An Act To Adopt the Interstate Medical Licensure Compact
Maine Legislature, Session 128, LD 1359
Committee: Labor, Commerce, Research and Economic Development
Sponsors: GRATWICK, TUCKER, BRAKEY, DILL, DOW, MAKER, MIRAMANT, CAMPBELL, DUCHESNE, HARLOW

Legislative Document
No. 1359
S.P. 467
In Senate, April 6, 2017
An Act To Adopt the Interstate Medical Licensure Compact
Reference to the Committee on Labor, Commerce, Research and Economic Development 
suggested and ordered printed.
HEATHER J.R. PRIEST
Secretary of the Senate
Presented by Senator GRATWICK of Penobscot.
Cosponsored by Representative TUCKER of Brunswick and
Senators: BRAKEY of Androscoggin, DILL of Penobscot, DOW of Lincoln, MAKER of 
Washington, MIRAMANT of Knox, Representatives: CAMPBELL of Orrington, DUCHESNE 
of Hudson, HARLOW of Portland.
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  32 MRSA c. 145 is enacted to read: 
CHAPTER 145 
INTERSTATE MEDICAL LICENSURE COMPACT 
§18501.  Short title 
This chapter may be known and cited as "the Interstate Medical Licensure Compact." 
§18502.  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 member 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 member board where the patient is located. State 
member 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. 
This compact is the Maine enactment of the Interstate Medical Licensure Compact as 
revised by the Interstate Medical Licensure Compact Commission.  The form, format and 
text of the compact have been changed minimally so as to conform to Maine statutory 
conventions.  The changes are technical in nature and it is the intent of the Legislature 
that this Act be interpreted as substantively the same as the Interstate Medical Licensure 
Compact that is enacted by other member states. 
§18503.  Definitions 
As used in this chapter, unless the context otherwise indicates, the following terms 
have the following meanings. 
1.  Bylaws.  "Bylaws" means those bylaws adopted by the interstate commission 
pursuant to section 18512 for its governance or for directing and controlling its actions 
and conduct. 
2.  Commissioner.  "Commissioner" means the voting representative appointed by a 
member board pursuant to section 18512. 
3.  Conviction.  "Conviction" means a finding by a court that an individual is guilty 
of a criminal offense through adjudication or entry of a plea of guilty or no contest to the 
charge by the offender. Evidence of an entry of a conviction of a criminal offense by the 
court is considered final for purposes of disciplinary action by a member board. 
4.  Expedited license.  "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.  "Interstate commission" means the Interstate Medical 
Licensure Compact Commission created pursuant to section 18512. 
6.  License.  "License" means authorization by a state for a physician to engage in the 
practice of medicine. 
7.  Medical practice act.  "Medical practice act" means the laws and rules governing 
the practice of allopathic and osteopathic medicine within a member state. 
8.  Member board.  "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.  "Member state" means a state that has enacted the compact. 
10.  Offense.  "Offense" means a felony, a Class A, Class B or Class C crime, an 
aggravated crime, a gross misdemeanor or a crime involving moral turpitude. 
11.  Physician.  "Physician" means a person who: 
A.  Is a graduate of a medical school accredited by the Liaison Committee on 
Medical Education or the American Osteopathic Association's Commission on 
Osteopathic College Accreditation, or its successor, or a medical school listed in the 
International Medical Education Directory database or its successor; 
B.  Passed each component of the United States Medical Licensing Examination or 
the Comprehensive Osteopathic Medical Licensing Examination within 3 attempts or 
a predecessor examination accepted by a state member 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 and been 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.  "Practice of medicine" means the clinical prevention, 
diagnosis or treatment of a 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.  "Rule" means a written statement by the interstate commission 
promulgated pursuant to section 18513 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; 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.  "State" means any state, commonwealth, district or territory of the United 
States. 
15.  State of principal license.  "State of principal license" means a member state 
where a physician holds a license to practice medicine and that has been designated as the 
state of principal license by the physician for purposes of registration and participation in 
the compact. 
§18504.  Eligibility 
1.  Eligibility requirements.  A physician may receive an expedited license under 
the terms and provisions of the compact. 
2.  Exception.  An individual who does not meet the requirements of section 18503, 
subsection 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. 
§18505.  Designation of state of principal license 
1.  State of principal license.  A physician must 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: 
A.  The state of primary residence for the physician; 
B.  The state where at least 25% of the physician's practice of medicine occurs; 
C.  The location of the physician's employer; or 
D.  If no state qualifies under paragraphs A to C, the state designated as the 
physician's state of residence for the purpose of federal income tax. 
