2022 -- H 8047

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LC005607

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2022

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- INTERSTATE MEDICAL

LICENSURE COMPACT

     

     Introduced By: Representatives Fogarty, Speakman, Ranglin-Vassell, Donovan,
Edwards, Handy, Cortvriend, Hull, J Lombardi, and Williams

     Date Introduced: March 25, 2022

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

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     SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS"

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is hereby amended by adding thereto the following chapter:

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CHAPTER 91

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INTERSTATE MEDICAL LICENSURE COMPACT

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     5-91-1. Purpose.

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     In order to strengthen access to health care, and in recognition of the advances in the

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delivery of health care, the member states of the Interstate Medical Licensure Compact have allied

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in common purpose to develop a comprehensive process that complements the existing licensing

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and regulatory authority of state medical boards, provides a streamlined process that allows

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physicians to become licensed in multiple states, thereby enhancing the portability of a medical

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license and ensuring the safety of patients. The compact creates another pathway for licensure and

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does not otherwise change a state’s existing medical practice act. The compact also adopts the

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prevailing standard for licensure and affirms that the practice of medicine occurs where the patient

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is located at the time of the physician-patient encounter, and therefore, requires the physician to be

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under the jurisdiction of the state medical board where the patient is located. State medical boards

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that participate in the compact retain the jurisdiction to impose an adverse action against a license

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to practice medicine in that state issued to a physician through the procedures in the compact.

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     5-91-2. Definitions.

 

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     The terms contained in this chapter shall have the following meanings:

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     (1) “Bylaws” means those bylaws established by the interstate commission pursuant to §5-

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91-11.

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     (2) “Commissioner” means the voting representative appointed by each member board

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pursuant to § 5-91-11.

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     (3) “Conviction” means a finding by a court that an individual is guilty of a criminal offense

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through adjudication, or entry of a plea of guilt or no contest to the charge by the offender. Evidence

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of an entry of a conviction of a criminal offense by the court shall be considered final for purposes

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of disciplinary action by a member board.

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     (4) “Expedited license” means a full and unrestricted medical license granted by a member

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state to an eligible physician through the process set forth in the compact.

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     (5) “Interstate commission” means the interstate commission created pursuant to §5-91-11.

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     (6) “License” means authorization by a member state for a physician to engage in the

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practice of medicine, which would be unlawful without authorization.

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     (7) “Medical practice act” means laws and regulations governing the practice of allopathic

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and osteopathic medicine within a member state.

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     (8) “Member board” means a state agency in a member state that acts in the sovereign

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interests of the state by protecting the public through licensure, regulation, and education of

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physicians as directed by the state government.

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     (9) “Member state” means a state that has enacted the compact.

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     (10) “Practice of medicine” means that clinical prevention, diagnosis, or treatment of

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human disease, injury, or condition requiring a physician to obtain and maintain a license in

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compliance with the medical practice act of a member state.

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     (11) “Physician” means any person who:

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     (i) Is a graduate of a medical school accredited by the Liaison Committee on Medical

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Education, the Commission on Osteopathic College Accreditation, or a medical school listed in the

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International Medical Education Directory or its equivalent;

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     (ii) Passed each component of the United State Medical Licensing Examination (USMLE)

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or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within three

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(3) attempts, or any of its predecessor examinations accepted by a state medical board as an

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equivalent examination for licensure purposes;

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     (iii) Successfully completed graduate medical education approved by the Accreditation

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Council for Graduate Medical Education or the American Osteopathic Association;

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     (iv) Holds specialty certification or a time-unlimited specialty certificate recognized by the

 

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American Board of Medical Specialties or the American Osteopathic Association’s Bureau of

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Osteopathic Specialists;

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     (v) Possesses a full and unrestricted license to engage in the practice of medicine issued by

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a member board;

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     (vi) Has never been convicted, received adjudication, deferred adjudication, community

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supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;

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     (vii) Has never held a license authorizing the practice of medicine subjected to discipline

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by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to

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non-payment of fees related to a license;

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     (viii) Has never had a controlled substance license or permit suspended or revoked by a

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state or the United States Drug Enforcement Administration; and

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     (ix) Is not under active investigation by a licensing agency or law enforcement authority in

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any state, federal, or foreign jurisdiction.

