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  H.B. No. 1616
 
 
 
 
AN ACT
  relating to the Interstate Medical Licensure Compact; authorizing
  fees.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle B, Title 3, Occupations Code, is
  amended by adding Chapter 171 to read as follows:
  CHAPTER 171. INTERSTATE MEDICAL LICENSURE COMPACT
         Sec. 171.001.  PURPOSE. In order to strengthen access to
  health care, and in recognition of the advances in the delivery of
  health care, the member states of the Interstate Medical Licensure
  Compact have allied in common purpose to develop a comprehensive
  process that complements the existing licensing and regulatory
  authority of state medical boards and provides a streamlined
  process that allows physicians to become licensed in multiple
  states, thereby enhancing the portability of a medical license and
  ensuring the safety of patients. The compact creates another
  pathway for licensure and does not otherwise change a state's
  existing medical practice act. The compact also adopts the
  prevailing standard for licensure and affirms that the practice of
  medicine occurs where the patient is located at the time of the
  physician-patient encounter, and therefore, requires the physician
  to be under the jurisdiction of the state medical board where the
  patient is located. State medical boards that participate in the
  compact retain the jurisdiction to impose an adverse action against
  a license to practice medicine in that state issued to a physician
  through the procedures in the compact.
         Sec. 171.002.  DEFINITIONS. In this chapter:
               (1)  "Bylaws" means those bylaws established by the
  interstate commission pursuant to Section 171.011 for its
  governance, or for directing and controlling its actions and
  conduct.
               (2)  "Commissioner" means the voting representative
  appointed by each member board pursuant to Section 171.011.
               (3)  "Conviction" means a finding by a court that an
  individual is guilty of a criminal offense through adjudication, or
  entry of a plea of guilt or no contest to the charge by the offender.
  Evidence of an entry of a conviction of a criminal offense by the
  court shall be considered final for purposes of disciplinary action
  by a member board.
               (4)  "Expedited license" means a full and unrestricted
  medical license granted by a member state to an eligible physician
  through the process set forth in the compact.
               (5)  "Interstate commission" means the interstate
  commission created pursuant to Section 171.011.
               (6)  "License" means authorization by a state for a
  physician to engage in the practice of medicine, which would be
  unlawful without the authorization.
               (7)  "Medical practice act" means laws and regulations
  governing the practice of allopathic and osteopathic medicine
  within a member state.
               (8)  "Member board" means a state agency in a member
  state that acts in the sovereign interests of the state by
  protecting the public through licensure, regulation, and education
  of physicians as directed by the state government.
               (9)  "Member state" means a state that has enacted the
  compact.
               (10)  "Offense" means a felony, gross misdemeanor, or
  crime of moral turpitude.
               (11)  "Physician" means any person who:
                     (A)  is a graduate of a medical school accredited
  by the Liaison Committee on Medical Education, the Commission on
  Osteopathic College Accreditation, or a medical school listed in
  the International Medical Education Directory or its equivalent;
                     (B)  passed each component of the United States
  Medical Licensing Examination (USMLE) or the Comprehensive
  Osteopathic Medical Licensing Examination (COMLEX-USA) within
  three attempts, or any of its predecessor examinations accepted by
  a state medical board as an equivalent examination for licensure
  purposes;
                     (C)  successfully completed graduate medical
  education approved by the Accreditation Council for Graduate
  Medical Education or the American Osteopathic Association;
                     (D)  holds specialty certification or a
  time-unlimited specialty certificate recognized by the American
  Board of Medical Specialties or the American Osteopathic
  Association's Bureau of Osteopathic Specialists;
                     (E)  possesses a full and unrestricted license to
  engage in the practice of medicine issued by a member board;
                     (F)  has never been convicted or received
  adjudication, deferred adjudication, community supervision, or
  deferred disposition for any offense by a court of appropriate
  jurisdiction;
                     (G)  has never held a license authorizing the
  practice of medicine subjected to discipline by a licensing agency
  in any state, federal, or foreign jurisdiction, excluding any
  action related to nonpayment of fees related to a license;
                     (H)  has never had a controlled substance license
  or permit suspended or revoked by a state or the United States Drug
  Enforcement Administration; and
                     (I)  is not under active investigation by a
  licensing agency or law enforcement authority in any state,
  federal, or foreign jurisdiction.
