An Act to Add the State of Maine to the Compact for Licensing Physician Assistants
Maine Legislature, Session 131, LD 2043
Committee Amendment CA_A_H908 (House)

COMMITTEE AMENDMENT "A" to H.P. 1305, L.D. 2043, "An Act to Add the 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
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'Sec. 1. 32 MRSA c. 145"A is enacted to read: 
CHAPTER 145-A 
PHYSICIAN ASSISTANTS LICENSURE COMP ACT 
§18531. Purpose 
In order to strengthen access to medical services, and in recognition of the advances in 
the delive1y of medical services, the participating states of the Physician Assistants 
Licensure Compact. referred to in this chapter as "the compact, 
have allied in common 
purpose to develop a comprehensive process that complements the existing authority of 
state licensing boards to license and discipline physician assistants and seeks to enhance 
the portability of a license to practice as a physician assistant while safeguarding the safety 
of patients. This compact allows medical services to be provided by physician assistants, 
via the mutual recognition of the licensee's qualifying license by other participating states. 
This compact also adopts the prevailing standard for physician assistant licensure and 
affirms that the practice and delivery of medical services by a physician assistant occurs 
where the patient is located at the time of the patient encounter and therefore requires the 
physician assistant 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 
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impose adverse action against a compact privilege in that state issued to a physician 
assistant through the procedures of this compact. 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. 
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COMMITTEE AMENDMENT"?( to H.P. 1305, L.D. 2043 
§18532. Definitions 
As used in this chapter, unless the· context otherwise indicates, the following terms 
have the following meanings. 
1. Adverse action. 
11Adverse 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 physician assistant's license, license application or privilege to practice, 
such as license denial, censure, revocation, suspension, probation. monitoring of the 
licensee or restriction on the licensee's practice. 
2. Commission. -
11Commission
means the Physician Assistants Licensure Compact 
Commission created pursuant to section 18537. 
3. Compact privilege. 
11Compact privilege" means the authorization granted by a 
remote state to allow a·licensee from another participating state to practice as a physician 
assistant to provide medical services and other licensed activity to a patient located in the 
remote state under the remote state's laws and regulations. 
4. Conviction. "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 guilty or no 
contest to the charge by the offender. 
5. Criminal background check. "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 28 Code of 
Federal Regulations, Section 20.3(d), from the state's criminal history record repository, as 
defined in 28 Code of Federal Regulations, Section 20.3(f). 
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6. Data system. 
11Data system" means the repository of information about licensees, 
including. but not limited to, license status and adverse actions, that is created and 
administered under the terms of the compact. 
7. Executive committee. 
11Executive committee
means a group of directors and ex 
officio members elected or appointed pursuant to section 18537, subsection 6. 
8. Investigative information. "Investigative information" means information, records 
and documents received or generated by a licensing board pursuant to an investigation. 
9. Jurisprudence requirement. 
11Jurisprudence reguirement
means the assessment 
of an individual's knowledge of the laws and rules governing the practice of a physician 
assistant in a state. 
10. License. 
"License" means the current authorization by a state, other than 
authorization pursuant to a compact privilege, for a physician assistant to provide medical 
services that would be unlawful without current authorization. 
11. Licensee. 
11Licensee
means an individual who holds a license from a state to 
provide medical services as a physician assistant. 
12. Licensing board. "Licensing board
means any state entity authorized to license 
and otherwise regulate ·physician assistants. 
13. Medical services. "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. 
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COMMITTEE AMENDMENT "/f,' to H.P. 1305, L.D. 2043 
14. Model compact. 
11Model compact" means the model for the Physician Assistants 
Licensure Compact on file with the Council of State Governments. or its successor 
organization. or other entity designated by the commission. 
15. Participating state, "Participating state
means a state that has enacted the 
compact. 
16. Physician assistant. "Physician assistant
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 tenn "physician assistant" is deemed synonymous with 
"physician assistant" and confers the same rights and responsibilities to the licensee under 
the provisions of this compact at the time of its enactment. 
17. Qualifying license, "Qualifying license" means an unrestricted license issued by a 
participating state to provide medical services as a physician assistant. 
18. Remote state. "Remote state
means a participating state where a licensee who is 
not licensed as a physician assistant is exercising or seeking to exercise the compact 
privilege, 
19. Rule, 
11Rule
means a regulation promulgated by an entity that has the force and 
effect of law. 
20. Significant investigative information. 
Significant investigative information" 
means investigative information that a licensing board. after an inquiry or investigation that 
includes notification and an opportunity for the physician assistant 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. 
21. State. "State1i' means any state, commonwealth. district or tenitory of the United 
States. 
