A provision in HB1622 imposes steep penalties on medical practices that miss a state board deadline—and most owners don't know it exists.
Most North Dakota business owners don't realize that HB1622, signed into law to regulate physician assistant licensing, contains a provision that could significantly increase compliance costs for any small medical or clinical practice employing a physician assistant under the compact privilege.
Here's what changed: Section 4 of HB1622, which amends North Dakota Century Code 43-17-46 (subsection 2), introduces a penalty structure for practices that fail to meet a state board deadline. Specifically, if a practice employing a compact-privileged PA misses the State Board of Medical Examiners' addendum questionnaire deadline, the penalty fee can be up to three times the standard physician assistant licensure fee—plus additional statutory penalties.
This provision applies to any small medical or clinical practice in North Dakota that:
The compact privilege allows PAs to practice across state lines under a single license, but it comes with specific reporting and compliance requirements. Missing the addendum questionnaire deadline—a form the board uses to verify ongoing eligibility and compliance—triggers the penalty.
The financial impact is direct and recurring. Instead of paying a standard PA licensure fee once, a practice that misses the deadline faces a penalty of up to three times that amount. For a practice with multiple compact-privileged PAs, this multiplies quickly. Beyond the tripled fee, additional statutory penalties apply, compounding the cost.
More importantly, this is a compliance obligation that falls on the practice, not the individual PA. That means your administrative team needs to track the board's deadline and ensure the addendum questionnaire is submitted on time, every time. Missing it once can be costly.
HB1622 became effective upon filing with the Secretary of State (Section 6, Page 19). The penalty provision in Section 4 is already in force, so practices employing compact-privileged PAs should ensure their compliance systems are in place now.
If your practice employs a physician assistant under the compact privilege, review your administrative procedures to confirm you have a system for tracking and submitting the State Board of Medical Examiners' addendum questionnaire by the required deadline. Confirm the deadline with the board directly, and consider adding it to your compliance calendar with a buffer for submission.
The provision is buried in a bill focused on PA licensing requirements, which is why many practice owners haven't heard about it. But for those affected, it's a material compliance cost that's easy to avoid with proper planning.
For a detailed, practice-specific guide to HB1622 compliance requirements, contact your state medical association or local business resource center.