The Vermont Statutes Online

Title 26: Professions and Occupations

Chapter 023: Medicine

• Subchapter 001: General Provisions

• § 1311. Definitions

  As used in this chapter:

  (1) “Practice of medicine” means:

  (A) using the designation “Doctor,” “Doctor of Medicine,” “Physician,” “Dr.,” “M.D.,” or any combination thereof in the conduct of any occupation or profession pertaining to the prevention, diagnosis, or treatment of human disease or condition unless the designation additionally contains the description of another branch of the healing arts for which one holds a valid license in Vermont;

  (B) advertising, holding out to the public, or representing in any manner that one is authorized to practice medicine in the jurisdiction;

  (C) offering or undertaking to prescribe, order, give, or administer any drug or medicine for the use of any other person;

  (D) offering or undertaking to prevent, diagnose, correct, or treat in any manner or by any means, methods, or devices any disease, illness, pain, wound, fracture, infirmity, defect, or abnormal physical or mental condition of any person, including the management of all aspects of pregnancy, labor and delivery, and postpartum care;

  (E) offering or undertaking to perform any surgical operation upon any person;

  (F) rendering a written or otherwise documented medical opinion concerning the diagnosis or treatment of a patient or the actual rendering of treatment to a patient within the State by a physician located outside the State as a result of the transmission of individual patient data by electronic or other means from within the State to the physician or his or her agent; or

  (G) rendering a determination of medical necessity or a decision affecting the diagnosis or treatment of a patient.

  (2) “Board” means the Board of Medical Practice established under section 1351 of this title.

  (3) “License” means license to practice medicine and surgery in the State as defined in subchapter 3 of this chapter. “Licensee” includes any individual licensed or certified by the Board.

  (4) “Medical director” means, for purposes of this chapter, a physician who is Board-certified or Board-eligible in his or her field of specialty, as determined by the American Board of Medical Specialties (ABMS), and who is charged by a health maintenance organization with responsibility for overseeing all clinical activities of the plan in this State, or his or her designee.

  (5) “Health maintenance organization,” as used in this section, has the same meaning as in 18 V.S.A. § 9402(9).

  (6) “Members” means members of the Board.

  (7) “Secretary” means the secretary of the Board. (Amended 1975, No. 249 (Adj. Sess.), § 1; 1999, No. 133 (Adj. Sess.), § 49; 2001, No. 129 (Adj. Sess.), § 20, eff. June 13, 2002; 2003, No. 34, § 4, eff. May 23, 2003; 2009, No. 25, § 10; 2011, No. 61, § 2, eff. June 2, 2011; 2015, No. 97 (Adj. Sess.), § 60; 2019, No. 126 (Adj. Sess.), § 1.)

• § 1312. Faith cure; mind healing; laying on of hands

  The provisions of this chapter shall apply to persons professing and attempting to cure disease by means of “faith cure,” “mind healing,” or “laying on of hands,” but shall not apply to persons who merely practice the religious tenets of their church without pretending a knowledge of medicine or surgery.

• § 1313. Exemptions

  (a) The provisions of this chapter shall not apply to the following:

  (1) A health care professional licensed or certified by the Office of Professional Regulation when that person is practicing within the scope of his or her profession.

  (2) A member of the U.S. Armed Forces or National Guard carrying out official military duties, including a National Guard member in state active duty status, or to any person giving aid, assistance, or relief in emergency or accident cases, pending the arrival of a regularly licensed physician.

  (3) A nonresident physician coming into this State to consult or using telecommunications to consult with a duly licensed practitioner herein.

  (4) A duly licensed physician in another state, in Canada, or in another nation as approved by the Board, who is visiting a medical school or a teaching hospital in this State to receive or conduct medical instruction for a period not to exceed three months, provided the practice is limited to that instruction and is under the supervision of a physician licensed by the Board.

  (5) A physician who is duly licensed and in good standing in another state, territory, or jurisdiction of the United States or in Canada if the physician is employed as or formally designated as the team physician by an athletic team visiting Vermont for a specific sporting event and the physician limits the practice of medicine in this State to medical treatment of the members, coaches, and staff of the sports team employing or designating the physician.

  (6) A student who is enrolled in an accredited educational program that leads to the issuance of a degree that would satisfy the educational requirement for a profession licensed or certified by the Board, who is engaged in an organized clinical training program, and who engages in acts constituting the practice of medicine while under the supervision of a Vermont-licensed or Vermont-certified health care professional who is qualified to supervise any acts by the student that constitute the practice of medicine. This exemption does not apply to postgraduate trainees who are required to obtain a training license.

  (b) The provisions of sections 1311 and 1312 of this title shall not apply to a person, firm, or corporation that manufactures or sells patent, compound, or proprietary medicines that are compounded according to the prescription of a physician who has been duly authorized to practice medicine, or to the domestic administration of family remedies. (Amended 1971, No. 221 (Adj. Sess.), § 2; 1995, No. 171 (Adj. Sess.), § 2; 2003, No. 34, § 14, eff. May 23, 2003; 2011, No. 61, § 2, eff. June 2, 2011; 2015, No. 94 (Adj. Sess.), § 2, eff. May 10, 2016; 2019, No. 126 (Adj. Sess.), § 1.)

• § 1314. Illegal practice

  (a) A person who, not being licensed, advertises or holds himself or herself out to the public as described in section 1311 of this title, or who, not being licensed, practices medicine as defined in section 1311 of this title, or who practices medicine under a fictitious or assumed name, or who impersonates another practitioner or who is not a licensed health care professional as defined in 18 V.S.A. § 5202 and signs a certificate of death for the purpose of burial or removal, shall be imprisoned not more than two years or fined not more than $10,000.00, or both.

  (b) An action shall not be maintained by such person for the recovery of compensation for such services. (Amended 2011, No. 61, § 2, eff. June 2, 2011.)

• § 1317. Unprofessional conduct to be reported to Board

  (a) Required reporters. Any hospital, clinic, community mental health center, or other health care institution in which a licensee performs professional services shall report to the Board, along with supporting information and evidence, any reportable disciplinary action taken by it or its staff.

  (b) Definition of reportable disciplinary action. A reportable disciplinary action is an action based on one or more of the following:

  (1) Acts or omissions of a licensee that relate to the licensee’s fitness or competence to practice medicine under the license held.

  (2) Acts or omissions of the licensee that constitute a violation of a law or rule that relates in any way to the practice of medicine.

  (3) Acts or omissions of the licensee that occur in the course of practice and result in one or more of the following:

  (A) Resignation, leave of absence, termination, or nonrenewal of an employment relationship or contract. This includes a licensee’s own initiation of such action following notification to the licensee by the reporter that the reporter or an affiliated entity is conducting an investigation or inquiry regarding an event that, assuming the accuracy of the information or allegation, is likely to result in reportable disciplinary action. The reporter or affiliated entity shall complete the investigation or inquiry even if the licensee initiates a resignation, leave of absence, termination, or nonrenewal, and shall make a report to the Board if the investigation results in a finding of a reportable disciplinary action. Resignations and leaves of absence that are entirely voluntary by the licensee, and terminations and nonrenewals of employment or contract by a required reporter that are not related to acts or omissions of the licensee, are not reportable disciplinary actions.

  (B) Revocation, suspension, restriction, relinquishment, or nonrenewal of a right or privilege. This includes a licensee’s own initiation of such action following notification to the licensee by the reporter that the reporter or an affiliated entity is conducting an investigation or inquiry regarding an event that, assuming the accuracy of the information or allegation, is likely to result in reportable disciplinary action. The reporter or affiliated entity shall complete the investigation or inquiry even if the licensee initiates a resignation, leave of absence, termination, or nonrenewal, and shall make a report to the Board if the investigation results in a finding of a reportable disciplinary action. Relinquishments of privileges that are entirely voluntary by the licensee, and revocations, nonrenewals, or other limitations on privileges by a required reporter that are not related to acts or omissions of the licensee, are not reportable disciplinary actions.

  (C) Written discipline that constitutes a censure, reprimand, or admonition, if it is the second or subsequent censure, reprimand, or admonition within a 12-month period for the same or related acts or omissions that previously resulted in written censure, reprimand, or admonition. The same or related acts or omissions includes similar behavior or behavior involving the same parties, or both. Oral censure, oral reprimand, and oral admonition are not considered reportable disciplinary actions, and notation of an oral censure, oral reprimand, or oral admonition in a personnel or supervisor’s file does not transform the action from oral to written.

  (D) Fine or any other form of monetary penalty imposed as a form of discipline.

  (E) Required education, remedial counseling, or monitoring that is imposed as a result of a completed, contested disciplinary process. This includes recommendation or referral for services from the Vermont Practitioner Recovery Network established pursuant to section 1401a of this chapter, or from an employer wellness program or similar program, as a result of a completed, contested disciplinary process.

  (c) Timing of reports. A required report of reportable disciplinary action under subsection (b) of this section shall be made within 30 days following the date on which the disciplinary action was taken or upon completion of an investigation or inquiry pursuant to subdivision (b)(3)(A) or (B) of this section.

  (d) Mental health services. If reportable disciplinary action is reported to the Board based on a licensee’s provision of mental health services, the Commissioner of Health shall forward the report to the Commissioners of Mental Health and of Disabilities, Aging, and Independent Living. Except as provided in section 1368 of this title, information provided to the Department of Health, the Department of Mental Health, or the Department of Disabilities, Aging, and Independent Living under this section shall be confidential unless the Department of Health decides to treat the report as a complaint; in which case, the provisions of section 1318 of this title shall apply.

  (e) Limitation on liability. A person who acts in good faith in accordance with the provisions of this section shall not be liable for damages in any civil action based on the fact that a report was made.

  (f) Violations. A reporter who violates this section shall be subject to a civil penalty of not more than $5,000.00, provided that a reporter who employs or grants privileges to five or more Board licensees and who violates this section shall be subject to a civil penalty of not more than $10,000.00. (Added 2001, No. 132 (Adj. Sess.), § 3, eff. June 13, 2002; amended 2007, No. 15, § 20; 2007, No. 172 (Adj. Sess.), § 7a; 2011, No. 61, § 2, eff. June 2, 2011; 2015, No. 23, § 13; 2019, No. 126 (Adj. Sess.), § 1.)

• § 1318. Accessibility and confidentiality of disciplinary matters

  (a) It is the purpose of this section both to protect the reputation of licensees from public disclosure of unwarranted complaints against them and to fulfill the public’s right to know of any action taken against a licensee when that action is based on a determination of unprofessional conduct.

  (b) All meetings and hearings of the Board shall be open to the public, except in accord with 1 V.S.A. § 313.

  (c)(1) The Commissioner of Health shall prepare and maintain a register of all complaints, which shall be a public record, and which shall show:

  (A) with respect to all complaints, the following information:

  (i) the date and the nature of the complaint, but not including the identity of the licensee; and

  (ii) a summary of the completed investigation; and

  (B) only with respect to complaints resulting in filing of disciplinary charges or stipulations or the taking of disciplinary action and except as provided in subdivision (2) of this subsection (c), the following additional information, except for medical and other protected health information contained therein pertaining to any identifiable person that is otherwise confidential by State or federal law:

  (i) the name and business addresses of the licensee and complainant;

  (ii) formal charges, provided they have been served or a reasonable effort to serve them has been made;

  (iii) the findings, conclusions, and order of the Board;

  (iv) the transcript of the hearing, if one has been made, and exhibits admitted at the hearing;

  (v) stipulations presented to the Board at a public meeting;

  (vi) final disposition of the matter by the courts; and

  (vii) a summary of the final disposition of the matter indicating any charges that were dismissed and any charges resulting in a finding of unprofessional conduct.

