FILED SENATE
Mar 29, 2021
GENERAL ASSEMBLY OF NORTH CAROLINA
S.B. 380
SESSION 2021 PRINCIPAL CLERK
S D
SENATE BILL DRS35156-NBf-13
Short Title: Interstate Medical Licensure Compact. (Public)
Sponsors: Senators Perry, deViere, and Krawiec (Primary Sponsors).
Referred to:
1 A BILL TO BE ENTITLED
2 AN ACT TO ESTABLISH AN INTERSTATE COMPACT FOR THE LICENSURE OF THE
3 PRACTICE OF MEDICINE.
4 The General Assembly of North Carolina enacts:
5 SECTION 1. Chapter 90 of the General Statutes is amended by adding a new Article
6 to read:
7 "Article 1M.
8 "Interstate Medical Licensure Compact.
9 "§ 90-21.140. Short title.
10 This Article shall be known as the "Interstate Medical Licensure Compact."
11 "§ 90-21.141. Purpose.
12 (a) The purpose of this Article is to strengthen access to health care, and, in recognition
13 of the advances in the delivery of health care, the member states of the Interstate Medical
14 Licensure Compact (Compact) have allied in common purpose to develop a comprehensive
15 process that complements the existing licensing and regulatory authority of state medical boards
16 and to provide a streamlined process that allows physicians to become licensed in multiple states,
17 thereby enhancing the portability of a medical license and ensuring the safety of patients.
18 (b) The Interstate Medical Licensure Compact creates another pathway for licensure and
19 does not otherwise change a state's existing medical practice act or provisions. The Compact
20 adopts the prevailing standard for licensure and affirms that the practice of medicine occurs
21 where the patient is located at the time of the physician-patient encounter and, therefore, requires
22 the physician to be under the jurisdiction of the state medical board where the patient is located.
23 State medical boards that participate in the Compact retain the jurisdiction to impose an adverse
24 action against a license to practice medicine in that state issued to a physician through the
25 procedures of the Compact.
26 "§ 90-21.142. Definitions.
27 The following definitions apply in this Article:
28 (1) Bylaws. – Bylaws established by the Interstate Commission pursuant to
29 G.S. 90-21.151.
30 (2) Commissioner. – The voting representative appointed by each member board
31 pursuant to G.S. 90-21.151.
32 (3) Conviction. – A finding by a court that an individual is guilty of a criminal
33 offense through adjudication, or entry of a plea of guilty or no contest to the
34 charge by the offender. Evidence of an entry of a conviction of a criminal
35 offense by a court shall be considered final for purposes of disciplinary action
36 by a member board.
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1 (4) Expedited license. – A full and unrestricted medical license granted by a
2 member state to an eligible physician through the process set forth in the
3 Compact.
4 (5) Interstate Commission. – The Interstate Medical Licensure Compact
5 Commission created pursuant to G.S. 90-21.151.
6 (6) License. – The authorization by a member state for a physician to engage in
7 the practice of medicine, which would be unlawful without authorization.
8 (7) Medical practice act. – Laws and regulations governing the practice of
9 allopathic and osteopathic medicine within a member state.
10 (8) Member board. – A state agency in a member state that acts in the sovereign
11 interests of the state by protecting the public through licensure, regulation, and
12 education of physicians as directed by the state government.
13 (9) Member state. – A state that has enacted the Compact.
14 (10) Physician. – Any person who meets all of the following qualifications:
15 a. Is a graduate of a medical school accredited by the Liaison Committee
16 on Medical Education, the Commission on Osteopathic College
17 Accreditation, or a medical school listed in the International Medical
18 Education Directory or its equivalent.
19 b. Has passed each component of the United States Medical Licensing
20 Examination (USMLE) or the Comprehensive Osteopathic Medical
21 Licensing Examination (COMLEX-USA) within three attempts, or
22 any of its predecessor examinations accepted by a state medical board
23 as an equivalent examination for licensure purposes.
24 c. Has successfully completed graduate medical education approved by
25 the Accreditation Council for Graduate Medical Education or the
26 American Osteopathic Association.
27 d. Holds specialty certification or a time-unlimited specialty certificate
28 recognized by the American Board of Medical Specialties or the
29 American Osteopathic Association's Bureau of Osteopathic
30 Specialists.
31 e. Possesses a full and unrestricted license to engage in the practice of
32 medicine issued by a member board.
