00 HOUSE BILL NO. 238 01 "An Act relating to an interstate compact on medical licensure; amending the duties of 02 the State Medical Board; and relating to the Department of Public Safety's authority to 03 conduct national criminal history record checks of physicians." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05  * Section 1. AS 08.64.101 is amended to read: 06 Sec. 08.64.101. Duties. The board shall 07 (1) examine and issue licenses to applicants; 08 (2) develop written guidelines to ensure that licensing requirements are 09 not unreasonably burdensome and the issuance of licenses is not unreasonably 10 withheld or delayed; 11 (3) after a hearing, impose disciplinary sanctions on persons who 12 violate this chapter or the regulations or orders of the board; 13 (4) adopt regulations ensuring that renewal of licenses is contingent 14 upon proof of continued competency on the part of the licensee; [AND] 01 (5) under regulations adopted by the board, contract with private 02 professional organizations to establish an impaired medical professionals program to 03 identify, confront, evaluate, and treat persons licensed under this chapter who abuse 04 alcohol, other drugs, or other substances or are mentally ill or cognitively impaired;  05 and  06 (6) implement the Interstate Medical Licensure Compact. 07  * Sec. 2. AS 08.64.190 is amended by adding a new subsection to read: 08 (b) An applicant shall submit, along with an application for an expedited 09 license under AS 08.64.550, the applicant's fingerprints and the fees required by the 10 Department of Public Safety under AS 12.62.160 for criminal justice information and 11 a national criminal history record check. The board shall forward the fingerprints and 12 fees to the Department of Public Safety to obtain a report of criminal justice 13 information under AS 12.62 and a national criminal history record check under 14 AS 12.62.400. 15  * Sec. 3. AS 08.64.250 is amended by adding a new subsection to read: 16 (b) The board shall waive the examination requirement and license by 17 credentials if the physician meets the requirements for an expedited license under 18 AS 08.64.520 - 08.64.550. 19  * Sec. 4. AS 08.64.315 is amended to read: 20 Sec. 08.64.315. Fees. The department shall set fees under AS 08.01.065 for 21 each of the following: 22 (1) application; 23 (2) license by examination; 24 (3) license by endorsement or waiver of examination; 25 (4) temporary permit; 26 (5) locum tenens permit; 27 (6) license renewal, active; 28 (7) license renewal, inactive; 29 (8) license by reexamination;  30 (9) expedited license issued or renewed under the Interstate  31 Medical Licensure Compact. 01  * Sec. 5. AS 08.64.370 is amended to read: 02 Sec. 08.64.370. Exceptions to application of AS 08.64.010 - 08.64.380  03 [CHAPTER]. AS 08.64.010 - 08.64.380 do [THIS CHAPTER DOES] not apply to 04 (1) officers in the regular medical service of the armed services of the 05 United States or the United States Public Health Service while in the discharge of their 06 official duties; 07 (2) a physician or osteopath, who is not a resident of this state, who is 08 asked by a physician or osteopath licensed in this state to help in the diagnosis or 09 treatment of a case; 10 (3) the practice of the religious tenets of a church; 11 (4) a physician in the regular medical service of the United States 12 Public Health Service or the armed services of the United States volunteering services 13 without pay or other remuneration to a hospital, clinic, medical office, or other 14 medical facility in the state; 15 (5) a person who is certified as a direct-entry midwife by the 16 department under AS 08.65 while engaged in the practice of midwifery whether or not 17 the person accepts compensation for those services. 18  * Sec. 6. AS 08.64.380(5) is amended to read: 19 (5) "practice of medicine" or "practice of osteopathy" means, unless  20 the context otherwise requires, [:] 21 (A) for a fee, donation or other consideration, to diagnose, 22 treat, operate on, prescribe for, or administer to, any human ailment, blemish, 23 deformity, disease, disfigurement, disorder, injury, or other mental or physical 24 condition; or to attempt to perform or represent that a person is authorized to 25 perform any of the acts set out in this subparagraph; 26 (B) to use or publicly display a title in connection with a 27 person's name including "doctor of medicine," "physician," "M.D.," or "doctor 28 of osteopathic medicine" or "D.O." or a specialist designation including 29 "surgeon," "dermatologist," or a similar title in such a manner as to show that 30 the person is willing or qualified to diagnose or treat the sick or injured; 31  * Sec. 7. AS 08.64 is amended by adding new sections to read: 01 Article 5. Interstate Medical Licensure Compact.  02 Sec. 08.64.500. Compact enacted. The Interstate Medical Licensure Compact 03 as contained in AS 08.64.500 - 08.64.740 is enacted into law and entered into on 04 behalf of the state with all other states and legally joining in it in a form substantially 05 as follows in AS 08.64.510 - 08.64.740. 06 Sec. 08.64.510. Purpose. In order to strengthen access to health care, and in 07 recognition of the advances in the delivery of health care, the member states of the 08 Interstate Medical Licensure Compact have allied in common purpose to develop a 09 comprehensive process that complements the existing licensing and regulatory 10 authority of state medical boards, provides a streamlined process that allows 11 physicians to become licensed in multiple states, thereby enhancing the portability of a 12 medical license and ensuring the safety of patients. The Compact creates another 13 pathway for licensure and does not otherwise change a state's existing Medical 14 Practice Act. The Compact also adopts the prevailing standard for licensure and 15 affirms that the practice of medicine occurs where the patient is located at the time of 16 the physician-patient encounter, and therefore, requires the physician to be under the 17 jurisdiction of the state medical board where the patient is located. State medical 18 boards that participate in the Compact retain the jurisdiction to impose an adverse 19 action against a license to practice medicine in that state issued to a physician through 20 the procedures in the Compact. 