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     (12) “Offense” means a felony, gross misdemeanor, or crime of moral turpitude.

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     (13) “Rule” means a written statement by the interstate commission promulgated pursuant

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to § 5-91-12 of the compact that is of general applicability, implements, interprets, or prescribes a

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policy or provision of the compact, or an organizational, procedural, or practice requirement of the

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interstate commission, and has the force and effect of statutory law in a member state, and includes

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the amendment, repeal, or suspension of an existing rule.

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     (14) “State” means any state, commonwealth, district, or territory of the United States.

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     (15) “State of principal license” means a member state where a physician holds a license

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to practice medicine and which has been designated as such by the physician for purposes of

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registration and participation in the compact.

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     5-91-3. Eligibility.

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     (a) A physician must meet the eligibility requirements as defined in § 5-91-2 to receive an

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expedited license under the terms and provisions of the compact.

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     (b) A physician who does not meet the requirements of § 5-91-2 may obtain a license to

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practice medicine in a member state if the individual complies with all laws and requirements, other

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than the compact, relating to the issuance of a license to practice medicine in that state.

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     5-91-4. Designation of state of principal license.

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     (a) A physician shall designate a member state as the state of principal license for purposes

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of registration for expedited licensure through the compact if the physician possesses a full and

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unrestricted license to practice medicine in that state, and the state is:

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     (1) The state of principal residence for the physician;

 

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     (2) The state where at least twenty-five percent (25%) of the practice of medicine occurs;

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or

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     (3) The location of the physician’s employer; or

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     (4) If no state qualifies under subsection (1), subsection (2), or subsection (3) of this

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section, the state designated as state of residence for purpose of federal income tax.

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     (b) A physician may redesignate a member state as state of principal license at any time,

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as long as the state meets the requirements of subsection (a) of this section.

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     (c) The interstate commission is authorized to develop rules to facilitate redesignation of

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another member state as the state of principal license.

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     5-91-5. Application and issuance of expedited licensure.

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     (a) A physician seeking licensure through the compact shall file an application for an

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expedited license with the member board of the state selected by the physician as the state of

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principal license.

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     (b) Upon receipt of an application for an expedited license, the member board within the

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state selected as the state of principal license shall evaluate whether the physician is eligible for

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expedited licensure and issue a letter of qualification, verifying or denying the physician’s

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eligibility, to the interstate commission.

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     (1) Static qualifications, which include verification of medical education, graduate medical

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education, results of any medical or licensing examination, and other qualifications as determined

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by the interstate commission through rule, shall not be subject to additional primary source

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verification where already primary source verified by the state of principal license.

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     (2) The member board within the state selected as the state of principal license shall, in the

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course of verifying eligibility, perform a criminal background check of an applicant, including the

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use of the results of fingerprint or other biometric data checks compliant with the requirements of

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the Federal Bureau of Investigation, with the exception of federal employees who have suitability

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determination in accordance with 5 C.F.R. §731.202.

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     (3) Appeal on the determination of eligibility shall be made to the member state where the

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application was filed and shall be subject to the law of that state.

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     (c) Upon verification in subsection (b) of this section, physicians eligible for an expedited

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license shall complete the registration process established by the interstate commission to receive

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a license in a member state selected pursuant to subsection (a) of this section, including the payment

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of any applicable fees.

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     (d) After receiving verification of eligibility under subsection (b) of this section and any

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fees under subsection (c) of this section, a member board shall issue an expedited license to the

 

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physician.

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     This license shall authorize the physician to practice medicine in the issuing state consistent

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with the medical practice act and all applicable laws and regulations of the issuing member board

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and member state.

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     (e) An expedited license shall be valid for a period consistent with the licensure period in

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the member state and in the same manner as required for other physicians holding a full and

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unrestricted license within the member state.

