Michigan 2025-2026 Regular Session

Michigan House Bill HB4032 Compare Versions

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1	1	HOUSE BILL NO. 4032 A bill to amend 1978 PA 368, entitled "Public health code," by amending section 16189 (MCL 333.16189), as amended by 2022 PA 38. the people of the state of michigan enact:
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25	25	HOUSE BILL NO. 4032
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29	29	A bill to amend 1978 PA 368, entitled
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31	31	"Public health code,"
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33	33	by amending section 16189 (MCL 333.16189), as amended by 2022 PA 38.
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35	35	the people of the state of michigan enact:
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37	37	1 2 3 4 Sec. 16189. (1) Beginning September 24, 2019, the interstate medical licensure compact is enacted into law and entered into by this state as a party with all jurisdictions that legally join in the compact, in the form substantially as follows: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 INTERSTATE MEDICAL LICENSURE COMPACT SECTION 1. PURPOSE In order to strengthen access to health care, and in recognition of the advances in the delivery of health care, the member states of the Interstate Medical Licensure Compact have allied in common purpose to develop a comprehensive process that complements the existing licensing and regulatory authority of state medical boards, provides a streamlined process that allows physicians to become licensed in multiple states, thereby enhancing the portability of a medical license and ensuring the safety of patients. The Compact creates another pathway for licensure and does not otherwise change a state's existing Medical Practice Act. The Compact also adopts the prevailing standard for licensure and affirms that the practice of medicine occurs where the patient is located at the time of the physician-patient encounter, and therefore, requires the physician to be under the jurisdiction of the state medical board where the patient is located. State medical boards that participate in the Compact retain the jurisdiction to impose an adverse action against a license to practice medicine in that state issued to a physician through the procedures in the Compact. SECTION 2. DEFINITIONS In this compact: (a) "Bylaws" means those bylaws established by the Interstate Commission pursuant to Section 11 for its governance, or for directing and controlling its actions and conduct. (b) "Commissioner" means the voting representative appointed by each member board pursuant to Section 11. (c) "Conviction" means a finding by a court that an individual 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 is guilty of a criminal offense through adjudication, or entry of a plea of guilt or no contest to the charge by the offender. Evidence of an entry of a conviction of a criminal offense by the court shall be considered final for purposes of disciplinary action by a member board. (d) "Expedited License" means a full and unrestricted medical license granted by a member state to an eligible physician through the process set forth in the Compact. (e) "Interstate Commission" means the interstate commission created pursuant to Section 11. (f) "License" means authorization by a state for a physician to engage in the practice of medicine, which would be unlawful without the authorization. (g) "Medical Practice Act" means laws and regulations governing the practice of allopathic and osteopathic medicine within a member state. (h) "Member Board" means a state agency in a member state that acts in the sovereign interests of the state by protecting the public through licensure, regulation, and education of physicians as directed by the state government. (i) "Member State" means a state that has enacted the Compact. (j) "Practice of medicine" means the diagnosis, treatment, prevention, cure, or relieving of a human disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device, diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do, any of these acts. (k) "Physician" means any person who: (1) Is a graduate of a medical school accredited by the 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 Liaison Committee on Medical Education, the Commission on Osteopathic College Accreditation, or a medical school listed in the International Medical Education Directory or its equivalent; (2) Passed each component of the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within three attempts, or any of its predecessor examinations accepted by a state medical board as an equivalent examination for licensure purposes; (3) Successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association; (4) Holds specialty certification or a time-unlimited specialty certificate recognized by the American Board of Medical Specialties or the American Osteopathic Association's Bureau of Osteopathic Specialists; however, the specialty certification or a time-unlimited specialty certificate does not have to be maintained once a physician is initially determined to be eligible for expedited licensure through the Compact; (5) Possesses a full and unrestricted license to engage in the practice of medicine issued by a member board; (6) Has never been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction; (7) Has never held a license authorizing the practice of medicine subjected to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-payment of fees related to a license; (8) Has never had a controlled substance license or permit suspended or revoked by a state or the United States Drug 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 Enforcement Administration; and (9) Is not under active investigation by a licensing agency or law enforcement authority in any state, federal, or foreign jurisdiction. (l) "Offense" means a felony, high court misdemeanor, or crime of moral turpitude. (m) "Rule" means a written statement by the Interstate Commission promulgated pursuant to Section 12 of the Compact that is of general applicability, implements, interprets, or prescribes a policy or provision of the Compact, or an organizational, procedural, or practice requirement of the Interstate Commission, and has the force and effect of statutory law in a member state, if the rule is not inconsistent with the laws of the member state. The term includes the amendment, repeal, or suspension of an existing rule. (n) "State" means any state, commonwealth, district, or territory of the United States. (o) "State of Principal License" means a member state where a physician holds a license to practice medicine and which has been designated as such by the physician for purposes of registration and participation in the Compact. SECTION 3. ELIGIBILITY (a) A physician must meet the eligibility requirements as defined in Section 2(k) to receive an expedited license under the terms and provisions of the Compact. (b) A physician who does not meet the requirements of Section 2(k) may obtain a license to practice medicine in a member state if the individual complies with all laws and requirements, other than the Compact, relating to the issuance of a license to practice 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 medicine in that state. SECTION 4. DESIGNATION OF STATE OF PRINCIPAL LICENSE (a) A physician shall designate a member state as the state of principal license for purposes of registration for expedited licensure through the Compact if the physician possesses a full and unrestricted license to practice medicine in that state, and the state is: (1) the state of primary residence for the physician, or (2) the state where at least 25% of the practice of medicine occurs, or (3) the location of the physician's employer, or (4) if no state qualifies under subsection (1), subsection (2), or subsection (3), the state designated as state of residence for purpose of federal income tax. (b) A physician may redesignate a member state as state of principal license at any time, as long as the state meets the requirements in subsection (a). (c) The Interstate Commission is authorized to develop rules to facilitate redesignation of another member state as the state of principal license. SECTION 5. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE (a) A physician seeking licensure through the Compact shall file an application for an expedited license with the member board of the state selected by the physician as the state of principal license. (b) Upon receipt of an application for an expedited license, the member board within the state selected as the state of principal license shall evaluate whether the physician is eligible for expedited licensure and issue a letter of qualification, 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 verifying or denying the physician's eligibility, to the Interstate Commission. (i) Static qualifications, which include verification of medical education, graduate medical education, results of any medical or licensing examination, and other qualifications as determined by the Interstate Commission through rule, shall not be subject to additional primary source verification where already primary source verified by the state of principal license. (ii) The member board within the state selected as the state of principal license shall, in the course of verifying eligibility, perform a criminal background check of an applicant, including the use of the results of fingerprint or other biometric data checks compliant with the requirements of the Federal Bureau of Investigation, with the exception of federal employees who have suitability determination in accordance with U.S. CFR ?731.202. (iii) Appeal on the determination of eligibility shall be made to the member state where the application was filed and shall be subject to the law of that state. (c) Upon verification in subsection (b), physicians eligible for an expedited license shall complete the registration process established by the Interstate Commission to receive a license in a member state selected pursuant to subsection (a), including the payment of any applicable fees. (d) After receiving verification of eligibility under subsection (b) and any fees under subsection (c), a member board shall issue an expedited license to the physician. This license shall authorize the physician to practice medicine in the issuing state consistent with the Medical Practice Act and all applicable laws and regulations of the issuing member board and member state. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 (e) An expedited license shall be valid for a period consistent with the licensure period in the member state and in the same manner as required for other physicians holding a full and unrestricted license within the member state. (f) An expedited license obtained through the Compact shall be terminated if a physician fails to maintain a license in the state of principal licensure for a non-disciplinary reason, without redesignation of a new state of principal licensure. (g) The Interstate Commission is authorized to develop rules regarding the application process, including payment of any applicable fees, and the issuance of an expedited license. SECTION 6. FEES FOR EXPEDITED LICENSURE (a) A member state issuing an expedited license authorizing the practice of medicine in that state, or the regulating authority of the member state, may impose a fee for a license issued or renewed through the Compact. (b) The Interstate Commission is authorized to develop rules regarding fees for expedited licenses. However, those rules shall not limit the authority of a member state, or the regulating authority of the member state, to impose and determine the amount of a fee under subsection (a). SECTION 7. RENEWAL AND CONTINUED PARTICIPATION (a) A physician seeking to renew an expedited license granted in a member state shall complete a renewal process with the Interstate Commission if the physician: (1) Maintains a full and unrestricted license in a state of principal license; (2) Has not been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 any offense by a court of appropriate jurisdiction; (3) Has not had a license authorizing the practice of medicine subject to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-payment of fees related to a license; and (4) Has not had a controlled substance license or permit suspended or revoked by a state or the United States Drug Enforcement Administration. (b) Physicians shall comply with all continuing professional development or continuing medical education requirements for renewal of a license issued by a member state. (c) The Interstate Commission shall collect any renewal fees charged for the renewal of a license and distribute the fees to the applicable member board. (d) Upon receipt of any renewal fees collected in subsection (c), a member board shall renew the physician's license. (e) Physician information collected by the Interstate Commission during the renewal process will be distributed to all member boards. (f) The Interstate Commission is authorized to develop rules to address renewal of licenses obtained through the Compact. SECTION 8. COORDINATED INFORMATION SYSTEM (a) The Interstate Commission shall establish a database of all physicians licensed, or who have applied for licensure, under Section 5. (b) Notwithstanding any other provision of law, member boards shall report to the Interstate Commission any public action or complaints against a licensed physician who has applied or received an expedited license through the Compact. