Gov. Ivey signs bill allowing Alabama to join PA licensure compact

Last week, Governor Kay Ivey signed legislation that sets Alabama to join a growing number of states participating in the Physician Assistant Licensure Compact under House Bill 156, sponsored by Representative Paul Lee, R-Dothan.

Supporters say the measure will expand access to care by making it easier for physician assistants to practice across state lines. The legislation allows Alabama to enter the interstate compact, which streamlines the process for licensed physician associates, or PAs, to obtain authorization to practice in other participating states without completing a full, duplicative licensure process each time.

Bonnie Minton, president of the Alabama Society of Physician Assistants, said the bill addresses administrative hurdles that can delay care.

“Currently, a PA who is licensed in one state must go through an oftentimes duplicative, time-consuming licensure process to be able to practice in another state,” Minton said. “That not only limits workforce mobility but also makes it harder to respond quickly to patient needs—particularly in rural and underserved areas of the state.”

Alabama has more than 1,400 practicing PAs. Under the compact, PAs licensed in member states will be able to apply for practice privileges in other compact states through a centralized system, while still maintaining their primary state license.

Minton said workforce flexibility is especially important as Alabama faces ongoing provider shortages. Access to health care consistently ranks among residents’ top concerns, she said, and joining the compact is one way to help address that gap.

Nearly half of the states, 24 in total, have adopted the Physician Assistant Licensure Compact, including neighboring Tennessee. Additional states are considering legislation this year.

Minton said the broader push for interstate compacts gained momentum following the COVID-19 pandemic, when states temporarily eased licensing restrictions to respond to urgent health care demands.

If implemented, the compact could allow Alabama health systems to more quickly recruit PAs to fill staffing gaps, whether in person or through telehealth. 

“For patients, this could mean shorter wait times, more consistent access to providers, and expanded access to quality care,” said Minton.

Joining the compact could also make Alabama more attractive to out-of-state PAs while giving Alabama-based providers more flexibility to practice elsewhere if needed.

“With patient needs always shifting, workforce shortages fluctuating, and care delivery models continuing to evolve, Alabama needs policies that allow providers to move more easily across state lines and help ensure that the state’s healthcare system can adapt,” said Minton.

Before Alabama PAs can begin using the compact, additional infrastructure must be completed at the national level. The Physician Assistant Compact Commission, composed of delegates from each participating state, is developing a shared database that will allow PAs to apply for multistate practice privileges and enable states to exchange licensure and disciplinary information.

Minton said the commission anticipates the system will be operational in early to mid-2027.

She emphasized that the compact includes safeguards to maintain professional standards. The multistate data system is designed to enhance public protection by facilitating the sharing of licensure and disciplinary information among compact states.

“At its core, the PA Licensure Compact is about patient access to care,” said Minton. “The compact allows PAs to spend more time doing what we are trained to do—caring for patients—and less time burdened by duplicative licensing procedures.”

With HB156, Alabama joins a national effort to modernize health care professional licensing, hoping to make its workforce more mobile and responsive to patient needs.