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     (f) An expedited license obtained through the compact shall be terminated if a physician

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fails to maintain a license in the state of principal licensure for a non-disciplinary reason, without

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redesignation of a new state of principal licensure.

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     (g) The interstate commission is authorized to develop rules regarding the application

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process, including payment of any applicable fees, and the issuance of an expedited license.

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     5-91-6. Fees for expedited licensure.

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     (a) A member state issuing an expedited license authorizing the practice of medicine in that

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state may impose a fee for a license issued or renewed through the compact.

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     (b) The interstate commission is authorized to develop rules regarding fees for expedited

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licenses.

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     5-91-7. Renewal and continued participation.

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     (a) A physician seeking to renew an expedited license granted in a member state shall

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complete a renewal process with the interstate commission if the physician:

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     (1) Maintains a full and unrestricted license in a state of principal license;

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     (2) Has not been convicted, received adjudication, deferred adjudication, community

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supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;

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     (3) Has not had a license authorizing the practice of medicine subject to discipline by a

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licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-

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payment of fees related to a license; and

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     (4) Has not had a controlled substance license or permit suspended or revoked by a state

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or the United States Drug Enforcement Administration.

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     (b) Physicians shall comply with all continuing professional development or continuing

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medical education requirements for renewal of a license issued by a member state.

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     (c) The interstate commission shall collect any renewal fees charged for the renewal of a

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license and distribute the fees to the applicable member board.

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     (d) Upon receipt of any renewal fees collected in subsection (c) of this section, a member

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board shall renew the physician’s license.

 

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     (e) Physician information collected by the interstate commission during the renewal

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process will be distributed to all member boards.

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     (f) The interstate commission is authorized to develop rules to address renewal of licenses

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obtained through the compact.

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     5-91-8. Coordinated information system.

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     (a) The interstate commission shall establish a database of all physicians licensed, or who

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have applied for licensure under § 5-91-5.

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     (b) Notwithstanding any other provision of law, member boards shall report to the interstate

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commission any public action or complaints against a licensed physician who has applied or

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received an expedited license through the compact.

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     (c) Member boards shall report disciplinary or investigatory information determined as

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necessary and proper by rule of the interstate commission.

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     (d) Member boards may report any non-public complaint, disciplinary, or investigatory

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information not required by subsection (c) of this section to the interstate commission.

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     (e) Member boards shall share complaint or disciplinary information about a physician

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upon request of another member board.

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     (f) All information provided to the interstate commission or distributed by member boards

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shall be confidential, filed under seal, and used only for investigatory or disciplinary matters.

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     (g) The interstate commission is authorized to develop rules for mandated or discretionary

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sharing of information by member boards.

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     5-91-9. Joint investigations.

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     (a) Licensure and disciplinary records of physicians are deemed investigative.

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     (b) In addition to the authority granted to a member board by its respective medical practice

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act or other applicable state law, a member board may participate with other member boards in

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joint investigations of physicians licensed by the member boards.

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     (c) A subpoena issued by a member state shall be enforceable in other member states.

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     (d) Member boards may share any investigative, litigation, or compliance materials in

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furtherance of any joint or individual investigation initiated under the compact.

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     (e) Any member state may investigate actual or alleged violations of the statutes

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authorizing the practice of medicine in any other member state in which a physician holds a license

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to practice medicine.

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     5-91-10. Disciplinary actions.

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     (a) Any disciplinary action taken by any member board against a physician licensed

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through the compact shall be deemed unprofessional conduct which may be subject to discipline

 

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by other member boards, in addition to any violation of the medical practice act or regulations in

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that state.

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     (b) If a license granted to a physician by the member board in the state of principal license

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is revoked, surrendered or relinquished in lieu of discipline, or suspended, then all licenses issued

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to the physician by member boards shall automatically be placed, without further action necessary

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by any member board, on the same status. If the member board in the state of principal license

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subsequently reinstates the physician’s license, a license issued to the physician by any other

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member board shall remain encumbered until that respective member board takes action to reinstate

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the license in a manner consistent with the medical practice act of that state.