  (2) The Commissioner shall remove from the register any of the information described in subdivision (1)(B) of this subsection if the final disposition of the matter dismisses all charges filed against a licensee in the same action. The Commissioner shall ensure that the period for appealing an order has expired prior to removing any such information from the register, and shall remove that information within five business days of the expiration of the appeal period.

  (d) The Commissioner shall not make public any information regarding disciplinary complaints, proceedings, or records, except the information required to be released under this section. The Commissioner shall, upon request, provide information that was maintained on the register under subdivision (c)(1) of this section but that was later removed from the register under the provisions of subdivision (c)(2) of this section.

  (e) A licensee or applicant shall have the right to inspect and copy all information in the possession of the Department of Health pertaining to the licensee or applicant, except investigatory files that have not resulted in charges of unprofessional conduct and attorney work product.

  (f) As used in this section, “disciplinary action” means action that suspends, revokes, limits, or conditions licensure or certification in any way, and includes reprimands and administrative penalties.

  (g) Nothing in this section shall prohibit the disclosure of information by the Commissioner regarding disciplinary complaints to Vermont or other state or federal law enforcement or regulatory agencies in the execution of its duties authorized by statute or regulation, including the Department of Disabilities, Aging, and Independent Living or the Department of Financial Regulation in the course of its investigations about an identified licensee, provided the agency or department agrees to maintain the confidentiality and privileged status of the information as provided in subsection (d) of this section.

  (h) Nothing in this section shall prohibit the Board, at its discretion, from sharing investigative and adjudicatory files of an identified licensee with another state, territorial, or international medical board at any time during the investigational or adjudicative process.

  (i) Neither the Commissioner nor any person who received documents, material, or information while acting under the authority of the Commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, material, or information. (Added 2001, No. 132 (Adj. Sess.), § 4, eff. June 13, 2002; amended 2003, No. 34, § 5, eff. May 23, 2003; 2011, No. 61, § 2, eff. June 2, 2011; 2011, No. 78 (Adj. Sess.), § 2, eff. April 2, 2012; 2013, No. 130 (Adj. Sess.), § 1.)

• Subchapter 002: Board of Medical Practice

• § 1351. Board of Medical Practice

  (a) The Board of Medical Practice is created. The Board shall be composed of 17 members, nine of whom shall be licensed physicians, one of whom shall be a physician assistant licensed pursuant to chapter 31 of this title, one of whom shall be a podiatrist licensed pursuant to chapter 7 of this title, and six of whom shall be persons not associated with the medical field. The Governor, with the advice and consent of the Senate, shall appoint the members of the Board. Appointments shall be for a term of five years, except that a vacancy occurring during a term shall be filled by an appointment by the Governor for the unexpired term. No member shall be appointed to more than two consecutive full terms, but a member appointed for less than a full term, originally or to fill a vacancy, may serve two full terms in addition to such part of a full term, and a former member shall again be eligible for appointment after a lapse of one or more years. Any member of the Board may be removed by the Governor at any time. The Board shall elect from its members a chair, vice chair, and secretary who shall serve for one year and until their successors are appointed and qualified. The Board shall meet upon the call of the Chair or the Commissioner of Health, or at such other times and places as the Board may determine. Except as otherwise provided in sections 1372, 1373, and 1374 of this title, nine members of the Board shall constitute a quorum for the transaction of business. The affirmative vote of the majority of the members present and voting shall be required to carry any motion or resolution, to adopt any rule, to pass any measure, or to authorize any decision or order of the Board.

  (b) In the performance of their duties, members of the Board shall be paid a per diem and their actual and necessary expenses as provided by 32 V.S.A. § 1010(b).

  (c) The Board of Medical Practice is established as an office within the Department of Health. With respect to the Board, the Commissioner shall have the following powers and duties to:

  (1) Appoint a director of the office.

  (2) Employ or contract for legal counsel and such assistants as may be required, to fix the compensation to be paid for these services, and to incur such other expenses as the Commissioner determines are necessary.

  (3) Employ, contract, or make arrangements for the performance of administrative, investigative, and similar services required or appropriate in the performance of the duties of the Board.

  (4) Act as custodian of the records of the Board.

  (5) Prepare an annual budget and administer money appropriated to the Board by the General Assembly. The budget of the Board shall be part of the budget of the Department. A Board of Medical Practice Regulatory Fee Fund is created. All Board regulatory fees received by the Department shall be deposited into this Fund and used to offset up to two years of the costs incurred by the Board, and shall not be used for any purpose other than professional regulation and responsibilities of the Board, as determined by the Commissioner of Health. To ensure that revenues derived by the Department are adequate to offset the cost of regulation, the Commissioner shall review fees from time to time, and present proposed fee changes to the General Assembly.

  (6) Prepare and maintain a registry of all physicians licensed by the Board.

  (7) Make available an accounting of all fees and fines received by the Board and all expenditures and costs of the Board annually.

  (d) The Commissioner of Health shall appoint, and may terminate the employment of, the Director, administrative support staff, and any investigator or private legal counsel employed or retained by the Board.

  (e) The Commissioner of Health shall adopt, amend, and repeal rules of the Board that the Commissioner determines necessary to carry out the provisions of this chapter and chapters 7, 29, 31, and 52 of this title.

  (f)(1) A classified State employee who is employed as an investigator by the Department of Health who is certified as a Level III law enforcement officer under 20 V.S.A. chapter 151 shall have the same powers as sheriffs in criminal matters and the enforcement of the law and in serving criminal process, and shall have all the immunities and matters of defense now available or hereafter made available to sheriffs in a suit brought against him or her in consequence for acts done in the course of his or her employment.

  (2) A Board of Medical Practice investigator employed by the Department of Health who is not certified as a Level III law enforcement officer under 20 V.S.A. chapter 151 shall annually obtain a minimum of 25 hours of training regarding the methods of conducting investigations of alleged unprofessional conduct, as approved by the Board.

  (3) Any Board of Medical Practice investigator employed by the Department of Health shall obtain as soon as practicable and thereafter maintain certification by a nationally or regionally recognized entity regarding the investigation of licensing cases, as approved by the Board. (Amended 1969, No. 187 (Adj. Sess.), § 2; 1975, No. 249 (Adj. Sess.), § 2; 1977, No. 91, § 1, eff. May 5, 1977; 1981, No. 100, § 12; 1985, No. 208 (Adj. Sess.), § 18, eff. June 30, 1986; 1989, No. 102, § 1; 1989, No. 250 (Adj. Sess.), § 92; 2001, No. 129 (Adj. Sess.), § 21, eff. June 13, 2002; 2001, No. 132 (Adj. Sess.), § 5, eff. June 13, 2002; 2003, No. 34, § 6, eff. May 23, 2003; 2003, No. 122 (Adj. Sess.), § 117a; 2009, No. 103 (Adj. Sess.), § 19d, eff. May 12, 2010; 2011, No. 61, § 2, eff. June 2, 2011; 2013, No. 130 (Adj. Sess.), § 3; 2013, No. 141 (Adj. Sess.), § 20, eff. July 1, 2015; 2015, No. 2, § 5, eff. March 12, 2015; 2015, No. 2, § 6; 2019, No. 126 (Adj. Sess.), § 1.)

• § 1352. Repealed. 2011, No. 61, § 9, eff. June 2, 2011.

• § 1353. Powers and duties of the Board

  The Board shall have the following powers and duties to:

  (1) License and certify health professionals pursuant to this title.

  (2) Investigate all complaints and charges of unprofessional conduct against any holder of a license or certificate, or any medical practitioner practicing pursuant to section 1313 of this title, and to hold hearings to determine whether such charges are substantiated or unsubstantiated. The Board may employ or contract with one or more hearing officers to schedule, oversee prehearing processes, preside over hearings, and assist with the preparation of reports and decisions.

  (3) Issue subpoenas and administer oaths in connection with any investigations, hearings, or disciplinary proceedings held under this chapter. Any individual or entity served with a subpoena issued by the Board shall comply notwithstanding the patient’s privilege established in 12 V.S.A. § 1612.

  (4) Take or cause depositions to be taken as needed in any investigation, hearing, or proceeding.

  (5) Undertake any such other actions and procedures specified in, or required or appropriate to carry out, the provisions of this chapter and chapters 7, 29, 31, and 52 of this title.

  (6) Require a licensee or applicant to submit to a mental or physical examination, and an evaluation of medical knowledge and skill by individuals or entities designated by the Board if the Board has a reasonable basis to believe a licensee or applicant may be incompetent or unable to practice medicine with reasonable skill and safety. The results of the examination or evaluation shall be admissible in any hearing before the Board. The results of an examination or evaluation obtained under this subsection and any information directly or indirectly derived from such examination or evaluation shall not be used for any purpose, including impeachment or cross-examination against the licensee or applicant in any criminal or civil case, except a prosecution for perjury or giving a false statement. The Board shall bear the cost of any examination or evaluation ordered and conducted pursuant to this subdivision in whole or in part if the licensee demonstrates financial hardship or other good cause. The licensee or applicant, at his or her expense, shall have the right to present the results or reports of independent examinations and evaluations for the Board’s due consideration. An order by the Board that a licensee or applicant submit to an examination, test, or evaluation shall be treated as a discovery order for the purposes of enforcement under 3 V.S.A. §§ 809a and 809b. The results of an examination or evaluation obtained under this subdivision shall be confidential except as provided in this subdivision.

  (7) Investigate all complaints of illegal practice of medicine and refer any substantiated illegal practice of medicine to the Office of the Attorney General or the State’s Attorney in the county in which the violation occurred.

  (8)(A) Inquire into the criminal history backgrounds of applicants for licensure and for biennial license renewal for all professionals licensed or certified by the Board. In obtaining these background checks, the Board may inquire directly of the Vermont Crime Information Center, the Federal Bureau of Investigation, the National Crime Information Center, or other holders of official criminal record information, and may arrange for these inquiries to be made by a commercial service.

  (B) Prior to acting on an initial or renewal application, the Board may obtain with respect to the applicant a Vermont criminal history record, an out-of-state criminal history record, and a criminal history record from the Federal Bureau of Investigation. Federal Bureau of Investigation background checks shall be fingerprint-supported, and fingerprints so obtained may be retained on file and used to notify the Board of future triggering events. Each applicant shall consent to the release of criminal history records to the Board on forms developed by the Vermont Crime Information Center.

  (C) An applicant or licensee shall bear any cost of obtaining a required criminal history background check.

  (D) The Board shall comply with all laws regulating the release of criminal history records and the protection of individual privacy.

  (E) No person shall confirm the existence or nonexistence of criminal history record information to any person who would not be eligible to receive the information pursuant to this chapter. As used in this subdivision, “criminal history record” has the same meaning as in 20 V.S.A. § 2056a.

