99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
SB1229

 

Introduced 2/11/2015, by Sen. David Koehler

 

SYNOPSIS AS INTRODUCED:
 
New Act

    Creates the Interstate Medical Licensure Compact Act. Provides that Illinois ratifies and approves the Interstate Medical Licensure Compact. The Compact provides that it will develop a comprehensive process that complements the existing licensing and regulatory authority of state medical boards and provides a streamlined process that allows physicians to become licensed in multiple states. The Compact provides for eligibility requirements, application requirements, fees, renewal requirements, information concerning investigation and discipline, and other procedures to implement the Compact.


LRB099 09241 AWJ 29444 b

 

 

A BILL FOR

 

SB1229LRB099 09241 AWJ 29444 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Sec. 1. Short title. This Act may be cited as the
5Interstate Medical Licensure Compact Act.
 
6    Sec. 5. Interstate Medical Licensure Compact. The State of
7Illinois ratifies and approves the following compact:
 
8
INTERSTATE MEDICAL LICENSURE COMPACT

 
9    SECTION 1. PURPOSE
10    In order to strengthen access to health care, and in
11recognition of the advances in the delivery of health care, the
12member states of the Interstate Medical Licensure Compact have
13allied in common purpose to develop a comprehensive process
14that complements the existing licensing and regulatory
15authority of state medical boards, provides a streamlined
16process that allows physicians to become licensed in multiple
17states, thereby enhancing the portability of a medical license
18and ensuring the safety of patients. The Compact creates
19another pathway for licensure and does not otherwise change a
20state's existing Medical Practice Act. The Compact also adopts
21the prevailing standard for licensure and affirms that the

 

 

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1practice of medicine occurs where the patient is located at the
2time of the physician-patient encounter, and therefore,
3requires the physician to be under the jurisdiction of the
4state medical board where the patient is located. State medical
5boards that participate in the Compact retain the jurisdiction
6to impose an adverse action against a license to practice
7medicine in that state issued to a physician through the
8procedures in the Compact.
 
9    SECTION 2. DEFINITIONS
10    In this compact:
11    (a) "Bylaws" means those bylaws established by the
12Interstate Commission pursuant to Section 11 for its
13governance, or for directing and controlling its actions and
14conduct.
15    (b) "Commissioner" means the voting representative
16appointed by each member board pursuant to Section 11.
17    (c) "Conviction" means a finding by a court that an
18individual is guilty of a criminal offense through
19adjudication, or entry of a plea of guilt or no contest to the
20charge by the offender. Evidence of an entry of a conviction of
21a criminal offense by the court shall be considered final for
22purposes of disciplinary action by a member board.
23    (d) "Expedited License" means a full and unrestricted
24medical license granted by a member state to an eligible
25physician through the process set forth in the Compact.

 

 

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1    (e) "Interstate Commission" means the interstate
2commission created pursuant to Section 11.
3    (f) "License" means authorization by a state for a
4physician to engage in the practice of medicine, which would be
5unlawful without the authorization.
6    (g) "Medical Practice Act" means laws and regulations
7governing the practice of allopathic and osteopathic medicine
8within a member state.
9    (h) "Member Board" means a state agency in a member state
10that acts in the sovereign interests of the state by protecting
11the public through licensure, regulation, and education of
12physicians as directed by the state government.
13    (i) "Member State" means a state that has enacted the
14Compact.
15    (j) "Practice of Medicine" means the clinical prevention,
16diagnosis, or treatment of human disease, injury, or condition
17requiring a physician to obtain and maintain a license in
18compliance with the Medical Practice Act of a member state.
19    (k) "Physician" means any person who:
20        (1) Is a graduate of a medical school accredited by the
21    Liaison Committee on Medical Education, the Commission on
22    Osteopathic College Accreditation, or a medical school
23    listed in the International Medical Education Directory or
24    its equivalent;
25        (2) Passed each component of the United States Medical
26    Licensing Examination (USMLE) or the Comprehensive

 

 

