Chief Sponsor: Raymond P. Ward

Senate Sponsor: Evan J. Vickers


8     General Description:
9          This bill enacts an interstate licensing compact to streamline the licensing of a
10     physician in multiple states.
11     Highlighted Provisions:
12          This bill:
13          ▸     establishes the purpose of the compact;
14          ▸     defines terms;
15          ▸     establishes eligibility for licensure under the compact;
16          ▸     establishes a license application issuance and renewal process;
17          ▸     establishes a database for physician licensure;
18          ▸     provides a process for joint investigations and disciplinary actions;
19          ▸     creates an Interstate Medical Licensure Compact Commission;
20          ▸     creates powers and duties for the Interstate Medical Licensure Compact
21     Commission, including:
22               •     finance powers;
23               •     organization and operation;
24               •     rulemaking; and
25               •     oversight;
26          ▸     establishes an enforcement mechanism and dispute resolution process for the
27     Interstate Medical Licensure Compact; and
28          ▸     provides a process for withdrawal from the compact and dissolution of the compact.
29     Money Appropriated in this Bill:

30          None
31     Other Special Clauses:
32          None
33     Utah Code Sections Affected:
34     ENACTS:
35          58-67b-101, Utah Code Annotated 1953
36          58-67b-102, Utah Code Annotated 1953
37          58-67b-103, Utah Code Annotated 1953
38          58-67b-104, Utah Code Annotated 1953
39          58-67b-105, Utah Code Annotated 1953
40          58-67b-106, Utah Code Annotated 1953
41          58-67b-107, Utah Code Annotated 1953
42          58-67b-108, Utah Code Annotated 1953
43          58-67b-109, Utah Code Annotated 1953
44          58-67b-110, Utah Code Annotated 1953
45          58-67b-111, Utah Code Annotated 1953
46          58-67b-112, Utah Code Annotated 1953
47          58-67b-113, Utah Code Annotated 1953
48          58-67b-114, Utah Code Annotated 1953
49          58-67b-115, Utah Code Annotated 1953
50          58-67b-116, Utah Code Annotated 1953
51          58-67b-117, Utah Code Annotated 1953
52          58-67b-118, Utah Code Annotated 1953
53          58-67b-119, Utah Code Annotated 1953
54          58-67b-120, Utah Code Annotated 1953
55          58-67b-121, Utah Code Annotated 1953
56          58-67b-122, Utah Code Annotated 1953
57          58-67b-123, Utah Code Annotated 1953

58          58-67b-124, Utah Code Annotated 1953
59          58-67b-125, Utah Code Annotated 1953

61     Be it enacted by the Legislature of the state of Utah:
62          Section 1. Section 58-67b-101 is enacted to read:

64          58-67b-101. Title.
65          This chapter is known as the "Interstate Medical Licensure Compact."
66          Section 2. Section 58-67b-102 is enacted to read:
67          58-67b-102. Section 1 -- Purpose.
68          In order to strengthen access to health care, and in recognition of the advances in the
69     delivery of health care, the member states of the Interstate Medical Licensure Compact have
70     allied in common purpose to develop a comprehensive process that complements the existing
71     licensing and regulatory authority of state medical boards and provides a streamlined process
72     that allows physicians to become licensed in multiple states, thereby enhancing the portability
73     of a medical license and ensuring the safety of patients. The Compact creates another pathway
74     for licensure and does not otherwise change a state's existing medical practice act. The
75     Compact also adopts the prevailing standard for licensure and affirms that the practice of
76     medicine occurs where the patient is located at the time of the physician-patient encounter, and
77     therefore, requires the physician to be under the jurisdiction of the state medical board where
78     the patient is located. State medical boards that participate in the Compact retain the
79     jurisdiction to impose an adverse action against a license to practice medicine in that state
80     issued to a physician through the procedures in the Compact.
81          Section 3. Section 58-67b-103 is enacted to read:
82          58-67b-103. Section 2 -- Definitions.
83          In this compact:
84          (1) "Bylaws" means those bylaws established by the Interstate Commission pursuant to
85     Section 58-67b-112 for its governance, or for directing and controlling its actions and conduct.