  (9) Inquire, at the Board’s discretion, of the Vermont Department for Children and Families or of the Vermont Department of Disabilities, Aging, and Independent Living to determine whether any applicant, licensee, or holder of certification who may provide care or treatment to a child or a vulnerable adult is listed on the Child Protection Registry or the vulnerable adult abuse, neglect, and exploitation registry.

  (10) As part of the license application or renewal process, collect data necessary to allow for workforce strategic planning required under 18 V.S.A. chapter 222.

  (11) During a declared state of emergency:

  (A) The Board or the Executive Director of the Board may issue a temporary license to an individual who is currently licensed to practice as a physician, physician assistant, or podiatrist in another jurisdiction, whose license is in good standing, and who is not subject to disciplinary proceedings in any other jurisdiction. The temporary license shall authorize the holder to practice in Vermont until the termination of the declared state of emergency or 90 days, whichever occurs first, provided the licensee remains in good standing, and may be reissued by the Board if the declared state of emergency continues longer than 90 days. Fees shall be waived when a license is required to provide services under this subdivision (A).

  (B) The Board or the Executive Director of the Board may waive supervision and scope of practice requirements for physician assistants, including the requirement for documentation of the relationship between a physician assistant and a physician pursuant to section 1735a of this title. The Board or Executive Director may impose limitations or conditions when granting a waiver under this subdivision (B).

  (12) Provide a pre-application determination of an individual’s criminal background. This determination shall not be binding on the Board in a future application if the individual violates probation or parole or is convicted of another crime following the determination.

  (A) The Board shall initiate this determination upon an individual’s “second chance” determination request. This request shall provide documentation related to the individual’s conviction or convictions, evidence of rehabilitation, and identification of the profession or professions for which the individual seeks licensure.

  (B) The individual shall submit this request online, accompanied by the fee for pre-application determinations set forth in section 1401a of this chapter. If the individual thereafter applies for licensure, this pre-application fee shall be deducted from that license application fee.

  (C) The Board shall:

  (i) process a request within 30 days of receiving a complete request;

  (ii) assess the nature of the underlying conviction or convictions, the nexus to the profession or professions for which the individual seeks licensure, and the provided evidence of rehabilitation; and

  (iii) respond to the individual’s request in writing.

  (13)(A) Establish uniform procedures applicable to all of the professions under its jurisdiction, providing for:

  (i) appropriate recognition of education, training, or service completed by a member of the U.S. Armed Forces toward the requirements of professional licensure;

  (ii) expedited issuance of a professional license to a person who is licensed in good standing in another regulatory jurisdiction:

  (I) whose spouse is a member of the U.S. Armed Forces and who has been subject to a military transfer to Vermont; and

  (II) who left employment to accompany his or her spouse to Vermont.

  (B) The Board may evaluate specific military credentials to determine equivalency to credentials within the Board’s jurisdiction. The determinations shall be adopted through written policy that shall be posted on the Board’s website.

  (14)(A) Adopt rules that prescribe a process for the Board to assess the equivalence of an applicant’s professional credentials earned outside the United States as compared to State licensing requirements for those professions within the Board’s jurisdiction.

  (B) Any determination of equivalence by the Board under this subdivision (14) shall be recorded in the applicant’s licensing file.

  (C) In administering this section, the Board may rely upon third-party credential verification services. The cost of such services shall be paid by the applicant.

  (15)(A) Not less than once every five years, review the continuing education and other continuing competency requirements for each of the professions it regulates. The review results shall be in writing and address the following:

  (i) the renewal requirements of the profession;

  (ii) the renewal requirements in other jurisdictions, particularly in the Northeast region;

  (iii) the cost of the renewal requirements for the profession’s licensees;

  (iv) an analysis of the utility and effectiveness of the renewal requirements with respect to public protection; and

  (v) recommendations to the Commissioner of Health on whether the continuing education or other continuing competency requirements should be modified.

  (B) The Commissioner of Health shall respond to the Board within 45 days of its submitted review results. The Commissioner may require the Board to reduce, modify, or otherwise change the renewal requirements, including by proposing any necessary amendments to statute or rule. (Amended 1975, No. 249 (Adj. Sess.), § 2; 1989, No. 250 (Adj. Sess.), § 38; 1991 No. 167 (Adj. Sess.), § 30; 1993, No. 108 (Adj. Sess.), §§ 24, 25, eff. Feb. 16, 1994; 1995, No. 188 (Adj. Sess.), §§ 1, 8, 9; 1999, No. 14, § 2; 2001, No. 132 (Adj. Sess.), § 7, eff. June 13, 2002; 2003, No. 34, § 8, eff. May 23, 2003; 2011, No. 61, § 2, eff. June 2, 2011; 2013, No. 79, § 43, eff. June 7, 2013; 2013, No. 119 (Adj. Sess.), § 15; 2019, No. 91 (Adj. Sess.), § 15, eff. March 30, 2020; 2019, No. 126 (Adj. Sess.), § 1; 2019, No. 152 (Adj. Sess.), § 15, eff. April 1, 2021.)

• § 1354. Unprofessional conduct

  (a) The Board shall find that any one of the following, or any combination of the following, whether the conduct at issue was committed within or outside the State, constitutes unprofessional conduct:

  (1) fraud or misrepresentation in applying for or procuring a medical license or in connection with applying for or procuring periodic renewal of a medical license;

  (2) all advertising of medical business that is intended or has a tendency to deceive the public or impose upon credulous or ignorant persons and so be harmful or injurious to public morals or safety;

  (3) [Repealed.]

  (4) abandonment of a patient;

  (5) habitual or excessive use or abuse of drugs, alcohol, or other substances that impair the licensee’s ability to practice medicine;

  (6) promotion by a physician of the sale of drugs, devices, appliances, or goods provided for a patient in such a manner as to exploit the patient for financial gain of the physician or selling, prescribing, giving away, or administering drugs for other than legal and legitimate therapeutic purposes;

  (7) conduct that evidences unfitness to practice medicine;

  (8) willfully making and filing false reports or records in his or her practice as a physician;

  (9) willful omission to file or record, or willfully impeding or obstructing a filing or recording, or inducing another person to omit to file or record medical reports required by law;

  (10) failure to make available promptly to a person using professional health care services, that person’s representative, succeeding health care professionals, or institutions, when given proper written request and direction of the person using professional health care services, copies of that person’s records in the possession or under the control of the licensed practitioner;

  (11) solicitation of professional patronage by agents or persons or profiting from the acts of those representing themselves to be agents of the licensed physician;

  (12) division of fees or agreeing to split or divide the fees received for professional services for any person for bringing to or referring a patient;

  (13) agreeing with clinical or bio-analytical laboratories to make payments to such laboratories for individual tests or test series for patients, unless the physician discloses on the bills to patients or third party payors the name of such laboratory, the amount or amounts to such laboratory for individual tests or test series, and the amount of his or her processing charge or procurement, if any, for each specimen taken;

  (14) willful misrepresentation in treatments;

  (15) practicing medicine with a physician who is not legally practicing within the State, or aiding or abetting such physician in the practice of medicine; except that it shall be legal to practice in an accredited preceptorship or residency training program or pursuant to section 1313 of this title;

  (16) gross overcharging for professional services on repeated occasions, including filing of false statements for collection of fees for which services are not rendered;

  (17) offering, undertaking, or agreeing to cure or treat disease by a secret method, procedure, treatment, or medicine;

  (18) consistent improper utilization of services;

  (19) consistent use of nonaccepted procedures that have a consistent detrimental effect upon patients;

  (20) professional incompetency resulting from physical or mental impairment;

  (21) permitting one’s name or license to be used by a person, group, or corporation when not actually in charge of or responsible for the treatment given;

  (22) in the course of practice, gross failure to use and exercise on a particular occasion or the failure to use and exercise on repeated occasions, that degree of care, skill, and proficiency that is commonly exercised by the ordinary skillful, careful, and prudent physician engaged in similar practice under the same or similar conditions, whether or not actual injury to a patient has occurred;

  (23) revocation of a license to practice medicine or surgery, or other disciplinary sanction, by another jurisdiction on one or more of the grounds specified in this section;

  (24) failure to comply with the provisions of 18 V.S.A. § 1852;

  (25) failure to comply with an order of the Board or violation of any term or condition of a license that is restricted or conditioned by the Board;

  (26) any physician who, in the course of a collaborative agreement with a nurse practitioner allows the nurse practitioner to perform a medical act that is outside the usual scope of the physician’s own practice or that the nurse practitioner is not qualified to perform by training or experience, or that the ordinary reasonable and prudent physician engaged in a similar practice would not agree should be written into the scope of the nurse practitioner’s practice;

  (27) failure to comply with provisions of federal statutes or regulations, or the statutes or rules of this or any other state, governing the practice of medicine or surgery;

  (28) practice of profession when medically or psychologically unfit to do so;

  (29) delegation of professional responsibilities to a person whom the licensed professional knows, or has reason to know, is not qualified by training, experience, education, or licensing credentials to perform them;

  (30) conviction of a crime related to the practice of the profession or conviction of a felony, whether or not related to the practice of the profession, or failure to report to the Board a conviction of any crime related to the practice of the profession or any felony in any court within 30 days of the conviction;

  (31) use of the services of an anesthesiologist assistant by an anesthesiologist in a manner that is inconsistent with the provisions of chapter 29 of this title;

  (32) use of the services of a radiologist assistant by a radiologist in a manner that is inconsistent with the provisions of chapter 52 of this title;

  (33)(A) providing, prescribing, dispensing, or furnishing medical services or prescription medication or prescription-only devices to a person in response to any communication transmitted or received by computer or other electronic means, when the licensee fails to take the following actions to establish and maintain a proper physician-patient relationship:

  (i) a reasonable effort to verify that the person requesting medication is in fact the patient, and is in fact who the person claims to be;

  (ii) establishment of documented diagnosis through the use of accepted medical practices; and

  (iii) maintenance of a current medical record;

  (B) for the purposes of this subdivision (33), an electronic, on-line, or telephonic evaluation by questionnaire is inadequate for the initial evaluation of the patient;

  (C) the following would not be in violation of this subdivision (33) if transmitted or received by computer or other electronic means:

  (i) initial admission orders for newly hospitalized patients;

  (ii) prescribing for a patient of another physician for whom the prescriber has taken the call;

  (iii) prescribing for a patient examined by a licensed advanced practice registered nurse, physician assistant, or other advanced practitioner authorized by law and supported by the physician;

  (iv) continuing medication on a short-term basis for a new patient, prior to the patient’s first appointment; or

  (v) emergency situations where life or health of the patient is in imminent danger;

  (34) failure to provide to the Board such information it may reasonably request in furtherance of its statutory duties. The patient privilege set forth in 12 V.S.A. § 1612 shall not bar the licensee’s obligations under this subsection (a) and no confidentiality agreement entered into in concluding a settlement of a malpractice claim shall exempt the licensee from fulfilling his or her obligations under this subdivision;

  (35) disruptive behavior that involves interaction with physicians, hospital personnel, office staff, patients, or support persons of the patient or others that interferes with patient care or could reasonably be expected to adversely affect the quality of care rendered to a patient;

  (36) commission of any sexual misconduct that exploits the physician-patient relationship, including sexual contact with a patient, surrogates, or key third parties;

  (37) prescribing, selling, administering, distributing, ordering, or dispensing any drug legally classified as a controlled substance for the licensee’s own use or to an immediate family member as defined by rule;

  (38) signing a blank or undated prescription form;

  (39) [Repealed.]

