Bill Text: NY A09859 | 2019-2020 | General Assembly | Introduced


Bill Title: Enacts the interstate medical licensure compact; provides a streamlined process that allows physicians to become licensed in multiple participating states, thereby enhancing the portability of a medical license and ensuring the safety of patients.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced) 2020-02-20 - referred to higher education [A09859 Detail]

Download: New_York-2019-A09859-Introduced.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                          9859

                   IN ASSEMBLY

                                    February 20, 2020
                                       ___________

        Introduced  by  M.  of  A.  PALMESANO  --  read once and referred to the
          Committee on Higher Education

        AN ACT to amend the education law, in relation to  enacting  the  inter-
          state medical licensure compact

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The education law is amended by adding a new article 169 to
     2  read as follows:
     3                                 ARTICLE 169
     4                    INTERSTATE MEDICAL LICENSURE COMPACT
     5  Section 8860. Short title.
     6          8861. Purpose.
     7          8862. Definitions.
     8          8863. Eligibility.
     9          8864. Designation of state of principal license.
    10          8865. Application and issuance of expedited licensure.
    11          8866. Fees for expedited licensure.
    12          8867. Renewal and continued participation.
    13          8868. Coordinated information system.
    14          8869. Joint investigations.
    15          8870. Disciplinary actions.
    16          8871. Interstate medical licensure compact commission.
    17          8872. Powers and duties of the interstate commission.
    18          8873. Finance powers.
    19          8874. Organization and operation of the interstate commission.
    20          8875. Rulemaking functions of the interstate commission.
    21          8876. Oversight of interstate compact.
    22          8877. Enforcement of interstate compact.
    23          8878. Default procedures.
    24          8879. Dispute resolution.
    25          8880. Member states, effective date and amendment.
    26          8881. Withdrawal.
    27          8882. Dissolution.
    28          8883. Severability and construction.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD15221-01-0

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     1          8884. Binding effect of compact and other laws.
     2    § 8860. Short  title.  This article shall be known and may be cited as
     3  the "interstate medical licensure compact".
     4    § 8861. Purpose. In order to strengthen access to health care, and  in
     5  recognition  of  the advances in the delivery of health care, the member
     6  states of the interstate medical licensure compact have allied in common
     7  purpose to develop a comprehensive process that complements the existing
     8  licensing and regulatory authority of state medical boards,  provides  a
     9  streamlined  process that allows physicians to become licensed in multi-
    10  ple states, thereby enhancing the portability of a medical  license  and
    11  ensuring  the  safety of patients.   The compact creates another pathway
    12  for licensure and does not otherwise change a state's  existing  medical
    13  practice act. The compact also adopts the prevailing standard for licen-
    14  sure  and affirms that the practice of medicine occurs where the patient
    15  is located at the time of the physician-patient  encounter,  and  there-
    16  fore,  requires  the physician to be under the jurisdiction of the state
    17  medical board where the patient is located. State  medical  boards  that
    18  participate  in the compact retain the jurisdiction to impose an adverse
    19  action against a license to practice medicine in that state issued to  a
    20  physician through the procedures in the compact.
    21    § 8862. Definitions. In this compact:
    22    1.  "Bylaws"  means those bylaws established by the interstate commis-
    23  sion pursuant to section eighty-eight hundred seventy-one of this  arti-
    24  cle for its governance, or for directing and controlling its actions and
    25  conduct.
    26    2.  "Commissioner"  means  the voting representative appointed by each
    27  member board pursuant to section  eighty-eight  hundred  seventy-one  of
    28  this article.
    29    3. "Conviction" means a finding by a court that an individual is guil-
    30  ty  of  a  criminal  offense through adjudication, or entry of a plea of
    31  guilt or no contest to the charge by the offender. Evidence of an  entry
    32  of  a  conviction of a criminal offense by the court shall be considered
    33  final for purposes of disciplinary action by a member board.
    34    4. "Expedited license" means a full and unrestricted  medical  license
    35  granted  by  a member state to an eligible physician through the process
    36  set forth in the compact.
    37    5. "Interstate commission" means  the  interstate  commission  created
    38  pursuant to section eighty-eight hundred seventy-one of this article.
    39    6.  "License" means authorization by a state for a physician to engage
    40  in the practice of medicine, which would be unlawful without the author-
    41  ization.
    42    7. "Medical practice act" means laws  and  regulations  governing  the
    43  practice of allopathic and osteopathic medicine within a member state.
    44    8.  "Member board" means a state agency in a member state that acts in
    45  the sovereign interests of the state by protecting  the  public  through
    46  licensure,  regulation,  and  education of physicians as directed by the
    47  state government.
    48    9. "Member state" means a state that has enacted the compact.
    49    10. "Practice of medicine" means the clinical  prevention,  diagnosis,
    50  or  treatment  of human disease, injury, or condition requiring a physi-
    51  cian to obtain and maintain a license in  compliance  with  the  medical
    52  practice act of a member state.
    53    11. "Physician" means any person who:
    54    (a)  Is  a  graduate  of  a  medical  school accredited by the Liaison
    55  Committee on Medical Education, the Commission  on  Osteopathic  College