21 Sec. 08.64.520. Definitions. In this compact, 22 (1) "bylaws" means those bylaws established by the Interstate 23 Commission pursuant to AS 08.64.610 for its governance, or for directing and 24 controlling its actions and conduct; 25 (2) "commissioner" means the voting representative appointed by each 26 member board pursuant to AS 08.64.610; 27 (3) "conviction" means a finding by a court that an individual is guilty 28 of a criminal offense through adjudication, or entry of a plea of guilt or no contest to 29 the charge by the offender. Evidence of an entry of a conviction of a criminal offense 30 by the court shall be considered final for purposes of disciplinary action by a member 31 board; 01 (4) "expedited license" means a full and unrestricted medical license 02 granted by a member state to an eligible physician through the process set forth in the 03 Compact; 04 (5) "Interstate Commission" means the interstate commission created 05 pursuant to AS 08.64.610; 06 (6) "license" means authorization by a state for a physician to engage 07 in the practice of medicine, which would be unlawful without the authorization; 08 (7) "Medical Practice Act" means laws and regulations governing the 09 practice of allopathic and osteopathic medicine within a member state; 10 (8) "member board" means a state agency in a member state that acts 11 in the sovereign interests of the state by protecting the public through licensure, 12 regulation, and education of physicians as directed by the state government; 13 (9) "member state" means a state that has enacted the Compact; 14 (10) "offense" means a felony, gross misdemeanor, or crime of moral 15 turpitude; 16 (11) "physician" means any person who 17 (A) is a graduate of a medical school accredited by the Liaison 18 Committee on Medical Education, the Commission on Osteopathic College 19 Accreditation, or a medical school listed in the International Medical 20 Education Directory or its equivalent; 21 (B) passed each component of the United States Medical 22 Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical 23 Licensing Examination (COMLEX-USA) within three attempts, or any of its 24 predecessor examinations accepted by a state medical board as an equivalent 25 examination for licensure purposes; 26 (C) successfully completed graduate medical education 27 approved by the Accreditation Council for Graduate Medical Education or the 28 American Osteopathic Association; 29 (D) holds specialty certification or a time-unlimited specialty 30 certificate recognized by the American Board of Medical Specialties or the 31 American Osteopathic Association's Bureau of Osteopathic Specialists; 01 (E) possesses a full and unrestricted license to engage in the 02 practice of medicine issued by a member board; 03 (F) has never been convicted, received adjudication, deferred 04 adjudication, community supervision, or deferred disposition for any offense 05 by a court of appropriate jurisdiction; 06 (G) has never held a license authorizing the practice of 07 medicine subjected to discipline by a licensing agency in any state, federal, or 08 foreign jurisdiction, excluding any action related to non-payment of fees 09 related to a license; 10 (H) has never had a controlled substance license or permit 11 suspended or revoked by a state or the United States Drug Enforcement 12 Administration; and 13 (I) is not under active investigation by a licensing agency or 14 law enforcement authority in any state, federal, or foreign jurisdiction; 15 (12) "practice of medicine" means the clinical prevention, diagnosis, or 16 treatment of human disease, injury, or condition requiring a physician to obtain and 17 maintain a license in compliance with the Medical Practice Act of a member state; 18 (13) "rule" means a written statement by the Interstate Commission 19 promulgated pursuant to AS 08.64.620 that is of general applicability, implements, 20 interprets, or prescribes a policy or provision of the Compact, or an organizational, 21 procedural, or practice requirement of the Interstate Commission, and has the force 22 and effect of law in a member state, and includes the amendment, repeal, or 23 suspension of an existing rule; 24 (14) "state" means any state, commonwealth, district, or territory of the 25 United States; 26 (15) "state of principal license" means a member state where a 27 physician holds a license to practice medicine and which has been designated as such 28 by the physician for purposes of registration and participation in the Compact. 29 Sec. 08.64.530. Eligibility. (a) A physician must meet the eligibility 30 requirements as defined in AS 08.64.520(11) to receive an expedited license under the 31 terms and provisions of the Compact. 01 (b) A physician who does not meet the requirements of AS 08.64.520(11) may 02 obtain a license to practice medicine in a member state if the individual complies with 03 all laws and requirements, other than the Compact, relating to the issuance of a license 04 to practice medicine in that state. 