Bill Text: IA SF273 | 2015-2016 | 86th General Assembly | Introduced
Bill Title: A bill for an act establishing an interstate medical licensure compact. (Formerly SSB 1019.)
Spectrum: Committee Bill
Status: (Engrossed - Dead) 2015-03-11 - Subcommittee, L. Miller, R. Taylor, and Winckler. H.J. 549. [SF273 Detail]
Download: Iowa-2015-SF273-Introduced.html
Senate File 273 - Introduced SENATE FILE BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO SSB 1019) A BILL FOR 1 An Act establishing an interstate medical licensure compact. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 1270SV (1) 86 tr/nh PAG LIN 1 1 Section 1. NEW SECTION. 148G.1 Interstate medical licensure 1 2 compact. 1 3 1. Purpose. 1 4 a. In order to strengthen access to health care, and in 1 5 recognition of the advances in the delivery of health care, 1 6 the member states of the interstate medical licensure compact 1 7 have allied in common purpose to develop a comprehensive 1 8 process that complements the existing licensing and regulatory 1 9 authority of state medical boards and provides a streamlined 1 10 process that allows physicians to become licensed in multiple 1 11 states, thereby enhancing the portability of a medical license 1 12 and ensuring the safety of patients. The compact creates 1 13 another pathway for licensure and does not otherwise change 1 14 a state's existing medical practice act. The compact also 1 15 adopts the prevailing standard for licensure and affirms that 1 16 the practice of medicine occurs where the patient is located 1 17 at the time of the physician=patient encounter, and therefore, 1 18 requires the physician to be under the jurisdiction of the 1 19 state medical board where the patient is located. 1 20 b. State medical boards that participate in the compact 1 21 retain the jurisdiction to impose an adverse action against 1 22 a license to practice medicine in that state issued to a 1 23 physician through the procedures in the compact. 1 24 2. Definitions. In this compact: 1 25 a. "Bylaws" means those bylaws established by the interstate 1 26 commission pursuant to subsection 11 for its governance, or for 1 27 directing and controlling its actions and conduct. 1 28 b. "Commissioner" means the voting representative appointed 1 29 by each member board pursuant to subsection 11. 1 30 c. "Conviction" means a finding by a court that 1 31 an individual is guilty of a criminal offense through 1 32 adjudication, or entry of a plea of guilt or no contest to the 1 33 charge by the offender. Evidence of an entry of a conviction 1 34 of a criminal offense by the court shall be considered final 1 35 for purposes of disciplinary action by a member board. 2 1 d. "Expedited license" means a full and unrestricted medical 2 2 license granted by a member state to an eligible physician 2 3 through the process set forth in the compact. 2 4 e. "Interstate commission" means the interstate commission 2 5 created pursuant to this section. 2 6 f. "License" means authorization by a state for a physician 2 7 to engage in the practice of medicine, which would be unlawful 2 8 without the authorization. 2 9 g. "Medical practice act" means laws and regulations 2 10 governing the practice of allopathic and osteopathic medicine 2 11 within a member state. 2 12 h. "Member board" means a state agency in a member state 2 13 that acts in the sovereign interests of the state by protecting 2 14 the public through licensure, regulation, and education of 2 15 physicians as directed by the state government. 2 16 i. "Member state" means a state that has enacted the 2 17 compact. 2 18 j. "Offense" means a felony, gross misdemeanor, or crime of 2 19 moral turpitude. 2 20 k. "Physician" means any person who satisfies all of the 2 21 following: 2 22 (1) Is a graduate of a medical school accredited by the 2 23 liaison committee on medical education, the commission on 2 24 osteopathic college accreditation, or a medical school listed 2 25 in the international medical education directory or its 2 26 equivalent. 2 27 (2) Passed each component of the United States medical 2 28 licensing examination or the comprehensive osteopathic medical 2 29 licensing examination within three attempts, or any of its 2 30 predecessor examinations accepted by a state medical board as 2 31 an equivalent examination for licensure purposes. 2 32 (3) Successfully completed graduate medical education 2 33 approved by the accreditation council for graduate medical 2 34 education or the American osteopathic association. 2 35 (4) Holds specialty certification or a time=unlimited 3 1 specialty certificate recognized by the American board of 3 2 medical specialties or the American osteopathic association's 3 3 bureau of osteopathic specialists. 3 4 (5) Possesses a full and unrestricted license to engage in 3 5 the practice of medicine issued by a member board. 3 6 (6) Has never been convicted, received adjudication, 3 7 deferred adjudication, community supervision, or deferred 3 8 disposition for any offense by a court of appropriate 3 9 jurisdiction. 3 10 (7) Has never held a license authorizing the practice of 3 11 medicine subjected to discipline by a licensing agency in any 3 12 state, federal, or foreign jurisdiction, excluding any action 3 13 related to nonpayment of fees related to a license. 3 14 (8) Has never had a controlled substance license or permit 3 15 suspended or revoked by a state or the United States drug 3 16 enforcement administration. 3 17 (9) Is not under active investigation by a licensing agency 3 18 or law enforcement authority in any state, federal, or foreign 3 19 jurisdiction. 3 20 l. "Practice of medicine" means the clinical prevention, 3 21 diagnosis, or treatment of human disease, injury, or condition 3 22 requiring a physician to obtain and maintain a license in 3 23 compliance with the medical practice act of a member state. 