title: RCW 18.71.210

text:
(1) No act or omission of any physician's trained advanced emergency medical technician and paramedic, as defined in RCW 18.71.200, or any emergency medical technician or first responder, as defined in RCW 18.73.030, done or omitted in good faith while rendering emergency medical service under the responsible supervision and control of a licensed physician or an approved medical program director or delegate(s) to a person who has suffered illness or bodily injury shall impose any liability upon:
(a) The physician's trained advanced emergency medical technician and paramedic, emergency medical technician, or first responder;
(b) The medical program director;
(c) The supervising physician(s);
(d) Any hospital, the officers, members of the staff, nurses, or other employees of a hospital;
(e) Any training agency or training physician(s);
(f) Any licensed ambulance service; or
(g) Any federal, state, county, city, or other local governmental unit or employees of such a governmental unit.
(2) This section shall apply to an act or omission committed or omitted in the performance of the actual emergency medical procedures and not in the commission or omission of an act which is not within the field of medical expertise of the physician's trained advanced emergency medical technician and paramedic, emergency medical technician, or first responder, as the case may be.
This section shall apply also to emergency medical technicians, advanced emergency medical technicians, paramedics, and medical program directors participating in a community assistance referral and education services program established under RCW 35.21.930.
(3) This section shall apply also, as to the entities and personnel described in subsection (1) of this section, to any act or omission committed or omitted in good faith by such entities or personnel in rendering services at the request of an approved medical program director in the training of emergency medical service personnel for certification or recertification pursuant to this chapter.
(4) This section shall apply also, as to the entities and personnel described in subsection (1) of this section, to any act or omission committed or omitted in good faith by such entities or personnel involved in the transport of patients to mental health facilities or chemical dependency programs, in accordance with applicable alternative facility procedures adopted under RCW 70.168.100.
(5) This section shall not apply to any act or omission which constitutes either gross negligence or willful or wanton misconduct.
[ 2015 c 157 s 5; 2015 c 93 s 4; 1997 c 275 s 1; 1997 c 245 s 1. Prior: 1995 c 103 s 1; 1995 c 65 s 4; 1989 c 260 s 4; 1987 c 212 s 502; 1986 c 68 s 4; 1983 c 112 s 3; 1977 c 55 s 4; 1971 ex.s. c 305 s 3.]
Notes:
Reviser's note: This section was amended by 2015 c 93 s 4 and by 2015 c 157 s 5, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
Effective date—1995 c 103: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect immediately [April 19, 1995]." [ 1995 c 103 s 3.]

catchline: Physician's trained advanced emergency medical technician and paramedic—Liability.


doc_type: statute

jurisdiction: wa

title: RCW 18.71.212

text:
The secretary of the department of health, in conjunction with the state emergency medical services and trauma care committee, shall evaluate, certify and terminate certification of medical program directors, and prescribe minimum standards defining duties and responsibilities and performance of duties and responsibilities.
[ 1990 c 269 s 19; 1986 c 68 s 2.]

license: public-domain-government-work

rule_set: Revised Code of Washington

code: rcw

unit: section

court: Washington State Legislature


title: RCW 18.71.213

text:
If a medical program director terminates certification, that medical program director's authority may be delegated by the department to any other licensed physician for a period of thirty days, or until a new medical program director is certified, whichever comes first.
[ 1986 c 68 s 3.]

catchline: Medical program directors—Termination—Temporary delegation of authority.


title: RCW 18.71.215

text:
The department of health shall defend and hold harmless approved medical program directors, delegates, or agents, including but not limited to hospitals and hospital personnel in their capacity of training emergency service medical personnel for certification or recertification pursuant to this chapter at the request of such directors, for any act or omission committed or omitted in good faith in the performance of their duties.
[ 1995 c 103 s 2; 1990 c 269 s 20; 1986 c 68 s 5; 1983 c 112 s 4.]
Notes:
Effective date—1995 c 103: See note following RCW 18.71.210.

catchline: Medical program directors—Liability for acts or omissions of others.


title: RCW 18.71.220

text:
No physician or hospital licensed in this state shall be subject to civil liability, based solely upon failure to obtain consent in rendering emergency medical, surgical, hospital, or health services to any individual regardless of age where its patient is unable to give his or her consent for any reason and there is no other person reasonably available who is legally authorized to consent to the providing of such care: PROVIDED, That such physician or hospital has acted in good faith and without knowledge of facts negating consent.
[ 2011 c 336 s 497; 1971 ex.s. c 305 s 4.]
Notes:
Immunity from liability for certain types of medical care: RCW 4.24.300.

catchline: Rendering emergency care—Immunity of physician or hospital from civil liability.


title: RCW 18.71.230

text:
A right to practice medicine and surgery by an individual in this state pursuant to *RCW 18.71.030 (5) through (12) shall be subject to discipline by order of the commission upon a finding by the commission of an act of unprofessional conduct as defined in RCW 18.130.180 or that the individual is unable to practice with reasonable skill or safety due to a mental or physical condition as described in RCW 18.130.170. Such physician shall have the same rights of notice, hearing, and judicial review as provided licensed physicians generally under this chapter and chapter 18.130 RCW.
[ 1994 sp.s. c 9 s 317; 1986 c 259 s 112; 1979 c 158 s 57; 1973 1st ex.s. c 110 s 2.]
Notes:
*Reviser's note: RCW 18.71.030 was amended by 2021 c 247 s 1, changing subsection (12) to subsection (13).
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Severability—1986 c 259: See note following RCW 18.130.010.

catchline: Disciplinary action against persons exempt from licensure.


title: RCW 18.71.240

text:
The right of medical treatment of an infant born alive in the course of an abortion procedure shall be the same as the right of an infant born prematurely of equal gestational age.
[ 1981 c 328 s 1.]

catchline: Abortion—Right to medical treatment of infant born alive.


title: RCW 18.71.250

text:
A physician licensed under this chapter who provides a parent with a positive prenatal or postnatal diagnosis of Down syndrome shall provide the parent with the information prepared by the department under RCW 43.70.738 at the time the physician provides the parent with the Down syndrome diagnosis.
[ 2016 c 70 s 5.]

catchline: Down syndrome—Parent information.


title: RCW 18.71.300

text:
The definitions in this section apply throughout RCW 18.71.310 through 18.71.340 unless the context clearly requires otherwise.
(1) "Entity" means a nonprofit corporation formed by physicians who have expertise in substance use disorders, mental illness, and other potentially impairing health conditions and who broadly represent the physicians of the state and that has been designated to perform any or all of the activities set forth in RCW 18.71.310(1) by the commission.
(2) "Impaired" or "impairment" means the inability to practice medicine with reasonable skill and safety to patients by reason of a health condition.
(3) "Physician health program" means the program for the prevention, detection, intervention, referral for evaluation and treatment, and monitoring of impaired or potentially impaired physicians established by the commission pursuant to RCW 18.71.310(1).
[ 2022 c 43 s 4; 1998 c 132 s 3; 1994 sp.s. c 9 s 329; 1989 c 119 s 1; 1987 c 416 s 1. Formerly RCW 18.72.301.]
Notes:
Finding—Intent—Severability—1998 c 132: See notes following RCW 18.71.0195.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Effective date—1987 c 416: "This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect July 1, 1987." [ 1987 c 416 s 10.]

catchline: Physician health program—Definitions.


