Committee hears push to join PA licensure compact tied to $204M rural health grant
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Summary
Supporters told lawmakers that joining the multistate physician assistant compact would speed licensure portability, help recruit PAs to rural New Hampshire and was a stated commitment in the state's $204 million CMS rural health transformation grant; officials flagged implementation work and an early 2027 operational timeline for the compact.
Senate Bill 425 would have New Hampshire join the multistate Physician Assistant (PA) Licensure Compact. Senator David Rochefort told the House Executive Departments and Administration committee on April 1 that adopting the compact would streamline licensure for PAs, preserve state scope of practice, and help recruit and retain clinicians in underserved rural areas.
Michael Bartlett of the American Academy of PAs described the compact’s mutual‑recognition model: a PA licensed in a compact member state obtains a compact privilege enabling practice in other member states without separate full licensure, while continuing to follow the laws and practice rules of the remote state. Bartlett said 24 states have enacted the compact and that it preserves state authority over scope and discipline while enabling a shared disciplinary data system and faster privileges.
Patricia Tilly and David Chorney from DHHS and the governor’s Go North office said joining the compact supported New Hampshire’s rural health transformation plan and helped secure enhanced federal funding: "New Hampshire received $204,000,000 in the grant," Chorney said, noting that states that committed to policies such as joining the PA compact received extra scoring weight in CMS’s evaluation. DHHS officials argued compact membership would help bring PAs into shortage areas, expand telehealth options, and speed recruiter pipelines.
Deidre (executive director, OPLC) explained operational differences between existing reciprocity and a compact privilege: reciprocity issues a New Hampshire license; a compact privilege is issued by a PA’s home state and allows portability across members while preserving continuing‑education and discipline processes. OPLC noted operational costs (IT setup estimated roughly $100,000–$500,000) and that the compact’s national commission was still operationalizing rules and databases, with a projected 2027 start for compact privileges. OPLC also flagged that the compact’s text restricts compact privileges for applicants with certain felony or misdemeanor convictions.
Committee members asked whether the compact would erode state control and how differences in state supervision or scope would be handled; supporters said PAs must comply with the laws of the state where they practice and that the compact reduces administrative friction without altering state law. The committee closed the hearing after questions and requested follow‑up materials on operational timelines and on the rural health grant commitments tied to the compact pledge.