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1    Osteopathic Medical Licensing Examination (COMLEX-USA)
2    within three attempts, or any of its predecessor
3    examinations accepted by a state medical board as an
4    equivalent examination for licensure purposes;
5        (3) Successfully completed graduate medical education
6    approved by the Accreditation Council for Graduate Medical
7    Education or the American Osteopathic Association;
8        (4) Holds specialty certification or a time-unlimited
9    specialty certificate recognized by the American Board of
10    Medical Specialties or the American Osteopathic
11    Association's Bureau of Osteopathic Specialists;
12        (5) Possesses a full and unrestricted license to engage
13    in the practice of medicine issued by a member board;
14        (6) Has never been convicted, received adjudication,
15    deferred adjudication, community supervision, or deferred
16    disposition for any offense by a court of appropriate
17    jurisdiction;
18        (7) Has never held a license authorizing the practice
19    of medicine subjected to discipline by a licensing agency
20    in any state, federal, or foreign jurisdiction, excluding
21    any action related to non-payment of fees related to a
22    license;
23        (8) Has never had a controlled substance license or
24    permit suspended or revoked by a state or the United States
25    Drug Enforcement Administration; and
26        (10) Is not under active investigation by a licensing

 

 

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1    agency or law enforcement authority in any state, federal,
2    or foreign jurisdiction.
3    (l) "Offense" means a felony, gross misdemeanor, or crime
4of moral turpitude.
5    (m) "Rule" means a written statement by the Interstate
6Commission promulgated pursuant to Section 12 of the Compact
7that is of general applicability, implements, interprets, or
8prescribes a policy or provision of the Compact, or an
9organizational, procedural, or practice requirement of the
10Interstate Commission, and has the force and effect of
11statutory law in a member state, and includes the amendment,
12repeal, or suspension of an existing rule.
13    (n) "State" means any state, commonwealth, district, or
14territory of the United States.
15    (o) "State of Principal License" means a member state where
16a physician holds a license to practice medicine and which has
17been designated as such by the physician for purposes of
18registration and participation in the Compact.
 
19    SECTION 3. ELIGIBILITY
20    (a) A physician must meet the eligibility requirements as
21defined in Section 2(k) to receive an expedited license under
22the terms and provisions of the Compact.
23    (b) A physician who does not meet the requirements of
24Section 2(k) may obtain a license to practice medicine in a
25member state if the individual complies with all laws and

 

 

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1requirements, other than the Compact, relating to the issuance
2of a license to practice medicine in that state.
 
3    SECTION 4. DESIGNATION OF STATE OF PRINCIPAL LICENSE
4    (a) A physician shall designate a member state as the state
5of principal license for purposes of registration for expedited
6licensure through the Compact if the physician possesses a full
7and unrestricted license to practice medicine in that state,
8and the state is:
9        (1) the state of primary residence for the physician,
10    or
11        (2) the state where at least 25% of the practice of
12    medicine occurs, or
13        (3) the location of the physician's employer, or
14        (4) if no state qualifies under subsection (1),
15    subsection (2), or subsection (3), the
16    state designated as state of residence for purpose of
17federal income tax.
18    (b) A physician may redesignate a member state as state of
19principal license at any time, as long as the state meets the
20requirements in subsection (a).
21    (c) The Interstate Commission is authorized to develop
22rules to facilitate redesignation of another member state as
23the state of principal license.
 
24    SECTION 5. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE

 

 

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1    (a) A physician seeking licensure through the Compact shall
2file an application for an expedited license with the member
3board of the state selected by the physician as the state of
4principal license.
5    (b) Upon receipt of an application for an expedited
6license, the member board within the state selected as the
7state of principal license shall evaluate whether the physician
8is eligible for expedited licensure and issue a letter of
9qualification, verifying or denying the physician's
10eligibility, to the Interstate Commission.
11        (i) Static qualifications, which include verification
12    of medical education, graduate medical education, results
13    of any medical or licensing examination, and other
14    qualifications as determined by the Interstate Commission
15    through rule, shall not be subject to additional primary
16    source verification where already primary source verified
17    by the state of principal license.
18        (ii) The member board within the state selected as the
19    state of principal license shall, in the course of
20    verifying eligibility, perform a criminal background check
21    of an applicant, including the use of the results of
22    fingerprint or other biometric data checks compliant with
23    the requirements of the Federal Bureau of Investigation,
24    with the exception of federal employees who have
25    suitability determination in accordance with U.S. C.F.R.
26    §731.202.