86          (2) "Commissioner" means the voting representative appointed by each member board
87     pursuant to Section 58-67b-112.
88          (3) "Conviction" means a finding by a court that an individual is guilty of a criminal
89     offense through adjudication, or entry of a plea of guilt or no contest to the charge by the
90     offender. Evidence of an entry of a conviction of a criminal offense by the court shall be
91     considered final for purposes of disciplinary action by a member board.
92          (4) "Expedited license" means a full and unrestricted medical license granted by a
93     member state to an eligible physician through the process set forth in the Compact.
94          (5) "Interstate Commission" means the interstate commission created pursuant to
95     Section 58-67b-112.
96          (6) "License" means authorization by a state for a physician to engage in the practice of
97     medicine, which would be unlawful without the authorization.
98          (7) "Medical practice act" means laws and regulations governing the practice of
99     allopathic and osteopathic medicine within a member state.
100          (8) "Member board" means a state agency in a member state that acts in the sovereign
101     interests of the state by protecting the public through licensure, regulation, and education of
102     physicians as directed by the state government.
103          (9) "Member state" means a state that has enacted the Compact.
104          (10) "Offense" means a felony, gross misdemeanor, or crime of moral turpitude.
105          (11) "Physician" means any person who:
106          (a) is a graduate of a medical school accredited by the Liaison Committee on Medical
107     Education, the Commission on Osteopathic College Accreditation, or a medical school listed in
108     the International Medical Education Directory or its equivalent;
109          (b) passed each component of the United States Medical Licensing Examination
110     (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination
111     (COMLEX-USA) within three attempts, or any of its predecessor examinations accepted by a
112     state medical board as an equivalent examination for licensure purposes;
113          (c) successfully completed graduate medical education approved by the Accreditation

114     Council for Graduate Medical Education or the American Osteopathic Association;
115          (d) holds specialty certification or a time-unlimited specialty certificate recognized by
116     the American Board of Medical Specialties or the American Osteopathic Association's Bureau
117     of Osteopathic Specialists;
118          (e) possesses a full and unrestricted license to engage in the practice of medicine issued
119     by a member board;
120          (f) has never been convicted, received adjudication, deferred adjudication, community
121     supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;
122          (g) has never held a license authorizing the practice of medicine subjected to discipline
123     by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related
124     to non-payment of fees related to a license;
125          (h) has never had a controlled substance license or permit suspended or revoked by a
126     state or the United States Drug Enforcement Administration; and
127          (i) is not under active investigation by a licensing agency or law enforcement authority
128     in any state, federal, or foreign jurisdiction.
129          (12) "Practice of medicine" means the clinical prevention, diagnosis, or treatment of
130     human disease, injury, or condition requiring a physician to obtain and maintain a license in
131     compliance with the medical practice act of a member state.
132          (13) "Rule" means a written statement by the Interstate Commission promulgated
133     pursuant to Section 58-67b-113 that is of general applicability, implements, interprets, or
134     prescribes a policy or provision of the Compact, or an organizational, procedural, or practice
135     requirement of the Interstate Commission, and has the force and effect of statutory law in a
136     member state, and includes the amendment, repeal, or suspension of an existing rule.
137          (14) "State" means any state, commonwealth, district, or territory of the United States.
138          (15) "State of principal license" means a member state where a physician holds a
139     license to practice medicine and which has been designated as such by the physician for
140     purposes of registration and participation in the Compact.
141          Section 4. Section 58-67b-104 is enacted to read:

142          58-67b-104. Section 3 -- Eligibility.
143          (1) A physician must meet the eligibility requirements as defined in Subsection
144     58-67b-103(11) to receive an expedited license under the terms and provisions of the Compact.
145          (2) A physician who does not meet the requirements of Subsection 58-67b-103(11)
146     may obtain a license to practice medicine in a member state if the individual complies with all
147     laws and requirements, other than the Compact, relating to the issuance of a license to practice
148     medicine in that state.
149          Section 5. Section 58-67b-105 is enacted to read:
150          58-67b-105. Section 4 -- Designation of state of principal license.
151          (1) A physician shall designate a member state as the state of principal license for
152     purposes of registration for expedited licensure through the Compact if the physician possesses
153     a full and unrestricted license to practice medicine in that state, and the state is:
154          (a) the state of primary residence for the physician;
155          (b) the state where at least 25% of the practice of medicine occurs;
156          (c) the location of the physician's employer; or
157          (d) if no state qualifies under Subsection (1)(a), Subsection (1)(b), or Subsection (1)(c),
158     the state designated as state of residence for purpose of federal income tax.
159          (2) A physician may redesignate a member state as state of principal license at any
160     time, as long as the state meets the requirements in Subsection (1).
161          (3) The Interstate Commission is authorized to develop rules to facilitate redesignation
162     of another member state as the state of principal license.
163          Section 6. Section 58-67b-106 is enacted to read:
164          58-67b-106. Section 5 -- Application and issuance of expedited licensure.
165          (1) A physician seeking licensure through the Compact shall file an application for an
166     expedited license with the member board of the state selected by the physician as the state of
167     principal license.
168          (2) Upon receipt of an application for an expedited license, the member board within
169     the state selected as the state of principal license shall evaluate whether the physician is eligible