05 Sec. 08.64.540. Designation of state of principal license. (a) A physician 06 shall designate a member state as the state of principal license for purposes of 07 registration for expedited licensure through the Compact if the physician possesses a 08 full and unrestricted license to practice medicine in that state, and the state is: 09 (1) the state of primary residence for the physician; 10 (2) the state where at least 25 percent of the practice of medicine 11 occurs; 12 (3) the location of the physician's employer; or 13 (4) if no state qualifies under (1) - (3) of this section, the state 14 designated as state of residence for purpose of federal income tax. 15 (b) A physician may redesignate a member state as state of principal license at 16 any time, as long as the state meets the requirements in (a) of this section. 17 (c) The Interstate Commission is authorized to develop rules to facilitate 18 redesignation of another member state as the state of principal license. 19 Sec. 08.64.550. Application and issuance of expedited license. (a) A 20 physician seeking licensure through the Compact shall file an application for an 21 expedited license with the member board of the state selected by the physician as the 22 state of principal license. 23 (b) Upon receipt of an application for an expedited license, the member board 24 within the state selected as the state of principal license shall evaluate whether the 25 physician is eligible for expedited licensure and issue a letter of qualification, 26 verifying or denying the physician's eligibility, to the Interstate Commission, as 27 follows: 28 (1) static qualifications, which include verification of medical 29 education, graduate medical education, results of any medical or licensing 30 examination, and other qualifications as determined by the Interstate Commission 31 through rule, may not be subject to additional primary source verification where 01 already primary source verified by the state of principal license; 02 (2) the member board within the state selected as the state of principal 03 license shall, in the course of verifying eligibility, perform a criminal background 04 check of an applicant, including the use of the results of fingerprint or other biometric 05 data checks compliant with the requirements of the Federal Bureau of Investigation, 06 with the exception of federal employees who have suitability determination in 07 accordance with 5 C.F.R. 731.202; 08 (3) an appeal on the determination of eligibility shall be made to the 09 member state where the application was filed and shall be subject to the law of that 10 state. 11 (c) Upon verification in (b) of this section, physicians eligible for an expedited 12 license shall complete the registration process established by the Interstate 13 Commission to receive a license in a member state selected pursuant to (a) of this 14 section, including the payment of any applicable fees. 15 (d) After receiving verification of eligibility under (b) of this section and any 16 fees under (c) of this section, a member board shall issue an expedited license to the 17 physician. This license shall authorize the physician to practice medicine in the issuing 18 state consistent with the Medical Practice Act and all applicable laws and regulations 19 of the issuing member board and member state. 20 (e) An expedited license shall be valid for a period consistent with the 21 licensure period in the member state and in the same manner as required for other 22 physicians holding a full and unrestricted license within the member state. 23 (f) An expedited license obtained though the Compact shall be terminated if a 24 physician fails to maintain a license in the state of principal licensure for a non- 25 disciplinary reason, without redesignation of a new state of principal licensure. 26 (g) The Interstate Commission is authorized to develop rules regarding the 27 application process, including payment of any applicable fees, and the issuance of an 28 expedited license. 29 Sec. 08.64.560. Fees for expedited licensure. (a) A member state issuing an 30 expedited license authorizing the practice of medicine in that state may impose a fee 31 for a license issued or renewed through the Compact. 01 (b) The Interstate Commission is authorized to develop rules regarding fees 02 for expedited licenses. 03 Sec. 08.64.570. Renewal and continued participation. (a) A physician 04 seeking to renew an expedited license granted in a member state shall complete a 05 renewal process with the Interstate Commission if the physician: 06 (1) maintains a full and unrestricted license in a state of principal 07 license; 08 (2) has not been convicted, received adjudication, deferred 09 adjudication, community supervision, or deferred disposition for any offense by a 10 court of appropriate jurisdiction; 11 (3) has not had a license authorizing the practice of medicine subject to 12 discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding 13 any action related to non-payment of fees related to a license; and 14 (4) has not had a controlled substance license or permit suspended or 15 revoked by a state or the United States Drug Enforcement Administration. 16 (b) Physicians shall comply with all continuing professional development or 17 continuing medical education requirements for renewal of a license issued by a 18 member state. 19 (c) The Interstate Commission shall collect any renewal fees charged for the 20 renewal of a license and distribute the fees to the applicable member board. 21 (d) Upon receipt of any renewal fees collected in (c) of this section, a member 22 board shall renew the physician's license. 23 (e) Physician information collected by the Interstate Commission during the 24 renewal process will be distributed to all member boards. 25 (f) The Interstate Commission is authorized to develop rules to address 26 renewal of licenses obtained through the Compact. 