Update Applicable to:	Effective Date
All Covered Healthcare Provider	July 1, 2025: Law enacted   October 1, 2025 – January 1, 2026: Most provisions take effect   April 1, 2026 – June 30, 2026: Remaining provisions phased in

What happened?

On July 1, 2025, Governor Josh Stein signed House Bill 67 into law, enacting Session Law 2025-37, a comprehensive healthcare workforce reform package, introducing major changes to licensing, practice authority, and workforce development across multiple healthcare professions in North Carolina.

Overview:

The law aims to address provider shortages, improve access to care, and modernize outdated regulations.

1. Interstate Medical Licensure Compact (IMLC) – (Effective Date: January 1, 2026)

• Allows eligible physicians to apply for expedited licensure in North Carolina and other compact states.
• Traditional licensure remains available.

2. Internationally-Trained Physician Employee (ITPE) License – (Effective Date: January 1, 2026)

• Creates a limited license for foreign-trained physicians with job offers in NC hospitals or rural clinics.
• Requires 130 weeks of medical education, postgraduate training or 10 years of practice, and a clean legal and professional record.
• Eligible for full licensure after four years.

3. Physician Assistant (PA) Licensure Compact – (Effective Date: April 1, 2026)

• Enables multistate practice for PAs while requiring compliance with local laws.
• Aims to expand access to care, especially in underserved areas.

4. Team-Based Practice for Physician Assistants – (Effective Date: Upon NCMB rule adoption or June 30, 2026)

• Removes the requirement for experienced PAs (4,000+ clinical hours, 1,000+ in specialty) to have a specific supervisory relationship in team-based settings.
• Introduces a supervised entry period and training requirements for new graduates and those changing specialties.

5. Clinical Pharmacist Practitioners (CPPs) – (Effective Date: October 1, 2025)

• Expands CPPs’ authority to provide delegated medical services under collaborative agreements with physicians.
• Requires a site-specific supervising physician and periodic performance reviews.

6. Pharmacist Test and Treat – (Effective Date: October 1, 2025)

• Authorizes pharmacists to perform CLIA-waived tests (e.g., for influenza) and initiate treatment understanding orders.
• Requires rulemaking and mandates insurance coverage for pharmacist-provided services.

7. Master’s-Level Psychologist Reforms – (Effective Date: January 1, 2026)

• Allows Licensed Psychological Associates (LPAs) to practice independently after 4,000 hours of supervised experience.
• Expands scope in neuropsychology and forensic psychology with proper training.

8. Behavioral Health Workforce Enhancement – (Effective Date: January 1, 2026)

• Expands qualifications for Associate and Qualified Professionals to include community college graduates with relevant experience.
• Aims to strengthen the behavioral health workforce.

9. Marriage and Family Therapy Licensure – (Effective Date: October 1, 2025)

• Reduces reciprocity requirements from five to two years of active licensure.
• Accepts California’s clinical exam as equivalent.

10. Surgical Smoke Evacuation – (Effective Date: January 1, 2026)

• Requires hospitals and ambulatory surgical centers to use smoke evacuation systems during procedures that generate surgical smoke.

Source References

• North Carolina HB 67 – Healthcare Workforce Reforms

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