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     (c) If disciplinary action is taken against a physician by a member board not in the state of

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principal license, any other member board may deem the action conclusive as to matter of law and

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fact decided, and:

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     (1) Impose the same or lesser sanction(s) against the physician as long as such sanctions

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are consistent with the medical practice act of that state; or

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     (2) Pursue separate disciplinary action against the physician under its respective medical

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practice act, regardless of the action taken in other member states.

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     (d) If a license granted to a physician by a member board is revoked, surrendered or

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relinquished in lieu of discipline, or suspended, then any license(s) issued to the physician by any

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other member board(s) shall be suspended, automatically and immediately without further action

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necessary by the other member board(s), for ninety (90) days upon entry of the order by the

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disciplining board, to permit the member board(s) to investigate the basis for the action under the

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medical practice act of that state. A member board may terminate the automatic suspension of the

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license it issued prior to the completion of the ninety (90) day suspension period in a manner

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consistent with the medical practice act of that state.

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     5-91-11. Interstate medical licensure compact commission.

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     (a) The member states hereby create the “Interstate Medical Licensure Compact

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Commission”.

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     (b) The purpose of the interstate commission is the administration of the Interstate Medical

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Licensure Compact, which is a discretionary state function.

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     (c) The interstate commission shall be a body corporate and joint agency of the member

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states and shall have all the responsibilities, powers, and duties set forth in the compact, and such

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additional powers as may be conferred upon it by a subsequent concurrent action of the respective

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legislatures of the member states in accordance with the terms of the compact.

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     (d) The interstate commission shall consist of two (2) voting representatives appointed by

 

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each member state who shall serve as commissioners. In states where allopathic and osteopathic

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physicians are regulated by separate member boards, or if the licensing and disciplinary authority

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is split between separate member boards, or if the licensing and disciplinary authority is split

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between multiple member boards within a member state, the member state shall appoint one

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representative from each member board. A commissioner shall be an:

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     (1) Allopathic or osteopathic physician appointed to a member board;

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     (2) Executive director, executive secretary, or similar executive of a member board; or

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     (3) Member of the public appointed to a member board.

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     (e) The interstate commission shall meet at least once each calendar year.

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     A portion of this meeting shall be a business meeting to address such matters as may

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properly come before the commission, including the election of officers. The chairperson may call

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additional meetings and shall call for a meeting upon the request of a majority of the member states.

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     (f) The bylaws may provide for meetings of the interstate commission to be conducted by

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telecommunication or electronic communication.

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     (g) Each commissioner participating at a meeting of the interstate commission is entitled

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to one vote. A majority of commissioners shall constitute a quorum for the transaction of business,

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unless a larger quorum is required by the bylaws of the interstate commission. A commissioner

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shall not delegate a vote to another commissioner. In the absence of its commissioner, a member

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state may delegate voting authority for a specified meeting to another person from that state who

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shall meet the requirements of subsection (d) of this section.

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     (h) The interstate commission shall provide public notice of all meetings and all meetings

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shall be open to the public. The interstate commission may close a meeting, in full or in portion,

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where it determines by a two-thirds (2/3) vote of the commissioners present that an open meeting

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would be likely to:

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     (1) Relate solely to the internal personnel practice and procedures of the interstate

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commission;

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     (2) Discuss matters specifically exempted from disclosure by federal statute;

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     (3) Discuss trade secrets, commercial, or financial information that is privileged or

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confidential;

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     (4) Involve accusing a person of a crime or formally censuring a person;

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     (5) Discuss information of a personal nature where disclosure would constitute a clearly

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unwarranted invasion of personal privacy;

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     (6) Discuss investigative records compiled for law enforcement purposes; or

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     (7) Specifically relate to the participation in a civil action or other legal proceeding.

 

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     (i) The interstate commission shall keep minutes which shall fully describe all matters

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discussed in a meeting and shall provide a full and accurate summary of actions taken, including

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record of any roll call votes.

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     (j) The interstate commission shall make its information and official records, to the extent

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not otherwise designated in the compact or by its rules, available to the public for inspection.

