In the last 18-months there has been an ever-changing legal landscape relating to reproductive health care and gender affirming care. In Washington state, these legitimate medical services are legal and protected. As evidence, there were recent bills passed by the Legislature and signed by the Governor in the 2023 session. One provides legal shields against predatory subpoenas and the other restricts both regulatory discipline and license application denials by the WMC, based on reproductive health care services.

However, practitioners licensed through the Interstate Medical Licensure Compact (IMLC) do not enjoy similar protections due to Compact requirements in statute. Practitioners providing reproductive care and gender affirming care that are licensed through the IMLC should consider the following actions to minimize the legal risk to their license(s).

Please be aware this is an option – it is not mandatory – and for consideration only, not required. All licensees should weigh the pros and cons of these changes before moving forward.

Mitigation Strategy Suggestions

• State of Principle License (SPL) – is your entry point into the compact. If that license has received discipline or is revoked, all Compact licenses in member states issued dependent on that SPL must receive a similar action or be revoked, per law. If you hold a Compact SPL that is not based in Washington and you provide reproductive services and/or gender affirming care, consider transferring your SPL designation to Washington.
• Physicians participating in the Compact may change their SPL at any time by using the Compact re-designation process. Learn more and re-designate here.  Please note, it is advisable to take this action soon as the criteria may be changing.
• As a reminder, you must show ONE of the following to designate Washington your SPL:
  • Your primary residence is Washington;
  • Twenty-five percent of your practice of medicine occurs in Washington;
  • Your employer is located in Washington;
  • Or, Washington state is your state of residence for Federal Income Tax purposes.
• Reciprocal License – is based on a valid SPL. Action taken against a Reciprocal license may allow other Compact licenses, including the SPL, to stand depending on the circumstances. If you hold a reciprocal compact license, consider contacting the WMC to convert the license free of charge to a standard MD license. There is no impact on scope or use and you will save $25 in renewal fees paid to the Compact. The added benefit is you will be insulated from automatic disciplinary actions of the Compact system. To change your license in this way please fill out this form. 

Interstate Medical Licensure Compact (IMLC)

The IMLC is a group of 41 U.S. jurisdictions that have passed common legislation to facilitate expedited licensure and coordinate data sharing among regulators. The IMLC proved an essential tool during the pandemic to allow cross border care, multi-state practice. It facilitated an expansion of telemedicine use. The primary benefit of the IMLC is the expedited initial licensing process.

As a reminder, there are two classifications of Compact license.

• The first is the State of Principle License (SPL), which is your entry point into the compact. If that license has received discipline or is revoked, all Compact licenses in member states issued dependent on that SPL must receive a similar action or be revoked, per law.
• The second is the Reciprocal license which is based on a valid SPL. Action taken against a Reciprocal license may allow other Compact licenses, including the SPL, to stand depending on the circumstances.

Despite protections provided in Washington law, the WMC cannot mitigate or eliminate Compact license requirements mandating we suspend a license pending the outcome of an investigation from suspensions or revocations originating in another Compact state. While we have a process to stay proceedings during investigation, a databank report based on the out-of-state action will still occur, regardless of its validity.

WMC has worked to update the rules related to how the Compact operates when it relates to discipline. We were successful in November 2022 with a Compact rule change to make sure that any reciprocal discipline from another state must also be a violation of practice in Washington.

WMC Is here to Help

We at the WMC know that this is a confusing time in medicine. We hope to provide you with proactive solutions to help continue your legal and legitimate practice so all of your patients may benefit from your care. We reiterate this is an option – but it is not mandatory – and for consideration only, not required. All licensees should weigh the pros and cons of these changes before moving forward.

The WMC Licensing Unit can help you with questions at: Medical.IMLC@wmc.wa.gov or calling 360-236-2750 option #1.