  (40) use of conversion therapy as defined in 18 V.S.A. § 8351 on a client younger than 18 years of age; or

  (41) failure to comply with one or more of the notice, disclosure, or advertising requirements in 18 V.S.A. § 4502 for administering stem cell or stem cell-related products not approved by the U.S. Food and Drug Administration.

  (b) The Board may also find that failure to practice competently by reason of any cause on a single occasion or on multiple occasions constitutes unprofessional conduct. Failure to practice competently includes, as determined by the Board:

  (1) performance of unsafe or unacceptable patient care; or

  (2) failure to conform to the essential standards of acceptable and prevailing practice.

  (c) The burden of proof in a disciplinary action shall be on the State to show by a preponderance of the evidence that the person has engaged in unprofessional conduct.

  (d)(1) Health care providers. Notwithstanding any other law to the contrary, no health care provider who is certified, registered, or licensed in Vermont shall be subject to professional disciplinary action by the Board, nor shall the Board take adverse action on an application for certification, registration, or licensure of a qualified health care provider, based solely on:

  (A) the health care provider providing or assisting in the provision of legally protected health care activity; or

  (B) a criminal, civil, or disciplinary action in another state against the health care provider that is based solely on the provider providing or assisting in the provision of legally protected health care activity.

  (2) Definitions. As used in this subsection:

  (A) “Health care provider” means a person who provides professional health care services to an individual during that individual’s medical care, treatment, or confinement.

  (B) “Health care services” means services for the diagnosis, prevention, treatment, cure, or relief of a physical or mental health condition, including procedures, products, devices, and medications.

  (C) “Legally protected health care activity” has the same meaning as in 1 V.S.A. § 150. (Amended 1967, No. 307 (Adj. Sess.), § 6, eff. March 22, 1968; 1975, No. 249 (Adj. Sess.), § 2; 1977, No. 259 (Adj. Sess.), § 6; 1985, No. 163 (Adj. Sess.), § 3; 1989, No. 161 (Adj. Sess.), §§ 1, 2; 1991, No. 167 (Adj. Sess.), § 31; 1993, No. 190 (Adj. Sess.), § 6, eff. June 11, 1994; 1993, No. 201 (Adj. Sess.), § 4; 2001, No. 132 (Adj. Sess.), § 8, eff. June 13, 2002; 2001, No. 151 (Adj. Sess.), § 19a, eff. June 27, 2002; 2003, No. 34, § 3, eff. May 23, 2003; 2009, No. 103 (Adj. Sess.), § 19c, eff. May 12, 2010; 2011, No. 61, § 2, eff. June 2, 2011; 2015, No. 138 (Adj. Sess.), § 3; 2017, No. 74, § 117; 2019, No. 123 (Adj. Sess.), § 2; 2019, No. 126 (Adj. Sess.), § 1; 2021, No. 61, § 3; 2023, No. 15, § 7, eff. May 10, 2023.)

• §§ 1355-1361. Repealed. 2019, No. 126 (Adj. Sess.), § 1.

• § 1362. Repealed. 1989, No. 250 (Adj. Sess.), § 92.

• § 1363. Repealed. 1991, No. 167 (Adj. Sess.), § 66(7).

• § 1364. References to the State Board of Medical Registration

  The State Board of Medical Registration is abolished. All references in the Vermont Statutes Annotated to the State Board of Medical Registration shall be deemed from and after July 1, 1976, to refer to the State Board of Medical Practice. (Added 1975, No. 249 (Adj. Sess.), § 2.)

• § 1365. Notice of conviction of crime; interim suspension of license

  (a) The Board shall treat a notice of conviction of a crime for which a licensee may be disciplined under section 1354 of this title as an unprofessional conduct complaint. A certified copy of the judgment of conviction shall be conclusive evidence of the fact that the conviction occurred.

  (b) Upon receipt of the certified copy of the judgment of conviction of a crime for which a licensee may be disciplined for unprofessional conduct, the Board may immediately suspend that person’s license until the time for appeal has elapsed and no appeal has been taken, or until the judgment of conviction has been affirmed on appeal or has otherwise become final, and until further order of the Board. The Board shall notify the licensee whose license has been suspended under this section and advise the licensee of his or her right to request a hearing, within 90 days. At such hearing, the licensee shall have the burden of showing why the suspension should not remain in effect pending appeal.

  (c) The disciplinary hearing shall not be commenced until all appeals from the conviction are concluded unless the licensee requests that the matter not be deferred. The sole issue to be determined at such hearing shall be the nature of the disciplinary action to be taken by the Board.

  (d) An interim suspension ordered under subsection (b) of this section shall automatically terminate if the licensee demonstrates that the conviction that served as the basis of the interim suspension has been reversed or vacated. However, a reversal or vacated conviction shall not prohibit the Board from pursuing disciplinary action based on any cause other than the overturned conviction. (Added 1995, No. 188 (Adj. Sess.), § 11; amended 2011, No. 61, § 2, eff. June 2, 2011; 2019, No. 126 (Adj. Sess.), § 1.)

• § 1366. Out-of-state discipline; interim suspension of license

  (a) The Board shall treat a certified copy of an order revoking or suspending the license of a person licensed to practice medicine or surgery in another jurisdiction on grounds for which a licensee may be disciplined under subdivision 1354(a)(23) of this title as an unprofessional conduct complaint. A certified copy of the order of revocation or suspension shall be conclusive evidence of the fact that the revocation or suspension occurred.

  (b) The Board shall treat as an unprofessional conduct complaint any notice of a statement of a licensing entity in another jurisdiction that verifies that a person licensed to practice medicine or surgery in that jurisdiction failed to renew, surrendered, or otherwise terminated his or her license during, or prior to initiation of, proceedings to revoke or suspend his or her license. A certified copy of the statement shall be conclusive evidence of the fact that such termination occurred.

  (c) Upon receipt of the certified copy of an order or statement referred to in subsection (a) or (b) of this section, the Board shall follow the procedures for interim suspension set forth in subsection 1365(b) of this chapter.

  (d) The sole issue to be determined at the disciplinary hearing on a complaint filed under subsection (a) of this section shall be the nature of the disciplinary action to be taken by the Board. (Added 1995, No. 188 (Adj. Sess.), § 12; 2019, No. 126 (Adj. Sess.), § 1.)

• § 1367. Appeals from Board orders

  A party aggrieved by a final order of the Board may, within 30 days of the order, appeal that order to the Vermont Supreme Court on the basis of the record created before the Board. (Added 2001, No. 132 (Adj. Sess.), § 10, eff. June 13, 2002.)

• § 1368. Data repository; licensee profiles

  (a) A data repository is created within the Department of Health that will be responsible for the compilation of all data required under this section, under this chapter, and under any other law or rule that requires the reporting of such information. Notwithstanding any provision of law to the contrary, licensees shall promptly report and the Department shall collect the following information to create individual profiles on all health care professionals licensed, certified, or registered by the Department, pursuant to the provisions of this title, in a format created by the Department that shall be available for dissemination to the public:

  (1) A description of any criminal convictions for felonies and serious misdemeanors, as determined by the Commissioner of Health, within the most recent 10 years. For the purposes of this subdivision, a person shall be deemed to be convicted of a crime if he or she pleaded guilty or was found or adjudged guilty by a court of competent jurisdiction.

  (2) A description of any charges to which a health care professional pleads nolo contendere or where sufficient facts of guilt were found and the matter was continued without a finding by a court of competent jurisdiction.

  (3)(A) A description of any formal charges served, findings, conclusions, and orders of the licensing authority, and final disposition of matters by the courts within the most recent 10 years, and a summary of the final disposition of such matters indicating any charges that were dismissed and any charges resulting in a finding of unprofessional conduct.

  (B) The Department shall remove from the data repository any charges, findings, conclusions, and order if the final disposition of the matter dismissed all charges filed against the licensee in the same action. The Department shall ensure that the period for appealing an order has expired prior to removing any such information from the data repository, and shall remove that information within five business days of the expiration of the appeal period.

  (4)(A) A description of any formal charges served by licensing authorities, findings, conclusions, and orders of such licensing authorities, and final disposition of matters by the courts in other states within the most recent 10 years.

  (B) Upon request of the licensee, the Department shall remove from the data repository any charges, findings, conclusions, and order if the final disposition of the matter dismissed all charges filed against the licensee in the same action. The Department shall confirm the dismissal and shall ensure that the period for appealing an order has expired prior to removing any such information from the data repository, and shall remove that information within five business days of the expiration of the appeal period or within five business days of the request of the licensee, whichever is later.

  (5) A description of revocation or involuntary restriction of hospital privileges for reasons related to competence or character that has been issued by the hospital’s governing body or any other official of the hospital after procedural due process has been afforded, or the resignation from, or nonrenewal of, medical staff membership or the restriction of privileges at a hospital taken in lieu of, or in settlement of, a pending disciplinary case related to competence or character in that hospital. Only cases that have occurred within the most recent 10 years shall be disclosed by the Board to the public.

  (6)(A) All medical malpractice court judgments and all medical malpractice arbitration awards in which a payment is awarded to a complaining party during the last 10 years, and all settlements of medical malpractice claims in which a payment is made to a complaining party within the last 10 years. Dispositions of paid claims shall be reported in a minimum of three graduated categories, indicating the level of significance of the award or settlement, if valid comparison data are available for the profession or specialty. Information concerning paid medical malpractice claims shall be put in context by comparing an individual health care professional’s medical malpractice judgment awards and settlements to the experience of other health care professionals within the same specialty within the New England region or nationally. The Commissioner may, in consultation with the Vermont Medical Society, report comparisons of individual health care professionals covered under this section to all similar health care professionals within the New England region or nationally.

  (B) Comparisons of malpractice payment data shall be accompanied by:

  (i) an explanation of the fact that professionals treating certain patients and performing certain procedures are more likely to be the subject of litigation than others;

  (ii) a statement that the report reflects data for the last 10 years, and the recipient should take into account the number of years the professional has been in practice when considering the data;

  (iii) an explanation that an incident giving rise to a malpractice claim may have occurred years before any payment was made, due to the time lawsuits take to move through the legal system;

  (iv) an explanation of the possible effect of treating high-risk patients on a professional’s malpractice history; and

  (v) an explanation that malpractice cases may be settled for reasons other than liability.

  (C)(i) Information concerning all settlements shall be accompanied by the following statement: “Settlement of a claim may occur for a variety of reasons that do not necessarily reflect negatively on the professional competence or conduct of the health care professional. A payment in settlement of a medical malpractice action or claim should not be construed as creating a presumption that medical malpractice has occurred.” Nothing in this subdivision (6) shall be construed to limit or prevent the licensing authority from providing further explanatory information regarding the significance of categories in which settlements are reported.

