Bill Text: TX SB517 | 2021-2022 | 87th Legislature | Introduced

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Bill Title: Relating to the Interstate Medical Licensure Compact; authorizing fees.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2021-03-09 - Referred to Health & Human Services [SB517 Detail]

Download: Texas-2021-SB517-Introduced.html

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87R1305 BEE-F
By: Huffman S.B. No. 517

A BILL TO BE ENTITLED
AN ACT
relating to the Interstate Medical Licensure Compact; authorizing
fees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle B, Title 3, Occupations Code, is
amended by adding Chapter 171 to read as follows:
CHAPTER 171. INTERSTATE MEDICAL LICENSURE COMPACT
Sec. 171.001. PURPOSE. In order to strengthen access to
health care, and in recognition of the advances in the delivery of
health care, the member states of the Interstate Medical Licensure
Compact have allied in common purpose to develop a comprehensive
process that complements the existing licensing and regulatory
authority of state medical boards and provides a streamlined
process that allows physicians to become licensed in multiple
states, thereby enhancing the portability of a medical license and
ensuring the safety of patients. The compact creates another
pathway for licensure and does not otherwise change a state's
existing medical practice act. The compact also adopts the
prevailing standard for licensure and affirms that the practice of
medicine occurs where the patient is located at the time of the
physician-patient encounter, and therefore, requires the physician
to be under the jurisdiction of the state medical board where the
patient is located. State medical boards that participate in the
compact retain the jurisdiction to impose an adverse action against
a license to practice medicine in that state issued to a physician
through the procedures in the compact.
Sec. 171.002. DEFINITIONS. In this chapter:
(1) "Bylaws" means those bylaws established by the
interstate commission pursuant to Section 171.011 for its
governance, or for directing and controlling its actions and
conduct.
(2) "Commissioner" means the voting representative
appointed by each member board pursuant to Section 171.011.
(3) "Conviction" means a finding by a court that an
individual is guilty of a criminal offense through adjudication, or
entry of a plea of guilt or no contest to the charge by the offender.
Evidence of an entry of a conviction of a criminal offense by the
court shall be considered final for purposes of disciplinary action
by a member board.
(4) "Expedited license" means a full and unrestricted
medical license granted by a member state to an eligible physician
through the process set forth in the compact.
(5) "Interstate commission" means the interstate
commission created pursuant to Section 171.011.
(6) "License" means authorization by a state for a
physician to engage in the practice of medicine, which would be
unlawful without the authorization.
(7) "Medical practice act" means laws and regulations
governing the practice of allopathic and osteopathic medicine
within a member state.
(8) "Member board" means a state agency in a member
state that acts in the sovereign interests of the state by
protecting the public through licensure, regulation, and education
of physicians as directed by the state government.
(9) "Member state" means a state that has enacted the
compact.
(10) "Offense" means a felony, gross misdemeanor, or
crime of moral turpitude.
(11) "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 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 or received
adjudication, deferred adjudication, community supervision, or
deferred disposition for any offense by a court of appropriate
jurisdiction;
(G) has never held a license authorizing the
practice of medicine subjected to discipline by a licensing agency
in any state, federal, or foreign jurisdiction, excluding any
action related to nonpayment of fees related to a license;
(H) has never had a controlled substance license
or permit suspended or revoked by a state or the United States Drug
Enforcement Administration; and
(I) is not under active investigation by a
licensing agency or law enforcement authority in any state,
federal, or foreign jurisdiction.
(12) "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.
(13) "Rule" means a written statement by the
interstate commission promulgated pursuant to Section 171.012 that
is of general applicability, implements, interprets, or prescribes
a policy or provision of the compact, or an organizational,
procedural, or practice requirement of the interstate commission,
and has the force and effect of statutory law in a member state, and
includes the amendment, repeal, or suspension of an existing rule.
(14) "State" means any state, commonwealth, district,
or territory of the United States.
(15) "State of principal license" means a member state
where a physician holds a license to practice medicine and that has
been designated as such by the physician for purposes of
registration and participation in the compact.
Sec. 171.003. ELIGIBILITY. (a) A physician must meet the
eligibility requirements as defined in Section 171.002(11) to
receive an expedited license under the terms and provisions of the
compact.
(b) A physician who does not meet the requirements of
Section 171.002(11) 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.
Sec. 171.004. 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:
(1) the state of primary residence for the physician;
(2) the state where at least 25 percent of the practice
of medicine occurs;
(3) the location of the physician's employer; or
(4) if no state qualifies under Subdivision (1), (2),
or (3), 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).
