311.6208 Interstate Medical Licensure Compact.
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/ky/chapter-311/311-6208A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
The Interstate Medical Licensure Compact is hereby enacted and entered into with all other jurisdictions that legally join in the Compact, which is, in form, substantially as follows:
ARTICLE I
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 and 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.
ARTICLE II
DEFINITIONS As used in this compact:
(1)"Bylaws" means those bylaws established by the Interstate Commission pursuant to
Article XI for its governance, or for directing and controlling its actions and
conduct.
(2)"Commissioner" means the voting representative appointed by each member board
pursuant to Article XI.
(3)"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.
(4)"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.
(5)"Interstate Commission" means the interstate commission created pursuant to
Article XI.
(6)"License" means authorization by a state for a physician to engage in the practice of
medicine, which would be unlawful without the authorization.
(7)"Medical Practice Act" means laws and regulations governing the practice of
allopathic and osteopathic medicine within a member state.
(8)"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.
(9)"Member state" means a state that has enacted the Compact.
(10)"Physician" means any person who:
(a)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;
(b)Passed each component of the United States Medical Licensing Examination
(USMLE) or the Comprehensive Osteopathic Medical Licensing Examination
(COMLEX-USA) within three
(3)attempts, or any of its predecessor
examinations accepted by a state medical board as an equivalent examination
for licensure purposes;
(c)Successfully completed graduate medical education approved by the
Accreditation Council for Graduate Medical Education or the American
Osteopathic Association;
(d)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;
(e)Possesses a full and unrestricted license to engage in the practice of medicine
issued by a member board;
(f)Has never been convicted, received adjudication, deferred adjudication,
community supervision, or deferred disposition for any offense by a court of
appropriate jurisdiction;
(g)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 nonpayment of fees related to a license;
(h)Has never had a controlled substance license or permit suspended or revoked
by a state or the United States Drug Enforcement Administration; and
(i)Is not under active investigation by a licensing agency or law enforcement
authority in any state, federal, or foreign jurisdiction.
(11)"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.
(12)"Offense" means a felony, gross misdemeanor, or crime of moral turpitude.
(13)"Rule" means a written statement by the Interstate Commission promulgated
pursuant to Article XII 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.
(14)"State" means any state, commonwealth, district, or territory of the United States.
(15)"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.
ARTICLE III
ELIGIBILITY
(1)A physician shall meet the eligibility requirements as defined in Article II to receive
an expedited license under the terms and provisions of the Compact.
(2)A physician who does not meet the requirements of Article II 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.
ARTICLE IV
DESIGNATION OF STATE OF PRINCIPAL LICENSE
(1)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:
(a)The state of primary residence for the physician;
(b)The state where at least twenty-five percent (25%) of the practice of medicine
occurs;
(c)The location of the physician's employer; or
(d)If no state qualifies under paragraph (a), paragraph (b), or paragraph (c), the
state designated as state of residence for purpose of federal income tax.
(2)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 (1).
(3)The Interstate Commission is authorized to develop rules to facilitate redesignation
of another member state as the state of principal license.
ARTICLE V
APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE
(1)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.
(2)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.
(a)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.
(b)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 5 C.F.R. sec. 731.202.
(c)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.
(3)Upon verification in subsection (2), 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 (1), including the
payment of any applicable fees.
(4)After receiving verification of eligibility under subsection
(2)and any fees under
subsection (3), 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.
(5)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.
(6)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
nondisciplinary reason, without redesignation of a new state of principal licensure.
(7)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.
ARTICLE VI
FEES FOR EXPEDITED LICENSURE
(1)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.
(2)The Interstate Commission is authorized to develop rules regarding fees for
expedited licenses.
ARTICLE VII
RENEWAL AND CONTINUED PARTICIPATION
(1)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:
(a)Maintains a full and unrestricted license in a state of principal license;
(b)Has not been convicted or received adjudication, deferred adjudication,
community supervision, or deferred disposition for any offense by a court of
appropriate jurisdiction;
(c)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 nonpayment of fees related to a license; and
(d)Has not had a controlled substance license or permit suspended or revoked by
a state or the United States Drug Enforcement Administration.
(2)Physicians shall comply with all continuing professional development or continuing
medical education requirements for renewal of a license issued by a member state.