  (ii) Pending malpractice claims and actual amounts paid by or on behalf of a professional in connection with a malpractice judgment, award, or settlement shall not be disclosed by the Commissioner of Health or by the licensing authority to the public. Nothing in this subdivision (6) shall be construed to prevent the licensing authority from investigating and disciplining a health care professional on the basis of medical malpractice claims that are pending.

  (7) The names of medical professional schools and dates of graduation.

  (8) Graduate medical education.

  (9) Specialty board certification.

  (10) The number of years in practice.

  (11) The names of the hospitals where the health care professional has privileges.

  (12) Appointments to medical school or professional school faculties, and indication as to whether the health care professional has had a responsibility for teaching graduate medical education within the last 10 years.

  (13) Information regarding publications in peer-reviewed medical literature within the last 10 years.

  (14) Information regarding professional or community service activities and awards.

  (15) The location of the health care professional’s primary practice setting.

  (16) The identification of any translating services that may be available at the health care professional’s primary practice location.

  (17) An indication of whether the health care professional participates in the Medicaid program, and is currently accepting new patients.

  (b) The Department shall provide individual health care professionals with a copy of their profiles prior to the initial release to the public and each time a physician’s profile is modified or amended. A health care professional shall be provided a reasonable time to correct factual inaccuracies that appear in such profile, and may elect to have his or her profile omit the information required under subdivisions (a)(12) through (14) of this section. In collecting information for such profiles and in disseminating the same, the Department shall inform health care professionals that they may choose not to provide such information required under subdivisions (a)(12) through (14).

  (c) The profile shall include the following conspicuous statement: “This profile contains information that may be used as a starting point in evaluating the professional. This profile should not, however, be your sole basis for selecting a professional.” (Added 2001, No. 132 (Adj. Sess.), § 15, eff. June 13, 2002; amended 2011, No. 61, § 2, eff. June 2, 2011; 2013, No. 130 (Adj. Sess.), § 2, eff. July 1, 2015; 2015, No. 23, § 14; 2017, No. 113 (Adj. Sess.), § 165.)

• § 1369. Repealed. 2013, No. 42, § 3.

• § 1370. Complaints; investigative committee

  (a)(1) Any individual, organization, or public officer may submit a written complaint to the Board alleging that any individual practicing medicine in the State committed unprofessional conduct or that an individual practiced without being licensed in violation of section 1314 of this chapter. The complaint shall specify the grounds on which the allegations of unprofessional conduct are based.

  (2) A person or organization shall not be liable in a civil action for damages resulting from the good faith reporting of information to the Board about alleged incompetent, unprofessional, or unlawful conduct of a licensee.

  (b)(1) The Board shall initiate an investigation of the individual complained against whenever a complaint is received. The Board may also act on its own initiative without having received a complaint.

  (2) The Executive Director shall designate three or more members, including at least one public member, to serve as an investigative committee to investigate and report to the Board its findings regarding the complaint and whether an evidentiary hearing is warranted. If there is an insufficient number of members to investigate a complaint by reason of disqualification, resignation, vacancy, or necessary absence, the Commissioner of Health may, at the request of the Board, appoint ad hoc members to serve on the investigative committee for that matter only.

  (3) If the investigative committee determines that an evidentiary hearing is warranted, the Executive Director shall prepare a specification of the charge or charges of unprofessional conduct made against the individual licensed by the Board, a copy of which shall be served upon the subject of the charge or charges, together with the notice of hearing set forth in subsection 1372(b) of this chapter. (Added 2019, No. 126 (Adj. Sess.), § 1.)

• § 1371. Access to documents; discovery

  (a)(1) A licensee who is notified that a specification of one or more charges of unprofessional conduct have been made against the individual in accordance with subdivision 1370(b)(3) of this chapter shall be entitled to inspect and copy all information in the possession of the Department of Health pertaining to the licensee, except:

  (A) investigatory files that have not resulted in charges of unprofessional conduct;

  (B) materials that constitute attorney work product; and

  (C) any other document or information that the Board has an obligation to protect from disclosure.

  (2) The Executive Director shall notify the licensee of the right to inspect and copy information as provided in subsection 1372(b) of this chapter.

  (b) A licensee who is notified that a specification of one or more charges of unprofessional conduct have been made against the individual in accordance with subdivision 1370(b)(3) of this chapter shall be entitled to produce fact witnesses, expert witnesses, and evidence on the licensee’s own behalf, to cross-examine witnesses testifying against the licensee, and to engage in other methods of discovery as set forth by order of the Board or its hearing officer.

  (c) A licensee who is notified that a specification of one or more charges of unprofessional conduct have been made against the individual in accordance with subdivision 1370(b)(3) of this chapter shall be entitled to request to depose witnesses by motion to the Board or its hearing officer. Any deposition so ordered shall be subject to:

  (1) the provisions of section 1376 of this chapter, relating to confidentiality and the inadmissibility of certain evidence;

  (2) limitations or conditions necessary to protect witnesses who are minors or who are adults subject to a guardianship or conservatorship; and

  (3) such other reasonable limitations as the Board or its hearing officer may provide in the interests of justice and consistent with the provisions of 3 V.S.A. § 810, relating to rules of evidence and official notice in contested cases. (Added 2019, No. 126 (Adj. Sess.), § 1.)

• § 1372. Hearing panel

  (a) Composition of hearing panel.

  (1) The Executive Director may designate a hearing panel constituting less than a quorum of the Board to conduct hearings that would otherwise be heard by the full Board. A hearing panel shall consist of at least three members, including at least one physician member of the Board and at least one public member of the Board. No member of the hearing panel shall have been a member of the investigative committee that reviewed the matter at the investigative stage. A party may move to disqualify a member of a hearing panel due to a conflict of interest.

  (2) If there is an insufficient number of members to serve on a hearing panel by reason of disqualification, resignation, vacancy, or necessary absence, the Commissioner of Health may, at the request of the Board, appoint ad hoc members to serve on the hearing panel for that matter only.

  (b) Time and notice of hearing.

  (1) The Executive Director or a hearing officer shall set a time for the evidentiary hearing as soon as convenient following the determination by the investigative committee that an evidentiary hearing is warranted, subject to the discovery needs of the parties as established in any prehearing or discovery conference or in any orders regulating discovery and depositions, or both, but no earlier than 30 days after service of the charge upon the individual complained against. A party may file motions to extend the time of the hearing for good cause.

  (2) The Executive Director shall issue a notice of the evidentiary hearing on the charges, which notice shall specify the time and place of the hearing and shall notify the individual complained against that he or she may file with the Executive Director a written response within 20 days of the date of service. The notice shall also notify the individual complained against that a record of the proceeding will be kept, that he or she will have the right to inspect and copy information as set forth in section 1371 of this chapter, and that he or she will have the opportunity to appear personally and to have counsel present, with the right to produce witnesses and evidence on his or her own behalf, to cross-examine witnesses testifying against him or her, and to examine such documentary evidence as may be produced against him or her.

  (c) Hearing panel report. Within 60 days after holding an evidentiary hearing under this section, unless the Board grants an extension, the hearing panel shall provide a written report of its findings of fact and its recommendations to the full Board, with a transcript of the evidence. (Added 2019, No. 126 (Adj. Sess.), § 1.)

• § 1373. Hearing before the Board

  (a) If the Board deems it necessary, following receipt of the report of the hearing panel pursuant to section 1372 of this chapter and after further notice to the individual complained against, the Board may take additional evidence at a hearing before the Board, which shall be conducted according to the same process as provided for the hearing panel.

  (b)(1) Five members of the Board, including at least one physician member and at least one public member, shall constitute a quorum for purposes of this section.

  (2) Members of the investigative committee designated pursuant to section 1370 of this chapter shall not sit with the Board when it conducts hearings under this section. (Added 2019, No. 126 (Adj. Sess.), § 1.)

• § 1374. Decision and order

  (a) Regardless of whether the Board makes its determination on the findings of the hearing panel pursuant to section 1372 of this chapter alone, on the findings of the hearing panel as supplemented by a hearing before the Board pursuant to section 1373 of this chapter, or on its own findings, the Board shall render its decision on the merits of the charge or charges on the basis of the evidence in the record before it.

  (b)(1) If a majority of the members of the Board present and voting find that the individual complained against committed unprofessional conduct as specified in one or more of the charges, the Board shall prepare written findings of fact, conclusions, and an order, copies of which shall be served upon the individual complained against.

  (A) In its order, the Board may do one or more of the following:

  (i) reprimand the individual complained against;

  (iii) take such other action relating to discipline or practice as the Board determines appropriate, including imposing an administrative penalty of not more than $1,000.00 for each act that constitutes an unprofessional conduct violation.

  (ii) condition, limit, suspend, or revoke the license, certificate, or practice of the individual complained against; or

  (B) Any monies received from the imposition of an administrative penalty imposed pursuant to this subdivision (2) shall be deposited into the Board of Medical Practice Regulatory Fee Fund for the purpose of providing education and training for Board members and licensees. The Commissioner of Health’s accounting under section 1351 of this chapter shall detail the receipts of administrative penalties and the purposes for which such monies were used.

  (c) If the Board finds the individual complained against not guilty of the charge or charges, or the charges against the individual are dismissed, the Board shall promptly order a dismissal of the charges and issue a statement that the charges were not proved.

  (d) Any order issued by the Board under this section shall be in full force and effect until further order of the Board or of a court of competent jurisdiction. (Added 2019, No. 126 (Adj. Sess.), § 1.)

• § 1375. Subpoenas; contempt

  (a) The Board may issue subpoenas to compel the attendance of witnesses at any investigation or hearing.

  (b) The Board shall issue subpoenas on behalf of the individual complained against at the request of such person. (Added 2019, No. 126 (Adj. Sess.), § 1.)

• § 1376. Confidentiality; inadmissibility of certain evidence

  (a) A hearing panel or the Board, or both, may close portions of a hearing or hearings to the public if the panel or Board deems it appropriate in order to protect the confidentiality of an individual or for medical and other protected health information pertaining to any identifiable person that is otherwise confidential under State or federal law.

  (b) In any proceeding under section 1372 or 1373 of this chapter that addresses an applicant’s or licensee’s alleged sexual misconduct, evidence of the sexual history of a victim of the alleged sexual misconduct shall neither be subject to discovery nor be admitted into evidence. Neither opinion evidence nor evidence of the reputation of a victim’s sexual conduct shall be admitted. At the request of a victim, a hearing panel or the Board may close portions of hearings to the public if the panel or Board deems it appropriate in order to protect the identity of a victim and the confidentiality of his or her medical records. (Added 2019, No. 126 (Adj. Sess.), § 1.)

• § 1377. Nondisciplinary financial penalty

  (a) For violations of statutes and Board rules of an administrative nature, the Board may, in its sole discretion, elect to offer a licensee the opportunity to pay a nondisciplinary financial penalty of not more than $250.00 for each instance of noncompliance. If the licensee accepts the offer and submits the required payment, the matter shall be considered to be closed in lieu of investigating the failure to comply with the rule or statute as unprofessional conduct.

