venue and jurisdictional defenses
to the extent it adopts or consents to participate in alternative dispute resolution proceedings.
Nothing herein shall affect or limit the selection or propriety of venue in any action against
a licensee for professional malpractice, misconduct, or any such similar matter; and
new text end

new text begin (3) the commission shall be entitled to receive service of process in any such proceeding
regarding the enforcement or interpretation of the compact or the commission's rules and
shall have standing to intervene in such a proceeding for all purposes. Failure to provide
service of process to the commission shall render a judgment or order void as to the
commission, this compact, or commission rules.
new text end

new text begin (b) Default, technical assistance, and termination:
new text end

new text begin (1) if the commission determines that a participating state has defaulted in the
performance of its obligations or responsibilities under this compact or the commission
rules, the commission shall:
new text end

new text begin (i) provide written notice to the defaulting state and other participating states describing
the default, the proposed means of curing the default, or any other action that the commission
may take; and
new text end

new text begin (ii) offer remedial training and specific technical assistance regarding the default;
new text end

new text begin (2) if a state in default fails to cure the default, the defaulting state may be terminated
from this compact upon an affirmative vote of a majority of the delegates of the participating
states, and all rights, privileges, and benefits conferred by this compact may be terminated
on the effective date of termination. A cure of the default does not relieve the offending
state of obligations or liabilities incurred during the period of default;
new text end

new text begin (3) termination of participation in this compact shall be imposed only after all other
means of securing compliance have been exhausted. Notice of intent to suspend or terminate
shall be given by the commission to the governor, the majority and minority leaders of the
defaulting state's legislature, and the licensing board or boards of each of the participating
states;
new text end

new text begin (4) a state that has been terminated is responsible for all assessments, obligations, and
liabilities incurred through the effective date of termination, including obligations that
extend beyond the effective date of termination;
new text end

new text begin (5) the commission shall not bear any costs related to a state that is found to be in default
or that has been terminated from this compact, unless agreed upon in writing between the
commission and the defaulting state;
new text end

new text begin (6) the defaulting state may appeal its termination from the compact by the commission
by petitioning the United States District Court for the District of Columbia or the federal
district where the commission has its principal offices. The prevailing member shall be
awarded all costs of such litigation, including reasonable attorney's fees; and
new text end

new text begin (7) upon the termination of a state's participation in the compact, the state shall
immediately provide notice to all licensees within that state of such termination:
new text end

new text begin (i) licensees who have been granted a compact privilege in that state shall retain the
compact privilege for 180 days following the effective date of such termination; and
new text end

new text begin (ii) licensees who are licensed in that state who have been granted a compact privilege
in a participating state shall retain the compact privilege for 180 days, unless the licensee
also has a qualifying license in a participating state or obtains a qualifying license in a
participating state before the 180-day period ends, in which case the compact privilege shall
continue.
new text end

new text begin (c) Dispute resolution:
new text end

new text begin (1) upon request by a participating state, the commission shall attempt to resolve disputes
related to this compact that arise among participating states and between participating and
nonparticipating states; and
new text end

new text begin (2) the commission shall promulgate a rule providing for both mediation and binding
dispute resolution for disputes, as appropriate.
new text end

new text begin (d) Enforcement:
new text end

new text begin (1) the commission, in the reasonable exercise of its discretion, shall enforce the
provisions of this compact and rules of the commission;
new text end

new text begin (2) if compliance is not secured after all means to secure compliance have been exhausted,
by majority vote, the commission may initiate legal action in the United States District
Court for the District of Columbia or the federal district where the commission has its
principal offices against a participating state in default, to enforce compliance with the
provisions of this compact and the commission's promulgated rules and bylaws. The relief
sought may include both injunctive relief and damages. In the event judicial enforcement
is necessary, the prevailing member shall be awarded all costs of such litigation, including
reasonable attorney's fees; and
new text end

new text begin (3) the remedies herein shall not be the exclusive remedies of the commission. The
commission may pursue any other remedies available under federal or state law.
new text end

new text begin (e) Legal action against the commission:
new text end

new text begin (1) a participating state may initiate legal action against the commission in the United
States District Court for the District of Columbia or the federal district where the commission
has its principal offices to enforce compliance with the provisions of the compact and the
commission's rules. The relief sought may include both injunctive relief and damages. In
the event judicial enforcement is necessary, the prevailing party shall be awarded all costs
of such litigation, including reasonable attorney's fees; and
new text end

new text begin (2) no person other than a participating state shall enforce this compact against the
commission.
new text end

new text begin ARTICLE XI
new text end

new text begin DATE OF IMPLEMENTATION OF THE PA LICENSURE COMPACT
COMMISSION
new text end

new text begin (a) This compact shall come into effect on the date on which the compact statute is
enacted into law in the seventh participating state.
new text end