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     (k) The interstate commission shall establish an executive committee, which shall include

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officers, members, and others as determined by the bylaws. The executive committee shall have

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the power to act on behalf of the interstate commission, with the exception of rulemaking, during

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periods when the interstate commission is not in session. When acting on behalf of the interstate

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commission, the executive committee shall oversee the administration of the compact including

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enforcement and compliance with the provisions of the compact, its bylaws and rules, and other

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such duties as necessary.

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     (l) The interstate commission shall establish other committees for governance and

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administration of the compact.

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     5-91-12. Powers and duties of the interstate commission.

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     The interstate commission shall have the following powers and duties:

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     (1) Oversee and maintain the administration of the compact;

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     (2) Promulgate rules which shall be binding to the extent and in the manner provided for

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in the compact;

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     (3) Issue, upon the request of a member state or member board, advisory opinions

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concerning the meaning or interpretation of the compact, its bylaws, rules, and actions;

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     (4) Enforce compliance with compact provisions, the rules promulgated by the interstate

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commission, and the bylaws, using all necessary and proper means, including, but not limited to,

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the use of judicial process;

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     (5) Establish and appoint committees including, but not limited to, an executive committee

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as required by § 5-91-11, which shall have the power to act on behalf of the interstate commission

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in carrying out its powers and duties;

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     (6) Pay, or provide for the payment of the expenses related to the establishment,

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organization, and ongoing activities of the interstate commission;

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     (7) Establish and maintain one or more offices;

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     (8) Borrow, accept, hire, or contract for services of personnel;

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     (9) Purchase and maintain insurance and bonds;

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     (10) Employ an executive director who shall have such powers to employ, select or appoint

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employees, agents, or consultants, and to determine their qualifications, define their duties, and fix

 

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their compensation;

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     (11) Establish personnel policies and programs relating to conflicts of interest, rates of

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compensation, and qualifications of personnel;

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     (12) Accept donations and grants of money, equipment, supplies, materials, and services

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and to receive, utilize, and dispose of it in a manner consistent with the conflict of interest policies

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established by the interstate commission;

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     (13) Lease, purchase, accept contributions or donations of, or otherwise to own, hold,

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improve or use, any property, real, personal, or mixed;

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     (14) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any

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property, real, personal, or mixed;

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     (15) Establish a budget and make expenditures;

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     (16) Adopt a seal and bylaws governing the management and operation of the interstate

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commission;

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     (17) Report annually to the legislatures and governors of the member states concerning the

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activities of the interstate commission during the preceding year. Such reports shall also include

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reports of financial audits and any recommendations that may have been adopted by the interstate

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commission;

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     (18) Coordinate education, training, and public awareness regarding the compact, its

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implementation, and its operation;

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     (19) Maintain records in accordance with the bylaws;

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     (20) Seek and obtain trademarks, copyrights, and patents; and

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     (21) Perform such functions as may be necessary or appropriate to achieve the purpose of

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the compact.

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     5-91-13. Finance powers.

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     (a) The interstate commission may levy on and collect an annual assessment from each

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member state to cover the cost of the operations and activities of the interstate commission and its

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staff. The total assessment must be sufficient to cover the annual budget approved each year for

28

which revenue is not provided by other sources. The aggregate annual assessment amount shall be

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allocated upon a formula to be determined by the interstate commission, which shall promulgate a

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rule binding upon all member states.

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     (b) The interstate commission shall not incur obligations of any kind prior to securing the

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funds adequate to meet the same.

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     (c) The interstate commission shall not pledge the credit of any of the member states, except

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by, and with the authority of, the member state.

 

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     (d) The interstate commission shall be subject to a yearly financial audit conducted by a

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certified or licensed accountant and the report of the audit shall be included in the annual report of

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the interstate commission.

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     5-91-14. Organization and operation of the interstate commission.

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     (a) The interstate commission shall, by a majority of commissioners present and voting,

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adopt bylaws to govern its conduct as may be necessary or appropriate to carry out the purposes of

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the compact within twelve (12) months of the first interstate commission meeting.