2.  Redesignation.  A physician may designate another member state as the state of 
principal license at any time after a designation under subsection 1, as long as the state 
meets the requirements in subsection 1. 
3.  Rules.  The interstate commission is authorized to adopt rules pursuant to section 
18516 to facilitate designation pursuant to subsection 2 of another member state as the 
state of principal license. 
§18506.  Application for and issuance of expedited license 
1.  Application.  A physician seeking licensure through the compact must file an 
application for an expedited license with the member board of the state selected by the 
physician as the state of principal license. 
2.  Evaluation.  Upon receipt of an application for an expedited license, the member 
board of the state selected by the physician 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. 
A.  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, are not 
subject to additional primary source verification when already verified by primary 
source by the state of principal license. 
B.  The member board of the state selected by the physician 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 in compliance with the requirements of the Federal Bureau of 
Investigation, with the exception of federal employees who have been determined 
suitable in accordance with 5 Code of Federal Regulations, Section 731.202. 
(1)  An appeal on the determination of eligibility must be made to the member 
state where the application was filed and is subject to the law of that state. 
3.  Registration process.  Upon verification in subsection 2, a physician eligible for 
an expedited license must complete the registration process established by the interstate 
commission to receive an expedited license in a member state selected pursuant to 
subsection 1, including the payment of any applicable fees under section 18507. 
4.  Expedited license.  After receiving verification of eligibility under subsection 2 
and any fees under subsection 3, a member board shall issue an expedited license to the 
physician. The license authorizes the physician to practice medicine in the issuing state 
consistent with the medical practice act and all applicable laws and rules of the issuing 
member board and member state. 
5.  Validity.  An expedited license is 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. 
6.  Termination.  An expedited license obtained through the compact must 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. 
7.  Rules.  The interstate commission is authorized to adopt rules pursuant to section 
18516 regarding the application process, including payment of any applicable fees, and 
the issuance of an expedited license. 
§18507.  Fees for expedited licensure 
1.  Fees.  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. 
2.  Rules.  The interstate commission is authorized to adopt rules pursuant to section 
18516 regarding fees for expedited licenses. 
§18508.  Renewal and continued participation 
1.  License renewal process.  A physician seeking to renew an expedited license 
granted in a member state must complete a renewal process with the interstate 
commission.  The physician is eligible for renewal if the physician: 
A.  Maintains a full and unrestricted license in a state of principal license; 
B.  Has not been convicted or received adjudication, deferred adjudication, 
community supervision or deferred disposition for any offense by a court of 
appropriate jurisdiction; 
C.  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 
D.  Has not had a controlled substance license or permit suspended or revoked by a 
state or the United States Drug Enforcement Administration. 
2.  Professional development.  A physician must comply with all continuing 
professional development or continuing medical education requirements for renewal of a 
license issued by a member state. 
3.  Renewal fees.  The interstate commission shall collect from the physician any 
renewal fee charged for the renewal of a license and distribute the fee to the applicable 
member board. 
4.  License renewal.  Upon receipt of the renewal fee collected in subsection 3, a 
member board shall renew the physician's license. 
5.  Physician information.  Physician information collected by the interstate 
commission during the renewal process must be distributed to all member boards. 
6.  Rules.  The interstate commission is authorized to adopt rules pursuant to section 
18516 to address renewal of licenses obtained through the compact. 
§18509.  Coordinated information system 
1.  Database.  The interstate commission shall establish a database of all physicians 
licensed or who have applied for licensure under section 18506. 
2.  Public action or complaint.  Notwithstanding any other provision of law, a 
member board shall report to the interstate commission any public action or complaint 
against a physician licensed by that member board who has applied for or received an 
expedited license through the compact. 
3.  Disciplinary or investigatory information.  A member board shall report 
disciplinary or investigatory information determined as necessary and proper by rule of 
the interstate commission. 
4.  Other reports.  A member board may report any nonpublic complaint, 
disciplinary or investigatory information not required to be reported by subsection 3 to 
the interstate commission. 
5.  Information sharing.  A member board shall share complaint or disciplinary 
information about a physician upon request of another member board. 
6.  Confidentiality.  Information provided to the interstate commission or distributed 
by a member board is confidential within the meaning of Title 1, section 402, subsection 
3, paragraph A and may be used only for investigatory or disciplinary matters under 
sections 18510 and 18511. 