 

 

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1        (iii) Appeal on the determination of eligibility shall
2    be made to the member state where the application was filed
3    and shall be subject to the law of that state.
4    (c) Upon verification in subsection (b), physicians
5eligible for an expedited license shall complete the
6registration process established by the Interstate Commission
7to receive a license in a member state selected pursuant to
8subsection (a), including the payment of any applicable fees.
9    (d) After receiving verification of eligibility under
10subsection (b) and any fees under subsection (c), a member
11board shall issue an expedited license to the physician. This
12license shall authorize the physician to practice medicine in
13the issuing state consistent with the Medical Practice Act and
14all applicable laws and regulations of the issuing member board
15and member state.
16    (e) An expedited license shall be valid for a period
17consistent with the licensure period in the member state and in
18the same manner as required for other physicians holding a full
19and unrestricted license within the member state.
20    (f) An expedited license obtained though the Compact shall
21be terminated if a physician fails to maintain a license in the
22state of principal licensure for a non-disciplinary reason,
23without redesignation of a new state of principal licensure.
24    (g) The Interstate Commission is authorized to develop
25rules regarding the application process, including payment of
26any applicable fees, and the issuance of an expedited license.
 

 

 

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1    SECTION 6. FEES FOR EXPEDITED LICENSURE
2    (a) A member state issuing an expedited license authorizing
3the practice of medicine in that state may impose a fee for a
4license issued or renewed through the Compact.
5    (b) The Interstate Commission is authorized to develop
6rules regarding fees for expedited
7    licenses.
 
8    SECTION 7. RENEWAL AND CONTINUED PARTICIPATION
9    (a) A physician seeking to renew an expedited license
10granted in a member state shall complete a renewal process with
11the Interstate Commission if the physician:
12        (1) Maintains a full and unrestricted license in a
13    state of principal license;
14        (2) Has not been convicted, received adjudication,
15    deferred adjudication, community supervision, or deferred
16    disposition for any offense by a court of appropriate
17    jurisdiction;
18        (3) Has not had a license authorizing the practice of
19    medicine subject to discipline by a licensing agency in any
20    state, federal, or foreign jurisdiction, excluding any
21    action related to non-payment of fees related to a license;
22    and
23        (4) Has not had a controlled substance license or
24    permit suspended or revoked by a state or the United States

 

 

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1    Drug Enforcement Administration.
2    (b) Physicians shall comply with all continuing
3professional development or continuing medical education
4requirements for renewal of a license issued by a member state.
5    (c) The Interstate Commission shall collect any renewal
6fees charged for the renewal of a license and distribute the
7fees to the applicable member board.
8    (d) Upon receipt of any renewal fees collected in
9subsection (c), a member board shall renew the physician's
10license.
11    (e) Physician information collected by the Interstate
12Commission during the renewal process will be distributed to
13all member boards.
14    (f) The Interstate Commission is authorized to develop
15rules to address renewal of licenses obtained through the
16Compact.
 
17    SECTION 8. COORDINATED INFORMATION SYSTEM
18    (a) The Interstate Commission shall establish a database of
19all physicians licensed, or who have applied for licensure,
20under Section 5.
21    (b) Notwithstanding any other provision of law, member
22boards shall report to the Interstate Commission any public
23action or complaints against a licensed physician who has
24applied or received an expedited license through the Compact.
25    (c) Member boards shall report disciplinary or

 

 

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1investigatory information determined as necessary and proper
2by rule of the Interstate Commission.
3    (d) Member boards may report any non-public complaint,
4disciplinary, or investigatory information not required by
5subsection (c) to the Interstate Commission.
6    (e) Member boards shall share complaint or disciplinary
7information about a physician upon request of another member
8board.
9    (f) All information provided to the Interstate Commission
10or distributed by member boards shall be confidential, filed
11under seal, and used only for investigatory or disciplinary
12matters.
13    (g) The Interstate Commission is authorized to develop
14rules for mandated or discretionary sharing of information by
15member boards.
 
16    SECTION 9. JOINT INVESTIGATIONS
17    (a) Licensure and disciplinary records of physicians are
18deemed investigative.
19    (b) In addition to the authority granted to a member board
20by its respective Medical Practice Act or other applicable
21state law, a member board may participate with other member
22    boards in joint investigations of physicians licensed by
23the member boards.
24    (c) A subpoena issued by a member state shall be
25enforceable in other member states.

 

 

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1    (d) Member boards may share any investigative, litigation,
2or compliance materials in furtherance of any joint or
3individual investigation initiated under the Compact.
4    (e) Any member state may investigate actual or alleged
5violations of the statutes authorizing the practice of medicine
6in any other member state in which a physician holds a license
7to practice medicine.
 
