CMA Works to Fix Problems Created by
New Retired/Volunteer License Categories
[Posted 04/22/04]

Physicians with "retired" licenses will no longer be allowed to practice medicine, even in a volunteer capacity, effective July 1. CMA has received a large volume of calls from physicians who are concerned about these new rules and how they will be affected.

"Retired" physicians who wish to volunteer their services will need to apply for the new "volunteer" license. "Volunteer" licenses will still be exempt from licensing fees. All physicians who practice for pay, no matter what the amount, will be required to maintain an "active" license and pay licensing fees.

Both volunteer and active licensees will be required to fulfill continuing medical education (CME) requirements. CMA successfully convinced the medical board that "retired" physicians with CME waivers who choose to change to active or volunteer status should not have to "make up" CME units; rather, they will be required to take the appropriate number of units in the future.

According to the board, it sought these licensing changes, which were authorized under last year’s SB 1077, because the board was not able to monitor whether "retired" physicians with licensing fee waivers actually meet the waiver requirements (limitation on earnings; 20 or more years of practice in California; services customarily provided free of charge). CMA did not take a position on the bill and has concerns with how it is being implemented.

One major concern is that retired physicians switching to active status may end up paying full licensing fees twice in a few short months, since there is no mechanism in place to prorate licensing fees. The law requires all physicians switching to active status to pay full fees at the time of the status change. Physicians will again be required to pay full fees on their regular renewal date.

CMA has reached an agreement, however, to craft a legislative fix for this double-fees problem. The medical board has agreed to support legislation that will allow them to provide refunds for physicians who have to pay to switch their license status before their official renewal date.

Below are some additional details.

NEW CME REQUIREMENTS—Eighty percent of the state’s 10,000 retired physicians have CME waivers, a fact that was unknown to the medical board until after SB 1077 passed. The Medical Board initially decided administratively that physicians with a CME waiver who change their license from retired to volunteer or active must make up 50 hours of CME. This is a huge burden given the brief time before the July 1 effective date. CMA persuaded the medical board to change this policy and allow a change to active or volunteer status without making up CME. The Medical Board now agrees that “retired” status physicians with CME waivers who choose to change to active or volunteer status will not have to “make-up” CME units but will simply need to take the appropriate number of units in the future.

NEW LANGUAGE ON "RETIRED LICENSE"—Physicians who choose to remain retired were initially told that the new license card would say “No Practice Allowed.” After strong objection by CMA, the medical board has agreed to simply trust that retired physicians will cease practice and will delete these words from the license.

DOUBLE LICENSE FEES FOR SOME—Physicians changing to active status are required to pay full fees at the time of the change in status ($600). The medical board will also require renewal on the previously scheduled renewal date at which time the physician will again be required to pay full fees. Thus, a physician who must change to active status by July 1 in order to continue to practice for pay and whose renewal date is coming up soon thereafter, will have to pay $600 twice in a short period of time or stop practicing until the renewal date. CMA is also negotiating with the board on this issue. They say they cannot change the renewal date administratively nor are they technically able to process prorated fees. CMA will craft a legislative fix and the medical board has agreed to support us in that.

LOW INCOME PHYSICIANS DISADVANTAGED—Requiring physicians who practice only a few hours a week or a month to pay full medical board licensing fees will be a hardship for some and may discourage those physicians from practicing at all. CMA is concerned that this will exacerbate the access/physician supply problem. Since the issue of income goes to the core of why the Board initiated the bill in the first place, CMA is developing a strategy to address the problem of enforcing income limits.

CME WAIVER IN JEOPARDY—While a CME waiver is still available under the law, the medical board has indicated it opposes such waivers and is telling physicians that they can apply but no waivers will be granted. While it appears that waivers have been freely granted in the past and there may be some reason to review criteria and duration of waivers, CMA does not believe that wholesale elimination of this option is appropriate. CMA will be working with the Medical Board on appropriate CME waiver requirements and limitations

Contact: Sandra Bressler, 415/882-5171 or sbressler@cmanet.org