SUBCHAPTER 32S - PHYSICIAN ASSISTANT REGULATIONS

section .0100 - repealed

21 NCAC 32S .0101 DEFINITIONS

21 NCAC 32S .0102 QUALIFICATIONS FOR LICENSE

History Note: Authority G.S. 90-11; 90-18(c)(13); 90-18.1;

Eff. May 1, 1999;

Amended Eff. June 1, 2006;

Repealed Eff. September 1, 2009.

21 NCAC 32S .0103 TEMPORARY LICENSE

History Note: Authority G.S. 90-18(13); 90-18.1;

Eff. May 1, 1999;

Repealed Eff. April 1, 2006.

21 NCAC 32S .0104 INACTIVE LICENSE STATUS

21 NCAC 32S .0105 ANNUAL REGISTRATION

21 NCAC 32S .0106 CONTINUING MEDICAL EDUCATION

21 NCAC 32S .0107 EXEMPTION FROM LICENSE

21 NCAC 32S .0108 SCOPE OF PRACTICE

21 NCAC 32S .0109 PRESCRIPTIVE AUTHORITY

21 NCAC 32S .0110 SUPERVISION OF PHYSICIAN ASSISTANTS

21 NCAC 32S .0111 SUPERVISING PHYSICIANS

21 NCAC 32S .0112 NOTIFICATION OF INTENT TO PRACTICE

21 NCAC 32S .0113 VIOLATIONS

History Note: Authority G.S. 90-13(c)(13); 90-14; 90-14(a)(11); 90-14.2; 90-15; 90-18(c)(13); 90-18.1; 90-171.23(14); 58 Fed. Reg. 31,171(1993) (to be codified at 21 C.F.R. 301);

Eff. May 1, 1999;

Amended Eff. July 1, 2006; June 1, 2006; April 1, 2006; April 1, 2005; May 1, 2004; April 1, 2004;

Repealed Eff. September 1, 2009.

21 NCAC 32S .0114 RESERVED FOR FUTURE CODIFICATION

21 NCAC 32S .0115 TITLE AND PRACTICE PROTECTION

21 NCAC 32S .0116 IDENTIFICATION REQUIREMENTS

21 NCAC 32S .0117 FEES

21 NCAC 32S .0118 PRACTICE DURING A DISASTER

History Note: Authority G.S. 90-12.1; 90-12.2; 90-15; 90-18(c)(13); 90-18.1; 166A-6;

Eff. May 1, 1999;

Amended Eff. April 1, 2006; April 1, 2005;

Repealed Eff. September 1, 2009.

SUBCHAPTER 32S - PHYSICIAN ASSISTANTs

Section .0200 – physician assistant registration

21 NCAC 32S .0201 DEFINITIONS

The following definitions apply to this Subchapter:

(1) "Board" means the North Carolina Medical Board.

(2) "Examination" means the Physician Assistant National Certifying Examination.

(3) "Family member" means a spouse, parent, grandparent, child, grandchild, sibling, aunt, uncle or first cousin, or persons to the same degree by marriage.

(4) "Physician Assistant" means a person licensed by the Board under the provisions of G.S. 90-9.3.

(5) "Physician Assistant License" means approval for the physician assistant to perform medical acts, tasks, or functions under North Carolina law.

(6) "Physician Assistant Educational Program" is the educational program set out in G.S. 90-9.3(a)(1).

(7) "License Renewal" means paying the annual fee and providing the information requested by the Board as outlined in this Subchapter.

(8) "Supervising" means overseeing the activities of, and accepting the responsibility for, the medical services rendered by a physician assistant.

(9) "Supervisory Arrangement" is the written statement that describes the medical acts, tasks and functions delegated to the physician assistant by the primary supervising physician appropriate to the physician assistant's education, qualification, training, skill and competence.

(10) "Supervising Physician" means a physician who is licensed by the Board and who is not prohibited by the Board from supervising physician assistants. The physician may serve as a primary supervising physician or as a back-up supervising physician.