(c) The interstate commission is authorized to develop
rules to facilitate redesignation of another member state as the
state of principal license.
Sec. 171.005. 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.
(1) Static qualifications, which include verification
of medical education, graduate medical education, results of any
medical or licensing examination, and other qualifications as
determined by the interstate commission through rule, shall not be
subject to additional primary source verification where already
primary source verified by the state of principal license.
(2) 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. Section
731.202.
(3) 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 in Subsection (b), 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),
including the payment of any applicable fees.
(d) After receiving verification of eligibility under
Subsection (b) and any fees under Subsection (c), 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 through the compact shall
be terminated if a physician fails to maintain a license in the
state of principal licensure for a nondisciplinary reason, without
redesignation of a new state of principal licensure.
(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.
Sec. 171.006. 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.
Sec. 171.007. 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:
(1) maintains a full and unrestricted license in a
state of principal license;
(2) has not been convicted or received adjudication,
deferred adjudication, community supervision, or deferred
disposition for any offense by a court of appropriate jurisdiction;
(3) 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
(4) 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 in Subsection
(c), 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.
Sec. 171.008. COORDINATED INFORMATION SYSTEM. (a) The
interstate commission shall establish a database of all physicians
licensed, or who have applied for licensure, under Section 171.005.
(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 for 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) 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.
Sec. 171.009. JOINT INVESTIGATIONS. (a) Licensure and
disciplinary records of physicians are considered 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.
Sec. 171.010. DISCIPLINARY ACTIONS. (a) Any disciplinary
action taken by any member board against a physician licensed
through the compact shall be considered 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 consider the action conclusive as to matter of law and
fact decided, and:
(1) impose the same or lesser sanction against the
physician so long as such sanction is consistent with the medical
practice act of that state; or
(2) 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 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 before the
completion of the 90-day suspension period in a manner consistent
with the medical practice act of that state.
Sec. 171.011. 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
joint agency of the member states and shall have all the
responsibilities, powers, and duties set forth in the compact, and
such additional powers as may be conferred upon it by a subsequent
concurrent action of the respective legislatures of the member
states in accordance with the terms of the compact.
(d) The interstate commission shall consist of two 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 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 representative from each member
board. A commissioner shall be:
(1) an allopathic or osteopathic physician appointed
to a member board;
(2) an executive director, executive secretary, or
similar executive of a member board; or
(3) 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 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).
(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 vote of the commissioners
present that an open meeting would be likely to:
(1) relate solely to the internal personnel practices
and procedures of the interstate commission;
(2) discuss matters specifically exempted from
disclosure by federal statute;
(3) discuss trade secrets or commercial or financial
information that is privileged or confidential;
(4) involve accusing a person of a crime, or formally
censuring a person;
(5) discuss information of a personal nature where
disclosure would constitute a clearly unwarranted invasion of
personal privacy;
(6) discuss investigative records compiled for law
enforcement purposes; or
(7) specifically relate to the participation in a
civil action or other legal proceeding.
(i) The interstate commission shall keep minutes that 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.
(j) 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.
(k) 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.
(l) The interstate commission may establish other
committees for governance and administration of the compact.
Sec. 171.012. POWERS AND DUTIES OF INTERSTATE COMMISSION.
The interstate commission shall have the duty and power to:
(1) oversee and maintain the administration of the
compact;
(2) promulgate rules that shall be binding to the
extent and in the manner provided for in the compact;
(3) issue, upon the request of a member state or member
board, advisory opinions concerning the meaning or interpretation
of the compact, its bylaws, rules, and actions;
(4) enforce compliance with compact provisions, the
rules promulgated by the interstate commission, and the bylaws,
using all necessary and proper means, including, but not limited
to, the use of judicial process;
(5) establish and appoint committees, including, but
not limited to, an executive committee as required by Section
171.011, which shall have the power to act on behalf of the
interstate commission in carrying out its powers and duties;
(6) pay or provide for the payment of the expenses
related to the establishment, organization, and ongoing activities
of the interstate commission;
(7) establish and maintain one or more offices;
(8) borrow, accept, hire, or contract for services of
personnel;
(9) purchase and maintain insurance and bonds;
(10) employ an executive director who shall have such
powers to employ, select, or appoint employees, agents, or
consultants, and to determine their qualifications, define their
duties, and fix their compensation;
(11) establish personnel policies and programs
relating to conflicts of interest, rates of compensation, and
qualifications of personnel;
(12) accept donations and grants of money, equipment,
supplies, materials and services, and receive, utilize, and dispose
of them in a manner consistent with the conflict-of-interest
policies established by the interstate commission;
(13) lease, purchase, accept contributions or
donations of, or otherwise own, hold, improve or use, any property,
real, personal, or mixed;
(14) sell, convey, mortgage, pledge, lease, exchange,
abandon, or otherwise dispose of any property, real, personal, or
mixed;
(15) establish a budget and make expenditures;
(16) adopt a seal and bylaws governing the management
and operation of the interstate commission;
(17) report annually to the legislatures and governors
of the member states concerning the activities of the interstate
commission during the preceding year, including reports of
financial audits and any recommendations that may have been adopted
by the interstate commission;
(18) coordinate education, training, and public
awareness regarding the compact, its implementation, and its
operation;
(19) maintain records in accordance with the bylaws;
(20) seek and obtain trademarks, copyrights, and
patents; and
(21) perform such functions as may be necessary or
appropriate to achieve the purposes of the compact.