title: RCW 18.71.310

text:
(1) The commission shall enter into a contract with the entity to implement a physician health program. The commission may enter into a contract with the entity for up to six years in length. The physician health program may include any or all of the following:
(a) Entering into relationships supportive of the physician health program with professionals who provide either evaluation or treatment services, or both;
(b) Receiving and assessing reports of suspected impairment from any source;
(c) Intervening in cases of verified impairment, or in cases where there is reasonable cause to suspect impairment;
(d) Upon reasonable cause, referring suspected or verified impaired physicians for evaluation or treatment;
(e) Monitoring the treatment and rehabilitation of participants including those ordered by the commission;
(f) Providing monitoring and care management support of program participants;
(g) Performing such other activities as agreed upon by the commission and the entity; and
(h) Providing prevention and education services.
(2) A contract entered into under subsection (1) of this section shall be financed by a surcharge of $70 per year or equivalent on each license renewal or issuance of a new license to be collected by the department of health from every physician, surgeon, and physician assistant licensed under this chapter in addition to other license fees. These moneys shall be placed in the impaired physician account to be used solely to support the physician health program.
(3) All funds in the impaired physician account shall be paid to the contract entity within sixty days of deposit.
[ 2024 c 15 s 2; 2022 c 43 s 5; 2009 c 98 s 1; 2001 c 109 s 1; 1998 c 132 s 4; 1997 c 79 s 2; 1994 sp.s. c 9 s 330; 1991 c 3 s 169; 1989 c 119 s 2; 1987 c 416 s 2. Formerly RCW 18.72.306.]
Notes:
Findings—2024 c 15: "The legislature finds that for over 30 years the Washington physicians health program has been the approved therapeutic alternative to discipline for Washington physicians, physician assistants, dentists, osteopathic physicians, podiatric physicians, and veterinarians with impairing or potentially impairing health conditions. To best support health care professionals and remain a model physician health program nationally, the license surcharge fees that provide the majority of program funding must be periodically increased to sustain and enhance services for impairing or potentially impairing health conditions and hiring qualified staff to handle the increased caseload complexity. More than ever, the legislature finds it is critical to maintain our current physician workforce and authorizing this fee increase, which is supported and paid for by the health care professionals that the program benefits, will provide the resources necessary for the program to continue essential services to the health care workforce." [ 2024 c 15 s 1.]
Finding—Intent—Severability—1998 c 132: See notes following RCW 18.71.0195.
Effective date—1997 c 79: See note following RCW 18.71.401.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Effective date—1987 c 416: See note following RCW 18.71.300.

catchline: Physician health program—License surcharge—Payment of funds.


title: RCW 18.71.315

text:
The impaired physician account is created in the custody of the state treasurer. All receipts from RCW 18.71.310 from license surcharges on physicians and physician assistants shall be deposited into the account. Expenditures from the account may only be used for the physician health program under this chapter. Only the secretary of health or the secretary's designee may authorize expenditures from the account. No appropriation is required for expenditures from this account.
[ 2022 c 43 s 6; 1998 c 132 s 12.]
Notes:
Finding—Intent—Severability—1998 c 132: See notes following RCW 18.71.0195.

catchline: Impaired physician account—Created.


title: RCW 18.71.320

text:
The entity shall develop procedures in consultation with the commission for:
(1) Periodic reporting of statistical information regarding physician health program participant activity;
(2) Periodic disclosure and joint review of such information as the commission may deem appropriate regarding reports received, contacts or investigations made, and the disposition of each report. However, the entity shall not disclose any personally identifiable information except as provided in subsections (3) and (4) of this section;
(3) Immediate reporting to the commission of the name and results of any contact or investigation regarding any suspected or verified impaired physician who is reasonably believed probably to constitute an imminent danger to himself or herself or to the public;
(4) Reporting to the commission, in a timely fashion, any suspected or verified impaired physician who fails to cooperate with the entity, fails to submit to evaluation or treatment, or whose impairment is not substantially alleviated through treatment, or who, in the opinion of the entity, is probably unable to practice medicine with reasonable skill and safety;
(5) Informing each participant of the physician health program of the program procedures, the responsibilities of program participants, and the possible consequences of noncompliance with the program.
[ 2022 c 43 s 7; 1998 c 132 s 5; 1994 sp.s. c 9 s 331; 1987 c 416 s 3. Formerly RCW 18.72.311.]
Notes:
Finding—Intent—Severability—1998 c 132: See notes following RCW 18.71.0195.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Effective date—1987 c 416: See note following RCW 18.71.300.

catchline: Physician health program—Procedures.


title: RCW 18.71.330

text:
If the commission has reasonable cause to believe that a physician is impaired, the commission shall cause an evaluation of such physician to be conducted by the entity or the entity's designee or the commission's designee for the purpose of determining if there is an impairment. The entity or appropriate designee shall report the findings of its evaluation to the commission.
[ 1998 c 132 s 6; 1994 sp.s. c 9 s 332; 1987 c 416 s 4. Formerly RCW 18.72.316.]
Notes:
Finding—Intent—Severability—1998 c 132: See notes following RCW 18.71.0195.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Effective date—1987 c 416: See note following RCW 18.71.300.

catchline: Impaired physician program—Evaluation of physician.


title: RCW 18.71.340

text:
All entity records are not subject to disclosure pursuant to chapter 42.56 RCW.
[ 2005 c 274 s 228; 1998 c 132 s 7; 1987 c 416 s 6. Formerly RCW 18.72.321.]
Notes:
Finding—Intent—Severability—1998 c 132: See notes following RCW 18.71.0195.
Effective date—1987 c 416: See note following RCW 18.71.300.

catchline: Impaired physician program—Entity records protected.


title: RCW 18.71.350

text:
(1) Every institution or organization providing professional liability insurance to physicians shall send a complete report to the commission of all malpractice settlements, awards, or payments in excess of twenty thousand dollars as a result of a claim or action for damages alleged to have been caused by an insured physician's incompetency or negligence in the practice of medicine. Such institution or organization shall also report the award, settlement, or payment of three or more claims during a five-year time period as the result of the alleged physician's incompetence or negligence in the practice of medicine regardless of the dollar amount of the award or payment.
(2) Reports required by this section shall be made within sixty days of the date of the settlement or verdict. Failure to comply with this section is punishable by a civil penalty not to exceed two hundred fifty dollars.
[ 1994 sp.s. c 9 s 333; 1993 c 367 s 17; 1986 c 300 s 6. Formerly RCW 18.72.340.]
Notes:
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Legislative findings—Severability—1986 c 300: See notes following RCW 18.57.245.

catchline: Report of malpractice payments by insurers.


title: RCW 18.71.360

text:
To assist in identifying impairment related to alcohol abuse, the commission may obtain a copy of the driving record of a physician or a physician assistant maintained by the department of licensing.
[ 1994 sp.s. c 9 s 334; 1991 c 215 s 2. Formerly RCW 18.72.345.]
Notes:
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.

catchline: Driving records.


title: RCW 18.71.401

text:
All assessments, fines, and other funds collected or received under this chapter must be deposited in the health professions account and used solely to administer and implement this chapter.
[ 1997 c 79 s 1.]
Notes:
Effective date—1997 c 79: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 1, 1997." [ 1997 c 79 s 6.]

catchline: Funds collected—Where deposited.


title: RCW 18.71.420

text:
The secretary of health shall allocate all appropriated funds to accomplish the purposes of this chapter.
[ 1991 c 3 s 171; 1983 c 71 s 3. Formerly RCW 18.72.400.]

catchline: Allocation of all appropriated funds.


