Expansive Disciplinary and Investigative Provisions in Interstate Medical Licensure Compact

Are certain investigative and disciplinary provisions in the Interstate Medical Licensure Compact applicable only to physicians licensed through the Compact?  The answer seems to be no. Read more in our letter to the Arizona Senate’s Health and Human Services Committee.

Madam Chair and Members of the Committee:

Thank you for allowing a lengthy discussion about HB 2502 at the March 16th hearing. I appreciate your hard work on this and other bills before the Committee.

It was stated at the hearing that provisions in the Compact only apply to physicians voluntarily licensed through the Compact. However, I’ve heard concerns from physicians about several sections that appear to apply more broadly, that may impact physicians who chose the traditional licensure pathway and are licensed in multiple Compact-participating states.

Specifically of concern are:

1) In Section 9: Joint Investigations:

C.  A SUBPOENA ISSUED BY A MEMBER STATE SHALL BE ENFORCEABLE IN OTHER MEMBER STATES.

This provision seems overly broad and there does not appear to be any other language in the bill that would limit this power to investigations concerning physicians licensed via the Compact. Nor does there appear to be any language restricting this provision to subpoenas issued by a State Medical Board or even limiting it to matters related to medical licensure.  Just this past week, a federal court judge reprimanded the Texas Medical Board for misuse of administrative subpoenas issued without court order.

2) Also in Section 9: Joint Investigations:

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.

 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.

Paragraphs B and E, above, also do not seem to be limited to physicians licensed via the Compact.

Other provisions in the Compact are indeed affirmatively limited to “physicians licensed through the Compact,” yet the above do not seem to be similarly limited.

3) For instance under Section 10: Disciplinary Actions:

Paragraph A is affirmatively limited to “physicians licensed through the Compact.”

A.  ANY DISCIPLINARY ACTION TAKEN BY ANY MEMBER BOARD AGAINST A PHYSICIAN LICENSED THROUGH THIS COMPACT SHALL BE DEEMED UNPROFESSIONAL CONDUCT THAT MAY BE SUBJECT TO DISCIPLINE BY OTHER MEMBER BOARDS, IN ADDITION TO ANY VIOLATION OF THE MEDICAL PRACTICE ACT OR REGULATIONS IN THAT STATE.

However Paragraph D does not appear to be limited to physicians licensed through the Compact and in addition requires mandatory, automatic, and immediate action by the Arizona Medical Board which could impact non-Compact-licensed physicians. In fact, Paragraph D states that it applies to “any license”:

D.  IF A LICENSE GRANTED TO A PHYSICIAN BY A MEMBER BOARD IS REVOKED, SURRENDERED OR RELINQUISHED IN LIEU OF DISCIPLINE, OR SUSPENDED, 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 NINETY DAYS ON 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 BEFORE THE COMPLETION OF THE NINETY‑DAY SUSPENSION PERIOD IN A MANNER CONSISTENT WITH THE MEDICAL PRACTICE ACT OF THAT STATE.

I would appreciate if you would take a close look at the above provisions in HB 2502. Thank you again for your dedication and service to the citizens of Arizona.

Sincerely,

AZ-AAPS

P.S.  I would also like to briefly reply to yesterday’s comments that Arizona’s neighbors are participating in the Compact.  While Nevada and Utah have joined the Compact, New Mexico and California have not.

The New Mexico Medical Board, for instance, determined that “[w]e do not need this [the Compact] as we already have an expedited licensure process.

The California Medical Association has made the point that  “[i]f there is a problem with California’s existing licensing process, the CMA believes that perhaps that is an issue that the Board should take up for all licensees, rather than just a subset that chooses to participate in the compact.”

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