               (12)  "Practice of medicine" means the clinical
  prevention, diagnosis, or treatment of human disease, injury, or
  condition requiring a physician to obtain and maintain a license in
  compliance with the medical practice act of a member state.
               (13)  "Rule" means a written statement by the
  interstate commission promulgated pursuant to Section 171.012 that
  is of general applicability, implements, interprets, or prescribes
  a policy or provision of the compact, or an organizational,
  procedural, or practice requirement of the interstate commission,
  and has the force and effect of statutory law in a member state, and
  includes the amendment, repeal, or suspension of an existing rule.
               (14)  "State" means any state, commonwealth, district,
  or territory of the United States.
               (15)  "State of principal license" means a member state
  where a physician holds a license to practice medicine and that has
  been designated as such by the physician for purposes of
  registration and participation in the compact.
         Sec. 171.003.  ELIGIBILITY. (a) A physician must meet the
  eligibility requirements as defined in Section 171.002(11) to
  receive an expedited license under the terms and provisions of the
  compact.
         (b)  A physician who does not meet the requirements of
  Section 171.002(11) may obtain a license to practice medicine in a
  member state if the individual complies with all laws and
  requirements, other than the compact, relating to the issuance of a
  license to practice medicine in that state.
         Sec. 171.004.  DESIGNATION OF STATE OF PRINCIPAL LICENSE.
  (a) A physician shall designate a member state as the state of
  principal license for purposes of registration for expedited
  licensure through the compact if the physician possesses a full and
  unrestricted license to practice medicine in that state, and the
  state is:
               (1)  the state of primary residence for the physician;
               (2)  the state where at least 25 percent of the practice
  of medicine occurs;
               (3)  the location of the physician's employer; or
               (4)  if no state qualifies under Subdivision (1), (2),
  or (3), the state designated as state of residence for purpose of
  federal income tax.
         (b)  A physician may redesignate a member state as state of
  principal license at any time, as long as the state meets the
  requirements in Subsection (a).
         (c)  The interstate commission is authorized to develop
  rules to facilitate redesignation of another member state as the
  state of principal license.
         Sec. 171.005.  APPLICATION AND ISSUANCE OF EXPEDITED
  LICENSURE. (a) A physician seeking licensure through the compact
  shall file an application for an expedited license with the member
  board of the state selected by the physician as the state of
  principal license.
         (b)  Upon receipt of an application for an expedited license,
  the member board within the state selected as the state of principal
  license shall evaluate whether the physician is eligible for
  expedited licensure and issue a letter of qualification, verifying
  or denying the physician's eligibility, to the interstate
  commission. 
               (1)  Static qualifications, which include verification
  of medical education, graduate medical education, results of any
  medical or licensing examination, and other qualifications as
  determined by the interstate commission through rule, shall not be
  subject to additional primary source verification where already
  primary source verified by the state of principal license.
               (2)  The member board within the state selected as the
  state of principal license shall, in the course of verifying
  eligibility, perform a criminal background check of an applicant,
  including the use of the results of fingerprint or other biometric
  data checks compliant with the requirements of the Federal Bureau
  of Investigation, with the exception of federal employees who have
  suitability determination in accordance with 5 C.F.R. Section
  731.202.
               (3)  Appeal on the determination of eligibility shall
  be made to the member state where the application was filed and
  shall be subject to the law of that state.
         (c)  Upon verification in Subsection (b), physicians
  eligible for an expedited license shall complete the registration
  process established by the interstate commission to receive a
  license in a member state selected pursuant to Subsection (a),
  including the payment of any applicable fees.
         (d)  After receiving verification of eligibility under
  Subsection (b) and any fees under Subsection (c), a member board
  shall issue an expedited license to the physician. This license
  shall authorize the physician to practice medicine in the issuing
  state consistent with the medical practice act and all applicable
  laws and regulations of the issuing member board and member state.
         (e)  An expedited license shall be valid for a period
  consistent with the licensure period in the member state and in the
  same manner as required for other physicians holding a full and
  unrestricted license within the member state.
         (f)  An expedited license obtained through the compact shall
  be terminated if a physician fails to maintain a license in the
  state of principal licensure for a nondisciplinary reason, without
  redesignation of a new state of principal licensure.