3 24 m. "Rule" means a written statement by the interstate 3 25 commission promulgated pursuant to subsection 12 that is of 3 26 general applicability, implements, interprets, or prescribes 3 27 a policy or provision of the compact, or an organizational, 3 28 procedural, or practice requirement of the interstate 3 29 commission, and has the force and effect of statutory law in a 3 30 member state, and includes the amendment, repeal, or suspension 3 31 of an existing rule. 3 32 n. "State" means any state, commonwealth, district, or 3 33 territory of the United States. 3 34 o. "State of principal license" means a member state where 3 35 a physician holds a license to practice medicine and which 4 1 has been designated as such by the physician for purposes of 4 2 registration and participation in the compact. 4 3 3. Eligibility. 4 4 a. A physician must meet the eligibility requirements as 4 5 defined in subsection 2, paragraph "k", to receive an expedited 4 6 license under the terms and provisions of the compact. 4 7 b. A physician who does not meet the requirements of 4 8 subsection 2, paragraph "k", may obtain a license to practice 4 9 medicine in a member state if the individual complies with all 4 10 laws and requirements, other than the compact, relating to the 4 11 issuance of a license to practice medicine in that state. 4 12 4. Designation of state of principal license. 4 13 a. A physician shall designate a member state as the state 4 14 of principal license for purposes of registration for expedited 4 15 licensure through the compact if the physician possesses a full 4 16 and unrestricted license to practice medicine in that state, 4 17 and the state is: 4 18 (1) The state of primary residence for the physician, or 4 19 (2) The state where at least twenty=five percent of the 4 20 practice of medicine occurs, or 4 21 (3) The location of the physician's employer, or 4 22 (4) If no state qualifies under subparagraph (1), 4 23 subparagraph (2), or subparagraph (3), the state designated as 4 24 state of residence for purposes of federal income tax. 4 25 b. A physician may redesignate a member state as the state 4 26 of principal license at any time, as long as the state meets 4 27 the requirements in paragraph "a". 4 28 c. The interstate commission is authorized to develop rules 4 29 to facilitate redesignation of another member state as the 4 30 state of principal license. 4 31 5. Application and issuance of expedited licensure. 4 32 a. A physician seeking licensure through the compact shall 4 33 file an application for an expedited license with the member 4 34 board of the state selected by the physician as the state of 4 35 principal license. 5 1 b. Upon receipt of an application for an expedited 5 2 license, the member board within the state selected as 5 3 the state of principal license shall evaluate whether the 5 4 physician is eligible for expedited licensure and issue a 5 5 letter of qualification, verifying or denying the physician's 5 6 eligibility, to the interstate commission. 5 7 (1) Static qualifications, which include verification of 5 8 medical education, graduate medical education, results of any 5 9 medical or licensing examination, and other qualifications as 5 10 determined by the interstate commission through rule, shall 5 11 not be subject to additional primary source verification where 5 12 already primary source=verified by the state of principal 5 13 license. 5 14 (2) The member board within the state selected as the 5 15 state of principal license shall, in the course of verifying 5 16 eligibility, perform a criminal background check of an 5 17 applicant, including the use of the results of fingerprint or 5 18 other biometric data checks compliant with the requirements 5 19 of the federal bureau of investigation, with the exception 5 20 of federal employees who have suitability determination in 5 21 accordance with 5 C.F.R. {731.202. 5 22 (3) Appeal on the determination of eligibility shall be made 5 23 to the member state where the application was filed and shall 5 24 be subject to the law of that state. 5 25 c. Upon verification in paragraph "b", physicians eligible 5 26 for an expedited license shall complete the registration 5 27 process established by the interstate commission to receive a 5 28 license in a member state selected pursuant to paragraph "a", 5 29 including the payment of any applicable fees. 5 30 d. After receiving verification of eligibility under 5 31 paragraph "b" and any fees under paragraph "c", a member board 5 32 shall issue an expedited license to the physician. This 5 33 license shall authorize the physician to practice medicine in 5 34 the issuing state consistent with the medical practice act and 5 35 all applicable laws and regulations of the issuing member board 6 1 and member state. 6 2 e. An expedited license shall be valid for a period 6 3 consistent with the licensure period in the member state and in 6 4 the same manner as required for other physicians holding a full 6 5 and unrestricted license within the member state. 6 6 f. An expedited license obtained through the compact shall 6 7 be terminated if a physician fails to maintain a license in 6 8 the state of principal license for a nondisciplinary reason, 6 9 without redesignation of a new state of principal license. 6 10 g. The interstate commission is authorized to develop rules 6 11 regarding the application process, including payment of any 6 12 applicable fees, and the issuance of an expedited license. 6 13 6. Fees for expedited licensure. 6 14 a. A member state issuing an expedited license authorizing 6 15 the practice of medicine in that state may impose a fee for a 6 16 license issued or renewed through the compact. 6 17 b. The interstate commission is authorized to develop rules 6 18 regarding fees for expedited licenses. 6 19 7. Renewal and continued participation. 6 20 a. A physician seeking to renew an expedited license granted 6 21 in a member state shall complete a renewal process with the 6 22 interstate commission if the physician satisfies the following: 6 23 (1) Maintains a full and unrestricted license in a state of 6 24 principal license. 