33 f. Has never been convicted, received adjudication, deferred
34 adjudication, community supervision, or deferred disposition for any
35 offense by a court of appropriate jurisdiction.
36 g. Has never held a license authorizing the practice of medicine subjected
37 to discipline by a licensing agency in any state, federal, or foreign
38 jurisdiction, excluding any action related to nonpayment of fees
39 related to a license.
40 h. Has never had a controlled substance license or permit suspended or
41 revoked by a state or the United States Drug Enforcement
42 Administration.
43 i. Is not under active investigation by a licensing agency or law
44 enforcement authority in any state, federal, or foreign jurisdiction.
45 (11) Practice of medicine. – Clinical prevention, diagnosis, or treatment of human
46 disease, injury, or condition requiring a physician to obtain and maintain a
47 license in compliance with the medical practice act of a member state.
48 (12) Offense. – A felony, gross misdemeanor, or crime of moral turpitude.
49 (13) Rule – A written statement by the Interstate Commission promulgated
50 pursuant to G.S. 90-21.152 of the Compact that is of general applicability,
51 implements, interprets, or prescribes a policy or provision of the Compact, or
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1 an organizational, procedural, or practice requirement of the Interstate
2 Commission, and has the force and effect of statutory law in a member state,
3 and includes the amendment, repeal, or suspension of an existing rule.
4 (14) State. – Any state, commonwealth, district, or territory of the United States.
5 (15) State of principal license. – A member state where a physician holds a license
6 to practice medicine and which has been designated as such by the physician
7 for purposes of registration and participation in the Compact.
8 "§ 90-21.143. Eligibility.
9 (a) A physician must meet the eligibility requirements as defined in G.S. 90-21.142(10)
10 to receive an expedited license under the terms and provisions of the Compact.
11 (b) A physician who does not meet the requirements of G.S. 90-21.142(10) may obtain a
12 license to practice medicine in a member state if the individual complies with all laws and
13 requirements, other than the Compact, relating to the issuance of a license to practice medicine
14 in that state.
15 "§ 90-21.144. Designation of state of principal license.
16 (a) A physician shall designate a member state as the state of principal license for
17 purposes of registration for expedited licensure through the Compact if the physician possesses
18 a full and unrestricted license to practice medicine in that state, and that state meets any one of
19 the following qualifications:
20 (1) The state is the principal residence for the physician.
21 (2) The physician conducts at least twenty-five percent (25%) of their practice of
22 medicine in the state.
23 (3) The state is the location of the physician's employer.
24 If no state qualifies under subdivision (1), (2), or (3) of this subsection, then the physician
25 may designate the state of residence for the purpose of federal income tax as their state of
26 principal license.
27 (b) A physician may redesignate a member state as a state of principal license at any time,
28 as long as the state meets the requirements of subsection (a) of this section.
29 (c) The Interstate Commission is authorized to develop rules to facilitate redesignation
30 of another member state as the state of principal license.
31 "§ 90-21.145. Application and issuance of expedited licensure.
32 (a) A physician seeking licensure through the Compact shall file an application for an
33 expedited license with the member board of the state selected by the physician as the state of
34 principal license.
35 (b) Upon receipt of an application for an expedited license, the member board within the
36 state selected as the state of principal license shall evaluate whether the physician is eligible for
37 expedited licensure and issue a letter of qualification, verifying or denying the physician's
38 eligibility, to the Interstate Commission.
39 (c) Static qualifications, which include verification of medical education, graduate
40 medical education, results of any medical or licensing examination, and other qualifications as
41 determined by the Interstate Commission through rule, shall not be subject to additional primary
42 source verification where already primary source verified by the state of principal license.
43 (d) The member board within the state selected as the state of principal license shall, in
44 the course of verifying eligibility, perform a criminal background check of an applicant,
45 including the use of the results of fingerprint or other biometric data checks in compliance with
46 the requirements of the Federal Bureau of Investigation, with the exception of federal employees
47 who have suitability determination in accordance with 5 C.F.R. § 731.202.