27 Sec. 08.64.580. Coordinated information system. (a) The Interstate 28 Commission shall establish a database of all physicians licensed, or who have applied 29 for licensure, under AS 08.64.550. 30 (b) Notwithstanding any other provision of law, member boards shall report to 31 the Interstate Commission any public action or complaints against a licensed physician 01 who has applied or received an expedited license through the Compact. 02 (c) Member boards shall report disciplinary or investigatory information 03 determined as necessary and proper by rule of the Interstate Commission. 04 (d) Member boards may report any non-public complaint, disciplinary, or 05 investigatory information not required by subsection (c) to the Interstate Commission. 06 (e) Member boards shall share complaint or disciplinary information about a 07 physician upon request of another member board. 08 (f) All information provided to the Interstate Commission or distributed by 09 member boards shall be confidential, filed under seal, and used only for investigatory 10 or disciplinary matters. 11 (g) The Interstate Commission is authorized to develop rules for mandated or 12 discretionary sharing of information by member boards. 13 Sec. 08.64.590. Joint investigations. (a) Licensure and disciplinary records of 14 physicians are deemed investigative. 15 (b) In addition to the authority granted to a member board by its respective 16 Medical Practice Act or other applicable state law, a member board may participate 17 with other member boards in joint investigations of physicians licensed by the member 18 boards. 19 (c) A subpoena issued by a member state shall be enforceable in other member 20 states. 21 (d) Member boards may share any investigative, litigation, or compliance 22 materials in furtherance of any joint or individual investigation initiated under the 23 Compact. 24 (e) Any member state may investigate actual or alleged violations of the 25 statutes authorizing the practice of medicine in any other member state in which a 26 physician holds a license to practice medicine. 27 Sec. 08.64.600. Disciplinary actions. (a) Any disciplinary action taken by any 28 member board against a physician licensed through the Compact shall be deemed 29 unprofessional conduct which may be subject to discipline by other member boards, in 30 addition to any violation of the Medical Practice Act or regulations in that state. 31 (b) If a license granted to a physician by the member board in the state of 01 principal license is revoked, surrendered or relinquished in lieu of discipline, or 02 suspended, then all licenses issued to the physician by member boards shall 03 automatically be placed, without further action necessary by any member board, on 04 the same status. If the member board in the state of principal license subsequently 05 reinstates the physician's license, a license issued to the physician by any other 06 member board shall remain encumbered until that respective member board takes 07 action to reinstate the license in a manner consistent with the Medical Practice Act of 08 that state. 09 (c) If disciplinary action is taken against a physician by a member board not in 10 the state of principal license, any other member board may deem the action conclusive 11 as to matter of law and fact decided, and impose the same or lesser sanction(s) against 12 the physician so long as such sanctions are consistent with the Medical Practice Act of 13 that state or pursue separate disciplinary action against the physician under its 14 respective Medical Practice Act, regardless of the action taken in other member states. 15 (d) If a license granted to a physician by a member board is revoked, 16 surrendered or relinquished in lieu of discipline, or suspended, then any license(s) 17 issued to the physician by any other member board(s) shall be suspended, 18 automatically and immediately without further action necessary by the other member 19 board(s), for ninety (90) days upon entry of the order by the disciplining board, to 20 permit the member board(s) to investigate the basis for the action under the Medical 21 Practice Act of that state. A member board may terminate the automatic suspension of 22 the license it issued prior to the completion of the ninety (90) day suspension period in 23 a manner consistent with the Medical Practice Act of that state. 24 Sec. 08.64.610. Interstate Medical Licensure Compact Commission. (a) 25 The member states hereby create the Interstate Medical Licensure Compact 26 Commission. 27 (b) The purpose of the Interstate Commission is the administration of the 28 Interstate Medical Licensure Compact, which is a discretionary state function. 29 (c) The Interstate Commission shall be a body corporate and joint agency of 30 the member states and shall have all the responsibilities, powers, and duties set forth in 31 the Compact, and such additional powers as may be conferred upon it by a subsequent 01 concurrent action of the respective legislatures of the member states in accordance 02 with the terms of the Compact. 03 (d) The Interstate Commission shall consist of two voting representatives 04 appointed by each member state who shall serve as Commissioners. In states where 05 allopathic and osteopathic physicians are regulated by separate member boards, or if 06 the licensing and disciplinary authority is split between multiple member boards 07 within a member state, the member state shall appoint one representative from each 08 member board. A Commissioner shall be 09 (1) an allopathic or osteopathic physician appointed to a member 10 board; 11 (2) an executive director, executive secretary, or similar executive of a 12 member board; or 13 (3) a member of the public appointed to a member board. 