§ 33-26-702 — Compact provisions generally

The Interstate Medical Licensure Compact is enacted into law and
entered into on behalf of this state with all other states
legally joining in the compact in a 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, 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
(a) In this compact:
(i) "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;
(ii) "Commissioner" means the voting representative
appointed by each member board pursuant to article XI;
(iii) "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;
(iv) "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;
(v) "Interstate commission" means the interstate
commission created pursuant to article XI;
(vi) "License" means authorization by a state for a
physician to engage in the practice of medicine, which would be
unlawful without the authorization;
(vii) "Medical practice act" means laws and
regulations governing the practice of allopathic and osteopathic
medicine within a member state;
(viii) "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;
(ix) "Member state" means a state that has enacted
the compact;
(x) "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;
(xi) "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
(J) Is not under active investigation by a
licensing agency or law enforcement authority in any state,
federal or foreign jurisdiction.
(xii) "Offense" means a felony, gross misdemeanor or
crime of moral turpitude;
(xiii) "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;
(xiv) "State" means any state, commonwealth, district
or territory of the United States;
(xv) "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
(a) A physician must meet the eligibility requirements as
defined in article II(a)(xi) to receive an expedited license
under the terms and provisions of the compact.
(b) A physician who does not meet the requirements of
article II(a)(xi) 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
(a) A physician shall designate a member state as the
state of principal license for purposes of registration for
expedited licensure through the compact if the physician
possesses a full and unrestricted license to practice medicine
in that state and the state is:
(i) The state of primary residence for the physician;
(ii) The state where at least twenty-five percent
(25%) of the practice of medicine occurs;
(iii) The location of the physician's employer; or
(iv) If no state qualifies under paragraph (a)(i),
(ii) or (iii) of this article, the state designated as state of
residence for purpose of federal income tax.
(b) A physician may redesignate a member state as state of
principal license at any time, as long as the state meets the
requirements in subsection (a) of this article.
(c) 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
(a) A physician seeking licensure through the compact
shall file an application for an expedited license with the
member board of the state selected by the physician as the state
of principal license.
(b) Upon receipt of an application for an expedited
license, the member board within the state selected as the state
of principal license shall evaluate whether the physician is
eligible for expedited licensure and issue a letter of
qualification, verifying or denying the physician's eligibility,
to the interstate commission, subject to the following:
(i) Static qualifications, which include verification
of medical education, graduate medical education, results of any
medical or licensing examination and other qualifications as
determined by the interstate commission through rule, shall not
be subject to additional primary source verification where
primary sources have already been verified by the state of
principal license;
(ii) The member board within the state selected as
the state of principal license shall, in the course of verifying
eligibility, perform a criminal background check of an
applicant, including the use of the results of fingerprint or
other biometric data checks compliant with the requirements of
the federal bureau of investigation, with the exception of
federal employees who have suitability determination in
accordance with 5 C.F.R. § 731.202;
(iii) Appeal on the determination of eligibility
shall be made to the member state where the application was
filed and shall be subject to the law of that state.
(c) Upon verification under subsection (b) of this
article, physicians eligible for an expedited license shall
complete the registration process established by the interstate
commission to receive a license in a member state selected
pursuant to subsection (a) of this article, including the
payment of any applicable fees.
(d) After receiving verification of eligibility under
subsection (b) of this article and any fees under subsection (c)
of this article, a member board shall issue an expedited license
to the physician. This license shall authorize the physician to
practice medicine in the issuing state consistent with the
medical practice act and all applicable laws and regulations of
the issuing member board and member state.
(e) An expedited license shall be valid for a period
consistent with the licensure period in the member state and in
the same manner as required for other physicians holding a full
and unrestricted license within the member state.
(f) An expedited license obtained though the compact shall
be terminated if a physician fails to maintain a license in the
state of principal licensure for a nondisciplinary reason,
without redesignation of a new state of principal licensure.
(g) The interstate commission is authorized to develop
rules regarding the application process, including payment of
any applicable fees and the issuance of an expedited license.
ARTICLE VI
Fees for Expedited Licensure
(a) A member state issuing an expedited license
authorizing the practice of medicine in that state may impose a
fee for a license issued or renewed through the compact.
(b) The interstate commission is authorized to develop
rules regarding fees for expedited licenses.
ARTICLE VII
Renewal and Continued Participation
(a) A physician seeking to renew an expedited license
granted in a member state shall complete a renewal process with
the interstate commission if the physician:
(i) Maintains a full and unrestricted license in a
state of principal license;
(ii) Has not been convicted, received adjudication,
deferred adjudication, community supervision or deferred
disposition for any offense by a court of appropriate
jurisdiction;
(iii) 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
(iv) Has not had a controlled substance license or
permit suspended or revoked by a state or the United States drug
enforcement administration.