7.  Rules.  The interstate commission is authorized to adopt rules pursuant to section 
18516 regarding mandated or discretionary sharing of information by member boards. 
§18510.  Joint investigations 
1.  Joint investigations.  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 a physician licensed by the 
member boards. 
2.  Subpoenas.  A subpoena issued by a member state is enforceable in other member 
states. 
3.  Materials sharing.  Notwithstanding any other provision of law, a member board 
may share any investigative, litigation or compliance materials in furtherance of any joint 
or individual investigation initiated under the compact. 
4.  Investigations in other member states.  A member state may investigate actual 
or alleged violations of the laws authorizing the practice of medicine in any other member 
state in which a physician holds a license to practice medicine. 
§18511.  Disciplinary actions 
1.  Unprofessional conduct.  A physician licensed through the compact who is the 
subject of a disciplinary action taken by a member board is deemed to have engaged in 
unprofessional conduct and may be subject to discipline by another member board, in 
addition to discipline for any violation of the medical practice act or rules in that member 
board's state. 
2.  License revocation.  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 must 
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 
remains encumbered until that respective member board takes action to reinstate the 
license in a manner consistent with the medical practice act of that member board's state. 
3.  Matter of law and fact decided.  If disciplinary action is taken against a 
physician by a member board not in the state of principal license, any other member 
board may deem the action conclusive as to matter of law and fact decided and may: 
A.  Impose the same or a lesser sanction against the physician as long as such 
sanction is consistent with the medical practice act of that member board's state; or 
B.  Pursue separate disciplinary action against the physician under the medical 
practice act of the member board's state, regardless of the action taken in other 
member states. 
4.  Licenses in other member states.  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 must 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 member board, to permit 
the other member board to investigate the basis for the action under the medical practice 
act of that member board's state. A member board may terminate the automatic 
suspension of the license it issued prior to the completion of the 90-day suspension period 
in a manner consistent with the medical practice act of that member board's state. 
§18512.  Interstate medical licensure compact commission 
1.  Commission established.  The Interstate Medical Licensure Compact 
Commission is established. 
2.  Duties.  The interstate commission shall administer the Interstate Medical 
Licensure Compact. 
3.  Powers.  The interstate commission is a body corporate and joint agency of the 
member states and has 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. 
4.  Membership.  The interstate commission consists of 2 voting representatives 
appointed by each member state, who serve as commissioners. In states where allopathic 
and osteopathic physicians are regulated by separate member boards, or if the licensing 
and disciplinary authority is split between multiple member boards within a member 
state, the member state shall appoint one representative from each member board. A 
commissioner must: 
A.  Be an allopathic or osteopathic physician appointed to a member board; 
B.  Be an executive director, executive secretary or similar executive of a member 
board; or 
C.  Be a member of the public appointed to a member board. 
5.  Meetings; officers.  The interstate commission shall meet at least once each 
calendar year to address such matters as may properly come before the commission, 
including the election of officers including the chair. The chair may call additional 
meetings and shall call for a meeting upon the request of a majority of the member states. 
6.  Telecommunication or electronic communication.  The bylaws of the 
commission may provide for meetings to be conducted by telecommunication or 
electronic communication. 
7.  Quorum.  A commissioner participating at a meeting of the interstate commission 
is entitled to one vote. A majority of commissioners constitutes a quorum for the 
transaction of business, unless a larger quorum is required by the bylaws of the interstate 
commission. A commissioner may 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 meets the requirements of subsection 4. 
8.  Public notice.  The interstate commission shall provide public notice of all 
meetings, and all meetings must be open to the public. The interstate commission may 
close a meeting, in full or in portion, if it determines by a 2/3 vote of the commissioners 
present that an open meeting would be likely to: 
A.  Relate solely to the internal personnel practices and procedures of the interstate 
commission; 
B.  Discuss matters specifically exempted from disclosure by federal statute; 
C.  Discuss trade secrets or commercial or financial information that is privileged or 
confidential; 
D.  Involve accusing a person of a crime or formally censuring a person; 
E.  Discuss information of a personal nature the disclosure of which would constitute 
a clearly unwarranted invasion of personal privacy; 
F.  Discuss investigative records compiled for law enforcement purposes; or 
G.  Specifically relate to participation in a civil action or other legal proceeding. 
9.  Minutes.  The interstate commission shall keep minutes that must fully describe 
all matters discussed in a meeting and provide a full and accurate summary of actions 
taken, including a record of any roll call votes. 
