Alabama adopts interstate license rules for physician assistants

The compact would let a physician assistant use a compact privilege to practice in another participating state. The privilege covers physician assistants who hold an unrestricted license from a participating state and provide care to patients located in another participating state. The physician assistant must meet the compact's eligibility rules and the remote state's laws. The remote state may charge a fee and may require completion of its legal or professional knowledge requirement. The compact privilege does not replace a separate state license when state law requires one. The compact takes effect when its law is enacted by the seventh participating state, and this act states that Alabama law takes effect October 1, 2026.

A physician assistant seeking a compact privilege would have to meet education, certification, licensing, criminal-history, and conduct requirements. The requirements apply to physician assistants seeking or maintaining a compact privilege, including those who want authority to prescribe controlled substances in another state. Applicants must hold a qualifying license, current national certification, and a required identifier. Applicants generally may not have felony or misdemeanor convictions, certain controlled-substance license problems, or current license restrictions caused by adverse action. A license restriction generally must have ended for two years before the person can regain a compact privilege. The physician assistant must report adverse action by a nonparticipating state within 30 days and meet each remote state's controlled-substance requirements. A compact privilege lasts until the qualifying license expires or is revoked, unless an adverse action ends it sooner; restoration after a qualifying license restriction requires two years after restrictions are removed.

The compact would establish a national commission to manage rules, fees, shared licensing information, and enforcement among participating states. Participating state licensing boards would report licenses, denials, adverse actions, and significant investigation information to the commission's data system. The commission may charge privilege fees and assess participating states to cover its operating costs. Remote states may discipline a compact privilege and may investigate through subpoenas and joint investigations, subject to due-process rules. The commission's rules generally have the force of law in participating states, but they cannot override conflicting laws about services physician assistants may perform. The commission may terminate a state's participation after notice and other compliance steps if the state fails to meet compact duties. The commission comes into existence when the compact becomes effective in the seventh participating state; commission rules take effect on dates the commission sets, subject to the compact's rulemaking procedures.