COMMONWEALTH OF PENNSYLVANIA HOUSE OF REPRESENTATIVES INSURANCE COMMITTEE STATE CAPITOL ROOM 205, RYAN OFFICE BUILDING

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1 COMMONWEALTH OF PENNSYLVANIA HOUSE OF REPRESENTATIVES INSURANCE COMMITTEE STATE CAPITOL ROOM 205, RYAN OFFICE BUILDING THURSDAY FEBRUARY 9, :30 AM HEARING ON SB 388 BEFORE: HONORABLE NICK MICOZZIE, MAJORITY CHAIRMAN HONORABLE TONY DeLUCA, MINORITY CHAIRMAN HONORABLE BRYAN BARBIN HONORABLE DOM COSTA HONORABLE GARY DAY HONORABLE ROBERT GODSHALL HONORABLE GLEN GRELL HONORABLE NICHOLAS KOTIK HONORABLE EDDIE DAY PASHINSKI HONORABLE MARGUERITE QUINN HONORABLE CURTIS SONNEY [1]

2 INDEX TESTIFIERS WITNESSES PAGE REPRESENTATIVE MICOZZIE 3 CHAIRMAN REPRESENTATIVE DeLUCA 3 CHAIRMAN KATIE TRUE 5 DEPARTMENT OF STATE DR. BERNARD DISHLER 10 PRESIDENT-ELECT, PA DENTAL ASSOCIATION MR. & MRS. FEINBERG 25 CONSTITUENTS, REP. DAVID M. MALONEY, SR. PATRICK O'CONNELL 46 LAW OFFICE OF PATRICK T. O'CONNELL DR. DOUGLAS MARINAK 54 CERTIFICATE 63 WRITTEN TESTIMONY SUBMITTED: DR. DONALD GORDON, DDS DR. RONALD BUSHICK, DDS ELMER GARDNER BYRON M. YATRON, ESQ. [2]

3 CHAIRMAN MICOZZIE: Good morning everyone. First of all I d like to thank everyone for your attendance at today s public hearing. My name is Nick Micozzie, I m the Chairman of the House Insurance Committee. This morning s hearing will focus on SB 388 sponsored by Senator Pat Vance. The bill amends Act 76 of 1933 known as the Dental Law to require dentists to carry medical professional liability insurance in the amount of a million dollars per concurrence or claim and three million dollars per annual advocate. The coverage can be through private insurance, self insurance, an employer, or for a dentist with a volunteer license a community base clinic. Under the bill proof of insurance must be provide to the State Board of Dentistry within 60 days of the policy issue date. Failure of proof of insurance will result in refusal revocation or suspension of a dental license. As you may imagine, this bill is not without controversy, my office has been contacted a number of dentists who take issue with the legislation. Their concern ranged from the level of malpractice insurance coverage required under the bill to an apparent lack of consideration of a part time dentist and the hardships this requirement might have on their ability to practice. With those concerns in mind I asked both the Department of State and the Pennsylvania Dental Association to respond to these concerns provided to the committee in the form of written comments. Before we begin, I d like my good friend and colleague, Representative DeLuca for a few opening remarks. CHAIRMAN DeLUCA: Thank you, Mr. Chairman. Thank you once again for scheduling these types of hearings, especially on this bill. This is an important piece of legislation, it s certainly an overdue piece of legislation that requires dentists practicing in the Commonwealth to obtain professional liability insurance. [3]

