New Jersey § 45:9-6

§ 45:9-6.

The State of New Jersey enacts and enters into the Interstate Medical Licensure Compact

with all other jurisdictions that legally join the compact in the form substantially

as follows: 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 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. Section 2. Definitions. As used in this compact: a. “ Bylaws ” means the bylaws established by the Interstate Commission pursuant to section 11

of this compact for its governance, or for directing and controlling its actions and

conduct. b. “ Commissioner ” means the voting representative appointed by each member board pursuant to section

11 of this compact. 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. 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. e. “ Interstate Commission ” means the Interstate Medical Licensure Compact Commission created pursuant to section

11 of this compact. f. “ License ” means authorization by a state for a physician to engage in the practice of medicine,

which would be unlawful without the authorization. g. “ Medical practice act ” means laws and regulations governing the practice of allopathic and osteopathic

medicine within a member state. 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. i. “ Member state ” means a state that has enacted the compact. 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. k. “ Physician ” means any person who: (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; (2) 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; (3) Successfully completed graduate medical education approved by the Accreditation

Council for Graduate Medical Education or the American Osteopathic Association; (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; (5) Possesses a full and unrestricted license to engage in the practice of medicine

issued by a member board; (6) Has never been convicted, received adjudication, deferred adjudication, community

supervision, or deferred disposition for any offense by a court of appropriate jurisdiction; (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; (8) Has never had a controlled substance license or permit suspended or revoked by

a state or the United States Drug Enforcement Administration; and (9) Is not under active investigation by a licensing agency or law enforcement authority

in any state, federal, or foreign jurisdiction. l . “ Offense ” means a felony, gross misdemeanor, or crime of moral turpitude. m. “ Rule ” means a written statement by the Interstate Commission promulgated pursuant to section

12 of this compact 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. n. “ State ” means any state, commonwealth, district, or territory of the United States. 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. Section 3. Eligibility. a. A physician shall meet the eligibility requirements specified in subsection k.

of section 2 of this compact to receive an expedited license under the terms and provisions

of the compact. b. A physician who does not meet the eligibility requirements set forth in subsection

k. of section 2 of this compact may obtain a license to practice medicine in a member

state if the individual complies with all laws and requirements, other than the compact,

related to the issuance of a license to practice medicine in that state. 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: (1) the state of primary residence for the physician; (2) the state where at least 25 percent of the physician's practice of medicine occurs; (3) the location of the physician's employer; or (4) if no state qualifies under paragraphs (1) through (3) of this subsection, the

state designated as the physician's state of residence for federal income tax purposes. b. A physician may redesignate a member state as the physician's state of principal

license at any time, provided the state meets the requirements for designation set

forth in subsection a. of this section. c. The Interstate Commission is authorized to develop rules to facilitate redesignation

of another member state as the physician's state of principal license. 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 physician's state of principal license. b. Upon receipt of an application for an expedited license, the member board within

the state selected as the physician's state of principal license shall evaluate whether

the physician is eligible for expedited licensure and issue a letter of qualification

to the Interstate Commission verifying or denying the physician's eligibility. (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 physician's

state of principal license. (2) The member board within the state selected as the physician's 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 . (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 of a physician's eligibility for expedited licensure pursuant

to subsection b. of this section, the physician shall complete the registration process

established by the Interstate Commission to receive a license in a member state selected

pursuant to subsection a. of this section, including the payment of any applicable

fees. d. Upon receiving verification of a physician's eligibility for expedited licensure

pursuant to subsection b. of this section and payment of any applicable fees pursuant

to subsection c. of this section, a member board shall issue an expedited license

to the physician. The license shall authorize the physician to practice medicine in the issuing state

consistent with the medical practice at 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 the physician

fails to maintain a license in the physician's state of principal licensure for a

non-disciplinary 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. 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. b. The Interstate Commission is authorized to develop rules regarding fees for expedited

licenses. 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: (1) Maintains a full and unrestricted license in a state of principal license; (2) Has not been convicted, 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 non-payment 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 pursuant to subsection c. of this section,

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. Section 8. Coordinated Information System. a. The Interstate Commission shall establish a database of all physicians licensed,

or who have applied for licensure, pursuant to section 5 of this compact. 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 non-public complaint, disciplinary, or investigatory

information not required pursuant to subsection c. of this section. 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. Section 9. Joint Investigations. a. Licensure and disciplinary records of physicians are deemed 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. 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. 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 deem the action conclusive

as to matter of law and fact decided, and: (1) impose the same or a lesser sanction against the physician, provided that the