         (g)  The interstate commission is authorized to develop
  rules regarding the application process, including payment of any
  applicable fees, and the issuance of an expedited license.
         Sec. 171.006.  FEES FOR EXPEDITED LICENSURE. (a) A member
  state issuing an expedited license authorizing the practice of
  medicine in that state may impose a fee for a license issued or
  renewed through the compact.
         (b)  The interstate commission is authorized to develop
  rules regarding fees for expedited licenses.
         Sec. 171.007.  RENEWAL AND CONTINUED PARTICIPATION. (a) A
  physician seeking to renew an expedited license granted in a member
  state shall complete a renewal process with the interstate
  commission if the physician:
               (1)  maintains a full and unrestricted license in a
  state of principal license;
               (2)  has not been convicted or received adjudication,
  deferred adjudication, community supervision, or deferred
  disposition for any offense by a court of appropriate jurisdiction;
               (3)  has not had a license authorizing the practice of
  medicine subject to discipline by a licensing agency in any state,
  federal, or foreign jurisdiction, excluding any action related to
  nonpayment of fees related to a license; and
               (4)  has not had a controlled substance license or
  permit suspended or revoked by a state or the United States Drug
  Enforcement Administration. 
         (b)  Physicians shall comply with all continuing
  professional development or continuing medical education
  requirements for renewal of a license issued by a member state.
         (c)  The interstate commission shall collect any renewal
  fees charged for the renewal of a license and distribute the fees to
  the applicable member board.
         (d)  Upon receipt of any renewal fees collected in Subsection
  (c), a member board shall renew the physician's license.
         (e)  Physician information collected by the interstate
  commission during the renewal process will be distributed to all
  member boards.
         (f)  The interstate commission is authorized to develop
  rules to address renewal of licenses obtained through the compact.
         Sec. 171.008.  COORDINATED INFORMATION SYSTEM. (a) The
  interstate commission shall establish a database of all physicians
  licensed, or who have applied for licensure, under Section 171.005.
         (b)  Notwithstanding any other provision of law, member
  boards shall report to the interstate commission any public action
  or complaints against a licensed physician who has applied for or
  received an expedited license through the compact.
         (c)  Member boards shall report disciplinary or
  investigatory information determined as necessary and proper by
  rule of the interstate commission.
         (d)  Member boards may report any nonpublic complaint,
  disciplinary, or investigatory information not required by
  Subsection (c) to the interstate commission.
         (e)  Member boards shall share complaint or disciplinary
  information about a physician upon request of another member board.
         (f)  All information provided to the interstate commission
  or distributed by member boards shall be confidential, filed under
  seal, and used only for investigatory or disciplinary matters.
         (g)  The interstate commission is authorized to develop
  rules for mandated or discretionary sharing of information by
  member boards.
         Sec. 171.009.  JOINT INVESTIGATIONS. (a) Licensure and
  disciplinary records of physicians are considered investigative.
         (b)  In addition to the authority granted to a member board
  by its respective medical practice act or other applicable state
  law, a member board may participate with other member boards in
  joint investigations of physicians licensed by the member boards.
         (c)  A subpoena issued by a member state shall be enforceable
  in other member states.
         (d)  Member boards may share any investigative, litigation,
  or compliance materials in furtherance of any joint or individual
  investigation initiated under the compact.
         (e)  Any member state may investigate actual or alleged
  violations of the statutes authorizing the practice of medicine in
  any other member state in which a physician holds a license to
  practice medicine.
         Sec. 171.010.  DISCIPLINARY ACTIONS. (a) Any disciplinary
  action taken by any member board against a physician licensed
  through the compact shall be considered unprofessional conduct
  which may be subject to discipline by other member boards, in
  addition to any violation of the medical practice act or
  regulations in that state.
         (b)  If a license granted to a physician by the member board
  in the state of principal license is revoked, surrendered or
  relinquished in lieu of discipline, or suspended, then all licenses
  issued to the physician by member boards shall automatically be
  placed, without further action necessary by any member board, on
  the same status. If the member board in the state of principal
  license subsequently reinstates the physician's license, a license
  issued to the physician by any other member board shall remain
  encumbered until that respective member board takes action to
  reinstate the license in a manner consistent with the medical
  practice act of that state.