170     for expedited licensure and issue a letter of qualification, verifying or denying the physician's
171     eligibility, to the Interstate Commission, including:
172          (a) static qualifications, which include verification of medical education, graduate
173     medical education, results of any medical or licensing examination, and other qualifications as
174     determined by the Interstate Commission through rule, shall not be subject to additional
175     primary source verification where the primary source has already been verified by the state of
176     principal license;
177          (b) (i) the member board within the state selected as the state of principal license shall,
178     in the course of verifying eligibility, perform a criminal background check of an applicant,
179     including the use of the results of fingerprint or other biometric data checks compliant with the
180     requirements of the Federal Bureau of Investigation, with the exception of federal employees
181     who have suitability determination in accordance with U.S. C.F.R. Sec. 731.202; and
182          (ii) if the state selected as the state of principal license is Utah:
183          (A) the member board in Utah shall submit the applicant's fingerprints and any other
184     personal identification information necessary for the performance of the background check to
185     the Bureau of Criminal Identification within the Utah Department of Public Safety; and
186          (B) the Bureau of Criminal Identification shall perform the background check,
187     including submitting the personal identification information to the Federal Bureau of
188     Investigation, and inform the member board of the results; and
189          (c) appeal on the determination of eligibility shall be made to the member state where
190     the application was filed and shall be subject to the law of that state.
191          (3) Upon verification in Subsection (2), physicians eligible for an expedited license
192     shall complete the registration process established by the Interstate Commission to receive a
193     license in a member state selected pursuant to Subsection (1), including the payment of any
194     applicable fees.
195          (4) After receiving verification of eligibility under Subsection (2) and any fees under
196     Subsection (3), a member board shall issue an expedited license to the physician. This license
197     shall authorize the physician to practice medicine in the issuing state consistent with the

198     medical practice act and all applicable laws and regulations of the issuing member board and
199     member state.
200          (5) An expedited license shall be valid for a period consistent with the licensure period
201     in the member state and in the same manner as required for other physicians holding a full and
202     unrestricted license within the member state.
203          (6) An expedited license obtained though the Compact shall be terminated if a
204     physician fails to maintain a license in the state of principal licensure for a non-disciplinary
205     reason, without redesignation of a new state of principal licensure.
206          (7) The Interstate Commission is authorized to develop rules regarding the application
207     process, including payment of any applicable fees, and the issuance of an expedited license.
208          Section 7. Section 58-67b-107 is enacted to read:
209          58-67b-107. Section 6 -- Fees for expedited licensure.
210          (1) A member state issuing an expedited license authorizing the practice of medicine in
211     that state may impose a fee for a license issued or renewed through the Compact.
212          (2) The Interstate Commission is authorized to develop rules regarding fees for
213     expedited licenses.
214          Section 8. Section 58-67b-108 is enacted to read:
215          58-67b-108. Section 7 -- Renewal and continued participation.
216          (1) A physician seeking to renew an expedited license granted in a member state shall
217     complete a renewal process with the Interstate Commission if the physician:
218          (a) maintains a full and unrestricted license in a state of principal license;
219          (b) has not been convicted or received adjudication, deferred adjudication, community
220     supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;
221          (c) has not had a license authorizing the practice of medicine subject to discipline by a
222     licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to
223     non-payment of fees related to a license; and
224          (d) has not had a controlled substance license or permit suspended or revoked by a
225     state or the United States Drug Enforcement Administration.

226          (2) Physicians shall comply with all continuing professional development or continuing
227     medical education requirements for renewal of a license issued by a member state.
228          (3) The Interstate Commission shall collect any renewal fees charged for the renewal of
229     a license and distribute the fees to the applicable member board.
230          (4) Upon receipt of any renewal fees collected in Subsection (3), a member board shall
231     renew the physician's license.
232          (5) Physician information collected by the Interstate Commission during the renewal
233     process will be distributed to all member boards.
234          (6) The Interstate Commission is authorized to develop rules to address renewal of
235     licenses obtained through the Compact.
236          Section 9. Section 58-67b-109 is enacted to read:
237          58-67b-109. Section 8 -- Coordinated information system.
238          (1) The Interstate Commission shall establish a database of all physicians licensed, or
239     who have applied for licensure, under Section 58-67b-106.
240          (2) Notwithstanding any other provision of law, member boards shall report to the
241     Interstate Commission any public action or complaints against a licensed physician who has
242     applied or received an expedited license through the Compact.
243          (3) Member boards shall report disciplinary or investigatory information determined as
244     necessary and proper by rule of the Interstate Commission.
245          (4) Member boards may report any non-public complaint, disciplinary, or investigatory
246     information not required by Subsection (3) to the Interstate Commission.
247          (5) Member boards shall share complaint or disciplinary information about a physician
248     upon request of another member board.
249          (6) All information provided to the Interstate Commission or distributed by member
250     boards shall be confidential, filed under seal, and used only for investigatory or disciplinary
251     matters.
252          (7) The Interstate Commission is authorized to develop rules for mandated or
253     discretionary sharing of information by member boards.