Sec. 171.013. 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 based on 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 before 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.
Sec. 171.014. ORGANIZATION AND OPERATION OF 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 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) 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 such person had a reasonable basis
for believing occurred, within the scope of interstate commission
employment, duties, or responsibilities. However, such person
shall not be protected from suit or liability for damage, loss,
injury, or liability caused by the intentional or wilful and wanton
misconduct of such person.
(e) The liability of the executive director and employees of
the interstate commission or representatives of the interstate
commission, acting within the scope of such persons' employment or
duties for acts, errors, or omissions occurring within such
persons' state, may not exceed the limits of liability set forth
under the constitution and laws of that state for state officials,
employees, and agents. The interstate commission is considered to
be an instrumentality of the states for the purposes of any such
action. Nothing in this subsection shall be construed to protect
such persons from suit or liability for damage, loss, injury, or
liability caused by the intentional or wilful and wanton misconduct
of such persons.
(f) The interstate commission shall defend the executive
director and its employees, and subject to the approval of the
attorney general or other appropriate legal counsel of the member
state represented by an interstate commission representative,
shall defend such interstate commission representative in any civil
action seeking to impose liability arising out of an actual or
alleged act, error, or omission that occurred within the scope of
interstate commission employment, duties, or responsibilities, or
that the defendant had a reasonable basis for believing occurred
within the scope of interstate commission employment, duties, or
responsibilities, provided that the actual or alleged act, error,
or omission did not result from intentional or wilful and wanton
misconduct on the part of such person.
(g) To the extent not covered by the state involved, the
member state, or the interstate commission, the representatives or
employees of the interstate commission shall be held harmless in
the amount of a settlement or judgment, including attorney's fees
and costs, obtained against such persons arising out of an actual or
alleged act, error, or omission that occurred within the scope of
interstate commission employment, duties, or responsibilities, or
that such persons had a reasonable basis for believing occurred
within the scope of interstate commission employment, duties, or
responsibilities, provided that the actual or alleged act, error,
or omission did not result from intentional or wilful and wanton
misconduct on the part of such persons.
Sec. 171.015. RULEMAKING FUNCTIONS OF 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 considered appropriate for the operations of the
interstate commission shall be made pursuant to a rulemaking
process that substantially conforms to the Revised Model State
Administrative Procedure Act of 2010, and subsequent amendments
thereto.
(c) Not later than 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.
Sec. 171.016. 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 that 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.
Sec. 171.017. 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.
Sec. 171.018. 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 provide:
(1) 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 and in
which the interstate commission specifies the conditions by which
the defaulting state must cure its default; and
(2) 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 that 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 has been found to be in default or that 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.
Sec. 171.019. 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 that 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.
Sec. 171.020. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT.
(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
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 before 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.
Sec. 171.021. WITHDRAWAL. (a) Once effective, the compact
shall continue in force and remain binding upon each and every
member state. A member state may withdraw from the compact by
specifically repealing the statute that 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
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 60 days
of its receipt of notice provided under Subsection (c).
(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.
Sec. 171.022. DISSOLUTION. (a) The compact shall dissolve
effective upon the date of the withdrawal or default of the member
state that reduces the membership in the compact to one 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.
Sec. 171.023. SEVERABILITY AND CONSTRUCTION. (a) The
provisions of the compact shall be severable, and if any phrase,
clause, sentence, or provision is considered 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.
Sec. 171.024. 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.
SECTION 2. This Act takes effect September 1, 2021.