FBI Raises Questions About Interstate Licensing Compact

Ken Terry

August 09, 2016

The Federal Bureau of Investigation (FBI) has informed state agencies in Minnesota and Montana that it has concerns about state laws that authorize those states to participate in the Interstate Medical Licensure Compact. Set to go into effect next January, the compact will allow doctors who hold medical licenses in one member state to easily obtain licenses in other states that participate in the compact.

In a July 7 letter to Minnesota's Bureau of Criminal Apprehension, which had asked the FBI to review that state's legislation, FBI attorney Christopher B. Chaney said that the law does not meet the requirements of the federal regulation empowering the agency to share information with the states for purposes of criminal background checks.

The FBI's chief objection to the statute — also expressed in a similar letter to the Montana Department of Justice — is that it "appears to authorize the dissemination" of FBI criminal data to the Interstate Medical Licensure Compact Commission, which the participating states set up to administer the compact. Calling this a "private nongovernmental entity," Chaney said that the law "requires member boards to report to the Interstate Commission disciplinary or investigatory information on a physician who has been issued an expedited license."

According to Chaney, there is no federal statutory authority for the FBI to share criminal files with an entity such as the Interstate Commission. He noted that the regulation does not permit a private organization to receive this information.

Criminal Information Not Shared

Responding to Chaney in a letter dated August 3, Ruth Martinez, executive director of the Minnesota Board of Medical Practice, said that the FBI had based its determination on "erroneous conclusions" and asked the agency to reverse its decision. She appended a letter from Rick Masters, special counsel for the National Center for Interstate Compacts, who addressed the FBI's concerns in detail.

Masters first refuted the claim that the Interstate Commission is a private entity, noting that the legislation that all member states have approved says that the Commission is a "joint agency of the member states." The provisions of the compact meet all of the FBI's requirements for information sharing with the states, he said.

Furthermore, Masters observed, the FBI "mischaracterizes how the Interstate Commission interacts with the individual state licensing boards and the process of licensure." It is the member state medical boards that will perform the background checks, including the use of FBI data, he said. "The results of that search are not transmitted…in any other manner other than a yes/no verification," he stated, meaning that no specific criminal records will be shared with the Commission.

"We aren't actually sharing the results of criminal background checks state to state," affirmed Martinez in an interview with Medscape Medical News. "It is used in the state of principal licensure where that background check is conducted only to determine whether the person meets the eligibility requirements outlined in the compact."

Ian Marquand, executive officer of the Montana Board of Medical Examiners and chair of the Interstate Commission, told Medscape Medical News that in his view, all that a state medical board should have to tell the Interstate Commission "is whether the doctor is qualified or not to receive a license in another state via the compact."

"Confident" Issue Will Be Resolved

The Commission is still working out the details of what information will be passed from the states to the Commission, he added. "But it can be as simple as yes, Dr Smith is certified as eligible to receive a license in another state via the compact, or Dr Smith is not, and no details are contained in that."

The Montana Board of Medical Examiners has not responded to or taken an official position on the FBI letter, Marquand said. Because the Minnesota board received its letter from the FBI first and has already responded to it, he said, the Montana board and the Interstate Commission will watch what happens in Minnesota before taking any further steps.

Martinez predicted that the FBI would reconsider its stance once it has the facts. We're very confident, in large part because their conclusions are so erroneous and based on misunderstanding," she said.

If the FBI sticks by its decision, she added, the Minnesota board is prepared "to go to the top" of the FBI to make its case.

The Federation of State Medical Boards (FSMB) initiated the interstate medical licensure compact andfinalized it in September 2014. By May 2015, seven states had joined the compact, which was the number needed to implement the agreement. To date, 17 states have passed a model bill allowing them to participate.

Under the compact process, physicians licensed in one state can be licensed in another state without filling out a formal application or sending records to the second state if they meet the compact's eligibility requirements and their principal state of licensure attests to their qualifications.

The compact is expected to benefit locum tenens physicians, doctors who practice in metropolitan areas that cross state lines, and doctors who practice telemedicine in multiple states.

The American Telemedicine Association has long wanted doctors licensed in one state to be licensed in every other state. The American Medical Association supports the FSMB compact because it enables state medical boards to retain control over the licensing and disciplining of physicians who practice within their jurisdictions.

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