RULES AND REGULATIONS
Title 49--PROFESSIONAL AND VOCATIONAL STANDARDS
STATE BOARD OF MEDICINE
AND
STATE BOARD OF OSTEOPATHIC MEDICINE
[49 PA. CODE CHS. 18 AND 25]
Respiratory Care Practitioners
[26 Pa.B. 5641] The State Board of Medicine and State Board of Osteopathic Medicine (Boards) amend Chapters 18 and 25 (relating to State Board of Medicine--practitioners, other than medical doctors; and State Board of Osteopathic Medicine) to read as set forth in Annex A. The amendments add new subchapters pertaining to the certification and practice of respiratory care practitioners in this Commonwealth. The Boards' notice of proposed rulemaking was published at 26 Pa.B. 757 (February 24, 1996).
Statutory Authority
The regulations are adopted under the authority of sections 13.1(c) and 36.1 of the Medical Practice Act of 1985 (MPA) (63 P. S. §§ 422.13a(c) and 422.36a) and sections 10.1(c) and 10.2 of the Osteopathic Medical Practice Act (OMPA) (63 P. S. §§ 271.10a(c) and 271.10b), added by the act of July 2, 1993 (P. L. 424, No. 60) and the act of July 2, 1993 (P. L. 418, No. 519) respectively. These sections require that the Boards issue certificates and temporary permits to individuals meeting the qualifications in the MPA and the OMPA to practice or offer to practice respiratory care in this Commonwealth. Under section 13.1(a) of the MPA and section 10.1(a) of the OMPA, on and after June 30, 1995, no person may practice, hold himself out to the public to practice or offer to practice as a respiratory care practitioner unless the individual holds a valid, current temporary permit or certificate issued by either Board. See section 3 of the act of July 2, 1993, section 13.1(a) of the MPA, section 3 of the act of July 2, 1993 and section 10.1(a) of the OMPA.
Under section 13.1(c) of the MPA and section 10.1(c) of the OMPA, the Boards are authorized to promulgate regulations to establish procedures for application, credentials, verification, examination, certification and fees.
Public Comments
Written comment, suggestions and objections were solicited within a 30-day period after publication. The Boards received reports from the House Professional Licensure Committee (House Committee) on March 19, 1996, and the Independent Regulatory Review Commission (IRRC) on April 24, 1996. The Boards received comments from the Pennsylvania Society for Respiratory Care, Inc. (PSRC), the Hospital Association of Pennsylvania (HAP), and from Paoli Memorial Hospital, Bryn Mawr Rehabilitation, Thomas Jefferson University Hospital and Main Line Health System and their staff members. As a result of the reports and the comments, numerous revisions have been made to these final-form regulations to include language to clarify language of various sections.
Summary of Changes
The House Committee and IRRC questioned part of the proposed §§ 18.310(c) and 25.510(c) (relating to inactive status). The Boards had proposed that a certificateholder who wished to return his certificate from inactive to active status submit, inter alia, a resume of professional activities since the most recent registration and a letter of good standing from another jurisdiction where the certificateholder was currently licensed or registered to practice. The House Committee and IRRC pointed out that the Boards' language presumed that while a certificateholder was inactive in this Commonwealth, he was practicing in another jurisdiction. The House Committee questioned the presumption and the statutory basis for the requirement of the resume and letter of good standing. The House Committee recommended that the Boards adopt the reactivation requirements found in § 16.15 (relating to biennial registration; inactive status and unregistered status). The Boards have done this. At IRRC's request, the Boards clarified §§ 18.310(d) and 25.510(d) to show that an applicant for reactivation will be required to pay only the current biennial fee.
The House Committee and IRRC also questioned the proposed §§ 18.306(a)(3) and 25.506(a)(3) (relating to temporary permits). The Boards had proposed, under section 36a(b)(4) of the MPA and section 10.2(b)(2) of the OMPA, that a temporary permit be issued to an applicant who has provided respiratory care services for at least 12-consecutive months prior to December 28, 1993. The House Committee and IRRC questioned the proposed regulatory language which appeared to authorize the grant of a temporary permit even for experience gained long before December 28, 1993, while requiring that the experience be gained in consecutive months. On final rulemaking, the Boards tracked the statutory language more closely and authorized the issuance of a temporary permit to an applicant who has continuously provided respiratory care services for a minimum of 12 months immediately preceding December 28, 1993. The Boards also made this change to §§ 18.307(a)(4) and 25.507(1)(iv) (relating to criteria for certification as a respiratory care practitioner).