4 Certainly I never knew they didn t have liability insurance since my daughter s a practicing nurse and she has to have it. Currently the Commonwealth requires many individuals from various medical health professions to obtain professional liability insurance. It is general knowledge that we require physicians to obtain professional liability insurance; however, we also require nurse practitioners, physician s assistance, chiropractors, physical therapists, optometrists, even dental hygienists who practice to have professional liability. Currently, dental hygiene practitioners are required to obtain professional liability insurance, yet dentists are not required to do the same. Now we all know dentistry is a highly skilled and specialized profession, failure to provide a high standard of professional care can cause serious costly and adverse affects on the health of a patient. One considers that the dentist provide treatment, abides on health issues, administer drugs, and performs surgical procedures, it becomes obvious that they should be required to obtain professional liability coverage. There have been several stories over the last few years of dental procedures resulting in injuries and in some cases death. Without requiring dentists to obtain malpractice practice insurance, patients who suffer due to the dentists malpractice can be left injured and out of pocket for the cost of the correct procedure. I want to be clear that I believe the vast majority of dentists are good practitioners. I believe that most dentists already obtain professional liability insurance because it is the right thing to do, it makes good business sense. I wonder why anyone would expose themselves to this sort of personal risk by not obtaining professional liability insurance. I find it unfortunate that if you take advantage of the system and fail to obtain liability insurance to protect not only themselves but to protect the patients. I think this is a good and [4]

5 necessary piece of legislation because it s going to help protect the consumers and the constituents of the Commonwealth of Pennsylvania. I look forward to hearing from the participants here today on this issue. I want to thank you Mr. Chairman. I see you re the first person to testify as a former colleague of ours who certainly did a good job in the House of Representatives and a well respected and I certainly want to commend the Governor for appointing her to the Department of State and I commend, it s one of the best choices he has made to put you to this spot, Madam Secretary, so thank you very much. CHAIRMAN MICOZZIE: Katie. And let me make a comment also, it s an honor for me to introduce you and of course you know we served a long time together, when are you coming back? We need you. COMMISSIONER TRUE: I think I found my niche for now thank you, but I do miss the battles sometimes and I do miss all my colleagues on occasion. CHAIRMAN MICOZZIE: You missed yesterday? COMMISSIONER TRUE: I watched some of it and I ll try to keep my remarks brief so as I think you all have been on the floor for a while and probably are looking forward to getting back to districts, but it s very nice to see you all. Good morning to all of you, Chairman Micozzie, Chairman Deluca, thank you for the kind words. And I appreciate you scheduling the hearing and the opportunity to talk with you on SB 388 which would require dentist s licensed by the Pennsylvania State Board of Dentistry to maintain medical professional liability insurance. As Commissioner of the Bureau of Professional and Occupational Affairs, I serve on the Dental Board as well an on 26 other boards and commissions. Having served with members of these boards and commissions since taking [5]

6 this position last year, I can tell you that each board member assumes his or her responsibility very seriously. For many professions the standards for licensure by the boards already include verifying that the license or potential licensee maintains liability insurance. For these professionals which includes doctors, physician assistants, nurse midwives, chiropractors, and optometrists, the General Assembly believed that ensuring the safety and protection of the public requires licensees to possess a minimum amount of liability insurance. In light of SB 388 we welcome the recognition that the nearly 10,000 dentists currently licensed by the Dental Board should now be added to the list of these professionals. Should SB 388 be enacted, Pennsylvania will become one of ten States in the nation requiring some form of liability insurance for dentists. The Department of State and the administration are supportive of requiring professional liability insurance for dentists as SB 388 provides. Certainly a dentist holds as much responsibility for a patient s welfare as other healthcare providers who are required by law to possess liability insurance. We believe that requiring all dentists to maintain a minimum amount of liability coverage protects both the consumer and the dentist in the event of a claim. As in the case with other licensed professionals, the State Board of Dentistry would be charged under the bill with verifying that dentists carry the insurance required prior to granting or renewing a dental license. In our review of SB 388, the Department of State consulted with the Pennsylvania Insurance Department, which also stands in support of this legislation. I would like thank Commissioner Consedine for his input and perspective. PID is not provided any operational duties under SB 388, and in its own evaluation believes the legislation would have minimal to no [6]