  (b) A matter closed by payment of a nondisciplinary financial penalty shall not be considered to be a disciplinary action, and the matter shall remain confidential in the manner of dismissed charges in accordance with section 1318 of this chapter.

  (c) The Board shall not be required to offer the option of a nondisciplinary financial penalty in any particular case and may elect to process any matter as a disciplinary action.

  (d) Any monies received from nondisciplinary financial penalties imposed pursuant to this section shall be deposited into the Board of Medical Practice Regulatory Fee Fund for the purpose of providing education and training for Board members and licensees. (Added 2019, No. 126 (Adj. Sess.), § 1.)

• Subchapter 003: Licenses

• § 1391. Qualifications for medical licensure

  (a) Basic requirements.

  (1) An applicant for physician licensure as a medical doctor shall meet each of the requirements set forth in subdivisions (2)(A) through (D) of this subsection. A requirement may be met either by satisfying the requirement on its own terms or by qualifying for an exception established in this chapter or by the Board by rule.

  (2) An applicant shall submit evidence of identity acceptable to the Board as set forth by rule and shall establish that the applicant:

  (A) is at least 18 years of age;

  (B) has completed high school, or the equivalent, and at least two years of undergraduate postsecondary school;

  (C) has graduated from a medical school accredited by an organization that is acceptable to the Board, or from a medical school that has been approved by the Board by rule, with a degree of doctor of medicine or an equivalent as may be determined by the Board; and

  (D) is of sound moral character and professional competence as evidenced by:

  (i) references submitted in accordance with rules adopted by the Board;

  (ii) a personal interview, as may be required in the discretion of the Board; and

  (iii) the applicant’s entire personal history, as established by information about the applicant’s academic, licensing examination, employment, professional credentialing, professional certification, professional regulation, civil litigation, and criminal records submitted by the applicant or otherwise obtained by the Board in the application process.

  (b) Postgraduate training requirements.

  (1) A graduate of a U.S. or Canadian medical school accredited by a body that is acceptable to the Board shall submit evidence of the successful completion of at least two years of postgraduate training in a U.S. or Canadian program accredited by an organization that is acceptable to the Board and that meets such other requirements as the Board may establish by rule.

  (2) A graduate of a Board-approved medical school outside the United States or Canada shall submit evidence of success of completing at least three years of postgraduate training in a U.S. or Canadian program accredited by an organization that is acceptable to the Board and that meets such other requirements as the Board may establish by rule.

  (c) Examination. An applicant shall satisfy the Board’s requirements for medical licensing examination as established by the Board by rule. The Board may identify which examinations are accepted, set passing standards, and set limits on time and numbers of attempts for exams. The Board may establish by rule exceptions or alternative means to meet examination requirements.

  (d) ECFMG certificate. A graduate of a medical school outside the United States or Canada shall also submit evidence of certification by the Educational Commission for Foreign Medical Graduates unless the individual qualifies for licensure as a Fifth Pathway applicant, as established by the Board by rule.

  (e) Current medical practice. An applicant for licensure shall have actively engaged in the practice of medicine, as defined by section 1311 of this chapter, within three years prior to the date on which the application for licensure becomes complete. In its discretion, the Board may license an applicant who does not meet this practice requirement but who agrees to such conditions as the Board may reasonably require to verify or confirm the applicant’s readiness to reenter the practice of medicine.

  (f) License by faculty appointment.

  (1) The Board may issue a license without examination to a reputable physician who is a resident of a foreign country and who furnishes to the Board satisfactory proof of appointment to the faculty of a medical college in Vermont that is accredited by the Liaison Committee on Medical Education (LCME). The Board may establish additional conditions and requirements by rule for this type of license.

  (2) An applicant for a license pursuant to this subsection shall furnish to the Board satisfactory proof that the applicant is at least 18 years of age, has good moral character, is licensed to practice medicine in the applicant’s country of residence, and has been appointed to the faculty of an LCME-accredited medical college located in Vermont. The application shall include detailed information concerning the nature and term of the appointment, the method by which the applicant’s performance will be monitored and evaluated, and any other information the Board may require by rule.

  (3) A license issued pursuant to this subsection shall be for a period not to exceed the term of the faculty appointment and may, in the Board’s discretion, be for a shorter period.

  (4) A license issued pursuant to this subsection shall expire automatically upon termination for any reason of the licensee’s faculty appointment. (Amended 1961, No. 256; 1967, No. 307 (Adj. Sess.), § 1, eff. March 22, 1968; 1969, No. 187 (Adj. Sess.), § 5; 1971, No. 14, § 15, eff. March 11, 1971; 1971, No. 184 (Adj. Sess.), § 19, eff. March 29, 1972; 1977, No. 91, § 2; 1977, No. 259 (Adj. Sess.), § 1; 1989, No. 250 (Adj. Sess.), §§ 39, 40; 2003, No. 34, § 9, eff. May 23, 2003; 2011, No. 61, § 2, eff. June 2, 2011; 2019, No. 126 (Adj. Sess.), § 1.)

• § 1392. Limited temporary license for postgraduate training

  (a) Qualifications for limited training license.

  (1) An applicant for a limited training license to practice medicine in a postgraduate training program shall meet each of requirements set forth in subdivisions (2)(A) through (E) of this subsection. A requirement may be met either by satisfying the requirement on its own terms or by qualifying for an exception established in this chapter or by the Board by rule.

  (2) An applicant shall submit evidence of identity acceptable to the Board and shall establish that the applicant:

  (A) is at least 18 years of age;

  (B) has graduated from a medical school accredited by an organization that is acceptable to the Board, or from a medical school that has been approved by the Board by rule;

  (C) has been accepted to participate in a postgraduate medical training program accredited by a body approved by the Board by rule;

  (D) is of sound moral character and professional competence as evidenced by the applicant’s entire personal history, as established by information about the applicant’s academic, licensing examination, employment, professional credentialing, professional certification, professional regulation, civil litigation, and criminal records submitted by the applicant or otherwise obtained by the Board in the application process; and

  (E) will be practicing in a program under the supervision of a Vermont-licensed physician who has acknowledged in writing:

  (i) the responsibility to ensure that the program operates in accordance with the requirements of the accrediting body; and

  (ii) the responsibility to ensure that physicians in training practice only under the close supervision and control of Vermont-licensed physicians.

  (b) Terms of limited training license.

  (1) A limited training license shall be issued for the period of a “training year,” which shall run from July 1 through June 30. All limited training licenses shall expire at 12:00 midnight on July 1, regardless of when issued, unless the holder leaves the program before that date, in which case the license expires upon the holder leaving the program. The Board may issue a limited training license up to 90 days prior to the beginning of a training year.

  (2) A limited training license shall be renewed annually for each licensee who intends to continue to practice in a training program, in accordance with such requirements as the Board may provide by rule.

  (3) A limited training license authorizes the holder to practice only within the approved training program and only at sites that are part of the hospital or other facility hosting the training program, along with such other locations as may be formally designated as a training site of the program.

  (4) A limited training license shall become invalid 14 days after the supervising physician described in subdivision (a)(2)(E) of this subsection stops supervising the program for any reason, unless documentation of a new supervising physician is filed with the Board prior to the expiration of the 14-day period.

  (5) A physician practicing under a limited training license is subject to the provisions of section 1354 of this chapter. (Added 2019, No. 126 (Adj. Sess.), § 1.)

• §§ 1393-1394. Repealed. 2019, No. 126 (Adj. Sess.), § 1.

• § 1395. License by endorsement

  (a) The Board shall have an endorsement process for physician licensure that requires not more than three years of practice in good standing in another jurisdiction within the United States, regardless of whether that jurisdiction has licensing requirements substantially equal to those of this State, provided the applicant meets one of the following postgraduate training requirements:

  (1) A graduate of a U.S. or Canadian medical school accredited by a body that is acceptable to the Board shall have successfully completed at least two years of postgraduate training in a U.S. or Canadian program accredited by an organization that is acceptable to the Board.

  (2) A graduate of a Board-approved medical school outside the United States or Canada shall have successfully completed at least three years of postgraduate training in a U.S. or Canadian program accredited by an organization that is acceptable to the Board.

  (b) If the Board determines that three years of demonstrated practice in another specific jurisdiction is not adequately protective of the public, it shall provide its rationale to the Commissioner, who may propose any necessary statutory or rule amendments in order to implement more restrictive requirements for endorsement for that jurisdiction.

  (c) The Board may issue to an endorsement applicant a waiver of the practice requirement if there is a showing that the waiver follows State policy and the public is adequately protected. (Amended 1967, No. 307 (Adj. Sess.), § 2, eff. March 22, 1968; 1977, No. 91, § 3, eff. May 5, 1977; 1977, No. 259 (Adj. Sess.), § 4; 1989, No. 250 (Adj. Sess.), § 41; 2001, No. 151 (Adj. Sess.), § 19b, eff. June 13, 2002; 2011, No. 61, § 2, eff. June 2, 2011; 2017, No. 39, § 2; 2019, No. 152 (Adj. Sess.), § 17, eff. April 1, 2021.)

• § 1396. Repealed. 2019, No. 126 (Adj. Sess.), § 1.

• § 1397. Repealed. 2011, No. 61, § 9(3), eff. June 2, 2011.

• § 1398. Refusal or revocation of licenses

  (a) The Board may refuse to issue a license or certificate to an applicant who applies to be licensed or certified under this chapter and who, by false or fraudulent representations, has obtained or sought to obtain practice in the profession, or by false or fraudulent representations in practice, has obtained or sought to obtain money or any other thing of value, or who assumes a name other than the applicant’s own for the purpose of misleading others, or for any other immoral, unprofessional, or dishonorable conduct.

  (b) A license or certificate shall not be suspended, except as provided in section 1365 or 1366 of this chapter; revoked; or refused until the holder or applicant:

  (1) is given a hearing before the Board using the same procedures as a hearing on disciplinary matters as set forth in sections 1372 through 1376 of this chapter;

  (2) is offered and declines or fails to attend a hearing; or

  (3) agrees to the action.

  (c) In the event of a revocation, the holder of any license or certificate so revoked shall promptly relinquish the license or certificate to the Secretary of the Board. (Amended 1967, No. 307 (Adj. Sess.), § 3, eff. March 22, 1968; 2011, No. 61, § 2, eff. June 2, 2011; 2019, No. 126 (Adj. Sess.), § 1.)

• § 1399. Repealed. 1975, No. 249 (Adj. Sess.), § 5.

• § 1400. Renewal of license; continuing medical education

  (a) Every person licensed to practice medicine by the Board shall apply biennially for the renewal of his or her license. At least one month prior to the date on which renewal is required, the Board shall send to each licensee a license renewal application form and notice of the date on which the existing license will expire. On or before the renewal date, the licensee shall file an application for license renewal and pay the required fee. The Board shall register the applicant and issue the renewal license. Within one month following the date renewal is required, the Board shall pay the license renewal fees into the Board of Medical Practice Regulatory Fee Fund.