title: RCW 18.71.430

text:
(1) The secretary shall employ an executive director that is:
(a) Hired by and serves at the pleasure of the commission;
(b) Exempt from the provisions of the civil service law, chapter 41.06 RCW and whose salary is established by the commission in accordance with RCW 43.03.028; and
(c) Responsible for performing all administrative duties of the commission, including preparing an annual budget, and any other duties as delegated to the executive director by the commission.
(2) Consistent with the budgeting and accounting act, the commission is responsible for proposing its own biennial budget which the secretary must submit to the office of financial management.
(3) Prior to adopting credentialing fees under RCW 43.70.250, the secretary shall collaborate with the commission to determine the appropriate fees necessary to support the activities of the commission.
(4) Prior to the secretary exercising the secretary's authority to adopt uniform rules and guidelines, or any other actions that might impact the licensing or disciplinary authority of the commission, the secretary shall first meet with the commission to determine how those rules or guidelines, or changes to rules or guidelines, might impact the commission's ability to effectively carry out its statutory duties. If the commission, in consultation with the secretary, determines that the proposed rules or guidelines, or changes to existing rules or guidelines, will negatively impact the commission's ability to effectively carry out its statutory duties, then the individual commission shall collaborate with the secretary to develop alternative solutions to mitigate the impacts. If an alternative solution cannot be reached, the parties may resolve the dispute through a mediator as set forth in subsection (6) of this section.
(5) The commission shall negotiate with the secretary to develop performance-based expectations, including identification of key performance measures. The performance expectations should focus on consistent, timely regulation of health care professionals.
(6) In the event there is a disagreement between the commission and the secretary, that is unable to be resolved through negotiation, a representative of both parties shall agree on the designation of a third party to mediate the dispute.
(7) The secretary shall employ staff that are hired and managed by the executive director provided that nothing contained in this section may be construed to alter any existing collective bargaining unit or the provisions of any existing collective bargaining agreement.
[ 2013 c 81 s 3; 2011 c 60 s 7; 2008 c 134 s 29.]
Notes:
Effective date—2013 c 81: See note following RCW 18.25.0167.
Effective date—2011 c 60: See note following RCW 29B.20.030.
Finding—Intent—Severability—2008 c 134: See notes following RCW 18.130.020.

catchline: Secretary and commission relationship.


title: RCW 18.71.440

text:
(1) The commission shall consider amending its rules on retired active physicians in a manner that improves access to health care services for the citizens of this state without compromising public safety. When considering whether to amend its rules, the commission shall, at a minimum, consider the following:
(a) Whether physicians holding retired active licenses should be allowed to provide health care services beyond primary care;
(b) Whether physicians holding retired active licenses should be allowed to provide health care services in settings beyond community clinics operated by public or private tax-exempt corporations; and
(c) The number and type of continuing education hours that physicians holding retired active licenses shall be required to obtain.
(2) The commission shall determine whether it will amend its rules in the manner suggested by this section no later than November 15, 2009. If the commission determines that it will not amend its rules, it shall provide a written explanation of its decision to the appropriate committees of the legislature no later than December 1, 2009.
[ 2009 c 403 s 4.]
Notes:
Finding—Intent—2009 c 403: See note following RCW 18.71.080.

catchline: Commission to consider amending rules—Retired active physicians.


title: RCW 18.71.450

text:
(1) By June 30, 2011, the commission shall repeal its rules on pain management, WAC 246-919-800 through 246-919-830.
(2) By June 30, 2011, the commission shall adopt new rules on chronic, noncancer pain management that contain the following elements:
(a)(i) Dosing criteria, including:
(A) A dosage amount that must not be exceeded unless a physician first consults with a practitioner specializing in pain management; and
(B) Exigent or special circumstances under which the dosage amount may be exceeded without consultation with a practitioner specializing in pain management.
(ii) The rules regarding consultation with a practitioner specializing in pain management must, to the extent practicable, take into account:
(A) Circumstances under which repeated consultations would not be necessary or appropriate for a patient undergoing a stable, ongoing course of treatment for pain management;
(B) Minimum training and experience that is sufficient to exempt a physician from the specialty consultation requirement;
(C) Methods for enhancing the availability of consultations;
(D) Allowing the efficient use of resources; and
(E) Minimizing the burden on practitioners and patients;
(b) Guidance on when to seek specialty consultation and ways in which electronic specialty consultations may be sought;
(c) Guidance on tracking clinical progress by using assessment tools focusing on pain interference, physical function, and overall risk for poor outcome; and
(d) Guidance on tracking the use of opioids, particularly in the emergency department.
(3) The commission shall consult with the agency medical directors' group, the department of health, the University of Washington, and the largest professional association of physicians in the state.
(4) The rules adopted under this section do not apply:
(a) To the provision of palliative, hospice, or other end-of-life care; or
(b) To the management of acute pain caused by an injury or a surgical procedure.
[ 2010 c 209 s 5.]

catchline: Pain management rules—Repeal—Adoption of new rules.


title: RCW 18.71.460

text:
In addition to the authority provided in RCW 42.52.804, the commission, its members, or staff as directed by the commission, may communicate, present information requested, volunteer information, testify before legislative committees, and educate the legislature, as the commission may from time to time see fit.
[ 2013 c 81 s 4.]
Notes:
Effective date—2013 c 81: See note following RCW 18.25.0167.

catchline: Commission—Information to legislature.


title: RCW 18.71.472

text:
Based on recommendations from the international medical graduate implementation work group, the commission shall adopt a clinical assessment to determine the readiness of international medical graduates to apply and serve in residency programs and adopt a grant award process for distributing funds pursuant to RCW 18.71.475.
[ 2020 c 325 s 2.]

catchline: International medical graduates—Clinical assessment.


title: RCW 18.71.475

text:
Subject to appropriation by the legislature and donations received from public and private entities, the department of health shall award grant funding to:
(1) Approved entities for career guidance and support services to international medical graduates including, but not limited to, assistance with educational commission for foreign medical graduates certification application and United States medical licensing examination preparation; and
(2) Health care facilities or clinical programs to provide supervised clinical training to international medical graduates.
[ 2020 c 325 s 3.]

catchline: International medical graduates—Grant funding.


title: RCW 18.71.480

text:
(1) The commission shall establish and administer the clinical experience graduate pilot program.
(2) The pilot program must allow an international medical graduate to participate in the program if the applicant:
(a) Holds a clinical experience license issued on or before July 1, 2026;
(b) Has completed two years of continuous supervised clinical practice under a clinical experience license;
(c) Does not have any active disciplinary action or significant disciplinary history as determined by the commission;
(d) Has obtained satisfactory clinical assessment evaluations from the supervising physician in all categories in a clinical assessment evaluation approved by the commission for the period of supervised practice;
(e) Has obtained an attestation from the supervising physician; and
(f) Has obtained a written endorsement from the medical director of the practice site if different than the supervising physician.
(3) The Washington medical commission shall engage with the American board of medical specialties to consider a process for board certification for program participants.
(4) The pilot program shall create a pathway to full, unrestricted medical licensure to provide primary care upon successful completion of the following:
(a) Two years of supervised clinical experience license practice in addition to the two years of continuous supervised clinical practice under a clinical experience license needed to qualify for the pilot program;
(b) Requirements of the clinical experience license program;
(c) Step 3 of the United States medical licensing examination; and
(d) Passing a clinical competency assessment approved by the commission.
(5) Practice sites eligible for the program include:
(a) Hospitals;
(b) Federally qualified health centers;
(c) Government entities;
(d) Private practices or physician employment groups with at least 10 full-time equivalent, board-certified physicians that deliver in-person patient care in Washington state; and
(e) Mental and behavioral health facilities, upon approval by the commission.
(6) By November 1, 2027, and until November 1, 2035, the commission must provide an annual report on the clinical experience graduate pilot program to the legislature. The report must include:
(a) Data about practice patterns of program participants, including, but not limited to, practice locations and specialty;
(b) Relevant disciplinary actions taken against pilot program participants; and
(c) Recommendations for how the pilot program could be expanded to include graduates of medical schools in the United States.
(7) This section expires June 30, 2035.
[ 2026 c 154 s 2.]