14 (e) The Interstate Commission shall meet at least once each calendar year. A 15 portion of this meeting shall be a business meeting to address such matters as may 16 properly come before the Commission, including the election of officers. The 17 chairperson may call additional meetings and shall call for a meeting upon the request 18 of a majority of the member states. 19 (f) The bylaws may provide for meetings of the Interstate Commission to be 20 conducted by telecommunication or electronic communication. 21 (g) Each Commissioner participating at a meeting of the Interstate 22 Commission is entitled to one vote. A majority of Commissioners shall constitute a 23 quorum for the transaction of business, unless a larger quorum is required by the 24 bylaws of the Interstate Commission. A Commissioner shall not delegate a vote to 25 another Commissioner. In the absence of its Commissioner, a member state may 26 delegate voting authority for a specified meeting to another person from that state who 27 shall meet the requirements of (d) of this section. 28 (h) The Interstate Commission shall provide public notice of all meetings and 29 all meetings shall be open to the public. The Interstate Commission may close a 30 meeting, in full or in portion, where it determines by a two-thirds vote of the 31 Commissioners present that an open meeting would be likely to 01 (1) relate solely to the internal personnel practices and procedures of 02 the Interstate Commission; 03 (2) discuss matters specifically exempted from disclosure by federal 04 statute; 05 (3) discuss trade secrets, commercial, or financial information that is 06 privileged or confidential; 07 (4) involve accusing a person of a crime, or formally censuring a 08 person; 09 (5) discuss information of a personal nature where disclosure would 10 constitute a clearly unwarranted invasion of personal privacy; 11 (6) discuss investigative records compiled for law enforcement 12 purposes; or 13 (7) specifically relate to the participation in a civil action or other legal 14 proceeding. 15 (i) The Interstate Commission shall keep minutes which shall fully describe all 16 matters discussed in a meeting and shall provide a full and accurate summary of 17 actions taken, including record of any roll call votes. 18 (j) The Interstate Commission shall make its information and official records, 19 to the extent not otherwise designated in the Compact or by its rules, available to the 20 public for inspection. 21 (k) The Interstate Commission shall establish an executive committee, which 22 shall include officers, members, and others as determined by the bylaws. The 23 executive committee shall have the power to act on behalf of the Interstate 24 Commission, with the exception of rulemaking, during periods when the Interstate 25 Commission is not in session. When acting on behalf of the Interstate Commission, 26 the executive committee shall oversee the administration of the Compact including 27 enforcement and compliance with the provisions of the Compact, its bylaws and rules, 28 and other such duties as necessary. 29 (l) The Interstate Commission may establish other committees for governance 30 and administration of the Compact. 31 Sec. 08.64.620. Powers and duties of the Interstate Commission. The 01 Interstate Commission shall have the duty and power to 02 (1) oversee and maintain the administration of the Compact; 03 (2) promulgate rules which shall be binding to the extent and in the 04 manner provided for in the Compact; 05 (3) issue, upon the request of a member state or member board, 06 advisory opinions concerning the meaning or interpretation of the Compact, its 07 bylaws, rules, and actions; 08 (4) enforce compliance with Compact provisions, the rules 09 promulgated by the Interstate Commission, and the bylaws, using all necessary and 10 proper means, including but not limited to the use of judicial process; 11 (5) establish and appoint committees including, but not limited to, an 12 executive committee as required by AS 08.64.610, which shall have the power to act 13 on behalf of the Interstate Commission in carrying out its powers and duties; 14 (6) pay, or provide for the payment of the expenses related to the 15 establishment, organization, and ongoing activities of the Interstate Commission; 16 (7) establish and maintain one or more offices; 17 (8) borrow, accept, hire, or contract for services of personnel; 18 (9) purchase and maintain insurance and bonds; 19 (10) employ an executive director who shall have such powers to 20 employ, select or appoint employees, agents, or consultants, and to determine their 21 qualifications, define their duties, and fix their compensation; 22 (11) establish personnel policies and programs relating to conflicts of 23 interest, rates of compensation, and qualifications of personnel; 24 (12) accept donations and grants of money, equipment, supplies, 25 materials and services, and to receive, utilize, and dispose of it in a manner consistent 26 with the conflict of interest policies established by the Interstate Commission; 27 (13) lease, purchase, accept contributions or donations of, or otherwise 28 to own, hold, improve or use, any property, real, personal, or mixed; 29 (14) sell, convey, mortgage, pledge, lease, exchange, abandon, or 30 otherwise dispose of any property, real, personal, or mixed; 31 (15) establish a budget and make expenditures; 01 (16) adopt a seal and bylaws governing the management and operation 02 of the Interstate Commission; 03 (17) report annually to the legislatures and governors of the member 04 states concerning the activities of the Interstate Commission during the preceding 05 year. Such reports shall also include reports of financial audits and any 06 recommendations that may have been adopted by the Interstate Commission; 07 (18) coordinate education, training, and public awareness regarding the 08 Compact, its implementation, and its operation; 09 (19) maintain records in accordance with the bylaws; 10 (20) seek and obtain trademarks, copyrights, and patents; and 11 (21) perform such functions as may be necessary or appropriate to 12 achieve the purposes of the Compact. 