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     1  Accreditation,  or  a medical school listed in the International Medical
     2  Education Directory or its equivalent;
     3    (b) Passed each component of the United States Medical Licensing Exam-
     4  ination (USMLE) or the Comprehensive Osteopathic Medical Licensing Exam-
     5  ination  (COMLEX-USA)  within  three attempts, or any of its predecessor
     6  examinations accepted by a state medical board as an equivalent examina-
     7  tion for licensure purposes;
     8    (c) Successfully completed graduate medical education approved by  the
     9  Accreditation  Council  for  Graduate  Medical Education or the American
    10  Osteopathic Association;
    11    (d)  Holds  specialty  certification  or  a  time-unlimited  specialty
    12  certificate  recognized  by the American Board of Medical Specialties or
    13  the American Osteopathic Association's Bureau  of  Osteopathic  Special-
    14  ists;
    15    (e)  Possesses  a full and unrestricted license to engage in the prac-
    16  tice of medicine issued by a member board;
    17    (f) Has never been convicted, received adjudication, deferred  adjudi-
    18  cation,  community  supervision, or deferred disposition for any offense
    19  by a court of appropriate jurisdiction;
    20    (g) Has never held a license  authorizing  the  practice  of  medicine
    21  subjected  to discipline by a licensing agency in any state, federal, or
    22  foreign jurisdiction, excluding any action  related  to  non-payment  of
    23  fees related to a license;
    24    (h)  Has  never had a controlled substance license or permit suspended
    25  or revoked by a state or the United  States  drug  enforcement  adminis-
    26  tration; and
    27    (i)  Is  not  under  active investigation by a licensing agency or law
    28  enforcement authority in any state, federal, or foreign jurisdiction.
    29    12. "Offense" means a felony, gross misdemeanor,  or  crime  of  moral
    30  turpitude.
    31    13.  "Rule"  means  a  written  statement by the interstate commission
    32  promulgated pursuant to section eighty-eight hundred seventy-two of this
    33  article that is of general  applicability,  implements,  interprets,  or
    34  prescribes  a  policy or provision of the compact, or an organizational,
    35  procedural, or practice requirement of the  interstate  commission,  and
    36  has  the  force  and  effect  of  statutory  law  in a member state, and
    37  includes the amendment, repeal, or suspension of an existing rule.
    38    14. "State" means any state, commonwealth, district, or  territory  of
    39  the United States.
    40    15.  "State  of principal license" means a member state where a physi-
    41  cian holds a license to practice medicine and which has been  designated
    42  as  such by the physician for purposes of registration and participation
    43  in the compact.
    44    § 8863. Eligibility. 1. A physician must meet the eligibility require-
    45  ments as defined in subdivision eleven of section  eighty-eight  hundred
    46  sixty-two  of  this  article  to  receive an expedited license under the
    47  terms and provisions of the compact.
    48    2. A physician who does not meet the requirements of subdivision elev-
    49  en of section eighty-eight hundred sixty-two of this article may  obtain
    50  a  license  to  practice  medicine  in  a member state if the individual
    51  complies with all laws and requirements, other than the compact,  relat-
    52  ing to the issuance of a license to practice medicine in that state.
    53    § 8864. Designation  of  state  of  principal  license. 1. A physician
    54  shall designate a member state as the state  of  principal  license  for
    55  purposes  of registration for expedited licensure through the compact if