§18533, State participation in compact 
1. Participation requirements. To participate in the compact, a state must: 
A. License physician assistants; 
B. Participate in the commission
1s 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 this compact and 
commission rules, of any adverse action against a licensee or license applicant and the 
existence of significant investigative infonnation regarding a licensee or license 
applicant; 
E. Fully implement, within a time frame established by commission rule, a criminal 
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background check requirement by its licensing board receiving the results of a criminal 
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background check and reporting to the commission whether the license applicant has 
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been granted a license: 
F. Comply with the rules of the commission; 
G. Use passage of a recognized national examination as a requirement for physician 
assistant licensure: and 
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H. Grant the compact privilege to a holder of a qualifying license in a pa1ticipating 
state. 
2, No prohibition on fee for compact privilege, Nothing in this compact prohibits a 
participating state from charging a fee for granting the compact privilege. 
§18534. Compact privilege 
1. Requirements, To exercise the compact privilege, a licensee must: 
A. Have graduated from a physician assistant program accredited by the Accreditation 
Review Commission on Education for the Physician Assistant. or its successor 
organization, or other programs authorized by commission rule; 
B. Hold a current certification from the National Commission on Certification of 
Physician Assistants, or its successor organization; 
C. Have no felony or misdemeanor conviction: 
D. Have never had a controlled substance license, pennit or registration suspended or 
revoked by a state or by the United States Department of Justice, Drug Enforcement 
Administration: 
E. Have a unique identifier as determined by commission rule: 
F. Hold a qualifying license; 
G. Have not had a revocation of a license or a limitation or restriction on any license 
currently held due to an adverse action. If a licensee has had a limitation or restriction 
on a license or compact privilege due to an adverse action, 2 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. 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 the discretion not to 
consider such action as an adverse action requiring the denial or removal of a compact 
privilege in that state; 
H. Notify the commission that the licensee is seeking the compact privilege in a remote 
state; 
I. 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 
J, Report to the commission any adverse action taken by a nonparticipating state within 
0 days after the action is taken. 
2. Validity. The compact privilege is valid until the expiration or revocation of the 
qualifying license unless terminated pursuant to an adverse action, The licensee must 
comply with all of the requirements of subsection 1 to maintain the compact privilege in a 
remote state. If a participating state takes adverse action against a qualifying license, the 
licensee loses the compact privilege in any remote state in which the licensee has a compact 
privilege until all of the following occur: 
A. The license is ·no longer limited or restricted; and 
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COMMITTEE AMENDMENT" A" to H.P. 1305, L.D. 2043 
B. Two years have elapsed from the date on which the license is no longer limited or 
restricted due to the adverse action. 
3. Compact privilege; restricted or limited license. Once a restricted or limited 
license satisfies the requirements of subsection 2. a licensee must meet the requirements of 
subsection 1 to obtain a compact privilege in any remote state. 
4. Authority to prescribe controlled substances. For each remote state in which a 
physician assistant seeks authority to prescribe controlled substances, the physician 
assistant must satisfy all requirements imposed by that state in granting or renewing that 
authority. 
§18535. Designation of state from which licensee is applying for compact privilege 
Upon a licensee's application for a compact privilege, the licensee shall 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. 
1. Primary residence. When applying for a compact privilege, the licensee shall 
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, 
2. Consent to service of process. When applying for a compact privilege, the licensee 
shall consent to accept service of process by mail at the licensee's primruy 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, related to any action brought or 
investigation conducted by the commission or a participating state. 
§18536. Adverse actions 
1. Participating state authority. A participating state in which a licensee is licensed 
has exclusive power to impose an adverse action against the qualifying license issued by 
that participating state. 
2. Remote state authority. In addition to the other powers conferred by state law, a 
remote state has the authority, in accordance with existing state due process law, to: 
A. Take adverse action against a physician assistant's compact privilege within that 
state to remove a licensee's compact privilege or take any 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. 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 must be enforced in the 
other 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 is 
located. 
3. Lawful conduct; subpoenas, Notwithstanding subsection 2, subpoenas may not be 
issued by a participating state to gather evidence of conduct in another state that is lawful 
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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. 
4. Lawful conduct; disciplinary action. Nothing in this compact authorizes a 
participating state to impose discipline against a physician assistant'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. 
5. Reported conduct. For purposes of taking adverse action, the participating state 
that 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 pa1ticipating state that issued the qualifying license. In so doing. the participating state 
shall apply its own state laws to determine appropriate action. 
6, Recovery. A participating state. if otherwise permitted by state law. may recover 
from the affected physician assistant the costs of investigations and dispositions of cases 
resulting from any adverse action taken against that physician assistant. 
7. Remote state findings. A participating state may take adverse action based on the 
factual findings of a remote state as long as the participating state follows its own 
procedures for taking the adverse action, 
8. Joint investigations. In addition to the authority granted to a participating state by 
its respective state physician assistant laws or regulations or other applicable state law. any 
participating state may paiticipate with other participating states in a joint investigation of 
a licensee. 
Participating states shall share any investigative, litigation or compliance materials in 
furtherance of any joint or individual investigation initiated under the compact. 
9, Deactivation. If adverse action is taken against a physician assistant's qualifying 
license, the physician assistant's compact privilege in all remote states must be deactivated 
until 2 years have elapsed after all restrictions have been removed from the state license. 