13 Sec. 08.64.630. Finance powers. (a) The Interstate Commission may levy on 14 and collect an annual assessment from each member state to cover the cost of the 15 operations and activities of the Interstate Commission and its staff. The total 16 assessment must be sufficient to cover the annual budget approved each year for 17 which revenue is not provided by other sources. The aggregate annual assessment 18 amount shall be allocated upon a formula to be determined by the Interstate 19 Commission, which shall promulgate a rule binding upon all member states. 20 (b) The Interstate Commission shall not incur obligations of any kind prior to 21 securing the funds adequate to meet the same. 22 (c) The Interstate Commission shall not pledge the credit of any of the 23 member states, except by, and with the authority of, the member state. 24 (d) The Interstate Commission shall be subject to a yearly financial audit 25 conducted by a certified or licensed public accountant and the report of the audit shall 26 be included in the annual report of the Interstate Commission. 27 Sec. 08.64.640. Organization and operation of the Interstate Commission. 28 (a) The Interstate Commission shall, by a majority of Commissioners present and 29 voting, adopt bylaws to govern its conduct as may be necessary or appropriate to carry 30 out the purposes of the Compact within twelve (12) months of the first Interstate 31 Commission meeting. 01 (b) The Interstate Commission shall elect or appoint annually from among its 02 Commissioners a chairperson, a vice-chairperson, and a treasurer, each of whom shall 03 have such authority and duties as may be specified in the bylaws. The chairperson, or 04 in the chairperson's absence or disability, the vice-chairperson, shall preside at all 05 meetings of the Interstate Commission. 06 (c) Officers selected in (b) of this section shall serve without remuneration 07 from the Interstate Commission. 08 (d) The officers and employees of the Interstate Commission shall be immune 09 from suit and liability, either personally or in their official capacity, for a claim for 10 damage to or loss of property or personal injury or other civil liability caused or 11 arising out of, or relating to, an actual or alleged act, error, or omission that occurred, 12 or that such person had a reasonable basis for believing occurred, within the scope of 13 Interstate Commission employment, duties, or responsibilities; provided that such 14 person shall not be protected from suit or liability for damage, loss, injury, or liability 15 caused by the intentional or willful and wanton misconduct of such person. The 16 immunity provided by this section shall be subject to the following: 17 (1) the liability of the executive director and employees of the 18 Interstate Commission or representatives of the Interstate Commission, acting within 19 the scope of such person's employment or duties for acts, errors, or omissions 20 occurring within such person's state, may not exceed the limits of liability set forth 21 under the constitution and laws of that state for state officials, employees, and agents; 22 the Interstate Commission is considered to be an instrumentality of the states for the 23 purposes of any such action; nothing in this paragraph shall be construed to protect 24 such person from suit or liability for damage, loss, injury, or liability caused by the 25 intentional or willful and wanton misconduct of such person; 26 (2) the Interstate Commission shall defend the executive director, its 27 employees, and subject to the approval of the attorney general or other appropriate 28 legal counsel of the member state represented by an Interstate Commission 29 representative, shall defend such Interstate Commission representative in any civil 30 action seeking to impose liability arising out of an actual or alleged act, error or 31 omission that occurred within the scope of Interstate Commission employment, duties 01 or responsibilities, or that the defendant had a reasonable basis for believing occurred 02 within the scope of Interstate Commission employment, duties, or responsibilities, 03 provided that the actual or alleged act, error, or omission did not result from 04 intentional or willful and wanton misconduct on the part of such person; and 05 (3) to the extent not covered by the state involved, member state, or the 06 Interstate Commission, the representatives or employees of the Interstate Commission 07 shall be held harmless in the amount of a settlement or judgment, including attorney's 08 fees and costs, obtained against such persons arising out of an actual or alleged act, 09 error, or omission that occurred within the scope of Interstate Commission 10 employment, duties, or responsibilities, or that such persons had a reasonable basis for 11 believing occurred within the scope of Interstate Commission employment, duties, or 12 responsibilities, provided that the actual or alleged act, error, or omission did not result 13 from intentional or willful and wanton misconduct on the part of such persons. 14 Sec. 08.64.650. Rulemaking functions of the Interstate Commission. (a) 15 The Interstate Commission shall promulgate reasonable rules in order to effectively 16 and efficiently achieve the purposes of the Compact. Notwithstanding the foregoing, 17 in the event the Interstate Commission exercises its rulemaking authority in a manner 18 that is beyond the scope of the purposes of the Compact, or the powers granted 19 hereunder, then such an action by the Interstate Commission shall be invalid and have 20 no force or effect. 