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     (b) The interstate commission shall elect or appoint annually from among its

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commissioners a chairperson, a vice-chairperson, and a treasurer, each of whom shall have such

10

authority and duties as may be specified in the bylaws. The chairperson, or in the chairperson’s

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absence or disability, the vice-chairperson, shall preside at all meetings of the interstate

12

commission.

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     (c) Officers selected in subsection (b) of this section shall serve without remuneration for

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the interstate commission.

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     (d) The officers and employees of the interstate commission shall be immune from suit and

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liability, either personally or in their official capacity, for a claim for damage to or loss of property

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or personal injury or other civil liability caused or arising out of, or relating to, an actual or alleged

18

act, error, or omission that occurred, or that such person had a reasonable basis for believing

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occurred, within the scope of interstate commission employment, duties, or responsibilities;

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provided that such person shall not be protected from suit or liability for damage, loss, injury, or

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liability caused by the intentional or willful and wanton misconduct of such person.

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     (e) The liability of the executive director and employees of the interstate commission or

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representatives of the interstate commission, acting within the scope of such person’s employment

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or duties for acts, errors, or omissions occurring within such person’s state, may not exceed the

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limits of liability set forth under the constitution and laws of that state for state officials, employees,

26

and agents. The interstate commission is considered to be an instrumentality of the states for the

27

purpose of any such action. Nothing in this subsection shall be construed to protect such person

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from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and

29

wanton misconduct of such person.

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     (f) The interstate commission shall defend the executive director, its employees, and

31

subject to the approval of the attorney general or other appropriate legal counsel of the member

32

state represented by an interstate commission representative, defend such interstate commission

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representative in any civil action seeking to impose liability arising out of an actual or alleged act,

34

error or omission that occurred within the scope of interstate commission employment, duties or

 

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responsibilities, or that the defendant had a reasonable basis for believing occurred within the scope

2

of interstate commission employment, duties, or responsibilities, provided that the actual or alleged

3

act, error, or omission did not result from intentional or willful and wanton misconduct on the part

4

of such person.

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     (g) To the extent not covered by the state involved, member state, or the interstate

6

commission, the representatives or employees of the interstate commission shall be held harmless

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in the amount of a settlement or judgment, including attorney’s fees and costs, obtained against

8

such persons arising out of an actual or alleged act, error, or omission that occurred within the scope

9

of the interstate commission employment, duties, or responsibilities, or that such persons had a

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reasonable basis for believing occurred within the scope of interstate commission employment,

11

duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result

12

from intentional or willful and wanton misconduct on the part of such person.

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     5-91-15. Rulemaking functions of the interstate commission.

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     (a) The interstate commission shall promulgate reasonable rules in order to effectively and

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efficiently achieve the purpose of the compact. Notwithstanding the foregoing, in the event the

16

interstate commission exercises its rulemaking authority in a manner that is beyond the scope of

17

the purposes of the compact, or the powers granted hereunder, then such an action by the interstate

18

commission shall be invalid and have no force or effect.

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     (b) Rules deemed appropriate for the operations of the interstate commission shall be made

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pursuant to a rulemaking process that substantially conforms to the “Model State Administrative

21

Procedure Act” of 2010, and subsequent amendments thereto.

22

     (c) Not later than thirty (30) days after a rule is promulgated, any person may file a petition

23

for judicial review of the rule in the United States District Court for the District of Columbia or the

24

federal district where the interstate commission has its principal offices, provided that the filing of

25

such a petition shall not stay or otherwise prevent the rule from becoming effective unless the court

26

finds that the petitioner has a substantial likelihood of success. The court shall give deference to

27

the actions of the interstate commission consistent with applicable law and shall not find the rule

28

to be unlawful if the rule represents a reasonable exercise of the authority granted to the interstate

29

commission.

30

     5-91-16. Oversight of interstate compact.

31

     (a) The executive, legislative, and judicial branches of state government in each member

32

state shall enforce the compact and shall take all actions necessary and appropriate to effectuate the

33

compact’s purposes and intent. The provisions of the compact and the rules promulgated hereunder

34

shall have standing as statutory law but shall not override existing state authority to regulate the

 

LC005607 - Page 12 of 17

1

practice of medicine.

