Pennsylvania has finalized its membership in the Interstate Medical Licensure Compact Act. Found at 63 P.S. §395.2, the General Assembly authorizes the Governor to execute the Interstate Compact for Medical Licensure of non-Pennsylvania based physicians. As I wrote previously last summer, the proposal substantially strips Pennsylvania medical licensees of many due process rights.Pennsylvania based physicians who seek licensure in member states become subject to those jurisdictions' criminal and disciplinary process, investigations and actions. My prior blog addresses the significant pit falls of that process. Reviewing the definition section of the enabling legislation (which is a nationwide standard set of definitions and procedures) helps understand how and why Commonwealth Pennsylvania physicians seeking multi-state licensure are at substantial exposure to extra jurisdiction disciplinary action without the many protections of Pennsylvania's administrative due process.A physician's medical license, granted by a member state to an eligible physician, is subject to this new law's legal definitions. First and foremost is the definition of conviction of any type of criminal act. 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. Potential criminal acts -- any "Offense” means: a felony, gross misdemeanor or crime of moral turpitude.At issue for Pennsylvania and/or New Jersey doctors is the difference in criminal versus administrative matters. A DUI in Pennsylvania is criminal versus New Jersey it is administrative. There are many matters in Pennsylvania that result in a summary resolution, not a felony and misdemeanor conviction. What is a gross misdemeanor? The Act does not differentiate. In Pennsylvania, criminal charges are brought after a preliminary hearing. Many states proceed by indictment. The Act does not distinguish enrollment in a non-conviction based diversion program. How difference states render disciplinary action based upon different standards of conduct (from that of Pennsylvania Medical Board) and resolution - which each member state will now have to unilaterally accept - is significant.These huge differences apply to all physicians. Who is a physician. Physician under the Act means a 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 or the Comprehensive Osteopathic Medical Licensing Examination 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 a state, federal or foreign jurisdiction, excluding an 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; and9. is not under active investigation by a licensing agency or law enforcement authority in a state, federal or foreign jurisdiction. Licensees must identify a state of primary licensure. That state will verify eligibility, conduct background checks, and maintain fingerprint and biometric data. However, these investigations and parameters are set through federal regulations, and not individual state law. Expedited licensure issued by the central processing state makes that interstate commission more powerful than the individual primary state. The interstate license is limited to a specific period of time in the same manner as required for the physicians holding a full unrestricted license within that state. And expedited license obtained through the compact shall be terminated if the physician fails to maintain a license in the state of principle licensure for a non-disciplinary reason, without re-designation of a new state or principle licensure.Because there's a coordinated information system, Pennsylvania's law allows member boards to report to the interstate commission any public action or complaints against a licensed physician who has applied to receive the expedited license through the compact. Member boards report disciplinary or investigation information and determine if it is necessary and proper basis for disciplinary action by the interstate commissions. Member boards may report any non-public complaint, disciplinary or investigative information to the commission. Member boards will share complaint or disciplinary information.. This means even the most minimal initial disciplinary investigatory claims, unfounded, without final disciplinary decision, by a member state is automatically reported to the entire commission. Disciplinary action from the commission, not an individual state jurisdiction, could be the basis for disciplinary action. How does the physician defend himself or herself against this.The Act specifically says "any disciplinary action taken by any member board against a physician license 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 practices act or regulations in that state. Such a disciplinary action by one state may be deemed conclusive as to a matter of law in fact, allowing the member jurisdictions to impose the same or less or sanction or pursue a separate disciplinary action against position under its respective medical practices act, regardless of action taken and other member states. Call me about your license application, conditional approvals, of pending discipline.