SB 303

SENATE BILL NO. 303
A bill to amend 1978 PA 368, entitled
"Public health code,"
(MCL 333.1101 to 333.25211) by adding section 16189.
the people of the state of michigan enact:
Sec. 16189. (1) 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:
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
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 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 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 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, 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.
(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 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.
(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 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 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 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) 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 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 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.
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 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 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 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 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
(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 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 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).
(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 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) may be known as the "interstate medical
licensure compact".