(a) "Primary Supervising Physician" is the physician who accepts full responsibility for the physician assistant's medical activities and professional conduct at all times, whether the physician personally is providing supervision or the supervision is being provided by a Back-up Supervising Physician. The Primary Supervising Physician shall assure the Board that the physician assistant is qualified by education, training and competence to perform all medical acts required of the physician assistant and is responsible for the physician assistant's performance in the particular field or fields in which the physician assistant is expected to perform medical acts.

(b) "Back-up Supervising Physician" means the physician who is responsible for supervision of the physician assistant's activities in the absence of the Primary Supervising Physician and while actively supervising the physician assistant.

(11) "Volunteer practice" means performance of medical acts, tasks, or functions without expectation of any form of payment or compensation.

History Note: Authority G.S. 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0202 QUALIFICATIONS AND REQUIREMENTS FOR LICENSE

(a) Except as otherwise provided in this Subchapter, an individual must obtain a license from the Board before practicing as a physician assistant. An applicant for a physician assistant license must:

(1) submit a completed application to the Board;

(2) meet the requirements set forth in G.S. 90-9.3 and has not committed any of the acts listed in G.S. 90-14;

(3) supply a certified copy of applicant's birth certificate if the applicant was born in the United States or a certified copy of a valid and unexpired U.S. passport. If the applicant does not possess proof of U.S. citizenship, the applicant must provide information about applicant's immigration and work status which the Board will use to verify applicant's ability to work lawfully in the United States;

(4) submit to the Board proof that the applicant has completed a Physician Assistant Educational Program; if a physician assistant was licensed in North Carolina after June 1, 1994, he/she must also show successful completion of the Physician Assistant National Certifying Examination;

(5) pay to the Board a non-refundable fee of two hundred dollars ($200.00) plus the cost of a criminal background check. There is no fee to apply for a physician assistant limited volunteer license;

(6) submit National Practitioner Data Bank (NPDB) and Healthcare Integrity and Protection Data Bank (HIPDB) reports. These reports must be requested by the Applicant and submitted to the Board within 60 days of the request;

(7) submit a Board Action Data Bank Inquiry from the Federation of State Medical Boards (FSMB). This report must be requested by the Applicant and submitted to the Board within 60 days of the request;

(8) submit to the Board two complete original fingerprint record cards, on fingerprint record cards supplied by the Board;

(9) submit to the Board a signed consent form allowing a search of local, state, and national files to disclose any criminal record;

(10) disclose whether he/she has ever been suspended from, placed on academic probation, expelled or required to resign from any school, including a PA educational program;

(11) attest that he/she has no license, certificate, or registration as a physician assistant currently under discipline, revocation, suspension or probation or any other adverse action resulting from a health care licensing board;

(12) certify that he or she is mentally and physically able to safely practice as a physician assistant and is of good moral character;

(13) provide the Board with three original recommendation forms dated within six months of the application. These recommendations shall come from persons under whom the applicant has worked or trained who are familiar with the applicant's academic competence or clinical skills. At least one reference form must be from a physician and two reference forms must be from peers under whom the applicant has worked or trained. References must be able to evaluate the applicant's academic competence, clinical skills and character as a physician assistant. References shall not be from any family member or in the case of new graduate applicants, references shall not be from fellow students of the applicant's Educational Program;

(14) if two years or more have passed since graduation from a Physician Assistant Educational Program, document that he/she has successfully completed at least 100 hours of continuing medical education (CME) during the preceding two years, at least 40 hours of which must be American Academy of Physician Assistants Category I CME; and

(15) supply any other information the Board deems necessary to evaluate the applicant's qualifications.

(b) An applicant may be required to appear in person for an interview with the Board.

History Note: Authority G.S. 90-3; 90-9.3; 90-11; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009;

Amended Eff. March 1, 2011.

21 NCAC 32S .0203 MANDATORY NOTIFICATION OF INTENT TO PRACTICE

(a) Prior to the performance of any medical acts, tasks, or functions under the supervision of a primary supervising physician, a physician assistant shall submit notification of such intent using the Board's Intent to Practice form located on the Board's website. The notification of intent to practice shall include:

(1) the name, practice addresses, and telephone number of the physician assistant; and

(2) the name, practice addresses, and telephone number of the primary supervising physician(s).