IRRC questioned the definition of ''CRTT'' in §§ 18.302 and 25.502 (relating to definitions). IRRC noted that the definitions do not delineate what ''CRTT'' stands for. In the NBRC Licensure Guide, ''CRTT'' is defined as the Certification Examination For Entry Level Respiratory Practitioners without an explanation of what the letters CRTT delineate. On final rulemaking, the Boards adopted the definition found in the Licensure Guide. IRRC also suggested that the Boards replace the word ''technician'' with ''practitioner,'' the word favored in both the MPA and OMPA. The Boards have adopted this suggestion.
IRRC and the PSRC were concerned that the list of functions in §§ 18.305 and 25.505 (relating to functions of respiratory care practitioner) which a respiratory care practitioner may perform did not include reference to ''indirect services, such as consultation or evaluation of an individual . . . '' as provided for in section 13.1(d) of the MPA and section 10.1(d) of the OMPA. On final rulemaking, the Boards included indirect services such as consultation or evaluation of an individual.
IRRC raised concerns regarding §§ 18.306 and 25.506. IRRC noted that subsection (a)(1) of the proposed rulemaking departed from section 36.1(b)(1) of the MPA and section 10.1(b)(1) of the OMPA by authorizing the issuance of a temporary permit to an applicant who had graduated from an approved respiratory care program and is awaiting results of the CRTT. IRRC correctly noted that the section section 36.1(b)(1) of the MPA and section 10.1(b)(1) of the OMPA authorize the issuance of a temporary permit to an applicant who has simply graduated from an approved respiratory care program. Section 36.1(c) of the MPA and section 10.1(b)(1) of the OMPA require the applicant to apply for the next scheduled examination. The Boards' final rulemaking tracks the statute.
IRRC made a similar observation regarding language in §§ 18.306(a)(2) and 25.506(a)(2) that the applicant ''is awaiting results of the CRTT.'' The Board adopted the suggestion in final rulemaking and eliminated the quoted language. The Boards also adopted the suggestion that subsection (a)(2) specify that the application is to the relevant board for a temporary permit.
IRRC noted that the Boards' proposed rulemaking in §§ 18.306(b) and 25.506(b) did not make provision for extensions of the temporary permit beyond 12 months in specific cases, as do the statutes at section 36.1(c) of the MPA and section 10.1(c) of the OMPA. In final rulemaking, the Boards have made provision for extensions. In final rulemaking, the Boards, at the suggestion of IRRC and HAP, specified that an applicant who failed the examination may apply to take it again. The Boards also adopted the suggestion of IRRC to identify the examination being referred to in this provision as the CRTT.
The PSRC expressed approval for the proposed rulemaking while raising one concern. The PSRC observed that under the MPA and OMPA the Boards are authorized to issue a temporary permit to anyone who has made continuous provision of respiratory care services for a minimum of 12 months immediately preceding the effective date of the acts. PSRC is concerned that the applicant under these provisions might not apply or practice for several years after December 28, 1993, the effective date of the acts. The PSRC would like to terminate this window for application on December 31, 1997. The Boards, however, lack the statutory authority to impose this termination date.
HAP and the individual hospitals, hospital employes and staff members raised concerns that certification of respiratory care practitioners will increase costs of delivering health care services. These commentators also asked that the following be removed from the lists of functions of respiratory care practitioners in §§ 18.305 and 25.505: administration of medical gases, humidity and aerosol therapy, incentive spirometry and bronchopulmonary hygiene. The Boards observed in their notice of proposed rulemaking at 26 Pa.B. 759 that certification of respiratory care practitioners might increase costs. Certification, however, is mandated by law. See, 26 Pa.B. 757--758. The list of functions of respiratory care practitioner derives directly from the lists contained in section 13.1(d) of the MPA and section 10.1(d) of the OMPA. Since the lists of functions have their basis in statute the Boards cannot remove them.
Persons Affected
Persons who practice or who seek to practice respiratory care in this Commonwealth on and after June 30, 1995, shall obtain a permit or a certificate.
