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1		AN ACT concerning State government.
2		Be it enacted by the People of the State of Illinois,
3		represented in the General Assembly:
4		Sec. 1. Short title. This Act may be cited as the
5		Interstate Medical Licensure Compact Act.
6		Sec. 5. Interstate Medical Licensure Compact. The State of
7		Illinois ratifies and approves the following compact:
8		INTERSTATE MEDICAL LICENSURE COMPACT
9		SECTION 1. PURPOSE
10		In order to strengthen access to health care, and in
11		recognition of the advances in the delivery of health care, the
12		member states of the Interstate Medical Licensure Compact have
13		allied in common purpose to develop a comprehensive process
14		that complements the existing licensing and regulatory
15		authority of state medical boards, provides a streamlined
16		process that allows physicians to become licensed in multiple
17		states, thereby enhancing the portability of a medical license
18		and ensuring the safety of patients. The Compact creates
19		another pathway for licensure and does not otherwise change a
20		state's existing Medical Practice Act. The Compact also adopts
21		the prevailing standard for licensure and affirms that the

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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