(b) The physician assistant shall not commence practice until he/she receives acknowledgment from the Board that the Board has received and processed the Intent to Practice Form. By checking the Board's website, the physician assistant can confirm that the primary supervising physician has been added to the physician assistant's personal information page on the Board's website.

(c) The physician assistant shall notify the Board of any changes to the information required in Paragraph (a) of this Rule within 15 days of the occurrence.

History Note: Authority G.S. 90-9.3; 90-14(a)(11); 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0204 ANNUAL RENEWAL

(a) A physician assistant shall renew his/her license each year no later than 30 days after his/her birthday by:

(1) completing the Board's renewal form; and

(2) submitting a nonrefundable fee of one hundred twenty dollars ($120.00), except that a physician assistant who renews not later than 30 days after his/her birthday shall pay an annual renewal fee of one hundred dollars ($100.00);

(b) If a physician assistant fails to renew his/her license, the Board shall send a certified notice, return receipt requested. If the physician assistant does not renew his/her license within 30 days of the date of the mailing of that notice, his/her license automatically becomes inactive.

History Note: Authority G.S. 90-9.3(c);

Eff. September 1, 2009.

21 NCAC 32S .0205 INACTIVE LICENSE STATUS

By notifying the board in writing, a physician assistant may elect to place his/her license on inactive status. A physician assistant with an inactive license shall not practice as a physician assistant. A physician assistant who engages in practice while his/her license is inactive is practicing without a license and is subject to discipline by the Board as well as criminal penalties.

History Note: Authority G.S. 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0206 LICENSE REACTIVATION

(a) A physician assistant may apply to reactivate his/her license if:

(1) he/she had a license in North Carolina;

(2) the license was placed on inactive status within the past calendar year; and

(3) the licensee did not become inactive as a result of disciplinary action or to avoid disciplinary action.

(b) A physician assistant requesting reactivation shall:

(1) complete the board's reactivation application;

(2) pay to the board a nonrefundable fee of one hundred twenty dollars ($120), plus the cost of a criminal background check;

(3) submit to the board two completed original fingerprint record cards, on fingerprint record cards provided by the Board;

(4) submit to the board a completed signed and dated original Authority for Release of Information Form allowing a search of local, state, and national files to disclose any criminal record;

(5) submit National Practitioner Data Bank (NPDB) and Healthcare Integrity and Protection Data Bank (HIPDB) reports, dated within 60 days of their submission to the board;

(6) submit a board action data bank inquiry from the Federation of State Medical Boards (FSMB), dated within 60 days of its submission to the board;

(7) provide documentation to the board verifying completion of 100 hours of continuing medical education during the preceding two years; and

(8) supply any other information the board deems necessary to evaluate the applicant's qualifications.

History Note: Authority G.S. 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0207 LICENSE REINSTATEMENT

(a) A physician assistant may apply to reinstate his/her license if the license has been inactive for more than one calendar year, or if the inactive status resulted from disciplinary action or was taken to avoid disciplinary action.

(b) A physician assistant requesting reinstatement shall satisfy all the requirements set forth in 21 NCAC 32S .0202.

History Note: Authority G.S. 90-9.3; 90-13(c)(13); 90-18.8;

Eff. September 1, 2009.

21 NCAC 32S .0208 LIMITED VOLUNTEER LICENSE

(a) A physician assistant who holds a regular license may convert that license to a limited volunteer license by notifying the Board in writing. A physician assistant practicing under a limited volunteer license shall practice with no expectation of payment or compensation whatsoever for any medical services rendered. A physician assistant holding a limited volunteer license may not accept any compensation, either directly or indirectly, whether monetary, in-kind, or otherwise, for the provision of medical services.

(b) A physician assistant with an inactive license who wishes to return to practice on a volunteer basis must first reinstate or reactivate his/her license, whichever applies, by complying with 21 NCAC 32S .0206 or 21 NCAC 32S .0207. Once reinstated or reactivated, a physician assistant may convert that license to a limited volunteer license pursuant to Paragraph (a) of this Rule without paying an additional fee.