catchline: Graduate pilot program—International medical graduates—Pathways to licensure. (Expires June 30, 2035.)


title: RCW 18.71.800

text:
(1) By January 1, 2019, the commission must adopt rules establishing requirements for prescribing opioid drugs. The rules may contain exemptions based on education, training, amount of opioids prescribed, patient panel, and practice environment.
(2) In developing the rules, the commission must consider the agency medical directors' group and centers for disease control guidelines, and may consult with the department of health, the University of Washington, and the largest professional association of physicians in the state.
[ 2017 c 297 s 6.]
Notes:
Findings—Intent—2017 c 297: See note following RCW 18.22.800.

catchline: Opioid drug prescribing rules—Adoption.


title: RCW 18.71.810

text:
By January 1, 2020, the commission must adopt or amend its rules to require physicians who prescribe opioids to inform patients of their right to refuse an opioid prescription or order for any reason. If a patient indicates a desire to not receive an opioid, the physician must document the patient's request and avoid prescribing or ordering opioids, unless the request is revoked by the patient.
[ 2019 c 314 s 8.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.

catchline: Opioid drugs—Right to refuse.


title: RCW 18.71.910

text:
All acts, or parts of acts, in any wise conflicting with the provisions of this act, are hereby repealed.
[ 1909 c 192 s 22.]

catchline: Repeal—1909 c 192.


title: RCW 18.71.920

text:
All acts and parts of acts to the extent that the same are in conflict herewith are hereby repealed.
[ 1957 c 60 s 6.]

catchline: Repeal—1957 c 60.


title: RCW 18.71A.010

text:
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "Collaboration" means how physician assistants shall interact with, consult with, or refer to a physician or other appropriate member or members of the health care team as indicated by the patient's condition, the education, experience, and competencies of the physician assistant, and the standard of care. The degree of collaboration must be determined by the practice, which may include decisions made by the physician assistant's employer, group, hospital service, and credentialing and privileging systems of licensed facilities.
(2) "Collaboration agreement" means a written agreement that describes the manner in which the physician assistant is supervised by or collaborates with at least one physician and that is signed by the physician assistant and one or more physicians or the physician assistant's employer.
(3) "Commission" means the Washington medical commission.
(4) "Department" means the department of health.
(5) "Employer" means the scope appropriate clinician, such as a medical director, who is authorized to enter into the collaboration agreement with a physician assistant on behalf of the facility, group, clinic, or other organization that employs the physician assistant.
(6) "Participating physician" means a physician that supervises or collaborates with a physician assistant pursuant to a collaboration agreement.
(7) "Physician" means a physician licensed under chapter 18.57 or 18.71 RCW.
(8) "Physician assistant" means a person who is licensed by the commission to practice medicine according to a collaboration agreement with one or more participating physicians and who is academically and clinically prepared to provide health care services and perform diagnostic, therapeutic, preventative, and health maintenance services.
(9) "Practice medicine" has the meaning defined in RCW 18.71.011 and also includes the practice of osteopathic medicine and surgery as defined in RCW 18.57.001.
(10) "Secretary" means the secretary of health or the secretary's designee.
[ 2024 c 62 s 2. Prior: 2020 c 80 s 2; prior: 2019 c 55 s 5; 1994 sp.s. c 9 s 318; 1990 c 196 s 1; 1988 c 113 s 1; 1975 1st ex.s. c 190 s 1; 1971 ex.s. c 30 s 1.]
Notes:
Effective date—2024 c 62 ss 1-8, 10-18, 20-26, 28, and 30-32: "Sections 1 through 8, 10 through 18, 20 through 26, 28, and 30 through 32 of this act take effect January 1, 2025." [ 2024 c 62 s 33.]
Intent—2024 c 62: See note following RCW 18.71A.020.
Effective date—2020 c 80 ss 1-10 and 60: "Sections 1 through 10 and 60 of this act take effect July 1, 2021." [ 2020 c 80 s 61.]
Intent—2020 c 80: "The legislature intends to modernize the practice of physician assistants in order to increase access to care, reduce barriers to employment of physician assistants, and optimize the manner in which physician assistants deliver quality medical care." [ 2020 c 80 s 1.]
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Severability—1971 ex.s. c 30: "If any provision of this 1971 act, or its application to any person or circumstance is held invalid, the remainder of the act, or the application of the provision to other persons or circumstances is not affected." [ 1971 ex.s. c 30 s 13.]
Washington medical commission: Chapter 18.71 RCW.

catchline: Definitions.


title: RCW 18.71A.020

text:
(1) The commission shall adopt rules fixing the qualifications and the educational and training requirements for licensure as a physician assistant or for those enrolled in any physician assistant training program. The requirements shall include completion of an accredited physician assistant training program approved by the commission and within one year successfully take and pass an examination approved by the commission, if the examination tests subjects substantially equivalent to the curriculum of an accredited physician assistant training program. An interim permit may be granted by the department of health for one year provided the applicant meets all other requirements. Physician assistants licensed by the board of medical examiners, or the commission as of July 1, 1999, shall continue to be licensed.
(2)(a) The commission shall adopt rules governing the extent to which:
(i) Physician assistant students may practice medicine during training; and
(ii) Physician assistants may practice after successful completion of a physician assistant training course.
(b) Such rules shall provide:
(i) That the practice of a physician assistant shall be limited to the performance of those services for which he or she is trained; and
(ii) That each physician assistant shall practice medicine only under the terms of one or more collaboration agreements, each signed by the physician assistant and one or more physicians licensed in this state or the physician assistant's employer. A collaboration agreement may be signed electronically using a method for electronic signatures approved by the commission.
(3) Applicants for licensure shall file an application with the commission on a form prepared by the secretary with the approval of the commission, detailing the education, training, and experience of the physician assistant and such other information as the commission may require. The application shall be accompanied by a fee determined by the secretary as provided in RCW 43.70.250 and 43.70.280. A surcharge of $70 per year shall be charged on each license renewal or issuance of a new license to be collected by the department and deposited into the impaired physician account for physician assistant participation in the physician health program. Each applicant shall furnish proof satisfactory to the commission of the following:
(a) That the applicant has completed an accredited physician assistant program approved by the commission and is eligible to take the examination approved by the commission;
(b) That the applicant is of good moral character; and
(c) That the applicant is physically and mentally capable of practicing medicine as a physician assistant with reasonable skill and safety. The commission may require an applicant to submit to such examination or examinations as it deems necessary to determine an applicant's physical or mental capability, or both, to safely practice as a physician assistant.
(4)(a) The commission may approve, deny, or take other disciplinary action upon the application for license as provided in the Uniform Disciplinary Act, chapter 18.130 RCW.
(b) The license shall be renewed as determined under RCW 43.70.250 and 43.70.280. The commission shall request licensees to submit information about their current professional practice at the time of license renewal and licensees must provide the information requested. This information may include practice setting, medical specialty, or other relevant data determined by the commission.
(5) All funds in the impaired physician account shall be paid to the contract entity within sixty days of deposit.
[ 2024 c 62 s 3; 2024 c 15 s 3; 2020 c 80 s 3; 2019 c 55 s 6; 2015 c 252 s 9; 2011 c 178 s 2; 2009 c 98 s 2; 1999 c 127 s 1; 1998 c 132 s 14; 1996 c 191 s 57; 1994 sp.s. c 9 s 319; 1993 c 28 s 5; 1992 c 28 s 2; 1990 c 196 s 2; 1971 ex.s. c 30 s 2.]
Notes:
Reviser's note: This section was amended by 2024 c 15 s 3 and by 2024 c 62 s 3, each without reference to the other. Both amendments are incorporated in the publication of this section under RCW 1.12.025(2). For rule of construction, see RCW 1.12.025(1).
Intent—2024 c 62: "From March 2020 through October 2022, physician assistants were permitted under the governor's proclamation 20-32 to work without a delegation agreement signed by a supervising physician. During the public health emergency, physician assistants provided safe and efficient care, expanding access to necessary services and procedures statewide. There continues to be a great need for additional providers in primary care and specialty areas, especially in medically underserved and rural communities. Therefore, the legislature intends to authorize physician assistants to enter into collaborative practice with physicians to provide team-based care and enhance access to health care for the people of the state." [ 2024 c 62 s 1.]
Effective date—2024 c 62 ss 1-8, 10-18, 20-26, 28, and 30-32: See note following RCW 18.71A.010.
Findings—2024 c 15: See note following RCW 18.71.310.
Effective date—2020 c 80 ss 1-10 and 60: See note following RCW 18.71A.010.
Intent—2020 c 80: See note following RCW 18.71A.010.
Intent—2015 c 252: See note following RCW 70.112.010.
Finding—Intent—Severability—1998 c 132: See notes following RCW 18.71.0195.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.