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 prior

to the completion of the 90 day suspension period in a manner consistent with the

medical practice act of that state. Section 11. 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 multiple

member boards within a member state, the member state shall appoint one representative

from each member board. Each 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 the 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 Intestate 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 meets the requirements

to serve as a commissioner pursuant to subsection d. of this section. 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 part, 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, which shall fully describe all matters

discussed in a meeting and shall provide a full and accurate summary of actions taken,

including a 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 may

be necessary. l . The Interstate Commission may establish other committees for governance and administration

of the compact. Section 12. Powers and Duties of the Interstate Commission. The Interstate Commission shall have the duty and power to: a. Oversee and maintain the administration of the compact; b. Promulgate rules, which shall be binding to the extent and in the manner provided

for in the compact; c. Issue, upon the request of a member state or member board, advisory opinions concerning

the meaning or interpretation of the compact and its bylaws, rules, and actions; d. 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; e. Establish and appoint committees, including, but not limited to, an executive committee

as required pursuant to section 11 of this compact, which shall have the power to

act on behalf of the Interstate Commission in carrying out its powers and duties; f. Pay, or provide for the payment of, the expenses related to the establishment,

organization, and ongoing activities of the Interstate Commission; g. Establish and maintain one or more offices; h. Borrow, accept, hire, or contract for services of personnel; i. Purchase and maintain insurance and bonds; j. Employ an executive director, who shall have the power to employ, select, or appoint

employees, agents, or consultants, and to determine their qualifications, define their

duties, and fix their compensation; k. Establish personnel policies and programs relating to conflicts of interest, rates

of compensation, and qualifications of personnel; l . Accept donations and grants of money, equipment, supplies, materials, and services,

and to receive, utilize, and dispose of the same in a manner consistent with the conflict

of interest policies established by the Interstate Commission; m. Lease, purchase, accept contributions or donations of, or otherwise own, hold,

improve, or use any real or personal property; n. Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose

of any real or personal property; o . Establish a budget and make expenditures; p. Adopt a seal and bylaws governing the management and operation of the Interstate

Commission; q. Report annually to the legislatures and governors of the member states concerning

the activities of the Interstate Commission during the preceding year. Such reports shall also include reports of financial audits and any recommendations

that may have been adopted by the Interstate Commission; r. Coordinate education, training, and public awareness regarding the compact, its

implementation, and its operation; s. Maintain records in accordance with the bylaws; t. Seek and obtain trademarks, copyrights, and patents; and u. Perform such functions as may be necessary or appropriate to achieve the purposes

of the compact. Section 13. 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 shall 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 upon 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 prior to 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 Interstate Commission's annual report. Section 14. Organization and Operation of the Interstate Commission. a. The Interstate Commission shall, within 12 months of the first Interstate Compact

meeting and 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. 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 pursuant to subsection b. of this section 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 has a reasonable basis for believing occurred, within the scope

of Interstate Commission employment, duties, or responsibilities; provided that such

person shall not be protected from suit or liability for damage, loss, injury, or

liability caused by the intentional or willful and wanton misconduct of such person. (1) The liability of the executive director and employees of the Interstate Commission

or representatives of the Interstate Commission, acting within the scope of such person's

employment or duties for acts, errors, or omissions occurring within such person's

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 person from suit or

liability for damage, loss, injury, or liability caused by the intentional or willful

and wanton misconduct of such person. (2) 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 willful

and wanton misconduct on the part of such person. (3) To the extent not covered by the state involved, 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 person 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 willful and wanton misconduct on the part of such persons. Section 15. Rulemaking Functions of the 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 deemed appropriate for the operations of the Interstate Commission shall

be made pursuant to a rulemaking process that substantially conforms to the “Model

State Administrative Procedure Act” of 2010, and subsequent amendments thereto. c. No 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. Section 16. Oversight of the 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 purposes and intent of the compact. 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 which 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. Section 17. 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. Section 18. 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 on 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: (1) Provide 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. The Interstate Commission shall specify the conditions by which the defaulting state

shall cure its default; and (2) Provide 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 affected by the termination of a member state or

the withdrawal of a member state. f. The member state which has been terminated is responsible for all dues, obligations,

and liabilities incurred through the effective date of termination, including any

obligations for which the performance of the obligation extends beyond the effective

date of termination. g. The Interstate Commission shall not bear any costs relating to any state that has

been found to be in default or which 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. Section 19. 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 which 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. Section 20. 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 non-member states, or their designees, shall be invited to participate

in the activities of the Interstate Compact on a non-voting basis prior to adoption

of the compact by all states. d. The Interstate Commission may propose amendments to the compact for enactment by

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. Section 21. Withdrawal. a. Once effective, the compact shall continue in force and remain binding upon each

and every member state; provided that 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 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 after receiving notice provided pursuant

to subsection c. of this section. e. The withdrawing state shall be responsible for all dues, obligations, and liabilities

incurred through the effective date of withdrawal, including any obligations for which

the performance of the obligation extends 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 shall be authorized to develop rules to address the effect

of 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 licensure. Section 22. Dissolution. a. The compact shall dissolve effective upon the date of the withdrawal or default

of the member state which 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 finds shall be distributed in accordance with the bylaws. Section 23. Severability and Construction. a. The provisions of the compact shall be severable, and if any phrase, clause, sentence,

or provision is deemed 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. Section 24. 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.