2022 -- S 2606 SUBSTITUTE A
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LC004884/SUB A
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STATE OF RHODE ISLAND
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2022
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AN ACT
RELATING TO BUSINESSES AND PROFESSIONS -- INTERSTATE MEDICAL
LICENSURE COMPACT
Introduced By: Senators Valverde, Miller, DiMario, Euer, and Lawson
Date Introduced: March 10, 2022
Referred To: Senate Health & Human Services
It is enacted by the General Assembly as follows:
1 SECTION 1. Title 5 of the General Laws entitled "BUSINESSES AND PROFESSIONS"
2 is hereby amended by adding thereto the following chapter:
3 CHAPTER 91
4 INTERSTATE MEDICAL LICENSURE COMPACT
5 5-91-1. Purpose.
6 In order to strengthen access to health care, and in recognition of the advances in the
7 delivery of health care, the member states of the Interstate Medical Licensure Compact have allied
8 in common purpose to develop a comprehensive process that complements the existing licensing
9 and regulatory authority of state medical boards, provides a streamlined process that allows
10 physicians to become licensed in multiple states, thereby enhancing the portability of a medical
11 license and ensuring the safety of patients. The compact creates another pathway for licensure and
12 does not otherwise change a state’s existing medical practice act. The compact also adopts the
13 prevailing standard for licensure and affirms that the practice of medicine occurs where the patient
14 is located at the time of the physician-patient encounter, and therefore, requires the physician to be
15 under the jurisdiction of the state medical board where the patient is located. State medical boards
16 that participate in the compact retain the jurisdiction to impose an adverse action against a license
17 to practice medicine in that state issued to a physician through the procedures in the compact.
18 5-91-2. Definitions.
 1 The terms contained in this chapter shall have the following meanings:
2 (1) “Bylaws” means those bylaws established by the interstate commission pursuant to §5-
3 91-11.
4 (2) “Commissioner” means the voting representative appointed by each member board
5 pursuant to § 5-91-11.
6 (3) “Conviction” means a finding by a court that an individual is guilty of a criminal offense
7 through adjudication, or entry of a plea of guilt or no contest to the charge by the offender. Evidence
8 of an entry of a conviction of a criminal offense by the court shall be considered final for purposes
9 of disciplinary action by a member board.
10 (4) “Expedited license” means a full and unrestricted medical license granted by a member
11 state to an eligible physician through the process set forth in the compact.
12 (5) “Interstate commission” means the interstate commission created pursuant to §5-91-11.
13 (6) “License” means authorization by a member state for a physician to engage in the
14 practice of medicine, which would be unlawful without authorization.
15 (7) “Medical practice act” means laws and regulations governing the practice of allopathic
16 and osteopathic medicine within a member state.
17 (8) “Member board” means a state agency in a member state that acts in the sovereign
18 interests of the state by protecting the public through licensure, regulation, and education of
19 physicians as directed by the state government.
20 (9) “Member state” means a state that has enacted the compact.
21 (10) “Practice of medicine” means that clinical prevention, diagnosis, or treatment of
22 human disease, injury, or condition requiring a physician to obtain and maintain a license in
23 compliance with the medical practice act of a member state.
24 (11) “Physician” means any person who:
25 (i) Is a graduate of a medical school accredited by the Liaison Committee on Medical
26 Education, the Commission on Osteopathic College Accreditation, or a medical school listed in the
27 International Medical Education Directory or its equivalent;
28 (ii) Passed each component of the United State Medical Licensing Examination (USMLE)
29 or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within three
30 (3) attempts, or any of its predecessor examinations accepted by a state medical board as an
31 equivalent examination for licensure purposes;
32 (iii) Successfully completed graduate medical education approved by the Accreditation
33 Council for Graduate Medical Education or the American Osteopathic Association;
34 (iv) Holds specialty certification or a time-unlimited specialty certificate recognized by the
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 1 American Board of Medical Specialties or the American Osteopathic Association’s Bureau of
2 Osteopathic Specialists;
3 (v) Possesses a full and unrestricted license to engage in the practice of medicine issued by
4 a member board;
5 (vi) Has never been convicted, received adjudication, deferred adjudication, community
6 supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;
7 (vii) Has never held a license authorizing the practice of medicine subjected to discipline
8 by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to
9 non-payment of fees related to a license;
10 (viii) Has never had a controlled substance license or permit suspended or revoked by a
11 state or the United States Drug Enforcement Administration; and
12 (ix) Is not under active investigation by a licensing agency or law enforcement authority in
13 any state, federal, or foreign jurisdiction.
