A BILL for an Act to create and enact chapter 43-17.5 of the North Dakota Century Code, relating to the physician assistant licensure compact.
SB 2108 would create a new chapter in the North Dakota Century Code to join the Physician Assistant Licensure Compact. The compact is designed to improve access to medical services by allowing physician assistants who hold an unrestricted qualifying license in one participating state to obtain a “compact privilege” to practice in other participating states, subject to each remote state’s laws, jurisprudence requirements, and controlled-substance prescribing rules. The bill also establishes the legal framework for interstate recognition of licensure, including eligibility standards, background checks, reporting obligations, and procedures for maintaining or losing compact privileges.
The bill creates a multi-state governance structure, the Physician Assistant Licensure Compact Commission, with authority to adopt binding rules, maintain a shared data system, collect fees and assessments, coordinate investigations, and resolve disputes among states. It also sets out detailed provisions on adverse actions, joint investigations, confidentiality, rulemaking, enforcement, withdrawal, and termination. The compact would not change malpractice law or professional liability rules, which remain governed by state law, but it would supersede conflicting state laws to the extent necessary to implement the compact.
If enacted, SB 2108 would add a new compact-based licensing chapter to state law and require North Dakota’s physician assistant licensing system to participate in interstate data sharing, complaint handling, adverse-action reporting, and criminal background check procedures. It would also authorize North Dakota physician assistants meeting compact requirements to seek practice privileges in other participating states, while allowing out-of-state compact licensees to practice in North Dakota under the compact privilege. The bill would affect physician assistants, state licensing boards, and the state’s regulatory relationship with the national compact commission, including potential fees, rule compliance, and enforcement obligations.
The bill appears to have been presented as a professional licensure modernization and access-to-care measure, with the text emphasizing portability of licenses, patient safety, and reduced burdens for military families. However, the recorded vote shows strong opposition in the Senate, with 0 yeas and 47 nays on second reading, and the bill ultimately failed. No committee transcripts were provided, so the available record shows legislative rejection rather than a divided committee debate.
The main points of contention likely centered on interstate control and regulatory authority. The compact gives a national commission power to adopt rules with the force of law, share investigative information, and influence state licensing decisions, which can raise concerns about state sovereignty and the extent to which North Dakota would cede control over physician assistant regulation. Other likely concerns include data sharing, enforcement across state lines, fees and assessments, and whether the compact’s benefits for workforce mobility justify the administrative and legal commitments. The vote suggests these concerns outweighed support for the access and portability goals.