Senate committee substitute to the 1st edition makes the following changes.

Amends GS 90-270.208, which provides for Physician Assistant (PA) Licensure Compact Commission (Commission) rulemaking procedures and effect, to stipulate that Rules of the Commission cannot modify or expand, in any way, the scope of practice of a PA as established by the laws of the Participating State.

Adds a $140 annual registration fee for those persons now required to register under GS 90-13.2 with a $25 fee if the person fails to register, payable to the NC Medical Board (Board). Imposes an initial PA licensure or privilege fee of $230 under GS 90-13.1 (license fees). Expands the definitions of license and licensee in GS 90-1.1 to include a physician assistant compact privilege and physician assistant compact privileges issued to a holder of a qualifying license in a qualifying state, respectively. Expands the Board’s powers to include implementing the Physician Assistant Licensure Compact, including issuing compact privileges, and appointing a delegate to serve on the Commission, as described. Makes conforming change to GS 90-11 (criminal background checks) to account for privilege holder applicants. Expands the Board’s disciplinary authority to include violations of the PA Licensure Compact, consistent with the provisions of the compact for compact privilege holders.

Changes the act's effective date to nine months after it becomes law (was, effective when the act becomes law).