         (c)  If disciplinary action is taken against a physician by a
  member board not in the state of principal license, any other member
  board may consider the action conclusive as to matter of law and
  fact decided, and:
               (1)  impose the same or lesser sanction against the
  physician so long as such sanction is consistent with the medical
  practice act of that state; or
               (2)  pursue separate disciplinary action against the
  physician under its respective medical practice act, regardless of
  the action taken in other member states.
         (d)  If a license granted to a physician by a member board is
  revoked, surrendered or relinquished in lieu of discipline, or
  suspended, then any license issued to the physician by any other
  member board shall be suspended, automatically and immediately
  without further action necessary by the other member board, for 90
  days upon entry of the order by the disciplining board, to permit
  the member board to investigate the basis for the action under the
  medical practice act of that state. A member board may terminate
  the automatic suspension of the license it issued before the
  completion of the 90-day suspension period in a manner consistent
  with the medical practice act of that state.
         Sec. 171.011.  INTERSTATE MEDICAL LICENSURE COMPACT
  COMMISSION. (a) The member states hereby create the Interstate
  Medical Licensure Compact Commission.
         (b)  The purpose of the interstate commission is the
  administration of the Interstate Medical Licensure Compact, which
  is a discretionary state function.
         (c)  The interstate commission shall be a body corporate and
  joint agency of the member states and shall have all the
  responsibilities, powers, and duties set forth in the compact, and
  such additional powers as may be conferred upon it by a subsequent
  concurrent action of the respective legislatures of the member
  states in accordance with the terms of the compact.
         (d)  The interstate commission shall consist of two voting
  representatives appointed by each member state who shall serve as
  commissioners. In states where allopathic and osteopathic
  physicians are regulated by separate member boards, or if the
  licensing and disciplinary authority is split between separate
  member boards, or if the licensing and disciplinary authority is
  split between multiple member boards within a member state, the
  member state shall appoint one representative from each member
  board. A commissioner shall be: 
               (1)  an allopathic or osteopathic physician appointed
  to a member board;
               (2)  an executive director, executive secretary, or
  similar executive of a member board; or
               (3)  a member of the public appointed to a member board. 
         (e)  The interstate commission shall meet at least once each
  calendar year. A portion of this meeting shall be a business meeting
  to address such matters as may properly come before the commission,
  including the election of officers. The chairperson may call
  additional meetings and shall call for a meeting upon the request of
  a majority of the member states.
         (f)  The bylaws may provide for meetings of the interstate
  commission to be conducted by telecommunication or electronic
  communication.
         (g)  Each commissioner participating at a meeting of the
  interstate commission is entitled to one vote. A majority of
  commissioners shall constitute a quorum for the transaction of
  business, unless a larger quorum is required by the bylaws of the
  interstate commission. A commissioner shall not delegate a vote to
  another commissioner. In the absence of its commissioner, a member
  state may delegate voting authority for a specified meeting to
  another person from that state who shall meet the requirements of
  Subsection (d).
         (h)  The interstate commission shall provide public notice
  of all meetings and all meetings shall be open to the public. The
  interstate commission may close a meeting, in full or in portion,
  where it determines by a two-thirds vote of the commissioners
  present that an open meeting would be likely to:
               (1)  relate solely to the internal personnel practices
  and procedures of the interstate commission;
               (2)  discuss matters specifically exempted from
  disclosure by federal statute;
               (3)  discuss trade secrets or commercial or financial
  information that is privileged or confidential;
               (4)  involve accusing a person of a crime, or formally
  censuring a person;
               (5)  discuss information of a personal nature where
  disclosure would constitute a clearly unwarranted invasion of
  personal privacy;
               (6)  discuss investigative records compiled for law
  enforcement purposes; or 
               (7)  specifically relate to the participation in a
  civil action or other legal proceeding.
         (i)  The interstate commission shall keep minutes that shall
  fully describe all matters discussed in a meeting and shall provide
  a full and accurate summary of actions taken, including record of
  any roll call votes. 
         (j)  The interstate commission shall make its information
  and official records, to the extent not otherwise designated in the
  compact or by its rules, available to the public for inspection. 