14 (12) “Offense” means a felony, gross misdemeanor, or crime of moral turpitude.
15 (13) “Rule” means a written statement by the interstate commission promulgated pursuant
16 to § 5-91-12 of the compact that is of general applicability, implements, interprets, or prescribes a
17 policy or provision of the compact, or an organizational, procedural, or practice requirement of the
18 interstate commission, and has the force and effect of statutory law in a member state, and includes
19 the amendment, repeal, or suspension of an existing rule.
20 (14) “State” means any state, commonwealth, district, or territory of the United States.
21 (15) “State of principal license” means a member state where a physician holds a license
22 to practice medicine and which has been designated as such by the physician for purposes of
23 registration and participation in the compact.
24 5-91-3. Eligibility.
25 (a) A physician must meet the eligibility requirements as defined in § 5-91-2 to receive an
26 expedited license under the terms and provisions of the compact.
27 (b) A physician who does not meet the requirements of § 5-91-2 may obtain a license to
28 practice medicine in a member state if the individual complies with all laws and requirements, other
29 than the compact, relating to the issuance of a license to practice medicine in that state.
30 5-91-4. Designation of state of principal license.
31 (a) A physician shall designate a member state as the state of principal license for purposes
32 of registration for expedited licensure through the compact if the physician possesses a full and
33 unrestricted license to practice medicine in that state, and the state is:
34 (1) The state of principal residence for the physician;
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 1 (2) The state where at least twenty-five percent (25%) of the practice of medicine occurs;
2 or
3 (3) The location of the physician’s employer; or
4 (4) If no state qualifies under subsection (1), subsection (2), or subsection (3) of this
5 section, the state designated as state of residence for purpose of federal income tax.
6 (b) A physician may redesignate a member state as state of principal license at any time,
7 as long as the state meets the requirements of subsection (a) of this section.
8 (c) The interstate commission is authorized to develop rules to facilitate redesignation of
9 another member state as the state of principal license.
10 5-91-5. Application and issuance of expedited licensure.
11 (a) A physician seeking licensure through the compact shall file an application for an
12 expedited license with the member board of the state selected by the physician as the state of
13 principal license.
14 (b) Upon receipt of an application for an expedited license, the member board within the
15 state selected as the state of principal license shall evaluate whether the physician is eligible for
16 expedited licensure and issue a letter of qualification, verifying or denying the physician’s
17 eligibility, to the interstate commission.
18 (1) Static qualifications, which include verification of medical education, graduate medical
19 education, results of any medical or licensing examination, and other qualifications as determined
20 by the interstate commission through rule, shall not be subject to additional primary source
21 verification where already primary source verified by the state of principal license.
22 (2) The member board within the state selected as the state of principal license shall, in the
23 course of verifying eligibility, perform a criminal background check of an applicant, including the
24 use of the results of fingerprint or other biometric data checks compliant with the requirements of
25 the Federal Bureau of Investigation, with the exception of federal employees who have suitability
26 determination in accordance with 5 C.F.R. §731.202.
27 (3) Appeal on the determination of eligibility shall be made to the member state where the
28 application was filed and shall be subject to the law of that state.
29 (c) Upon verification in subsection (b) of this section, physicians eligible for an expedited
30 license shall complete the registration process established by the interstate commission to receive
31 a license in a member state selected pursuant to subsection (a) of this section, including the payment
32 of any applicable fees.
33 (d) After receiving verification of eligibility under subsection (b) of this section and any
34 fees under subsection (c) of this section, a member board shall issue an expedited license to the
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 1 physician.
2 This license shall authorize the physician to practice medicine in the issuing state consistent
3 with the medical practice act and all applicable laws and regulations of the issuing member board
4 and member state.
5 (e) An expedited license shall be valid for a period consistent with the licensure period in
6 the member state and in the same manner as required for other physicians holding a full and
7 unrestricted license within the member state.
8 (f) An expedited license obtained through the compact shall be terminated if a physician
9 fails to maintain a license in the state of principal licensure for a non-disciplinary reason, without
10 redesignation of a new state of principal licensure.
11 (g) The interstate commission is authorized to develop rules regarding the application
12 process, including payment of any applicable fees, and the issuance of an expedited license.