(b) Physicians shall comply with all continuing
professional development or continuing medical education
requirements for renewal of a license issued by a member state.
(c) The interstate commission shall collect any renewal
fees charged for the renewal of a license and distribute the
fees to the applicable member board.
(d) Upon receipt of any renewal fees collected under
subsection (c) of this article, a member board shall renew the
physician's license.
(e) Physician information collected by the interstate
commission during the renewal process will be distributed to all
member boards.
(f) The interstate commission is authorized to develop
rules to address renewal of licenses obtained through the
compact.
ARTICLE VIII
Coordinated Information System
(a) The interstate commission shall establish a database
of all physicians licensed, or who have applied for licensure,
under article V.
(b) Notwithstanding any other provision of law, member
boards shall report to the interstate commission any public
action or complaints against a licensed physician who has
applied or received an expedited license through the compact.
(c) Member boards shall report disciplinary or
investigatory information determined as necessary and proper by
rule of the interstate commission.
(d) Member boards may report any nonpublic complaint,
disciplinary or investigatory information not required by
subsection (c) of this article, to the interstate commission.
(e) Member boards shall share complaint or disciplinary
information about a physician upon request of another member
board.
(f) All information provided to the interstate commission
or distributed by member boards shall be confidential, filed
under seal and used only for investigatory or disciplinary
matters.
(g) The interstate commission is authorized to develop
rules for mandated or discretionary sharing of information by
member boards.
ARTICLE IX
Joint Investigations
(a) Licensure and disciplinary records of physicians are
deemed investigative.
(b) In addition to the authority granted to a member board
by its respective medical practice act or other applicable state
law, a member board may participate with other member boards in
joint investigations of physicians licensed by the member
boards.
(c) A subpoena issued by a member state shall be
enforceable in other member states.
(d) Member boards may share any investigative, litigation
or compliance materials in furtherance of any joint or
individual investigation initiated under the compact.
(e) Any member state may investigate actual or alleged
violations of the statutes authorizing the practice of medicine
in any other member state in which a physician holds a license
to practice medicine.
ARTICLE X
Disciplinary Actions
(a) Any disciplinary action taken by any member board
against a physician licensed through the compact shall be deemed
unprofessional conduct which may be subject to discipline by
other member boards, in addition to any violation of the medical
practice act or regulations in that state.
(b) If a license granted to a physician by the member
board in the state of principal license is revoked, surrendered
or relinquished in lieu of discipline, or suspended, then all
licenses issued to the physician by member boards shall
automatically be placed, without further action necessary by any
member board, on the same status. If the member board in the
state of principal license subsequently reinstates the
physician's license, a license issued to the physician by any
other member board shall remain encumbered until that respective
member board takes action to reinstate the license in a manner
consistent with the medical practice act of that state.
(c) If disciplinary action is taken against a physician by
a member board not in the state of principal license, any other
member board may deem the action conclusive as to matter of law
and fact decided and:
(i) Impose the same or lesser sanction against the
physician so long as such sanctions are consistent with the
medical practice act of that state; or
(ii) Pursue separate disciplinary action against the
physician under its respective medical practice act, regardless
of the action taken in other member states.
(d) If a license granted to a physician by a member board
is revoked, surrendered or relinquished in lieu of discipline or
suspended, then any license issued to the physician by any other
member board shall be suspended, automatically and immediately
without further action necessary by the other member board, for
ninety (90) days upon entry of the order by the disciplining
board, to permit the member board 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
(a) The member states hereby create the "Interstate
Medical Licensure Compact Commission."
(b) The purpose of the interstate commission is the
administration of the Interstate Medical Licensure Compact,
which is a discretionary state function.
(c) The interstate commission shall be a body corporate
and shall have all the responsibilities, powers and duties set
forth in the compact and such additional powers as may be
conferred upon it by a subsequent concurrent action of the
respective legislatures of the member states in accordance with
the terms of the compact.
(d) The interstate commission shall consist of two (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:
(i) An allopathic or osteopathic physician appointed
to a member board;
(ii) An executive director, executive secretary or
similar executive of a member board; or
(iii) A member of the public appointed to a member
board.
(e) The interstate commission shall meet at least once
each calendar year. A portion of this meeting shall be a
business meeting to address such matters as may properly come
before the commission, including the election of officers. The
chairperson may call additional meetings and shall call for a
meeting upon the request of a majority of the member states.