catchline: Rules fixing qualifications and restricting practice—Applications—Discipline—Payment of funds.


title: RCW 18.71A.023

text:
An applicant with military training or experience satisfies the training or experience requirements of this chapter unless the commission determines that the military training or experience is not substantially equivalent to the standards of this state.
[ 2011 c 32 s 6.]

catchline: Practice requirements—Military training or experience.


title: RCW 18.71A.025

text:
(1) The uniform disciplinary act, chapter 18.130 RCW, governs the issuance and denial of licenses and the discipline of licensees under this chapter.
(2) The commission shall consult with the board of osteopathic medicine and surgery when investigating allegations of unprofessional conduct against a licensee who is supervised by or is collaborating with a physician licensed under chapter 18.57 RCW.
[ 2024 c 62 s 4; 2020 c 80 s 4; 1986 c 259 s 106.]
Notes:
Effective date—2024 c 62 ss 1-8, 10-18, 20-26, 28, and 30-32: See note following RCW 18.71A.010.
Intent—2024 c 62: See note following RCW 18.71A.020.
Effective date—2020 c 80 ss 1-10 and 60: See note following RCW 18.71A.010.
Intent—2020 c 80: See note following RCW 18.71A.010.
Severability—1986 c 259: See note following RCW 18.130.010.

catchline: Application of uniform disciplinary act.


title: RCW 18.71A.030

text:
(1) A physician assistant may practice medicine in this state to the extent permitted by the collaboration agreement. A physician assistant shall be subject to discipline under chapter 18.130 RCW.
(2)(a) A physician assistant who has completed fewer than 4,000 hours of postgraduate clinical practice must work under the supervision of a participating physician, as described in the collaboration agreement and determined at the practice site. A physician assistant with 4,000 or more hours of postgraduate clinical practice may work in collaboration with a participating physician, if the physician assistant has completed 2,000 or more supervised hours in the physician assistant's chosen specialty.
(b) If a physician assistant chooses to change specialties after the completion of 4,000 hours of postgraduate clinical practice, the first 2,000 hours of postgraduate clinical practice in the new specialty must be completed under the supervision of a participating physician, as described in the collaboration agreement and determined at the practice site.
(c) Supervision shall not be construed to necessarily require the personal presence of the participating physician or physicians at the place where services are rendered.
(3)(a) Physician assistants may provide services that they are competent to perform based on their education, training, and experience and that are consistent with their collaboration agreement. The participating physician or physicians, or the physician assistant's employer, and the physician assistant shall determine which procedures may be performed and the degree of autonomy under which the procedure is performed.
(b) Physician assistants may practice in any area of medicine or surgery as long as the practice is not beyond the scope of expertise and clinical practice of the participating physician or physicians or the group of physicians within the department or specialty areas in which the physician assistant practices.
(c) A physician assistant who has at least 10 years or 20,000 hours of postgraduate clinical experience in a specialty may continue to provide those specialty services if the physician assistant is employed in a practice setting where those services are outside the specialty of the physician assistant's participating physician or physicians, as outlined in the collaboration agreement, if the practice is located in a rural area as identified by the department under RCW 70.180.011 or in an underserved area as designated by the health resources and services administration as a medically underserved area or having a medically underserved population. The physician assistant must complete continuing education related to that specialty while performing services outside the specialty of the physician assistant's participating physician or physicians.
(4) A physician assistant working with an anesthesiologist who is acting as a participating physician as defined in RCW 18.71A.010 to deliver general anesthesia or intrathecal anesthesia pursuant to a collaboration agreement shall show evidence of adequate education and training in the delivery of the type of anesthesia being delivered on the physician assistant's collaboration agreement as stipulated by the commission.
[ 2024 c 62 s 5; 2020 c 80 s 5; 2016 c 155 s 23; 2013 c 203 s 6; 1994 sp.s. c 9 s 320; 1993 c 28 s 6; 1990 c 196 s 3; 1971 ex.s. c 30 s 3.]
Notes:
Effective date—2024 c 62 ss 1-8, 10-18, 20-26, 28, and 30-32: See note following RCW 18.71A.010.
Intent—2024 c 62: See note following RCW 18.71A.020.
Effective date—2020 c 80 ss 1-10 and 60: See note following RCW 18.71A.010.
Intent—2020 c 80: See note following RCW 18.71A.010.
Rules—2013 c 203: "The medical quality assurance commission [medical commission] and board of osteopathic medicine and surgery, working in collaboration with a statewide organization representing the interests of physician assistants, shall adopt new rules modernizing the current rules regulating physician assistants and report to the legislature by December 31, 2014." [ 2013 c 203 s 8.]
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.

catchline: Limitations on practice—Scope of practice.


title: RCW 18.71A.045

text:
Foreign medical school graduates shall not be eligible for licensing as physician assistants after July 1, 1989.
[ 1994 sp.s. c 9 s 322; 1988 c 113 s 2.]
Notes:
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.

catchline: Eligibility of foreign medical school graduates.


title: RCW 18.71A.050

text:
No physician or employer who enters into a collaboration agreement with a licensed physician assistant in accordance with and within the terms of any permission granted by the commission is considered as aiding and abetting an unlicensed person to practice medicine. The physician assistant shall retain responsibility for any act which constitutes the practice of medicine as defined in RCW 18.71.011 or the practice of osteopathic medicine and surgery as defined in RCW 18.57.001 when performed by the physician assistant.
[ 2024 c 62 s 6; 2020 c 80 s 7; 1994 sp.s. c 9 s 323; 1993 c 28 s 8; 1990 c 196 s 5; 1986 c 259 s 114; 1971 ex.s. c 30 s 5.]
Notes:
Effective date—2024 c 62 ss 1-8, 10-18, 20-26, 28, and 30-32: See note following RCW 18.71A.010.
Intent—2024 c 62: See note following RCW 18.71A.020.
Effective date—2020 c 80 ss 1-10 and 60: See note following RCW 18.71A.010.
Intent—2020 c 80: See note following RCW 18.71A.010.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Severability—1986 c 259: See note following RCW 18.130.010.

