SS/HCS/HB 2974 - This act modifies provisions relating to license reciprocity, including waivers of certain requirements for reciprocity of licenses providing telehealth services, the Dietitian Licensure Compact, the Dentist and Dental Hygienist Compact, the Athletic Trainer Compact, and the PA Compact. LICENSE RECIPROCITY WAIVERS - TELEHEALTH (SECTION 324.009) Those health care providers, who hold a current license issued by another jurisdiction and are licensed in Missouri with a waiver of examination, educational, or experience requirements, shall be deemed to be fully licensed to practice within the profession's scope of practice in Missouri and may provide telehealth services to the same extent and manner as health care providers who receive a license without a waiver. This provision is identical to HCS/SS#2/SB 1233 (2026), SB 1691 (2026), provision in HCS/HB 2300 (2026), and in HCS/HB 2372 (2026). DIETITIAN LICENSURE COMPACT (SECTION 324.1800) This act establishes the Dietitian Licensure Compact ("Compact"), which facilitates the interstate practice of dietetics and authorizes dietitians licensed in a participating state to practice in other participating states. The Compact sets forth the requirements to be met in order for a state to join and the requirements for a dietitian to obtain and exercise the ability to practice in other participating states. The Compact further provides that a dietitian with compact privilege shall function within the scope of practice authorized by the participating state in which they seek to practice and shall be subject to that state's regulatory authority. A dietitian whose privilege in a participating state is encumbered or removed is not eligible for compact privilege in other participating states until the encumbrance or removal has passed and all requirements are met. Additionally, the Compact creates the Dietitian Licensure Compact Commission ("Commission"), which is a joint government agency of the participating states tasked with administering and implementing the Compact. The Compact provides for its powers and duties, including the development and maintenance of a coordinated database and reporting system containing licensure, adverse actions, and investigative information on all licensees and applicants. Each participating state shall have one Commissioner, who shall be selected within sixty days by the licensing authority of the participating state. Additionally, there shall be an Executive Committee of the Commission, composed of nine members, to act on behalf of the Commission. Upon enactment, the Compact shall be reviewed by the Commission to determine if it is materially different from the Model Compact and whether the state qualifies for participation in the Compact. Any state that adopts the Compact subsequent to the Commission’s initial adoption of the rules and bylaws shall be subject to the rules and bylaws existing on the date on which the Compact becomes law. Any participating state may withdraw from the Compact by repealing the Compact, but such withdrawal shall not take effect until 180 days after the enactment of the repeal. Finally, the Compact shall be binding upon participating states and shall supersede any conflict with state law. These provisions are identical to provisions in SCS/HB 1961 (2026), in the perfected HCS/HB 268 (2025), in HB 397 (2025), and in HB 2477 (2024) and are substantially similar to a provision in SB 1339 (2026) and in SB 412 (2025). ATHLETIC TRAINERS COMPACT (SECTION 334.730) This act establishes the Athletic Trainers Compact ("Compact"), which facilitates the interstate practice of athletic training and provides for athletic trainers licensed in a participating state the ability to practice in other participating states. The Compact sets forth the requirements to be met in order for a state to join and maintain membership in the Compact. Additionally, the Compact provides the requirements for an athletic trainer to obtain and exercise the ability to practice in the remote participating states. The Compact further provides that an athletic trainer with compact privilege shall function within the scope of practice of the state in which the patient is located and the remote practicing state. The athletic trainers also shall be subject to that remote state's regulatory authority. Participating states shall report any adverse action and significant investigative information to the Compact Data System. An adverse action against an athletic trainer in any participating state shall result in deactivation of the compact privilege during the pendency of the action. An encumbered license in a member state shall not be entitled to compact privilege until the encumbrance has passed and has exceeded two years since any encumbrance or restriction. Additionally, the Compact creates the Athletic Trainer Licensure Compact Commission ("Commission"), which is a joint government agency to administer and implement the Compact, and provides for its powers and duties. Each participating state shall be entitled to one delegate, who shall be selected within sixty days of the effective date, on the Commission. Additionally, there shall be an Executive Committee of the Commission to act on behalf of the Commission. Furthermore, the Compact shall come into effect on the date in which the seventh state enacts the Compact into law. Any participating state may withdraw from the Compact by repealing the Compact, but such withdrawal shall not take effect until 180 days after the enactment of the repeal. Finally, the Compact shall be binding upon participating states and shall supersede any conflict with state law. This act is identical to SB 1149 (2025) and is substantially similar to provisions in HB 1844 (2026) and in HCS/HB 2300 (2026). PA LICENSURE COMPACT (SECTION 334.1800) This act establishes the PA Licensure Compact ("Compact"), which allows for the interstate licensure of physician assistants. The Compact sets forth the requirements to be met in order for a state to join and maintain membership in the Compact. Additionally, the Compact provides the requirements for a physician assistant to obtain and exercise the ability to practice in the remote participating states. A compact privilege expires when the licensee's qualifying license in the participating state from which the licensee applied for the compact privilege expires. A participating state in which a licensee is licensed shall have exclusive power to impose adverse actions against the license issued by that state. A remote state shall have the authority to take adverse action to remove the compact privilege within that state for a physician assistant. Participating states may also conduct joint investigations with other participating states. Participating states shall report licensure data along with any adverse action and significant investigative information to the data system established in the Compact. Additionally, the Compact creates the PA Licensure Compact Commission ("Commission"), which is a joint government agency of participating states with the power to administer and implement the Compact. Each participating state shall be entitled to one delegate, who shall be selected by the state's licensing authority for physician assistants and who shall either be a current physician assistant, physician, or member or administrator of the licensing board. The Commission shall meet at least once a year. Additionally, there shall be an Executive Committee to act on behalf of the Commission, including on day-to-day activities related to the administration of the Compact. The Executive Committee shall be composed of seven members from the current Commission and two of members from national professional and certification organizations. The Commission may levy and collect an annual assessment from each participating state and impose fees on licensees to whom it grants compact privileges to cover the costs of the operations and activities of the Commission and its staff. Commissioners, officers, executive directors, employees, and agents of the Commission shall be immune from liability, both personally and in their official capacity, for any claim for damages arising out of any acts or omissions that occurred within the scope of the Commission's employment, duties, or responsibilities, except for those damages caused by intentional or willful or wanton misconduct. The procurement of insurance by the Commission shall not limit such immunity. For any actions by or against the Commission, venue is proper in a court of competent jurisdiction where the principal office of the Commission is located. Upon enactment, the Compact shall be reviewed by the Commission to determine if it is materially different from the Model Compact and whether the state qualifies for participation in the Compact. Any state that adopts the Compact subsequent to the Commission’s initial adoption of the rules and bylaws shall be subject to the rules and bylaws existing on the date on which the Compact becomes law. Finally, the Compact shall be binding upon participating states and shall supersede any conflict with state law. These provisions are identical to provisions in HCS/SS#2/SB 1233 (2026), SCS/SB 1492 (2026), and HB 3129 (2026) and is similar to HB 1388 (2025). KATIE O'BRIEN