21 (b) Rules deemed appropriate for the operations of the Interstate Commission 22 shall be made pursuant to a rulemaking process that substantially conforms to the 23 "Model State Administrative Procedure Act" of 2010, and subsequent amendments 24 thereto. 25 (c) Not later than thirty (30) days after a rule is promulgated, any person may 26 file a petition for judicial review of the rule in the United States District Court for the 27 District of Columbia or the federal district where the Interstate Commission has its 28 principal offices, provided that the filing of such a petition shall not stay or otherwise 29 prevent the rule from becoming effective unless the court finds that the petitioner has a 30 substantial likelihood of success. The court shall give deference to the actions of the 31 Interstate Commission consistent with applicable law and shall not find the rule to be 01 unlawful if the rule represents a reasonable exercise of the authority granted to the 02 Interstate Commission. 03 Sec. 08.64.660. Oversight of Interstate Compact. (a) The executive, 04 legislative, and judicial branches of state government in each member state shall 05 enforce the Compact and shall take all actions necessary and appropriate to effectuate 06 the Compact's purposes and intent. The provisions of the Compact and the rules 07 promulgated hereunder shall have standing as law but shall not override existing state 08 authority to regulate the practice of medicine. 09 (b) All courts shall take judicial notice of the Compact and the rules in any 10 judicial or administrative proceeding in a member state pertaining to the subject matter 11 of the Compact which may affect the powers, responsibilities or actions of the 12 Interstate Commission. 13 (c) The Interstate Commission shall be entitled to receive all service of 14 process in any such proceeding, and shall have standing to intervene in the proceeding 15 for all purposes. Failure to provide service of process to the Interstate Commission 16 shall render a judgment or order void as to the Interstate Commission, the Compact, or 17 promulgated rules. 18 Sec. 08.64.670. Enforcement of Interstate Compact. (a) The Interstate 19 Commission, in the reasonable exercise of its discretion, shall enforce the provisions 20 and rules of the Compact. 21 (b) The Interstate Commission may, by majority vote of the Commissioners, 22 initiate legal action in the United States District Court for the District of Columbia, or, 23 at the discretion of the Interstate Commission, in the federal district where the 24 Interstate Commission has its principal offices, to enforce compliance with the 25 provisions of the Compact, and its promulgated rules and bylaws, against a member 26 state in default. The relief sought may include both injunctive relief and damages. In 27 the event judicial enforcement is necessary, the prevailing party shall be awarded all 28 costs of such litigation including reasonable attorney's fees. 29 (c) The remedies herein shall not be the exclusive remedies of the Interstate 30 Commission. The Interstate Commission may avail itself of any other remedies 31 available under state law or the regulation of a profession. 01 Sec. 08.64.680. Default procedures. (a) The grounds for default include, but 02 are not limited to, failure of a member state to perform such obligations or 03 responsibilities imposed upon it by the Compact, or the rules and bylaws of the 04 Interstate Commission promulgated under the Compact. 05 (b) If the Interstate Commission determines that a member state has defaulted 06 in the performance of its obligations or responsibilities under the Compact, or the 07 bylaws or promulgated rules, the Interstate Commission shall 08 (1) provide written notice to the defaulting state and other member 09 states, of the nature of the default, the means of curing the default, and any action 10 taken by the Interstate Commission; the Interstate Commission shall specify the 11 conditions by which the defaulting state must cure its default; and 12 (2) provide remedial training and specific technical assistance 13 regarding the default. 14 (c) If the defaulting state fails to cure the default, the defaulting state shall be 15 terminated from the Compact upon an affirmative vote of a majority of the 16 Commissioners and all rights, privileges, and benefits conferred by the Compact shall 17 terminate on the effective date of termination. A cure of the default does not relieve 18 the offending state of obligations or liabilities incurred during the period of the 19 default. 20 (d) Termination of membership in the Compact shall be imposed only after all 21 other means of securing compliance have been exhausted. Notice of intent to terminate 22 shall be given by the Interstate Commission to the governor, the majority and minority 23 leaders of the defaulting state's legislature, and each of the member states. 24 (e) The Interstate Commission shall establish rules and procedures to address 25 licenses and physicians that are materially impacted by the termination of a member 26 state, or the withdrawal of a member state. 27 (f) The member state which has been terminated is responsible for all dues, 28 obligations, and liabilities incurred through the effective date of termination including 29 obligations, the performance of which extends beyond the effective date of 30 termination. 31 (g) The Interstate Commission shall not bear any costs relating to any state 01 that has been found to be in default or which has been terminated from the Compact, 02 unless otherwise mutually agreed upon in writing between the Interstate Commission 03 and the defaulting state. 