         (k)  The interstate commission shall establish an executive
  committee, which shall include officers, members, and others as
  determined by the bylaws. The executive committee shall have the
  power to act on behalf of the interstate commission, with the
  exception of rulemaking, during periods when the interstate
  commission is not in session. When acting on behalf of the
  interstate commission, the executive committee shall oversee the
  administration of the compact, including enforcement and
  compliance with the provisions of the compact, its bylaws and
  rules, and other such duties as necessary. 
         (l)  The interstate commission may establish other
  committees for governance and administration of the compact.
         Sec. 171.012.  POWERS AND DUTIES OF INTERSTATE COMMISSION.
  The interstate commission shall have the duty and power to:
               (1)  oversee and maintain the administration of the
  compact;
               (2)  promulgate rules that shall be binding to the
  extent and in the manner provided for in the compact;
               (3)  issue, upon the request of a member state or member
  board, advisory opinions concerning the meaning or interpretation
  of the compact, its bylaws, rules, and actions;
               (4)  enforce compliance with compact provisions, the
  rules promulgated by the interstate commission, and the bylaws,
  using all necessary and proper means, including, but not limited
  to, the use of judicial process; 
               (5)  establish and appoint committees, including, but
  not limited to, an executive committee as required by Section
  171.011, which shall have the power to act on behalf of the
  interstate commission in carrying out its powers and duties;
               (6)  pay or provide for the payment of the expenses
  related to the establishment, organization, and ongoing activities
  of the interstate commission;
               (7)  establish and maintain one or more offices;
               (8)  borrow, accept, hire, or contract for services of
  personnel;
               (9)  purchase and maintain insurance and bonds;
               (10)  employ an executive director who shall have such
  powers to employ, select, or appoint employees, agents, or
  consultants, and to determine their qualifications, define their
  duties, and fix their compensation;
               (11)  establish personnel policies and programs
  relating to conflicts of interest, rates of compensation, and
  qualifications of personnel;
               (12) accept donations and grants of money, equipment,
  supplies, materials and services, and receive, utilize, and dispose
  of them in a manner consistent with the conflict-of-interest
  policies established by the interstate commission;
               (13)  lease, purchase, accept contributions or
  donations of, or otherwise own, hold, improve or use, any property,
  real, personal, or mixed;
               (14)  sell, convey, mortgage, pledge, lease, exchange,
  abandon, or otherwise dispose of any property, real, personal, or
  mixed;
               (15)  establish a budget and make expenditures;
               (16)  adopt a seal and bylaws governing the management
  and operation of the interstate commission;
               (17)  report annually to the legislatures and governors
  of the member states concerning the activities of the interstate
  commission during the preceding year, including reports of
  financial audits and any recommendations that may have been adopted
  by the interstate commission;
               (18)  coordinate education, training, and public
  awareness regarding the compact, its implementation, and its
  operation;
               (19)  maintain records in accordance with the bylaws; 
               (20)  seek and obtain trademarks, copyrights, and
  patents; and
               (21)  perform such functions as may be necessary or
  appropriate to achieve the purposes of the compact.
         Sec. 171.013.  FINANCE POWERS. (a) The interstate
  commission may levy on and collect an annual assessment from each
  member state to cover the cost of the operations and activities of
  the interstate commission and its staff. The total assessment must
  be sufficient to cover the annual budget approved each year for
  which revenue is not provided by other sources. The aggregate
  annual assessment amount shall be allocated based on a formula to be
  determined by the interstate commission, which shall promulgate a
  rule binding upon all member states.
         (b)  The interstate commission shall not incur obligations
  of any kind before securing the funds adequate to meet the same.
         (c)  The interstate commission shall not pledge the credit of
  any of the member states, except by, and with the authority of, the
  member state.
         (d)  The interstate commission shall be subject to a yearly
  financial audit conducted by a certified or licensed public
  accountant and the report of the audit shall be included in the
  annual report of the interstate commission.
         Sec. 171.014.  ORGANIZATION AND OPERATION OF INTERSTATE
  COMMISSION. (a) The interstate commission shall, by a majority of
  commissioners present and voting, adopt bylaws to govern its
  conduct as may be necessary or appropriate to carry out the purposes
  of the compact within 12 months of the first interstate commission
  meeting.