7 impact on the Children s Heath Program, CHIP, nor would it impact the Department s workload associated with any potential verification of proper self-insurance by dentists. Generally, PID believes the bill sets a positive precedent for ensuring that health care providers carry liability coverage by providing the appropriate licensing board with the authority to verify coverage at the time of license insurance or renewal. Again, I want to thank you for your time and attention to this important issue. We look forward to working with you to ensure the citizens of the Commonwealth continue to have ready access to the highest quality dental services our licensees can provide. Thank you again, and I stand ready for questions, I did bring with me from habit of sitting where you are sitting, Chief Counsel, my Chief Counsel, Travis Gery if you get into any legal matters and he d be happy to take questions. CHIARMAN MICCOZIE: Representative DeLuca. CHAIRMAN DeLUCA: Thank you Mr. Chairman, again good morning Commissioner. I just have one question, and I think what we re probably going to hear is about part time dentistry and are there some professions where the statutory difference in their license status between those who are full time actively practicing and those who are part time or semi-retired, if so how many are there? And I wouldn t ask, I don t think you ll probably be able to answer how many there are part time categories right now but if you can get that to us, do you follow my question? COMMISSIONER TRUE: I do, and we don t really know of any difference, if you are practicing whether it s two hours a year or full time, you still have to have an active license. So, you would still have to have some type of insurance, liability insurance. CHAIRMAN DeLUCA: Thank you. CHAIRMAN MICCOZIE: Representative Grell. [7]

8 REPRESENTATIVE GRELL: Thank you. Commissioner, my question is along the same lines. You don t have a designation of an inactive dentist as some other professions, if you want to retain the title but you retired from practice but you still want to retain that title you can go on an inactive status. Does your licensing board have that status with respect to dentists? COMMISSIONER TRUE: Yes, you can go on inactive status. REPRESENTATIVE GRELL: And if somebody, do you have dentists that are on inactive status? I mean is that a solution to a dentist who claims or who says I m not practicing anymore, they can just go in inactive status? COMMISSIONER TRUE: They can go on inactive status, but they can t practice anymore. REPRESENTATIVE GRELL: Okay, yeah, I mean I understand that would be inactive and they can come off of inactive status? COMMISSIONER TRUE: Yes, yes, and then they have to meet the CE requirements to get back into if they hadn t kept up their continuing-ed then they d have to do that to get back their active license to practice. But then regardless of whether it s two months or occasionally or full time. REPRESENTATIVE GRELL: But I was looking ahead at some of the other testimony, I think it s just written testimony and that s one of the concerns that there are dentists out there that have no intention of practicing anymore but they want to remain dentists, so the solution for them to this legislation could be to simply go on inactive status and stay on inactive status. Or if somebody was disabled and not able to practice for a while they can temporarily go onto inactive status and avoid the requirement for insurance and then when they were going to actively practice again they could go back on active status assuming they were still qualified through CE. [8]

9 COMMISSIONER TRUE: I think that s a correct assumption. REPRESENTATIVE GRELL: Thank you Mr. Chairman. CHAIRMAN MICOZZIE: Representative Quinn. REPRESENTATIVE QUINN: Thank you and welcome Commissioner. COMMISSIONER TRUE: Thank you. REPRESENTATIVE QUINN: You mentioned nine other States that have the minimum liability insurance coverage, is there a common denominator on what amount that they in those other States that they require the dentists to carry amount of insurance? COMMISSIONER TRUE: I m sorry, what was the first part? REPRESENTATIVE QUINN: In nine other States you said we d become the tenth. COMMISSIONER TRUE: Ten. REPRESENTATIVE QUINN: Oh in ten others, they require this, what is the amount of insurance that they ask them to carry? Is there a common denominator there? COMMISSIONER TRUE: There seems to, to tell you the truth, I have a sheet that explains each State and glancing at it, it s usually around a million dollars. There doesn t seem to be a big disparity of one over the other. REPRESENTATIVE QUINN: And are they, is it a national carrier, I know the physicians we have the problem with lack of availability, there s not a lot of options for medical malpractice insurance. COMMISSIONER TRUE: Perhaps the insurance folks that are going to talk, I don t know about a national carrier, I don t want to say the wrong thing. But I don t know but perhaps they could when they come up they would be better able to answer that. REPRESENTATIVE QUINN: I ll direct my questions there. [9]