6 25 (2) Has not been convicted, received adjudication, deferred 6 26 adjudication, community supervision, or deferred disposition 6 27 for any offense by a court of appropriate jurisdiction. 6 28 (3) Has not had a license authorizing the practice of 6 29 medicine subject to discipline by a licensing agency in any 6 30 state, federal, or foreign jurisdiction, excluding any action 6 31 related to nonpayment of fees related to a license. 6 32 (4) Has not had a controlled substance license or permit 6 33 suspended or revoked by a state or the United States drug 6 34 enforcement administration. 6 35 b. Physicians shall comply with all continuing professional 7 1 development or continuing medical education requirements for 7 2 renewal of a license issued by a member state. 7 3 c. The interstate commission shall collect any renewal fees 7 4 charged for the renewal of a license and distribute the fees 7 5 to the applicable member board. 7 6 d. Upon receipt of any renewal fees collected in paragraph 7 7 "c", a member board shall renew the physician's license. 7 8 e. Physician information collected by the interstate 7 9 commission during the renewal process will be distributed to 7 10 all member boards. 7 11 f. The interstate commission is authorized to develop rules 7 12 to address renewal of licenses obtained through the compact. 7 13 8. Coordinated information system. 7 14 a. The interstate commission shall establish a database of 7 15 all physicians licensed, or who have applied for licensure, 7 16 under subsection 5. 7 17 b. Notwithstanding any other provision of law, member boards 7 18 shall report to the interstate commission any public action 7 19 or complaints against a licensed physician who has applied or 7 20 received an expedited license through the compact. 7 21 c. Member boards shall report disciplinary or investigatory 7 22 information determined as necessary and proper by rule of the 7 23 interstate commission. 7 24 d. Member boards may report any nonpublic complaint, 7 25 disciplinary, or investigatory information not required by 7 26 paragraph "c" to the interstate commission. 7 27 e. Member boards shall share complaint or disciplinary 7 28 information about a physician upon request of another member 7 29 board. 7 30 f. All information provided to the interstate commission or 7 31 distributed by member boards shall be confidential, filed under 7 32 seal, and used only for investigatory or disciplinary matters. 7 33 g. The interstate commission is authorized to develop rules 7 34 for mandated or discretionary sharing of information by member 7 35 boards. 8 1 9. Joint investigations. 8 2 a. Licensure and disciplinary records of physicians are 8 3 deemed investigative. 8 4 b. In addition to the authority granted to a member board by 8 5 its respective medical practice Act or other applicable state 8 6 law, a member board may participate with other member boards 8 7 in joint investigations of physicians licensed by the member 8 8 boards. 8 9 c. A subpoena issued by a member state shall be enforceable 8 10 in other member states. 8 11 d. Member boards may share any investigative, litigation, or 8 12 compliance materials in furtherance of any joint or individual 8 13 investigation initiated under the compact. 8 14 e. Any member state may investigate actual or alleged 8 15 violations of the statutes authorizing the practice of medicine 8 16 in any other member state in which a physician holds a license 8 17 to practice medicine. 8 18 10. Disciplinary actions. 8 19 a. Any disciplinary action taken by any member board against 8 20 a physician licensed through the compact shall be deemed 8 21 unprofessional conduct which may be subject to discipline 8 22 by other member boards, in addition to any violation of the 8 23 medical practice Act or regulations in that state. 8 24 b. If a license granted to a physician by the member board 8 25 in the state of principal license is revoked, surrendered, 8 26 or relinquished in lieu of discipline, or suspended, then 8 27 all licenses issued to the physician by member boards shall 8 28 automatically be placed, without further action necessary by 8 29 any member board, on the same status. If the member board 8 30 in the state of principal license subsequently reinstates 8 31 the physician's license, a license issued to the physician 8 32 by any other member board shall remain encumbered until that 8 33 respective member board takes action to reinstate the license 8 34 in a manner consistent with the medical practice Act of that 8 35 state. 9 1 c. If disciplinary action is taken against a physician by a 9 2 member board not in the state of principal license, any other 9 3 member board may deem the action conclusive as to matter of law 9 4 and fact decided and either: 9 5 (1) Impose the same or lesser sanctions against the 9 6 physician so long as such sanctions are consistent with the 9 7 medical practice Act of that state, or 9 8 (2) Pursue separate disciplinary action against the 9 9 physician under its respective medical practice Act, regardless 9 10 of the action taken in other member states. 9 11 d. If a license granted to a physician by a member board is 9 12 revoked, surrendered, or relinquished in lieu of discipline, 9 13 or suspended, then any licenses issued to the physician by 9 14 any other member boards shall be suspended, automatically and 9 15 immediately without further action necessary by the other 9 16 member boards, for ninety days upon entry of the order by the 9 17 disciplining board, to permit the member boards to investigate 9 18 the basis for the action under the medical practice Act of that 9 19 state. A member board may terminate the automatic suspension 9 20 of the license it issued prior to the completion of the 9 21 ninety=day suspension period in a manner consistent with the 9 22 medical practice Act of that state. 