Texas legislature seeks to delegate authority to a new interstate bureaucracy

The Sunset Commission bill for the Texas Medical Board, HB3040 and SB315, includes the Interstate Medical Licensure Compact, which, if passed, would bind Texas to a new quasi-governmental interstate agency with authority to grant expedited medical licenses for physicians who wish to practice in multiple states.

The Compact is new legislation that grants licensing and rule-making authority to an appointed Interstate Medical Licensure Commission that will have power to litigate against states from the US district court in DC.[i]  Additionally, the Compact’s disciplinary and investigative provisions are overly broad and may weaken physician due process rights.[ii] The rules written by this new licensing commission will be binding on states as law and supersede state law.[iii]

The financial burden to the member states is unknown and the rules, which are binding as statutory law, are still being written.  The state must comply and enforce the commission’s rules because the Compact includes a supremacy clause, superseding state law.[iv]  The citizens of the state cannot vote commissioners out of office.  The Interstate Commission will grow in wealth and power, enabling them to lobby for their agenda, which may not align with the best interests of patients in the State of Texas.

Proponents of this law insist that it is necessary to provide expedited multistate licenses for interstate telemedicine services. However, the states can simply reciprocate (endorse) the licenses of other states to expedite them—there is no need for a whole new bureaucracy.  For example, there is a neurology group based in Denver that already is contracted with over 30 hospitals in Texas, providing telemedicine neurology services and using Texas licenses.

Current state medical boards are very capable of handling complaints arising from telemedicine and protecting the citizens of their respective states. The differences in regulation between states may create legal challenges to telemedicine services, especially in relation to issues like assisted suicide.    Texas could be importing some of the practices that are currently not legal here, because the commission would have the power to write rules permitting it, and the state’s law would be nullified in those circumstances.  The Default and Enforcement section of the Compact establishes the district federal court in DC as the expected court where disputes will be settled.[v]

This Compact will bring Texas physicians and patients under the influence of an agency that will be given unlimited financial support and no accountability to Texas citizens.  This should be considered unacceptable to our legislators. The compact language needs to be removed from the Texas Medical Board Sunset bills, HB3040 and SB315.

[i] Section 15(c), Section 17(b), Section 18(h)

[ii] Sections 9 and 10

[iii] Section 24(b) and (c)

[iv] Section 24(b)

[v] Section 17(b) and Section 18(h)