10.  Public records.  The interstate commission shall make its information and 
official records, to the extent not otherwise designated in the compact or by rules adopted 
by the interstate commission, available to the public for inspection. 
11.  Executive committee.  The interstate commission shall establish an executive 
committee, which must include officers, members and others as determined by the 
bylaws. The executive committee has 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 of and compliance with the provisions of the compact and the interstate 
commission's bylaws and rules, and perform other such duties as necessary. 
12.  Other committees.  The interstate commission may establish other committees, 
in addition to the executive committee under subsection 11, for governance and 
administration of the compact. 
§18513.  Powers and duties of the interstate commission 
1.  Duties.  The interstate commission shall: 
A.  Oversee and maintain the administration of the compact; 
B.  Adopt rules pursuant to section 18516, which are binding to the extent and in the 
manner provided for in the compact; 
C.  Issue, upon the request of a member state or member board, advisory opinions 
concerning the meaning or interpretation of the compact and the interstate 
commission's bylaws, rules and actions; 
D.  Enforce compliance with compact provisions and the rules and bylaws adopted by 
the interstate commission using all necessary and proper means, including but not 
limited to the use of judicial process; 
E.  Pay, or provide for the payment of, the expenses related to the establishment, 
organization and ongoing activities of the interstate commission; 
F.  Purchase and maintain insurance and bonds; 
G.  Employ an executive director who has the power to employ, select or appoint 
employees, agents or consultants and to determine their qualifications, define their 
duties and fix their compensation; 
H.  Establish personnel policies and programs relating to conflicts of interest, rates of 
compensation and qualifications of personnel; 
I.  Establish a budget and make expenditures; 
J.  Adopt a seal and bylaws governing the management and operation of the interstate 
commission; 
K.  Report annually to the legislatures and governors of the member states concerning 
the activities of the interstate commission during the preceding year. Reports must 
include reports of financial audits and any recommendations adopted by the interstate 
commission; and 
L.  Maintain records in accordance with the bylaws. 
2.  Powers.  The interstate commission may: 
A.  Establish and appoint committees, including, but not limited to, an executive 
committee as required by section 18512, that have the power to act on behalf of the 
interstate commission in carrying out its powers and duties; 
B.  Establish and maintain one or more offices; 
C.  Borrow, accept, hire or contract for the services of personnel; 
D.  Accept donations and grants of money, equipment, supplies, materials and 
services, and receive, use and dispose of donations and grants in a manner consistent 
with the conflict of interest policies established by the interstate commission; 
E.  Lease, purchase, accept contributions or donations of or otherwise own, hold, 
improve or use any property, real, personal or mixed; 
F.  Sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise dispose of 
any property, real, personal or mixed; 
G.  Coordinate education, training and public awareness regarding the compact and 
its implementation and operation; 
H.  Seek and obtain trademarks, copyrights and patents; and 
I.  Perform such functions as may be necessary or appropriate to achieve the purposes 
of the compact. 
§18514.  Finance powers 
1.  Annual assessment.  The interstate commission may levy an annual assessment 
on and collect the 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 must be allocated 
upon a formula to be determined by the interstate commission. The interstate commission 
shall adopt the formula by rule binding upon all member states. 
2.  Obligations.  The interstate commission may not incur an obligation of any kind 
prior to securing the funds adequate to meet that obligation. 
3.  Credit.  The interstate commission may not pledge the credit of another member 
state, except by and with the authority of that member state. 
4.  Financial audit.  The interstate commission is subject to a yearly financial audit 
conducted by a certified or licensed public accountant, and the report of the audit must be 
included in the annual report of the interstate commission under section 18513, 
subsection 1, paragraph K. 
§18515.  Organization and operation of the interstate commission 
1.  Bylaws.  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. 
2.  Officers.  The interstate commission shall elect or appoint annually from among 
its commissioners a chair, a vice-chair and a treasurer, each of whom has the authority 
and duties as specified in the bylaws. The chair, or in the chair's absence or disability, the 
vice-chair, shall preside at all meetings of the interstate commission. 
3.  Remuneration.  Officers selected in subsection 2 serve without remuneration 
from the interstate commission. 