  (b) A licensee for renewal of an active license to practice medicine shall have completed continuing medical education that shall meet minimum criteria as established by rule, by the Board, by August 31, 2012 and that shall be in effect for the renewal of licenses to practice medicine expiring after August 31, 2014. The Board shall require a minimum of 10 hours of continuing medical education by rule. The training provided by the continuing medical education shall be designed to assure that the licensee has updated his or her knowledge and skills in his or her own specialties and also has kept abreast of advances in other fields for which patient referrals may be appropriate. The Board shall require evidence of current professional competence in recognizing the need for timely appropriate consultations and referrals to assure fully informed patient choice of treatment options, including treatments such as those offered by hospice, palliative care, and pain management services.

  [Subsection (c) effective 60 days after the adoption of the maintenance of licensure rule for physicians.]

  (c) A licensee for renewal of an active license to practice medicine shall have practiced medicine within the last three years as defined in section 1311 of this title or have complied with the requirements for updating knowledge and skills as defined by Board rules.

  (d) All licensees shall demonstrate that the requirements for licensure are met.

  (e) A licensee shall promptly provide the Board with new or changed information pertinent to the information in his or her license and license renewal applications at the time he or she becomes aware of the new or changed information.

  (f) A person who practices medicine and who fails to renew his or her license in accordance with the provisions of this section shall be deemed an illegal practitioner and shall forfeit the right to so practice or to hold himself or herself out as a person licensed to practice medicine in the State until reinstated by the Board, except that a physician while on extended active duty as a member of the U.S. Armed Forces, a reserve component of the U.S. Armed Forces, the National Guard, or the State Guard who is licensed as a physician at the time of an activation or deployment shall receive an extension of licensure up to 90 days following the physician’s return from activation or deployment, provided the physician notifies the Board of his or her activation or deployment prior to the expiration of the current license and certifies that the circumstances of the activation or deployment impede good faith efforts to make timely application for renewal of the license.

  (g) Any person who allows a license to lapse by failing to renew the same in accordance with the provisions of this section may be reinstated by the Board by payment of the renewal fee, the late renewal penalty, and if applicable, by completion of the required continuing medical education requirement as established in subsection (b) of this section and any other requirements for licensure as required by this section and Board rule. (Amended 1967, No. 307 (Adj. Sess.), § 5, eff. March 22, 1968; 1975, No. 118, § 80; 1975, No. 249 (Adj. Sess.), § 3; 1977, No. 91, § 4, eff. May 5, 1977; 1989, No. 250 (Adj. Sess.), § 42; 1995, No. 178 (Adj. Sess.), § 81; 2001, No. 132 (Adj. Sess.), § 12, eff. June 13, 2002; 2011, No. 60, § 7, eff. June 1, 2011; 2011, No. 61, § 2, eff. June 2, 2011; 2019, No. 126 (Adj. Sess.), § 1.)

• § 1401. Expired.

• § 1401a. Fees

  (a) The Department of Health shall collect the following fees:

  (1) Application for licensure, $650.00; the Board shall use at least $25.00 of this fee to support the cost of maintaining the Vermont Practitioner Recovery Network, which, for the protection of the public, monitors and evaluates, coordinates services for, and promotes rehabilitation of licensees who have or potentially have an impaired ability to practice medicine with reasonable skill and safety.

  (2) Biennial renewal, $525.00; the Board shall use at least $25.00 of this fee to support the cost of maintaining the Vermont Practitioner Recovery Network, which, for the protection of the public, monitors and evaluates, coordinates services for, and promotes rehabilitation of licensees who have or potentially have an impaired ability to practice medicine with reasonable skill and safety.

  (3) Initial limited temporary license; annual renewal $75.00.

  (4) Pursuant to qualifications and procedures determined by the Board, the Department shall, upon request, waive application fees to qualified military members and military spouses.

  (b) The Department of Health may charge the following fees:

  (1) Late renewal penalty of $25.00 for a renewal submitted less than 30 days late. Thereafter, the Department may increase the late renewal penalty by $5.00 for every additional month or fraction of a month, provided the total penalty for a late renewal shall not exceed $100.00.

  (2) Reinstatement of revoked or suspended license, $20.00.

  (3) Replacement of license, $20.00.

  (4) Verification of license, $40.00 and in fiscal year 2010 and thereafter $50.00.

  (5) Pre-application criminal background determination, $25.00.

  (c)(1) Notwithstanding any other provision of this chapter, a physician who holds an unrestricted license in all jurisdictions where the physician is currently licensed and who meets the criteria of the Board shall be licensed without fee if the physician certifies to the Board that he or she shall limit practice in Vermont solely to providing:

  (A) pro bono services at a free or reduced-fee health care clinic in Vermont; or

  (B) volunteer services through the Vermont Medical Reserve Corps.

  (2) A physician, under this subsection, shall file with the Board using forms provided on the Board’s website, information on medical qualifications, professional discipline, criminal record, malpractice claims, or any other such information as the Board may require. A license granted under this subsection shall authorize the licensee to practice medicine either on a voluntary basis at a free or reduced fee clinic in Vermont or in connection with the Vermont Medical Reserve Corps, respectively.

  (d) If at any time an assessment is imposed on the State for its membership in the Interstate Medical Licensure Compact Commission pursuant to section 1420m of this title, the Board and the Board of Osteopathic Physicians and Surgeons shall assume responsibility for paying the assessment from their respective special funds in proportional amounts based on their numbers of licensees for professions eligible for licensure through the Compact. (Added 1993, No. 108 (Adj. Sess.), § 26, eff. Feb. 16, 1994; amended 1995, No. 186 (Adj. Sess.), § 25; 1999, No. 49, § 209; 2001, No. 132 (Adj. Sess.), § 13, eff. June 13, 2002; 2003, No. 163 (Adj. Sess.), § 4; 2003, No. 163 (Adj. Sess.), § 4a, eff. July 1, 2006; 2007, No. 76, § 18; 2011, No. 61, § 2, eff. June 2, 2011; 2015, No. 57, § 13; 2017, No. 39, § 3; 2017, No. 115 (Adj. Sess.), § 3a, eff. Jan. 1, 2020; 2019, No. 152 (Adj. Sess.), § 18, eff. April 1, 2021.)

• § 1402. Health maintenance organization; medical director

  A medical director who is a physician employed by a health maintenance organization in this State, which has individuals who have entered into contracts with a health maintenance organization for the provision of health care services, or on whose behalf such an arrangement has been made, shall possess a full and unrestricted license issued by the Board. (Added 1999, No. 133 (Adj. Sess.), § 50; amended 2001, No. 129 (Adj. Sess.), § 22, eff. June 13, 2002.)

• § 1403. Professional corporations; medicine

  A person licensed to practice medicine under this chapter may own shares in a professional corporation created under 11 V.S.A. chapter 4 that provides professional services in the medical and nursing professions. (Added 2007, No. 14, § 1, eff. May 2, 2007; amended 2011, No. 61, § 2, eff. June 2, 2011.)

• § 1404. Applicant for expedited licensure; fingerprint data

  (a) An applicant for expedited licensure pursuant to section 1420e of this chapter shall submit a full set of fingerprints to the Board for the purpose of obtaining State and federal criminal background checks pursuant to subdivision 1420e(b)(2) of this chapter. The Department of Public Safety may exchange fingerprint data with the Federal Bureau of Investigation.

  (b) Communications between the Board and the Interstate Medical Licensure Compact Commission regarding verification of physician eligibility for licensure under the Interstate Medical Licensure Compact shall not include any information received from the Federal Bureau of Investigation related to State and federal criminal background checks performed for the purposes of subdivision 1420e(b)(2) of this chapter. (Added 2017, No. 115 (Adj. Sess.), § 3, eff. Jan. 1, 2020.)

• Subchapter 003A: Interstate Medical Licensure Compact

• § 1420. Interstate Medical Licensure Compact; adoption

  This subchapter is the Vermont adoption of the Interstate Medical Licensure Compact as revised by the Interstate Medical Licensure Compact Commission. The form, format, and text of the compact have been conformed to the conventions of the Vermont Statutes Annotated. It is the intent of the General Assembly that this subchapter be interpreted as substantively the same as the Interstate Medical Licensure Compact that is enacted by other member states. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420a. 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420b. Definitions

  As used in this compact:

  (1) “Bylaws” means those bylaws established by the Interstate Commission pursuant to section 1420k of this subchapter for its governance or for directing and controlling its actions and conduct.

  (2) “Commissioner” means the voting representative appointed by each member board pursuant to section 1420k of this subchapter.

  (3) “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.

  (4) “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.

  (5) “Interstate Commission” means the interstate commission created pursuant to section 1420k of this subchapter.

  (6) “License” means authorization by a state for a physician to engage in the practice of medicine, which would be unlawful without the authorization.

  (7) “Medical Practice Act” means laws and regulations governing the practice of allopathic and osteopathic medicine within a member state.

  (8) “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.

  (9) “Member State” means a state that has enacted the Compact.

  (10) “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.

  (11) “Physician” means any person who:

  (A) 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;

  (B) 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;

  (C) successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association;

  (D) 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;

  (E) possesses a full and unrestricted license to engage in the practice of medicine issued by a member board;

  (F) has never been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;

  (G) 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 nonpayment of fees related to a license;

  (H) has never had a controlled substance license or permit suspended or revoked by a state or the U.S. Drug Enforcement Administration; and

  (I) is not under active investigation by a licensing agency or law enforcement authority in any state, federal, or foreign jurisdiction.

  (12) “Offense” means a felony, gross misdemeanor, or crime of moral turpitude.

  (13) “Rule” means a written statement by the Interstate Commission promulgated pursuant to section 1420l of this subchapter 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.

  (14) “State” means any state, commonwealth, district, or territory of the United States.

  (15) “State of Principal License” means a member state where a physician holds a license to practice medicine and that has been designated as such by the physician for purposes of registration and participation in the Compact. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420c. Eligibility

  (a) A physician must meet the eligibility requirements as defined in subdivision 1420b(11) of this subchapter to receive an expedited license under the terms and provisions of the Compact.

  (b) A physician who does not meet the requirements of subdivision 1420b(11) of this subchapter may obtain a license to practice medicine in a member state if the individual complies with all laws and requirements, other than the Compact, relating to the issuance of a license to practice medicine in that state. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420d. 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 practice of medicine occurs;

  (3) the location of the physician’s employer; or

  (4) if no state qualifies under subdivision (1), (2), or (3) of this subsection, the state designated as state of residence for purpose of federal income tax.

  (b) A physician may redesignate a member state as state of principal license at any time, as long as the state meets the requirements in subsection (a) of this section.

  (c) The Interstate Commission is authorized to develop rules to facilitate redesignation of another member state as the state of principal license. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420e. 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 state of principal license.

  (b) Upon receipt of an application for an expedited license, the member board within the state selected as the state of principal license shall evaluate whether the physician is eligible for expedited licensure and issue a letter of qualification, verifying or denying the physician’s eligibility, to the Interstate Commission.

  (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 state of principal license.

  (2) The member board within the state selected as the 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 C.F.R. § 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 in subsection (b) of this section, physicians eligible for an expedited license 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) After receiving verification of eligibility under subsection (b) and any fees under subsection (c) of this section, a member board shall issue an expedited license to the physician. This license shall authorize the physician to practice medicine in the issuing state consistent with the Medical Practice Act 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 a physician fails to maintain a license in the state of principal licensure for a nondisciplinary 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420f. 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420g. 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 nonpayment 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 U.S. 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 in 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420h. Coordinated information system

  (a) The Interstate Commission shall establish a database of all physicians licensed or who have applied for licensure under section 1420e of this subchapter.