10 COMMISSIONER TRUE: Okay, sorry. CHAIRMAN MICOZZIE: Katie, thank you. COMMISSIONER TRUE: Thank you, thank you both, nice to see you. CHAIRMAN MICOZZIE: The next to testify is Dr. Bernard Dishler, President Elect of the Pennsylvania Dental Association, Welcome, Doctor. DR. DISHLER: Thank you, and I ve asked Mr. Gil Davis who is our CEO of our insurance agency to also be here for technical assistance. CHAIRMAN MICOZZIE: You may begin. DR. DISHLER: Good morning Chairman Micozzie and members of the House Insurance Committee. My name is Dr. Bernie Dishler and I m a general dentist practicing in Elkins Park, Pennsylvania. I am President Elect of the Pennsylvania Dental Association and I m here representing more than 5,500 practicing and retiring dentists. Thank you for the opportunity to speak to you today about SB 388, legislation requiring most dentists to carry a specified amount of professional liability coverage in order to maintain a license to practice dentistry in Pennsylvania. The PDA believes it in incumbent on the dental profession to align with other health care professionals who practice under similar requirements and we support SB 388 as written. PDA worked with Senator Patricia Vance, the primary sponsor of SB 388, and her staff to add some very important amendments to the legislation that exempt volunteer dentists who are covered by the facility in which they practice or any licensee who is otherwise covered by an employer. We thank Senator Vance for agreeing to these amendments in order to facilitate more volunteerism among dental professionals. [10]

11 We understand that several licensees have raised concerns about SB 388 but believe they can be addressed during the implementation phase and that they do not rise to the level of needing addressed in SB 388. PDA would like to address the following points: Professional liability coverage amount; SB 388 requires dentists, with the exceptions noted above, to maintain liability insurance in the minimum amount of 1 million dollars per occurrence or claim and 3 million per annual aggregate. PDA believes this is an acceptable amount of minimum coverage for dentists, as it is the industry standard and recommended by all, if not most, insurers. These amounts are on par with what is required of most other health care professionals. Very little distinction can be made between geographical differences among providers. While it is true that the southeast region of the State, if sometimes more litigious that other areas, insurers do not recommend coverage is lower than what is required in SB 388 for any provider. They might actually recommend more coverage for those residing in the southeast. Premiums are often lower for dentists residing in all other areas other than the southeast Pennsylvania, but the industry standard of 1 million per claim and 3 million per aggregate applies to all. The same can be said for any distinction that can be made between general dentists and specialists. The insurance industry does not differentiate much between general dentists and specialists, with the exception of oral surgeons who more than likely purchase a higher amount of coverage due to the nature of their work. Licensed dentists who do not practice: There are a number of dentists who maintain a Pennsylvania license but do not actively practice. These dentists are often retired, live in other States, or stop practicing indefinitely because of a disability, to raise children, or decide for other [11]

12 reasons not to practice. However, they do maintain an active license and comply with continuing education and other requirements. As long as the State Board of Dentistry correctly interprets Section 3.2 in the proposed legislation, we believe that dentists who meet these criteria do not have to purchase insurance unless they practice for any duration of time and on any patient. Section 3.2 reads, in part, "A person licensed and practicing dentistry shall maintain medical professional liability insurance " We believe that this is appropriate, so long as practicing is not removed from the Act, and there is a way to attest that coverage has been purchased after an attestation from dentists that they have not been practicing, should they decide to practice on any patient. Those dentists practicing on a part time basis or even for shorter durations of time will have to purchase insurance in the amount deemed acceptable in the statue. But PDA agrees with the provision that allows them to purchase insurance if and when they decide to practice in a limited capacity or full time basis. Thank you for allowing me to testify before you today. I would be happy to answer any questions you may have. CHAIRMAN MICOZZIE: Doctor, can you explain the activities of a volunteer as far as the dentistry, how do they, what do they volunteer for? DR. DISHLER: Well, there are several clinics throughout the State. I happen to volunteer in one, Health Link in Bensalem Pennsylvania and we go on a regular basis and treat patients without any remuneration. CHAIRMAN MICOZZIE: Would you, you have liability insurance though, don t you? DR. DISHLER: I do, but if I did not the clinic is covered by a federal plan. [12]