catchline: Physician's and employer's liability, responsibility of physician assistant.


title: RCW 18.71A.060

text:
No health care services may be performed under this chapter in any of the following areas:
(1) The measurement of the powers or range of human vision, or the determination of the accommodation and refractive state of the human eye or the scope of its functions in general, or the fitting or adaptation of lenses or frames for the aid thereof.
(2) The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training, or orthoptics.
(3) The prescribing of contact lenses for, or the fitting or adaptation of contact lenses to, the human eye.
(4) Nothing in this section shall preclude the performance of routine visual screening.
(5) The practice of dentistry or dental hygiene as defined in chapters 18.32 and 18.29 RCW respectively. The exemptions set forth in RCW 18.32.030 (1) and (8), shall not apply to a physician assistant.
(6) The practice of chiropractic as defined in chapter 18.25 RCW including the adjustment or manipulation of the articulations of the spine.
(7) The practice of podiatric medicine and surgery as defined in chapter 18.22 RCW.
[ 1994 sp.s. c 9 s 324; 1990 c 196 s 6; 1973 c 77 s 21; 1971 ex.s. c 30 s 6.]
Notes:
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.

catchline: Limitations on health care services.


title: RCW 18.71A.085

text:
Any physician assistant acupuncturist currently licensed by the commission may continue to perform acupuncture under the physician assistant license as long as he or she maintains licensure as a physician assistant.
[ 1994 sp.s. c 9 s 325; 1990 c 196 s 10.]
Notes:
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.

catchline: Acupuncture.


title: RCW 18.71A.090

text:
(1) A physician assistant may sign and attest to any certificates, cards, forms, or other required documentation that the physician assistant's participating physician or physician group may sign, provided that it is within the physician assistant's scope of practice and is consistent with the terms of the physician assistant's collaboration agreement as required by this chapter.
(2) Notwithstanding any federal law, rule, or medical staff bylaw provision to the contrary, a physician is not required to countersign orders written in a patient's clinical record or an official form by a physician assistant with whom the physician has a collaboration agreement.
[ 2024 c 62 s 7; 2020 c 80 s 8; 2007 c 264 s 3.]
Notes:
Effective date—2024 c 62 ss 1-8, 10-18, 20-26, 28, and 30-32: See note following RCW 18.71A.010.
Intent—2024 c 62: See note following RCW 18.71A.020.
Effective date—2020 c 80 ss 1-10 and 60: See note following RCW 18.71A.010.
Intent—2020 c 80: See note following RCW 18.71A.010.
Finding—Intent—2007 c 264: "The legislature finds that some state agencies and departments do not accept the signature of physician assistants on certain certificates, reports, and other documents that their supervising physician is permitted to sign, notwithstanding the fact that the signing of such documents is within the physician assistant's scope of practice, covered under their practice arrangement plan, and permitted pursuant to WAC 246-918-140.
It is therefore the intent of the legislature to clarify in statute what was adopted by rule in WAC 246-918-140, that a physician assistant may sign and attest to any document that might ordinarily be signed by the supervising physician and that is consistent with the terms of the practice arrangement plan." [ 2007 c 264 s 1.]

catchline: Signing and attesting to required documentation.


title: RCW 18.71A.100

text:
(1) By June 30, 2011, the commission shall adopt new rules on chronic, noncancer pain management that contain the following elements:
(a)(i) Dosing criteria, including:
(A) A dosage amount that must not be exceeded unless a physician assistant first consults with a practitioner specializing in pain management; and
(B) Exigent or special circumstances under which the dosage amount may be exceeded without consultation with a practitioner specializing in pain management.
(ii) The rules regarding consultation with a practitioner specializing in pain management must, to the extent practicable, take into account:
(A) Circumstances under which repeated consultations would not be necessary or appropriate for a patient undergoing a stable, ongoing course of treatment for pain management;
(B) Minimum training and experience that is sufficient to exempt a physician assistant from the specialty consultation requirement;
(C) Methods for enhancing the availability of consultations;
(D) Allowing the efficient use of resources; and
(E) Minimizing the burden on practitioners and patients;
(b) Guidance on when to seek specialty consultation and ways in which electronic specialty consultations may be sought;
(c) Guidance on tracking clinical progress by using assessment tools focusing on pain interference, physical function, and overall risk for poor outcome; and
(d) Guidance on tracking the use of opioids, particularly in the emergency department.
(2) The commission shall consult with the agency medical directors' group, the department of health, the University of Washington, and the largest professional association of physician assistants in the state.
(3) The rules adopted under this section do not apply:
(a) To the provision of palliative, hospice, or other end-of-life care; or
(b) To the management of acute pain caused by an injury or a surgical procedure.
[ 2010 c 209 s 6.]

catchline: Pain management rules—Criteria for new rules.


title: RCW 18.71A.110

text:
A physician assistant who provides a parent with a positive prenatal or postnatal diagnosis of Down syndrome shall provide the parent with the information prepared by the department under RCW 43.70.738 at the time the physician assistant provides the parent with the Down syndrome diagnosis.
[ 2016 c 70 s 6.]

catchline: Down syndrome—Parent information.


title: RCW 18.71A.120

text:
(1)(a) Prior to commencing practice, a physician assistant licensed in Washington state must enter into a collaboration agreement that identifies at least one participating physician and that is signed by one or more participating physicians or the physician assistant's employer.
(b) A collaboration agreement must be signed by a physician if the physician assistant's employer is not a physician.
(c) If a participating physician is not a signatory to the collaboration agreement, the participating physician must be provided notice of the agreement and an opportunity to decline participation. Entering into a collaboration agreement is voluntary for the physician assistant and the participating physician or employer. A physician may not be compelled to participate in a collaboration agreement as a condition of employment.
(d) Prior to entering into the collaboration agreement, the participating physician or physicians, employer, or their designee must verify the physician assistant's credentials.
(e) The protections of RCW 43.70.075 apply to any participating physician or employer who reports to the commission acts of retaliation or reprisal for declining to sign a collaboration agreement.
(f) The collaboration agreement must be available either electronically or on paper at the physician assistant's primary location of practice and made available to the commission upon request.
(g) The commission shall develop a model collaboration agreement.
(h) The commission shall establish administrative procedures, administrative requirements, and fees as provided in RCW 43.70.250 and 43.70.280.
(2) A collaboration agreement must include all of the following:
(a) The duties and responsibilities of the physician assistant and the participating physician or physicians. The collaboration agreement must describe the supervision or collaboration requirements for specified procedures or areas of practice, depending on the number of postgraduate clinical practice hours completed. The collaboration agreement may only include acts, tasks, or functions that the physician assistant is qualified to perform by education, training, or experience. The acts, tasks, or functions included in the collaboration agreement must also be within the scope of expertise and clinical practice of either the participating physician or physicians or the group of physicians within the department or specialty areas in which the physician assistant is practicing, unless otherwise authorized by law, rule, or the commission;
(b) A process between the physician assistant and participating physician or physicians for communication, availability, and decision making when providing medical treatment to a patient or in the event of an acute health care crisis not previously covered by the collaboration agreement, such as a flu pandemic or other unforeseen emergency. Communications may occur in person, electronically, by telephone, or by an alternate method;
(c) If there is only one participating physician identified in the collaboration agreement, a protocol for designating another participating physician for consultation in situations in which the physician is not available;
(d) The signature of the physician assistant and the signature or signatures of the participating physician or physicians, or employer;
(e) If the physician assistant is working under the supervision of a participating physician, in accordance with RCW 18.71A.030, a plan for how the physician assistant will be supervised;
(f) An attestation by the physician assistant of the number of postgraduate clinical practice hours completed, including the number of hours completed in a chosen specialty, at the time the physician assistant signs the collaboration agreement; and
(g) A termination provision. A physician assistant or physician may terminate the collaboration agreement as it applies to a single participating physician without terminating the agreement with respect to the remaining participating physicians. If the termination results in no participating physician being designated on the agreement, a new participating physician must be designated for the agreement to be valid.
(i) Except as provided in (g)(ii) of this subsection, the physician assistant or participating physician must provide written notice at least thirty days prior to the termination.
(ii) The physician assistant or participating physician may terminate the collaboration agreement immediately due to good faith concerns regarding unprofessional conduct or failure to practice medicine while exercising reasonable skill and safety.
(3) The physician assistant is responsible for tracking the number of postgraduate clinical hours completed, including the number of hours completed in a chosen specialty.
(4) A collaboration agreement may be amended for any reason.
(5) Whenever a physician assistant is practicing in a manner inconsistent with the collaboration agreement, the commission may take disciplinary action under chapter 18.130 RCW.
(6) Whenever a physician is subject to disciplinary action under chapter 18.130 RCW related to the practice of a physician assistant, the case must be referred to the appropriate disciplining authority.
(7) A physician assistant, physician, or employer may participate in more than one collaboration agreement if the physician or employer is reasonably able to fulfill the duties and responsibilities in each agreement.
(8) Nothing in this section shall be construed as prohibiting physician assistants from owning their own practice or clinic.
[ 2024 c 62 s 8; 2020 c 80 s 6.]
Notes:
Effective date—2024 c 62 ss 1-8, 10-18, 20-26, 28, and 30-32: See note following RCW 18.71A.010.
Intent—2024 c 62: See note following RCW 18.71A.020.
Effective date—2020 c 80 ss 1-10 and 60: See note following RCW 18.71A.010.
Intent—2020 c 80: See note following RCW 18.71A.010.