13 5-91-6. Fees for expedited licensure.
14 (a) A member state issuing an expedited license authorizing the practice of medicine in that
15 state may impose a fee for a license issued or renewed through the compact.
16 (b) The interstate commission is authorized to develop rules regarding fees for expedited
17 licenses.
18 5-91-7. Renewal and continued participation.
19 (a) A physician seeking to renew an expedited license granted in a member state shall
20 complete a renewal process with the interstate commission if the physician:
21 (1) Maintains a full and unrestricted license in a state of principal license;
22 (2) Has not been convicted, received adjudication, deferred adjudication, community
23 supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;
24 (3) Has not had a license authorizing the practice of medicine subject to discipline by a
25 licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-
26 payment of fees related to a license; and
27 (4) Has not had a controlled substance license or permit suspended or revoked by a state
28 or the United States Drug Enforcement Administration.
29 (b) Physicians shall comply with all continuing professional development or continuing
30 medical education requirements for renewal of a license issued by a member state.
31 (c) The interstate commission shall collect any renewal fees charged for the renewal of a
32 license and distribute the fees to the applicable member board.
33 (d) Upon receipt of any renewal fees collected in subsection (c) of this section, a member
34 board shall renew the physician’s license.
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 1 (e) Physician information collected by the interstate commission during the renewal
2 process will be distributed to all member boards.
3 (f) The interstate commission is authorized to develop rules to address renewal of licenses
4 obtained through the compact.
5 5-91-8. Coordinated information system.
6 (a) The interstate commission shall establish a database of all physicians licensed, or who
7 have applied for licensure under § 5-91-5.
8 (b) Notwithstanding any other provision of law, member boards shall report to the interstate
9 commission any public action or complaints against a licensed physician who has applied or
10 received an expedited license through the compact.
11 (c) Member boards shall report disciplinary or investigatory information determined as
12 necessary and proper by rule of the interstate commission.
13 (d) Member boards may report any non-public complaint, disciplinary, or investigatory
14 information not required by subsection (c) of this section to the interstate commission.
15 (e) Member boards shall share complaint or disciplinary information about a physician
16 upon request of another member board.
17 (f) All information provided to the interstate commission or distributed by member boards
18 shall be confidential, filed under seal, and used only for investigatory or disciplinary matters.
19 (g) The interstate commission is authorized to develop rules for mandated or discretionary
20 sharing of information by member boards.
21 5-91-9. Joint investigations.
22 (a) Licensure and disciplinary records of physicians are deemed investigative.
23 (b) In addition to the authority granted to a member board by its respective medical practice
24 act or other applicable state law, a member board may participate with other member boards in
25 joint investigations of physicians licensed by the member boards.
26 (c) A subpoena issued by a member state shall be enforceable in other member states.
27 (d) Member boards may share any investigative, litigation, or compliance materials in
28 furtherance of any joint or individual investigation initiated under the compact.
29 (e) Any member state may investigate actual or alleged violations of the statutes
30 authorizing the practice of medicine in any other member state in which a physician holds a license
31 to practice medicine.
32 5-91-10. Disciplinary actions.
33 (a) Any disciplinary action taken by any member board against a physician licensed
34 through the compact shall be deemed unprofessional conduct which may be subject to discipline
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 1 by other member boards, in addition to any violation of the medical practice act or regulations in
2 that state.
3 (b) If a license granted to a physician by the member board in the state of principal license
4 is revoked, surrendered or relinquished in lieu of discipline, or suspended, then all licenses issued
5 to the physician by member boards shall automatically be placed, without further action necessary
6 by any member board, on the same status. If the member board in the state of principal license
7 subsequently reinstates the physician’s license, a license issued to the physician by any other
8 member board shall remain encumbered until that respective member board takes action to reinstate
9 the license in a manner consistent with the medical practice act of that state.
10 (c) If disciplinary action is taken against a physician by a member board not in the state of
11 principal license, any other member board may deem the action conclusive as to matter of law and
12 fact decided, and:
13 (1) Impose the same or lesser sanction(s) against the physician as long as such sanctions
14 are consistent with the medical practice act of that state; or
15 (2) Pursue separate disciplinary action against the physician under its respective medical
16 practice act, regardless of the action taken in other member states.
17 (d) If a license granted to a physician by a member board is revoked, surrendered or
18 relinquished in lieu of d