(f) The bylaws may provide for meetings of the interstate
commission to be conducted by telecommunication or electronic
communication.
(g) Each commissioner participating at a meeting of the
interstate commission is entitled to one (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 (d) of this article.
(h) The interstate commission shall provide public notice
of all meetings and all meetings shall be open to the public.
The interstate commission may close a meeting, in full or in
portion, where it determines by a two-thirds (2/3) vote of the
commissioners present that an open meeting would be likely to:
(i) Relate solely to the internal personnel practices
and procedures of the interstate commission;
(ii) Discuss matters specifically exempted from
disclosure by federal statute;
(iii) Discuss trade secrets, commercial or financial
information that is privileged or confidential;
(iv) Involve accusing a person of a crime or formally
censuring a person;
(v) Discuss information of a personal nature where
disclosure would constitute a clearly unwarranted invasion of
personal privacy;
(vi) Discuss investigative records compiled for law
enforcement purposes; or
(vii) Specifically relate to the participation in a
civil action or other legal proceeding.
(j) 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.
(k) 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.
(m) 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.
(n) The interstate commission may establish other
committees for governance and administration of the compact.
ARTICLE XII
Powers and Duties of the Interstate Commission
(a) The interstate commission shall have the duty and
power to:
(i) Oversee and maintain the administration of the
compact;
(ii) Promulgate rules which shall be binding to the
extent and in the manner provided for in the compact;
(iii) 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;
(iv) 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;
(v) 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;
(vi) Pay or provide for the payment of the expenses
related to the establishment, organization and ongoing
activities of the interstate commission;
(vii) Establish and maintain one (1) or more offices;
(viii) Borrow, accept, hire or contract for services
of personnel;
(ix) Purchase and maintain insurance and bonds;
(x) Employ an executive director who shall have such
powers to employ, select or appoint employees, agents or
consultants and to determine their qualifications, define their
duties and fix their compensation;
(xi) Establish personnel policies and programs
relating to conflicts of interest, rates of compensation and
qualifications of personnel;
(xii) Accept donations and grants of money,
equipment, supplies, materials and services and to receive,
utilize and dispose of it in a manner consistent with the
conflict of interest policies established by the interstate
commission;
(xiii) Lease, purchase, accept contributions or
donations of or otherwise to own, hold, improve or use, any
property, real, personal or mixed;
(xiv) Sell, convey, mortgage, pledge, lease,
exchange, abandon or otherwise dispose of any property, real,
personal or mixed;
(xv) Establish a budget and make expenditures;
(xvi) Adopt a seal and bylaws governing the
management and operation of the interstate commission;
(xvii) 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;
(xviii) Coordinate education, training and public
awareness regarding the compact, its implementation and its
operation;
(xix) Maintain records in accordance with the bylaws;
(xx) Seek and obtain trademarks, copyrights and
patents; and
(xxi) Perform such functions as may be necessary or
appropriate to achieve the purposes of the compact.
ARTICLE XIII
Finance Powers
(a) The interstate commission may levy on and collect an
annual assessment from each member state to cover the cost of
the operations and activities of the interstate commission and
its staff. The total assessment must be sufficient to cover the
annual budget approved each year for which revenue is not
provided by other sources. The aggregate annual assessment
amount shall be allocated upon a formula to be determined by the
interstate commission, which shall promulgate a rule binding
upon all member states.
(b) The interstate commission shall not incur obligations
of any kind prior to securing the funds adequate to meet the
same.
(c) The interstate commission shall not pledge the credit
of any of the member states, except by, and with the authority
of, the member state.
(d) The interstate commission shall be subject to a yearly
financial audit conducted by a certified or licensed public
accountant and the report of the audit shall be included in the
annual report of the interstate commission.
ARTICLE XIV
Organization and operation of the Interstate Commission
(a) The interstate commission shall, by a majority of
commissioners present and voting, adopt bylaws to govern its
conduct as may be necessary or appropriate to carry out the
purposes of the compact within twelve (12) months of the first
interstate commission meeting.
(b) The interstate commission shall elect or appoint
annually from among its commissioners a chairperson, a
vice-chairperson and a treasurer, each of whom shall have such
authority and duties as may be specified in the bylaws. The
chairperson, or in the chairperson's absence or disability, the
vice-chairperson, shall preside at all meetings of the
interstate commission.
(c) Officers selected in subsection (b) of this article
shall serve without remuneration from the interstate commission.