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     1  the physician possesses a full  and  unrestricted  license  to  practice
     2  medicine in that state, and the state is:
     3    (a) the state of primary residence for the physician, or
     4    (b)  the  state  where at least twenty-five percent of the practice of
     5  medicine occurs, or
     6    (c) the location of the physician's employer, or
     7    (d) if no state qualifies under paragraph (a), (b),  or  (c)  of  this
     8  subdivision,  the  state designated as state of residence for purpose of
     9  federal income tax.
    10    2. A physician may redesignate a member state as  state  of  principal
    11  license  at  any  time,  as  long as the state meets the requirements of
    12  subdivision one of this section.
    13    3. The interstate commission is authorized to develop rules to facili-
    14  tate redesignation of another member state as  the  state  of  principal
    15  license.
    16    § 8865. Application  and  issuance of expedited licensure. 1. A physi-
    17  cian seeking licensure through the compact shall file an application for
    18  an expedited license with the member board of the state selected by  the
    19  physician as the state of principal license.
    20    2. Upon receipt of an application for an expedited license, the member
    21  board  within the state selected as the state of principal license shall
    22  evaluate whether the physician is eligible for expedited  licensure  and
    23  issue  a  letter  of qualification, verifying or denying the physician's
    24  eligibility, to the interstate commission.
    25    (a) Static  qualifications,  which  include  verification  of  medical
    26  education, graduate medical education, results of any medical or licens-
    27  ing  examination,  and  other qualifications as determined by the inter-
    28  state commission through rule, shall not be subject to additional prima-
    29  ry source verification where already  primary  source  verified  by  the
    30  state of principal license.
    31    (b) The member board within the state selected as the state of princi-
    32  pal  license  shall,  in  the course of verifying eligibility, perform a
    33  criminal background check of an applicant,  including  the  use  of  the
    34  results of fingerprint or other biometric data checks compliant with the
    35  requirements  of the Federal Bureau of Investigation, with the exception
    36  of federal employees who have suitability  determination  in  accordance
    37  with U.S. C.F.R. § 731.202.
    38    (c)  Appeal  on  the determination of eligibility shall be made to the
    39  member state where the application was filed and shall be subject to the
    40  law of that state.
    41    3. Upon verification under subdivision two of this section, physicians
    42  eligible for an expedited license shall complete the registration  proc-
    43  ess  established  by the interstate commission to receive a license in a
    44  member state selected pursuant  to  subdivision  one  of  this  section,
    45  including the payment of any applicable fees.
    46    4.  After  receiving verification of eligibility under subdivision two
    47  of this section and any fees under subdivision three of this section,  a
    48  member  board  shall  issue  an expedited license to the physician. This
    49  license shall authorize the physician to practice medicine in the  issu-
    50  ing  state  consistent  with the medical practice act and all applicable
    51  laws and regulations of the issuing member board and member state.
    52    5. An expedited license shall be valid for a  period  consistent  with
    53  the  licensure  period  in  the  member  state and in the same manner as
    54  required for other physicians holding a full  and  unrestricted  license
    55  within the member state.

        A. 9859                             5

     1    6.  An  expedited  license obtained though the compact shall be termi-
     2  nated if a physician fails to maintain a license in the state of princi-
     3  pal licensure for a non-disciplinary reason, without redesignation of  a
     4  new state of principal licensure.
     5    7.  The interstate commission is authorized to develop rules regarding
     6  the application process, including payment of any applicable  fees,  and
     7  the issuance of an expedited license.
     8    § 8866. Fees  for  expedited  licensure.  1. A member state issuing an
     9  expedited license authorizing the practice of medicine in that state may
    10  impose a fee for a license issued or renewed through the compact.
    11    2. The interstate commission is authorized to develop rules  regarding
    12  fees for expedited licenses.
    13    § 8867. Renewal and continued participation. 1. A physician seeking to
    14  renew  an  expedited  license granted in a member state shall complete a
    15  renewal process with the interstate commission if the physician:
    16    (a) Maintains a full and unrestricted license in a state of  principal
    17  license;
    18    (b)  Has  not  been convicted, received adjudication, deferred adjudi-
    19  cation, community supervision, or deferred disposition for  any  offense
    20  by a court of appropriate jurisdiction;
    21    (c) Has not had a license authorizing the practice of medicine subject
    22  to  discipline  by  a licensing agency in any state, federal, or foreign
    23  jurisdiction, excluding  any  action  related  to  non-payment  of  fees
    24  related to a license; and
    25    (d)  Has not had a controlled substance license or permit suspended or
    26  revoked by a state or the United States drug enforcement administration.
    27    2. Physicians shall comply with all continuing  professional  develop-
    28  ment  or  continuing  medical  education  requirements  for renewal of a
    29  license issued by a member state.
    30    3. The interstate commission shall collect any  renewal  fees  charged
    31  for  the  renewal of a license and distribute the fees to the applicable
    32  member board.
    33    4. Upon receipt of any renewal fees collected in subdivision three  of
    34  this section, a member board shall renew the physician's license.
    35    5. Physician information collected by the interstate commission during
    36  the renewal process will be distributed to all member boards.
    37    6. The interstate commission is authorized to develop rules to address
    38  renewal of licenses obtained through the compact.
    39    § 8868. Coordinated  information  system. 1. The interstate commission
    40  shall establish a database of  all  physicians  licensed,  or  who  have
    41  applied  for licensure, under section eighty-eight hundred sixty-five of
    42  this article.
    43    2. Notwithstanding any other provision of  law,  member  boards  shall
    44  report  to  the  interstate  commission  any public action or complaints
    45  against a licensed physician who has applied or  received  an  expedited
    46  license through the compact.
    47    3.  Member  boards shall report disciplinary or investigatory informa-
    48  tion determined as necessary  and  proper  by  rule  of  the  interstate
    49  commission.
    50    4. Member boards may report any non-public complaint, disciplinary, or
    51  investigatory  information  not  required  by  subdivision three of this
    52  section to the interstate commission.
    53    5. Member boards shall share  complaint  or  disciplinary  information
    54  about a physician upon request of another member board.