254          Section 10. Section 58-67b-110 is enacted to read:
255          58-67b-110. Section 9 -- Joint investigations.
256          (1) Licensure and disciplinary records of physicians are deemed investigative.
257          (2) In addition to the authority granted to a member board by its respective medical
258     practice act or other applicable state law, a member board may participate with other member
259     boards in joint investigations of physicians licensed by the member boards.
260          (3) A subpoena issued by a member state shall be enforceable in other member states.
261          (4) Member boards may share any investigative, litigation, or compliance materials in
262     furtherance of any joint or individual investigation initiated under the Compact.
263          (5) Any member state may investigate actual or alleged violations of the statutes
264     authorizing the practice of medicine in any other member state in which a physician holds a
265     license to practice medicine.
266          Section 11. Section 58-67b-111 is enacted to read:
267          58-67b-111. Section 10 -- Disciplinary actions.
268          (1) Any disciplinary action taken by any member board against a physician licensed
269     through the Compact shall be deemed unprofessional conduct which may be subject to
270     discipline by other member boards, in addition to any violation of the medical practice act or
271     regulations in that state.
272          (2) If a license granted to a physician by the member board in the state of principal
273     license is revoked, surrendered or relinquished in lieu of discipline, or suspended, then all
274     licenses issued to the physician by member boards shall automatically be placed, without
275     further action necessary by any member board, on the same status. If the member board in the
276     state of principal license subsequently reinstates the physician's license, a license issued to the
277     physician by any other member board shall remain encumbered until that respective member
278     board takes action to reinstate the license in a manner consistent with the medical practice act
279     of that state.
280          (3) If disciplinary action is taken against a physician by a member board not in the state
281     of principal license, any other member board may deem the action conclusive as to matter of

282     law and fact decided, and:
283          (a) impose the same or lesser sanctions against the physician so long as such sanctions
284     are consistent with the medical practice act of that state; or
285          (b) pursue separate disciplinary action against the physician under its respective
286     medical practice act, regardless of the action taken in other member states.
287          (4) If a license granted to a physician by a member board is revoked, surrendered or
288     relinquished in lieu of discipline, or suspended, then any licenses issued to the physician by any
289     other member boards shall be suspended, automatically and immediately without further action
290     necessary by the other member boards, for 90 days upon entry of the order by the disciplining
291     board, to permit the member boards to investigate the basis for the action under the medical
292     practice act of that state. A member board may terminate the automatic suspension of the
293     license it issued prior to the completion of the 90-day suspension period in a manner consistent
294     with the medical practice act of that state.
295          Section 12. Section 58-67b-112 is enacted to read:
296          58-67b-112. Section 11 -- Interstate Medical Licensure Compact Commission.
297          (1) The member states hereby create the "Interstate Medical Licensure Compact
298     Commission."
299          (2) The purpose of the Interstate Commission is the administration of the Interstate
300     Medical Licensure Compact, which is a discretionary state function.
301          (3) The Interstate Commission shall be a body corporate and joint agency of the
302     member states and shall have all the responsibilities, powers, and duties set forth in the
303     Compact, and such additional powers as may be conferred upon it by a subsequent concurrent
304     action of the respective legislatures of the member states in accordance with the terms of the
305     Compact.
306          (4) The Interstate Commission shall consist of two voting representatives appointed by
307     each member state who shall serve as commissioners. In states where allopathic and
308     osteopathic physicians are regulated by separate member boards, or if the licensing and
309     disciplinary authority is split between multiple member boards within a member state, the

310     member state shall appoint one representative from each member board. A commissioner shall
311     be:
312          (a) an allopathic or osteopathic physician appointed to a member board;
313          (b) an executive director, executive secretary, or similar executive of a member board;
314     or
315          (c) a member of the public appointed to a member board.
316          (5) The Interstate Commission shall meet at least once each calendar year. A portion
317     of this meeting shall be a business meeting to address such matters as may properly come
318     before the commission, including the election of officers. The chairperson may call additional
319     meetings and shall call for a meeting upon the request of a majority of the member states.
320          (6) The bylaws may provide for meetings of the Interstate Commission to be conducted
321     by telecommunication or electronic communication.
322          (7) Each commissioner participating at a meeting of the Interstate Commission is
323     entitled to one vote. A majority of commissioners shall constitute a quorum for the transaction
324     of business, unless a larger quorum is required by the bylaws of the Interstate Commission. A
325     commissioner shall not delegate a vote to another commissioner. In the absence of its
326     commissioner, a member state may delegate voting authority for a specified meeting to another
327     person from that state who shall meet the requirements of Subsection (4).
328          (8) The Interstate Commission shall provide public notice of all meetings and all
329     meetings shall be open to the public. The Interstate Commission may close a meeting, in full
330     or in portion, where it determines by a two-thirds vote of the commissioners present that an
331     open meeting would be likely to:
332          (a) relate solely to the internal personnel practices and procedures of the Interstate
333     Commission;
334          (b) discuss matters specifically exempted from disclosure by federal statute;
335          (c) discuss trade secrets, commercial, or financial information that is privileged or
336     confidential;
337          (d) involve accusing a person of a crime, or formally censuring a person;

