As Maine Goes, So Goes Massachusetts?

by Nada Hassanein, Stateline

April 13, 2026

Alabama, Maine and Virginia recently adopted policies that make it easier for physician assistants to practice and serve more patients.

Alabama became the 24th state to adopt the PA Licensure Compact, an agreement between states that authorizes these clinicians to practice across state lines. The compact can help remove administrative barriers for physician assistants, making it easier for them to fill gaps in rural and underserved communities that don’t have enough primary care medical professionals, advocates say.

Alabama has about 1,400 physician assistants. The legislation, sponsored by Republican state Rep. Paul Lee, received unanimous support in both the House and Senate.

Ten states — Alaska, Hawaii, Illinois, Massachusetts, Michigan, Missouri, New Hampshire, New York, Pennsylvania and Rhode Island — have pending legislation that would allow them to join the compact, according to the American Academy of Physician Associates.

States are making it easier for physician assistants to work across state lines

Virginia enacted a law last week to allow physician assistants with three years of full-time clinical experience to practice without a physician practice agreement.

Earlier this month, Maine Democratic Gov. Janet Mills signed legislation that updates state policies to remove the requirement for PAs to consult with and have practice agreements with physicians. The state has about 1,100 PAs.

The American Medical Association, which represents physicians, opposes such laws. The group’s policy stance is that PAs should practice under the direction and supervision of a physician.

Maine joined seven other states to remove the requirement for a supervisory agreement, according to the American Academy of Physician Associates: Iowa, Montana, New Hampshire, North Dakota, South Dakota, Utah and Wyoming,

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

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Nada Hassanein is a health care reporter for Stateline with a focus on inequities.

Stateline is part of States Newsroom, the nation’s largest state-focused nonprofit news organization.

{IMAGE: From website of American Academy of Physician Associates]