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     1    6.  All  information provided to the interstate commission or distrib-
     2  uted by member boards shall be confidential, filed under seal, and  used
     3  only for investigatory or disciplinary matters.
     4    7.  The  interstate  commission  is  authorized  to  develop rules for
     5  mandated or discretionary sharing of information by member boards.
     6    § 8869. Joint investigations. 1. Licensure and disciplinary records of
     7  physicians are deemed investigative.
     8    2. In addition to the authority granted  to  a  member  board  by  its
     9  respective  medical practice act or other applicable state law, a member
    10  board may participate with other member boards in  joint  investigations
    11  of physicians licensed by the member boards.
    12    3.  A  subpoena issued by a member state shall be enforceable in other
    13  member states.
    14    4. Member boards may share any investigative, litigation,  or  compli-
    15  ance  materials  in furtherance of any joint or individual investigation
    16  initiated under the compact.
    17    5. Any member state may investigate actual or  alleged  violations  of
    18  the  statutes  authorizing  the practice of medicine in any other member
    19  state in which a physician holds a license to practice medicine.
    20    § 8870. Disciplinary actions. 1. Any disciplinary action taken by  any
    21  member  board  against a physician licensed through the compact shall be
    22  deemed unprofessional conduct which may  be  subject  to  discipline  by
    23  other  member  boards, in addition to any violation of the medical prac-
    24  tice act or regulations in that state.
    25    2. If a license granted to a physician by  the  member  board  in  the
    26  state  of  principal  license is revoked, surrendered or relinquished in
    27  lieu of discipline, or suspended, then all licenses issued to the physi-
    28  cian by member boards shall automatically  be  placed,  without  further
    29  action  necessary by any member board, on the same status. If the member
    30  board in the state of  principal  license  subsequently  reinstates  the
    31  physician's  license,  a  license  issued  to the physician by any other
    32  member board shall remain encumbered until that respective member  board
    33  takes  action  to  reinstate the license in a manner consistent with the
    34  medical practice act of that state.
    35    3. If disciplinary action is taken against a  physician  by  a  member
    36  board  not in the state of principal license, any other member board may
    37  deem the action conclusive as to matter of law and fact decided, and:
    38    (a) impose the same or lesser sanction or sanctions against the physi-
    39  cian so long as such sanctions are consistent with the medical  practice
    40  act of that state; or
    41    (b)  pursue  separate  disciplinary action against the physician under
    42  its respective medical practice act, regardless of the action  taken  in
    43  other member states.
    44    4.  If  a license granted to a physician by a member board is revoked,
    45  surrendered, or relinquished in lieu of discipline, or  suspended,  then
    46  any  license  or  licenses  issued  to the physician by any other member
    47  board or boards shall be suspended, automatically and immediately  with-
    48  out  further  action  necessary by the other member board or boards, for
    49  ninety days upon entry of the order by the disciplining board, to permit
    50  the member board or boards to investigate the basis for the action under
    51  the medical practice act of that state. A member board may terminate the
    52  automatic suspension of the license it issued prior to the completion of
    53  the ninety day suspension period in a manner consistent with the medical
    54  practice act of that state.

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     1    § 8871. Interstate medical licensure compact commission. 1. The member
     2  states hereby create the "interstate medical licensure  compact  commis-
     3  sion".
     4    2.  The  purpose of the interstate commission is the administration of
     5  the interstate medical licensure compact, which is a discretionary state
     6  function.
     7    3. The interstate commission shall be a body corporate and joint agen-
     8  cy of the member states and shall have all the responsibilities, powers,
     9  and duties set forth in the compact, and such additional powers  as  may
    10  be conferred upon it by a subsequent concurrent action of the respective
    11  legislatures  of  the  member states in accordance with the terms of the
    12  compact.
    13    4. The interstate commission shall consist  of  two  voting  represen-
    14  tatives appointed by each member state who shall serve as commissioners.
    15  In  states  where allopathic and osteopathic physicians are regulated by
    16  separate member boards, or if the licensing and  disciplinary  authority
    17  is  split  between  multiple  member  boards  within a member state, the
    18  member state shall appoint one representative from each member board.  A
    19  commissioner shall be a or an:
    20    (a) Allopathic or osteopathic physician appointed to a member board;
    21    (b) Executive director, executive secretary, or similar executive of a
    22  member board; or
    23    (c) Member of the public appointed to a member board.
    24    5.  The  interstate  commission shall meet at least once each calendar
    25  year. A portion of this meeting shall be a business meeting  to  address
    26  such  matters  as may properly come before the commission, including the
    27  election of officers. The chairperson may call additional  meetings  and
    28  shall  call  for  a meeting upon the request of a majority of the member
    29  states.
    30    6. The bylaws may provide for meetings of the interstate commission to
    31  be conducted by telecommunication or electronic communication.
    32    7. Each commissioner participating at  a  meeting  of  the  interstate
    33  commission  is  entitled  to one vote. A majority of commissioners shall
    34  constitute a quorum for the transaction of  business,  unless  a  larger
    35  quorum is required by the bylaws of the interstate commission. A commis-
    36  sioner shall not delegate a vote to another commissioner. In the absence
    37  of  its commissioner, a member state may delegate voting authority for a
    38  specified meeting to another person from that state who shall  meet  the
    39  requirements of subdivision four of this section.
    40    8.  The interstate commission shall provide public notice of all meet-
    41  ings and all meetings shall  be  open  to  the  public.  The  interstate
    42  commission  may  close a meeting, in full or in portion, where it deter-
    43  mines by a two-thirds vote of the commissioners  present  that  an  open
    44  meeting would be likely to:
    45    (a)  Relate  solely to the internal personnel practices and procedures
    46  of the interstate commission;
    47    (b) Discuss matters specifically exempted from disclosure  by  federal
    48  statute;
    49    (c)  Discuss  trade secrets, commercial, or financial information that
    50  is privileged or confidential;
    51    (d) Involve accusing a person of a  crime,  or  formally  censuring  a
    52  person;
    53    (e)  Discuss  information  of a personal nature where disclosure would
    54  constitute a clearly unwarranted invasion of personal privacy;
    55    (f)  Discuss  investigative  records  compiled  for  law   enforcement
    56  purposes; or