8    SECTION 10. DISCIPLINARY ACTIONS
9    (a) Any disciplinary action taken by any member board
10against a physician licensed through the Compact shall be
11deemed unprofessional conduct which may be subject to
12discipline by other member boards, in addition to any violation
13of the Medical Practice Act or regulations in that state.
14    (b) If a license granted to a physician by the member board
15in the state of principal license is revoked, surrendered or
16relinquished in lieu of discipline, or suspended, then all
17licenses issued to the physician by member boards shall
18automatically be placed, without further action necessary by
19any member board, on the same status. If the member board in
20the state of principal license subsequently reinstates the
21physician's license, a licensed issued to the physician by any
22other member board shall remain encumbered until that
23respective member board takes action to reinstate the license
24in a manner consistent with the Medical Practice Act of that
25state.

 

 

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1    (c) If disciplinary action is taken against a physician by
2a member board not in the state of principal license, any other
3member board may deem the action conclusive as to matter of law
4and fact decided, and:
5        (i) impose the same or lesser sanction(s) against the
6    physician so long as such sanctions are consistent with the
7    Medical Practice Act of that state;
8        (ii) or pursue separate disciplinary action against
9    the physician under its respective Medical Practice Act,
10    regardless of the action taken in other member states.
11    (d) If a license granted to a physician by a member board
12is revoked, surrendered or relinquished in lieu of discipline,
13or suspended, then any license(s) issued to the physician by
14any other member board(s) shall be suspended, automatically and
15immediately without further action necessary by the other
16member board(s), for ninety (90) days upon entry of the order
17by the disciplining board, to permit the member board(s) to
18investigate the basis for the action under the Medical Practice
19Act of that state. A member board may terminate the automatic
20suspension of the license it issued prior to the completion of
21the ninety (90) day suspension period in a manner consistent
22with the Medical Practice Act of that state.
 
23    SECTION 11. INTERSTATE MEDICAL LICENSURE COMPACT
24COMMISSION
25    (a) The member states hereby create the "Interstate Medical

 

 

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1Licensure Compact Commission".
2    (b) The purpose of the Interstate Commission is the
3administration of the Interstate Medical Licensure Compact,
4which is a discretionary state function.
5    (c) The Interstate Commission shall be a body corporate and
6joint agency of the member states and shall have all the
7responsibilities, powers, and duties set forth in the Compact,
8and such additional powers as may be conferred upon it by a
9subsequent concurrent action of the respective legislatures of
10the member states in accordance with the terms of the Compact.
11    (d) The Interstate Commission shall consist of two voting
12representatives appointed by each member state who shall serve
13as Commissioners. In states where allopathic and osteopathic
14physicians are regulated by separate member boards, or if the
15licensing and disciplinary authority is split between multiple
16member boards within a member state, the member state shall
17appoint one representative from each member board. A
18Commissioner shall be a(n):
19        (1) Allopathic or osteopathic physician appointed to a
20    member board;
21        (2) Executive director, executive secretary, or
22    similar executive of a member board; or
23        (3) Member of the public appointed to a member board.
24    (e) The Interstate Commission shall meet at least once each
25calendar year. A portion of this meeting shall be a business
26meeting to address such matters as may properly come before the

 

 

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1Commission, including the election of officers. The
2chairperson may call additional meetings and shall call for a
3meeting upon the request of a majority of the member states.
4    (f) The bylaws may provide for meetings of the Interstate
5Commission to be conducted by telecommunication or electronic
6communication.
7    (g) Each Commissioner participating at a meeting of the
8Interstate Commission is entitled to one vote. A majority of
9Commissioners shall constitute a quorum for the transaction of
10business, unless a larger quorum is required by the bylaws of
11the Interstate Commission. A Commissioner shall not delegate a
12vote to another Commissioner. In the absence of its
13Commissioner, a member state may delegate voting authority for
14a specified meeting to another person from that state who shall
15meet the requirements of subsection (d).
16    (h) The Interstate Commission shall provide public notice
17of all meetings and all meetings shall be open to the public.
18The Interstate Commission may close a meeting, in full or in
19portion, where it determines by a two-thirds vote of the
20Commissioners present that an open meeting would be likely to:
21        (1) Relate solely to the internal personnel practices
22    and procedures of the Interstate Commission;
23        (2) Discuss matters specifically exempted from
24    disclosure by federal statute;
25        (3) Discuss trade secrets, commercial, or financial
26    information that is privileged or confidential;

 

 