9 23 11. Interstate medical licensure compact commission. 9 24 a. The member states hereby create the interstate medical 9 25 licensure compact commission. 9 26 b. The purpose of the interstate commission is the 9 27 administration of the interstate medical licensure compact, 9 28 which is a discretionary state function. 9 29 c. The interstate commission shall be a body corporate 9 30 and joint agency of the member states and shall have all the 9 31 responsibilities, powers, and duties set forth in the compact, 9 32 and such additional powers as may be conferred upon it by a 9 33 subsequent concurrent action of the respective legislatures of 9 34 the member states in accordance with the terms of the compact. 9 35 d. The interstate commission shall consist of two voting 10 1 representatives appointed by each member state who shall serve 10 2 as commissioners. In states where allopathic and osteopathic 10 3 physicians are regulated by separate member boards, or if 10 4 the licensing and disciplinary authority is split between 10 5 multiple member boards within a member state, the member state 10 6 shall appoint one representative from each member board. A 10 7 commissioner shall be one of the following: 10 8 (1) An allopathic or osteopathic physician appointed to a 10 9 member board. 10 10 (2) An executive director, executive secretary, or similar 10 11 executive of a member board. 10 12 (3) A member of the public appointed to a member board. 10 13 e. The interstate commission shall meet at least once each 10 14 calendar year. A portion of this meeting shall be a business 10 15 meeting to address such matters as may properly come before 10 16 the commission, including the election of officers. The 10 17 chairperson may call additional meetings and shall call for a 10 18 meeting upon the request of a majority of the member states. 10 19 f. The bylaws may provide for meetings of the interstate 10 20 commission to be conducted by telecommunication or electronic 10 21 communication. 10 22 g. Each commissioner participating at a meeting of the 10 23 interstate commission is entitled to one vote. A majority of 10 24 commissioners shall constitute a quorum for the transaction 10 25 of business, unless a larger quorum is required by the bylaws 10 26 of the interstate commission. A commissioner shall not 10 27 delegate a vote to another commissioner. In the absence of its 10 28 commissioner, a member state may delegate voting authority for 10 29 a specified meeting to another person from that state who shall 10 30 meet the requirements of paragraph "d". 10 31 h. The interstate commission shall provide public notice 10 32 of all meetings and all meetings shall be open to the public. 10 33 The interstate commission may close a meeting, in full or 10 34 in portion, where it determines by a two=thirds vote of the 10 35 commissioners present that an open meeting would be likely to 11 1 result in one or more of the following: 11 2 (1) Relate solely to the internal personnel practices and 11 3 procedures of the interstate commission. 11 4 (2) Discuss matters specifically exempted from disclosure 11 5 by federal statute. 11 6 (3) Discuss trade secrets, commercial, or financial 11 7 information that is privileged or confidential. 11 8 (4) Involve accusing a person of a crime, or formally 11 9 censuring a person. 11 10 (5) Discuss information of a personal nature where 11 11 disclosure would constitute a clearly unwarranted invasion of 11 12 personal privacy. 11 13 (6) Discuss investigative records compiled for law 11 14 enforcement purposes. 11 15 (7) Specifically relate to the participation in a civil 11 16 action or other legal proceeding. 11 17 i. The interstate commission shall keep minutes which shall 11 18 fully describe all matters discussed in a meeting and shall 11 19 provide a full and accurate summary of actions taken, including 11 20 record of any roll call votes. 11 21 j. The interstate commission shall make its information 11 22 and official records, to the extent not otherwise designated 11 23 in the compact or by its rules, available to the public for 11 24 inspection. 11 25 k. The interstate commission shall establish an executive 11 26 committee, which shall include officers, members, and others as 11 27 determined by the bylaws. The executive committee shall have 11 28 the power to act on behalf of the interstate commission, with 11 29 the exception of rulemaking, during periods when the interstate 11 30 commission is not in session. When acting on behalf of the 11 31 interstate commission, the executive committee shall oversee 11 32 the administration of the compact including enforcement and 11 33 compliance with the provisions of the compact, its bylaws and 11 34 rules, and other such duties as necessary. 11 35 l. The interstate commission may establish other committees 12 1 for governance and administration of the compact. 12 2 12. Powers and duties of the interstate commission. The 12 3 interstate commission shall have power to perform the following 12 4 functions: 12 5 a. Oversee and maintain the administration of the compact. 12 6 b. Promulgate rules which shall be binding to the extent and 12 7 in the manner provided for in the compact. 12 8 c. Issue, upon the request of a member state or 12 9 member board, advisory opinions concerning the meaning or 12 10 interpretation of the compact, its bylaws, rules, and actions. 12 11 d. Enforce compliance with compact provisions, the rules 12 12 promulgated by the interstate commission, and the bylaws, using 12 13 all necessary and proper means, including but not limited to 12 14 the use of judicial process. 12 15 e. Establish and appoint committees including but not 12 16 limited to an executive committee as required by subsection 11, 12 17 which shall have the power to act on behalf of the interstate 12 18 commission in carrying out its powers and duties. 