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     1    (g)  Specifically  relate  to  the  participation in a civil action or
     2  other legal proceeding.
     3    9.  The  interstate  commission  shall  keep minutes which shall fully
     4  describe all matters discussed in a meeting and shall provide a full and
     5  accurate summary of actions taken, including record  of  any  roll  call
     6  votes.
     7    10.  The interstate commission shall make its information and official
     8  records, to the extent not otherwise designated in the compact or by its
     9  rules, available to the public for inspection.
    10    11. The interstate commission shall establish an executive  committee,
    11  which  shall  include officers, members, and others as determined by the
    12  bylaws. The executive committee shall have the power to act on behalf of
    13  the interstate commission, with  the  exception  of  rulemaking,  during
    14  periods when the interstate commission is not in session. When acting on
    15  behalf of the interstate commission, the executive committee shall over-
    16  see  the administration of the compact including enforcement and compli-
    17  ance with the provisions of the compact, its bylaws and rules, and other
    18  such duties as necessary.
    19    12. The interstate  commission  may  establish  other  committees  for
    20  governance and administration of the compact.
    21    § 8872. Powers and duties of the interstate commission. The interstate
    22  commission shall have the duty and power to:
    23    1. Oversee and maintain the administration of the compact;
    24    2.  Promulgate  rules  which shall be binding to the extent and in the
    25  manner provided for in the compact;
    26    3. Issue, upon the request of a member state or member board, advisory
    27  opinions concerning the meaning or interpretation of  the  compact,  its
    28  bylaws, rules, and actions;
    29    4.  Enforce  compliance with compact provisions, the rules promulgated
    30  by the interstate commission, and the bylaws, using  all  necessary  and
    31  proper means, including but not limited to the use of judicial process;
    32    5.  Establish and appoint committees including, but not limited to, an
    33  executive committee as required by section eighty-eight  hundred  seven-
    34  ty-one  of  this article, which shall have the power to act on behalf of
    35  the interstate commission in carrying out its powers and duties;
    36    6. Pay, or provide for the payment of  the  expenses  related  to  the
    37  establishment,  organization,  and  ongoing activities of the interstate
    38  commission;
    39    7. Establish and maintain one or more offices;
    40    8. Borrow, accept, hire, or contract for services of personnel;
    41    9. Purchase and maintain insurance and bonds;
    42    10. Employ an executive director who shall have such powers to employ,
    43  select or appoint employees, agents, or consultants,  and  to  determine
    44  their qualifications, define their duties, and fix their compensation;
    45    11. Establish personnel policies and programs relating to conflicts of
    46  interest, rates of compensation, and qualifications of personnel;
    47    12. Accept donations and grants of money, equipment, supplies, materi-
    48  als and services, and to receive, utilize, and dispose of it in a manner
    49  consistent  with  the  conflict  of interest policies established by the
    50  interstate commission;
    51    13. Lease, purchase, accept contributions or donations of,  or  other-
    52  wise  to  own,  hold,  improve, or use, any property, real, personal, or
    53  mixed;
    54    14. Sell, convey,  mortgage,  pledge,  lease,  exchange,  abandon,  or
    55  otherwise dispose of any property, real, personal, or mixed;
    56    15. Establish a budget and make expenditures;