Fiscal Impact
Commonwealth These new subchapters establish fees for the issuance of temporary permits, certifications and biennial renewal for respiratory care practitioners. Revenue generated from these fees will be used to cover the costs of administration of the certification program. The regulations will not otherwise impose additional costs on the Commonwealth.
Political Subdivisions The new subchapters should not have any direct fiscal impact upon political subdivisions in this Commonwealth.
Private Sector The new subchapters may impose additional costs upon the private sector. In particular, entities who provide respiratory care services may incur additional costs in bringing their facilities into compliance by employing or utilizing certified practitioners. Persons wishing to obtain certification from the Boards will incur those costs associated with the administration of the certification program, as well as costs associated with the qualifying examination.
General Public The regulations should impose no additional costs upon the general public.
Paperwork Requirements
Persons seeking temporary permits or certifications will be required to obtain application forms from the Boards in order to obtain certification.
Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), the Boards submitted a copy of the notice of proposed rulemaking, published at 26 Pa.B. 757, to IRRC and the Chairpersons of the House Committee and the Senate Committee on Consumer Protection and Professional Licensure.
In compliance with section 5(b.1) of the Regulatory Review Act, the Boards provided IRRC and the Committees with a copy of comments received as well as other documentation.
These final-form regulations were approved by the House Committee on October 1, 1996, and approved by the Senate Committee on September 25, 1996. IRRC met on October 3, 1996, and approved the regulations in accordance with section 5(c) of the Regulatory Review Act.
Contact Persons
Interested persons are invited to submit questions regarding these regulations to Cindy Warner, Administrative Assistant for the State Board of Medicine, at (717) 783-1400, or Gina Bittner, Administrative Assistant for the State Board of Osteopathic Medicine, at (717) 783- 4858.
Findings
The Boards find that:
(1) Public notice of intention to adopt regulations was given under section 201 and 202 of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. §§ 1201 and 1202) and the regulations promulgated under those sections at 1 Pa. Code §§ 7.1--7.2.
(2) The regulations of the State Boards are necessary for the administration of the MPA (63 P. S. §§ 422.1--422.45) and the OMPA (63 P. S. §§ 271.1--271.18).
Order
The Boards order that:
(a) The regulations of the State Boards, 49 Pa. Code Chapters 18 and 25, are amended by adding §§ 18.301--18.310 and §§ 25.501--25.510 to read as set forth in Annex A (Editor's Note: Sections 25.501--25.510 were proposed as §§ 25.292--25.301 at 26 Pa.B. 757 (February 24, 1996)).
(b) The Boards shall submit of this order and Annex A to the Office of General Counsel and the Office of Attorney General for approval as to legality as required by law.
(c) The Boards shall certify this order and Annex A and shall deposit them with the Legislative Reference Bureau as required by law.
(d) The regulations shall take effect immediately upon publication in the Pennsylvania Bulletin.
CHARLES J. BANNON, M.D.,
ChairpersonSILVIA M. FERRETTI, D.O.,
Chairperson(Editor's Note: For the text of the order of the Independent Regulatory Review Commission relating to this document, see 26 Pa.B. 3180 (October 26, 1999).)
Fiscal Note: Fiscal Note 16A-532 remains valid for the final adoption of the subject regulations.
Annex A
TITLE 49. PROFESSIONAL AND
VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND
OCCUPATIONAL AFFAIRS
CHAPTER 18. STATE BOARD OF MEDICINE--PRACTITIONERS OTHER THAN MEDICAL DOCTORS
Subchapter F. RESPIRATORY CARE PRACTITIONERS Sec.
18.301. Purpose. 18.302. Definitions. 18.303. Fees. 18.304. Certification of respiratory care practitioners; practice; exceptions. 18.305. Functions of respiratory care practitioners. 18.306. Temporary permits. 18.307. Criteria for certification as a respiratory care practitioner. 18.308. Change of name or address. 18.309. Renewal of certification. 18.310. Inactive status. § 18.301. Purpose.
This subchapter implements sections 13.1 and 36.1 of the act (63 P. S. §§ 422.13a and 422.36a), which were added by section 3 of the act of July 2, 1993 (P. L. 424, No. 60) to provide for the certification of respiratory care practitioners.