12 19 f. Pay, or provide for the payment of, the expenses related 12 20 to the establishment, organization, and ongoing activities of 12 21 the interstate commission. 12 22 g. Establish and maintain one or more offices. 12 23 h. Borrow, accept, hire, or contract for services of 12 24 personnel. 12 25 i. Purchase and maintain insurance and bonds. 12 26 j. Employ an executive director who shall have such 12 27 powers to employ, select, or appoint employees, agents, or 12 28 consultants, and to determine their qualifications, define 12 29 their duties, and fix their compensation. 12 30 k. Establish personnel policies and programs relating 12 31 to conflicts of interest, rates of compensation, and 12 32 qualifications of personnel. 12 33 l. Accept donations and grants of money, equipment, 12 34 supplies, materials, and services, and to receive, utilize, and 12 35 dispose of the same in a manner consistent with the conflict of 13 1 interest policies established by the interstate commission. 13 2 m. Lease, purchase, accept contributions or donations of, or 13 3 otherwise to own, hold, improve, or use, any property, real, 13 4 personal, or mixed. 13 5 n. Sell, convey, mortgage, pledge, lease, exchange, abandon, 13 6 or otherwise dispose of any property, real, personal, or mixed. 13 7 o. Establish a budget and make expenditures. 13 8 p. Adopt a seal and bylaws governing the management and 13 9 operation of the interstate commission. 13 10 q. Report annually to the legislatures and governors of 13 11 the member states concerning the activities of the interstate 13 12 commission during the preceding year. Such reports shall also 13 13 include reports of financial audits and any recommendations 13 14 that may have been adopted by the interstate commission. 13 15 r. Coordinate education, training, and public awareness 13 16 regarding the compact, its implementation, and its operation. 13 17 s. Maintain records in accordance with the bylaws. 13 18 t. Seek and obtain trademarks, copyrights, and patents. 13 19 u. Perform such functions as may be necessary or appropriate 13 20 to achieve the purposes of the compact. 13 21 13. Finance powers. 13 22 a. The interstate commission may levy on and collect an 13 23 annual assessment from each member state to cover the cost of 13 24 the operations and activities of the interstate commission and 13 25 its staff. The total assessment must be sufficient to cover 13 26 the annual budget approved each year for which revenue is not 13 27 provided by other sources. The aggregate annual assessment 13 28 amount shall be allocated upon a formula to be determined 13 29 by the interstate commission, which shall promulgate a rule 13 30 binding upon all member states. 13 31 b. The interstate commission shall not incur obligations of 13 32 any kind prior to securing the funds adequate to meet the same. 13 33 c. The interstate commission shall not pledge the credit of 13 34 any of the member states, except by, and with the authority of, 13 35 the member state. 14 1 d. The interstate commission shall be subject to a yearly 14 2 financial audit conducted by a certified or licensed public 14 3 accountant and the report of the audit shall be included in the 14 4 annual report of the interstate commission. 14 5 14. Organization and operation of the interstate commission. 14 6 a. The interstate commission shall, by a majority of 14 7 commissioners present and voting, adopt bylaws to govern its 14 8 conduct as may be necessary or appropriate to carry out the 14 9 purposes of the compact within twelve months of the first 14 10 interstate commission meeting. 14 11 b. The interstate commission shall elect or appoint annually 14 12 from among its commissioners a chairperson, a vice chairperson, 14 13 and a treasurer, each of whom shall have such authority and 14 14 duties as may be specified in the bylaws. The chairperson, 14 15 or in the chairperson's absence or disability, the vice 14 16 chairperson, shall preside at all meetings of the interstate 14 17 commission. 14 18 c. Officers selected in paragraph "b" shall serve without 14 19 remuneration from the interstate commission. 14 20 d. The officers and employees of the interstate commission 14 21 shall be immune from suit and liability, either personally or 14 22 in their official capacity, for a claim for damage to or loss 14 23 of property or personal injury or other civil liability caused 14 24 or arising out of, or relating to, an actual or alleged act, 14 25 error, or omission that occurred, or that such person had a 14 26 reasonable basis for believing occurred, within the scope of 14 27 interstate commission employment, duties, or responsibilities, 14 28 provided that such person shall not be protected from suit or 14 29 liability for damage, loss, injury, or liability caused by the 14 30 intentional or willful and wanton misconduct of such person. 14 31 (1) The liability of the executive director and employees of 14 32 the interstate commission or representatives of the interstate 14 33 commission, acting within the scope of such person's employment 14 34 or duties for acts, errors, or omissions occurring within such 14 35 person's state, may not exceed the limits of liability set 15 1 forth under the constitution and laws of that state for state 15 2 officials, employees, and agents. The interstate commission 15 3 is considered to be an instrumentality of the states for 15 4 the purposes of any such action. Nothing in this paragraph 15 5 "d" shall be construed to protect such person from suit or 15 6 liability for damage, loss, injury, or liability caused by the 15 7 intentional or willful and wanton misconduct of such person. 