AN ACT to make modifications to the laws pertaining to the north carolina medical board.

The General Assembly of North Carolina enacts:

SECTION 1.  Article 1 of Chapter 90 of the General Statutes is amended by adding a new section to read:

§ 90‑12.2B.  Licensure by endorsement.

(a)        The Board may issue a license as a physician, physician assistant, or anesthesiologist assistant in North Carolina to an applicant who submits an application for licensure by endorsement to the Board and satisfies all of the following, as applicable to the applicant's licensure:

(1)        Has held an active, full, and unrestricted license in at least one other United States jurisdiction, including any state, territory, or district, for at least five years. Physicians applying for a license to practice medicine must have practiced with an active, full, and unrestricted license for at least two years after completing training after graduating from medical school in a residency program approved by any of the following:

a.         The Accreditation Council for Graduate Medical Education.

b.         The American Osteopathic Association.

c.         The Royal College of Physicians and Surgeons of Canada.

d.         The College of Family Physicians of Canada.

(2)        An employer submits a letter to the Board verifying that the applicant has accepted an offer of full‑time employment to practice consistent with the applicant's respective licensure in person at a physical location in this State rendering care to individuals in this State.

(3)        Provides to the Board sufficient proof of identification, including the applicant's social security number, certified or official copy of birth certificate, copy of drivers license, United States passport, or other government‑issued identification. The applicant shall include documentation of any legal name change.

(4)        Provides an attestation that the applicant meets all of the following:

a.         Is in good standing in all jurisdictions of licensure where the applicant holds an active license, has not been disciplined in the last five years by any occupational licensing board preceding the application by endorsement, and has no pending investigations by any occupational licensing board.

b.         Is not the subject to any adverse action taken by any regulatory board or agency overseeing the applicant's respective licensure in the last five years preceding the application for licensure by endorsement.

c.         Has actively practiced as a physician, physician assistant, or anesthesiologist assistant for an average of 20 hours or more per week during the two years immediately preceding the application for licensure by endorsement.

d.         Has no misdemeanor or felony convictions in the last five years preceding the application for licensure by endorsement.

e.         Meets the licensure requirements of physicians under G.S. 90‑9.1 or G.S. 90‑9.2, physician assistants under G.S. 90‑9.3, or anesthesiologist assistants under G.S. 90‑9.4.

f.          Meets the examination requirements of G.S. 90‑10.1 for physician licensure.

g.         Is able to satisfy all licensing requirements of any applicable Board rule, including 21 NCAC 32B .1303, 21 NCAC 32S .0202, and 21 NCAC 32W .0103, as amended, for physicians, physician assistants, and anesthesiologist assistants, respectively.

(b)        Licensees who have received a licensure in accordance with subsection (a) of this section shall submit to the Board any additional licensure information for a license as required by any applicable Board rule, including 21 NCAC 32B .1303, as amended, within 120 days of receipt of licensure by endorsement under this section. Failure to provide the necessary information under this section shall constitute a basis for the Board to investigate that failure and take appropriate action. The Board has the authority to investigate and take appropriate action against an applicant or licensee who applied for or received licensure by endorsement under this section. The Board shall retain jurisdiction over the holder of any inactive license issued by the Board.

(c)        A license issued under this section shall become inactive after 180 days unless the applicant meets all of the requirements of subsection (b) of this section.

(d)       An applicant for licensure by endorsement shall pay the applicable license fees under G.S. 90‑13.1 and applicable criminal background check fees under G.S. 90‑11.

SECTION 2.  G.S. 90‑13.1 reads as rewritten:

§ 90‑13.1.  License fees.

(a)        Each applicant for a license to practice medicine and surgery in this State under G.S. 90‑9.1, 90‑9.2, or 90‑12.02 shall pay to the North Carolina Medical Board an application fee of four hundred dollars ($400.00).not to exceed five hundred fifty dollars ($550.00).

(a1)      Physicians applying for licensure by endorsement under G.S. 90‑12.2B shall pay to the Board an application fee not to exceed eight hundred twenty‑five dollars ($825.00).

(b)        Each applicant for a limited license to practice in a medical education and training program under G.S. 90‑12.01 shall pay to the Board a fee of one hundred dollars ($100.00).one hundred twenty‑five dollars ($125.00).