All disciplinary orders by the participating state that has issued the physician assistant's 
qualifying license that impose adverse action against the physician assistant's license must 
include a statement that the physician assistant's compact privilege is deactivated in all 
participating states during the pendency of the order. 
10. Notification. If a participating state takes adverse action, it shall promptly notify 
the administrator of the commission's data system. 
§18537. Establishment of Physician Assistants Licensure Compact Commission 
1. Commission established. The participating states hereby create and establish a 
joint government agency and national administrative body known as the Physician 
Assistants Licensure Compact Commission. 
A. The commission is an instrumentality of the compact states acting jointly and is not 
an instrumentality of any one state. 
B, The commission comes into existence on or after the effective date of the compact 
as set forth in section 18541. 
2. 
Membership, voting and meetings. Membership. voting and meetings are 
governed by this subsection. 
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A. 
Each paiiicipating state has and is limited to one delegate selected by that 
participating state's licensing board or, if the state has more than one licensing board, 
selected collectiv_ely by the participating state's licensing boards. 
B. The delegate must be either: 
(1) A current physician assistant, physician or public member of a licensing board 
or physician assistant council or committee; or 
(2) An administrator of a licensing board. 
C. Any delegate may be removed or suspended from office as provided by the law of 
the state from which the delegate is appointed. 
D. The participating state licensing board shall fill any vacancy occurring on the 
commission within 60 days. 
E. Each delegate is entitled to one vote with regard to the promulgation of rules and 
creation of bylaws and must otherwise have an opportunity to participate in the 
business and affairs of the commission. 
F. 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, videoconference or other means of communication. 
G. The commission shall meet at least once during each calendar yeai·, Additional 
meetings must be held as set forth in this compact and the bylaws. 
H. The commission shall by rule establish a term of office for delegates. 
3. Powers and duties. The commission has the following powers and duties: 
A. To establish a code of ethics for the commission: 
B. To establish the fiscal year of the commission; 
C. To establish fees: 
D. To establish bylaws: 
E. To maintain the commission's financial records in accordance with the bylaws; 
F. To meet and take such actions as are consistent with the provisions of this compact 
and the bylaws: • 
G. To promulgate rules to facilitate and coordinate implementation and administration 
of this compact. Rules have the force and effect of law and are binding in all 
participating states: 
H. To bring and prosecute legal proceedings or actions in the name of the commission, 
as long as the standing of any state licensing board to sue or be sued under applicable 
law is not affected: 
I. To purchase and maintain insurance and bonds; 
J. To borrow, accept or contract for services of personnel, including, but not limited 
to, employees of a participating state; 
K. 
To hire employees and engage contractors, elect or appoint officers, fix 
compensation. define duties and grant such individuals appropriate authority to cany 
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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. 
To accept appropriate donations and grants of money, equipment, supplies, 
materials and services and receive, use and dispose of the same, as long as at all times 
the commission avoids any appearance of impropriety or conflict of interest: 
M. To lease, purchase, accept appropriate gifts or donations of or otherwise own, hold, 
improve or use any propei:ty, real, personal or mixed, as long as at all times the 
commission avoids any appearance of impropriety; 
N, To sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise dispose 
of any property, real, personal or mixed; 
0. To establish a budget and make expenditures: 
P, To borrow money: 
O. To 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: 
R. To provide information to, receive information from and cooperate with law 
~nforcement agencies: 
S. To elect a chair, vice-chair, secretary and treasurer and such other officers of the 
commission as provided in the bylaws: 
T. To reserve for itself, in addition to those reserved exclusively to the commission 
under the compact, powers that the executive committee may not exercise: 
U, To approve or disapprove a state's participation in the compact based upon the 
commission's determination as to whether the state's compact legislation departs in a 
material manner from the model compact language: 
V, To prepare and provide to the pa1ticipating states an annual report: and 
W. To perform such other functions as may be necessary or appropriate to achieve the 
purposes of this compact consistent with the state regulation of physician assistant 
licensure and practice, 
4. Meetings of commission. Meetings of the commission are governed by this 
subsection, 
A. Except as provided in paragraphs B and C, all meetings must be open to the public 
and public notice of meetings must be posted on the commission's publicly accessible 
website at least 3 0 days prior to a public meeting. 
B. The commission may convene a public meeting for any of the reasons it may 
dispense with notice of proposed rulemaking under section 1853 9, subsection 12 by 
providing at least 24 hours' notice on the commission's publicly accessible website and 
by any other means described in the commission's rules, 
C, The commission may convene in a closed, nonpublic meeting or convene in a closed 
meeting for part of an otherwise public meeting to receive legal advice or to discuss: 
(1) Noncompliance of a participating state with its obligations under the compact: 
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(2) 
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; 
(3) Current, threatened or reasonably anticipated litigation; 
( 4) Negotiation of contracts for the purchase, lease or sale of goods, services or 
real estate: 
(5) Accusing any person of a crime or formally censuring any person: 
(6) Disclosure of trade secrets or commercial or financial information that is 
privileged or confidential; 
(7) 
Disclosure of information of a personal nature when disclosure would 
constitute a clearly unwarranted invasion of personal privacy: 
(8) Disclosure of investigative records compiled for law enforcement purposes; 
(9) 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 
the compact: 
(10) Legal advice; or 
(11) Matters specifically exempted from disclosure by federal or participating state 
statute. 