04 (h) The defaulting state may appeal the action of the Interstate Commission by 05 petitioning the United States District Court for the District of Columbia or the federal 06 district where the Interstate Commission has its principal offices. The prevailing party 07 shall be awarded all costs of such litigation including reasonable attorney's fees. 08 Sec. 08.64.690. Dispute resolution. (a) The Interstate Commission shall 09 attempt, upon the request of a member state, to resolve disputes which are subject to 10 the Compact and which may arise among member states or member boards. 11 (b) The Interstate Commission shall promulgate rules providing for both 12 mediation and binding dispute resolution as appropriate. 13 Sec. 08.64.700. Member states, effective date and amendment. (a) Any state 14 is eligible to become a member state of the Compact. 15 (b) The Compact shall become effective and binding upon legislative 16 enactment of the Compact into law by no less than seven (7) states. Thereafter, it shall 17 become effective and binding on a state upon enactment of the Compact into law by 18 that state. 19 (c) The governors of non-member states, or their designees, shall be invited to 20 participate in the activities of the Interstate Commission on a non-voting basis prior to 21 adoption of the Compact by all states. 22 (d) The Interstate Commission may propose amendments to the Compact for 23 enactment by the member states. No amendment shall become effective and binding 24 upon the Interstate Commission and the member states unless and until it is enacted 25 into law by unanimous consent of the member states. 26 Sec. 08.64.710. Withdrawal. (a) Once effective, the Compact shall continue in 27 force and remain binding upon each and every member state; provided that a member 28 state may withdraw from the Compact by specifically repealing the statute which 29 enacted the Compact into law. 30 (b) Withdrawal from the Compact shall be by the enactment of a statute 31 repealing the same, but shall not take effect until one (1) year after the effective date 01 of such statute and until written notice of the withdrawal has been given by the 02 withdrawing state to the governor of each other member state. 03 (c) The withdrawing state shall immediately notify the chairperson of the 04 Interstate Commission in writing upon the introduction of legislation repealing the 05 Compact in the withdrawing state. 06 (d) The Interstate Commission shall notify the other member states of the 07 withdrawing state's intent to withdraw within sixty (60) days of its receipt of notice 08 provided under (c) of this section. 09 (e) The withdrawing state is responsible for all dues, obligations and liabilities 10 incurred through the effective date of withdrawal, including obligations, the 11 performance of which extend beyond the effective date of withdrawal. 12 (f) Reinstatement following withdrawal of a member state shall occur upon 13 the withdrawing state reenacting the Compact or upon such later date as determined by 14 the Interstate Commission. 15 (g) The Interstate Commission is authorized to develop rules to address the 16 impact of the withdrawal of a member state on licenses granted in other member states 17 to physicians who designated the withdrawing member state as the state of principal 18 license. 19 Sec. 08.64.720. Dissolution. (a) The Compact shall dissolve effective upon the 20 date of the withdrawal or default of the member state which reduces the membership 21 in the Compact to one (1) member state. 22 (b) Upon the dissolution of the Compact, the Compact becomes null and void 23 and shall be of no further force or effect, and the business and affairs of the Interstate 24 Commission shall be concluded and surplus funds shall be distributed in accordance 25 with the bylaws. 26 Sec. 08.64.730. Severability and construction. (a) The provisions of the 27 Compact shall be severable, and if any phrase, clause, sentence, or provision is 28 deemed unenforceable, the remaining provisions of the Compact shall be enforceable. 29 (b) The provisions of the Compact shall be liberally construed to effectuate its 30 purposes. 31 (c) Nothing in the Compact shall be construed to prohibit the applicability of 01 other interstate compacts to which the states are members. 02 Sec. 08.64.740. Binding effect of compact and other laws. (a) Nothing herein 03 prevents the enforcement of any other law of a member state that is not inconsistent 04 with the Compact. 05 (b) All laws in a member state in conflict with the Compact are superseded to 06 the extent of the conflict. 07 (c) All lawful actions of the Interstate Commission, including all rules and 08 bylaws promulgated by the Commission, are binding upon the member states. 09 (d) All agreements between the Interstate Commission and the member states 10 are binding in accordance with their terms. 11 (e) In the event any provision of the Compact exceeds the constitutional limits 12 imposed on the legislature of any member state, such provision shall be ineffective to 13 the extent of the conflict with the constitutional provision in question in that member 14 state. 15 Sec. 08.64.750. Compact administrator. Under the compact established in 16 AS 08.64.500 - AS 08.64.740, the chair of the board may designate a person to serve 17 as the compact administrator. The compact administrator shall cooperate with all 18 departments, agencies, and officers of and in the government of this state and its 19 subdivisions in facilitating the proper administration of the compact. 20  * Sec. 8. AS 12.62.400(a) is amended by adding a new paragraph to read: 21 (18) expedited licensure as a physician through the Interstate Medical 22 Licensure Compact under AS 08.64.550.