(3)The Interstate Commission shall collect any renewal fees charged for the renewal of
a license and distribute the fees to the applicable member board.
(4)Upon receipt of any renewal fees collected in subsection (3), a member board shall
renew the physician's license.
(5)Physician information collected by the Interstate Commission during the renewal
process shall be distributed to all member boards.
(6)The Interstate Commission is authorized to develop rules to address renewal of
licenses obtained through the Compact.
ARTICLE VIII
COORDINATED INFORMATION SYSTEM
(1)The Interstate Commission shall establish a database of all physicians licensed, or
who have applied for licensure, under Article V.
(2)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.
(3)Member boards shall report disciplinary or investigatory information determined as
necessary and proper by rule of the Interstate Commission.
(4)Member boards may report any nonpublic complaint, disciplinary, or investigatory
information not required by subsection
(3)to the Interstate Commission.
(5)Member boards shall share complaint or disciplinary information about a physician
upon request of another member board.
(6)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.
(7)The Interstate Commission is authorized to develop rules for mandated or
discretionary sharing of information by member boards.
ARTICLE IX
JOINT INVESTIGATIONS
(1)Licensure and disciplinary records of physicians are deemed investigative.
(2)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.
(3)A subpoena issued by a member state shall be enforceable in other member states.
(4)Member boards may share any investigative, litigation, or compliance materials in
furtherance of any joint or individual investigation initiated under the Compact.
(5)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.
ARTICLE X
DISCIPLINARY ACTIONS
(1)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.
(2)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.
(3)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:
(a)Impose the same or lesser sanctions against the physician so long as such
sanctions are consistent with the Medical Practice Act of that state; or
(b)Pursue separate disciplinary action against the physician under its respective
Medical Practice Act, regardless of the action taken in other member states.
(4)If a license granted to a physician by a member board is revoked, surrendered or
relinquished in lieu of discipline, or suspended, then any licenses issued to the
physician by any other member boards shall be suspended, automatically and
immediately without further action necessary by the other member boards, for
ninety
(90)days upon entry of the order by the disciplining board, to permit the
member boards 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.
ARTICLE XI
INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION
(1)The member states hereby create the "Interstate Medical Licensure Compact
Commission."
(2)The purpose of the Interstate Commission is the administration of the Interstate
Medical Licensure Compact, which is a discretionary state function.
(3)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.
(4)The Interstate Commission shall consist of two
(2)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
(1)representative from each
member board. A commissioner shall be an:
(a)Allopathic or osteopathic physician appointed to a member board;
(b)Executive director, executive secretary, or similar executive of a member
board; or
(c)Member of the public appointed to a member board.
(5)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.
(6)The bylaws may provide for meetings of the Interstate Commission to be conducted
by telecommunication or electronic communication.
(7)Each commissioner participating at a meeting of the Interstate Commission is
entitled to one
(1)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 (4).
(8)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 (2/3) vote of the
commissioners present that an open meeting would be likely to:
(a)Relate solely to the internal personnel practices and procedures of the
Interstate Commission;
(b)Discuss matters specifically exempted from disclosure by federal statute;
(c)Discuss trade secrets, commercial, or financial information that is privileged
or confidential;
(d)Involve accusing a person of a crime, or formally censuring a person;
(e)Discuss information of a personal nature where disclosure would constitute a
clearly unwarranted invasion of personal privacy;
(f)Discuss investigative records compiled for law enforcement purposes; or
(g)Specifically relate to the participation in a civil action or other legal
proceeding.
(9)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.
(10)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.
(11)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.
(12)The Interstate Commission may establish other committees for governance and
administration of the Compact.