15 8 (2) The interstate commission shall defend the executive 15 9 director, its employees, and subject to the approval of 15 10 the attorney general or other appropriate legal counsel of 15 11 the member state represented by an interstate commission 15 12 representative, shall defend such interstate commission 15 13 representative in any civil action seeking to impose liability 15 14 arising out of an actual or alleged act, error, or omission 15 15 that occurred within the scope of interstate commission 15 16 employment, duties, or responsibilities, or that the defendant 15 17 had a reasonable basis for believing occurred within the 15 18 scope of interstate commission employment, duties, or 15 19 responsibilities, provided that the actual or alleged act, 15 20 error, or omission did not result from intentional or willful 15 21 and wanton misconduct on the part of such person. 15 22 (3) To the extent not covered by the state involved, member 15 23 state, or the interstate commission, the representatives or 15 24 employees of the interstate commission shall be held harmless 15 25 in the amount of a settlement or judgment, including attorney 15 26 fees and costs, obtained against such persons arising out of 15 27 an actual or alleged act, error, or omission that occurred 15 28 within the scope of interstate commission employment, duties, 15 29 or responsibilities, or that such persons had a reasonable 15 30 basis for believing occurred within the scope of interstate 15 31 commission employment, duties, or responsibilities, provided 15 32 that the actual or alleged act, error, or omission did not 15 33 result from intentional or willful and wanton misconduct on the 15 34 part of such persons. 15 35 15. Rulemaking functions of the interstate commission. 16 1 a. The interstate commission shall promulgate reasonable 16 2 rules in order to effectively and efficiently achieve the 16 3 purposes of the compact. Notwithstanding the foregoing, in 16 4 the event the interstate commission exercises its rulemaking 16 5 authority in a manner that is beyond the scope of the purposes 16 6 of the compact, or the powers granted hereunder, then such an 16 7 action by the interstate commission shall be invalid and have 16 8 no force or effect. 16 9 b. Rules deemed appropriate for the operations of the 16 10 interstate commission shall be made pursuant to a rulemaking 16 11 process that substantially conforms to the model state 16 12 administrative procedure Act of 2010, and subsequent amendments 16 13 thereto. 16 14 c. Not later than thirty days after a rule is promulgated, 16 15 any person may file a petition for judicial review of the 16 16 rule in the United States district court for the District 16 17 of Columbia or the federal district where the interstate 16 18 commission has its principal offices, provided that the filing 16 19 of such a petition shall not stay or otherwise prevent the 16 20 rule from becoming effective unless the court finds that the 16 21 petitioner has a substantial likelihood of success. The 16 22 court shall give deference to the actions of the interstate 16 23 commission consistent with applicable law and shall not find 16 24 the rule to be unlawful if the rule represents a reasonable 16 25 exercise of the authority granted to the interstate commission. 16 26 16. Oversight of interstate compact. 16 27 a. The executive, legislative, and judicial branches 16 28 of state government in each member state shall enforce the 16 29 compact and shall take all actions necessary and appropriate to 16 30 effectuate the compact's purposes and intent. The provisions 16 31 of the compact and the rules promulgated hereunder shall have 16 32 standing as statutory law but shall not override existing state 16 33 authority to regulate the practice of medicine. 16 34 b. All courts shall take judicial notice of the compact and 16 35 the rules in any judicial or administrative proceeding in a 17 1 member state pertaining to the subject matter of the compact 17 2 which may affect the powers, responsibilities, or actions of 17 3 the interstate commission. 17 4 c. The interstate commission shall be entitled to receive 17 5 all service of process in any such proceeding, and shall have 17 6 standing to intervene in the proceeding for all purposes. 17 7 Failure to provide service of process to the interstate 17 8 commission shall render a judgment or order void as to the 17 9 interstate commission, the compact, or promulgated rules. 17 10 17. Enforcement of interstate compact. 17 11 a. The interstate commission, in the reasonable exercise of 17 12 its discretion, shall enforce the provisions and rules of the 17 13 compact. 17 14 b. The interstate commission may, by majority vote of 17 15 the commissioners, initiate legal action in the United 17 16 States district court for the District of Columbia, or, at 17 17 the discretion of the interstate commission, in the federal 17 18 district where the interstate commission has its principal 17 19 offices, to enforce compliance with the provisions of the 17 20 compact, and its promulgated rules and bylaws, against a 17 21 member state in default. The relief sought may include 17 22 both injunctive relief and damages. In the event judicial 17 23 enforcement is necessary, the prevailing party shall be awarded 17 24 all costs of such litigation including reasonable attorney 17 25 fees. 17 26 c. The remedies herein shall not be the exclusive remedies 17 27 of the interstate commission. The interstate commission may 17 28 avail itself of any other remedies available under state law or 17 29 the regulation of a profession. 17 30 18. Default procedures. 17 31 a. The grounds for default include but are not limited 17 32 to failure of a member state to perform such obligations or 17 33 responsibilities imposed upon it by the compact, or the rules 17 34 and bylaws of the interstate commission promulgated under the 17 35 compact. 18 1 b. If the interstate commission determines that a member 18 2 state has defaulted in the performance of its obligations 18 3 or responsibilities under the compact, or the bylaws or 18 4 promulgated rules, the interstate commission shall do the 18 5 following: 18 6 (1) Provide written notice to the defaulting state and other 18 7 member states of the nature of the default, the means of curing 18 8 the default, and any action taken by the interstate commission. 