House Bill 67 / SL 2025-37
House Bill 67 is a broad health care workforce reform act that makes changes across multiple licensed professions and insurance rules in North Carolina. The bill joins North Carolina to the Interstate Medical Licensure Compact, creating a streamlined pathway for physicians to obtain licenses in multiple states while preserving state medical board authority over discipline and practice standards. It also creates a separate licensure pathway for internationally trained physicians to work in certain North Carolina hospitals and rural practices, and it establishes a new compact for physician assistants that allows qualified PAs to practice across participating states through compact privileges.
The bill also revises North Carolina psychology law by allowing certain licensed psychological associates to qualify for independent practice after meeting post-licensure experience requirements, and it updates the Psychology Board’s composition and appointment process. In addition, it expands pharmacist authority by allowing pharmacists to perform CLIA-waived influenza testing and initiate treatment under protocols, and by requiring insurers, third-party administrators, and pharmacy benefit managers to treat pharmacist-provided covered services and pharmacy-related requirements more like other covered health care services. The bill further authorizes collaborative practice arrangements for pharmacists and clarifies credentialing treatment for pharmacists employed by contracted facilities.
Beyond licensure and pharmacy changes, the act adds a hospital and ambulatory surgical facility requirement to use smoke evacuation/filtering systems during procedures likely to generate surgical smoke. It also creates a community college pathway for certain behavioral health workforce roles, allowing associate-degree holders with supervised experience to qualify as associate professionals, qualified professionals, or substance abuse prevention professionals under the relevant administrative rule framework. Finally, it revises marriage and family therapy reciprocity rules by shortening the required out-of-state practice period for reciprocal licensure and making related criminal background-check provisions apply to those applicants.
The bill’s impact on state law is substantial: it amends multiple chapters of the General Statutes, creates new interstate compacts and licensure categories, and directs several boards and agencies to adopt implementing rules. It affects the North Carolina Medical Board, Board of Pharmacy, Psychology Board, Marriage and Family Therapy Licensure Board, Department of Health and Human Services, insurers, hospitals, ambulatory surgical facilities, and health professionals seeking licensure, compact privileges, or expanded practice authority. Several provisions also preempt conflicting state law to the extent of inconsistency with the compacts or new statutory requirements.
No committee transcripts or recorded votes were provided, so there is no documented floor or committee debate to summarize. Based on the bill’s structure and final enactment, the overall sentiment appears favorable toward expanding access to care and easing workforce shortages through licensure portability, new practice pathways, and broader use of pharmacists and allied health professionals. The main likely points of contention are the scope of independent practice and reduced supervision for some professions, the creation of interstate compact authority, and the extent to which insurers and facilities must accommodate new provider roles and safety requirements.
HB67 amends numerous provisions in Chapters 90, 58, 110, and 131E of the General Statutes and creates new Articles for the Interstate Medical Licensure Compact and the PA Licensure Compact. It changes licensure, discipline, fee, background-check, and board-governance rules for physicians, physician assistants, psychologists, pharmacists, and marriage and family therapists, while also imposing new facility standards for surgical smoke evacuation and new insurance coverage and credentialing rules for pharmacist services. The bill also directs multiple boards and agencies to adopt temporary or permanent rules to implement the new statutory framework, and several compact provisions supersede conflicting state law to the extent of conflict.
The bill appears to have been received as a workforce and access-to-care measure, with its final enactment indicating broad legislative support. Its themes are expansion of licensure portability, reduced administrative barriers, and increased use of nonphysician clinicians in defined settings. Because no committee discussion or vote record was provided, there is no documented opposition or amendment debate to characterize, but the breadth of the bill suggests it was a major health workforce package rather than a narrow technical change.
The most likely areas of contention are the compact provisions and the expanded practice authority for certain professions. The physician assistant and pharmacist sections expand cross-state practice and collaborative authority, while the psychology and marriage-and-family-therapy sections loosen supervision or reciprocity requirements, which could raise concerns about patient safety, professional oversight, and board authority. The insurance provisions requiring coverage and credentialing parity for pharmacist services may also be disputed by insurers and pharmacy benefit managers. The surgical smoke mandate and the internationally trained physician pathway could likewise prompt debate over compliance costs, facility operations, and standards for verifying qualifications.