D. If a meeting. or po1tion of a meeting, is closed pursuant to paragraph C, the chair 
of the meeting or the chair's designee shall certify that the meeting may be closed and 
shall reference each relevant exempting provision. 
E. 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 
and the reasons for those actions. including a description of the views expressed. All 
documents considered in connection with an action must be identified in the minutes, 
All minutes and documents of a closed meeting must remain under seal, subject to 
release by a majority vote of the commission or order of a court of competent 
jurisdiction. 
5. Financing of commission. Financing of the commission is governed by this 
subsection. 
A. The commission shall pay, or provide for the payment of. the reasonable expenses 
of its establishment. organization and ongoing activities. 
B. The commission may accept any appropriate revenue sources. donations and grants 
of money, equipment. supplies, materials and services, 
C, 
The commission may levy on and collect an annual assessment from each 
participating state or impose compact privilege fees on licensees of paiticipating states 
to whom a compact privilege is granted to cover the cost of the operations and activities 
of the commission and its staff. which must be in a total amount sufficient to cover its 
annual budget as approved each year for which revenue is not provided by other 
sources. The aggregate annual assessment amount levied on paiticipating states must 
be allocated based upon a formula to be determined by commission rule, 
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COMMITTEE AMENDMENT "A" to H.P. 1305, L.D. 2043 
(1) A compact privilege expires when the licensee's qualifying license in the 
participating state from which the licensee applied for the compact privilege 
expires. 
(2) If the licensee terminates the qualifying license through which the licensee 
applied for the compact privilege before the license's scheduled expiration, and the 
licensee has a qualifying license in another pa1ticipating state, the licensee shall 
infmm the commission that the licensee is changing to that participating state the 
participating state through which the licensee applies for a compact privilege and 
pay to the commission any compact privilege fee required by commission rule. 
D. The commission may not incur obligations of any kind prior to securing the funds 
adequate to meet the obligations, and the commission may not pledge the credit of any 
of the paiticipating states, except by and with the authority of the pa1ticipating state. 
E. The commission shall keep accurate accounts of all receipts and disbursements. 
The receipts and.disbursements of the commission are subject to the financial review 
and accounting procedures established under its bylaws. All receipts and disbursements 
of funds handled by the commission are subject to an annual financial review by a 
certified or licensed public accountant, and the report of the financial review must be 
included in and become part of the annual report of the commission. 
6, Executive committee, The establishment of an executive committee is governed 
by this subsection. 
A. The executive committee has the power to act on behalf of the commission 
according to the terms of this compact and commission rules. 
B. The executive committee is composed ofup to 9 members: 
(1) Seven voting members who are elected by the commission from the current 
membership of the commission; 
(2) One ex officio, nonvoting member from a recognized national professional 
association of physician assistants: and 
(3) One ex officio, nonvoting member from a recognized national organization that 
certifies physician assistants. 
The ex officio members must be selected by their respective organizations. 
C. The commission may remove any member of the executive committee as provided 
in bylaws. 
D. The executive committee shall meet at least annually. 
E. The executive committee shall: 
(1) Recommend to the entire commission changes to the rules or bylaws, changes 
to this compact, fees paid by participating states such as annual dues and any 
commission compact fee charged to licensees for the compact privilege; 
(2) Ensure compact administration services are appropriately provided, by contract 
or otherwise; 
(3) Prepare and recommend the commission's budget; 
( 4) Maintain financial records on behalf of the commission: 
Page l0-131LR2722(02) 
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COMMITTEE AMENDMENT" A" to H.P. 1305, L.D. 2043 
(5) Monitor compact compliance of participating states and provide compliance 
reports to the commission; 
(6) Establish additional committees as necessa1y; 
(7) 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 
(8) Perform other duties as provided in rules or bylaws. 
7. Qualified immunity, defense and indemnification. Qualified immunity, defense 
and indemnification are governed by this subsection. 
A. The members, officers, executive director, employees and representatives of the 
commission are immune from suit and liability, either personally or 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, except that nothing in this paragraph may 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 may not in any way compromise or limit the 
immunity granted under this subsection. 
B. 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 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, except that nothing in this paragraph may be construed to prohibit that 
person from retaining that person's own counsel, and as long as the actual or alleged 
act, e1ror or omission did not result from that person's intentional or willful or wanton 
misconduct. 
C. 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 the person had a reasonable basis for believing occurred 
within the scope of commission employment, duties or responsibilities, as long as the 
actual or alleged act. error or omission did not result from the intentional or willful or 
wanton misconduct of that person. 