18 9 The interstate commission shall specify the conditions by which 18 10 the defaulting state must cure its default. 18 11 (2) Provide remedial training and specific technical 18 12 assistance regarding the default. 18 13 c. If the defaulting state fails to cure the default, the 18 14 defaulting state shall be terminated from the compact upon an 18 15 affirmative vote of a majority of the commissioners and all 18 16 rights, privileges, and benefits conferred by the compact shall 18 17 terminate on the effective date of termination. A cure of the 18 18 default does not relieve the offending state of obligations or 18 19 liabilities incurred during the period of the default. 18 20 d. Termination of membership in the compact shall be imposed 18 21 only after all other means of securing compliance have been 18 22 exhausted. Notice of intent to terminate shall be given by 18 23 the interstate commission to the governor, the majority and 18 24 minority leaders of the defaulting state's legislature, and 18 25 each of the member states. 18 26 e. The interstate commission shall establish rules and 18 27 procedures to address licenses and physicians that are 18 28 materially impacted by the termination of a member state, or 18 29 the withdrawal of a member state. 18 30 f. The member state which has been terminated is responsible 18 31 for all dues, obligations, and liabilities incurred through 18 32 the effective date of termination including obligations, the 18 33 performance of which extends beyond the effective date of 18 34 termination. 18 35 g. The interstate commission shall not bear any costs 19 1 relating to any state that has been found to be in default or 19 2 which has been terminated from the compact, unless otherwise 19 3 mutually agreed upon in writing between the interstate 19 4 commission and the defaulting state. 19 5 h. The defaulting state may appeal the action of the 19 6 interstate commission by petitioning the United States district 19 7 court for the District of Columbia or the federal district 19 8 where the interstate commission has its principal offices. The 19 9 prevailing party shall be awarded all costs of such litigation 19 10 including reasonable attorney fees. 19 11 19. Dispute resolution. 19 12 a. The interstate commission shall attempt, upon the request 19 13 of a member state, to resolve disputes which are subject to 19 14 the compact and which may arise among member states or member 19 15 boards. 19 16 b. The interstate commission shall promulgate rules 19 17 providing for both mediation and binding dispute resolution as 19 18 appropriate. 19 19 20. Member states, effective date, and amendment. 19 20 a. Any state is eligible to become a member state of the 19 21 compact. 19 22 b. The compact shall become effective and binding upon 19 23 legislative enactment of the compact into law by no less than 19 24 seven states. Thereafter, it shall become effective and 19 25 binding on a state upon enactment of the compact into law by 19 26 that state. 19 27 c. The governors of nonmember states, or their designees, 19 28 shall be invited to participate in the activities of the 19 29 interstate commission on a nonvoting basis prior to adoption 19 30 of the compact by all states. 19 31 d. The interstate commission may propose amendments to the 19 32 compact for enactment by the member states. No amendment shall 19 33 become effective and binding upon the interstate commission and 19 34 the member states unless and until it is enacted into law by 19 35 unanimous consent of the member states. 20 1 21. Withdrawal. 20 2 a. Once effective, the compact shall continue in force and 20 3 remain binding upon each and every member state, provided that 20 4 a member state may withdraw from the compact by specifically 20 5 repealing the statute which enacted the compact into law. 20 6 b. Withdrawal from the compact shall be by the enactment 20 7 of a statute repealing the same, but shall not take effect 20 8 until one year after the effective date of such statute and 20 9 until written notice of the withdrawal has been given by the 20 10 withdrawing state to the governor of each other member state. 20 11 c. The withdrawing state shall immediately notify the 20 12 chairperson of the interstate commission in writing upon the 20 13 introduction of legislation repealing the compact in the 20 14 withdrawing state. 20 15 d. The interstate commission shall notify the other member 20 16 states of the withdrawing state's intent to withdraw within 20 17 sixty days of its receipt of notice provided under paragraph 20 18 "c". 20 19 e. The withdrawing state is responsible for all dues, 20 20 obligations, and liabilities incurred through the effective 20 21 date of withdrawal, including obligations, the performance of 20 22 which extend beyond the effective date of withdrawal. 20 23 f. Reinstatement following withdrawal of a member state 20 24 shall occur upon the withdrawing state reenacting the compact 20 25 or upon such later date as determined by the interstate 20 26 commission. 20 27 g. The interstate commission is authorized to develop 20 28 rules to address the impact of the withdrawal of a member 20 29 state on licenses granted in other member states to physicians 20 30 who designated the withdrawing member state as the state of 20 31 principal license. 20 32 22. Dissolution. 20 33 a. The compact shall dissolve effective upon the date of 20 34 the withdrawal or default of the member state which reduces the 20 35 membership in the compact to one member state. 21 1 b. Upon the dissolution of the compact, the compact becomes 21 2 null and void and shall be of no further force or effect, and 21 3 the business and affairs of the interstate commission shall be 21 4 concluded and surplus funds shall be distributed in accordance 21 5 with the bylaws. 21 6 23. Severability and construction. 