Letter: Proposed Interstate Licensing Bills Are "Wolves in Sheep Clothing"

The proposed legislation Interstate Medical Licensure Compact (S. 2497 and H. 7771) and revised Nursing Compact (H. 8077) are a set of wolves in sheep clothing. Beyond the flowery introduction, these proposed laws transfer legislative authority over nursing and medical licensure to out of state Compact Commission Boards. When these Compact Boards pass rules, these "rules" will have the force of law in RI. The rules affect the licensure and practice of physicians and nurses. Why would our legislature give unelected Compact boards the ability to make laws in RI?

This Medical Compact Board in Washington, DC will determine if RI physicians licensed through this Compact legislation can keep or lose their license for not renewing an out of state medical license which they used to obtain an expedited RI medical license before they moved to practice here in RI.

Numerous physicians testified on Capitol Hill in front of the Senate Health and Human Services Committee warning of the ill-advised transfer of lawmaking in RI to Compact Boards in Washington, DC. Physicians and nurses will follow the path of least resistance to licensure proposed by the Compact bills to the detriment of RI's patients. Physicians typically recertify for their Board exams every ten years. Hospitals typically require Board certification starting 5 years after training. If a physician misses the opportunity to take an annual Board recertification exam because of family illness, cancelled airline flights, etc., the hospitals have the option of waiving the requirement for a year.

Under the Compact rules, a physician who fell out of Board certification would not be allowed to renew their RI Medical Compact license, and could lose their RI medical license when their board certification expired. This legislation takes the power from the Department of Health and Legislature to control licensure, and transfers it out of state. In a family practice setting, 1500 - 2000 patients would lose their physician when the Compact rescinded his/her Compact-based RI medical license. Paperwork would take months to reapply or renew a RI medical license under the usual non-expedited processes. Patients could not see their physician until a new RI medical license was issued.

We need to attract new physicians.

This legislation discriminates against physicians finishing their residency and fellowship training since they must wait 2-3 years to take their Board exams.

As the smallest state, we have to pay the Compact Commission with a blank check for their fancy Washington offices, executive director, and office staff to bill our - and every other Compact states' - physicians. RI agrees to follow the rules the Compact has yet to write.

The best part: If RI does not follow the Compact rules, the Compact gets to sue RI and then RI has to pay the Compact's lawyers fees and hire DC lawyers. And if RI decides to leave the Compact, it takes a year to exit as the Compact expense bills keep coming. In essence, if RI decides the Compact is too expensive, the Compact Commission can hold the RI licenses of Compact pathway physicians (and their patients) hostage to try to prevent RI from leaving the Compact.

At least 30% of states, having considered this Interstate Medical Licensure Compact, have declined/waived participation including Massachusetts. At least 18 medical societies and up to 97% of doctors are against linking the Maintenance of Certification programs of the Compact to licensure. If Rhode Island had followed Massachusetts’ lead in declining the Curt Schilling 38 Studios "deal," RI would have been much better off. Let's not make the same mistake twice.

Sincerely,

Lisa Frappier, D.O.
Riverside, RI