An interstate compact is a legal agreement among states. In the case of the Interstate Medical Licensure Compact (also referred to here as the IMLC or just “the compact”), it’s an agreement that addresses the licensing of physicians across state lines.

A group of state medical board executives, administrators and attorneys wrote the language of the IMLC in 2013 and 2014. The national Federation of State Medical Boards also was involved and helped facilitate the creation of the compact. But no one “owns” the IMLC.

It creates a new “expedited” pathway to state licensure for experienced physicians who have outstanding practice histories. It sets the qualifications for licensure and outlines the process for physicians to apply and receive licenses in states where they’re not currently licensed. The IMLC also details the role of the governing IMLC Commission and sets limits on what the Commission can do.

The state Legislature must pass a bill authorizing the state to join the compact. Then the Governor must sign it. The language of the compact must be identical in each state.

The compact creates a Commission made up of two representatives from each adopting state. Commissioners must be either: A physician member of a medical or osteopathic physician licensing board A public member of such a board An executive director or administrator of such a board If a state has only one medical board, then both Commissioners must come from that board. But if it has two boards, a medical board, and an osteopathic board, then each board gets one seat. Only the Commission can enforce the IMLC through its bylaws, rules, policies, and advisory opinions. No other governmental agency or private entity has control over how the IMLC is implemented.

Yes. Once seven states adopted it, the compact became active and in force. The Commission was seated in October 2015. But the compact is not yet fully operational. The Commission still has a lot of work to do to prepare for the actual licensing of physicians.

At the Commissions June 24 meeting, the Commission chose January 2017 as the target month for the issuance of first licenses via the Compact. The Commissioners understand that states, organizations and other entitles are watching its work.

The compact states that a physician must apply to a state within the compact where the physician already has a license. That state becomes the physician’s State of Principal License or “home state.” The home state reviews the physician’s qualifications and shares the results with the Commission. The Commission then notifies the “receiving state(s)” within the compact where the physician wishes to be licensed.

Submitting an application and paying whatever fees are assessed. It’s also possible the physician might be asked by the home state to provide evidence to verify “state of principal license. 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 patients located.

Conducting the review of the applying physician’s qualifications under terms of the compact; informing the Commission of the results.

Mostly, the Commission will act as an information exchange between a home state/state of principal license and a receiving state. The compact also envisions the Commission as the entity that collects fees from physicians and transfers licensure fees to receiving states. The Commission also will collect data about physician applications for licensure and actual licensure via the IMLC.

Issuing licenses to qualified physicians once notified by the Commission and depositing license fees when received from the Commission. State medical boards participating in the Compact are required to share complaint/investigative information with each other. The license to practice medicine may be revoked by any or all of the compact states.

Yes, but all states chosen must have adopted the compact. A physician practicing under the Compact is bound to comply with the statutes, rules, and regulations of each compact state wherein he/she chooses to practice medicine.

Under the IMLC, the process would repeat exactly as it operated the first time. However, the Commission could write rules about this subject. (None are contemplated at this time.)

The letter of qualification is valid for one year.

Commission meetings (including meetings of the Executive Committee) are publicized through the participating states. The Commission also sends news releases to people and organizations who have expressed a desire to be on the Commission’s “interested parties” list. The Commission also shares meeting notices and press releases with the Federation of State Medical Boards and the National Center for Interstate Compacts/Council of State Governments. Commission meetings are open to the public and include a telephone conference call for individuals who cannot attend in person. It’s possible that video conferencing also might be used in the future.