All Roll Calls
Yes: 106 • No: 12
South DakotaHB 1146101st South Dakota Legislature (2026)House
adopt the physician assistant licensure compact.
Sponsored By: Davis, Sydney (Republican), Rehfeldt, Taylor (Republican)
Signed by Governor
CompactsHealth CareProfessions and Occupations
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Bill Overview
Analyzed Economic Effects
7 provisions identified: 0 benefits, 1 costs, 6 mixed.
Physician assistants and states face compact fees
Participating states can charge physician assistants for permission to practice through the compact. The Commission can charge assistants fees and assess states annually when other revenue cannot cover its approved annual budget. Commission rules set fee amounts and each state's share; the law states no dollar amounts. Assistants changing their designated participating state must pay any required fee. States can recover investigation costs when state law allows, and the Commission must secure funds before taking on obligations.
Compact staff gain limited lawsuit protection
Commission members, officers, staff, and representatives receive protection from civil lawsuits for covered actions within their Commission duties. The Commission must defend them and cover qualifying claims, settlements, and judgments. Protection also covers actions reasonably believed to fall within those duties, but excludes intentional, willful, or wanton misconduct. These protections do not reduce a physician assistant's liability for professional malpractice.
Compact states share binding physician assistant rules
The law establishes a shared Commission; the compact takes effect upon enactment by a seventh participating state. South Dakota's enactment alone does not establish that this threshold has been reached. Each state gets one voting delegate, and joining states must follow existing Commission rules and bylaws. Commission rules have legal force, but courts can block conflicts with state laws defining physician assistants' permitted medical services. A majority of participating-state legislatures can reject a rule within four years, ending it throughout the compact. Compact amendments bind states only after all participating states enact materially the same changes.
Physician assistant records shared with privacy safeguards
The Commission must run a shared system for identification, licenses, discipline, application denials, and significant investigation information. States must submit required records, and the Commission must quickly alert participating states about reported discipline. Significant investigation information is available only to participating states; other records can be kept nonpublic when law allows. Privacy designations do not excuse reporting, but denial reports exclude criminal history when law bars sharing it. The Commission must remove information expunged under federal or the submitting state's law once that state reports the expungement. Commission-certified records count as authenticated business records and receive applicable hearsay exceptions in court and administrative proceedings.
Physician assistants face coordinated safety oversight
South Dakota must maintain licensing, complaint investigations, shared reporting, and a recognized national exam requirement for physician assistants. Commission rules set the deadline for criminal background checks. South Dakota can discipline practice permission within the state, with existing due-process protections; only the issuing state controls the qualifying license. Discipline against that license shuts off compact permissions everywhere else until all restrictions end and two more years pass. States must report discipline promptly; assistants must report discipline from nonparticipating states to the Commission within 30 days. States can share investigations and enforce subpoenas where evidence is located, but cannot use them to investigate protected lawful out-of-state conduct.
Physician assistants gain cross-state practice with limits
South Dakota joins a compact that lets eligible physician assistants get permission to practice in other participating states. Assistants need an unrestricted qualifying license, an accredited or Commission-approved education, and current national certification. They must have no felony or misdemeanor conviction, current license discipline, or suspended or revoked controlled-substance license or registration. They need a Commission identifier, must notify the Commission, and must meet the other state's legal-knowledge, prescribing, and fee requirements. Restrictions caused by discipline generally require a two-year wait after they end. Practice permission expires with the qualifying license; switching licenses early requires another participating-state qualifying license and notice to the Commission.
Physician assistants get time after states leave
A state's voluntary withdrawal takes effect 180 days after it enacts a repeal law. It must keep recognizing compact practice rights for at least 180 days after notice of withdrawal. When the Commission terminates a state's participation, existing permissions to practice there last 180 days after termination takes effect. Assistants licensed through the terminated state also keep permissions elsewhere for 180 days. Those permissions continue with an existing or newly obtained qualifying license in a participating state before the deadline. After voluntary withdrawal, keeping permissions elsewhere likewise requires a license in another participating state within the 180-day period.
Sponsors & Cosponsors
Sponsors
Davis, Sydney
Republican • Senate
Rehfeldt, Taylor
Republican • House
Cosponsors
Emery, Eric
Democratic • House
Goodwin, Tim
Republican • House
Healy, Erin
Democratic • House
Hulse, Amber
Republican • Senate
Muckey, Erik
Democratic • House
Perry, Carl
Republican • Senate
Roby, Matt
Republican • House
Rohl, Michael H.
Republican • Senate
Uhre-Balk, Nicole
Democratic • House
Walburg, Tim
Republican • House
Roll Call Votes
Senate vote • 2/25/2026
Do Pass Amended
Yes: 32 • No: 1
Senate vote • 2/23/2026
Do Pass
Yes: 7 • No: 0
House vote • 2/17/2026
Do Pass Amended
Yes: 56 • No: 10
House vote • 2/10/2026
Do Pass Amended
Yes: 11 • No: 1
Actions Timeline
Signed by the Governor
3/9/2026HouseDelivered to the Governor
3/3/2026HouseSigned by the President
3/2/2026SenateSigned by the Speaker
2/26/2026HouseSenate Do Pass Amended, Passed, YEAS 32, NAYS 1
2/25/2026SenateSenate Deferred to another day, Passed
2/24/2026SenateCertified uncontested, placed on consent
2/23/2026SenateSenate Health and Human Services Do Pass, Passed, YEAS 7, NAYS 0
2/23/2026SenateScheduled for hearing
2/23/2026SenateFirst read in Senate and referred to Senate Health and Human Services
2/18/2026SenateHouse of Representatives Do Pass Amended, Passed, YEAS 56, NAYS 10
2/17/2026HouseHouse of Representatives Deferred to another day, Passed
2/12/2026HouseHouse Health and Human Services Do Pass Amended, Passed, YEAS 11, NAYS 1
2/10/2026HouseHouse Health and Human Services Motion to amend, Passed
2/10/2026HouseFirst read in House and referred to House Health and Human Services
1/27/2026House
Bill Text
Introduced
1/26/2026
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