House committee substitute to the 2nd edition makes the following changes.

Amends GS 90-13.1 by no longer increasing the licensing fees for applicants for a license to practice medicine and surgery, applicants for a limited license to practice in a medical education and training program, and initial and annual licensure of an anesthesiologist assistant. Also removes the proposed fee for the initial licensure of a physician assistant. Changes the amount of the cap on the proposed application fees for physicians applying for licensure by from $825 to $500, anesthesiologist assistants applying for licensure by endorsement from $300 to $250, and physician assistants applying for licensure by endorsement from $500 to $330.

Removes the proposed changes to GS 90-13.2, registration every year with NC Medical Board (Board).

Removes the proposed changes to GS 90-689, which increased the specified licensing and application fees.

Changes the effective date of new GS 90-12.2B (licensure by endorsement) and the changes to GS 90-13.1, so that they are now effective January 1, 2026 (was, October 1, 2025).

Amends GS 90-16 by adding the Office of the State Auditor to the list of entities to whom all of the listed types of confidential records and documents may be released.