13 CHAIRMAN MICOZZIE: Oh, they are covered. The volunteers are covered by the liability insurance? DR. DISHLER: Yes. CHAIRMAN MICOZZIE: Anybody have questions? CHAIRMAN DeLUCA: Doctor, I have one question, suppose you have somebody who was not practicing for whatever reason, grandbabies, maternity leave or some other reason, sickness or something and evidently like Representative Grell says that they can put their license in inactive status and now they want to go back and practice and you re saying they would have to pick up insurance, is that correct? DR. DISHLER: Yes. CHAIRMAN DeLUCA: They could not practice on a patient until that insurance is purchased, is that correct? DR. DISHLER: According to this Act, yes. CHAIRMAN DeLUCA: In other words, I m inactive; I decide everything s okay right now I have the continued education, I want to go work for maybe you. I can t work for you until I show that I have liability insurance, correct? DR. DISHLER: Correct. CHAIRMAN DELUCA: That s all. DR. DISHLER: Under this bill. CHIARMAN MICOZZIE: Representative. REPRESENTATIVE PASHINSKI: Thank you Mr. Chairman, Doctor Dishler, how about for college instruction, if a dentist is an instructor, not necessarily a practicing dentist but he s instructing the students, demonstration? [13]

14 DR. DISHLER: I m not sure of that, I believe the school has coverage for that. REPRESENTATIVE PASHINSKI: It s a concern, I bring this up because I know of a wonderful young dentist that was a practicing dentist and then due to an accident the physical defect that was occurred by the accident wouldn t allow him to be a practicing dentist, but his knowledge of course is obviously current and he is an incredible instructor. To what degree he demonstrates on a patient I'm not aware of, I was just wondering if that should be considered? DR. DISHLER: I must tell you I m not an expert on that view. REPRESENTATIVE PASHINSKI: Maybe later on when the insurance folks come up we can talk about that. MR. DAVIS: Most dental schools have coverage; they re covered under the school policy that covers the medical side and it's inclusive usually so most dentists will be covered under the schools policy. DR. DISHLER: As I think of it the students who are doing the treatment or practicing and they don t have a license, so the school would have to have some coverage. REPRESENTATIVE PASHINSKI: Terrific, thank you. CHAIRMAN MICOZZIE: Representative Godshall. REPRESENTATIVE GODSHALL: I know in the past there has been some problems on occasion like in nursing homes, dentists going into a nursing home on an emergency and so forth. Are there any kind of special privileges for those people saying dentists going into a nursing home? DR. DISHLER: They would be practicing and it would be covered by their policy. REPRESENTATIVE GODSHALL: If they re covered only in the office say where they work? [14]

15 DR. DISHLER: No, they re covered anywhere REPRESENTATIVE GODSHALL: They can go anywhere at all as long as they have insurance? MR. DAVIS: Yeah, the insurance follows them where ever they practice, insurance policy doesn t dictate where they practice. REPRESENTATIVE GODSHALL: Just very briefly, is there any kind of a limited license for dentistry as there is in medicine, you know is there any kind of a limited capacity license in dentistry? DR. DISHLER: I don t know of one maybe Commissioner True? REPRESENTATIVE GODSHALL: There isn t? So you re either a full fledged dentist or Okay, that's all I wanted. Thank you. CHAIRMAN MICOZZIE: Since there s going to be liability insurance, do you think it s going to increase suits against dentists? Whenever a dentist now doesn t have liability insurance and we mandate the liability insurance, is it going to be an increase in lawsuits? DR. DISHLER: You know I have to tell you, I don t know of a dentist that doesn t have liability insurance. I mean there have been a few, but if you ll excuse me the attorneys know that the dentists have liability insurance. REPRESENTATIVE GODSAHLL: Yeah but in this case here, they don t have liability insurance, now they are going to have liability insurance a patient has a problem, do you think there s going to be an increase in lawsuits, knowing lawyers DR. DISHLER: You re just mandating it, the dentists already have the insurance. MR. DAVIS: I don t know, I don t think so at all. As Dr. Dishler has said, majority of dentists in Pennsylvania, I would say it s 98 percent that have malpractice insurance already and [15]