        A. 9859                             9

     1    16.  Adopt a seal and bylaws governing the management and operation of
     2  the interstate commission;
     3    17.  Report  annually  to the legislatures and governors of the member
     4  states concerning the activities of the interstate commission during the
     5  preceding year.  Such reports shall also include  reports  of  financial
     6  audits  and any recommendations that may have been adopted by the inter-
     7  state commission;
     8    18. Coordinate education, training, and public awareness regarding the
     9  compact, its implementation, and its operation;
    10    19. Maintain records in accordance with the bylaws;
    11    20. Seek and obtain trademarks, copyrights, and patents; and
    12    21. Perform such functions as  may  be  necessary  or  appropriate  to
    13  achieve the purposes of the compact.
    14    § 8873. Finance  powers.  1. The interstate commission may levy on and
    15  collect an annual assessment from each member state to cover the cost of
    16  the operations and activities  of  the  interstate  commission  and  its
    17  staff. The total assessment must be sufficient to cover the annual budg-
    18  et  approved each year for which revenue is not provided by other sourc-
    19  es. The aggregate annual assessment amount shall  be  allocated  upon  a
    20  formula  to  be  determined  by  the  interstate commission, which shall
    21  promulgate a rule binding upon all member states.
    22    2. The interstate commission shall not incur obligations of  any  kind
    23  prior to securing the funds adequate to meet the same.
    24    3. The interstate commission shall not pledge the credit of any of the
    25  member states, except by, and with the authority of, the member state.
    26    4.  The  interstate  commission shall be subject to a yearly financial
    27  audit conducted by a certified or licensed  public  accountant  and  the
    28  report of the audit shall be included in the annual report of the inter-
    29  state commission.
    30    § 8874. Organization  and  operation  of the interstate commission. 1.
    31  The interstate commission shall, by a majority of commissioners  present
    32  and  voting,  adopt  bylaws to govern its conduct as may be necessary or
    33  appropriate to carry out the  purposes  of  the  compact  within  twelve
    34  months of the first interstate commission meeting.
    35    2.  The  interstate  commission  shall  elect or appoint annually from
    36  among its commissioners a chairperson, a vice-chairperson, and a  treas-
    37  urer, each of whom shall have such authority and duties as may be speci-
    38  fied  in the bylaws. The chairperson, or in the chairperson's absence or
    39  disability, the vice-chairperson, shall preside at all meetings  of  the
    40  interstate commission.
    41    3. Officers selected pursuant to subdivision two of this section shall
    42  serve without remuneration from the interstate commission.
    43    4.  The  officers  and employees of the interstate commission shall be
    44  immune from suit and liability, either personally or in  their  official
    45  capacity,  for  a  claim  for  damage to or loss of property or personal
    46  injury or other civil liability caused or arising out  of,  or  relating
    47  to,  an actual or alleged act, error, or omission that occurred, or that
    48  such person had a reasonable basis for believing  occurred,  within  the
    49  scope  of interstate commission employment, duties, or responsibilities;
    50  provided that such person shall not be protected from suit or  liability
    51  for  damage,  loss,  injury,  or  liability caused by the intentional or
    52  willful and wanton misconduct of such person.
    53    (a) The liability of the  executive  director  and  employees  of  the
    54  interstate  commission  or representatives of the interstate commission,
    55  acting within the scope of such person's employment or duties for  acts,
    56  errors,  or  omissions  occurring  within  such  person's state, may not

        A. 9859                            10

     1  exceed the limits of liability set forth under the constitution and laws
     2  of that state for state officials, employees, and agents. The interstate
     3  commission is considered to be an instrumentality of the states for  the
     4  purposes  of  any  such  action.    Nothing  in  this paragraph shall be
     5  construed to protect such person from  suit  or  liability  for  damage,
     6  loss,  injury,  or  liability  caused  by the intentional or willful and
     7  wanton misconduct of such person.
     8    (b) The interstate commission shall defend the executive director, its
     9  employees, and subject to the approval of the attorney general or  other
    10  appropriate  legal  counsel of the member state represented by an inter-
    11  state commission representative, shall defend such interstate commission
    12  representative in any civil action seeking to impose  liability  arising
    13  out  of an actual or alleged act, error or omission that occurred within
    14  the scope of interstate commission employment,  duties  or  responsibil-
    15  ities,  or  that  the  defendant  had  a  reasonable basis for believing
    16  occurred within the scope of interstate commission  employment,  duties,
    17  or  responsibilities, provided that the actual or alleged act, error, or
    18  omission did not result from intentional or willful and  wanton  miscon-
    19  duct on the part of such person.
    20    (c)  To the extent not covered by the state involved, member state, or
    21  the interstate commission,  the  representatives  or  employees  of  the
    22  interstate  commission shall be held harmless in the amount of a settle-
    23  ment or judgment, including attorney's fees and costs, obtained  against
    24  such persons arising out of an actual or alleged act, error, or omission
    25  that  occurred  within  the  scope  of interstate commission employment,
    26  duties, or responsibilities, or that such persons had a reasonable basis
    27  for believing occurred within the scope of interstate commission employ-
    28  ment, duties, or responsibilities, provided that the actual  or  alleged
    29  act,  error,  or omission did not result from intentional or willful and
    30  wanton misconduct on the part of such persons.
    31    § 8875. Rulemaking functions of the interstate  commission.  1.    The
    32  interstate  commission  shall  promulgate  reasonable  rules in order to
    33  effectively  and  efficiently  achieve  the  purposes  of  the  compact.
    34  Notwithstanding  the  foregoing,  in the event the interstate commission
    35  exercises its rulemaking authority in a manner that is beyond the  scope
    36  of  the  purposes  of the compact, or the powers granted hereunder, then
    37  such an action by the interstate commission shall be invalid and have no
    38  force or effect.
    39    2. Rules deemed appropriate  for  the  operations  of  the  interstate
    40  commission  shall be made pursuant to a rulemaking process that substan-
    41  tially conforms to the federal Model State Administrative Procedure  Act
    42  of 2010, and subsequent amendments thereto.
    43    3.  Not later than thirty days after a rule is promulgated, any person
    44  may file a petition for judicial review of the rule in the United States
    45  District Court for the District of  Columbia  or  the  federal  district
    46  where the interstate commission has its principal offices, provided that
    47  the  filing  of  such a petition shall not stay or otherwise prevent the
    48  rule from becoming effective unless the court finds that the  petitioner
    49  has  a substantial likelihood of success. The court shall give deference
    50  to the actions of the interstate commission consistent  with  applicable
    51  law  and shall not find the rule to be unlawful if the rule represents a
    52  reasonable exercise of the authority granted to the  interstate  commis-
    53  sion.
    54    § 8876. Oversight  of  interstate  compact. 1. The executive, legisla-
    55  tive, and judicial branches of state government  in  each  member  state
    56  shall  enforce  the  compact  and  shall  take all actions necessary and