D. Venue is proper and judicial proceedings by or against the commission must 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. 
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E. This subsection may not be construed as a limitation on the liability of any licensee 
for professional malpractice or misconduct, which is governed solely by any other 
applicable state laws. 
F. This subsection may not be constmed to designate the venue or jurisdiction to bring 
actions for alleged acts of malpractice, professional misconduct, negligence or other 
such civil action pe1taining to the practice of a physician assistant. All such matters 
must be determined exclusively by state law other than this compact. 
G. This subsection may not 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, the federal Clayton Act or 
any other state or federal antitrust or anticompetitive law or regulation. 
H. This subsection may not be construed to be a waiver of sovereign immunity by the 
participating states or by the commission. 
§18538. Data system 
1. Data and reporting system. The commission shall provide for the development, 
maintenance, operation and use of a coordinated data and reporting system containing 
licensure information, • adverse action information and the reporting of any significant 
investigative information on all licensed physician assistants and applicants denied a 
license in participating states. 
2. Uniform data set submission. Notwithstanding any provision of state law to the 
contrary, a participating state shall submit a uniform data set to the data system on all 
physician assistants to whom this compact is applicable, using a unique identifier, as 
required by the rules of the commission, including: 
A. Identifying information; 
B. Licensure data: 
C. Adverse actions against a license or compact privilege; 
D. Any denial of application for licensure and the reasons for that denial, excluding 
the reporting of any criminal histoi:y record information where prohibited by law; 
E. The existence of significant investigative information; and 
F. 
Other information that may facilitate the administration of this compact, as 
determined by the rules of the commission. 
3. 
Significant investigative information availability. 
Significant investigative 
information pertaining to a licensee in any participating state may be made available only 
to other participating states. 
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4. 
Adverse action information. 
The commission shall promptly notify all 
participating states of any adverse action taken against a licensee or an individual applying 
for a license. Adverse action information pe1taining to a licensee in any participating state 
must be available to any other participating state. 
5. Confidential information. Participating states contributing infonnation 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'. 
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COMMITTEE AMENDMENT "A" to H.P. 1305, L.D. 2043 
Notwithstanding any such designation, such inf01mation must be reported to the 
commission through the data system. 
6. Information expungement. Any information submitted to the data system that is 
subsequently required to be expunged pursuant to federal law or by the laws of the 
participating state contributing the infonnation must be removed from the data system upon 
reporting of such by the participating state to the commission, 
§18539. Rulemaking 
1. Powers. The commission shall exercise its rule-making powers pursuant to the 
criteria set forth in this section and the rules adopted under this section. Rules and 
amendments become binding as of the date specified in each rule or amendment. 
2. Promulgation, The commission shall promulgate reasonable rules in order to 
effectively and efficiently implement and administer this compact and achieve its purpose. 
A commission rule is invalid and has no force or effect only if a court of competent 
jurisdiction holds that the rule is invalid because the commission exercised its rule-making 
authority in a manner that is beyond the scope of the purposes of the compact, or the powers 
granted under the compact. or based upon another applicable standard ofreview. 
3, Rule conflict with law. The rules of the commission have the force of law in each 
participating state, except that where the rules of the commission conflict with the laws of 
the participating state that establish the medical services a physician assistant may perform 
in the participating state, as held by a court of competent jurisdiction, the rules of the 
commission are ineffective in that state to the extent of the conflict. 
4. Rule rejection. If a majority of the legislatures of the participating states rejects a 
rule, by enactment of a statute or resolution in the same manner used to adopt the compact 
within 4 years of the date of adoption of the rule, that rule has no further force and effect 
in any participating state or in any state applying to participate in the compact. 
5. Rule adoption procedure. Rules or amendments to the rules must be adopted at a 
regular or special meeting of the commission. 
6. 
Notice, Prior to promulgation and adoption of a final rule or rules by the 
commission, and at least 3 0 days in advance of the meeting at which the rule will be 
0 
considered and voted_ upon, the commission shall file a notice of proposed rulemaking: 
A. On the publicly accessible 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 ways as the commission may specify by rule, 
6 
7. Notice requirements. The notice of proposed rulemaking must include: 
A. The proposed time, date and location of the public hearing on the proposed rule and 
8 
the proposed time, date and location of the meeting at which the rule will be considered 
and voted upon; 
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 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. 1305, L.D. 2043 
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. 
8. Public comment. Prior to adoption of a proposed rule, the commission shall allow 
interested persons to submit written data. facts. opinions and arguments. which must be 
made available to the public. 
9. Hearing by electronic means; notice, If a hearing under this section is held via 
electronic means, the commission shall publish the mechanism for access to the hearing. 
A. All persons wishing to be heard at the hearing must notify the executive director of 
the commission or other designated member in writing of their desire to appear and 
testify at the hearing not less than 5 business days before the scheduled date of the 
hearing. 
B. Hearings must be conducted in a manner providing each person who wishes to 
comment a fair and reasonable opportunity to comment orally or in writing. 