History Note: Authority G.S. 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0209 non applicability

This Subchapter does not apply to:

(1) a student enrolled in a Physician Assistant Educational Program accredited by the Commission on Accreditation of Allied Health Education Programs or its successor organizations;

(2) a physician assistant employed by the federal government while performing duties incident to that employment; or

(3) an agent or employee of a physician who performs delegated tasks in the office of a physician but who is not rendering services as a physician assistant and identifying him/herself as a physician assistant.

History Note: Authority G.S. 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0210 IDENTIFICATION REQUIREMENTS

A physician assistant shall keep proof of current licensure and renewal available for inspection at the primary place of practice and shall, when engaged in professional activities, wear a name tag consistent with G.S. 90-640.

History Note: Authority G.S.90-9.3; 90-18(c)(13); 90-640;

Eff. September 1, 2009.

21 NCAC 32S .0211 AGENCY

Physician assistants are the agents of their supervising physicians in the performance of all medical practice-related activities, including the ordering of diagnostic, therapeutic and other medical services.

History Note: Authority G.S. 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0212 PRESCRIPTIVE AUTHORITY

A physician assistant may prescribe, order, procure, dispense and administer drugs and medical devices subject to the following conditions:

(1) the physician assistant complies with all state and federal laws regarding prescribing including G.S. 90-18.1(b);

(2) each supervising physician and physician assistant incorporates within their written supervisory arrangements, as defined in Rule .0201(8) of this Subchapter, instructions for prescribing, ordering, and administering drugs and medical devices and a policy for periodic review by the physician of these instructions and policy;

(3) In order to compound and dispense drugs, the physician assistant complies with G.S. 90-18.1(c);

(4) in order to prescribe controlled substances,

(a) the physician assistant must have a valid Drug Enforcement Administration (DEA) registration and prescribe in accordance with DEA rules;

(b) All prescriptions for substances falling within schedules II, IIN, III, and IIIN, as defined in the federal Controlled Substances Act, shall not exceed a legitimate 30 day supply;

(c) the supervising physician must possess the same schedule(s) of controlled substances as the physician assistant's DEA registration;

(5) each prescription issued by the physician assistant contains, in addition to other information required by law, the following:

(a) the physician assistant's name, practice address and telephone number;

(b) the physician assistant's license number and, if applicable, the physician assistant's DEA number for controlled substances prescriptions; and

(6) the physician assistant documents prescriptions in writing on the patient's record, including the medication name and dosage, amount prescribed, directions for use, and number of refills; and

(7) a physician assistant who requests, receives, and dispenses medication samples to patients complies with all applicable state and federal regulations.

History Note: Authority G.S. 90-18(c)(13); 90-18.1; 90-18.2A; 90-171.23(14); 21 C.F.R. 301;

Eff. September 1, 2009.

21 NCAC 32S .0213 SUPERVISION OF PHYSICIAN ASSISTANTS

(a) A physician assistant may perform medical acts, tasks, or functions only under the supervision of a physician. Supervision shall be continuous but, except as otherwise provided in the rules of this Subchapter, shall not be construed as requiring the physical presence of the supervising physician at the time and place that the services are rendered.

(b) Each team of physician(s) and physician assistant(s) shall ensure that the physician assistant's scope of practice is identified; that delegation of medical tasks is appropriate to the skills of the supervising physician(s) as well as the physician assistant's level of competence; that the relationship of, and access to, each supervising physician is defined; and that a process for evaluation of the physician assistant's performance is established.

(c) Each supervising physician and physician assistant shall sign a statement, as defined in Rule .0201(8) of this Subchapter, that describes the supervisory arrangements in all settings. Written prescribing instructions are required for each approved site. This statement shall be kept on file at all practice sites, and must be available upon request by the Board.

(d) A primary supervising physician and a physician assistant in a new practice arrangement shall meet monthly for the first six months to discuss practice relevant clinical issues and quality improvement measures. Thereafter, the primary supervising physician and the physician assistant shall meet at least once every six months. A written record of these meetings shall be signed and dated by both the supervising physician and the physician assistant, and shall be available for inspection upon request by the Board agent. The written record shall include a description of the relevant clinical issues discussed and the quality improvement measures taken.