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1        (4) Involve accusing a person of a crime, or formally
2    censuring a person;
3        (5) Discuss information of a personal nature where
4    disclosure would constitute a clearly unwarranted invasion
5    of personal privacy;
6        (6) Discuss investigative records compiled for law
7    enforcement purposes; or
8        (7) Specifically relate to the participation in a civil
9    action or other legal proceeding.
10    (i) The Interstate Commission shall keep minutes which
11shall fully describe all matters discussed in a meeting and
12shall provide a full and accurate summary of actions taken,
13including record of any roll call votes.
14    (j) The Interstate Commission shall make its information
15and official records, to the extent not otherwise designated in
16the Compact or by its rules, available to the public for
17inspection.
18    (k) The Interstate Commission shall establish an executive
19committee, which shall include officers, members, and others as
20determined by the bylaws. The executive committee shall have
21the power to act on behalf of the Interstate Commission, with
22the exception of rulemaking, during periods when the Interstate
23Commission is not in session. When acting on behalf of the
24Interstate Commission, the executive committee shall oversee
25the administration of the Compact including enforcement and
26compliance with the provisions of the Compact, its bylaws and

 

 

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1rules, and other such duties as necessary.
2    (l) The Interstate Commission may establish other
3committees for governance and administration of the Compact.
 
4    SECTION 12. POWERS AND DUTIES OF THE INTERSTATE COMMISSION
5    The Interstate Commission shall have the duty and power to:
6    (a) Oversee and maintain the administration of the Compact;
7    (b) Promulgate rules which shall be binding to the extent
8and in the manner provided for in the Compact;
9    (c) Issue, upon the request of a member state or member
10board, advisory opinions concerning the meaning or
11interpretation of the Compact, its bylaws, rules, and actions;
12    (d) Enforce compliance with Compact provisions, the rules
13promulgated by the Interstate Commission, and the bylaws, using
14all necessary and proper means, including but not limited to
15the use of judicial process;
16    (e) Establish and appoint committees including, but not
17limited to, an executive committee as required by Section 11,
18which shall have the power to act on behalf of the Interstate
19Commission in carrying out its powers and duties;
20    (f) Pay, or provide for the payment of the expenses related
21to the establishment, organization, and ongoing activities of
22the Interstate Commission;
23    (g) Establish and maintain one or more offices;
24    (h) Borrow, accept, hire, or contract for services of
25personnel;

 

 

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1    (i) Purchase and maintain insurance and bonds;
2    (j) Employ an executive director who shall have such powers
3to employ, select or appoint employees, agents, or consultants,
4and to determine their qualifications, define their duties, and
5fix their compensation;
6    (k) Establish personnel policies and programs relating to
7conflicts of interest, rates of compensation, and
8qualifications of personnel;
9    (l) Accept donations and grants of money, equipment,
10supplies, materials and services, and to receive, utilize, and
11dispose of it in a manner consistent with the conflict of
12interest policies established by the Interstate Commission;
13    (m) Lease, purchase, accept contributions or donations of,
14or otherwise to own, hold, improve or use, any property, real,
15personal, or mixed;
16    (n) Sell, convey, mortgage, pledge, lease, exchange,
17abandon, or otherwise dispose of any property, real, personal,
18or mixed;
19    (o) Establish a budget and make expenditures;
20    (p) Adopt a seal and bylaws governing the management and
21operation of the Interstate Commission;
22    (q) Report annually to the legislatures and governors of
23the member states concerning the activities of the Interstate
24Commission during the preceding year. Such reports shall also
25include reports of financial audits and any recommendations
26that may have been adopted by the Interstate Commission;

 

 

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1    (r) Coordinate education, training, and public awareness
2regarding the Compact, its implementation, and its operation;
3    (s) Maintain records in accordance with the bylaws;
4    (t) Seek and obtain trademarks, copyrights, and patents;
5and
6    (u) Perform such functions as may be necessary or
7appropriate to achieve the purposes of the Compact.
 
8    SECTION 13. FINANCE POWERS
9    (a) The Interstate Commission may levy on and collect an
10annual assessment from each member state to cover the cost of
11the operations and activities of the Interstate Commission and
12its staff. The total assessment must be sufficient to cover the
13annual budget approved each year for which revenue is not
14provided by other sources. The aggregate annual assessment
15amount shall be allocated upon a formula to be determined by
16the Interstate Commission, which shall promulgate a rule
17binding upon all member states.
18    (b) The Interstate Commission shall not incur obligations
19of any kind prior to securing the funds adequate to meet the
20same.
21    (c) The Interstate Commission shall not pledge the credit
22of any of the member states, except by, and with the authority
23of, the member state.
24    (d) The Interstate Commission shall be subject to a yearly
25financial audit conducted by a certified or licensed public

 

 

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1accountant and the report of the audit shall be included in the
2annual report of the Interstate Commission.
 