338          (e) discuss information of a personal nature where disclosure would constitute a clearly
339     unwarranted invasion of personal privacy;
340          (f) discuss investigative records compiled for law enforcement purposes; or
341          (g) specifically relate to the participation in a civil action or other legal proceeding.
342          (9) The Interstate Commission shall keep minutes which shall fully describe all matters
343     discussed in a meeting and shall provide a full and accurate summary of actions taken,
344     including record of any roll call votes.
345          (10) The Interstate Commission shall make its information and official records, to the
346     extent not otherwise designated in the Compact or by its rules, available to the public for
347     inspection.
348          (11) The Interstate Commission shall establish an executive committee, which shall
349     include officers, members, and others as determined by the bylaws. The executive committee
350     shall have the power to act on behalf of the Interstate Commission, with the exception of
351     rulemaking, during periods when the Interstate Commission is not in session. When acting on
352     behalf of the Interstate Commission, the executive committee shall oversee the administration
353     of the Compact including enforcement and compliance with the provisions of the Compact, its
354     bylaws and rules, and other such duties as necessary.
355          (12) The Interstate Commission may establish other committees for governance and
356     administration of the Compact.
357          Section 13. Section 58-67b-113 is enacted to read:
358          58-67b-113. Section 12 -- Powers and duties of the Interstate Commission.
359          The Interstate Commission shall have the duty and power to:
360          (1) oversee and maintain the administration of the Compact;
361          (2) promulgate rules which shall be binding to the extent and in the manner provided
362     for in the Compact;
363          (3) issue, upon the request of a member state or member board, advisory opinions
364     concerning the meaning or interpretation of the Compact, its bylaws, rules, and actions;
365          (4) enforce compliance with Compact provisions, the rules promulgated by the

366     Interstate Commission, and the bylaws, using all necessary and proper means, including but not
367     limited to the use of judicial process;
368          (5) establish and appoint committees including, but not limited to, an executive
369     committee as required by Section 58-67b-112, which shall have the power to act on behalf of
370     the Interstate Commission in carrying out its powers and duties;
371          (6) pay, or provide for the payment of the expenses related to the establishment,
372     organization, and ongoing activities of the Interstate Commission;
373          (7) establish and maintain one or more offices;
374          (8) borrow, accept, hire, or contract for services of personnel;
375          (9) purchase and maintain insurance and bonds;
376          (10) employ an executive director who shall have the power to employ, select, or
377     appoint employees, agents, or consultants, and to determine their qualifications, define their
378     duties, and fix their compensation;
379          (11) establish personnel policies and programs relating to conflicts of interest, rates of
380     compensation, and qualifications of personnel;
381          (12) accept donations and grants of money, equipment, supplies, materials, and
382     services, and to receive, utilize, and dispose of it in a manner consistent with the conflict of
383     interest policies established by the Interstate Commission;
384          (13) lease, purchase, accept contributions or donations of, or otherwise own, hold,
385     improve, or use, any property, real, personal, or mixed;
386          (14) sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
387     any property, real, personal, or mixed;
388          (15) establish a budget and make expenditures;
389          (16) adopt a seal and bylaws governing the management and operation of the Interstate
390     Commission;
391          (17) report annually to the legislatures and governors of the member states concerning
392     the activities of the Interstate Commission during the preceding year, which shall include
393     reports of financial audits and any recommendations that may have been adopted by the