48 (e) Appeal on the determination of eligibility to the member state shall be made to the
49 member state where the application was filed and shall be subject to the laws of that state.
50 (f) Upon verification of eligibility in subsection (b) of this section, physicians eligible
51 for an expedited license shall complete the registration process established by the Interstate
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1 Commission to receive a license in a member state selected pursuant to subsection (a) of this
2 section, including the payment of any applicable fees.
3 (g) After receiving verification of eligibility under subsection (b) of this section and any
4 fees under subsection (f) of this section, a member board shall issue an expedited license to the
5 physician. This license shall authorize the physician to practice medicine in the issuing state
6 consistent with the medical practice act and all applicable laws and regulations of the issuing
7 member board and member state.
8 (h) An expedited license shall be valid for a period consistent with the licensure period
9 in the member state and in the same manner as required for other physicians holding a full and
10 unrestricted license within the member state.
11 (i) An expedited license obtained through the Compact shall be terminated if a physician
12 fails to maintain a license in the state of principal licensure for a nondisciplinary reason, without
13 redesignation of a new state of principal licensure.
14 (j) The Interstate Commission is authorized to develop rules regarding the application
15 process, including payment of any applicable fees, and the issuance of an expedited license.
16 "§ 90-21.146. Fees for expedited licensure.
17 (a) A member state issuing an expedited license authorizing the practice of medicine in
18 that state may impose a fee for a license issued or renewed through the Compact.
19 (b) The Interstate Commission is authorized to develop rules regarding fees for expedited
20 licenses.
21 "§ 90-21.147. Renewal and continued participation.
22 (a) A physician seeking to renew an expedited license granted in a member state shall
23 complete a renewal process with the Interstate Commission if the physician meets all of the
24 following qualifications:
25 (1) Maintains a full and unrestricted license in a state of principal license.
26 (2) Has not been convicted, received adjudication, deferred adjudication,
27 community supervision, or deferred disposition for any offense by a court of
28 appropriate jurisdiction.
29 (3) Has not had a license authorizing the practice of medicine subject to discipline
30 by a licensing agency in any state, federal, or foreign jurisdiction, excluding
31 any action related to nonpayment of fees related to a license.
32 (4) Has not had a controlled substance license or permit suspended or revoked by
33 a state or the United States Drug Enforcement Administration.
34 (b) Physicians shall comply with all continuing professional development or continuing
35 medical education requirements for renewal of a license issued by a member state.
36 (c) The Interstate Commission shall collect any renewal fees charged for the renewal of
37 a license and distribute the fees to the applicable member board.
38 (d) Upon receipt of any renewal fees collected under subsection (c) of this section, a
39 member board shall renew the physician's license.
40 (e) Physician information collected by the Interstate Commission during the renewal
41 process will be distributed to all member boards.
42 (f) The Interstate Commission is authorized to develop rules to address renewal of
43 licenses obtained through the Compact.
44 "§ 90-21.148. Coordinated Information System.
45 (a) The Interstate Commission shall establish a database of all physicians who are
46 licensed, or who have applied for licensure, under G.S. 90-21.145.
47 (b) Notwithstanding any other provision of law, member boards shall report to the
48 Interstate Commission any public action or complaints against a licensed physician who has
49 applied or received an expedited license through the Compact.
50 (c) Member boards shall report disciplinary or investigatory information determined as
51 necessary and proper by rule of the Interstate Commission.
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1 (d) Member boards may report any nonpublic complaint, disciplinary, or investigatory
2 information not required by subsection (c) of this section to the Interstate Commission.
3 (e) Member boards shall share complaint or disciplinary information about a physician
4 upon request of another member board.
5 (f) All information provided to the Interstate Commission or distributed by member
6 boards shall be confidential, filed under seal, and used only for investigatory or disciplinary
7 matters.
8 (g) The Interstate Commission is authorized to develop rules for mandated or
9 discretionary sharing of information by member boards.
10 "§ 90-21.149. Joint investigations.
11 (a) Licensure and disciplinary records are deemed investigative.
12 (b) In addition to authority granted to a member board by its respective medical practice
13 act or other applicable state law, a member board may participate with other member boards in
14 joint investigations of physicians licensed by the member boards.
15 (c) A subpoena issued by a member state shall be enforceable in other memb