title: RCW 18.71A.140

text:
(1) On or after July 1, 2021, no new licenses may be issued under *chapter 18.57A RCW. The commission shall license physician assistants licensed under *chapter 18.57A RCW prior to July 1, 2021, as physician assistants under this chapter when they renew their licenses.
(2) The board of osteopathic medicine and surgery remains the disciplining authority under chapter 18.130 RCW for conduct occurring while a physician assistant is licensed under *chapter 18.57A RCW.
[ 2020 c 80 s 10.]
Notes:
*Reviser's note: Chapter 18.57A RCW was repealed in its entirety by section 59, chapter 80, Laws of 2020, effective July 1, 2022.
Effective date—2020 c 80 ss 1-10 and 60: See note following RCW 18.71A.010.
Intent—2020 c 80: See note following RCW 18.71A.010.

catchline: Licenses issued under chapter 18.57A RCW.


title: RCW 18.71A.150

text:
The commission and the board of osteopathic medicine and surgery shall adopt any rules necessary to implement requirements related to collaboration agreements entered into under this chapter.
[ 2024 c 62 s 9; 2020 c 80 s 11.]
Notes:
Intent—2024 c 62: See note following RCW 18.71A.020.

catchline: Rules—Collaboration agreements.


title: RCW 18.71A.800

text:
(1) By January 1, 2019, the commission must adopt rules establishing requirements for prescribing opioid drugs. The rules may contain exemptions based on education, training, amount of opioids prescribed, patient panel, and practice environment.
(2) In developing the rules, the commission must consider the agency medical directors' group and centers for disease control guidelines, and may consult with the department of health, the University of Washington, and the largest professional association of physician assistants in the state.
[ 2017 c 297 s 7.]
Notes:
Findings—Intent—2017 c 297: See note following RCW 18.22.800.

catchline: Opioid drug prescribing rules—Adoption.


title: RCW 18.71A.810

text:
By January 1, 2020, the commission must adopt or amend its rules to require physician assistants who prescribe opioids to inform patients of their right to refuse an opioid prescription or order for any reason. If a patient indicates a desire to not receive an opioid, the physician assistant must document the patient's request and avoid prescribing or ordering opioids, unless the request is revoked by the patient.
[ 2019 c 314 s 9.]
Notes:
Declaration—2019 c 314: See note following RCW 18.22.810.

catchline: Opioid drugs—Right to refuse.


title: RCW 18.71A.820

text:
A physician assistant practicing under a practice agreement that was entered into before July 1, 2025, may continue to practice under the practice agreement until the physician assistant enters into a collaboration agreement, as defined in RCW 18.71A.010. A physician assistant described in this section shall enter into a collaboration agreement not later than the date on which the physician assistant's license is due for renewal or July 1, 2025, whichever is later.
[ 2024 c 62 s 10.]
Notes:
Effective date—2024 c 62 ss 1-8, 10-18, 20-26, 28, and 30-32: See note following RCW 18.71A.010.
Intent—2024 c 62: See note following RCW 18.71A.020.

catchline: Practice agreements prior to July 1, 2025.


title: RCW 18.71B.010

text:
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, 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.
[ 2017 c 195 s 1.]

catchline: Purpose.


title: RCW 18.71B.020

text:
In this compact:
(1) "Bylaws" means those bylaws established by the interstate commission pursuant to RCW 18.71B.110 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 RCW 18.71B.110.
(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 RCW 18.71B.110.
(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) "Offense" means a felony, gross misdemeanor, or crime of moral turpitude.
(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 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 United States 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) "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.
(13) "Rule" means a written statement by the interstate commission promulgated pursuant to RCW 18.71B.120 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 which has been designated as such by the physician for purposes of registration and participation in the compact.
[ 2017 c 195 s 2.]

catchline: Definitions.


title: RCW 18.71B.030

text:
(1) A physician must meet the eligibility requirements as defined in RCW 18.71B.020(11) to receive an expedited license under the terms and provisions of the compact.
(2) A physician who does not meet the requirements of RCW 18.71B.020(11) 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.
[ 2017 c 195 s 3.]

catchline: Eligibility.


title: RCW 18.71B.040

text:
(1) 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:
(a) The state of primary residence for the physician; or
(b) The state where at least twenty-five percent of the practice of medicine occurs; or
(c) The location of the physician's employer; or
(d) If no state qualifies under (a), (b), or (c) of this subsection, the state designated as state of residence for purpose of federal income tax.
(2) 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 (1) of this section.
(3) The interstate commission is authorized to develop rules to facilitate redesignation of another member state as the state of principal license.
[ 2017 c 195 s 4.]

catchline: Designation of state of principal license.


title: RCW 18.71B.050

text:
(1) 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.
(2) 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.
(a) 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.
(b) 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] United States 5 C.F.R. § 731.202.
(c) Appeal on the determination of eligibility shall be made to the member state where the application was filed and shall be subject to the laws of that state.
(3) Upon verification in subsection (2) 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 (1) of this section, including the payment of any applicable fees.
(4) After receiving verification of eligibility under subsection (2) of this section and any fees under subsection (3) 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.
(5) 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.
(6) 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.
(7) 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.
[ 2017 c 195 s 5.]

catchline: Application and issuance of expedited licensure.


title: RCW 18.71B.060

text:
(1) 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.
(2) The interstate commission is authorized to develop rules regarding fees for expedited licenses.
[ 2017 c 195 s 6.]

catchline: Fees for expedited licensure.


