A buried provision in HB156 shifts how out-of-state PAs can practice in Alabama—and it affects how you hire and credential them.
Most Alabama business owners who employ or contract with physician assistants have never heard of the interstate PA compact. But starting October 1, 2026, it could change how you credential and manage those hires.
Here's what's happening: Alabama passed HB156, which establishes an interstate licensure compact for physician assistants. Buried in that bill is a provision that lets out-of-state PAs practice in Alabama under a "compact privilege" instead of obtaining a traditional Alabama license.
Until now, if you hired a PA licensed in Georgia or Tennessee, that person had to get an Alabama license from the Alabama Board of Medical Examiners—and pay Alabama's licensing fee. That was the only way they could legally practice here.
Under the compact, starting October 1, 2026, an out-of-state PA can instead use a "compact privilege." Think of it as a credential tied to their home-state license. They don't need to apply for or pay Alabama's separate license fee. They can practice in Alabama as long as they maintain their home-state license and meet compact requirements.
For your business, this means:
Faster hiring. You may be able to bring on out-of-state PAs more quickly, since they skip the Alabama Board application process.
Lower credentialing costs. No Alabama license fee for compact-privileged PAs—though you'll still need to verify their credentials and maintain your own compliance.
New tracking requirements. You'll need to understand which PAs are licensed traditionally (old way) versus operating under compact privilege (new way), since they have different oversight structures.
If you run a clinic, urgent care center, or any healthcare business that employs or contracts with PAs, this applies to you. It's especially relevant if you hire from neighboring states or use locum tenens (temporary) PAs.
The Alabama Board of Medical Examiners will oversee the compact framework, but the practical change happens at your credentialing desk.
HB156 takes effect October 1, 2026. That gives you roughly a year to understand how the compact works and how it might affect your hiring and credentialing processes. The compact privilege provision is detailed in Section 14 of the bill (Page 37) and referenced in the Fiscal Note (Page 1).
Start conversations with your HR and compliance teams about the difference between traditional Alabama licensure and compact privilege. When you're recruiting or credentialing PAs in 2026 and beyond, ask whether they'll be using compact privilege or seeking an Alabama license—it affects your paperwork and timelines.
If you work with a credentialing service or legal advisor, flag this change for their attention. The Alabama Board of Medical Examiners will issue guidance as the October 2026 date approaches.
For a more detailed, business-specific breakdown of how this affects your operations, credentialing workflows, and hiring timeline, a free resource guide is available through most Alabama healthcare and trades associations.
Source: HB156, Section 14 (Page 37); Fiscal Note (Page 1). Effective October 1, 2026.