PA Licensure Compact

The PA Compact is an optional agreement between states that will allow PAs with a license in a compact member state to more easily become authorized to practice in any other member state. A state opts to become a member of the compact by adopting the PA Compact through its legislative process. The PA Compact is completely optional for licensees.

The PA Compact is the result of a joint initiative that began in 2019 between the American Academy of Physician Associates (AAPA), the Federation of State Medical Boards (FSMB), and the National Commission on Certification of Physician Assistants (NCCPA). The Council of State Governments (CSG) has provided technical assistance in the development of the compact and its consideration by states.

The PA Compact will provide a streamlined process for eligible PAs to obtain authorization to practice in other compact member states through a compact privilege, without the need to apply through each state’s licensure application process. Once the compact becomes operational after seven states have adopted the compact model legislation, eligible PAs will only need to complete a single application to receive compact privileges from each compact state in which they intend to practice.

For example, a PA with practice locations in three compact states or who delivers care through telemedicine in those three states will no longer need to apply for an individual license from each state. A PA will be able to maintain a license in one state and through a single application obtain compact privileges to practice in the additional two states. This will significantly reduce the burden of going through multiple application processes, and may reduce fees for the PA, but more importantly will reduce delays in providing patient care and increase patient access as this PA can now see patients in all three jurisdictions.

Delaware, Utah, Washington, Wisconsin, West Virginia, Nebraska, Virginia, Oklahoma, Maine, Colorado, Minnesota and Tennessee

AAPA is working closely with state constituent organizations to introduce and enact the PA Compact. Please contact your AAPA state advocacy and outreach liaison to find out the status of your state.

PAs cannot yet apply for a compact privilege. The PA Compact has been activated, which means that the process to operationalize the compact – and be able to give out privileges to practice – has begun. The process for a licensure compact to become fully operational can take anywhere from 18-24 months after its activation, which is typical of other licensure compacts as well. Applications for compact privileges will not be available until the compact commission becomes fully operational.

Each state that enacts the PA Compact will choose a delegate for the PA Compact Commission. These delegates must be the following: a member of the entity that regulates the PA profession in the state (either a current PA, a physician, or a public member of a licensing board or PA Council/Committee) OR an administrator of that regulatory body. The Inaugural Compact Commission meeting is set to meet in Fall 2024 and will work to operationalize the compact including hiring staff, developing a data system, and writing rules.

The PA Compact will be available for PAs holding an unrestricted license issued by a compact member state and meet the following requirements set forth by the compact:

• Have graduated from a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or other programs authorized by the PA Licensure Compact Commission.
• Hold current NCCPA certification.
• Have no felony or misdemeanor convictions.
• Have never had a controlled substance license or permit suspended or revoked.
• Have a unique identifier as determined by the compact commission.
• Have no limitation or restriction on any state license or compact privilege in a remote state.
• Meet any jurisprudence requirements of the state where a compact privilege is being sought and pay any required fees.
• Report to the PA Licensure Compact Commission any adverse action taken by a non-member state within 30 days after the action is taken.

The compact will reduce time and cost burdens for PAs to engage in multistate practice, whether in person or by telemedicine. The compact will also establish a multistate data system that will enhance public protection by facilitating the sharing of licensure and disciplinary information across compact members states.

Furthermore, the PA Compact will allow for increased license portability, an area of particular need for PAs who travel or relocate regularly, including the military spouse community. With an active interstate PA Compact, a currently practicing PA can maintain licensure and avoid licensing-related downtime between jobs, as long as relevant states are members of the compact.

With the COVID-19 pandemic, telemedicine usage increased substantially; however, licensing requirements were not permanently changed in response. A PA – no matter how they are delivering care – must be licensed or otherwise authorized to practice in the state or jurisdiction in which the patient is located. The PA Licensure Compact would make it easier for PAs to obtain the necessary state authorization to see patients, including through telemedicine. For example, for those in rural communities, a telemedicine visit may be more feasible than a long drive to a medical office.

State collaboration and supervision requirements are preserved with a state’s participation in the PA Compact. PAs must follow collaboration and supervision requirements of the state where the patient is located. The compact provides PAs with the authorization to practice from a licensure aspect. PA professionals may be subject to other requirements in order to legally practice, including supervision/collaboration and prescribing authority requirements. PAs practicing under the compact must abide by the laws and regulations of where the patient is located/where they are providing services.

If you would like to advocate for the compact in your state, please contact your state membership organization or your target=”_blank” rel=”noopener”>AAPA state advocacy and outreach liaison.

Compact commission meetings will be open to the public, and there will be opportunities for public comment. Information can be found on pacompact.org.