394     Interstate Commission;
395          (18) coordinate education, training, and public awareness regarding the Compact, its
396     implementation, and its operation;
397          (19) maintain records in accordance with the bylaws;
398          (20) seek and obtain trademarks, copyrights, and patents; and
399          (21) perform such functions as may be necessary or appropriate to achieve the purposes
400     of the Compact.
401          Section 14. Section 58-67b-114 is enacted to read:
402          58-67b-114. Section 13 -- Finance powers.
403          (1) The Interstate Commission may levy and collect an annual assessment from each
404     member state to cover the cost of the operations and activities of the Interstate Commission and
405     its staff. The total assessment must be sufficient to cover the annual budget approved each year
406     for which revenue is not provided by other sources. The aggregate annual assessment amount
407     shall be allocated upon a formula to be determined by the Interstate Commission, which shall
408     promulgate a rule binding upon all member states.
409          (2) The Interstate Commission shall not incur obligations of any kind prior to securing
410     the funds adequate to meet the same.
411          (3) The Interstate Commission shall not pledge the credit of any of the member states,
412     except by, and with the authority of, the member state.
413          (4) The Interstate Commission shall be subject to a yearly financial audit conducted by
414     a certified or licensed public accountant and the report of the audit shall be included in the
415     annual report of the Interstate Commission.
416          Section 15. Section 58-67b-115 is enacted to read:
417          58-67b-115. Section 14 -- Organization and operation of the Interstate
418     Commission.
419          (1) The Interstate Commission shall, by a majority of commissioners present and
420     voting, adopt bylaws to govern its conduct as may be necessary or appropriate to carry out the
421     purposes of the Compact within 12 months of the first Interstate Commission meeting.

422          (2) The Interstate Commission shall elect or appoint annually from among its
423     commissioners a chairperson, a vice-chairperson, and a treasurer, each of whom shall have
424     such authority and duties as may be specified in the bylaws. The chairperson, or in the
425     chairperson's absence or disability, the vice-chairperson, shall preside at all meetings of the
426     Interstate Commission.
427          (3) Officers selected in Subsection (2) shall serve without remuneration from the
428     Interstate Commission.
429          (4) (a) The officers and employees of the Interstate Commission shall be immune from
430     suit and liability, either personally or in their official capacity, for a claim for damage to or loss
431     of property or personal injury or other civil liability caused or arising out of, or relating to, an
432     actual or alleged act, error, or omission that occurred, or that such person had a reasonable
433     basis for believing occurred, within the scope of Interstate Commission employment, duties, or
434     responsibilities, provided that such person shall not be protected from suit or liability for
435     damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of
436     such person.
437          (b) The liability of the executive director and employees of the Interstate Commission
438     or representatives of the Interstate Commission, acting within the scope of such person's
439     employment or duties for acts, errors, or omissions occurring within such person's state, may
440     not exceed the limits of liability set forth under the constitution and laws of that state for state
441     officials, employees, and agents. The Interstate Commission is considered to be an
442     instrumentality of the states for the purposes of any such action. Nothing in this Subsection
443     (4)(b) shall be construed to protect such person from suit or liability for damage, loss, injury, or
444     liability caused by the intentional or willful and wanton misconduct of such person.
445          (c) The Interstate Commission shall defend the executive director, its employees, and
446     subject to the approval of the attorney general or other appropriate legal counsel of the member
447     state represented by an Interstate Commission representative, such Interstate Commission
448     representative in any civil action seeking to impose liability arising out of an actual or alleged
449     act, error, or omission that occurred within the scope of Interstate Commission employment,

450     duties or responsibilities, or that the defendant had a reasonable basis for believing occurred
451     within the scope of Interstate Commission employment, duties, or responsibilities, provided
452     that the actual or alleged act, error, or omission did not result from intentional or willful and
453     wanton misconduct on the part of such person.
454          (d) To the extent not covered by the state involved, the member state, or the Interstate
455     Commission, the representatives or employees of the Interstate Commission shall be held
456     harmless in the amount of a settlement or judgment, including attorney fees and costs, obtained
457     against such persons arising out of an actual or alleged act, error, or omission that occurred
458     within the scope of Interstate Commission employment, duties, or responsibilities, or that such
459     persons had a reasonable basis for believing occurred within the scope of Interstate
460     Commission employment, duties, or responsibilities, provided that the actual or alleged act,
461     error, or omission did not result from intentional or willful and wanton misconduct on the part
462     of such persons.
463          Section 16. Section 58-67b-116 is enacted to read:
464          58-67b-116. Section 15 -- Rulemaking functions of the Interstate Commission.
465          (1) The Interstate Commission shall promulgate reasonable rules in order to effectively
466     and efficiently achieve the purposes of the Compact. Notwithstanding the foregoing, in the
467     event the Interstate Commission exercises its rulemaking authority in a manner that is beyond
468     the scope of the purposes of the Compact, or the powers granted hereunder, then such an action
469     by the Interstate Commission shall be invalid and have no force or effect.
470          (2) Rules deemed appropriate for the operations of the Interstate Commission shall be
471     made pursuant to a rulemaking process that substantially conforms to the "Revised Model State
472     Administrative Procedure Act" of 2010, and subsequent amendments thereto.
473          (3) Not later than 30 days after a rule is promulgated, any person may file a petition for
474     judicial review of the rule in the United States District Court for the District of Columbia or the
475     federal district where the Interstate Commission has its principal offices, provided that the
476     filing of such a petition shall not stay or otherwise prevent the rule from becoming effective
477     unless the court finds that the petitioner has a substantial likelihood of success. The court shall