title: RCW 18.71B.070

text:
(1) 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:
(a) Maintains a full and unrestricted license in a state of principal license;
(b) Has not been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;
(c) 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
(d) Has not had a controlled substance license or permit suspended or revoked by a state or the United States drug enforcement administration.
(2) Physicians shall comply with all continuing professional development or continuing medical education requirements for renewal of a license issued by a member state.
(3) The interstate commission shall collect any renewal fees charged for the renewal of a license and distribute the fees to the applicable member board.
(4) Upon receipt of any renewal fees collected in subsection (3) of this section, a member board shall renew the physician's license.
(5) Physician information collected by the interstate commission during the renewal process with [will] be distributed to all member boards.
(6) The interstate commission is authorized to develop rules to address renewal of licenses obtained through the compact.
[ 2017 c 195 s 7.]

catchline: Renewal and continued participation.


title: RCW 18.71B.080

text:
(1) The interstate commission shall establish a database of all physicians licensed, or who have applied for licensure, under RCW 18.71B.050.
(2) 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.
(3) Member boards shall report disciplinary or investigatory information determined as necessary and proper by rule of the interstate commission.
(4) Member boards may report any nonpublic complaint, disciplinary, or investigatory information not required by subsection (3) of this section to the interstate commission.
(5) Member boards shall share complaint or disciplinary information about a physician upon request of another member board.
(6) 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.
(7) The interstate commission is authorized to develop rules for mandated or discretionary sharing of information by member boards.
[ 2017 c 195 s 8.]

catchline: Coordinated information system.


title: RCW 18.71B.090

text:
(1) Licensure and disciplinary records of physicians are deemed investigative.
(2) 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.
(3) A subpoena issued by a member state shall be enforceable in other member states.
(4) Member boards may share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the compact.
(5) 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.
[ 2017 c 195 s 9.]

catchline: Joint investigations.


title: RCW 18.71B.100

text:
(1) Any disciplinary action taken by any member board against a physician licensed through the compact shall be deemed unprofessional conduct which may be subject to discipline by other member boards, in addition to any violation of the medical practice act or regulations in that state.
(2) 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.
(3) 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:
(a) Impose the same or lesser sanctions against the physician so long as such sanctions are consistent with the medical practice act of that state; or
(b) Pursue separate disciplinary action against the physician under its respective medical practice act, regardless of the action taken in other member states.
(4) If a license granted to a physician by a member board is revoked, surrendered or relinquished in lieu of discipline, or suspended, then any licenses issued to the physician by any other member boards shall be suspended, automatically and immediately without further action necessary by the other member boards, for ninety 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 ninety-day suspension period in a manner consistent with the medical practice act of that state.
[ 2017 c 195 s 10.]

catchline: Disciplinary actions.


title: RCW 18.71B.110

text:
(1) The member states hereby create the "interstate medical licensure compact commission."
(2) The purpose of the interstate commission is the administration of the interstate medical licensure compact, which is a discretionary state function.
(3) 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.
(4) 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:
(a) An allopathic or osteopathic physician appointed to a member board;
(b) An executive director, executive secretary, or similar executive of a member board; or
(c) A member of the public appointed to a member board.
(5) 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.
(6) The bylaws may provide for meetings of the interstate commission to be conducted by telecommunication or electronic communication.
(7) 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 (4) of this section.
(8) 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, where it determines by a two-thirds vote of the commissioners present that an open meeting would be likely to:
(a) Relate solely to the internal personnel practices and procedures of the interstate commission;
(b) Discuss matters specifically exempted from disclosure by federal statute;
(c) Discuss trade secrets, commercial, or financial information that is privileged or confidential;
(d) Involve accusing a person of a crime, or formally censuring a person;
(e) Discuss information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
(f) Discuss investigative records compiled for law enforcement purposes; or
(g) Specifically relate to the participation in a civil action or other legal proceeding.
(9) The interstate commission shall keep minutes which 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.
(10) 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.
(11) 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 rule making, 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 and compliance with the provisions of the compact, its bylaws and rules, and other such duties as necessary.
(12) The interstate commission may establish other committees for governance and administration of the compact.
[ 2017 c 195 s 11.]

catchline: Interstate medical licensure compact commission.


title: RCW 18.71B.120

text:
The interstate commission shall have the duty and power to:
(1) Oversee and maintain the administration of the compact;
(2) Promulgate rules which 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 RCW 18.71B.110, 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.
[ 2017 c 195 s 12.]

catchline: Interstate commission—Powers and duties.


title: RCW 18.71B.130

text:
(1) 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.
(2) The interstate commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same.
(3) The interstate commission shall not pledge the credit of any of the member states, except by, and with the authority of, the member state.
(4) 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.
[ 2017 c 195 s 13.]

catchline: Interstate commission—Finance powers.


title: RCW 18.71B.140

text:
(1) The interstate commission shall, by a majority of 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 twelve months of the first interstate commission meeting.
(2) The interstate commission shall elect or appoint annually from among its commissioners a chair, a vice chair, and a treasurer, each of whom shall have such authority and duties as may be specified in the bylaws. The chair, or in the chair's absence or disability, the vice chair, shall preside at all meetings of the interstate commission.
(3) Officers selected in subsection (2) of this section shall serve without renumeration from the interstate commission.
(4) 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.
(a) 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.
(b) 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.
(c) 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 attorneys' 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.
[ 2017 c 195 s 14.]

catchline: Interstate commission—Organization and operation.


title: RCW 18.71B.150

text:
(1) 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 rule-making 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.
(2) Rules deemed appropriate for the operations of the interstate commission shall be made pursuant to a rule-making process that substantially conforms to the "model state administrative procedure act" of 2010, and subsequent amendments thereto.
(3) Not later than thirty days after a rule is promulgated, any person may file a petition for judicial review of the rule in the United States 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.
[ 2017 c 195 s 15.]


title: RCW 18.71B.160

text:
(1) 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.
(2) 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 manner [matter] of the compact which may affect the powers, responsibilities, or actions of the interstate commission.
(3) 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.
[ 2017 c 195 s 16.]

catchline: State enforcement—Judicial notice—Service of process.


title: RCW 18.71B.170

text:
(1) The interstate commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of the compact.
(2) The interstate commission may, by majority vote of the commissioners, initiate legal action in the United States 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 attorneys' fees.
(3) 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.
[ 2017 c 195 s 17.]

catchline: Enforcement by interstate commission.


title: RCW 18.71B.180

text:
(1) 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.
(2) 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:
(a) 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
(b) Provide remedial training and specific technical assistance regarding the default.
(3) 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.
(4) 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.
(5) 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.
(6) The member state which 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.
(7) The interstate commission shall not bear any costs relating to any state that has been found to be in default or which has been terminated from the compact, unless otherwise mutually agreed upon in writing between the interstate commission and the defaulting state.
(8) The defaulting state may appeal the action of the interstate commission by petitioning the United States 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 attorneys' fees.
[ 2017 c 195 s 18.]

catchline: Default.


title: RCW 18.71B.190

text:
(1) The interstate commission shall attempt, upon the request of a member state, to resolve disputes which are subject to the compact and which may arise among member states or member boards.
(2) The interstate commission shall promulgate rules providing for both mediation and binding dispute resolution as appropriate.
[ 2017 c 195 s 19.]

catchline: Dispute resolution.


title: RCW 18.71B.200

text:
(1) 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 which enacted the compact into law.
(2) 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.
(3) 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.
(4) The interstate commission shall notify the other member states of the withdrawing state's intent to withdraw within sixty days of its receipt of notice provided under subsection (3) of this section.
(5) The withdrawing state is responsible for all dues, obligations, and liabilities incurred through the effective date of withdrawal, including obligations, the performance of which extend beyond the effective date of withdrawal.
(6) 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.
(7) 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.
[ 2017 c 195 s 21.]

catchline: Withdrawal.