History Note: Authority G.S. 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0214 SUPERVISING PHYSICIAN

A physician wishing to serve as a primary supervising physician must exercise supervision of the physician assistant in accordance with rules adopted by the Board. The physician shall retain professional responsibility for the care rendered by the physician assistant within the scope of the supervisory arrangement.

History note: Authority G.S. 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0215 RESPONSIBILITIES OF PRIMARY SUPERVISING PHYSICIANS IN REGARD TO BACK-UP SUPERVISING PHYSICIANS

(a) The primary supervising physician shall ensure that a supervising physician, either primary or back-up, is readily accessible for the physician assistant to consult whenever the physician assistant is performing medical acts, tasks, or functions.

(b) A back-up supervising physician must be licensed to practice medicine by the Board, not prohibited by the Board from supervising a physician assistant, and approved by the primary supervising physician as a person willing and qualified to assume responsibility for the care rendered by the physician assistant in the absence of the primary supervising physician. An ongoing list of all approved back-up supervising physicians, signed and dated by each back-up supervising physician, the primary supervising physician, and the physician assistant, must be retained as part of the Supervisory Arrangement.

History Note: Authority G.S. 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0216 CONTINUING MEDICAL EDUCATION

(a) A physician assistant must complete at least 100 hours of continuing medical education (CME) every two years, at least 40 hours of which must be American Academy of Physician Assistants Category I CME. CME documentation must be available for inspection by the board or its agent upon request. The two year period shall run from the physician assistant's birthday, beginning in the year 1999, or the first birthday following initial licensure, whichever occurs later.

(b) A physician assistant who possesses a current certification with the National Commission on Certification of Physician Assistants (NCCPA) will be deemed in compliance with the requirement of Paragraph (a) of this Rule. The physician assistant must attest on his or her annual renewal that he or she is currently certified by the NCCPA.

History Note: Authority G.S. 90-5.1(a)(3) and (10); 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009;

Amended Eff. November 1, 2010.

21 NCAC 32S .0217 VIOLATIONS

The Board may take disciplinary action against a supervising physician or a physician assistant, pursuant to G.S. 90-14. It is unprofessional or dishonorable conduct for a physician assistant to violate the rules of this Subchapter, or to represent him/herself as a physician.

History Note: Authority G.S. 90-9.3; 90-14; 90-14.2;

Eff. September 1, 2009.

21 NCAC 32S .0218 TITLE AND PRACTICE PROTECTION

(a) Any person not licensed by the Board violates G.S. 90-18.1 if he or she:

(1) falsely identifies him/herself as a physician assistant;

(2) uses any combination or abbreviation of the term "physician assistant" to indicate or imply that he or she is a physician assistant; or

(3) acts as a physician assistant without being licensed by the Board.

(b) An unlicensed physician may not use the title of "physician assistant" or practice as a physician assistant unless he/she fulfills the requirements of this Subchapter.

History Note: Authority G.S. 90-9.3; 90-18(c)(13); 90-18.1;

Eff. September 1, 2009.

21 NCAC 32S .0219 limited physician assistant license for DISASTERs and emergencies

(a) The Board shall, pursuant to G.S. 90-12.5, issue a limited physician assistant license under the following conditions:

(1) the Governor of the State of North Carolina has declared a disaster or state of emergency, or in the event of an occurrence for which a county or municipality has enacted an ordinance to deal with states of emergency under G.S. 14-288.12, 14-288.13, or 14-288.14, or to protect the public health, safety or welfare of its citizens under Article 22 of Chapter 130A of the General Statutes, G.S. 160A-174(a) or G.S. 153A-121(a);

(2) the applicant provides government-issued photo identification;

(3) the applicant provides proof of licensure, certification or authorization to practice as a physician assistant in another state, the District of Columbia, US Territory or Canadian province;

(4) applicant affirms under oath that such license is in good standing; and

(5) no grounds exist pursuant to G.S. 90-14(a) for the Board to deny a license.