(c)        An applicant for a limited volunteer license under G.S. 90‑12.1A or G.S. 90‑12.1B shall not pay a fee.

(d)       A fee of twenty‑five dollars ($25.00) shall be paid for the issuance of a duplicate license.

(e)        All fees shall be paid in advance to the North Carolina Medical Board, to be held in a fund for the use of the Board.

(f)        For the initial and annual licensure of an anesthesiologist assistant, the Board may require the payment of a fee not to exceed one hundred fifty dollars ($150.00).two hundred dollars ($200.00).

(g)        Anesthesiologist assistants applying for licensure by endorsement under G.S. 90‑12.2B shall pay to the Board an application fee not to exceed three hundred dollars ($300.00).

(h)        For the initial licensure of a physician assistant, the Board shall require the payment of a fee not to exceed three hundred twenty‑five dollars ($325.00).

(i)         Physician assistants applying for licensure by endorsement under G.S. 90‑12.2B shall pay to the Board an application fee not to exceed five hundred dollars ($500.00).

SECTION 3.  G.S. 90‑13.2 reads as rewritten:

§ 90‑13.2.  Registration every year with Board.

(a)        Every licensee shall register annually with the Board no later than 30 days after the person's birthday.

(b)        A person who registers with the Board shall report to the Board the person's name and office and residence address and any other information required by the Board, and shall pay an annual registration fee of two hundred fifty dollars ($250.00), not to exceed three hundred fifty dollars ($350.00), except those who have a limited license to practice in a medical education and training program approved by the Board for the purpose of education or training shall pay a registration fee of one hundred twenty‑five dollars ($125.00), one hundred fifty dollars ($150.00), and those who have a retired limited volunteer license pursuant to G.S. 90‑12.1B or a limited volunteer license pursuant to G.S. 90‑12.1A shall pay no annual registration fee. However, licensees who have a limited license to practice for the purpose of education and training under G.S. 90‑12.01 shall not be required to pay more than one annual registration fee for each year of training.

(b1)      Physician assistants shall pay an annual registration fee not to exceed two hundred dollars ($200.00). A physician assistant who fails to register as required by this section shall pay an additional fee of twenty‑five dollars ($25.00) to the Board.

(c)        Repealed by Session Laws 2016‑117, s. 2(i), effective October 1, 2016.

(d)       A licensee who is not actively engaged in the performance of medical acts, tasks, or functions in North Carolina and who does not wish to register the license may direct the Board to place the license on inactive status.

(e)        A physician who fails to register as required by this section shall pay an additional fee of fifty dollars ($50.00) to the Board. The license of any physician who fails to register and who remains unregistered for a period of 30 days after certified notice of the failure is automatically inactive. The Board shall retain jurisdiction over the holder of the inactive license.

(f)        Except as provided in G.S. 90‑12.1B, a person whose license is inactive shall not practice medicine in North Carolina nor be required to pay the annual registration fee.

(g)        Upon payment of all accumulated fees and penalties, the license of the licensee may be reinstated, subject to the Board requiring the licensee to appear before the Board for an interview and to comply with other licensing requirements. The penalty may not exceed the applicable maximum fee for a license under G.S. 90‑13.1.

(h)        The Board shall not deny a licensee's annual registration based solely on the licensee's failure to become board certified.

SECTION 4.  G.S. 90‑689 reads as rewritten:

§ 90‑689.  Expenses; fees.

(a)        All fees shall be payable to the Medical Board and deposited in the name of the Medical Board in financial institutions designated by the Medical Board as official depositories. These fees shall be used to carry out the purposes of this Article.

(b)        All salaries, compensation, and expenses incurred or allowed to carry out the purposes of this Article shall be paid by the Medical Board exclusively out of the fees received by the Medical Board as authorized by this Article or funds received from other sources. In no case shall any salary, expense, or other obligation authorized by this Article be charged against the State treasury.

(c)        The Committee, upon the approval of the Medical Board, shall establish fees not exceeding the following amounts:

(1)        License application                                 $350.00$400.00

(2)        Biennial renewal of license                    $350.00$400.00

(3)        Late renewal of license                           $100.00

(4)        Provisional license                                 $175.00$200.00

(5)        Copies of rules                                            Cost.

SECTION 5.  The North Carolina Medical Board may adopt temporary rules to implement the provisions of this act.

SECTION 6.  This act becomes effective October 1, 2025.