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 (c) Member boards shall report disciplinary or investigatory information determined as necessary and proper by rule of the Interstate Commission. (d) Member boards may report any non-public complaint, disciplinary, or investigatory information not required by subsection (c) to the Interstate Commission. (e) Member boards shall share complaint or disciplinary information about a physician upon request of another member board. (f) All information provided to the Interstate Commission or distributed by member boards shall be confidential, filed under seal, and used only for investigatory or disciplinary matters. (g) The Interstate Commission is authorized to develop rules for mandated or discretionary sharing of information by member boards. SECTION 9. JOINT INVESTIGATIONS (a) Licensure and disciplinary records of physicians are deemed investigative. (b) In addition to the authority granted to a member board by its respective Medical Practice Act or other applicable state law, a member board may participate with other member boards in joint investigations of physicians licensed by the member boards. (c) A subpoena issued by a member state shall be enforceable in other member states. (d) Member boards may share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact. (e) Any member state may investigate actual or alleged violations of the statutes authorizing the practice of medicine in any other member state in which a physician holds a license to 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 practice medicine. SECTION 10. DISCIPLINARY ACTIONS (a) Any disciplinary action taken by any member board against a physician licensed through the Compact shall be deemed unprofessional conduct which may be subject to discipline by other member boards, in addition to any violation of the Medical Practice Act or regulations in that state. (b) If a license granted to a physician by the member board in the state of principal license is revoked, surrendered or relinquished in lieu of discipline, or suspended, then all licenses issued to the physician by member boards shall automatically be placed, without further action necessary by any member board, on the same status. If the member board in the state of principal license subsequently reinstates the physician's license, a license issued to the physician by any other member board shall remain encumbered until that respective member board takes action to reinstate the license in a manner consistent with the Medical Practice Act of that state. (c) If disciplinary action is taken against a physician by a member board not in the state of principal license, any other member board may deem the action conclusive as to matter of law and fact decided, and: (i) impose the same or lesser sanction(s) against the physician so long as such sanctions are consistent with the Medical Practice Act of that state; (ii) or pursue separate disciplinary action against the physician under its respective Medical Practice Act, regardless of the action taken in other member states. (d) If a license granted to a physician by a member board is 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 revoked, surrendered or relinquished in lieu of discipline, or suspended, then any license(s) issued to the physician by any other member board(s) shall be suspended, automatically and immediately without further action necessary by the other member board(s), for ninety (90) days upon entry of the order by the disciplining board, to permit the member board(s) to investigate the basis for the action under the Medical Practice Act of that state. A member board may terminate the automatic suspension of the license it issued prior to the completion of the ninety (90) day suspension period in a manner consistent with the Medical Practice Act of that state. SECTION 11. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION (a) The member states hereby create the "Interstate Medical Licensure Compact Commission". (b) The purpose of the Interstate Commission is the administration of the Interstate Medical Licensure Compact, which is a discretionary state function. (c) The Interstate Commission shall be a body corporate and joint agency of the member states and shall have all the responsibilities, powers, and duties set forth in the Compact, and such additional powers as may be conferred upon it by a subsequent concurrent action of the respective legislatures of the member states in accordance with the terms of the Compact. (d) The Interstate Commission shall consist of two voting representatives appointed by each member state who shall serve as Commissioners. In states where allopathic and osteopathic physicians are regulated by separate member boards, or if the licensing and disciplinary authority is split between multiple member boards within a member state, the member state shall appoint one representative from each member board. A Commissioner shall be 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 a(n): (1) Allopathic or osteopathic physician appointed to a member board; (2) Executive director, executive secretary, or similar executive of a member board; or (3) Member of the public appointed to a member board. (e) The Interstate Commission shall meet at least once each calendar year. A portion of this meeting shall be a business meeting to address such matters as may properly come before the Commission, including the election of officers. The chairperson may call additional meetings and shall call for a meeting upon the request of a majority of the member states. (f) The bylaws may provide for meetings of the Interstate Commission to be conducted by telecommunication or electronic communication. (g) Each Commissioner participating at a meeting of the Interstate Commission is entitled to one vote. A majority of Commissioners shall constitute a quorum for the transaction of business, unless a larger quorum is required by the bylaws of the Interstate Commission. A Commissioner shall not delegate a vote to another Commissioner. In the absence of its Commissioner, a member state may delegate voting authority for a specified meeting to another person from that state who shall meet the requirements of subsection (d). (h) The Interstate Commission shall provide public notice of all meetings and all meetings shall be open to the public. The Interstate Commission may close a meeting, in full or in portion, where it determines by a two-thirds vote of the Commissioners present that an open meeting would be likely to: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 (1) Relate solely to the internal personnel practices and procedures of the Interstate Commission; (2) Discuss matters specifically exempted from disclosure by federal statute; (3) Discuss trade secrets, commercial, or financial information that is privileged or confidential; (4) Involve accusing a person of a crime, or formally censuring a person; (5) Discuss information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy; (6) Discuss investigative records compiled for law enforcement purposes; or (7) Specifically relate to the participation in a civil action or other legal proceeding. (i) The Interstate Commission shall keep minutes which shall fully describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, including record of any roll call votes. (j) The Interstate Commission shall make its information and official records, to the extent not otherwise designated in the Compact or by its rules, available to the public for inspection. (k) The Interstate Commission shall establish an executive committee, which shall include officers, members, and others as determined by the bylaws. The executive committee shall have the power to act on behalf of the Interstate Commission, with the exception of rulemaking, during periods when the Interstate Commission is not in session. When acting on behalf of the Interstate Commission, the executive committee shall oversee the 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 administration of the Compact including enforcement and compliance with the provisions of the Compact, its bylaws and rules, and other such duties as necessary. (l) The Interstate Commission may establish other committees for governance and administration of the Compact. SECTION 12. POWERS AND DUTIES OF THE INTERSTATE COMMISSION The Interstate Commission shall have the duty and power to: (a) Oversee and maintain the administration of the Compact; (b) Promulgate rules which shall be binding to the extent and in the manner provided for in the Compact; (c) Issue, upon the request of a member state or member board, advisory opinions concerning the meaning or interpretation of the Compact, its bylaws, rules, and actions; (d) Enforce compliance with Compact provisions, the rules promulgated by the Interstate Commission, and the bylaws, using all necessary and proper means, including but not limited to the use of judicial process; (e) Establish and appoint committees including, but not limited to, an executive committee as required by Section 11, which shall have the power to act on behalf of the Interstate Commission in carrying out its powers and duties; (f) Pay, or provide for the payment of the expenses related to the establishment, organization, and ongoing activities of the Interstate Commission; (g) Establish and maintain one or more offices; (h) Borrow, accept, hire, or contract for services of personnel; (i) Purchase and maintain insurance and bonds; (j) Employ an executive director who shall have such powers to 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 employ, select or appoint employees, agents, or consultants, and to determine their qualifications, define their duties, and fix their compensation; (k) Establish personnel policies and programs relating to conflicts of interest, rates of compensation, and qualifications of personnel; (l) Accept donations and grants of money, equipment, supplies, materials and services, and to receive, utilize, and dispose of it in a manner consistent with the conflict of interest policies established by the Interstate Commission; (m) Lease, purchase, accept contributions or donations of, or otherwise to own, hold, improve or use, any property, real, personal, or mixed; (n) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed; (o) Establish a budget and make expenditures; (p) Adopt a seal and bylaws governing the management and operation of the Interstate Commission; (q) Report annually to the legislatures and governors of the member states concerning the activities of the Interstate Commission during the preceding year. Such reports shall also include reports of financial audits and any recommendations that may have been adopted by the Interstate Commission; (r) Coordinate education, training, and public awareness regarding the Compact, its implementation, and its operation; (s) Maintain records in accordance with the bylaws; (t) Seek and obtain trademarks, copyrights, and patents; and (u) Perform such functions as may be necessary or appropriate to achieve the purposes of the Compact. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 SECTION 13. FINANCE POWERS (a) The Interstate Commission may levy on and collect an annual assessment from each member state to cover the cost of the operations and activities of the Interstate Commission and its staff. The total assessment, subject to appropriation, must be sufficient to cover the annual budget approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated upon a formula to be determined by the Interstate Commission, which shall promulgate a rule binding upon all member states. (b) The Interstate Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same. (c) The Interstate Commission shall not pledge the credit of any of the member states, except by, and with the authority of, the member state. (d) The Interstate Commission shall be subject to a yearly financial audit conducted by a certified or licensed public accountant and the report of the audit shall be included in the annual report of the Interstate Commission. SECTION 14. ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION (a) The Interstate Commission shall, by a majority of Commissioners present and voting, adopt bylaws to govern its conduct as may be necessary or appropriate to carry out the purposes of the Compact within twelve (12) months of the first Interstate Commission meeting. (b) The Interstate Commission shall elect or appoint annually from among its Commissioners a chairperson, a vice-chairperson, and a treasurer, each of whom shall have such authority and duties as 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 may be specified in the bylaws. The chairperson, or in the chairperson's absence or disability, the vice-chairperson, shall preside at all meetings of the Interstate Commission. (c) Officers selected in subsection (b) shall serve without remuneration from the Interstate Commission. (d) The officers and employees of the Interstate Commission shall be immune from suit and liability, either personally or in their official capacity, for a claim for damage to or loss of property or personal injury or other civil liability caused or arising out of, or relating to, an actual or alleged act, error, or omission that occurred, or that such person had a reasonable basis for believing occurred, within the scope of Interstate Commission employment, duties, or responsibilities; provided that such person shall not be protected from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person. (1) The liability of the executive director and employees of the Interstate Commission or representatives of the Interstate Commission, acting within the scope of such person's employment or duties for acts, errors, or omissions occurring within such person's state, may not exceed the limits of liability set forth under the constitution and laws of that state for state officials, employees, and agents. The Interstate Commission is considered to be an instrumentality of the states for the purposes of any such action. Nothing in this subsection shall be construed to protect such person from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person. (2) The Interstate Commission shall defend the executive 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 director, its employees, and subject to the approval of the attorney general or other appropriate legal counsel of the member state represented by an Interstate Commission representative, shall defend such Interstate Commission representative in any civil action seeking to impose liability arising out of an actual or alleged act, error or omission that occurred within the scope of Interstate Commission employment, duties or responsibilities, or that the defendant had a reasonable basis for believing occurred within the scope of Interstate Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such person. (3) To the extent not covered by the state involved, member state, or the Interstate Commission, the representatives or employees of the Interstate Commission shall be held harmless in the amount of a settlement or judgment, including attorney's fees and costs, obtained against such persons arising out of an actual or alleged act, error, or omission that occurred within the scope of Interstate Commission employment, duties, or responsibilities, or that such persons had a reasonable basis for believing occurred within the scope of Interstate Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such persons. SECTION 15. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION (a) The Interstate Commission shall promulgate reasonable rules in order to effectively and efficiently achieve the purposes of the Compact. Notwithstanding the foregoing, in the event the Interstate Commission exercises its rulemaking authority in a 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 manner that is beyond the scope of the purposes of the Compact, or the powers granted hereunder, then such an action by the Interstate Commission shall be invalid and have no force or effect. (b) Rules deemed appropriate for the operations of the Interstate Commission shall be made pursuant to a rulemaking process that substantially conforms to the "Model State Administrative Procedure Act" of 2010, and subsequent amendments thereto. (c) Not later than thirty (30) days after a rule is promulgated, any person may file a petition for judicial review of the rule in the United States District Court for the District of Columbia or the federal district where the Interstate Commission has its principal offices, provided that the filing of such a petition shall not stay or otherwise prevent the rule from becoming effective unless the court finds that the petitioner has a substantial likelihood of success. The court shall give deference to the actions of the Interstate Commission consistent with applicable law and shall not find the rule to be unlawful if the rule represents a reasonable exercise of the authority granted to the Interstate Commission. SECTION 16. OVERSIGHT OF INTERSTATE COMPACT (a) The executive, legislative, and judicial branches of state government in each member state shall enforce the Compact and shall take all actions necessary and appropriate to effectuate the Compact's purposes and intent. The provisions of the Compact and the rules promulgated hereunder shall have standing as statutory law but shall not override existing state authority to regulate the practice of medicine. (b) All courts shall take judicial notice of the Compact and 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of the Compact which may affect the powers, responsibilities or actions of the Interstate Commission. (c) The Interstate Commission shall be entitled to receive all service of process in any such proceeding, and shall have standing to intervene in the proceeding for all purposes. Failure to provide service of process to the Interstate Commission shall render a judgment or order void as to the Interstate Commission, the Compact, or promulgated rules. SECTION 17. ENFORCEMENT OF INTERSTATE COMPACT (a) The Interstate Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of the Compact. (b) The Interstate Commission may, by majority vote of the Commissioners, initiate legal action in the United States District Court for the District of Columbia, or, at the discretion of the Interstate Commission, in the federal district where the Interstate Commission has its principal offices, to enforce compliance with the provisions of the Compact, and its promulgated rules and bylaws, against a member state in default. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation including reasonable attorney's fees. (c) The remedies herein shall not be the exclusive remedies of the Interstate Commission. The Interstate Commission may avail itself of any other remedies available under state law or the regulation of a profession. SECTION 18. DEFAULT PROCEDURES 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 (a) The grounds for default include, but are not limited to, failure of a member state to perform such obligations or responsibilities imposed upon it by the Compact, or the rules and bylaws of the Interstate Commission promulgated under the Compact. (b) If the Interstate Commission determines that a member state has defaulted in the performance of its obligations or responsibilities under the Compact, or the bylaws or promulgated rules, the Interstate Commission shall: (1) Provide written notice to the defaulting state and other member states, of the nature of the default, the means of curing the default, and any action taken by the Interstate Commission. The Interstate Commission shall specify the conditions by which the defaulting state must cure its default; and (2) Provide remedial training and specific technical assistance regarding the default. (c) If the defaulting state fails to cure the default, the defaulting state shall be terminated from the Compact upon an affirmative vote of a majority of the Commissioners and all rights, privileges, and benefits conferred by the Compact shall terminate on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of the default. (d) Termination of membership in the Compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to terminate shall be given by the Interstate Commission to the governor, the majority and minority leaders of the defaulting state's legislature, and each of the member states. (e) The Interstate Commission shall establish rules and 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 procedures to address licenses and physicians that are materially impacted by the termination of a member state, or the withdrawal of a member state. (f) The member state which has been terminated is responsible for all dues, obligations, and liabilities incurred through the effective date of termination including obligations, the performance of which extends beyond the effective date of termination. (g) The Interstate Commission shall not bear any costs relating to any state that has been found to be in default or which has been terminated from the Compact, unless otherwise mutually agreed upon in writing between the Interstate Commission and the defaulting state. (h) The defaulting state may appeal the action of the Interstate Commission by petitioning the United States District Court for the District of Columbia or the federal district where the Interstate Commission has its principal offices. The prevailing party shall be awarded all costs of such litigation including reasonable attorney's fees. SECTION 19. DISPUTE RESOLUTION (a) The Interstate Commission shall attempt, upon the request of a member state, to resolve disputes which are subject to the Compact and which may arise among member states or member boards. (b) The Interstate Commission shall promulgate rules providing for both mediation and binding dispute resolution as appropriate. SECTION 20. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT (a) Any state is eligible to become a member state of the Compact. (b) The Compact shall become effective and binding upon 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 legislative enactment of the Compact into law by no less than seven (7) states. Thereafter, it shall become effective and binding on a state upon enactment of the Compact into law by that state. (c) The governors of non-member states, or their designees, shall be invited to participate in the activities of the Interstate Commission on a non-voting basis prior to adoption of the Compact by all states. (d) The Interstate Commission may propose amendments to the Compact for enactment by the member states. No amendment shall become effective and binding upon the Interstate Commission and the member states unless and until it is enacted into law by unanimous consent of the member states. SECTION 21. WITHDRAWAL (a) Once effective, the Compact shall continue in force and remain binding upon each and every member state; provided that a member state may withdraw from the Compact by specifically repealing the statute which enacted the Compact into law. (b) Withdrawal from the Compact shall be by the enactment of a statute repealing the same, but shall not take effect until one (1) year after the effective date of such statute and until written notice of the withdrawal has been given by the withdrawing state to the governor of each other member state. (c) The withdrawing state shall immediately notify the chairperson of the Interstate Commission in writing upon the introduction of legislation repealing the Compact in the withdrawing state. (d) The Interstate Commission shall notify the other member states of the withdrawing state's intent to withdraw within sixty (60) days of its receipt of notice provided under subsection (c). 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 (e) The withdrawing state is responsible for all dues, obligations and liabilities incurred through the effective date of withdrawal, including obligations, the performance of which extend beyond the effective date of withdrawal. (f) Reinstatement following withdrawal of a member state shall occur upon the withdrawing state reenacting the Compact or upon such later date as determined by the Interstate Commission. (g) The Interstate Commission is authorized to develop rules to address the impact of the withdrawal of a member state on licenses granted in other member states to physicians who designated the withdrawing member state as the state of principal license. SECTION 22. DISSOLUTION (a) The Compact shall dissolve effective upon the date of the withdrawal or default of the member state which reduces the membership in the Compact to one (1) member state. (b) Upon the dissolution of the Compact, the Compact becomes null and void and shall be of no further force or effect, and the business and affairs of the Interstate Commission shall be concluded and surplus funds shall be distributed in accordance with the bylaws. SECTION 23. SEVERABILITY AND CONSTRUCTION (a) The provisions of the Compact shall be severable, and if any phrase, clause, sentence, or provision is deemed unenforceable, the remaining provisions of the Compact shall be enforceable. (b) The provisions of the Compact shall be liberally construed to effectuate its purposes. (c) Nothing in the Compact shall be construed to prohibit the applicability of other interstate compacts to which the states are 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 members. SECTION 24. BINDING EFFECT OF COMPACT AND OTHER LAWS (a) Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the Compact. (b) All laws in a member state in conflict with the Compact are superseded to the extent of the conflict. (c) All lawful actions of the Interstate Commission, including all rules and bylaws promulgated by the Commission, are binding upon the member states. (d) All agreements between the Interstate Commission and the member states are binding in accordance with their terms. (e) In the event any provision of the Compact exceeds the constitutional limits imposed on the legislature of any member state, such provision shall be ineffective to the extent of the conflict with the constitutional provision in question in that member state. (2) Subsection (1) shall may be known as the "interstate medical licensure compact". (3) This section is repealed effective March 28, 2025.