4.  Immunity and liability.  An officer or employee of the interstate commission is 
immune from suit and liability, either personally or in that person's 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 that officer or employee has a reasonable basis for believing occurred, within the 
scope of interstate commission employment, duties or responsibilities, except that that 
officer or employee is not protected from suit or liability for damage, loss, injury or 
liability caused by the intentional or willful and wanton misconduct of that officer or 
employee. 
A.  The liability of the executive director or an employee or representative of the 
interstate commission, acting within the scope of that executive director's, 
representative's or employee's employment or duties for acts, errors or omissions 
occurring within that executive director's, representative's or employee's state may 
not exceed the limits of liability set forth under the constitution and laws of that state 
for state officials, employees and agents. The interstate commission is considered to 
be an instrumentality of the states for the purposes of any action to enforce liability. 
Nothing in this paragraph may be construed to protect a person from suit or liability 
for damage, loss or injury caused by the intentional or willful and wanton misconduct 
of the executive director, representative or employee. 
B.  The interstate commission shall defend the executive director, an employee and, 
subject to the approval of the attorney general or other appropriate legal counsel of 
the member state, an interstate commission representative in any civil action seeking 
to impose liability arising out of an actual or alleged act, error or omission that 
occurred or that the defendant had a reasonable basis for believing occurred within 
the scope of interstate commission employment, duties or responsibilities, as long as 
the actual or alleged act, error or omission did not result from intentional or willful 
and wanton misconduct on the part of the executive director, employee or 
representative. 
C.  To the extent not covered by the state involved, a member state or the interstate 
commission, a representative or employee of the interstate commission must be held 
harmless in the amount of a settlement or judgment, including attorney's fees and 
costs, obtained against that person arising out of an actual or alleged act, error or 
omission that occurred or that that representative or employee has a reasonable basis 
for believing occurred within the scope of interstate commission employment, duties 
or responsibilities, as long as the actual or alleged act, error or omission did not result 
from intentional or willful and wanton misconduct on the part of that representative 
or employee. 
§18516.  Rule-making functions of the interstate commission 
1.  Rules.  The interstate commission shall adopt reasonable rules, which are routine 
technical rules pursuant to Title 5, chapter 375, subchapter 2-A, in order to effectively 
and efficiently achieve the purposes of the compact; however, if the interstate 
commission exercises its rule-making authority in a manner that is beyond the scope of 
the purposes of the compact or the powers granted under the compact, then such an action 
by the interstate commission is invalid and has no force or effect. 
2.  Rules conformation.  Rules for the operations of the interstate commission must 
be adopted pursuant to a rule-making process that substantially conforms to the "Revised 
Model State Administrative Procedure Act" (2010), as amended, of the National 
Conference of Commissioners on Uniform State Laws. 
3.  Judicial review.  Not later than 30 days after a rule is adopted, a 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, as long as the filing of such a petition does 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 may not find the rule to be unlawful if the 
rule represents a reasonable exercise of the authority granted to the interstate commission. 
§18517.  Oversight of interstate compact 
1.  Enforcement.  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 adopted under the compact have standing as statutory law 
but do not override existing state authority to regulate the practice of medicine. 
2.  Courts.  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. 
3.  Service of process.  The interstate commission is entitled to receive all service of 
process in any proceeding under subsection 2 and has standing to intervene in the 
proceeding for all purposes. Failure to provide service of process to the interstate 
commission renders a judgment or order void as to the interstate commission, the 
compact or adopted rules. 
§18518.  Enforcement of interstate compact 
1.  Enforcement.  The interstate commission, in the reasonable exercise of its 
discretion, shall enforce the provisions and rules of the compact. 
2.  Compliance.  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 adopted 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. 
3.  Remedies.  The remedies in this section are not 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. 
§18519.  Default procedures 
1.  Grounds.  The grounds for default under section 18518 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 
adopted under the compact. 
2.  Default.  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 adopted rules, the interstate commission shall: 
A.  Provide written notice to the defaulting state and other member states of the 
nature of the default, the means of curing the default and any action taken by the 
interstate commission. The interstate commission shall specify the conditions by 
which the defaulting state must cure its default; and 
B.  Provide remedial training and specific technical assistance regarding the default. 
3.  Termination.  If a defaulting state fails to cure the default, the defaulting state 
must be terminated from the compact in accordance with subsection 4 upon an 
affirmative vote of a majority of the commissioners and all rights, privileges and benefits 
conferred by the compact 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. 