C. All hearings must be recorded. A copy of the recording and the written data, facts,. 
opinions and arguments received in response to the proposed rulemaking must be made 
available on request. 
D. Nothing in this section may be construed as requiring a separate hearing on each 
rule. Rules may be grouped for the convenience of the commission at hearings required 
by this section. . 
10. Consideration. Following a public hearing under this section, the commission 
shall consider all written and oral comments timely received. 
11. Final action. The commission shall, by majority vote of all members, take final 
action on the proposed rule and shall determine the effective date of the rule, if adopted, 
based on the rule-making record and the full text of the rule. 
A. If adopted, the rule must be posted on the commission's publicly accessible website. 
B. The commission may adopt changes to the proposed rule as long as the changes do 
not broaden the orfginal purpose of the proposed rule. 
C. The commission shall provide on its publicly accessible 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 persons who submitted 
comments described in subsection 10. 
D. The commission shall determine a reasonable effective date for the rule. Except for 
an emergency as provided in subsection 12, the effective date of the rule may not be 
earlier than 30 days after the commission issues the notice that it has adopted the rule. 
12. Emergency rulemaking. Upon determination that an emergency exists, the 
commission may consider and adopt an emergency rule with 24 hours' notice, without the 
opportunity for comment or hearing. as long as the usual rule-making procedures provided 
in the compact and in this section are 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 subsection, "emergency rule" means a rule that must be adopted immediately in 
order to: 
A. Meet an imminent threat to public health, safety or welfare; 
co·MMITTEE AMENDMENT 
COMMITTEE AMENDMENT "A;" to H.P. 1305, L.D. 2043 
B. Prevent a loss of commission or participating state funds; 
C. Meet a deadline for the promulgation of an administrative rule that is established 
by federal law or'rule; or 
D. Protect public health and safety. 
13, Rule revisions. The commission or an authorized committee of the commission 
may direct revisions to a previously adopted rule for purposes of correcting typographical 
errors, errors in format. errors in consistency or grammatical errors. Public notice of any 
revisions must be posted on the publicly accessible website of the commission. The 
revision is 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 must 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 
talces effect without further action. If the revision is challenged, the revision may not take 
effect without the approval of the commission, 
14. Application of participating state requirements. Notwithstanding any provision 
of law to the contrary. a participating state's rule-making requirements do not apply under 
this compact. 
§18540. Oversight, dispute resolution and enforcement 
1. Oversight. Oversight of the compact is governed by this subsection. 
A. 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. 
B. Venue is proper and judicial proceedings by or against the commission must 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 in this paragraph affects or limits the selection 
or propriety of venue in any action against a licensee for professional malpractice, 
misconduct or any such similar matter. 
C. The commissi0n is entitled to receive service of process in any proceeding regarding 
the enforcement or interpretation of the compact or the commission's rules and has 
standing to intervene in such a proceeding for all purposes. Failure to provide the 
commission with service of process renders a judgment or order in such a proceeding 
void as to the commission. this compact or commission rules. 
5 
2. Default and technical assistance, If the commission determines that a participating 
state has defaulted fu the performance of its obligations or responsibilities under this 
compact or the commission rules, the commission shall: 
A. Provide written notice to the defaulting state and other participating states. The 
9 
notice must describe the default. the proposed means of curing the default and any other 
action that the commission may take: and 
B. Provide remedial training and specific technical assistance regarding the default. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. 1305, L.D. 2043 
3. Termination from compact. If a state in default fails to cure the default, the 
defaulting state may be terminated from the compact upon an affirmative vote of a majority 
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. 
4. Termination regulation. Termination of participation in the compact may be 
imposed only after all other means of securing compliance have been exhausted. Notice 
of intent to suspend or te1minate must be given by the commission to the governor. the 
majority and minority leaders of the defaulting state's legislature and to the licensing boards 
of each of the participating states. 
5. Responsibilities after termination. 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. 
6. Costs. The commission may not bear any costs related to a state that is found to be 
in default or that has been te1minated from the compact, unless agreed upon in writing 
between the commission and the defaulting state. 
7. Appeal. A defaulting state that has been terminated 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 must be awarded all costs of that litigation, including reasonable 
attorney's fees. 
8. Notice of termination to licensees. Upon the termination of a state's participation 
in the compact, that state shall immediately provide notice to all licensees within that state 
of the termination and that: 
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. A licensee who is licensed in that state who has been granted a compact privilege in 
a participating state retains 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 stat~ before the 180-day period ends, in which case the compact privilege 
continues. 
9. Dispute resolution. Dispute resolution is governed by this subsection, 
A. Upon request by a participating state, the commission shall attempt to resolve 
disputes related to the compact that arise among participating states and between 
participating and nonparticipating states, 
B. The commission shall promulgate a rule providing for both mediation and binding 
dispute resolution for disputes as appropriate. 
