SB196: Bill Text

SB196,20 Section 20. 448.07 (2) of the statutes is amended to read:

SB196,8,13 448.07 (2) Fees. The Except as otherwise provided in s. 448.980, the fees for examination and licenses granted under this subchapter are specified in s. 440.05, and the renewal fee for such licenses is determined by the department under s. 440.03 (9) (a). Compact licenses shall be subject to additional fees and assessments, as established by the department, the board, or the interstate medical licensure compact commission, to cover any costs incurred by the department or the board for this state's participation in the interstate medical licensure compact under s. 448.980 and costs incurred by the interstate medical licensure compact commission for its administration of the renewal process for the interstate medical licensure compact under s. 448.980.

SB196,21 Section 21. Subchapter VIII of chapter 448 [precedes 448.980] of the statutes is created to read:

SB196,8,16 Chapter 448

SB196,8,17 Subchapter VIII

SB196,8,18 interstate medical licensure

SB196,8,19 compact

SB196,8,21 448.980 Interstate medical licensure compact. The following compact is hereby ratified and entered into:

SB196,9,11 (1) Section 1 — 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, 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.

SB196,9,12 (2) Section 2 — Definitions. In this compact:

SB196,9,15 (a) "Bylaws" means those bylaws established by the interstate commission pursuant to sub. (11) for its governance, or for directing and controlling its actions and conduct.

SB196,9,17 (b) "Commissioner" means the voting representative appointed by each member board pursuant to sub. (11).

SB196,9,22 (c) "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.

SB196,9,25 (d) "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.

SB196,10,2 (e) "Interstate commission" means the interstate commission created pursuant to sub. (11).

SB196,10,4 (f) "License" means authorization by a state for a physician to engage in the practice of medicine, which would be unlawful without the authorization.

SB196,10,6 (g) "Medical practice act" means laws and regulations governing the practice of allopathic and osteopathic medicine within a member state.

SB196,10,9 (h) "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.

SB196,10,10 (i) "Member state" means a state that has enacted the compact.

SB196,10,13 (j) "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.

SB196,10,14 (k) "Physician" means any person who:

SB196,10,18 1. 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;

SB196,10,22 2. Passed each component of the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within 3 attempts, or any of its predecessor examinations accepted by a state medical board as an equivalent examination for licensure purposes;

SB196,10,25 3. Successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association;

SB196,11,3 4. 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;

SB196,11,5 5. Possesses a full and unrestricted license to engage in the practice of medicine issued by a member board;

SB196,11,8 6. Has never been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;

SB196,11,11 7. 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 non-payment of fees related to a license;

SB196,11,13 8. Has never had a controlled substance license or permit suspended or revoked by a state or the united states drug enforcement administration; and

SB196,11,15 9. Is not under active investigation by a licensing agency or law enforcement authority in any state, federal, or foreign jurisdiction.

SB196,11,16 (L) "Offense" means a felony, gross misdemeanor, or crime of moral turpitude.

SB196,11,22 (m) "Rule" means a written statement by the interstate commission promulgated pursuant to sub. (12) 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.

SB196,11,24 (n) "State" means any state, commonwealth, district, or territory of the United States.

SB196,12,3 (o) "State of principal license" means a member state where a physician holds a license to practice medicine and which has been designated as such by the physician for purposes of registration and participation in the compact.

SB196,12,6 (3) Section 3 — Eligibility. (a) A physician must meet the eligibility requirements as defined in sub. (2) (k) to receive an expedited license under the terms and provisions of the compact.

SB196,12,10 (b) A physician who does not meet the requirements of sub. (2) (k) 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.

SB196,12,14 (4) Section 4 — 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:

SB196,12,15 1. The state of primary residence for the physician; or

SB196,12,16 2. The state where at least 25% of the practice of medicine occurs, or

SB196,12,17 3. The location of the physician's employer; or

SB196,12,19 4. If no state qualifies under subd. 1., 2., or 3., the state designated as state of residence for purpose of federal income tax.

SB196,12,21 (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 par. (a).

SB196,12,23 (c) The interstate commission is authorized to develop rules to facilitate redesignation of another member state as the state of principal license.