(d) The officers and employees of the interstate
commission shall be immune from suit and liability, either
personally or in their official capacity, for a claim for damage
to or loss of property or personal injury or other civil
liability caused or arising out of, or relating to, an actual or
alleged act, error or omission that occurred, or that the
officer or employee had a reasonable basis for believing
occurred, within the scope of interstate commission employment,
duties or responsibilities provided that an officer or employee
shall not be protected from suit or liability for damage, loss,
injury or liability caused by the intentional or willful and
wanton misconduct of the officer or employee. The immunity
provided by this article shall be subject to the following:
(i) The liability of the executive director and
employees of the interstate commission or representatives of the
interstate commission, acting within the scope of the officer's
or employee's employment or duties for acts, errors or omissions
occurring within the officer's or employee's state, may not
exceed the limits of liability set forth under the constitution
and laws of that state for state officials, employees and
agents. The interstate commission is considered to be an
instrumentality of the states for the purposes of any such
action. Nothing in this subsection shall be construed to protect
the officer or employee from suit or liability for damage, loss,
injury or liability caused by the intentional or willful and
wanton misconduct of the officer or employee;
(ii) 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 an 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 the officer or employee;
(iii) 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 the
officers and employees 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
officers and employees 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 the officers or
employees.
ARTICLE XV
Rulemaking functions of the Interstate Commission
(a) The interstate commission shall promulgate reasonable
rules in order to effectively and efficiently achieve the
purposes of the compact. Notwithstanding the foregoing, in the
event the interstate commission exercises its rulemaking
authority in a manner that is beyond the scope of the purposes
of the compact, or the powers granted hereunder, then such an
action by the interstate commission shall be invalid and have no
force or effect.
(b) Rules deemed appropriate for the operations of the
interstate commission shall be made pursuant to a rulemaking
process that substantially conforms to the "Model State
Administrative Procedure Act" of 2010 and subsequent amendments
thereto.
(c) Not later than thirty (30) days after a rule is
promulgated, any person may file a petition for judicial review
of the rule in the United States District Court for the District
of Columbia or the federal district where the interstate
commission has its principal offices, provided that the filing
of such a petition shall not stay or otherwise prevent the rule
from becoming effective unless the court finds that the
petitioner has a substantial likelihood of success. The court
shall give deference to the actions of the interstate commission
consistent with applicable law and shall not find the rule to be
unlawful if the rule represents a reasonable exercise of the
authority granted to the interstate commission.
ARTICLE XVI
Oversight of Interstate Compact
(a) The executive, legislative and judicial branches of
state government in each member state shall enforce the compact
and shall take all actions necessary and appropriate to
effectuate the compact's purposes and intent. The provisions of
the compact and the rules promulgated hereunder shall have
standing as statutory law but shall not override existing state
authority to regulate the practice of medicine.
(b) All courts shall take judicial notice of the compact
and the rules in any judicial or administrative proceeding in a
member state pertaining to the subject matter of the compact
which may affect the powers, responsibilities or actions of the
interstate commission.
(c) The interstate commission shall be entitled to receive
all service of process in any such proceeding and shall have
standing to intervene in the proceeding for all purposes.
Failure to provide service of process to the interstate
commission shall render a judgment or order void as to the
interstate commission, the compact or promulgated rules.
ARTICLE XVII
Enforcement of Interstate Compact
(a) The interstate commission, in the reasonable exercise
of its discretion, shall enforce the provisions and rules of the
compact.
(b) The interstate commission may, by majority vote of the
commissioners, initiate legal action in the United States
District Court for the District of Columbia or, at the
discretion of the interstate commission, in the federal district
where the interstate commission has its principal offices, to
enforce compliance with the provisions of the compact and its
promulgated rules and bylaws, against a member state in default.
The relief sought may include both injunctive relief and
damages. In the event judicial enforcement is necessary, the
prevailing party shall be awarded all costs of such litigation
including reasonable attorney's fees.
(c) The remedies herein shall not be the exclusive
remedies of the interstate commission. The interstate commission
may avail itself of any other remedies available under state law
or the regulation of a profession.
ARTICLE XVIII
Default Procedures
(a) The grounds for default include, but are not limited
to, failure of a member state to perform such obligations or
responsibilities imposed upon it by the compact or the rules and
bylaws of the interstate commission promulgated under the
compact.
(b) If the interstate commission determines that a member
state has defaulted in the performance of its obligations or
responsibilities under the compact or the bylaws or promulgated
rules, the interstate commission shall:
(i) 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
(ii) Provide remedial training and specific technical
assistance regarding the default.
(c) If the defaulting state fails to cure the default, the
defaulting state shall be terminated from the compact upon an
affirmative vote of a majority of the commissioners and all
rights, privileges and benefits conferred by the compact shall
terminate on the effective date of termination. A cure of the
default does not relieve the offending state of obligations or
liabilities incurred during the period of the default.