16 because it s been industry standard since I ve been involved in this business in the 80's that we carry a million three. Most dentists have a million three. The increase, no, I mean and the attorney s, it s been a million three for years and the national average of a dental claim is in the thousand. REPRESENTATIVE GODSHALL: Maybe I m missing the point, right now there are dentists who do not have liability insurance. HB 338 will mandate certain dentists have to have liability insurance if this is enacted. True? DR. DISHLER: Just a few. REPRESENTATIVE GODSHALL: Well how many? DR. DISHLER: Well, Gil said less than 2 percent and I think that s probably REPRESENTATIVE GODSHALL: 2 percent of 5,000, what is it? MR. DAVIS: There s about 8,000 dentists total with non-members. REPRESNTATIVE GODSHALL: How many? DR. DISHLER: How about 8 thousand dentists practicing in Pennsylvania MR. DAVIS: 10,000. REPRESENTATIVE GODSHALL: Oh, okay, so the answer is no. CHAIRMAN MICOZZIE: Representative Maloney. REPRESENTATIVE MALONEY: Thank you Mr. Chairman, on those lines then, please forgive me, I always pick this seat and this has that flexible microphone, however, thank you Doctor, appreciate it. Just to be clear especially with volunteerism, I guess the way I would understand this is, if you re practicing you might be under an umbrella policy, you might be under a firms policy and that s how you re covered then, that s what would give you the protection insurance wise. I guess my specific question would be are you then required to be [16]

17 identified with that firm or if you re a volunteer, would you be identified as a practicing dentist that would automatically put you under that umbrella? DR. DISHLER: I m not sure what you mean by identified. REPRESENTATIVE MALONEY: Well in the light of the question that was asked in volunteering, if you volunteered as a dentist for maybe a clinic and an issue came up, are you required to be identified in there as a practicing licensed dentist so that you are covered under that insurance, so that if there was an issue down the road or whatever you could say no,i was identified there and I m covered. DR. DISHLER: Yes, any institution that I m involved with every year asks me to submit my malpractice insurance, the first page as well as my license so that they have that and my DA number. REPRESENTATIVE MALONEY: Right, I just want to be clear because I think there was a little bit of a question and some came up from me in the last several months as to that very point, if somebody was volunteering and they weren t really identified there in that clinic, you know, you could have come back and you know say they weren t here, but no, we have documentation that says they are under our umbrella and so on. That was why I wanted to make sure that s clear. I just do want to say I really appreciate this and I really had the tremendous benefit of having a root canal Friday. DR. DISHLER: I m glad to hear you say it was a benefit. REPRESENTATIVE MALONEY: It gave me a little enlightening of certain procedures that I was not privy to before. But I did ask a lot of questions during this process with my dentist and surgeon and so on, really basically what I understand is to probably quote the last dentist [17]