3    SECTION 14. ORGANIZATION AND OPERATION OF THE INTERSTATE
4COMMISSION
5    (a) The Interstate Commission shall, by a majority of
6Commissioners present and voting, adopt bylaws to govern its
7conduct as may be necessary or appropriate to carry out the
8purposes
9    of the Compact within twelve (12) months of the first
10Interstate Commission meeting.
11    (b) The Interstate Commission shall elect or appoint
12annually from among its Commissioners a chairperson, a
13vice-chairperson, and a treasurer, each of whom shall have such
14authority and duties as may be specified in the bylaws. The
15chairperson, or in the chairperson's absence or disability, the
16vice-chairperson, shall preside at all meetings of the
17Interstate Commission.
18    (c) Officers selected in subsection (b) shall serve without
19remuneration from the Interstate Commission.
20    (d) The officers and employees of the Interstate Commission
21shall be immune from suit and liability, either personally or
22in their official capacity, for a claim for damage to or loss
23of property or personal injury or other civil liability caused
24or arising out of, or relating to, an actual or alleged act,
25error, or omission that occurred, or that such person had a

 

 

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1reasonable basis for believing occurred, within the scope of
2Interstate Commission employment, duties, or responsibilities;
3provided that such person shall not be protected from suit or
4liability for damage, loss, injury, or liability caused by the
5intentional or willful and wanton misconduct of such person.
6        (1) The liability of the executive director and
7    employees of the Interstate Commission or representatives
8    of the Interstate Commission, acting within the scope of
9    such person's employment or duties for acts, errors, or
10    omissions occurring within such person's state, may not
11    exceed the limits of liability set forth under the
12    constitution and laws of that state for state officials,
13    employees, and agents. The Interstate Commission is
14    considered to be an instrumentality of the states for the
15    purposes of any such action. Nothing in this subsection
16    shall be construed to protect such person from suit or
17    liability for damage, loss, injury, or liability caused by
18    the intentional or willful and wanton misconduct of such
19    person.
20        (2) The Interstate Commission shall defend the
21    executive director, its employees, and subject to the
22    approval of the attorney general or other appropriate legal
23    counsel of the member state represented by an Interstate
24    Commission representative, shall defend such Interstate
25    Commission representative in any civil action seeking to
26    impose liability arising out of an actual or alleged act,

 

 

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1    error or omission that occurred within the scope of
2    Interstate Commission employment, duties or
3    responsibilities, or that the defendant had a reasonable
4    basis for believing occurred within the scope of Interstate
5    Commission employment, duties, or responsibilities,
6    provided that the actual or alleged act, error, or omission
7    did not result from intentional or willful and wanton
8    misconduct on the part of such person.
9        (3) To the extent not covered by the state involved,
10    member state, or the Interstate Commission, the
11    representatives or employees of the Interstate Commission
12    shall be held harmless in the amount of a settlement or
13    judgment, including attorney's fees and costs, obtained
14    against such persons arising out of an actual or alleged
15    act, error, or omission that occurred within the scope of
16    Interstate Commission employment, duties, or
17    responsibilities, or that such persons had a reasonable
18    basis for believing occurred within the scope of Interstate
19    Commission employment, duties, or responsibilities,
20    provided that the actual or alleged act, error, or omission
21    did not result from intentional or willful and wanton
22    misconduct on the part of such persons.
 
23    SECTION 15. RULEMAKING FUNCTIONS OF THE INTERSTATE
24COMMISSION
25    (a) The Interstate Commission shall promulgate reasonable

 

 

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1rules in order to effectively and efficiently achieve the
2purposes of the Compact. Notwithstanding the foregoing, in the
3event
4    the Interstate Commission exercises its rulemaking
5authority in a manner that is beyond the scope of the purposes
6of the Compact, or the powers granted hereunder, then such an
7action by the Interstate Commission shall be invalid and have
8no force or effect.
9    (b) Rules deemed appropriate for the operations of the
10Interstate Commission shall be made pursuant to a rulemaking
11process that substantially conforms to the "Model State
12Administrative Procedure Act" of 2010, and subsequent
13amendments thereto.
14    (c) Not later than thirty (30) days after a rule is
15promulgated, any person may file a petition for judicial review
16of the rule in the United States District Court for the
17District of Columbia or the federal district where the
18Interstate Commission has its principal offices, provided that
19the filing of such a petition shall not stay or otherwise
20prevent the rule from becoming effective unless the court finds
21that the petitioner has a substantial likelihood of success.
22The court shall give deference to the actions of the Interstate
23Commission consistent with applicable law and shall not find
24the rule to be unlawful if the rule represents a reasonable
25exercise of the authority granted to the Interstate Commission.
 