(d) Termination of membership in the compact shall be
imposed only after all other means of securing compliance have
been exhausted. Notice of intent to terminate shall be given by
the interstate commission to the governor, the majority and
minority leaders of the defaulting state's legislature and each
of the member states.
(e) The interstate commission shall establish rules and
procedures to address licenses and physicians that are
materially impacted by the termination of a member state or the
withdrawal of a member state.
(f) The member state which has been terminated is
responsible for all dues, obligations and liabilities incurred
through the effective date of termination including obligations,
the performance of which extends beyond the effective date of
termination.
(g) The interstate commission shall not bear any costs
relating to any state that has been found to be in default or
which has been terminated from the compact, unless otherwise
mutually agreed upon in writing between the interstate
commission and the defaulting state.
(h) The defaulting state may appeal the action of the
interstate commission by petitioning the United States District
Court for the District of Columbia or the federal district where
the interstate commission has its principal offices. The
prevailing party shall be awarded all costs of such litigation
including reasonable attorney's fees.
ARTICLE XIX
Dispute Resolution
(a) The interstate commission shall attempt, upon the
request of a member state, to resolve disputes which are subject
to the compact and which may arise among member states or member
boards.
(b) The interstate commission shall promulgate rules
providing for both mediation and binding dispute resolution as
appropriate.
ARTICLE XX
Member States, Effective Date and Amendments
(a) Any state is eligible to become a member state of the
compact.
(b) The compact shall become effective and binding upon
legislative enactment of the compact into law by no less than
seven (7) states. Thereafter, it shall become effective and
binding on a state upon enactment of the compact into law by
that state.
(c) The governors of 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.
(d) The interstate commission may propose amendments to
the compact for enactment by the member states. No amendment
shall become effective and binding upon the interstate
commission and the member states unless and until it is enacted
into law by unanimous consent of the member states.
ARTICLE XXI
Withdrawal
(a) Once effective, the compact shall continue in force
and remain binding upon each and every member state, provided
that a member state may withdraw from the compact by
specifically repealing the statute which enacted the compact
into law.
(b) Withdrawal from the compact shall be by the enactment
of a statute repealing the same, but shall not take effect until
one (1) year after the effective date of such statute and until
written notice of the withdrawal has been given by the
withdrawing state to the governor of each other member state.
(c) The withdrawing state shall immediately notify the
chairperson of the interstate commission in writing upon the
introduction of legislation repealing the compact in the
withdrawing state.
(d) The interstate commission shall notify the other
member states of the withdrawing state's intent to withdraw
within sixty (60) days of its receipt of notice provided under
subsection (c) of this article.
(e) The withdrawing state is responsible for all dues,
obligations and liabilities incurred through the effective date
of withdrawal, including obligations, the performance of which
extend beyond the effective date of withdrawal.
(f) Reinstatement following withdrawal of a member state
shall occur upon the withdrawing state reenacting the compact or
upon such later date as determined by the interstate commission.
(g) The interstate commission is authorized to develop
rules to address the impact of the withdrawal of a member state
on licenses granted in other member states to physicians who
designated the withdrawing member state as the state of
principal license.
ARTICLE XXII
Dissolution
(a) The compact shall dissolve effective upon the date of
the withdrawal or default of the member state which reduces the
membership in the compact to one (1) member state.
(b) Upon the dissolution of the compact, the compact
becomes null and void and shall be of no further force or effect
and the business and affairs of the interstate commission shall
be concluded and surplus funds shall be distributed in
accordance with the bylaws.
ARTICLE XXIII
Severability and Construction
(a) The provisions of the compact shall be severable and
if any phrase, clause, sentence or provision is deemed
unenforceable, the remaining provisions of the compact shall be
enforceable.
(b) The provisions of the compact shall be liberally
construed to effectuate its purposes.
(c) Nothing in the compact shall be construed to prohibit
the applicability of other interstate compacts to which the
states are members.
ARTICLE XXIV
Binding Effect of Compact and Other Laws
(a) Nothing herein prevents the enforcement of any other
law of a member state that is not inconsistent with the compact.
(b) All laws in a member state in conflict with the
compact are superseded to the extent of the conflict.
(c) All lawful actions of the interstate commission,
including all rules and bylaws promulgated by the commission,
are binding upon the member states.
(d) All agreements between the interstate commission and
the member states are binding in accordance with their terms.
(e) In the event any provision of the compact exceeds the
constitutional limits imposed on the legislature of any member
state, such provision shall be ineffective to the extent of the
conflict with the constitutional provision in question in that
member state.