         (b)  The interstate commission shall elect or appoint
  annually from among its commissioners a chairperson, a vice
  chairperson, and a treasurer, each of whom shall have such
  authority and duties as may be specified in the bylaws. The
  chairperson, or in the chairperson's absence or disability, the
  vice chairperson, shall preside at all meetings of the interstate
  commission.
         (c)  Officers selected in Subsection (b) shall serve without
  remuneration from the interstate commission.
         (d)  The officers and employees of the interstate commission
  shall be immune from suit and liability, either personally or in
  their official capacity, for a claim for damage to or loss of
  property or personal injury or other civil liability caused or
  arising out of, or relating to, an actual or alleged act, error, or
  omission that occurred, or that such person had a reasonable basis
  for believing occurred, within the scope of interstate commission
  employment, duties, or responsibilities.  However, such person
  shall not be protected from suit or liability for damage, loss,
  injury, or liability caused by the intentional or wilful and wanton
  misconduct of such person.
         (e)  The liability of the executive director and employees of
  the interstate commission or representatives of the interstate
  commission, acting within the scope of such persons' employment or
  duties for acts, errors, or omissions occurring within such
  persons' state, may not exceed the limits of liability set forth
  under the constitution and laws of that state for state officials,
  employees, and agents. The interstate commission is considered to
  be an instrumentality of the states for the purposes of any such
  action. Nothing in this subsection shall be construed to protect
  such persons from suit or liability for damage, loss, injury, or
  liability caused by the intentional or wilful and wanton misconduct
  of such persons.
         (f)  The interstate commission shall defend the executive
  director and its employees, and subject to the approval of the
  attorney general or other appropriate legal counsel of the member
  state represented by an interstate commission representative,
  shall defend such interstate commission representative in any civil
  action seeking to impose liability arising out of an actual or
  alleged act, error, or omission that occurred within the scope of
  interstate commission employment, duties, or responsibilities, or
  that the defendant had a reasonable basis for believing occurred
  within the scope of interstate commission employment, duties, or
  responsibilities, provided that the actual or alleged act, error,
  or omission did not result from intentional or wilful and wanton
  misconduct on the part of such person.
         (g)  To the extent not covered by the state involved, the
  member state, or the interstate commission, the representatives or
  employees of the interstate commission shall be held harmless in
  the amount of a settlement or judgment, including attorney's fees
  and costs, obtained against such persons arising out of an actual or
  alleged act, error, or omission that occurred within the scope of
  interstate commission employment, duties, or responsibilities, or
  that such persons had a reasonable basis for believing occurred
  within the scope of interstate commission employment, duties, or
  responsibilities, provided that the actual or alleged act, error,
  or omission did not result from intentional or wilful and wanton
  misconduct on the part of such persons.
         Sec. 171.015.  RULEMAKING FUNCTIONS OF INTERSTATE
  COMMISSION. (a) The interstate commission shall promulgate
  reasonable rules in order to effectively and efficiently achieve
  the purposes of the compact. Notwithstanding the foregoing, in the
  event the interstate commission exercises its rulemaking authority
  in a manner that is beyond the scope of the purposes of the compact,
  or the powers granted hereunder, then such an action by the
  interstate commission shall be invalid and have no force or effect.
         (b)  Rules considered appropriate for the operations of the
  interstate commission shall be made pursuant to a rulemaking
  process that substantially conforms to the Revised Model State
  Administrative Procedure Act of 2010, and subsequent amendments
  thereto.
         (c)  Not later than 30 days after a rule is promulgated, any
  person may file a petition for judicial review of the rule in the
  United States District Court for the District of Columbia or the
  federal district where the interstate commission has its principal
  offices, provided that the filing of such a petition shall not stay
  or otherwise prevent the rule from becoming effective unless the
  court finds that the petitioner has a substantial likelihood of
  success. The court shall give deference to the actions of the
  interstate commission consistent with applicable law and shall not
  find the rule to be unlawful if the rule represents a reasonable
  exercise of the authority granted to the interstate commission.