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47	47	Sec. 16189. (1) Beginning September 24, 2019, the interstate medical licensure compact is enacted into law and entered into by this state as a party with all jurisdictions that legally join in the compact, in the form substantially as follows:
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107	107	INTERSTATE MEDICAL LICENSURE COMPACT
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109	109	INTERSTATE MEDICAL LICENSURE COMPACT
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111	111	SECTION 1. PURPOSE
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113	113	In order to strengthen access to health care, and in recognition of the advances in the delivery of health care, the member states of the Interstate Medical Licensure Compact have allied in common purpose to develop a comprehensive process that complements the existing licensing and regulatory authority of state medical boards, provides a streamlined process that allows physicians to become licensed in multiple states, thereby enhancing the portability of a medical license and ensuring the safety of patients. The Compact creates another pathway for licensure and does not otherwise change a state's existing Medical Practice Act. The Compact also adopts the prevailing standard for licensure and affirms that the practice of medicine occurs where the patient is located at the time of the physician-patient encounter, and therefore, requires the physician to be under the jurisdiction of the state medical board where the patient is located. State medical boards that participate in the Compact retain the jurisdiction to impose an adverse action against a license to practice medicine in that state issued to a physician through the procedures in the Compact.
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115	115	SECTION 2. DEFINITIONS
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117	117	In this compact:
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119	119	(a) "Bylaws" means those bylaws established by the Interstate Commission pursuant to Section 11 for its governance, or for directing and controlling its actions and conduct.
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121	121	(b) "Commissioner" means the voting representative appointed by each member board pursuant to Section 11.
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123	123	(c) "Conviction" means a finding by a court that an individual
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183	183	is guilty of a criminal offense through adjudication, or entry of a plea of guilt or no contest to the charge by the offender. Evidence of an entry of a conviction of a criminal offense by the court shall be considered final for purposes of disciplinary action by a member board.
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185	185	(d) "Expedited License" means a full and unrestricted medical license granted by a member state to an eligible physician through the process set forth in the Compact.
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187	187	(e) "Interstate Commission" means the interstate commission created pursuant to Section 11.
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189	189	(f) "License" means authorization by a state for a physician to engage in the practice of medicine, which would be unlawful without the authorization.
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191	191	(g) "Medical Practice Act" means laws and regulations governing the practice of allopathic and osteopathic medicine within a member state.
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193	193	(h) "Member Board" means a state agency in a member state that acts in the sovereign interests of the state by protecting the public through licensure, regulation, and education of physicians as directed by the state government.
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195	195	(i) "Member State" means a state that has enacted the Compact.
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197	197	(j) "Practice of medicine" means the diagnosis, treatment, prevention, cure, or relieving of a human disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device, diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do, any of these acts.
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199	199	(k) "Physician" means any person who:
200	200
201	201	(1) Is a graduate of a medical school accredited by the
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261	261	Liaison Committee on Medical Education, the Commission on Osteopathic College Accreditation, or a medical school listed in the International Medical Education Directory or its equivalent;
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263	263	(2) Passed each component of the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within three attempts, or any of its predecessor examinations accepted by a state medical board as an equivalent examination for licensure purposes;
264	264
265	265	(3) Successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association;
266	266
267	267	(4) Holds specialty certification or a time-unlimited specialty certificate recognized by the American Board of Medical Specialties or the American Osteopathic Association's Bureau of Osteopathic Specialists; however, the specialty certification or a time-unlimited specialty certificate does not have to be maintained once a physician is initially determined to be eligible for expedited licensure through the Compact;
268	268
269	269	(5) Possesses a full and unrestricted license to engage in the practice of medicine issued by a member board;
270	270
271	271	(6) Has never been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;
272	272
273	273	(7) Has never held a license authorizing the practice of medicine subjected to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-payment of fees related to a license;
274	274
275	275	(8) Has never had a controlled substance license or permit suspended or revoked by a state or the United States Drug
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335	335	Enforcement Administration; and
336	336
337	337	(9) Is not under active investigation by a licensing agency or law enforcement authority in any state, federal, or foreign jurisdiction.
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339	339	(l) "Offense" means a felony, high court misdemeanor, or crime of moral turpitude.
340	340
341	341	(m) "Rule" means a written statement by the Interstate Commission promulgated pursuant to Section 12 of the Compact that is of general applicability, implements, interprets, or prescribes a policy or provision of the Compact, or an organizational, procedural, or practice requirement of the Interstate Commission, and has the force and effect of statutory law in a member state, if the rule is not inconsistent with the laws of the member state. The term includes the amendment, repeal, or suspension of an existing rule.
342	342
343	343	(n) "State" means any state, commonwealth, district, or territory of the United States.
344	344
345	345	(o) "State of Principal License" means a member state where a physician holds a license to practice medicine and which has been designated as such by the physician for purposes of registration and participation in the Compact.
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347	347	SECTION 3. ELIGIBILITY
348	348
349	349	(a) A physician must meet the eligibility requirements as defined in Section 2(k) to receive an expedited license under the terms and provisions of the Compact.
350	350
351	351	(b) A physician who does not meet the requirements of Section 2(k) may obtain a license to practice medicine in a member state if the individual complies with all laws and requirements, other than the Compact, relating to the issuance of a license to practice
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411	411	medicine in that state.
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413	413	SECTION 4. DESIGNATION OF STATE OF PRINCIPAL LICENSE
414	414
415	415	(a) A physician shall designate a member state as the state of principal license for purposes of registration for expedited licensure through the Compact if the physician possesses a full and unrestricted license to practice medicine in that state, and the state is:
416	416
417	417	(1) the state of primary residence for the physician, or
418	418
419	419	(2) the state where at least 25% of the practice of medicine occurs, or
420	420
421	421	(3) the location of the physician's employer, or
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423	423	(4) if no state qualifies under subsection (1), subsection (2), or subsection (3), the state designated as state of residence for purpose of federal income tax.
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425	425	(b) A physician may redesignate a member state as state of principal license at any time, as long as the state meets the requirements in subsection (a).
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427	427	(c) The Interstate Commission is authorized to develop rules to facilitate redesignation of another member state as the state of principal license.
428	428
429	429	SECTION 5. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE
430	430
431	431	(a) A physician seeking licensure through the Compact shall file an application for an expedited license with the member board of the state selected by the physician as the state of principal license.
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433	433	(b) Upon receipt of an application for an expedited license, the member board within the state selected as the state of principal license shall evaluate whether the physician is eligible for expedited licensure and issue a letter of qualification,
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493	493	verifying or denying the physician's eligibility, to the Interstate Commission.
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495	495	(i) Static qualifications, which include verification of medical education, graduate medical education, results of any medical or licensing examination, and other qualifications as determined by the Interstate Commission through rule, shall not be subject to additional primary source verification where already primary source verified by the state of principal license.
496	496
497	497	(ii) The member board within the state selected as the state of principal license shall, in the course of verifying eligibility, perform a criminal background check of an applicant, including the use of the results of fingerprint or other biometric data checks compliant with the requirements of the Federal Bureau of Investigation, with the exception of federal employees who have suitability determination in accordance with U.S. CFR ?731.202.
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499	499	(iii) Appeal on the determination of eligibility shall be made to the member state where the application was filed and shall be subject to the law of that state.
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501	501	(c) Upon verification in subsection (b), physicians eligible for an expedited license shall complete the registration process established by the Interstate Commission to receive a license in a member state selected pursuant to subsection (a), including the payment of any applicable fees.
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503	503	(d) After receiving verification of eligibility under subsection (b) and any fees under subsection (c), a member board shall issue an expedited license to the physician. This license shall authorize the physician to practice medicine in the issuing state consistent with the Medical Practice Act and all applicable laws and regulations of the issuing member board and member state.
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563	563	(e) An expedited license shall be valid for a period consistent with the licensure period in the member state and in the same manner as required for other physicians holding a full and unrestricted license within the member state.
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565	565	(f) An expedited license obtained through the Compact shall be terminated if a physician fails to maintain a license in the state of principal licensure for a non-disciplinary reason, without redesignation of a new state of principal licensure.
566	566
567	567	(g) The Interstate Commission is authorized to develop rules regarding the application process, including payment of any applicable fees, and the issuance of an expedited license.
568	568
569	569	SECTION 6. FEES FOR EXPEDITED LICENSURE
570	570
571	571	(a) A member state issuing an expedited license authorizing the practice of medicine in that state, or the regulating authority of the member state, may impose a fee for a license issued or renewed through the Compact.
572	572
573	573	(b) The Interstate Commission is authorized to develop rules regarding fees for expedited licenses. However, those rules shall not limit the authority of a member state, or the regulating authority of the member state, to impose and determine the amount of a fee under subsection (a).
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575	575	SECTION 7. RENEWAL AND CONTINUED PARTICIPATION
576	576
577	577	(a) A physician seeking to renew an expedited license granted in a member state shall complete a renewal process with the Interstate Commission if the physician:
578	578
579	579	(1) Maintains a full and unrestricted license in a state of principal license;
580	580
581	581	(2) Has not been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for
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641	641	any offense by a court of appropriate jurisdiction;
642	642
643	643	(3) Has not had a license authorizing the practice of medicine subject to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-payment of fees related to a license; and
644	644
645	645	(4) Has not had a controlled substance license or permit suspended or revoked by a state or the United States Drug Enforcement Administration.
646	646
647	647	(b) Physicians shall comply with all continuing professional development or continuing medical education requirements for renewal of a license issued by a member state.
648	648
649	649	(c) The Interstate Commission shall collect any renewal fees charged for the renewal of a license and distribute the fees to the applicable member board.
650	650
651	651	(d) Upon receipt of any renewal fees collected in subsection (c), a member board shall renew the physician's license.
652	652
653	653	(e) Physician information collected by the Interstate Commission during the renewal process will be distributed to all member boards.