SB196,13,2 (5) Section 5 — 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.

SB196,13,6 (b) 1. 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.

SB196,13,11 2. 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.

SB196,13,17 3. 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 CFR 731.202.

SB196,13,19 4. 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.

SB196,13,23 (c) Upon verification in par. (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 par. (a), including the payment of any applicable fees.

SB196,14,3 (d) After receiving verification of eligibility under par. (b) and any fees under par. (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.

SB196,14,6 (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.

SB196,14,9 (f) An expedited license obtained though the compact shall be terminated if a physician fails to maintain a license in the state of principal licensure for a non-disciplinary reason, without redesignation of a new state of principal licensure.

SB196,14,12 (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.

SB196,14,15 (6) Section 6 — 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.

SB196,14,17 (b) The interstate commission is authorized to develop rules regarding fees for expedited licenses.

SB196,14,20 (7) Section 7 — 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:

SB196,14,21 1. Maintains a full and unrestricted license in a state of principal license;

SB196,14,24 2. Has not been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;

SB196,15,3 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 non-payment of fees related to a license; and

SB196,15,5 4. Has not had a controlled substance license or permit suspended or revoked by a state or the united states drug enforcement administration.

SB196,15,8 (b) Physicians shall comply with all continuing professional development or continuing medical education requirements for renewal of a license issued by a member state.

SB196,15,10 (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.

SB196,15,12 (d) Upon receipt of any renewal fees collected in par. (c), a member board shall renew the physician's license.

SB196,15,14 (e) Physician information collected by the interstate commission during the renewal process will be distributed to all member boards.

SB196,15,16 (f) The interstate commission is authorized to develop rules to address renewal of licenses obtained through the compact.

SB196,15,19 (8) Section 8 — Coordinated information system. (a) The interstate commission shall establish a database of all physicians licensed, or who have applied for licensure, under sub. (5).

SB196,15,22 (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 or received an expedited license through the compact.

SB196,15,24 (c) Member boards shall report disciplinary or investigatory information determined as necessary and proper by rule of the interstate commission.

SB196,16,2 (d) Member boards may report any non-public complaint, disciplinary, or investigatory information not required by par. (c) to the interstate commission.

SB196,16,4 (e) Member boards shall share complaint or disciplinary information about a physician upon request of another member board.

SB196,16,7 (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.

SB196,16,9 (g) The interstate commission is authorized to develop rules for mandated or discretionary sharing of information by member boards.

SB196,16,11 (9) Section 9 — Joint investigations. (a) Licensure and disciplinary records of physicians are deemed investigative.

SB196,16,15 (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.

SB196,16,17 (c) A subpoena issued by a member state shall be enforceable in other member states.

SB196,16,20 (d) Member boards may share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the compact.

SB196,16,23 (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.

SB196,17,2 (10) Section 10 — Disciplinary actions. (a) Any disciplinary action taken by any member board against a physician licensed through the compact shall be deemed 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.

SB196,17,11 (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.

SB196,17,14 (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 deem the action conclusive as to matter of law and fact decided, and:

SB196,17,16 1. Impose the same or lesser sanctions against the physician so long as such sanctions are consistent with the medical practice act of that state; or

SB196,17,19 2. Pursue separate disciplinary action against the physician under its respective medical practice act, regardless of the action taken in other member states.

SB196,18,3 (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 prior to the completion of the 90 day suspension period in a manner consistent with the medical practice act of that state.

SB196,18,6 (11) Section 11 — Interstate medical licensure compact commission. (a) The member states hereby create the "Interstate Medical Licensure Compact Commission."

SB196,18,8 (b) The purpose of the interstate commission is the administration of the interstate medical licensure compact, which is a discretionary state function.

SB196,18,13 (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.

SB196,18,19 (d) The interstate commission shall consist of 2 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 multiple member boards within a member state, the member state shall appoint one representative from each member board. A Commissioner shall be:

SB196,18,20 1. An allopathic or osteopathic physician appointed to a member board;

SB196,18,22 2. An executive director, executive secretary, or similar executive of a member board; or