        A. 9859                            11

     1  appropriate  to  effectuate  the  compact's  purposes  and  intent.  The
     2  provisions of the compact and the rules promulgated hereunder shall have
     3  standing as statutory law but shall not override existing state authori-
     4  ty to regulate the practice of medicine.
     5    2.  All courts shall take judicial notice of the compact and the rules
     6  in any judicial or administrative proceeding in a member state  pertain-
     7  ing  to  the  subject matter of the compact which may affect the powers,
     8  responsibilities or actions of the interstate commission.
     9    3. The interstate commission shall be entitled to receive all  service
    10  of  process in any such proceeding, and shall have standing to intervene
    11  in the proceeding for all purposes. Failure to provide service of  proc-
    12  ess  to  the interstate commission shall render a judgment or order void
    13  as to the interstate commission, the compact, or promulgated rules.
    14    § 8877. Enforcement of interstate compact. 1. The  interstate  commis-
    15  sion,  in  the  reasonable exercise of its discretion, shall enforce the
    16  provisions and rules of the compact.
    17    2. The interstate commission may, by majority vote of the  commission-
    18  ers,  initiate  legal action in the United States District Court for the
    19  District of Columbia, or, at the discretion of  the  interstate  commis-
    20  sion,  in  the  federal district where the interstate commission has its
    21  principal offices, to enforce compliance  with  the  provisions  of  the
    22  compact, and its promulgated rules and bylaws, against a member state in
    23  default.  The  relief  sought  may  include  both  injunctive relief and
    24  damages. In the event judicial enforcement is necessary, the  prevailing
    25  party shall be awarded all costs of such litigation including reasonable
    26  attorney's fees.
    27    3.  The  remedies  herein  shall  not be the exclusive remedies of the
    28  interstate commission.  The interstate commission may  avail  itself  of
    29  any  other  remedies  available  under  state law or the regulation of a
    30  profession.
    31    § 8878. Default procedures. 1. The grounds for  default  include,  but
    32  are  not  limited  to,  failure  of a member state to perform such obli-
    33  gations or responsibilities imposed upon it by the compact, or the rules
    34  and bylaws of the interstate commission promulgated under the compact.
    35    2. If the interstate commission determines that  a  member  state  has
    36  defaulted  in  the  performance  of  its obligations or responsibilities
    37  under the compact, or the bylaws or promulgated  rules,  the  interstate
    38  commission shall:
    39    (a)  Provide  written  notice to the defaulting state and other member
    40  states, of the nature of the default, the means of curing  the  default,
    41  and  any  action  taken  by  the interstate commission.   The interstate
    42  commission shall specify the conditions by which  the  defaulting  state
    43  must cure its default; and
    44    (b)  Provide  remedial  training  and  specific  technical  assistance
    45  regarding the default.
    46    3. If the defaulting state fails to cure the default,  the  defaulting
    47  state shall be terminated from the compact upon an affirmative vote of a
    48  majority  of  the commissioners and all rights, privileges, and benefits
    49  conferred by the compact shall terminate on the effective date of termi-
    50  nation. A cure of the default does not relieve the  offending  state  of
    51  obligations or liabilities incurred during the period of the default.
    52    4.  Termination  of  membership  in  the compact shall be imposed only
    53  after all other means of securing compliance have been exhausted. Notice
    54  of intent to terminate shall be given by the  interstate  commission  to
    55  the  governor,  the  majority  and  minority  leaders  of the defaulting
    56  state's legislature, and each of the member states.