ARTICLE XII
POWERS AND DUTIES OF THE INTERSTATE COMMISSION The Interstate Commission shall have the duty and power to:
(1)Oversee and maintain the administration of the Compact;
(2)Promulgate rules which shall be binding to the extent and in the manner provided
for in the Compact;
(3)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;
(4)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;
(5)Establish and appoint committees, including but not limited to an executive
committee as required by Article XI, which shall have the power to act on behalf of
the Interstate Commission in carrying out its powers and duties;
(6)Pay, or provide for the payment of, the expenses related to the establishment,
organization, and ongoing activities of the Interstate Commission;
(7)Establish and maintain one
(1)or more offices;
(8)Borrow, accept, hire, or contract for services of personnel;
(9)Purchase and maintain insurance and bonds;
(10)Employ an executive director who shall have the powers to employ, select or
appoint employees, agents, or consultants, and to determine their qualifications,
define their duties, and fix their compensation;
(11)Establish personnel policies and programs relating to conflicts of interest, rates of
compensation, and qualifications of personnel;
(12)Accept donations and grants of money, equipment, supplies, materials and services,
and to receive, utilize, and dispose of them in a manner consistent with the conflict
of interest policies established by the Interstate Commission;
(13)Lease, purchase, accept contributions or donations of, or otherwise to own, hold,
improve or use, any property, real, personal, or mixed;
(14)Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
any property, real, personal, or mixed;
(15)Establish a budget and make expenditures;
(16)Adopt a seal and bylaws governing the management and operation of the Interstate
Commission;
(17)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;
(18)Coordinate education, training, and public awareness regarding the Compact, its
implementation, and its operation;
(19)Maintain records in accordance with the bylaws;
(20)Seek and obtain trademarks, copyrights, and patents; and
(21)Perform such functions as may be necessary or appropriate to achieve the purposes
of the Compact.
ARTICLE XIII
FINANCE POWERS
(1)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 shall 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.
(2)The Interstate Commission shall not incur obligations of any kind prior to securing
the funds adequate to meet the same.
(3)The Interstate Commission shall not pledge the credit of any of the member states,
except by, and with the authority of, the member state.
(4)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.
ARTICLE XIV
ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION
(1)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.
(2)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.
(3)Officers selected in subsection
(2)shall serve without remuneration from the
Interstate Commission.
(4)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.
(a)The liability of the executive director and employees of the Interstate
Commission or representatives of the Interstate Commission, acting within the
scope of their employment or duties for acts, errors, or omissions occurring
within their 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.
(b)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.
(c)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.
ARTICLE XV
RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION
(1)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.
(2)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.
(3)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.
ARTICLE XVI
OVERSIGHT OF INTERSTATE COMPACT
(1)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.
(2)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.
(3)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.
ARTICLE XVII
ENFORCEMENT OF INTERSTATE COMPACT
(1)The Interstate Commission, in the reasonable exercise of its discretion, shall enforce
the provisions and rules of the Compact.
(2)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.
(3)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.
ARTICLE XVIII
DEFAULT PROCEDURES
(1)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.
(2)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:
(a)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
(b)Provide remedial training and specific technical assistance regarding the
default.
(3)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.
(4)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.
(5)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.
(6)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.
(7)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.
(8)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.
ARTICLE XIX
DISPUTE RESOLUTION
(1)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.
(2)The Interstate Commission shall promulgate rules providing for both mediation and
binding dispute resolution as appropriate.
ARTICLE XX
MEMBER STATES, EFFECTIVE DATE AND AMENDMENT
(1)Any state is eligible to become a member state of the Compact.
(2)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.
(3)The governors of nonmember states, or their designees, shall be invited to
participate in the activities of the Interstate Commission on a nonvoting basis prior
to adoption of the Compact by all states.
(4)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.
ARTICLE XXI
WITHDRAWAL
(1)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.
(2)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.
(3)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.
(4)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 (3).
(5)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.
(6)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.
(7)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.
ARTICLE XXII
DISSOLUTION
(1)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.
(2)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.
ARTICLE XXIII
SEVERABILITY AND CONSTRUCTION
(1)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.
(2)The provisions of the Compact shall be liberally construed to effectuate its
purposes.
(3)Nothing in the Compact shall be construed to prohibit the applicability of other
interstate compacts to which the states are members.
ARTICLE XXIV
BINDING EFFECT OF COMPACT AND OTHER LAWS
(1)Nothing herein prevents the enforcement of any other law of a member state that is
not inconsistent with the Compact.
(2)All laws in a member state in conflict with the Compact are superseded to the extent
of the conflict.
(3)All lawful actions of the Interstate Commission, including all rules and bylaws
promulgated by the Commission, are binding upon the member states.
(4)All agreements between the Interstate Commission and the member states are
binding in accordance with their terms.
(5)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.