In June 2019, a joint initiative by The Council of State Governments, Federation of State Medical Boards, American Academy of Physician Associates and the National Commission on Certification of Physician Assistants, was created to develop an interstate compact for the interstate practice of physician assistants (PAs). Funding support for this initiative came from the U.S. Department of Health and Human Services.

The physician assistants compact (PA Compact) will facilitate the ability of licensed PAs to practice in multiple states without having to obtain an individual state professional license in each state of practice. The compact will provide for greater in-person and telehealth access to care and will significantly enhance practitioner mobility, including in times of public health emergencies. The PA Compact will also strengthen public protection by establishing a data system that facilitates information sharing and coordination on disciplinary action between participating states.

In the PA Compact licensure mobility is facilitated through a “privilege to practice” model, which allows individual licensees to seek a compact privilege in any compact member state they choose. The licensee’s application for a privilege to practice in a specific state is expedited by utilizing the compact data system to ensure the individual is eligible for that privilege by meeting the requirements in the compact.

The PA Compact includes various requirements for states to adhere to prior to enacting the model legislation. These requirements ensure there are baseline standards to be met for states to start issuing compact privileges. Some of these requirements include requiring a national exam and continuing education for all PA licensees. To obtain privileges to practice in compact member states individual licensees must also meet specific requirements laid out in the compact, such as obtaining NCCPA certification and graduating from a nationally accredited PA program.

The partner organizations met as a working group throughout the compact development process to develop the compact language. As part of the development process, the working group engaged stakeholders within the PA profession and the healthcare industry to solicit input and feedback. The working group utilized stakeholder feedback to revise the compact and respond to received concerns and suggestions.

One of the major motivations behind the desire to develop an interstate compact for physicians assistants is the success of other compacts for healthcare professions, such as the Nurse Licensure Compact and the Interstate Medical Licensure Compact for physicians. Both compacts have been enacted in nearly 40 states. The development of interstate compacts for healthcare professions have been extremely popular amongst states because of their ability to strengthen state’s healthcare workforce and provide additional pathways to care for patients. The PA Compact working group considered and incorporated many aspects of other compacts for healthcare professions. While the PA Compact is similar to other compacts in how it facilitates multistate practice, each compact is unique and responds to the specific needs of the profession.

The working group approved the final version of the PA Compact in October 2022, which is being made available to states for 2023 legislative sessions. CSG and the project partners will provide educational and technical assistance for stakeholders and states interested in the compact. Supporting resources and information about the compact may be found at www.pacompact.org.


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