Frequently Asked Questions about the Interstate Medical Licensure Compact

What is the Interstate Medical Licensure Compact?

The Interstate Medical Licensure Compact creates a new pathway to expedite the licensing of physicians seeking to practice medicine in multiple states. States participating in the Compact agree to share information with each other and work together in new ways to significantly streamline the licensing process.

What are the goals of the Compact?

The Compact will make it easier for physicians to obtain licenses to practice in multiple states and strengthens public protection because it will help states share investigative and disciplinary information that they cannot share now. The Compact aims to increase access to health care for individuals in underserved or rural areas and allow patients to more easily consult medical experts through the use of telemedicine technologies.

What states are participating in the Compact?

As of January 2017, the Compact is being implemented in eighteen U.S. states, with others expected to adopt it soon. States participating so far include Alabama, Arizona, Colorado, Idaho, Illinois, Iowa, Kansas, Minnesota, Mississippi, Montana, Nevada, New Hampshire, Pennsylvania, South Dakota, Utah, West Virginia, Wisconsin, and Wyoming.

Has the Compact begun its new licensure process?

A commission of representatives from states participating in the Compact has begun formally meeting and is implementing the administrative processes needed to begin the expedited licensure process, but licenses via the Compact process have not begun to be issued yet.

What is driving the need for an Interstate Compact?

Among the issues driving the need for a Compact are physician shortages, the expected influx of millions of new patients into the health care system as a result of the Affordable Care Act, and the growing need to increase access to health care for individuals in underserved or rural areas through the use of telemedicine. Proponents of telemedicine have often cited the time-consuming state-by-state licensure process for multiple-license holders as a key barrier to overcome in order for telemedicine to continue to grow and thrive. The Compact would make it easier and faster for physicians to obtain a license to practice in multiple states, thus helping extend the impact and availability of their care at a time when demand is expected to grow significantly.

Who is eligible to seek licensure through the Compact process?

Surveys estimate that nearly 80% of the physician population licensed in the United States could be eligible for expedited licensure via the Compact process.

To be eligible for expedited licensure, physicians must:

  • Possess a full and unrestricted license to practice medicine in a Compact state
  • Possess specialty certification or be in possession of a time unlimited specialty certificate
  • Have no discipline on any state medical license
  • Have no discipline related to controlled substances
  • Not be under investigation by any licensing or law enforcement agency
  • Have passed the USMLE or COMLEX (or equivalent) within 3 attempts
  • Have successfully completed a graduate medical education (GME) program

Physicians who are ineligible for the expedited licensure process facilitated by the Compact will still be able to seek additional licenses in those states where they desire to practice, using the traditional state-by-state licensure processes.

How will the Compact be administered?

The Interstate Medical Licensure Compact Commission, which has begun meeting, will provide oversight and administration of the Compact, including creating and enforcing rules and promoting interstate cooperation, ultimately ensuring that the Compact continues to facilitate safe and expedient access to care and physician licensure. Each state participating in the Compact will have two representatives to the commission.

Will physicians eligible for the Compact receive a single license to practice in multiple states?

No. Each license to practice medicine will be issued by a state medical board and physicians will need to be licensed in the state where the patient is located. A license obtained through the expedited procedure will provide the same licensing currently provided for physicians by state medical boards: the only difference is that the process of obtaining a license will be significantly streamlined.

How will a physician apply for expedited licensure through the Compact?

An eligible physician will designate a member state as the state of principal licensure and select the other member states in which a medical license is desired. The state of principal licensure will verify the physician’s eligibility and provide credential information to the Interstate Commission. The Interstate Commission will then collect applicable fees and transmit the physician’s information and licensure fees to the additional states. Upon receipt in the additional states, the physician will be granted a license.

What state can serve as the state of principal licensure?

The physician must possess a full and unrestricted license to practice medicine in the state of principal licensure, and the state must be (1) the state of primary residence for the physician, or (2) the state where at least 25% of the practice of medicine occurs, or (3) the location of the physician’s employer, or (4) if no state qualifies, the state designated as state of residence for purpose of federal income tax.

How long will it take for physicians to be licensed in other states?

The Compact will substantially reduce the time it takes to receive multiple licenses. As soon as eligibility is verified and fees are transferred, additionally selected states will issue a full and unrestricted license to the physician.

How much will additional licenses cost?

State licensure fees will continue to vary from state to state, but it is anticipated that state medical boards may choose to charge a reduced fee for a license obtained through the Compact.

Does the Interstate Compact change a state’s Medical Practice Act?

The Compact creates another pathway for licensure, but does not otherwise change a state’s existing Medical Practice Act. A physician applying for expedited licensure through the Compact will be granted the same full and unrestricted license to practice medicine as he/she would receive if applying through the current state licensure processes.

What will happen to a license if a physician is disciplined in a Compact state?

Any disciplinary action on a license issued by a member state may be subject to discipline by other member states. Other member states that have issued a license to the physician may impose the same or lesser sanctions on that license or pursue separate disciplinary action based on the respective Medical Practice Act.

How does a state become a member of the Interstate Medical Licensure Compact?

Interstate compacts are formal agreements between states that have the characteristics of both statutory law and contractual agreement. In order for a state to join the Interstate Medical Licensure Compact, state legislatures must enact the Compact into state law.

Will the Interstate Medical Licensure Compact usurp state authority to regulate medicine?

No. Facilitating expedited medical licensure through the Interstate Medical Licensure Compact ensures that states retain their Constitutionally-mandated role in regulating the practice of medicine and protecting patient welfare. The Compact represents the efforts of the states to develop a dynamic, self-regulatory system of expedited licensure over which the member states can maintain control through a coordinated legislative and administrative process.

How will the Commission be funded? How much will it cost?

Under the terms of the Compact, the Commission may assess processing fees for expedited licensure, ultimately off-setting any burden on the member states. Additionally, the Compact Commission is enabled to seek grants and secure outside funding, through private grants, or federal appropriations in support of license portability.

Where can I learn more about the Interstate Compact?

Please call (202) 463-4000 or visit