2

     (b) All courts shall take judicial notice of the compact and the rules in any judicial or

3

administrative proceeding in a member state pertaining to the subject matter of the compact which

4

may affect the powers, responsibilities or actions of the interstate commission.

5

     (c) The interstate commission shall be entitled to receive all services of process in any such

6

proceeding, and shall have standing to intervene in the proceeding for all purposes. Failure to

7

provide service of process to the interstate commission shall render a judgment or order void as to

8

the interstate commission, the compact, or promulgated rules.

9

     5-91-17. Enforcement of interstate compact.

10

     (a) The interstate commission, in the reasonable exercise of its discretion, shall enforce the

11

provisions and rules of the compact.

12

     (b) The interstate commission may, by majority vote of the commissioners, initiate legal

13

action in the United States Court for the District of Columbia, or, at the discretion of the interstate

14

commission, in the federal district where the interstate commission has its principal offices, to

15

enforce compliance with the provisions of the compact, and its promulgated rules and bylaws,

16

against a member state in default. The relief sought may include both injunctive relief and damages.

17

In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of

18

such litigation including reasonable attorney’s fees.

19

     (c) The remedies herein shall not be the exclusive remedies of the interstate commission.

20

The interstate commission may avail itself of any other remedies available under state law or

21

regulation of a profession.

22

     5-91-18. Default procedures.

23

     (a) The grounds for default include, but are not limited to, failure of a member state to

24

perform such obligations or responsibilities imposed upon it by the compact, or the rules and

25

bylaws of the interstate commission promulgated under the compact.

26

     (b) If the interstate commission determines that a member state has defaulted in the

27

performance of its obligations or responsibilities under the compact, or the bylaws or promulgated

28

rules, the interstate commission shall:

29

     (1) Provide written notice to the defaulting state and other member states, of the nature of

30

the default, the means of curing the default, and any action taken by the interstate commission. The

31

interstate commission shall specify the conditions by which the defaulting state must cure its

32

default; and

33

     (2) Provide remedial training and specific technical assistance regarding the default.

34

     (c) If the defaulting state fails to cure the default, the defaulting state shall be terminated

 

LC005607 - Page 13 of 17

1

from the compact upon an affirmative vote of a majority of the commissioners and all rights,

2

privileges, and benefits conferred by the compact shall terminate on the effective date of

3

termination. A cure of the default does not relieve the offending state of obligations or liabilities

4

incurred during the period of the default.

5

     (d) Termination of membership in the compact shall be imposed only after all other means

6

of securing compliance have been exhausted. Notice of intent to terminate shall be given by the

7

interstate commission to the governor, the majority and minority leaders of the defaulting state’s

8

legislature, and each of the member states.

9

     (e) The interstate commission shall establish rules and procedures to address licenses and

10

physicians that are materially impacted by the termination of a member state, or the withdrawal of

11

a member state.

12

     (f) The member state which has been terminated is responsible for all dues, obligations,

13

and liabilities incurred through the effective date of termination including obligations, the

14

performance of which extends beyond the effective date of termination.

15

     (g) The interstate commission shall not bear any costs relating to any state that has been

16

found to be in default or which has been terminated from the compact, unless otherwise mutually

17

agreed upon in writing between the interstate commission and the defaulting state.

18

     (h) The defaulting state may appeal the action of the interstate commission by petitioning

19

the United States District Court for the District of Columbia or the federal district where the

20

interstate commission has its principal offices. The prevailing party shall be awarded all costs of

21

such litigation including reasonable attorney’s fees.

22

     5-91-19. Dispute resolution.

23

     (a) The interstate commission shall attempt, upon the request of a member state, to resolve

24

disputes which are subject to the compact and which may arise among member states or member

25

boards.

26

     (b) The interstate commission shall promulgate rules providing for both mediation and

27

binding dispute resolution as appropriate.

28

     5-91-20. Member states - Effective date - Amendment.

29

     (a) Any state is eligible to become a member of the compact.