18 was, you almost have to be an idiot not to have it. So, that was almost verbatim so I really appreciate this, so thank you. CHAIRMAN MICOZZIE: Was your question being asked when your mouth was open? REPRESENTATIVE MALONEY: You know, that s a very convenient time to ask a politician a question. CHAIRMAN MICOZZIE: Representative Sonney. REPRESENTATIVE SONNEY: Thank you Mr. Chairman one of my questions was already answered, I was curious as to how many practicing dentists don t carry some type of liability insurance and you said it s very very few, so with that being said I can assume that when this was first proposed that your members, you know you received probably little to no pushback from your members because they were already covered. Do you know what the general cost is for this liability insurance? For this million dollars, the million three that you said is pretty standard today? MR. DAVIS: Again, it varies geographically with southeast there s different pricing going on, on average it s about $ across the State with Philadelphia being the most expensive, about $3,000 and then taking the average about $1800. REPRESENTATIVE SONNEY: Thank you, thank you Mr. Chairman. CHAIRMAN MACOZZIE: Representative Barbin. REPRESENTATIVE BARBIN: Thank you Mr. Chairman and thank you Doctor Dishler, I heard the testimony from our former Representative and now our Commissioner for Bureau of Occupational Affairs and she stated her testimony was that there was approximately 10,000 dentists that are licensed in Pennsylvania and you re testimony this morning says that there are 5,500 practicing and retired dentists. And what I m trying to get at, just so that we understand [18]

19 what the public policy is whether we should fix it once and for all or whether we should just let it go in the form that it s been sent over by the Senate, what I think the public needs to know is exactly how many of the people that are in this number 10,000, not how many in the 5,500 number. How many of those people are actually licensed but maybe not practicing? Because what you say here is there 5,500 that are licensed and retired, we don t know if that s an and or an or, can you break down your number, explain it to the public by what you mean by that number. DR. DISHLER: Let me just explain, I represent the members of the Pennsylvania Dental Association, there are some dentists who are not members. REPRESENTATIVE BARBIN: Alright, so there s 10,000 dentists and there s 5,500 Pennsylvania Dental Association Dentists? DR. DISHLER: Well and there is one other thing, we have licensees who don t practice in Pennsylvania who are licensed to practice in Pennsylvania but chose to practice in another State, so I m assuming that 10,000 includes all of those people as well. REPRESENTATIVE BARBIN: Alright and see that s true in all learner professions, I m a member of the Pennsylvania Bar Association, we have plenty of lawyers that passed the Pennsylvania Bar Association, moved to the District of Columbia, got a District of Columbia license, but they maintain their status as a lawyer by taking the CLE credits not just for the District of Columbia but also for Pennsylvania. Not a single one of them isn't required to have insurance even if they are not practicing in Pennsylvania, you have to have insurance and see what the problem is that s come out of this case from Berks County is there are doctors that may have been practiced, licensed here, may have been licensed there but they come into Pennsylvania and they don t have insurance. Now, [19]

20 we have a system that was set up to cover the free clinics if you re a licensed dentist and if you practice in a free clinic, you re covered by the free clinic. If you re in a school, you re covered by the school. The problem that we worry about is the situation that happened in Reading where somebody who was supposed to have insurance doesn t have insurance, so the question is, if a doctor has to have malpractice insurance, and a lawyer has to have malpractice insurance, and an engineer has to have malpractice insurance, why in the world shouldn t a dentist have to have malpractice insurance, and why in the world should a dentist who s inactive not be inactive? What you re doing is, you re allowing through this Dental Board interpretation licensed and practicing to create a special category that doesn t apply to any other learned professions? And that s the problem, there wasn t insurance from the guy from Reading and what I m saying is, why shouldn t you be required as Representative Grell stated that if you to be in a learned profession in Pennsylvania why shouldn t you be forced to go on inactive status? DR. DISHLER: Going from active to inactive is not as easy as buying an insurance policy. Suppose a woman is on maternity leave and she decides to go back and practice one day a week. All she has to do is call her insurance agent and say I m going to be practicing one day a week and she s covered, but to go onto an active status from an inactive status requires a little more and I don t think it s necessary, I disagree that, I think using the word practicing covers a lot of territory where there are some exceptions. Somebody is disabled and comes back as long as they keep their CE up all they have to do is get their insurance and their license is okay. REPRESENTATIVE BARBIN: Well then go back to my question, how many of these people, how many people of the 5,500 are in that category? How many people are out of State that want to keep their license and not go on inactive and don t want to be covered by this [20]

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