4.  Notice of intent.  Termination of membership in the compact may be imposed 
only after all other means of securing compliance have been exhausted. Notice of intent 
to terminate must be given by the interstate commission to the governor of the defaulting 
state, the majority and minority leaders of the defaulting state's legislature and each of the 
member states. 
5.  Rules.  The interstate commission shall adopt rules pursuant to section 18516 and 
procedures to address licenses and physicians that are materially affected by the 
termination of a member state or the withdrawal of a member state. 
6.  Obligations.  A 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. 
7.  Costs.  The interstate commission may not bear any costs relating to any state that 
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. 
8.  Appeal.  A defaulting state may appeal an 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 
must be awarded all costs of such litigation including reasonable attorney's fees. 
§18520.  Dispute resolution 
1.  Resolution.  The interstate commission shall attempt, upon the request of a 
member state, to resolve disputes that are subject to the compact and that arise among 
member states or member boards. 
2.  Rules.  The interstate commission shall adopt rules pursuant to section 18516 
providing for both mediation and binding dispute resolution, as appropriate. 
§18521.  Member states, effective date and amendment 
1.  Eligibility.  Any state is eligible to become a member state of the compact. 
2.  Effective date.  The compact becomes effective and binding upon legislative 
enactment of the compact into law by no fewer than 7 states. Thereafter, it becomes 
effective and binding on a state upon enactment of the compact into law by that state. 
3.  Participation by nonmember states.  The governors of nonmember states, or 
their designees, must be invited to participate in the activities of the interstate commission 
on a nonvoting basis prior to adoption of the compact by all states. 
4.  Amendments to compact.  The interstate commission may propose amendments 
to the compact for enactment by the member states. An amendment does not become 
effective and binding upon the interstate commission and the member states until it is 
enacted into law by unanimous consent of the member states. 
§18522.  Withdrawal 
1.  Repeal.  Once effective, the compact continues in force and remains binding upon 
each member state, except that a member state may withdraw from the compact by 
specifically repealing the statute that enacted the compact into law. 
2.  Effective date.  Withdrawal from the compact is by the enactment of a statute 
repealing the compact, but does not take effect until one year after the effective date of 
that statute and until written notice of the withdrawal has been given by the withdrawing 
state to the governor of each other member state. 
3.  Intent.  The withdrawing state shall immediately notify the chair of the interstate 
commission in writing upon the introduction of legislation repealing the compact in the 
withdrawing state. 
4.  Notification.  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 3. 
5.  Obligations.  The withdrawing state is responsible for all dues, obligations and 
liabilities incurred through the effective date of withdrawal, including obligations the 
performance of which extends beyond the effective date of withdrawal. 
6.  Reinstatement.  Reinstatement following withdrawal of a member state occurs 
upon the withdrawing state's reenacting the compact or upon such later date as 
determined by the interstate commission. 
7.  Rules.  The interstate commission is authorized to adopt rules pursuant to section 
18516 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. 
§18523.  Dissolution 
1.  Effective date.  The compact dissolves effective upon the date of the withdrawal 
or default of the member state that reduces the membership in the compact to one 
member state. 
2.  Surplus funds.  Upon the dissolution of the compact, the compact becomes null 
and void and is of no further force or effect, and the business and affairs of the interstate 
commission are concluded and surplus funds must be distributed in accordance with the 
bylaws. 
§18524.  Construction 
1.  Liberal construction.  The provisions of the compact must be liberally construed 
to effectuate its purposes. 
2.  Applicability of other compacts.  Nothing in the compact may be construed to 
prohibit the applicability of other interstate compacts of which the states are members. 
§18525.  Binding effect of compact and other laws 
1.  Other law.  Nothing in this chapter prevents the enforcement of any other law of a 
member state that is not inconsistent with the compact. 
2.  Conflicts.  All laws in a member state in conflict with the compact are superseded 
to the extent of the conflict. 
3.  Actions.  All lawful actions of the interstate commission, including all rules and 
bylaws adopted by the commission, are binding upon the member states. 
4.  Agreements.  All agreements between the interstate commission and the member 
states are binding in accordance with their terms. 
5.  Constitutional limits.  In the event any provision of the compact exceeds the 
constitutional limits imposed on the legislature of any member state, that provision is 
ineffective to the extent of the conflict with the constitutional provision in question in that 
member state. 
SUMMARY 
This bill enacts the Interstate Medical Licensure Compact.  The compact provides a 
mechanism by which a physician licensed in one member state may apply for and receive 
an expedited license in another member state.