478     give deference to the actions of the Interstate Commission consistent with applicable law and
479     shall not find the rule to be unlawful if the rule represents a reasonable exercise of the authority
480     granted to the Interstate Commission.
481          Section 17. Section 58-67b-117 is enacted to read:
482          58-67b-117. Section 16 -- Oversight of Interstate Compact.
483          (1) The executive, legislative, and judicial branches of state government in each
484     member state shall enforce the Compact and shall take all actions necessary and appropriate to
485     effectuate the Compact's purposes and intent. The provisions of the Compact and the rules
486     promulgated hereunder shall have standing as statutory law but shall not override existing state
487     authority to regulate the practice of medicine.
488          (2) All courts shall take judicial notice of the Compact and the rules in any judicial or
489     administrative proceeding in a member state pertaining to the subject matter of the Compact
490     which may affect the powers, responsibilities, or actions of the Interstate Commission.
491          (3) The Interstate Commission shall be entitled to receive all service of process in any
492     such proceeding, and shall have standing to intervene in the proceeding for all purposes.
493     Failure to provide service of process to the Interstate Commission shall render a judgment or
494     order void as to the Interstate Commission, the Compact, or promulgated rules.
495          Section 18. Section 58-67b-118 is enacted to read:
496          58-67b-118. Section 17 -- Enforcement of Interstate Compact.
497          (1) The Interstate Commission, in the reasonable exercise of its discretion, shall
498     enforce the provisions and rules of the Compact.
499          (2) The Interstate Commission may, by majority vote of the commissioners, initiate
500     legal action in the United States District Court for the District of Columbia, or, at the discretion
501     of the Interstate Commission, in the federal district where the Interstate Commission has its
502     principal offices, to enforce compliance with the provisions of the Compact, and its
503     promulgated rules and bylaws, against a member state in default. The relief sought may
504     include both injunctive relief and damages. In the event judicial enforcement is necessary, the
505     prevailing party shall be awarded all costs of such litigation including reasonable attorney fees.

506          (3) The remedies herein shall not be the exclusive remedies of the Interstate
507     Commission. The Interstate Commission may avail itself of any other remedies available
508     under state law or the regulation of a profession.
509          Section 19. Section 58-67b-119 is enacted to read:
510          58-67b-119. Section 18 -- Default procedures.
511          (1) The grounds for default include, but are not limited to, failure of a member state to
512     perform such obligations or responsibilities imposed upon it by the Compact, or the rules and
513     bylaws of the Interstate Commission promulgated under the Compact.
514          (2) If the Interstate Commission determines that a member state has defaulted in the
515     performance of its obligations or responsibilities under the Compact, or the bylaws or
516     promulgated rules, the Interstate Commission shall:
517          (a) provide written notice to the defaulting state and other member states, of the nature
518     of the default, the means of curing the default, and any action taken by the Interstate
519     Commission. The Interstate Commission shall specify the conditions by which the defaulting
520     state must cure its default; and
521          (b) provide remedial training and specific technical assistance regarding the default.
522          (3) If the defaulting state fails to cure the default, the defaulting state shall be
523     terminated from the Compact upon an affirmative vote of a majority of the commissioners and
524     all rights, privileges, and benefits conferred by the Compact shall terminate on the effective
525     date of termination. A cure of the default does not relieve the offending state of obligations or
526     liabilities incurred during the period of the default.
527          (4) Termination of membership in the Compact shall be imposed only after all other
528     means of securing compliance have been exhausted. Notice of intent to terminate shall be
529     given by the Interstate Commission to the governor, the majority and minority leaders of the
530     defaulting state's legislature, and each of the member states.
531          (5) The Interstate Commission shall establish rules and procedures to address licenses
532     and physicians that are materially impacted by the termination of a member state, or the
533     withdrawal of a member state.