10. Enforcement. Enforcement of the compact is governed by this subsection. 
A. The commission, in the reasonable exercise of its discretion. shall enforce the 
provisions of the compact and the rules of the commission. 
B. If compliance is not secured after all means to secure compliance have been 
exhausted, the commission may, by majority vote, initiate legal action in the United 
• Page 16 - 131LR2722(02) 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" ft" to H.P. 1305, L.D. 2043 
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 rules and bylaws. 
The relief sought may include both injunctive relief and damages.· If judicial 
enforcement is necessary, the prevailing party must be awarded all costs of such 
litigation, including reasonable attorney's fees. 
C. The remedies in this subsection are not the exclusive remedies of the commission. 
The commission may pursue any other remedies available under federal or state law. 
11. Legal action against commission. 
Legal action against the commission is 
governed by this subsection. 
A. 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 its· rules. The relief sought may include both injunctive relief and 
damages. If judicial enforcement is necessary, the prevailing party must be awarded all 
costs of such litigation, including reasonable attorney's fees. 
B. A person other than a participating state may not enforce this compact against the 
commission. 
§18541. 
Date of implementation of compact; commission and associated rules, 
withdrawal and amendment 
1. Effective date. The compact takes effect on the date on which the compact statute 
is enacted into law in the 7th pa1ticipating state. 
A. On or after the effective date of the compact, the commission shall convene and 
review the enactment of each of the states that enacted the compact prior to the 
commission convening, refe1Ted to in this subsection as 
11a charter participating state," 
to determine whether the statute enacted by each charter participating state is materially 
different from the model compact. 
(1) A charter participating state whose enactment is found to be materially different 
from the model compact is entitled to the default process set forth in section 18540, 
subsection 2. 
(2) If a participating state later withdraws from the compact or its participation is 
terminated, the commission remains in existence and the compact remains in effect 
even if the number of pa1ticipating states is less than 7. Participating states enacting 
the compact subsequent to the commission convening are subject to the process set 
forth in section 18537. subsection 3, paragraph U to determine whether their 
enactments are materially different from the model compact and whether they 
qualify for participation in the compact. 
B. Participating states enacting the compact subsequent to the 7 initial charter 
pa1ticipating states are subject to the process set forth in section 18537, subsection 3, 
paragraph U to determine whether their enactments are materially different from the 
model compact and whether they qualify for participation in the compact. 
C. 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 
• Page 17 - 131LR2722(02) 
COMMITTEE AMENDMENT 
/4 
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COMMITTEE AMENDMENT "A-" to H.P. 1305, L.D. 2043 
commission coming into existence must be considered to be actions of the commission 
unless specifically repudiated by the commission. 
2. Subsequent participating states, A state that joins the compact subsequent to the 
commission's initial adoption of rules is subject to the rules as they exist on the date on 
which the compact becomes law in that state. A rule that has been previously adopted by 
the commission has the full force and effect of law on the date the compact becomes law 
in that state. 
3, Withdrawal. • A participating state may withdraw from this compact by enacting a 
statute repealing the compact. 
A. A participating state's withdrawal does 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 remain in effect. If a 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 pa1ticipating states 
are not affected by the passage of the 180 days. 
B. Withdrawal does 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. 
C. Upon the enactment of a statute withdrawing a state from this compact. that state 
shall immediately provide notice of the withdrawal to all licensees within that state. 
The withdrawing state shall continue to recognize all licenses granted pursuant to this 
compact for a minimum of 180 days after the date of the notice of withdrawal. 
4. Other agreements or arrangements. Nothing contained in this compact may be 
construed to invalidate or prevent any physician assistant licensure agreement or other 
cooperative arrangement between participating states or between a participating state and 
a nonparticipating state that does not conflict with the provisions of this compact. 
5, Amendment. This compact may be amended by the participating states. An 
amendment to this compact does not become effective and binding upon any participating 
state until it is enacted into the laws of all participating states as determined by the 
commission. 
§18542. Construction and severability 
1. Construction. This compact and the commission's rule-making authority must be 
liberally construed so as to effectuate the purposes of the compact. Provisions of the 
compact expressly authorizing or requiring the promulgation of rules may not be construed 
to limit the commission's rule-making authority solely for those purposes. 
2, Severability. The provisions of this compact are 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. a state seeking participation in the 
compact or the United States, or the applicability of a phrase, clause, sentence or provision 
of this compact 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 of the compact to any other government, agency, person or 
circumstance may not be affected. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A-'' to H.P. 1305, L.D. 2043 
3, Denial of participation. Notwithstanding subsections 1 and 2. the commission 
may deny a state's participation in the compact or. in accordance with the requirements of 
section 18540. 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 is held to be contraty to the constitution of any participating 
state, the compact remains 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. 
§18543, Binding effect of compact and other laws 
1. Enforcement, Nothing in this chapter prevents the enforcement of any other law 
of a participating state that is not inconsistent with the compact. 
2. 
Conflict, Any laws in a participating state in conflict with the compact are 
superseded to the extent of the conflict. 