654	654
655	655	(f) The Interstate Commission is authorized to develop rules to address renewal of licenses obtained through the Compact.
656	656
657	657	SECTION 8. COORDINATED INFORMATION SYSTEM
658	658
659	659	(a) The Interstate Commission shall establish a database of all physicians licensed, or who have applied for licensure, under Section 5.
660	660
661	661	(b) Notwithstanding any other provision of law, member boards shall report to the Interstate Commission any public action or complaints against a licensed physician who has applied or received an expedited license through the Compact.
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721	721	(c) Member boards shall report disciplinary or investigatory information determined as necessary and proper by rule of the Interstate Commission.
722	722
723	723	(d) Member boards may report any non-public complaint, disciplinary, or investigatory information not required by subsection (c) to the Interstate Commission.
724	724
725	725	(e) Member boards shall share complaint or disciplinary information about a physician upon request of another member board.
726	726
727	727	(f) All information provided to the Interstate Commission or distributed by member boards shall be confidential, filed under seal, and used only for investigatory or disciplinary matters.
728	728
729	729	(g) The Interstate Commission is authorized to develop rules for mandated or discretionary sharing of information by member boards.
730	730
731	731	SECTION 9. JOINT INVESTIGATIONS
732	732
733	733	(a) Licensure and disciplinary records of physicians are deemed investigative.
734	734
735	735	(b) In addition to the authority granted to a member board by its respective Medical Practice Act or other applicable state law, a member board may participate with other member boards in joint investigations of physicians licensed by the member boards.
736	736
737	737	(c) A subpoena issued by a member state shall be enforceable in other member states.
738	738
739	739	(d) Member boards may share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.
740	740
741	741	(e) Any member state may investigate actual or alleged violations of the statutes authorizing the practice of medicine in any other member state in which a physician holds a license to
742	742
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746	746
747	747	3
748	748
749	749	4
750	750
751	751	5
752	752
753	753	6
754	754
755	755	7
756	756
757	757	8
758	758
759	759	9
760	760
761	761	10
762	762
763	763	11
764	764
765	765	12
766	766
767	767	13
768	768
769	769	14
770	770
771	771	15
772	772
773	773	16
774	774
775	775	17
776	776
777	777	18
778	778
779	779	19
780	780
781	781	20
782	782
783	783	21
784	784
785	785	22
786	786
787	787	23
788	788
789	789	24
790	790
791	791	25
792	792
793	793	26
794	794
795	795	27
796	796
797	797	28
798	798
799	799	29
800	800
801	801	practice medicine.
802	802
803	803	SECTION 10. DISCIPLINARY ACTIONS
804	804
805	805	(a) Any disciplinary action taken by any member board against a physician licensed through the Compact shall be deemed unprofessional conduct which may be subject to discipline by other member boards, in addition to any violation of the Medical Practice Act or regulations in that state.
806	806
807	807	(b) If a license granted to a physician by the member board in the state of principal license is revoked, surrendered or relinquished in lieu of discipline, or suspended, then all licenses issued to the physician by member boards shall automatically be placed, without further action necessary by any member board, on the same status. If the member board in the state of principal license subsequently reinstates the physician's license, a license issued to the physician by any other member board shall remain encumbered until that respective member board takes action to reinstate the license in a manner consistent with the Medical Practice Act of that state.
808	808
809	809	(c) If disciplinary action is taken against a physician by a member board not in the state of principal license, any other member board may deem the action conclusive as to matter of law and fact decided, and:
810	810
811	811	(i) impose the same or lesser sanction(s) against the physician so long as such sanctions are consistent with the Medical Practice Act of that state;
812	812
813	813	(ii) or pursue separate disciplinary action against the physician under its respective Medical Practice Act, regardless of the action taken in other member states.
814	814
815	815	(d) If a license granted to a physician by a member board is
816	816
817	817	1
818	818
819	819	2
820	820
821	821	3
822	822
823	823	4
824	824
825	825	5
826	826
827	827	6
828	828
829	829	7
830	830
831	831	8
832	832
833	833	9
834	834
835	835	10
836	836
837	837	11
838	838
839	839	12
840	840
841	841	13
842	842
843	843	14
844	844
845	845	15
846	846
847	847	16
848	848
849	849	17
850	850
851	851	18
852	852
853	853	19
854	854
855	855	20
856	856
857	857	21
858	858
859	859	22
860	860
861	861	23
862	862
863	863	24
864	864
865	865	25
866	866
867	867	26
868	868
869	869	27
870	870
871	871	28
872	872
873	873	29
874	874
875	875	revoked, surrendered or relinquished in lieu of discipline, or suspended, then any license(s) issued to the physician by any other member board(s) shall be suspended, automatically and immediately without further action necessary by the other member board(s), for ninety (90) days upon entry of the order by the disciplining board, to permit the member board(s) to investigate the basis for the action under the Medical Practice Act of that state. A member board may terminate the automatic suspension of the license it issued prior to the completion of the ninety (90) day suspension period in a manner consistent with the Medical Practice Act of that state.
876	876
877	877	SECTION 11. INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION
878	878
879	879	(a) The member states hereby create the "Interstate Medical Licensure Compact Commission".
880	880
881	881	(b) The purpose of the Interstate Commission is the administration of the Interstate Medical Licensure Compact, which is a discretionary state function.
882	882
883	883	(c) The Interstate Commission shall be a body corporate and joint agency of the member states and shall have all the responsibilities, powers, and duties set forth in the Compact, and such additional powers as may be conferred upon it by a subsequent concurrent action of the respective legislatures of the member states in accordance with the terms of the Compact.
884	884
885	885	(d) The Interstate Commission shall consist of two voting representatives appointed by each member state who shall serve as Commissioners. In states where allopathic and osteopathic physicians are regulated by separate member boards, or if the licensing and disciplinary authority is split between multiple member boards within a member state, the member state shall appoint one representative from each member board. A Commissioner shall be
886	886
887	887	1
888	888
889	889	2
890	890
891	891	3
892	892
893	893	4
894	894
895	895	5
896	896
897	897	6
898	898
899	899	7
900	900
901	901	8
902	902
903	903	9
904	904
905	905	10
906	906
907	907	11
908	908
909	909	12
910	910
911	911	13
912	912
913	913	14
914	914
915	915	15
916	916
917	917	16
918	918
919	919	17
920	920
921	921	18
922	922
923	923	19
924	924
925	925	20
926	926
927	927	21
928	928
929	929	22
930	930
931	931	23
932	932
933	933	24
934	934
935	935	25
936	936
937	937	26
938	938
939	939	27
940	940
941	941	28
942	942
943	943	29
944	944
945	945	a(n):
946	946
947	947	(1) Allopathic or osteopathic physician appointed to a member board;
948	948
949	949	(2) Executive director, executive secretary, or similar executive of a member board; or
950	950
951	951	(3) Member of the public appointed to a member board.
952	952
953	953	(e) The Interstate Commission shall meet at least once each calendar year. A portion of this meeting shall be a business meeting to address such matters as may properly come before the Commission, including the election of officers. The chairperson may call additional meetings and shall call for a meeting upon the request of a majority of the member states.
954	954
955	955	(f) The bylaws may provide for meetings of the Interstate Commission to be conducted by telecommunication or electronic communication.
956	956
957	957	(g) Each Commissioner participating at a meeting of the Interstate Commission is entitled to one vote. A majority of Commissioners shall constitute a quorum for the transaction of business, unless a larger quorum is required by the bylaws of the Interstate Commission. A Commissioner shall not delegate a vote to another Commissioner. In the absence of its Commissioner, a member state may delegate voting authority for a specified meeting to another person from that state who shall meet the requirements of subsection (d).
958	958
959	959	(h) The Interstate Commission shall provide public notice of all meetings and all meetings shall be open to the public. The Interstate Commission may close a meeting, in full or in portion, where it determines by a two-thirds vote of the Commissioners present that an open meeting would be likely to:
960	960
961	961	1
962	962
963	963	2
964	964
965	965	3
966	966
967	967	4
968	968
969	969	5
970	970
971	971	6
972	972
973	973	7
974	974
975	975	8
976	976
977	977	9
978	978
979	979	10
980	980
981	981	11
982	982
983	983	12
984	984
985	985	13
986	986
987	987	14
988	988
989	989	15
990	990
991	991	16
992	992
993	993	17
994	994
995	995	18
996	996
997	997	19
998	998
999	999	20
1000	1000
1001	1001	21
1002	1002
1003	1003	22
1004	1004
1005	1005	23
1006	1006
1007	1007	24
1008	1008
1009	1009	25
1010	1010
1011	1011	26
1012	1012
1013	1013	27
1014	1014
1015	1015	28
1016	1016
1017	1017	29
1018	1018
1019	1019	(1) Relate solely to the internal personnel practices and procedures of the Interstate Commission;
1020	1020
1021	1021	(2) Discuss matters specifically exempted from disclosure by federal statute;
1022	1022
1023	1023	(3) Discuss trade secrets, commercial, or financial information that is privileged or confidential;
1024	1024
1025	1025	(4) Involve accusing a person of a crime, or formally censuring a person;
1026	1026
1027	1027	(5) Discuss information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
1028	1028
1029	1029	(6) Discuss investigative records compiled for law enforcement purposes; or
1030	1030
1031	1031	(7) Specifically relate to the participation in a civil action or other legal proceeding.
1032	1032
1033	1033	(i) The Interstate Commission shall keep minutes which shall fully describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, including record of any roll call votes.