        A. 9859                            12

     1    5. The interstate commission shall establish rules and  procedures  to
     2  address  licenses  and  physicians  that  are materially impacted by the
     3  termination of a member state, or the withdrawal of a member state.
     4    6.  The  member state which has been terminated is responsible for all
     5  dues, obligations, and liabilities incurred through the  effective  date
     6  of  termination  including obligations, the performance of which extends
     7  beyond the effective date of termination.
     8    7. The interstate commission shall not bear any costs relating to  any
     9  state  that has been found to be in default or which has been terminated
    10  from the compact, unless  otherwise  mutually  agreed  upon  in  writing
    11  between the interstate commission and the defaulting state.
    12    8.  The  defaulting  state  may  appeal  the  action of the interstate
    13  commission by petitioning the  United  States  District  Court  for  the
    14  District  of  Columbia  or  the  federal  district  where the interstate
    15  commission has its principal offices.  The  prevailing  party  shall  be
    16  awarded  all  costs  of  such litigation including reasonable attorney's
    17  fees.
    18    § 8879. Dispute  resolution.  1.  The  interstate   commission   shall
    19  attempt,  upon  the request of a member state, to resolve disputes which
    20  are subject to the compact and which may arise among  member  states  or
    21  member boards.
    22    2. The interstate commission shall promulgate rules providing for both
    23  mediation and binding dispute resolution as appropriate.
    24    § 8880. Member  states,  effective date and amendment. 1. Any state is
    25  eligible to become a member state of the compact.
    26    2. The compact shall become effective  and  binding  upon  legislative
    27  enactment  of  the compact into law by no less than seven states. There-
    28  after, it shall become effective and binding on a state  upon  enactment
    29  of the compact into law by that state.
    30    3.  The  governors  of non-member states, or their designees, shall be
    31  invited to participate in the activities of the interstate commission on
    32  a non-voting basis prior to adoption of the compact by all states.
    33    4. The interstate commission may propose amendments to the compact for
    34  enactment by the member states. No amendment shall become effective  and
    35  binding  upon the interstate commission and the member states unless and
    36  until it is enacted into law by unanimous consent of the member states.
    37    § 8881. Withdrawal. 1. Once effective, the compact shall  continue  in
    38  force and remain binding upon each and every member state; provided that
    39  a  member  state may withdraw from the compact by specifically repealing
    40  the statute which enacted the compact into law.
    41    2. Withdrawal from the compact shall be by the enactment of a  statute
    42  repealing  the  same, but shall not take effect until one year after the
    43  effective date of such statute and until written  notice  of  the  with-
    44  drawal  has  been given by the withdrawing state to the governor of each
    45  other member state.
    46    3. The withdrawing state shall immediately notify the  chairperson  of
    47  the  interstate  commission  in  writing upon the introduction of legis-
    48  lation repealing the compact in the withdrawing state.
    49    4. The interstate commission shall notify the other member  states  of
    50  the  withdrawing  state's  intent  to  withdraw within sixty days of its
    51  receipt of notice provided under subdivision three of this section.
    52    5. The withdrawing state is responsible for all dues, obligations  and
    53  liabilities incurred through the effective date of withdrawal, including
    54  obligations,  the  performance of which extend beyond the effective date
    55  of withdrawal.

        A. 9859                            13

     1    6. Reinstatement following withdrawal of a member  state  shall  occur
     2  upon  the  withdrawing  state  reenacting the compact or upon such later
     3  date as determined by the interstate commission.
     4    7. The interstate commission is authorized to develop rules to address
     5  the  impact  of  the withdrawal of a member state on licenses granted in
     6  other member states to physicians who designated the withdrawing  member
     7  state as the state of principal license.
     8    § 8882. Dissolution.  1. The compact shall dissolve effective upon the
     9  date of the withdrawal or default of the member state which reduces  the
    10  membership in the compact to one member state.
    11    2.  Upon  the dissolution of the compact, the compact becomes null and
    12  void and shall be of no further force or effect, and  the  business  and
    13  affairs  of  the  interstate  commission  shall be concluded and surplus
    14  funds shall be distributed in accordance with the bylaws.
    15    § 8883. Severability  and  construction.  1.  The  provisions  of  the
    16  compact  shall  be  severable,  and  if any phrase, clause, sentence, or
    17  provision is deemed  unenforceable,  the  remaining  provisions  of  the
    18  compact shall be enforceable.
    19    2.  The  provisions  of  the  compact  shall be liberally construed to
    20  effectuate its purposes.
    21    3. Nothing in the compact shall be construed to prohibit the  applica-
    22  bility of other interstate compacts to which the states are members.
    23    § 8884. Binding effect of compact and other laws. 1. Nothing contained
    24  in  this  article  shall  prevent  the enforcement of any other law of a
    25  member state that is not inconsistent with the compact.
    26    2. All laws in a member state in conflict with the compact are  super-
    27  seded to the extent of the conflict.
    28    3.  All  lawful  actions  of  the interstate commission, including all
    29  rules and bylaws promulgated by the commission,  are  binding  upon  the
    30  member states.
    31    4.  All  agreements  between  the interstate commission and the member
    32  states are binding in accordance with their terms.
    33    5. In the event any provision of the  compact  exceeds  the  constitu-
    34  tional  limits  imposed  on  the  legislature  of any member state, such
    35  provision shall be ineffective to the extent of the  conflict  with  the
    36  constitutional provision in question in that member state.
    37    § 2. This act shall take effect immediately.
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