3. Binding agreements. All permissible agreements between the commission and the 
participating states are binding in accordance with their terms. 
§18544. Legislative intent 
This compact is the Maine enactment of the Physician Assistants Li censure Compact. 
The form, format and text of the compact have been changed minimally so as to conform 
to Maine statutory conventions. The changes are technical in nature and it is the intent of 
the Legislature that this compact be interpreted as substantively the same as the compact 
that is enacted by other participating states. 
Sec. 2. 
Appropriations and allocations. The following appropriations and 
allocations are made. 
PROFESSIONAL AND FINANCIAL REGULATION, DEPARTMENT OF 
Administrative Services - Professional and Financial Regulation 0094 
Initiative: Allocates one-time funds for the STA-CAP and technology costs associated with 
implementing the compact for licensing physician assistants. 
OTHERSPECIALREVENUEFUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Licensure in Medicine - Board of 0376 
$0 
2024-25 
$106,350 
$106,350 
Initiative: Allocates funds for one Comprehensive Health Planner II position and related 
All Other costs to rp.anage increased responsibilities including application review for 
compact privilege, compact compliance, compact reporting, joint investigations and 
discipline reporting. 
OTHER SPECIAL REVENUE FUNDS 
POSITIONS - LEGISLATIVE COUNT 
Personal Services 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
2023-24 
0.000 
$0 
$0 
$0 
COMMITTEE AMENDMENT 
2024-25 
1.000 
$95,584 
$11,072 
$106,656 
··-"' 
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COMMITTEE AMENDMENT".(\" to H.P. 1305, L.D. 2043 
Licensure in Medicine - Board of 0376 
Initiative: Allocates _funds for the STA-CAP and rule-making costs associated with 
implementing the compact for licensing physician assistants. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Osteopathic Licenslire - Board of 0383 
2023-24 
$0 
$0 
2024-25 
$2,660 
$2,660 
Initiative: Allocates funds for the STA-CAP and rule-making costs associate_d with 
implementing the compact for licensing physician assistants. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
PROFESSIONAL AND FINANCIAL 
REGULATION, DEPARTMENT OF 
DEPARTMENT TOTALS 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
2023-24 
$0 
$0 
2023-24 
$0 
$0 
$1,962 
2024-25 
$217,628 
$217,628 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section 
number to read consecutively. 
SUMMARY 
This amendment replaces the bill, which is a concept draft. The amendment enacts the 
Physician Assistants. Licensure Compact, which provides a mechanism to facilitate 
interstate practice by licensed physician assistants in order to improve public access to the 
services of physician assistants. The form, format and text of the Physician Assistants 
Licensure Compact have been changed minimally so as to conform to Maine statutory 
conventions. The changes are technical in nature and it is the intent of the Legislature that 
this compact be interpreted as substantively the same as the Physician Assistants Licensure 
Compact that is enac~ed by other participating states. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/06/24 :t:Pac:. 
LD 2043 
LR 2722(02) 
An Act to Add the State of Maine to the Compact for Licensing Physician Assistants 
Fiscal Note for Bill as Amended by Committee Amendment Jt' {1--t-~) 
Committee: Health Coverage, Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Possible future fee increase - Other Special Revenue Funds 
'.ppropria tions1 AII.oca tion.s 
0th.er Special Revenue Funds 
Fiscal Detail and Notes 
FY2023-24 
$0 
$217,628 
Projections 
FY 2025-26 
$123,257 
Projections 
FY 2026-27 
$126,425 
This legislation adds the State of Maine to the Compact for Licensing Physician Assistants contingent upon 7 states 
ehacting it into law. According to information provided by the Department of Professional and Financial Regulation 
(DPFR), there are 3 states that have enacted it and at least 12 states that have legislation pending. This fiscal note 
assumes that at least 7 states will enact the compact and it will become effective during the 2024-25 fiscal year. 
Given this assumptioni this bill includes ongoing Other Special Revenue. Funds allocations totaling $217,628 in fiscal 
year 2024-25 to DPFR and the affected affiliated boards to join and participate in the physician assistants compact. 
Of that amount, $109,316 is allocated to the Board of Li censure in Medicine for rulemaking costs and for one 
Comprehensive Health Planner II position and related All Other costs to manage the increase in responsibilities of the 
board, including the review of applications for compact privilege, compact compliance, joint investigations and 
reporting req1.1irements. $1,962 is allocated to the Board of Osteopathic Li censure for its share of the rulemaking 
costs. Fin~lly, $106,350 is allocated on a one-time basis to the Administrative Services - Professional and Financial 
Regulation program within DPFR. Of this amount, $7,350 is for STA-CAP and $99,000 is for technology costs that 
are reimbursed by transfers from the 2 boards. 
The impact on the dedicated revenue received by each board cannot be detem1ined at this time, To the extent that 
either board cannot support the additional costs associated with this bill within the amount of revenue currently 
received, fees may need to be increased. 
LR2722(02) - Fiscal Note - Page 1 of 1