1034	1034
1035	1035	(j) The Interstate Commission shall make its information and official records, to the extent not otherwise designated in the Compact or by its rules, available to the public for inspection.
1036	1036
1037	1037	(k) The Interstate Commission shall establish an executive committee, which shall include officers, members, and others as determined by the bylaws. The executive committee shall have the power to act on behalf of the Interstate Commission, with the exception of rulemaking, during periods when the Interstate Commission is not in session. When acting on behalf of the Interstate Commission, the executive committee shall oversee the
1038	1038
1039	1039	1
1040	1040
1041	1041	2
1042	1042
1043	1043	3
1044	1044
1045	1045	4
1046	1046
1047	1047	5
1048	1048
1049	1049	6
1050	1050
1051	1051	7
1052	1052
1053	1053	8
1054	1054
1055	1055	9
1056	1056
1057	1057	10
1058	1058
1059	1059	11
1060	1060
1061	1061	12
1062	1062
1063	1063	13
1064	1064
1065	1065	14
1066	1066
1067	1067	15
1068	1068
1069	1069	16
1070	1070
1071	1071	17
1072	1072
1073	1073	18
1074	1074
1075	1075	19
1076	1076
1077	1077	20
1078	1078
1079	1079	21
1080	1080
1081	1081	22
1082	1082
1083	1083	23
1084	1084
1085	1085	24
1086	1086
1087	1087	25
1088	1088
1089	1089	26
1090	1090
1091	1091	27
1092	1092
1093	1093	28
1094	1094
1095	1095	29
1096	1096
1097	1097	administration of the Compact including enforcement and compliance with the provisions of the Compact, its bylaws and rules, and other such duties as necessary.
1098	1098
1099	1099	(l) The Interstate Commission may establish other committees for governance and administration of the Compact.
1100	1100
1101	1101	SECTION 12. POWERS AND DUTIES OF THE INTERSTATE COMMISSION
1102	1102
1103	1103	The Interstate Commission shall have the duty and power to:
1104	1104
1105	1105	(a) Oversee and maintain the administration of the Compact;
1106	1106
1107	1107	(b) Promulgate rules which shall be binding to the extent and in the manner provided for in the Compact;
1108	1108
1109	1109	(c) Issue, upon the request of a member state or member board, advisory opinions concerning the meaning or interpretation of the Compact, its bylaws, rules, and actions;
1110	1110
1111	1111	(d) Enforce compliance with Compact provisions, the rules promulgated by the Interstate Commission, and the bylaws, using all necessary and proper means, including but not limited to the use of judicial process;
1112	1112
1113	1113	(e) Establish and appoint committees including, but not limited to, an executive committee as required by Section 11, which shall have the power to act on behalf of the Interstate Commission in carrying out its powers and duties;
1114	1114
1115	1115	(f) Pay, or provide for the payment of the expenses related to the establishment, organization, and ongoing activities of the Interstate Commission;
1116	1116
1117	1117	(g) Establish and maintain one or more offices;
1118	1118
1119	1119	(h) Borrow, accept, hire, or contract for services of personnel;
1120	1120
1121	1121	(i) Purchase and maintain insurance and bonds;
1122	1122
1123	1123	(j) Employ an executive director who shall have such powers to
1124	1124
1125	1125	1
1126	1126
1127	1127	2
1128	1128
1129	1129	3
1130	1130
1131	1131	4
1132	1132
1133	1133	5
1134	1134
1135	1135	6
1136	1136
1137	1137	7
1138	1138
1139	1139	8
1140	1140
1141	1141	9
1142	1142
1143	1143	10
1144	1144
1145	1145	11
1146	1146
1147	1147	12
1148	1148
1149	1149	13
1150	1150
1151	1151	14
1152	1152
1153	1153	15
1154	1154
1155	1155	16
1156	1156
1157	1157	17
1158	1158
1159	1159	18
1160	1160
1161	1161	19
1162	1162
1163	1163	20
1164	1164
1165	1165	21
1166	1166
1167	1167	22
1168	1168
1169	1169	23
1170	1170
1171	1171	24
1172	1172
1173	1173	25
1174	1174
1175	1175	26
1176	1176
1177	1177	27
1178	1178
1179	1179	28
1180	1180
1181	1181	29
1182	1182
1183	1183	employ, select or appoint employees, agents, or consultants, and to determine their qualifications, define their duties, and fix their compensation;
1184	1184
1185	1185	(k) Establish personnel policies and programs relating to conflicts of interest, rates of compensation, and qualifications of personnel;
1186	1186
1187	1187	(l) Accept donations and grants of money, equipment, supplies, materials and services, and to receive, utilize, and dispose of it in a manner consistent with the conflict of interest policies established by the Interstate Commission;
1188	1188
1189	1189	(m) Lease, purchase, accept contributions or donations of, or otherwise to own, hold, improve or use, any property, real, personal, or mixed;
1190	1190
1191	1191	(n) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;
1192	1192
1193	1193	(o) Establish a budget and make expenditures;
1194	1194
1195	1195	(p) Adopt a seal and bylaws governing the management and operation of the Interstate Commission;
1196	1196
1197	1197	(q) Report annually to the legislatures and governors of the member states concerning the activities of the Interstate Commission during the preceding year. Such reports shall also include reports of financial audits and any recommendations that may have been adopted by the Interstate Commission;
1198	1198
1199	1199	(r) Coordinate education, training, and public awareness regarding the Compact, its implementation, and its operation;
1200	1200
1201	1201	(s) Maintain records in accordance with the bylaws;
1202	1202
1203	1203	(t) Seek and obtain trademarks, copyrights, and patents; and
1204	1204
1205	1205	(u) Perform such functions as may be necessary or appropriate to achieve the purposes of the Compact.
1206	1206
1207	1207	1
1208	1208
1209	1209	2
1210	1210
1211	1211	3
1212	1212
1213	1213	4
1214	1214
1215	1215	5
1216	1216
1217	1217	6
1218	1218
1219	1219	7
1220	1220
1221	1221	8
1222	1222
1223	1223	9
1224	1224
1225	1225	10
1226	1226
1227	1227	11
1228	1228
1229	1229	12
1230	1230
1231	1231	13
1232	1232
1233	1233	14
1234	1234
1235	1235	15
1236	1236
1237	1237	16
1238	1238
1239	1239	17
1240	1240
1241	1241	18
1242	1242
1243	1243	19
1244	1244
1245	1245	20
1246	1246
1247	1247	21
1248	1248
1249	1249	22
1250	1250
1251	1251	23
1252	1252
1253	1253	24
1254	1254
1255	1255	25
1256	1256
1257	1257	26
1258	1258
1259	1259	27
1260	1260
1261	1261	28
1262	1262
1263	1263	29
1264	1264
1265	1265	SECTION 13. FINANCE POWERS
1266	1266
1267	1267	(a) The Interstate Commission may levy on and collect an annual assessment from each member state to cover the cost of the operations and activities of the Interstate Commission and its staff. The total assessment, subject to appropriation, must be sufficient to cover the annual budget approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated upon a formula to be determined by the Interstate Commission, which shall promulgate a rule binding upon all member states.
1268	1268
1269	1269	(b) The Interstate Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same.
1270	1270
1271	1271	(c) The Interstate Commission shall not pledge the credit of any of the member states, except by, and with the authority of, the member state.
1272	1272
1273	1273	(d) The Interstate Commission shall be subject to a yearly financial audit conducted by a certified or licensed public accountant and the report of the audit shall be included in the annual report of the Interstate Commission.
1274	1274
1275	1275	SECTION 14. ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION
1276	1276
1277	1277	(a) The Interstate Commission shall, by a majority of Commissioners present and voting, adopt bylaws to govern its conduct as may be necessary or appropriate to carry out the purposes of the Compact within twelve (12) months of the first Interstate Commission meeting.
1278	1278
1279	1279	(b) The Interstate Commission shall elect or appoint annually from among its Commissioners a chairperson, a vice-chairperson, and a treasurer, each of whom shall have such authority and duties as
1280	1280
1281	1281	1
1282	1282
1283	1283	2
1284	1284
1285	1285	3
1286	1286
1287	1287	4
1288	1288
1289	1289	5
1290	1290
1291	1291	6
1292	1292
1293	1293	7
1294	1294
1295	1295	8
1296	1296
1297	1297	9
1298	1298
1299	1299	10
1300	1300
1301	1301	11
1302	1302
1303	1303	12
1304	1304
1305	1305	13
1306	1306
1307	1307	14
1308	1308
1309	1309	15
1310	1310
1311	1311	16
1312	1312
1313	1313	17
1314	1314
1315	1315	18
1316	1316
1317	1317	19
1318	1318
1319	1319	20
1320	1320
1321	1321	21
1322	1322
1323	1323	22
1324	1324
1325	1325	23
1326	1326
1327	1327	24
1328	1328
1329	1329	25
1330	1330
1331	1331	26
1332	1332
1333	1333	27
1334	1334
1335	1335	28
1336	1336
1337	1337	29
1338	1338
1339	1339	may be specified in the bylaws. The chairperson, or in the chairperson's absence or disability, the vice-chairperson, shall preside at all meetings of the Interstate Commission.
1340	1340
1341	1341	(c) Officers selected in subsection (b) shall serve without remuneration from the Interstate Commission.
