By Andrew C. Harvan, Esq., PAMED’s legal and regulatory analyst
Recently, the Pennsylvania Medical Society (PAMED) has received a number of questions pertaining to volunteer licenses. Here are answers to physicians’ frequently asked questions.
What is a volunteer license?
Volunteer licenses are issued by the State Boards of Medicine and Osteopathic Medicine to physicians who practice only in approved clinics, or upon referral from approved organizations, without remuneration.
There is no fee to apply for or renew a volunteer license. Volunteer licenses are valid for the biennial period for which it is issued and must be renewed biennially.
Who can apply for a volunteer license?
Volunteer licenses are available to retiring health care practitioners or non-retired practitioners who are not required, because the practitioner is not otherwise practicing medicine or providing health care services in Pennsylvania, to maintain professional liability insurance under the Medical Care Availability and Reduction of Error (MCARE) Act.
To qualify for a volunteer license, a physician must currently hold an active unrestricted license. The Volunteer Health Services Act, at 35 P.S. §449.43, defines a “licensee” as an individual who holds a current, active, unrestricted license as a health care practitioner issued by the appropriate board.” Pursuant to the Volunteer Health Services Act, at 35 P.S. §449.44, only a licensee in good standing who retires from active practice or a non-retired licensee not otherwise currently providing health care services in Pennsylvania and who is exempted from the MCARE Act’s professional liability insurance requirements may be issued a volunteer license. Volunteer licenses will thus only be issued to applicants with a current, active, unrestricted license.
An active retired licensee who wishes to apply for a volunteer license would need to reactivate their license before applying for a volunteer license. Note that a license which has been inactive, expired, or actively-retired for four years or longer requires a review by the full Board before reactivation.
To apply for a volunteer license, an applicant must complete an application. On this application, the applicant must verify that they intend to practice without personal remuneration for professional services in an approved clinic. The applicant must also include a letter signed by the director or chief operating officer of the named clinic. This letter must state that the applicant has been authorized, by the governing body or responsible officer of the clinic, to provide volunteer services in the named clinic.
Access the Volunteer License Application here.
What are a volunteer licensee’s CME requirements?
The Volunteer Health Services Act, 35 P.S. §§ 449.41 et seq., provides that physicians who hold only a volunteer license must complete a minimum of 20 continuing medical education (CME) credit hours during the preceding biennial period as a condition of biennial renewal and are otherwise exempt from any continuing education requirements imposed by the MCARE Act or by state board rulemaking. A physician with an active unrestricted license who also volunteers is subject to the MCARE Act’s 100-hour CME requirements.
Volunteer licensees are subject to the CME requirements imposed by the Child Protective Services Law (CPSL). Volunteer licensees must take 2 approved CME hours in mandated child abuse recognition and reporting. PAMED members can access our state-approved child abuse and recognition course that also offers CME here.
Physicians seeking re-licensure must complete at least 2 CME hours in pain management, identification of addiction, or the practices of prescribing opioids. Volunteer licensees could be subject to these requirements if they:
- Are not exempt from the Drug Enforcement Administration’s (DEA) requirements for registration under its applicable laws and regulations, as well as any state law; or
- Use the registration of another person or entity as permitted by law to prescribe controlled substances in any manner.
Additional information on complying with Pennsylvania’s opioid CME requirements can be found here, and PAMED’s opioids CME courses are available here.
Does a volunteer licensee have liability protection?
Yes, under the Volunteer Health Services Act, a volunteer licensee who, in good faith, renders professional health care services within the scope of their practice is not liable for civil damages arising as a result of any act or omission in the rendering of such care unless the conduct of the licensee falls substantially below professional standards. Also, a volunteer licensee could be liable for civil damages if it is shown that the licensee did an act or omitted the doing of an act which the licensee was under a recognized duty to a patient to do. The licensee must have known or had reason to know that this act or omission created a substantial risk of actual harm to the patient.
A physician who holds only a volunteer license is exempt from the MCARE Act’s requirements regarding the maintenance of liability insurance coverage. Volunteer licensees or approved clinics acting on behalf of volunteer licensees may elect to purchase primary insurance to cover services rendered at the clinic. However, there is no obligation for such licensees or entities to purchase excess coverage.
Certain volunteer health professionals are also now eligible for liability coverage under the Federal Tort Claims Act (FTCA). Through the FTCA, eligible Federally Qualified Health Centers (FQHCs) and their employees can be granted liability protection. To file a medical professional liability claim under the FTCA, a plaintiff must file an administrative claim against the United States not a suit against the health center or individual providers. Updates to the FTCA in 2016 allow for volunteer health professionals at FQHCs to be afforded this same protection if they are deemed FQHC employees.
Can a volunteer licensee prescribe for family members?
Yes, under the Volunteer Health Services Act, a holder of a volunteer license who was able to prescribe medication while an active unrestricted licensee may prescribe medication to any member of their family notwithstanding the member's ability to pay for their own care or whether that member is being treated at an approved clinic.
However, note that any physician prescribing medication to a patient, regardless of whether such patient is a family member of the physician, must comply with regulations enacted by the State Board of Medicine at 49 Pa. Code §16.92. These requirements include conducting an initial medical history and physical examination prior to prescribing unless emergency circumstances justify otherwise.
Where can I find more information?
For State Board of Medicine regulations regarding volunteer licenses, see 49 Pa. Code §16.18. For State Board of Osteopathic Medicine regulations regarding volunteer licenses, see 49 Pa. Code § § 25.601-25.607.
These license renewal and CME resources are available to PAMED members:
PAMED members with questions can contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.