30

     (b) The compact shall become effective and binding upon legislative enactment of the

31

compact into law by no less than seven (7) states. Thereafter, it shall become effective and binding

32

on a state upon enactment of the compact into law by that state.

33

     (c) The governors of non-member states, or their designees, shall be invited to participate

34

in the activities of the interstate commission on a non-voting basis prior to adoption of the compact

 

LC005607 - Page 14 of 17

1

by all states.

2

     (d) The interstate commission may propose amendments to the compact for enactment by

3

the member states. No amendment shall become effective and binding upon the interstate

4

commission and the member states unless and until it is enacted into law by unanimous consent of

5

the member states.

6

     5-91-21. Withdrawal.

7

     (a) Once effective, the compact shall continue in force and remain binding upon each and

8

every member state; provided that a member state may withdraw from the compact by specifically

9

repealing the statute which enacted the compact into law.

10

     (b) Withdrawal from the compact shall be by the enactment of a statute repealing the same,

11

but shall not take effect until one year after the effective date of such statute and until written notice

12

of the withdrawal has been given by the withdrawing state to the governor of each other member

13

state.

14

     (c) The withdrawing state shall immediately notify the chairperson of the interstate

15

commission in writing upon the introduction of legislation repealing the compact in the

16

withdrawing state.

17

     (d) The interstate commission shall notify the other member states of the withdrawing

18

state’s intent to withdraw within sixty (60) days of its receipt of notice provided under subsection

19

(c) of this section.

20

     (e) The withdrawing state is responsible for all dues, obligations and liabilities incurred

21

through the effective date of withdrawal, including obligations, the performance of which extend

22

beyond the effective date of withdrawal.

23

     (f) Reinstatement following withdrawal of a member state shall occur upon the

24

withdrawing state reenacting the compact or upon such later date as determined by the interstate

25

commission.

26

     (g) The interstate commission is authorized to develop rules to address the impact of the

27

withdrawal of a member state on licenses granted in other member states to physicians who

28

designated the withdrawing member state as the state of principal license.

29

     5-91-22. Dissolution.

30

     (a) The compact shall dissolve effective upon the date of the withdrawal or default of the

31

member state which reduces the membership of the compact to one member state.

32

     (b) Upon the dissolution of the compact, the compact becomes null and void and shall be

33

of no further force or effect, and the business and affairs of the interstate commission shall be

34

concluded, and surplus funds shall be distributed in accordance with the bylaws.

 

LC005607 - Page 15 of 17

1

     5-91-23. Severability and construction.

2

     (a) The provisions of the compact shall be severable, and if any phrase, clause, sentence,

3

or provision is deemed unenforceable, the remaining provisions of the compact shall be

4

enforceable.

5

     (b) The provisions of the compact shall be liberally construed to effectuate its purposes.

6

     (c) Nothing in the compact shall be construed to prohibit the applicability of other interstate

7

compacts to which the member states are members.

8

     5-91-24. Binding effect of compact and other laws.

9

     (a) Nothing herein prevents the enforcement of any other law of a member state that is not

10

inconsistent with the compact.

11

     (b) All laws in a member state in conflict with the compact are superseded to the extent of

12

the conflict.

13

     (c) All lawful actions of the interstate commission, including all rules and bylaws

14

promulgated by the commission, are binding upon the member states.

15

     (d) All agreements between the interstate commission and the member states are binding

16

in accordance with their terms.

17

     (e) In the event any provision of the compact exceeds the constitutional limits imposed on

18

the legislature of any member state, such provision shall be ineffective to the extent of the conflict

19

with the constitutional provision in question in that member state.

20

     SECTION 2. This act shall take effect upon passage.

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LC005607 - Page 16 of 17

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS -- INTERSTATE MEDICAL

LICENSURE COMPACT

***

1

     This act would create the Interstate Medical Licensure Compact allowing physicians to

2

become licensed in multiple states and practice under the jurisdiction of the state in which the

3

patient is located.

4

     This act would take effect upon passage.

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LC005607 - Page 17 of 17