1342	1342
1343	1343	(d) The officers and employees of the Interstate Commission shall be immune from suit and liability, either personally or in their official capacity, for a claim for damage to or loss of property or personal injury or other civil liability caused or arising out of, or relating to, an actual or alleged act, error, or omission that occurred, or that such person had a reasonable basis for believing occurred, within the scope of Interstate Commission employment, duties, or responsibilities; provided that such person shall not be protected from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person.
1344	1344
1345	1345	(1) The liability of the executive director and employees of the Interstate Commission or representatives of the Interstate Commission, acting within the scope of such person's employment or duties for acts, errors, or omissions occurring within such person's state, may not exceed the limits of liability set forth under the constitution and laws of that state for state officials, employees, and agents. The Interstate Commission is considered to be an instrumentality of the states for the purposes of any such action. Nothing in this subsection shall be construed to protect such person from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person.
1346	1346
1347	1347	(2) The Interstate Commission shall defend the executive
1348	1348
1349	1349	1
1350	1350
1351	1351	2
1352	1352
1353	1353	3
1354	1354
1355	1355	4
1356	1356
1357	1357	5
1358	1358
1359	1359	6
1360	1360
1361	1361	7
1362	1362
1363	1363	8
1364	1364
1365	1365	9
1366	1366
1367	1367	10
1368	1368
1369	1369	11
1370	1370
1371	1371	12
1372	1372
1373	1373	13
1374	1374
1375	1375	14
1376	1376
1377	1377	15
1378	1378
1379	1379	16
1380	1380
1381	1381	17
1382	1382
1383	1383	18
1384	1384
1385	1385	19
1386	1386
1387	1387	20
1388	1388
1389	1389	21
1390	1390
1391	1391	22
1392	1392
1393	1393	23
1394	1394
1395	1395	24
1396	1396
1397	1397	25
1398	1398
1399	1399	26
1400	1400
1401	1401	27
1402	1402
1403	1403	28
1404	1404
1405	1405	29
1406	1406
1407	1407	director, its employees, and subject to the approval of the attorney general or other appropriate legal counsel of the member state represented by an Interstate Commission representative, shall defend such Interstate Commission representative in any civil action seeking to impose liability arising out of an actual or alleged act, error or omission that occurred within the scope of Interstate Commission employment, duties or responsibilities, or that the defendant had a reasonable basis for believing occurred within the scope of Interstate Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such person.
1408	1408
1409	1409	(3) To the extent not covered by the state involved, member state, or the Interstate Commission, the representatives or employees of the Interstate Commission shall be held harmless in the amount of a settlement or judgment, including attorney's fees and costs, obtained against such persons arising out of an actual or alleged act, error, or omission that occurred within the scope of Interstate Commission employment, duties, or responsibilities, or that such persons had a reasonable basis for believing occurred within the scope of Interstate Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such persons.
1410	1410
1411	1411	SECTION 15. RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION
1412	1412
1413	1413	(a) The Interstate Commission shall promulgate reasonable rules in order to effectively and efficiently achieve the purposes of the Compact. Notwithstanding the foregoing, in the event the Interstate Commission exercises its rulemaking authority in a
1414	1414
1415	1415	1
1416	1416
1417	1417	2
1418	1418
1419	1419	3
1420	1420
1421	1421	4
1422	1422
1423	1423	5
1424	1424
1425	1425	6
1426	1426
1427	1427	7
1428	1428
1429	1429	8
1430	1430
1431	1431	9
1432	1432
1433	1433	10
1434	1434
1435	1435	11
1436	1436
1437	1437	12
1438	1438
1439	1439	13
1440	1440
1441	1441	14
1442	1442
1443	1443	15
1444	1444
1445	1445	16
1446	1446
1447	1447	17
1448	1448
1449	1449	18
1450	1450
1451	1451	19
1452	1452
1453	1453	20
1454	1454
1455	1455	21
1456	1456
1457	1457	22
1458	1458
1459	1459	23
1460	1460
1461	1461	24
1462	1462
1463	1463	25
1464	1464
1465	1465	26
1466	1466
1467	1467	27
1468	1468
1469	1469	28
1470	1470
1471	1471	29
1472	1472
1473	1473	manner that is beyond the scope of the purposes of the Compact, or the powers granted hereunder, then such an action by the Interstate Commission shall be invalid and have no force or effect.
1474	1474
1475	1475	(b) Rules deemed appropriate for the operations of the Interstate Commission shall be made pursuant to a rulemaking process that substantially conforms to the "Model State Administrative Procedure Act" of 2010, and subsequent amendments thereto.
1476	1476
1477	1477	(c) Not later than thirty (30) days after a rule is promulgated, any person may file a petition for judicial review of the rule in the United States District Court for the District of Columbia or the federal district where the Interstate Commission has its principal offices, provided that the filing of such a petition shall not stay or otherwise prevent the rule from becoming effective unless the court finds that the petitioner has a substantial likelihood of success. The court shall give deference to the actions of the Interstate Commission consistent with applicable law and shall not find the rule to be unlawful if the rule represents a reasonable exercise of the authority granted to the Interstate Commission.
1478	1478
1479	1479	SECTION 16. OVERSIGHT OF INTERSTATE COMPACT
1480	1480
1481	1481	(a) The executive, legislative, and judicial branches of state government in each member state shall enforce the Compact and shall take all actions necessary and appropriate to effectuate the Compact's purposes and intent. The provisions of the Compact and the rules promulgated hereunder shall have standing as statutory law but shall not override existing state authority to regulate the practice of medicine.
1482	1482
1483	1483	(b) All courts shall take judicial notice of the Compact and
1484	1484
1485	1485	1
1486	1486
1487	1487	2
1488	1488
1489	1489	3
1490	1490
1491	1491	4
1492	1492
1493	1493	5
1494	1494
1495	1495	6
1496	1496
1497	1497	7
1498	1498
1499	1499	8
1500	1500
1501	1501	9
1502	1502
1503	1503	10
1504	1504
1505	1505	11
1506	1506
1507	1507	12
1508	1508
1509	1509	13
1510	1510
1511	1511	14
1512	1512
1513	1513	15
1514	1514
1515	1515	16
1516	1516
1517	1517	17
1518	1518
1519	1519	18
1520	1520
1521	1521	19
1522	1522
1523	1523	20
1524	1524
1525	1525	21
1526	1526
1527	1527	22
1528	1528
1529	1529	23
1530	1530
1531	1531	24
1532	1532
1533	1533	25
1534	1534
1535	1535	26
1536	1536
1537	1537	27
1538	1538
1539	1539	28
1540	1540
1541	1541	29
1542	1542
1543	1543	the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of the Compact which may affect the powers, responsibilities or actions of the Interstate Commission.
1544	1544
1545	1545	(c) The Interstate Commission shall be entitled to receive all service of process in any such proceeding, and shall have standing to intervene in the proceeding for all purposes. Failure to provide service of process to the Interstate Commission shall render a judgment or order void as to the Interstate Commission, the Compact, or promulgated rules.
1546	1546
1547	1547	SECTION 17. ENFORCEMENT OF INTERSTATE COMPACT
1548	1548
1549	1549	(a) The Interstate Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of the Compact.
1550	1550
1551	1551	(b) The Interstate Commission may, by majority vote of the Commissioners, initiate legal action in the United States District Court for the District of Columbia, or, at the discretion of the Interstate Commission, in the federal district where the Interstate Commission has its principal offices, to enforce compliance with the provisions of the Compact, and its promulgated rules and bylaws, against a member state in default. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation including reasonable attorney's fees.
1552	1552
1553	1553	(c) The remedies herein shall not be the exclusive remedies of the Interstate Commission. The Interstate Commission may avail itself of any other remedies available under state law or the regulation of a profession.
1554	1554
1555	1555	SECTION 18. DEFAULT PROCEDURES
1556	1556
1557	1557	1
1558	1558
1559	1559	2
1560	1560
1561	1561	3
1562	1562
1563	1563	4
1564	1564
1565	1565	5
1566	1566
1567	1567	6
1568	1568
1569	1569	7
1570	1570
1571	1571	8
1572	1572
1573	1573	9
1574	1574
1575	1575	10
1576	1576
1577	1577	11
1578	1578
1579	1579	12
1580	1580
1581	1581	13
1582	1582
1583	1583	14
1584	1584
1585	1585	15
1586	1586
1587	1587	16
1588	1588
1589	1589	17
1590	1590
1591	1591	18
1592	1592
1593	1593	19
1594	1594
1595	1595	20
1596	1596
1597	1597	21
1598	1598
1599	1599	22
1600	1600
1601	1601	23
1602	1602
1603	1603	24
1604	1604
1605	1605	25
1606	1606
1607	1607	26
1608	1608
1609	1609	27
1610	1610
1611	1611	28
1612	1612
1613	1613	29
1614	1614
1615	1615	(a) The grounds for default include, but are not limited to, failure of a member state to perform such obligations or responsibilities imposed upon it by the Compact, or the rules and bylaws of the Interstate Commission promulgated under the Compact.
1616	1616
1617	1617	(b) If the Interstate Commission determines that a member state has defaulted in the performance of its obligations or responsibilities under the Compact, or the bylaws or promulgated rules, the Interstate Commission shall:
1618	1618
1619	1619	(1) Provide written notice to the defaulting state and other member states, of the nature of the default, the means of curing the default, and any action taken by the Interstate Commission. The Interstate Commission shall specify the conditions by which the defaulting state must cure its default; and
1620	1620
1621	1621	(2) Provide remedial training and specific technical assistance regarding the default.