§ 18.302. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
Act--The Medical Practice Act of 1985 (63 P. S. §§ 422.1--422.45.)
CRTT--The Certification Examination For Entry Level Respiratory Therapy Practitioners, a National uniform examination developed and administered by the NBRC for certified respiratory care therapy practitioners.
JRCRTE--The Joint Review Committee on Respiratory Therapy Education, which accredits respiratory care programs.
NBRC--The National Board for Respiratory Care, the agency recognized by the Board to credential respiratory care practitioners.
Respiratory care practitioner--A person who has been certified in accordance with the act and this subchapter.
§ 18.303. Fees.
The following is the schedule of fees charged by the Board:
(1) Temporary permit $15 (2) Initial certification $15 (3) Certification examination $90 (Effective 7-96) $100 (4) Reexamination $60 (5) Biennial renewal of certification $25 § 18.304. Certification of respiratory care practitioners; practice; exceptions.
(a) A person may not practice or hold himself out as being able to practice as a respiratory care practitioner in this Commonwealth unless the person holds a valid, current temporary permit or certificate issued by the Board, or the State Board of Osteopathic Medicine under Chapter 25 (relating to State Board of Osteopathic Medicine), or is exempted under section 13.1(e) of the act (63 P. S. § 422.13a(e)) or section 10.1(e) of the Osteopathic Medical Practice Act (63 P. S. § 271.10a(e)).
(b) A person may not use the words ''respiratory care practitioner,'' the letters ''R.C.P.'' or similar words and related abbreviations to imply that respiratory care services are being provided, unless the services are provided by a respiratory care practitioner who holds a valid, current temporary permit or certificate issued by the Board or the State Board of Osteopathic Medicine and only while working under the supervision of a licensed physician.
§ 18.305. Functions of respiratory care practitioners.
(a) Under section 13.1(d) of the act (63 P. S. § 422.13a(d)), a respiratory care practitioner may implement direct respiratory care to an individual being treated by either a licensed medical doctor or a licensed doctor of osteopathic medicine, upon physician prescription or referral, or under medical direction and approval consistent with standing orders or protocols of an institution or health care facility. This care may constitute indirect services such as consultation or evaluation of an individual and also includes, but is not limited to, the following services:
(1) Administration of medical gases.
(2) Humidity and aerosol therapy.
(3) Administration of aerosolized medications.
(4) Intermittent positive pressure breathing.
(5) Incentive spirometry.
(6) Bronchopulmonary hygiene.
(7) Management and maintenance of natural airways.
(8) Maintenance and insertion of artificial airways.
(9) Cardiopulmonary rehabilitation.
(10) Management and maintenance of mechanical ventilation.
(11) Measurement of ventilatory flows, volumes and pressures.
(12) Analysis of ventilatory gases and blood gases.
(b) Under section 13.1(d) of the act, a respiratory care practitioner may perform the activities listed in subsection (a) only upon physician prescription or referral or while under medical direction consistent with standing orders or protocols in an institution or health care facility.
§ 18.306. Temporary permits.
(a) A temporary permit will be issued to an applicant who submits evidence satisfactory to the Board, on forms supplied by the Board, that the applicant has met one or more of the following criteria:
(1) Has graduated from a respiratory care program approved by the JRCRTE.
(2) Is enrolled in a respiratory care program approved by the JRCRTE and expects to graduate within 30 days of the date of application to the Board for a temporary permit.
(3) Has continuously provided respiratory care services for a minimum of 12 months immediately preceding December 28, 1993.
(b) A temporary permit is valid for 12 months and for an additional period as the Board may, in each case, specially determine except that a temporary permit expires if the holder fails the CRTT. An applicant who fails the CRTT may apply to retake it.
§ 18.307. Criteria for certification as a respiratory care practitioner.
The Board will approve for certification as a respiratory care practitioner an applicant who:
(1) Submits evidence satisfactory to the Board, on forms supplied by the Board, that the applicant has met one or more of the following criteria:
(i) Has graduated from a respiratory care program approved by the JRCRTE and passed the CRTT as determined by the NBRC.
(ii) Has been credentialed as a Certified Respiratory Therapy Technician or Registered Respiratory Therapist by the NBRC.
(iii) Holds a valid license, certificate or registration as a respiratory care practitioner in another state, territory or the District of Columbia which has been issued based on requirements substantially the same as those required by the Commonwealth, including the examination requirement.