(b) In response to the specific circumstances presented by a declared disaster or state of emergency and in order to best serve the public interest, the Board may limit the physician assistant's scope of practice including, but not limited to, the following: geography; term; type of practice; prescribing, administering and dispensing therapeutic measures, tests, procedures and drugs; supervision; and practice setting.

(c) The physician assistant must practice under the direct supervision of an on-site physician. The supervising physician must be licensed in this State or approved to practice in this State during a disaster or state of emergency pursuant to G.S. 90-12.5 and 21 NCAC 32B .1705. The physician assistant may perform only those medical acts, tasks, and functions delegated by the supervising physician and not limited by the physician assistant's scope of practice as set out in Paragraph (b) of this Rule.

(d) A team of physician(s) and physician assistant(s) practicing pursuant to this Rule is not required to maintain on-site documentation describing supervisory arrangements and instructions for prescriptive authority as otherwise required by 21 NCAC 32S .0213.

(e) A physician assistant holding a Limited Physician Assistant License for Disasters and Emergencies shall not receive any other or additional compensation outside his or her usual compensation, either direct or indirect, monetary, in-kind, or otherwise for the provision of medical services during a disaster or emergency.

History Note: Authority G.S. 90-9.3; 90-12.5; 90-18(c)(13); 166A-6;

Eff. September 1, 2009;

Amended Eff. November 1, 2010.

21 NCAC 32S .0220 EXPEDITED APPLICATION FOR PHYSICIAN ASSISTANT LICENSURE

(a) An physician assistant who has been licensed, certified, or authorized to practice in at least one other state, the District of Columbia, U.S. Territory or Canadian province for at least five years, has been in active clinical practice during the past two years and who has a clean license application, as defined in Paragraph (c) of this Rule, may apply for a license on an expedited basis.

(b) In order to apply for an expedited Physician Assistant License, an applicant shall:

(1) submit a completed application, using the Board's form, attesting under oath that the information on the application is true and complete, and authorizing the release to the Board of all information pertaining to the application;

(2) submit documentation of a legal name change, if applicable;

(3) on the Board's form, submit a recent photograph, at least two inches by two inches, certified as a true likeness of the applicant by a notary public;

(4) supply a certified copy of applicant’s birth certificate if applicant was born in the United States or a certified copy of a valid and unexpired US passport. If the applicant does not possess proof of U.S. citizenship, the applicant must provide information about applicant's immigration and work status, which the Board will use to verify applicant's ability to work lawfully in the United States;

(5) provide proof that applicant had held an active license, certification or authorization as a physician assistant in at least one other state or jurisdiction for the last five years immediately preceding this application;

(6) submit proof of successful completion of the Physician Assistant National Certifying Examination;

(7) submit proof of current certification by the National Commission on Certification of Physician Assistants;

(8) provide proof of an active clinical practice, providing patient care for an average of 20 hours or more per week, for at least the last two years;

(9) submit a NPDB/HIPDB report dated within 60 days of applicant's oath;

(10) submit a FSMB Board Action Data Bank report;

(11) submit two completed fingerprint cards supplied by the Board;

(12) submit a signed consent form allowing a search of local, state, and national files to disclose any criminal record;

(13) pay to the Board a non-refundable fee of two hundred dollars ($200.00), as required by 21 NCAC 32S .0202, plus the cost of a criminal background check;

(14) upon request, supply any additional information the Board deems necessary to evaluate the applicant's qualifications.

(1) professional liability insurance claim(s) or payment(s);

(2) criminal record;

(3) medical condition(s) which could affect the physician assistant’s ability to practice safely;

(4) regulatory board complaint(s), investigation(s), or action(s) (including applicant's withdrawal of a license application);

(5) adverse action taken by a health care institution;

(6) investigation(s) or action(s) taken by a federal agency, the US military, medical societies or associations; or

(7) suspension or expulsion from any school, including an educational program for physician assistants.

(d) All reports must be submitted directly to the Board from the primary source, when possible.

(e) An application must be completed within one year of the date on which the application fee is paid. If not, the applicant shall be charged a new application fee.

History Note: Authority G.S. 90-9.3; 90-13.1;

Eff. November 1, 2010.