new text begin (b) On or after the effective date of the compact, the commission shall convene and
review the enactment of each of the charter participating states to determine if the statute
enacted by each charter participating state is materially different than the model compact.
A charter participating state whose enactment is found to be materially different from the
model compact shall be entitled to the default process set forth in article X, paragraph (b).
new text end

new text begin (c) If any participating state later withdraws from the compact or its participation is
terminated, the commission shall remain in existence and the compact shall remain in effect
even if the number of participating states should be less than seven. Participating states
enacting the compact subsequent to the commission convening shall be subject to the process
set forth in article VII, paragraph (c), clause (21), to determine if their enactments are
materially different from the model compact and whether they qualify for participation in
the compact.
new text end

new text begin (d) Any participating state enacting the compact subsequent to the seven initial charter
participating states shall be subject to the process set forth in article VII, paragraph (c),
clause (21), to determine if the state's enactment is materially different from the model
compact and whether the state qualifies for participation in the compact.
new text end

new text begin (e) All actions taken for the benefit of the commission or in furtherance of the purposes
of the administration of the compact prior to the effective date of the compact or the
commission coming into existence shall be considered to be actions of the commission
unless specifically repudiated by the commission.
new text end

new text begin (f) Any state that joins this compact shall be subject to the commission's rules and bylaws
as they exist on the date on which this compact becomes law in that state. Any rule that has
been previously adopted by the commission shall have the full force and effect of law on
the day this compact becomes law in that state.
new text end

new text begin (g) Any participating state may withdraw from this compact by enacting a statute
repealing the same:
new text end

new text begin (1) a participating state's withdrawal shall not take effect until 180 days after enactment
of the repealing statute. During this 180-day period, all compact privileges that were in
effect in the withdrawing state and were granted to licensees licensed in the withdrawing
state shall remain in effect. If any licensee licensed in the withdrawing state is also licensed
in another participating state or obtains a license in another participating state within the
180 days, the licensee's compact privileges in other participating states shall not be affected
by the passage of the 180 days;
new text end

new text begin (2) withdrawal shall not affect the continuing requirement of the state licensing board
or boards of the withdrawing state to comply with the investigative and adverse action
reporting requirements of this compact prior to the effective date of withdrawal; and
new text end

new text begin (3) upon the enactment of a statute withdrawing a state from this compact, the state shall
immediately provide notice of such withdrawal to all licensees within that state. Such
withdrawing state shall continue to recognize all licenses granted pursuant to this compact
for a minimum of 180 days after the date of such notice of withdrawal.
new text end

new text begin (h) Nothing contained in this compact shall be construed to invalidate or prevent any
PA licensure agreement or other cooperative arrangement between participating states or a
participating state and a nonparticipating state that does not conflict with the provisions of
this compact.
new text end

new text begin (i) This compact may be amended by the participating states. No amendment to this
compact shall become effective and binding upon any participating state until it is enacted
materially in the same manner into the laws of all participating states, as determined by the
commission.
new text end

new text begin ARTICLE XII
new text end

new text begin CONSTRUCTION AND SEVERABILITY
new text end

new text begin (a) This compact and the commission's rulemaking authority shall be liberally construed
so as to effectuate the purposes of the compact and its implementation and administration.
Provisions of the compact expressly authorizing or requiring the promulgation of rules shall
not be construed to limit the commission's rulemaking authority solely for those purposes.
new text end

new text begin (b) The provisions of this compact shall be severable and if any phrase, clause, sentence,
or provision of this compact is held by a court of competent jurisdiction to be contrary to
the constitution of any participating state, of a state seeking participation in the compact,
or of the United States, or the applicability thereof to any government, agency, person, or
circumstance is held to be unconstitutional by a court of competent jurisdiction, the validity
of the remainder of this compact and the applicability thereof to any government, agency,
person, or circumstance shall not be affected thereby.
new text end

new text begin (c) Notwithstanding paragraph (b) or any provision of this article, the commission may
deny a state's participation in the compact or, in accordance with the requirements of article
X, paragraph (b), terminate a participating state's participation in the compact, if it determines
that a constitutional requirement of a participating state is, or would be with respect to a
state seeking to participate in the compact, a material departure from the compact. Otherwise,
if this compact shall be held to be contrary to the constitution of any participating state, the
compact shall remain in full force and effect as to the remaining participating states and in
full force and effect as to the participating state affected as to all severable matters.
new text end

new text begin ARTICLE XIII
new text end

new text begin BINDING EFFECT OF THE COMPACT
new text end

new text begin (a) Nothing herein prevents the enforcement of any other law of a participating state
that is not inconsistent with this compact.
new text end

new text begin (b) Any laws in a participating state in conflict with this compact are superseded to the
extent of the conflict.
new text end

new text begin (c) All agreements between the commission and the participating states are binding in
accordance with their terms.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 2. new text begin DIRECTION TO BOARD OF MEDICAL PRACTICE.
new text end

new text begin The Board of Medical Practice must publish the effective date of the compact in
Minnesota Statutes, section 148.675, in the State Register and on the board's website.
new text end