 

 

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1    SECTION 16. OVERSIGHT OF INTERSTATE COMPACT
2    (a) The executive, legislative, and judicial branches of
3state government in each member state shall enforce the Compact
4and shall take all actions necessary and appropriate to
5effectuate the Compact's purposes and intent. The provisions of
6the Compact and the rules promulgated hereunder shall have
7standing as statutory law but shall not override existing state
8authority to regulate the practice of medicine.
9    (b) All courts shall take judicial notice of the Compact
10and the rules in any judicial or administrative proceeding in a
11member state pertaining to the subject matter of the Compact
12which may affect the powers, responsibilities or actions of the
13Interstate Commission.
14    (c) The Interstate Commission shall be entitled to receive
15all service of process in any such proceeding, and shall have
16standing to intervene in the proceeding for all purposes.
17Failure to provide service of process to the Interstate
18Commission shall render a judgment or order void as to the
19Interstate Commission, the Compact, or promulgated rules.
 
20    SECTION 17. ENFORCEMENT OF INTERSTATE COMPACT
21    (a) The Interstate Commission, in the reasonable exercise
22of its discretion, shall enforce the provisions and rules of
23the Compact.
24    (b) The Interstate Commission may, by majority vote of the
25Commissioners, initiate legal action in the United States

 

 

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1District Court for the District of Columbia, or, at the
2discretion of the Interstate Commission, in the federal
3district where the Interstate Commission has its principal
4offices, to enforce compliance with the provisions of the
5Compact, and its promulgated rules and bylaws, against a member
6state in default. The relief sought may include both injunctive
7relief and damages. In the event judicial enforcement is
8necessary, the prevailing party shall be awarded all costs of
9such litigation including reasonable attorney's fees.
10    (c) The remedies herein shall not be the exclusive remedies
11of the Interstate Commission. The Interstate Commission may
12avail itself of any other remedies available under state law or
13the regulation of a profession.
 
14    SECTION 18. DEFAULT PROCEDURES
15    (a) The grounds for default include, but are not limited
16to, failure of a member state to perform such obligations or
17responsibilities imposed upon it by the Compact, or the rules
18and bylaws of the Interstate Commission promulgated under the
19Compact.
20    (b) If the Interstate Commission determines that a member
21state has defaulted in the performance of its obligations or
22responsibilities under the Compact, or the bylaws or
23promulgated rules, the Interstate Commission shall:
24        (1) Provide written notice to the defaulting state and
25    other member states, of the nature of the default, the

 

 

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1    means of curing the default, and any action taken by the
2    Interstate Commission. The Interstate Commission shall
3    specify the conditions by which the defaulting state must
4    cure its default; and
5        (2) Provide remedial training and specific technical
6    assistance regarding the default.
7    (c) If the defaulting state fails to cure the default, the
8defaulting state shall be terminated from the Compact upon an
9affirmative vote of a majority of the Commissioners and all
10rights, privileges, and benefits conferred by the Compact shall
11terminate on the effective date of termination. A cure of the
12default does not relieve the offending state of obligations or
13liabilities incurred during the period of the default.
14    (d) Termination of membership in the Compact shall be
15imposed only after all other means of securing compliance have
16been exhausted. Notice of intent to terminate shall be given by
17the Interstate Commission to the governor, the majority and
18minority leaders of the defaulting state's legislature, and
19each of the member states.
20    (e) The Interstate Commission shall establish rules and
21procedures to address licenses and physicians that are
22materially impacted by the termination of a member state, or
23the withdrawal of a member state.
24    (f) The member state which has been terminated is
25responsible for all dues, obligations, and liabilities
26incurred through the effective date of termination including

 

 

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1obligations, the
2    performance of which extends beyond the effective date of
3termination.
4    (g) The Interstate Commission shall not bear any costs
5relating to any state that has been found to be in default or
6which has been terminated from the Compact, unless otherwise
7mutually agreed upon in writing between the Interstate
8Commission and the defaulting state.
9    (h) The defaulting state may appeal the action of the
10Interstate Commission by petitioning the United States
11District Court for the District of Columbia or the federal
12district where the Interstate Commission has its principal
13offices. The prevailing party shall be awarded all costs of
14such litigation including reasonable attorney's fees.
 