         Sec. 171.016.  OVERSIGHT OF INTERSTATE COMPACT. (a) The
  executive, legislative, and judicial branches of state government
  in each member state shall enforce the compact and shall take all
  actions necessary and appropriate to effectuate the compact's
  purposes and intent. The provisions of the compact and the rules
  promulgated hereunder shall have standing as statutory law but
  shall not override existing state authority to regulate the
  practice of medicine.
         (b)  All courts shall take judicial notice of the compact and
  the rules in any judicial or administrative proceeding in a member
  state pertaining to the subject matter of the compact that may
  affect the powers, responsibilities, or actions of the interstate
  commission.
         (c)  The interstate commission shall be entitled to receive
  all service of process in any such proceeding, and shall have
  standing to intervene in the proceeding for all purposes. Failure
  to provide service of process to the interstate commission shall
  render a judgment or order void as to the interstate commission, the
  compact, or promulgated rules.
         Sec. 171.017.  ENFORCEMENT OF INTERSTATE COMPACT. (a) The
  interstate commission, in the reasonable exercise of its
  discretion, shall enforce the provisions and rules of the compact.
         (b)  The interstate commission may, by majority vote of the
  commissioners, initiate legal action in the United States District
  Court for the District of Columbia, or, at the discretion of the
  interstate commission, in the federal district where the interstate
  commission has its principal offices, to enforce compliance with
  the provisions of the compact, and its promulgated rules and
  bylaws, against a member state in default. The relief sought may
  include both injunctive relief and damages. In the event judicial
  enforcement is necessary, the prevailing party shall be awarded all
  costs of such litigation including reasonable attorney's fees.
         (c)  The remedies herein shall not be the exclusive remedies
  of the interstate commission. The interstate commission may avail
  itself of any other remedies available under state law or the
  regulation of a profession.
         Sec. 171.018.  DEFAULT PROCEDURES. (a) The grounds for
  default include, but are not limited to, failure of a member state
  to perform such obligations or responsibilities imposed upon it by
  the compact, or the rules and bylaws of the interstate commission
  promulgated under the compact.
         (b)  If the interstate commission determines that a member
  state has defaulted in the performance of its obligations or
  responsibilities under the compact, or the bylaws or promulgated
  rules, the interstate commission shall provide:
               (1)  written notice to the defaulting state and other
  member states of the nature of the default, the means of curing the
  default, and any action taken by the interstate commission and in
  which the interstate commission specifies the conditions by which
  the defaulting state must cure its default; and
               (2)  remedial training and specific technical
  assistance regarding the default.
         (c)  If the defaulting state fails to cure the default, the
  defaulting state shall be terminated from the compact upon an
  affirmative vote of a majority of the commissioners and all rights,
  privileges, and benefits conferred by the compact shall terminate
  on the effective date of termination. A cure of the default does not
  relieve the offending state of obligations or liabilities incurred
  during the period of the default.
         (d)  Termination of membership in the compact shall be
  imposed only after all other means of securing compliance have been
  exhausted. Notice of intent to terminate shall be given by the
  interstate commission to the governor, the majority and minority
  leaders of the defaulting state's legislature, and each of the
  member states. 
         (e)  The interstate commission shall establish rules and
  procedures to address licenses and physicians that are materially
  impacted by the termination of a member state, or the withdrawal of
  a member state.
         (f)  The member state that has been terminated is responsible
  for all dues, obligations, and liabilities incurred through the
  effective date of termination, including obligations, the
  performance of which extends beyond the effective date of
  termination.
         (g)  The interstate commission shall not bear any costs
  relating to any state has been found to be in default or that has
  been terminated from the compact, unless otherwise mutually agreed
  upon in writing between the interstate commission and the
  defaulting state.
         (h)  The defaulting state may appeal the action of the
  interstate commission by petitioning the United States District
  Court for the District of Columbia or the federal district where the
  interstate commission has its principal offices. The prevailing
  party shall be awarded all costs of such litigation, including
  reasonable attorney's fees.
         Sec. 171.019.  DISPUTE RESOLUTION. (a) The interstate
  commission shall attempt, upon the request of a member state, to
  resolve disputes which are subject to the compact and that may arise
  among member states or member boards.
         (b)  The interstate commission shall promulgate rules
  providing for both mediation and binding dispute resolution as
  appropriate.