(iv) Has continuously provided respiratory care services for a minimum of 12 months immediately preceding December 28, 1993, and has passed the CRTT as determined by the NBRC.
(2) Has paid the appropriate fee in the form of a check or money order.
§ 18.308. Change of name or address.
A certificateholder shall inform the Board in writing within 10 days of a change of name or mailing address.
§ 18.309. Renewal of certification.
(a) A certification issued under this subchapter expires on December 31 of every even-numbered year unless renewed for the next biennium.
(b) Biennial renewal forms and other forms and literature to be distributed by the Board will be forwarded to the last mailing address given to the Board.
(c) To retain the right to engage in practice, the certificateholder shall renew certification in the manner prescribed by the Board and pay the required fee prior to the expiration of the next biennium.
(d) When a certification is renewed after December 31 of an even-numbered year, a penalty fee of $5 for each month or part of a month of practice beyond the renewal date will be charged in addition to the renewal fee.
§ 18.310. Inactive status.
(a) A certificateholder who does not intend to practice in this Commonwealth and who does not desire to renew certification shall inform the Board in writing. Written confirmation of inactive status will be forwarded to the certificateholder.
(b) A certificateholder shall notify the Board, in writing, of his desire to reactivate the registration.
(c) A certificateholder who is applying to return to active status is required to pay fees which are due for the current biennium and submit a sworn statement stating the period of time during which the certificateholder was not engaged in practice in this Commonwealth.
(d) The applicant for reactivation will not be assessed a fee or penalty for preceding biennial periods in which the applicant did not engage in practice in this Commonwealth.
CHAPTER 25. STATE BOARD OF
OSTEOPATHIC MEDICINE
Subchapter K. RESPIRATORY CARE PRACTITIONERS Sec.
25.501. Purpose. 25.502. Definitions. 25.503. Fees. 25.504. Certification of respiratory care practitioners; practice; exceptions. 25.505. Functions of respiratory care practitioners. 25.506. Temporary permits. 25.507. Criteria for certification as a respiratory care practitioner. 25.508. Change of name or address. 25.509. Renewal of certification. 25.510. Inactive status. § 25.501. Purpose.
This subchapter implements sections 10.1 and 10.2 of the act (63 P. S. §§ 271.10a and 271.10b), which were added by section 3 of the act of July 2, 1993 (P. L. 418, No. 59) to provide for the certification of respiratory care practitioners.
§ 25.502. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:
Act--The Osteopathic Medical Practice Act (63 P. S. §§ 271.1--271.18).
CRTT--The Certification Examination For Entry Level Respiratory Therapy Practitioners, a National uniform examination developed and administered by the NBRC for certified respiratory care therapy practitioners.
JRCRTE--The Joint Review Committee on Respiratory Therapy Education, which accredits respiratory care programs.
NBRC--The National Board for Respiratory Care, the agency recognized by the Board to certify respiratory care practitioners.
Respiratory care practitioner--A person who has been certified in accordance with the act and this subchapter.
§ 25.503. Fees.
The following is the schedule of fees charged by the Board:
(1) Temporary permit $15 (2) Initial certification $15 (3) Certification examination $90 (Effective 7-96) $100 (4) Reexamination $60 (5) Biennial renewal of certification $25 § 25.504. Certification of respiratory care practitioners; practice; exceptions.
(a) A person may not practice or hold himself out as being able to practice as a respiratory care practitioner in this Commonwealth unless the person holds a valid, current temporary permit or certificate issued by the Board, or the State Board of Medicine under Chapter 18 (relating to State Board of Medicine--practitioners other than medical doctors) or is exempted under section 10.1(e) of the act (63 P. S. §§ 271.10a(e)) or section 13.1(e) of the Medical Practice Act of 1985 (63 P. S. § 422.13a(e)).
(b) A person may not use the words ''respiratory care practitioner,'' the letters ''R.C.P.'' or similar words and related abbreviations to imply that respiratory care services are being provided, unless the services are provided by a respiratory care practitioner who holds a valid, current temporary permit or certificate issued by the Board or the State Board of Medicine and only while working under the supervision of a licensed physician.
§ 25.505. Functions of respiratory care practitioners.