  (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 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 nonpublic complaint, disciplinary, or investigatory information not required by subsection (c) of this section to the Interstate Commission.

  (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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420i. 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420j. Disciplinary actions

  (a) Any disciplinary action taken by any member board against a physician licensed through the 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.

  (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 lesser sanction or sanctions against the physician so long as such sanctions are 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 or licenses issued to the physician by any other member board shall be suspended, automatically and immediately without further action necessary by the other member boards, for 90 days upon entry of the order by the disciplining board, to permit the member boards 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420k. 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. A 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 this 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 Interstate 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 shall meet the requirements of 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 portion, when 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 when 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 that shall fully describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, including 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 of and compliance with the provisions of the Compact, its bylaws and rules, and other such duties as necessary.

  (l) The Interstate Commission may establish other committees for governance and administration of the Compact. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420l. Powers and duties of the Interstate Commission

  The Interstate Commission shall have a duty and power to:

  (1) Oversee and maintain the administration of the Compact;

  (2) Promulgate rules that shall be binding to the extent and in the manner provided for in the Compact;

  (3) Issue, upon the request of a member state or member board, advisory opinions concerning the meaning or interpretation of the Compact, its bylaws, rules, and actions;

  (4) 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;

  (5) Establish and appoint committees including, but not limited to, an executive committee as required by section 1420k of this subchapter, which shall have the power to act on behalf of the Interstate Commission in carrying out its powers and duties;

  (6) Pay or provide for the payment of the expenses related to the establishment, organization, and ongoing activities of the Interstate Commission;

  (7) Establish and maintain one or more offices;

  (8) Borrow, accept, hire, or contract for services of personnel;

  (9) Purchase and maintain insurance and bonds;

  (10) Employ an executive director who shall have such powers to employ, select, or appoint employees, agents, or consultants and to determine their qualifications, define their duties, and fix their compensation;

  (11) Establish personnel policies and programs relating to conflicts of interest, rates of compensation, and qualifications of personnel;

  (12) Accept donations and grants of money, equipment, supplies, materials, and services and to receive, utilize, and dispose of it in a manner consistent with the conflict-of-interest policies established by the Interstate Commission;

  (13) Lease, purchase, accept contributions or donations of, or otherwise to own, hold, improve or use, any property, real, personal, or mixed;

  (14) Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;

  (15) Establish a budget and make expenditures;

  (16) Adopt a seal and bylaws governing the management and operation of the Interstate Commission;

  (17) 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;

  (18) Coordinate education, training, and public awareness regarding the Compact, its implementation, and its operation;

  (19) Maintain records in accordance with the bylaws;

  (20) Seek and obtain trademarks, copyrights, and patents; and

  (21) Perform such functions as may be necessary or appropriate to achieve the purposes of the Compact. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420m. 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 must 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 annual report of the Interstate Commission. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420n. Organization and operation of the Interstate Commission

  (a) The Interstate Commission shall, by a majority of the Commissioners present and voting, adopt bylaws to govern its conduct as may be necessary or appropriate to carry out the purposes of the Compact within 12 months of the first Interstate Commission meeting.

  (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 in 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 had 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, 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 persons 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420o. 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) Not later than 30 days after a rule is promulgated, any person may file a petition for judicial review of the rule in the U.S. 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420p. Oversight of 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 Compact’s purposes and intent. 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 that 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420q. 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 U.S. 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420r. 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 upon 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 must 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 impacted by the termination of a member state or the withdrawal of a member state.

  (f) The member state that has been terminated is responsible for all dues, obligations, and liabilities incurred through the effective date of termination including obligations, the performance of which 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 that 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 U.S. 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420s. Dispute resolution

  (a) The Interstate Commission shall attempt, upon the request of a member state, to resolve disputes that are subject to the Compact and that 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420t. 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 fewer 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 Commission on a nonvoting basis prior to adoption of the Compact by all states.

  (d) The Interstate Commission may propose amendments to the Compact for enactment by the 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420u. 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 other 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 of its receipt of notice provided under subsection (c) of this section.

  (e) The withdrawing state is responsible for all dues, obligations, and liabilities incurred through the effective date of withdrawal, including obligations, the performance of which 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 is authorized to develop rules to address the impact of the 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 license. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420v. Dissolution

  (a) The Compact shall dissolve effective on the date of the withdrawal or default of the member state that 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 funds shall be distributed in accordance with the bylaws. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420w. 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• § 1420x. 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. (Added 2017, No. 115 (Adj. Sess.), § 1, eff. Jan. 1, 2020.)

• Subchapter 004: Professional Liability

• § 1441. Definitions and purpose

  As used in this subchapter, the term “peer review committee” shall mean the Vermont professional standards review organization or its subsidiary committees, the Vermont Program for Quality in Health Care, Inc. or its subsidiary committees, a peer review committee or other comparable committee established by a health maintenance organization in accordance with the provisions of 18 V.S.A. § 9414, or a committee of a state or local professional association or of a hospital or other health care provider that is formed to evaluate and improve the quality of health care rendered by providers of health services or to determine that health services rendered were professionally indicated or were performed in compliance with the applicable standard of care or that the cost of health care rendered was considered reasonable by the providers of professional health services in the area. (Added 1975, No. 249 (Adj. Sess.), § 4, eff. April 7, 1976; amended 1989, No. 108, § 1, eff. June 22, 1989; 1993, No. 30, § 20, eff. May 21, 1993.)

• § 1442. Immunity from liability of members of committee of professional society formed to maintain standards

  (a) There shall be no monetary liability on the part of, and no cause of action for damages shall arise against, any member of a peer review committee, any peer review committee or its predecessor or subsidiary organization, any person acting or employed as staff for a peer review committee, any person under a contract or other formal agreement with a peer review committee, or any person who participates with or assists a peer review committee for any act or proceeding related to peer review activities undertaken or performed within the scope of the functions of the peer review committee; provided that the member, peer review committee, predecessor or subsidiary organization, or person acts without malice, has made a reasonable effort to obtain the facts of the matter acted upon, and the action is taken with the reasonable belief that the action is warranted by the facts known after a reasonable effort to obtain all the facts. For purposes of this section, liability of a committee shall be determined with reference to acts taken by a majority of the members of the committee present at a meeting at which there was a quorum.

  (b) This subchapter shall not be construed to confer immunity from liability on any professional association or upon any health professional while performing services other than as a member of a peer review committee.

  (c) The provisions of subsection (a) of this section shall not apply in the case of a violation of section 1443 of this title or any law relating to confidentiality of medical records. (Added 1975, No. 249 (Adj. Sess.), § 4, eff. April 7, 1976; amended 1989, No. 108, §§ 2, 2a, eff. June 22, 1989.)

• § 1443. Records immune from discovery

  (a) The proceedings, reports, and records of committees defined in section 1441 of this title including information and evidence required to be reported pursuant to section 1317 of this title shall be confidential and privileged, and shall not be subject to discovery or introduction into evidence in any civil action against a provider of professional health services arising out of the matters that are subject to evaluation and review by such committee, and no person who was in attendance at a meeting of such committee shall be permitted or required to testify in any such civil action as to any findings, recommendations, evaluations, opinions, or other actions of such committees or any members thereof. However, information, documents, or records otherwise available from original sources are not to be construed as immune from discovery or use in any such action merely because they were presented during the proceedings of such committee, nor shall any person who testifies before such committee or who is a member of such committee be prevented from testifying as to matters within his or her knowledge, but such witness shall not be asked about his or her testimony before such committee or about opinions formed by him or her as a result of such committee hearings.

  (b) Notwithstanding the provisions of subsection (a) of this section, a peer review committee shall provide the Board with all supporting information and evidence pertaining to information required to be reported under section 1317 of this title and shall provide access to such information and evidence to the Department of Health as provided in and for the purpose of determining a hospital’s compliance with 18 V.S.A. chapter 43a.

  (c) Notwithstanding the provisions of section 1318 of this title, relating to accessibility and confidentiality of disciplinary matters, the proceedings, reports, records, reporting information, and evidence of a peer review committee provided by the committee to the Board in accordance with the provisions of section 1317 of this title or to the Department of Health in accordance with 18 V.S.A. chapter 43a and subsection (b) of this section may be used by the Board or by the Commissioner of Health for disciplinary and enforcement purposes but shall not be subject to public disclosure. (Added 1975, No. 249 (Adj. Sess.), § 4, eff. April 7, 1976; amended 1991, No. 167 (Adj. Sess.), § 34; 2001, No. 132 (Adj. Sess.), § 14, eff. June 13, 2002; 2005, No. 215 (Adj. Sess.), § 325; 2019, No. 131 (Adj. Sess.), § 276; 2023, No. 53, § 127, eff. June 8, 2023.)

• § 1444. Liability for actions of agent

  (a) A physician may delegate to a medical technician or other assistant or employee certain activities related to medical care and treatment that the individual is qualified to perform by training, education, experience, or a combination of these when the activities are under the control of the physician. The physician delegating the activities to the individual shall be legally liable for the individual’s performance of those activities, and in this relationship, the individual shall be the physician’s agent.

  (b)(1) Nothing in this section shall be construed to apply to a nurse acting pursuant to chapter 28 of this title.

  (2) Nothing in this section shall be construed to apply to a physician assistant acting pursuant to chapter 31 of this title. Liability for the actions or inactions of a physician assistant shall be governed by the provisions of section 1739 of this title. (Added 2019, No. 123 (Adj. Sess.), § 3.)

• Subchapter 005: Quality Assurance Data

• § 1445. Findings

  The General Assembly finds that the Vermont Program for Quality in Health Care, Inc., a nonprofit corporation, is organized for the purpose of implementing and maintaining a statewide quality assurance system based on the collection and interpretation of clinical data, feedback of such data to physicians and, when necessary, the provision of professional accountability. (Added 1989, No. 108, § 3, eff. June 22, 1989.)

• § 1446. Directors of corporation

  The Board of Directors of the Vermont Program for Quality in Health Care, Inc. shall include the Commissioner of Health and two directors, each of whom represents at least one of the following populations: elders, people with disabilities, or people with low income. (Added 1989, No. 108, § 3, eff. June 22, 1989; amended 2011, No. 61, § 2, eff. June 2, 2011; 2013, No. 96 (Adj. Sess.), § 175.)

• § 1447. Dissolution

  In the event of dissolution without a successor, the corporation shall transfer all its quality assurance data to the Department of Health. While the data is in the possession of the Department of Health, the Commissioner may disclose such data to the public as long as individual patients or health care practitioners are not directly or indirectly identifiable. (Added 1989, No. 108, § 3, eff. June 22, 1989.)

• § 1448. Release of clinical data authorized

  Hospitals licensed under 18 V.S.A. § 1905 may release clinical data to the Vermont Program for Quality in Health Care, Inc., for use in a statewide quality assurance system. (Added 1989, No. 108, § 3, eff. June 22, 1989.)

• § 1449. Repealed. 2009, No. 33, § 83(k).