1622	1622
1623	1623	(c) If the defaulting state fails to cure the default, the defaulting state shall be terminated from the Compact upon an affirmative vote of a majority of the Commissioners and all rights, privileges, and benefits conferred by the Compact shall terminate on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of the default.
1624	1624
1625	1625	(d) Termination of membership in the Compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to terminate shall be given by the Interstate Commission to the governor, the majority and minority leaders of the defaulting state's legislature, and each of the member states.
1626	1626
1627	1627	(e) The Interstate Commission shall establish rules and
1628	1628
1629	1629	1
1630	1630
1631	1631	2
1632	1632
1633	1633	3
1634	1634
1635	1635	4
1636	1636
1637	1637	5
1638	1638
1639	1639	6
1640	1640
1641	1641	7
1642	1642
1643	1643	8
1644	1644
1645	1645	9
1646	1646
1647	1647	10
1648	1648
1649	1649	11
1650	1650
1651	1651	12
1652	1652
1653	1653	13
1654	1654
1655	1655	14
1656	1656
1657	1657	15
1658	1658
1659	1659	16
1660	1660
1661	1661	17
1662	1662
1663	1663	18
1664	1664
1665	1665	19
1666	1666
1667	1667	20
1668	1668
1669	1669	21
1670	1670
1671	1671	22
1672	1672
1673	1673	23
1674	1674
1675	1675	24
1676	1676
1677	1677	25
1678	1678
1679	1679	26
1680	1680
1681	1681	27
1682	1682
1683	1683	28
1684	1684
1685	1685	29
1686	1686
1687	1687	procedures to address licenses and physicians that are materially impacted by the termination of a member state, or the withdrawal of a member state.
1688	1688
1689	1689	(f) The member state which has been terminated is responsible for all dues, obligations, and liabilities incurred through the effective date of termination including obligations, the performance of which extends beyond the effective date of termination.
1690	1690
1691	1691	(g) The Interstate Commission shall not bear any costs relating to any state that has been found to be in default or which has been terminated from the Compact, unless otherwise mutually agreed upon in writing between the Interstate Commission and the defaulting state.
1692	1692
1693	1693	(h) The defaulting state may appeal the action of the Interstate Commission by petitioning the United States District Court for the District of Columbia or the federal district where the Interstate Commission has its principal offices. The prevailing party shall be awarded all costs of such litigation including reasonable attorney's fees.
1694	1694
1695	1695	SECTION 19. DISPUTE RESOLUTION
1696	1696
1697	1697	(a) The Interstate Commission shall attempt, upon the request of a member state, to resolve disputes which are subject to the Compact and which may arise among member states or member boards.
1698	1698
1699	1699	(b) The Interstate Commission shall promulgate rules providing for both mediation and binding dispute resolution as appropriate.
1700	1700
1701	1701	SECTION 20. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT
1702	1702
1703	1703	(a) Any state is eligible to become a member state of the Compact.
1704	1704
1705	1705	(b) The Compact shall become effective and binding upon
1706	1706
1707	1707	1
1708	1708
1709	1709	2
1710	1710
1711	1711	3
1712	1712
1713	1713	4
1714	1714
1715	1715	5
1716	1716
1717	1717	6
1718	1718
1719	1719	7
1720	1720
1721	1721	8
1722	1722
1723	1723	9
1724	1724
1725	1725	10
1726	1726
1727	1727	11
1728	1728
1729	1729	12
1730	1730
1731	1731	13
1732	1732
1733	1733	14
1734	1734
1735	1735	15
1736	1736
1737	1737	16
1738	1738
1739	1739	17
1740	1740
1741	1741	18
1742	1742
1743	1743	19
1744	1744
1745	1745	20
1746	1746
1747	1747	21
1748	1748
1749	1749	22
1750	1750
1751	1751	23
1752	1752
1753	1753	24
1754	1754
1755	1755	25
1756	1756
1757	1757	26
1758	1758
1759	1759	27
1760	1760
1761	1761	28
1762	1762
1763	1763	29
1764	1764
1765	1765	legislative enactment of the Compact into law by no less than seven (7) states. Thereafter, it shall become effective and binding on a state upon enactment of the Compact into law by that state.
1766	1766
1767	1767	(c) The governors of non-member states, or their designees, shall be invited to participate in the activities of the Interstate Commission on a non-voting basis prior to adoption of the Compact by all states.
1768	1768
1769	1769	(d) The Interstate Commission may propose amendments to the Compact for enactment by the member states. No amendment shall become effective and binding upon the Interstate Commission and the member states unless and until it is enacted into law by unanimous consent of the member states.
1770	1770
1771	1771	SECTION 21. WITHDRAWAL
1772	1772
1773	1773	(a) Once effective, the Compact shall continue in force and remain binding upon each and every member state; provided that a member state may withdraw from the Compact by specifically repealing the statute which enacted the Compact into law.
1774	1774
1775	1775	(b) Withdrawal from the Compact shall be by the enactment of a statute repealing the same, but shall not take effect until one (1) year after the effective date of such statute and until written notice of the withdrawal has been given by the withdrawing state to the governor of each other member state.
1776	1776
1777	1777	(c) The withdrawing state shall immediately notify the chairperson of the Interstate Commission in writing upon the introduction of legislation repealing the Compact in the withdrawing state.
1778	1778
1779	1779	(d) The Interstate Commission shall notify the other member states of the withdrawing state's intent to withdraw within sixty (60) days of its receipt of notice provided under subsection (c).
1780	1780
1781	1781	1
1782	1782
1783	1783	2
1784	1784
1785	1785	3
1786	1786
1787	1787	4
1788	1788
1789	1789	5
1790	1790
1791	1791	6
1792	1792
1793	1793	7
1794	1794
1795	1795	8
1796	1796
1797	1797	9
1798	1798
1799	1799	10
1800	1800
1801	1801	11
1802	1802
1803	1803	12
1804	1804
1805	1805	13
1806	1806
1807	1807	14
1808	1808
1809	1809	15
1810	1810
1811	1811	16
1812	1812
1813	1813	17
1814	1814
1815	1815	18
1816	1816
1817	1817	19
1818	1818
1819	1819	20
1820	1820
1821	1821	21
1822	1822
1823	1823	22
1824	1824
1825	1825	23
1826	1826
1827	1827	24
1828	1828
1829	1829	25
1830	1830
1831	1831	26
1832	1832
1833	1833	27
1834	1834
1835	1835	28
1836	1836
1837	1837	29
1838	1838
1839	1839	(e) The withdrawing state is responsible for all dues, obligations and liabilities incurred through the effective date of withdrawal, including obligations, the performance of which extend beyond the effective date of withdrawal.
1840	1840
1841	1841	(f) Reinstatement following withdrawal of a member state shall occur upon the withdrawing state reenacting the Compact or upon such later date as determined by the Interstate Commission.
1842	1842
1843	1843	(g) The Interstate Commission is authorized to develop rules to address the impact of the withdrawal of a member state on licenses granted in other member states to physicians who designated the withdrawing member state as the state of principal license.
1844	1844
1845	1845	SECTION 22. DISSOLUTION
1846	1846
1847	1847	(a) The Compact shall dissolve effective upon the date of the withdrawal or default of the member state which reduces the membership in the Compact to one (1) member state.
1848	1848
1849	1849	(b) Upon the dissolution of the Compact, the Compact becomes null and void and shall be of no further force or effect, and the business and affairs of the Interstate Commission shall be concluded and surplus funds shall be distributed in accordance with the bylaws.
1850	1850
1851	1851	SECTION 23. SEVERABILITY AND CONSTRUCTION
1852	1852
1853	1853	(a) The provisions of the Compact shall be severable, and if any phrase, clause, sentence, or provision is deemed unenforceable, the remaining provisions of the Compact shall be enforceable.
1854	1854
1855	1855	(b) The provisions of the Compact shall be liberally construed to effectuate its purposes.
1856	1856
1857	1857	(c) Nothing in the Compact shall be construed to prohibit the applicability of other interstate compacts to which the states are
1858	1858
1859	1859	1
1860	1860
1861	1861	2
1862	1862
1863	1863	3
1864	1864
1865	1865	4
1866	1866
1867	1867	5
1868	1868
1869	1869	6
1870	1870
1871	1871	7
1872	1872
1873	1873	8
1874	1874
1875	1875	9
1876	1876
1877	1877	10
1878	1878
1879	1879	11
1880	1880
1881	1881	12
1882	1882
1883	1883	13
1884	1884
1885	1885	14
1886	1886
1887	1887	15
1888	1888
1889	1889	16
1890	1890
1891	1891	17
1892	1892
1893	1893	18
1894	1894
1895	1895	19
1896	1896
1897	1897	members.
1898	1898
1899	1899	SECTION 24. BINDING EFFECT OF COMPACT AND OTHER LAWS
1900	1900
1901	1901	(a) Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the Compact.
1902	1902
1903	1903	(b) All laws in a member state in conflict with the Compact are superseded to the extent of the conflict.
1904	1904
1905	1905	(c) All lawful actions of the Interstate Commission, including all rules and bylaws promulgated by the Commission, are binding upon the member states.
1906	1906
1907	1907	(d) All agreements between the Interstate Commission and the member states are binding in accordance with their terms.
1908	1908
1909	1909	(e) In the event any provision of the Compact exceeds the constitutional limits imposed on the legislature of any member state, such provision shall be ineffective to the extent of the conflict with the constitutional provision in question in that member state.
1910	1910
1911	1911	(2) Subsection (1) shall may be known as the "interstate medical licensure compact".
1912	1912
1913	1913	(3) This section is repealed effective March 28, 2025.