534          (6) The member state which has been terminated is responsible for all dues,
535     obligations, and liabilities incurred through the effective date of termination including
536     obligations, the performance of which extends beyond the effective date of termination.
537          (7) The Interstate Commission shall not bear any costs relating to any state that has
538     been found to be in default or which has been terminated from the Compact, unless otherwise
539     mutually agreed upon in writing between the Interstate Commission and the defaulting state.
540          (8) The defaulting state may appeal the action of the Interstate Commission by
541     petitioning the United States District Court for the District of Columbia or the federal district
542     where the Interstate Commission has its principal offices. The prevailing party shall be
543     awarded all costs of such litigation including reasonable attorney fees.
544          Section 20. Section 58-67b-120 is enacted to read:
545          58-67b-120. Section 19 -- Dispute resolution.
546          (1) The Interstate Commission shall attempt, upon the request of a member state, to
547     resolve disputes which are subject to the Compact and which may arise among member states
548     or member boards.
549          (2) The Interstate Commission shall promulgate rules providing for both mediation and
550     binding dispute resolution as appropriate.
551          Section 21. Section 58-67b-121 is enacted to read:
552          58-67b-121. Section 20 -- Member states, effective date and amendment.
553          (1) Any state is eligible to become a member state of the Compact.
554          (2) The Compact shall become effective and binding upon legislative enactment of the
555     Compact into law by no less than seven states. Thereafter, it shall become effective and
556     binding on a state upon enactment of the Compact into law by that state.
557          (3) The governors of non-member states, or their designees, shall be invited to
558     participate in the activities of the Interstate Commission on a non-voting basis prior to adoption
559     of the Compact by all states.
560          (4) The Interstate Commission may propose amendments to the Compact for
561     enactment by the member states. No amendment shall become effective and binding upon the

562     Interstate Commission and the member states unless and until it is enacted into law by
563     unanimous consent of the member states.
564          Section 22. Section 58-67b-122 is enacted to read:
565          58-67b-122. Section 21 -- Withdrawal.
566          (1) Once effective, the Compact shall continue in force and remain binding upon each
567     and every member state, provided that a member state may withdraw from the Compact by
568     specifically repealing the statute that enacted the Compact into law.
569          (2) Withdrawal from the Compact shall be by the enactment of a statute repealing the
570     same, but shall not take effect until one year after the effective date of such statute and until
571     written notice of the withdrawal has been given by the withdrawing state to the governor of
572     each other member state.
573          (3) The withdrawing state shall immediately notify the chairperson of the Interstate
574     Commission in writing upon the introduction of legislation repealing the Compact in the
575     withdrawing state.
576          (4) The Interstate Commission shall notify the other member states of the withdrawing
577     state's intent to withdraw within 60 days of its receipt of notice provided under Subsection (3).
578          (5) The withdrawing state is responsible for all dues, obligations, and liabilities
579     incurred through the effective date of withdrawal, including obligations, the performance of
580     which extend beyond the effective date of withdrawal.
581          (6) Reinstatement following withdrawal of a member state shall occur upon the
582     withdrawing state reenacting the Compact or upon such later date as determined by the
583     Interstate Commission.
584          (7) The Interstate Commission is authorized to develop rules to address the impact of
585     the withdrawal of a member state on licenses granted in other member states to physicians who
586     designated the withdrawing member state as the state of principal license.
587          Section 23. Section 58-67b-123 is enacted to read:
588          58-67b-123. Section 22 -- Dissolution.
589          (1) The Compact shall dissolve effective upon the date of the withdrawal or default of

590     the member state that reduces the membership in the Compact to one member state.
591          (2) Upon the dissolution of the Compact, the Compact becomes null and void and shall
592     be of no further force or effect, and the business and affairs of the Interstate Commission shall
593     be concluded and surplus funds shall be distributed in accordance with the bylaws.
594          Section 24. Section 58-67b-124 is enacted to read:
595          58-67b-124. Section 23 -- Severability and construction.
596          (1) The provisions of the Compact shall be severable, and if any phrase, clause,
597     sentence, or provision is deemed unenforceable, the remaining provisions of the Compact shall
598     be enforceable.
599          (2) The provisions of the Compact shall be liberally construed to effectuate its
600     purposes.
601          (3) Nothing in the Compact shall be construed to prohibit the applicability of other
602     interstate compacts to which the states are members.
603          Section 25. Section 58-67b-125 is enacted to read:
604          58-67b-125. Section 24 -- Binding effect of Compact and other laws.
605          (1) Nothing herein prevents the enforcement of any other law of a member state that is
606     not inconsistent with the Compact.
607          (2) All laws in a member state, including Title 63G, Chapter 4, Administrative
608     Procedures Act, in conflict with the Compact are superseded to the extent of the conflict.
609          (3) All lawful actions of the Interstate Commission, including all rules and bylaws
610     promulgated by the Commission, are binding upon the member states.
611          (4) All agreements between the Interstate Commission and the member states are
612     binding in accordance with their terms.
613          (5) In the event any provision of the Compact exceeds the constitutional limits imposed
614     on the legislature of any member state, such provision shall be ineffective to the extent of the
615     conflict with the constitutional provision in question in that member state.