15    SECTION 19. DISPUTE RESOLUTION
16    (a) The Interstate Commission shall attempt, upon the
17request of a member state, to resolve disputes which are
18subject to the Compact and which may arise among member states
19or member boards.
20    (b) The Interstate Commission shall promulgate rules
21providing for both mediation and binding dispute resolution as
22appropriate.
 
23    SECTION 20. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT
24    (a) Any state is eligible to become a member state of the

 

 

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1Compact.
2    (b) The Compact shall become effective and binding upon
3legislative enactment of the Compact into law by no less than
4seven (7) states. Thereafter, it shall become effective and
5binding on a state upon enactment of the Compact into law by
6that state.
7    (c) The governors of non-member states, or their designees,
8shall be invited to participate in the activities of the
9Interstate Commission on a non-voting basis prior to adoption
10of the Compact by all states.
11    (d) The Interstate Commission may propose amendments to the
12Compact for enactment by the member states. No amendment shall
13become effective and binding upon the Interstate Commission and
14the member states unless and until it is enacted into law by
15unanimous consent of the member states.
 
16    SECTION 21. WITHDRAWAL
17    (a) Once effective, the Compact shall continue in force and
18remain binding upon each and every member state; provided that
19a member state may withdraw from the Compact by specifically
20repealing the statute which enacted the Compact into law.
21    (b) Withdrawal from the Compact shall be by the enactment
22of a statute repealing the same, but shall not take effect
23until one (1) year after the effective date of such statute and
24until written notice of the withdrawal has been given by the
25withdrawing state to the governor of each other member state.

 

 

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1    (c) The withdrawing state shall immediately notify the
2chairperson of the Interstate Commission in writing upon the
3introduction of legislation repealing the Compact in the
4withdrawing state.
5    (d) The Interstate Commission shall notify the other member
6states of the withdrawing state's intent to withdraw within
7sixty (60) days of its receipt of notice provided under
8subsection (c).
9    (e) The withdrawing state is responsible for all dues,
10obligations and liabilities incurred through the effective
11date of withdrawal, including obligations, the performance of
12which extend beyond the effective date of withdrawal.
13    (f) Reinstatement following withdrawal of a member state
14shall occur upon the withdrawing state reenacting the Compact
15or upon such later date as determined by the Interstate
16Commission.
17    (g) The Interstate Commission is authorized to develop
18rules to address the impact of the withdrawal of a member state
19on licenses granted in other member states to physicians who
20designated the withdrawing member state as the state of
21principal license.
 
22    SECTION 22. DISSOLUTION
23    (a) The Compact shall dissolve effective upon the date of
24the withdrawal or default of the member state which reduces the
25membership in the Compact to one (1) member state.

 

 

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1    (b) Upon the dissolution of the Compact, the Compact
2becomes null and void and shall be of no further force or
3effect, and the business and affairs of the Interstate
4Commission shall be concluded and surplus funds shall be
5distributed in accordance with the bylaws.
 
6    SECTION 23. SEVERABILITY AND CONSTRUCTION
7    (a) The provisions of the Compact shall be severable, and
8if any phrase, clause, sentence, or provision is deemed
9unenforceable, the remaining provisions of the Compact shall be
10enforceable.
11    (b) The provisions of the Compact shall be liberally
12construed to effectuate its purposes.
13    (c) Nothing in the Compact shall be construed to prohibit
14the applicability of other interstate compacts to which the
15states are members.
 
16    SECTION 24. BINDING EFFECT OF COMPACT AND OTHER LAWS
17    (a) Nothing herein prevents the enforcement of any other
18law of a member state that is not inconsistent with the
19Compact.
20    (b) All laws in a member state in conflict with the Compact
21are superseded to the extent of the conflict.
22    (c) All lawful actions of the Interstate Commission,
23including all rules and bylaws promulgated by the Commission,
24are binding upon the member states.

 

 

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1    (d) All agreements between the Interstate Commission and
2the member states are binding in accordance with their terms.
3    (e) In the event any provision of the Compact exceeds the
4constitutional limits imposed on the legislature of any member
5state, such provision shall be ineffective to the extent of the
6conflict with the constitutional provision in question in that
7member state.