21 7 a. The provisions of the compact shall be severable, 21 8 and if any phrase, clause, sentence, or provision is deemed 21 9 unenforceable, the remaining provisions of the compact shall 21 10 be enforceable. 21 11 b. The provisions of the compact shall be liberally 21 12 construed to effectuate its purposes. 21 13 c. Nothing in the compact shall be construed to prohibit the 21 14 applicability of other interstate compacts to which the states 21 15 are members. 21 16 24. Binding effect of compact and other laws. 21 17 a. Nothing herein prevents the enforcement of any other law 21 18 of a member state that is not inconsistent with the compact. 21 19 b. All laws in a member state in conflict with the compact 21 20 are superseded to the extent of the conflict. 21 21 c. All lawful actions of the interstate commission, 21 22 including all rules and bylaws promulgated by the commission, 21 23 are binding upon the member states. 21 24 d. All agreements between the interstate commission and the 21 25 member states are binding in accordance with their terms. 21 26 e. In the event any provision of the compact exceeds the 21 27 constitutional limits imposed on the legislature of any member 21 28 state, such provision shall be ineffective to the extent of the 21 29 conflict with the constitutional provision in question in that 21 30 member state. 21 31 EXPLANATION 21 32 The inclusion of this explanation does not constitute agreement with 21 33 the explanation's substance by the members of the general assembly. 21 34 This bill seeks to enact the interstate medical licensure 21 35 compact, which would allow physicians to secure licensure 22 1 in states in which they do not hold a traditional license. 22 2 Passage of the bill means Iowa would become a compact member 22 3 state. The compact shall become effective and binding upon 22 4 passage by at least seven states. 22 5 The bill recognizes the creation of an interstate medical 22 6 licensure compact commission to administer the compact. Its 22 7 commissioners would include two representatives from each 22 8 member state. The commissioners must be an allopathic or 22 9 osteopathic physician appointed to a state board, an executive 22 10 member of a state board, or a member of the public on a state 22 11 board. The interstate commission must hold at least one 22 12 meeting per year and all meetings would be open to the public, 22 13 subject to closure for specified topics. The interstate 22 14 commission must create an executive committee and may establish 22 15 other committees as necessary to govern and administer the 22 16 compact. The interstate commission will have the power to 22 17 adopt bylaws, create its own rules, enforce compliance with 22 18 its bylaws and rules, establish and maintain offices, purchase 22 19 and maintain insurance and bonds, employ an executive director 22 20 who may employ and fix compensation and duties for employees, 22 21 establish a budget and make expenditures, seek and obtain 22 22 trademarks, copyrights, and patents, and lease, buy, and sell 22 23 property, as well as other functions it deems necessary. 22 24 Physicians must designate a member state as their state of 22 25 principal license for purposes of applying for an expedited 22 26 license. An expedited license is a full and unrestricted 22 27 license granted by a member state. A physician seeking an 22 28 expedited license to practice medicine must apply to the board 22 29 of medicine in the physician's state of principal license. The 22 30 board of medicine must then verify or deny the physician's 22 31 eligibility for an expedited license to the interstate 22 32 commission. An expedited license granted to a physician shall 22 33 be terminated if the physician fails to maintain a license in 22 34 the physician's state of principal license. 22 35 The interstate commission shall have authority to establish 23 1 and maintain a database of all physicians who have applied for 23 2 an expedited license. Medical boards of member states may 23 3 participate in investigations of physicians in conjunction with 23 4 other boards of other member states. A physician subjected 23 5 to disciplinary action by any medical board of a member state 23 6 may also be subject to discipline by another member state 23 7 medical board. If a physician's license is suspended, revoked, 23 8 surrendered, or relinquished due to discipline by one medical 23 9 board of a member state, the physician's license shall be 23 10 automatically placed on the same status by other medical boards 23 11 of member states without additional disciplinary action. 23 12 The interstate commission's officers and employees shall be 23 13 immune from liability for claims of damage that occurred within 23 14 the scope of their duties. The interstate commission may 23 15 propose amendments to the compact that would become effective 23 16 upon passage by at least seven member states. The interstate 23 17 commission may initiate legal action to enforce the compact's 23 18 provisions and rules. If a member state defaults in its 23 19 performance of the compact's responsibilities, the interstate 23 20 commission shall notify the state as such and provide training 23 21 and assistance to remedy the default. If a member state fails 23 22 to cure its default, that state's rights and privileges under 23 23 the compact shall be terminated upon a vote of the majority of 23 24 commissioners. 23 25 The executive, legislative, and judicial branches of Iowa 23 26 would maintain authority to enforce the compact. The compact's 23 27 provisions would not override the state's existing authority 23 28 to regulate the practice of medicine. The board of medicine 23 29 would have jurisdiction to impose an adverse action against 23 30 a medical license issued in Iowa pursuant to the compact's 23 31 procedures. Member states may withdraw upon enactment of a 23 32 statute repealing the compact. The compact would dissolve when 23 33 membership declines to one state. LSB 1270SV (1) 86 tr/nh
