Last Updated: Jul 22, 2020
By Andrew C. Harvan, Esq., PAMED’s legal and regulatory analyst
One of the first questions that physicians contemplating retirement must consider is what to do with their license to practice. Many retiring physicians decide to change the status of their license to active-retired.
The Pennsylvania Medical Society (PAMED) often receives questions regarding active-retired licenses from member physicians. This blog provides answers to some of the most common questions that members have asked PAMED.
What are active-retired licenses?
Benefits of an active-retired license include exemption from the Medical Care Availability and Reduction of Error Act’s (Mcare Act) professional liability insurance and most of the state’s continuing medical education (CME) requirements. Active-retired licensees can only write prescriptions and provide care to themselves and immediate family members.
Note that active-retired licensees are required to renew biennially and pay a biennial fee for renewal.
What prescriptions can I write with an active-retired license?
With an active-retired license, a physician can only write prescriptions for themselves and immediate family members. The Mcare Act defines immediate family members as a parent, spouse, child, or adult sibling residing in the same household.
When writing prescriptions for themselves or immediate family members, active-retired physicians must still comply with statutory requirements and applicable licensure board regulations. Note this would include relevant Prescription Drug Monitoring Program (PDMP) requirements. State Board of Medicine regulations, see 49 Pa. Code §16.92, provide the minimum standards of practice that allopathic physicians must adhere to when prescribing, administering, and dispensing drugs.
The Centers for Medicare & Medicaid Services (CMS) requires certain physicians and other eligible professionals to enroll in the Medicare program, via a CMS-855O application, for the sole purpose of ordering or certifying items or services for Medicare beneficiaries, and prescribing Part D drugs. Active-retired physicians encountering difficulties filling their prescriptions might need to submit this form. The CMS-855O application can be accessed here.
Are active-retired licensees required to maintain professional liability insurance? The Mcare Act requires physicians actively practicing in Pennsylvania to maintain certain amounts of medical professional liability insurance and contribute to the Mcare Fund. However, under the Mcare Act, active-retired licensees are exempted from this requirement and are not required to maintain liability insurance or participate in the Mcare Fund as directed under the Act.
Physicians should notify the Pennsylvania Insurance Department’s Mcare Compliance Unit when they go on active-retired status. If physicians do not notify the Compliance Unit when they transition to active-retired status, the Department will think that they are non-compliant with the Mcare Act.
Physicians can contact the Mcare Compliance Unit at (717) 783-3770 Ext 280. A Mcare Compliance Form, which can be accessed here, will also need to be completed to verify Mcare exemption.
Although no longer practicing, retired physicians still need professional liability protection because claims can be made long after care has been provided. Physicians considering retirement should consult with their medical professional liability insurance provider to ensure that they are protected in their retirement years. Some medical professional insurance policies have an automatic extended reporting endorsement (i.e. tail coverage)—a policy obtained by physicians in active practice that, when continuously covered by the claims-made policy, will provide automatic tail coverage upon full retirement.
If a physician’s existing policy does not already include tail coverage, their liability insurance carrier is required to offer, for a period of 60 days, tail coverage upon cancellation, termination, or non-renewal of claims-made coverage. Physicians must purchase tail coverage to comply with state law, but they are not required to purchase it from their current malpractice provider; physicians can shop around for alternative carriers.
Mcare instructs that tail coverage should be received within 120 calendar days of the cancellation, termination, or non-renewal of claims-made coverage. The tail covers losses and expenses occurring during a claims-made coverage period. The one-time fee paid for the tail coverage would protect the physician indefinitely for any claim made after the cancellation, termination, or non-renewal of the claims-made coverage in Pennsylvania.
What are the renewal requirements for active-retired licensees?
Active-retired licenses must be renewed every even-numbered year on the same schedule as an active-unrestricted license. The renewal deadlines are Oct. 31 for DOs and Dec. 31 for MDs. In 2020, the renewal fee for an active-retired license is also the same as an active-unrestricted license, $360 for MDs and $330 for DOs.
Physicians with an active-retired license are exempt from the 100-credit CME requirement that physicians with active status must meet.
However, an active-retired licensee is required to complete 2-credits of CME in child abuse recognition and reporting as well as 2-credits of CME in pain management, identification of addiction, or the practice of prescribing or dispensing of opioids. There are certain exemptions to the opioid education requirement. These exemptions apply unless a physician has a DEA registration number or prescribes under another individual or entity’s DEA registration. Click here for additional information on these exemptions.
There are no additional licensure CME requirements for active-retired licensees other than the required opioid and child abuse recognition/reporting education.
How do I change my status to active-retired?
You can change the status of your license to active-retired when you renew online through the Pennsylvania Licensing System (PALS).
There is a renewal question on PALS that asks whether you would like to change your licensure status to active-retired. If you answer yes to this question, your license will remain active until its current expiration date. On your license’s expiration date, your renewal will be processed and the status of your license will be changed to active-retired.
For example, an MD who changes their status to active-retired while renewing on PALS would retain their current licensure status until December 31st. On December 31st, the MD’s renewal will process, changing their status to active-retired. The MD would then have an active-retired license from December 31st onward.
You can also change the status of your license by submitting a status change application to your licensure board. The application for MDs can be found here and the application for DOs can be found here.
Can I return to active practice?
If you have an active-retired license and would like to return to active practice, beyond providing care to yourself and immediate family members, you will need to reactivate your license.
To reactivate your license, you must complete a status change application and submit it to your licensure board. You will also need to get caught up on your CME requirements for the preceding biennial licensure period and obtain professional liability insurance.
Note that a MD license which has been inactive, expired, or active-retired for four years or longer requires a review by the full State Board of Medicine before reactivation. The Board may require the licensee to undergo a re-entry clinical skills assessment before reinstating the licensee’s license.
More information on how to reactivate your medical license can be found here.
I have an active-retired license, can I also apply for a volunteer license?
To qualify for a volunteer license, a physician must currently hold an 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. Additional information on volunteer licenses can be found here.
Where Can I Find More Information?
The State Board of Medicine can be contacted at (717) 783-1400 or emailed at firstname.lastname@example.org. The State Board of Osteopathic Medicine can be contacted at (717) 783-4858 or emailed at email@example.com. When calling, listen closely to the prompts and choose the option to speak with a board representative.
PAMED also has numerous resources to assist physicians with licensure questions.
- PAMED’s resources on licensure requirements can be accessed here.
- Click here to access PAMED’s wealth of CME resources.
- Answers to PAMED members’ FAQs on PALS renewal can be accessed here.
- Access PAMED’s Quick Consult Series here for insight on numerous legal topics relevant to the practice of medicine.
PAMED members with questions can also contact PAMED’s KnowledgeCenter at (855) 726-3348 or KnowledgeCenter@pamedsoc.org.
PAMED's Legal Resource Center provides quality, timely legal advocacy and resources for member physicians who practice in Pennsylvania. Get details at www.pamedsoc.org/LegalResourceCenter.