Public Act 099-0076
 
HB3680 EnrolledLRB099 09861 AWJ 30073 b

    AN ACT concerning State government.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 1. Short title. This Act may be cited as the
Interstate Medical Licensure Compact Act.
 
    Section 5. Interstate Medical Licensure Compact. The State
of Illinois ratifies and approves the following compact:
 
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 clinical prevention,
diagnosis, or treatment of human disease, injury, or condition
requiring a physician to obtain and maintain a license in
compliance with the Medical Practice Act of a member state.
    (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;
        (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
        (10) 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, gross 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, and 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. C.F.R.
    §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 though 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 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.
 
    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 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.
 
    Section 99. Effective date. This Act takes effect upon
becoming law.