         Sec. 171.020.  MEMBER STATES, EFFECTIVE DATE AND AMENDMENT.
  (a) Any state is eligible to become a member state of the compact.
         (b)  The compact shall become effective and binding upon
  legislative enactment of the compact into law by no less than seven
  states. Thereafter, it shall become effective and binding on a
  state upon enactment of the compact into law by that state.
         (c)  The governors of nonmember states, or their designees,
  shall be invited to participate in the activities of the interstate
  commission on a nonvoting basis before adoption of the compact by
  all states.
         (d)  The interstate commission may propose amendments to the
  compact for enactment by the member states. No amendment shall
  become effective and binding upon the interstate commission and the
  member states unless and until it is enacted into law by unanimous
  consent of the member states.
         Sec. 171.021.  WITHDRAWAL. (a) Once effective, the compact
  shall continue in force and remain binding upon each and every
  member state.  A member state may withdraw from the compact by
  specifically repealing the statute that enacted the compact into
  law.
         (b)  Withdrawal from the compact shall be by the enactment of
  a statute repealing the same, but shall not take effect until one
  year after the effective date of such statute and until written
  notice of the withdrawal has been given by the withdrawing state to
  the governor of each other member state.
         (c)  The withdrawing state shall immediately notify the
  chairperson of the interstate commission in writing upon the
  introduction of legislation repealing the compact in the
  withdrawing state.
         (d)  The interstate commission shall notify the other member
  states of the withdrawing state's intent to withdraw within 60 days
  of its receipt of notice provided under Subsection (c).
         (e)  The withdrawing state is responsible for all dues,
  obligations, and liabilities incurred through the effective date of
  withdrawal, including obligations, the performance of which extend
  beyond the effective date of withdrawal.
         (f)  Reinstatement following withdrawal of a member state
  shall occur upon the withdrawing state reenacting the compact or
  upon such later date as determined by the interstate commission.
         (g)  The interstate commission is authorized to develop
  rules to address the impact of the withdrawal of a member state on
  licenses granted in other member states to physicians who
  designated the withdrawing member state as the state of principal
  license.
         Sec. 171.022.  DISSOLUTION. (a) The compact shall dissolve
  effective upon the date of the withdrawal or default of the member
  state that reduces the membership in the compact to one member
  state.
         (b)  Upon the dissolution of the compact, the compact becomes
  null and void and shall be of no further force or effect, and the
  business and affairs of the interstate commission shall be
  concluded and surplus funds shall be distributed in accordance with
  the bylaws.
         Sec. 171.023.  SEVERABILITY AND CONSTRUCTION. (a) The
  provisions of the compact shall be severable, and if any phrase,
  clause, sentence, or provision is considered unenforceable, the
  remaining provisions of the compact shall be enforceable.
         (b)  The provisions of the compact shall be liberally
  construed to effectuate its purposes.
         (c)  Nothing in the compact shall be construed to prohibit
  the applicability of other interstate compacts to which the states
  are members.
         Sec. 171.024.  BINDING EFFECT OF COMPACT AND OTHER LAWS. (a)
  Nothing herein prevents the enforcement of any other law of a member
  state that is not inconsistent with the compact.
         (b)  All laws in a member state in conflict with the compact
  are superseded to the extent of the conflict.
         (c)  All lawful actions of the interstate commission,
  including all rules and bylaws promulgated by the commission, are
  binding upon the member states.
         (d)  All agreements between the interstate commission and
  the member states are binding in accordance with their terms.
         (e)  In the event any provision of the compact exceeds the
  constitutional limits imposed on the legislature of any member
  state, such provision shall be ineffective to the extent of the
  conflict with the constitutional provision in question in that
  member state.
         SECTION 2.  This Act takes effect September 1, 2021.
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
 
         I certify that H.B. No. 1616 was passed by the House on April
  15, 2021, by the following vote:  Yeas 144, Nays 1, 1 present, not
  voting.
 
  ______________________________
  Chief Clerk of the House   
 
 
         I certify that H.B. No. 1616 was passed by the Senate on May
  21, 2021, by the following vote:  Yeas 30, Nays 1.
 
  ______________________________
  Secretary of the Senate    
  APPROVED:  _____________________
                     Date          
   
            _____________________
                   Governor