The Physician Assistant Licensure Compact: Update and What It Means for PAs

January 3, 2024

By Meghan Pudeler, Director, State Advocacy & Outreach

In 2023, the PA profession reached a pivotal point in the mission to secure a PA Licensure Compact when states not only began introducing the model legislation but also passing the bills in short order.

To date, three states – Utah, Delaware, and Wisconsin – have enacted the PA Compact. Legislation is currently pending in six states, with many states looking to introduce bills quickly in the 2024 legislative sessions.

How did we get here?
While the need for a licensure compact for the PA profession has been a topic of conversation for years, the real work began in 2019 when Federation of State Medical Boards (FSMB), the Council of State Governments (CSG), AAPA, NCCPA, and key PA stakeholders began working on an interstate PA Licensure Compact model legislation. The language was finalized in December 2022, and states began introducing the language during the 2023 legislative session.

What is the PA Licensure Compact?
The PA Licensure Compact (PA Compact) is an interstate professional licensing compact for PAs which will address licensure portability, streamline PA licensing, and expand access to care for patients. The PA Compact will provide licensed PAs  the opportunity to practice in states that join the compact without the need to apply through each state’s licensure application process. This applies to PAs whether they are practicing in person or by telemedicine.

After seven states have enacted the compact model legislation, the compact will be activated and begin the process to operationalize the compact and be able to give out privileges to practice. Eligible PAs can then complete a single application to receive a compact privilege (which is equivalent to a license) from each compact state in which they intend to practice.

Take, for example, a PA who currently holds a license and practices in three states. If these three states join the PA compact, the PA would no longer need to apply for an individual license in each state. The PA would be able to maintain a license in one state and apply for a privilege to practice through a single application in the others. This would significantly reduce administrative burdens and may reduce licensing fees for the PA. However, most importantly, it would reduce delays to providing patient care and increase patient access, as the PA could see patients in all three jurisdictions.

The PA compact is completely optional – PAs may utilize the compact to obtain privileges to practice in all states in which they are practicing or wish to practice, or they may continue to obtain a single state license in states. Furthermore, the PA compact will not change scope of practice – PAs utilizing the compact must still abide by the state laws and regulations in the state in which they are practicing.

The PA Compact will also establish a multistate data system that will enhance public protection by facilitating the sharing of licensure and disciplinary information across compact member states.

Increased licensure portability is a 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.

What’s next?
The PA Compact is available for state legislative enactment, but it is not yet operational and is not currently issuing compact privileges. The compact will be activated and begin the process to operationalize the compact when seven states have enacted the compact model legislation. Historically, the process for a licensure compact to become fully operational can take up to 24 months after its activation. Applications for compact privileges will not be available until the compact commission becomes fully operational.

To see where your state is at in the process, please visit: pacompact.org. If you would like to advocate for the compact in your state, please contact your state membership organization.

For more information on the PA Compact, please visit the PA compact website: https://pacompact.org.

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