(a) Under section 10.1(d) of the act (63 P. S. § 271.10a(d)), a respiratory care practitioner may implement direct respiratory care to an individual being treated by either a licensed medical doctor or a licensed doctor of osteopathic medicine, upon physician prescription or referral, or under medical direction and approval consistent with standing orders or protocols of an institution or health care facility. This care may constitute indirect services such as consultation or evaluation of an individual and also includes, but is not limited to, the following services:
(1) Administration of medical gases.
(2) Humidity and aerosol therapy.
(3) Administration of aerosolized medications.
(4) Intermittent positive pressure breathing.
(5) Incentive spirometry.
(6) Bronchopulmonary hygiene.
(7) Management and maintenance of natural airways.
(8) Maintenance and insertion of artificial airways.
(9) Cardiopulmonary rehabilitation.
(10) Management and maintenance of mechanical ventilation.
(11) Measurement of ventilatory flows, volumes and pressures.
(12) Analysis of ventilatory gases and blood gases.
(b) Under section 10.1(d) of the act, a respiratory care practitioner may perform the activities listed in subsection (a) only upon physician prescription or referral or while under medical direction consistent with standing orders or protocols in an institution or health care facility.
§ 25.506. Temporary permits.
(a) A temporary permit will be issued to an applicant who submits evidence satisfactory to the Board, on forms supplied by the Board, that the applicant has met one or more of the following criteria:
(1) Has graduated from a respiratory care program approved by the JRCRTE.
(2) Is enrolled in a respiratory care program approved by the JRCRTE and expects to graduate within 30 days of the date of application to the Board for a temporary permit.
(3) Has continuously provided respiratory care services for a minimum of 12 months immediately preceding December 28, 1993.
(b) A temporary permit is valid for 12 months and for an additional period as the Board may, in each case, specially determine except that a temporary permit expires if the holder fails the CRTT. An applicant who fails the CRTT may apply to retake it.
§ 25.507. Criteria for certification as a respiratory care practitioner.
The Board will approve for certification as a respiratory care practitioner an applicant who:
(1) Submits evidence satisfactory to the Board, on forms supplied by the Board, that the applicant has met one or more of the following criteria:
(i) Has graduated from a respiratory care program approved by the JRCRTE and passed the CRTT as determined by the NBRC.
(ii) Has been credentialed as a Certified Respiratory Therapy Technician or Registered Respiratory Therapist by the NBRC.
(iii) Holds a valid license, certificate or registration as a respiratory care practitioner in another state, territory or the District of Columbia which has been issued based on requirements substantially the same as those required by the Commonwealth, including the examination requirement.
(iv) Has continuously provided respiratory care services for a minimum of 12 months immediately preceding December 28, 1993, and has passed the CRTT as determined by the NBRC.
(2) Has paid the appropriate fee in the form of a check or money order.
§ 25.508. Change of name or address.
A certificateholder shall inform the Board in writing within 10 days of a change of name or mailing address.
§ 25.509. Renewal of certification.
(a) A certification issued under this subchapter expires on December 31 of every even-numbered year unless renewed for the next biennium.
(b) Biennial renewal forms and other forms and literature to be distributed by the Board will be forwarded to the last mailing address given to the Board.
(c) To retain the right to engage in practice, the certificateholder shall renew certification in the manner prescribed by the Board and pay the required fee prior to the expiration of the next biennium.
(d) When a certification is renewed after December 31 of an even-numbered year, a penalty fee of $5 for each month or part of a month of practice beyond the renewal date will be charged in addition to the renewal fee.
§ 25.510. Inactive status.
(a) A certificateholder who does not intend to practice in this Commonwealth and who does not desire to renew certification shall inform the Board in writing. Written confirmation of inactive status will be forwarded to the certificateholder.
(b) A certificateholder shall notify the Board, in writing, of his desire to reactivate the registration.
(c) A certificateholder who is applying to return to active status is required to pay fees which are due for the current biennium and submit a sworn statement stating the period of time during which the certificateholder was not engaged in practice in this Commonwealth.
(d) The applicant for reactivation will not be assessed a fee or penalty for preceding biennial periods in which the applicant did not engage in practice in this Commonwealth.
[Pa.B. Doc. No. 96-1930. Filed for public inspection November 15, 1996, 9:00 a.m.]
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