Health Law Blog by Lamb McErlane attorneys Vasilios J. Kalogredis, Esq. and Sonal Parekh, Esq.

On December 21, 2023, the Commonwealth Court of Pennsylvania (the “Court”) reversed and remanded the State Board of Dentistry’s (“Board”) decision to deny the application of Joshua Haentges, D.D.S. (“Dr. Haentges”) for dental licensure by endorsement based on the Board’s contention that the licensing requirements of New York State were not substantially equivalent to that of Pennsylvania.

Background

Dr. Haentges obtained his New York dental license and began practicing dentistry in 2017. In late 2020 to early 2021, Dr. Haentges purchased two dental offices from a retiring dentist, one in Watkins Glen, New York (“Watkins Office”) and the other in Elkland, Pennsylvania (“Elkland Office”). Dr. Haentges began his practice at the Watkins Office, and filed an application for licensure by endorsement in Pennsylvania on May 4, 2021 to be able to practice in the Elkland Office. A licensure by endorsement allows for licensure of certain out-of-state professionals. Licensure by endorsement requires that (1) the applicant hold a current license from another state, territory or country, and (2) the licensing board/commission determines that that state’s, territory’s or country’s requirements are substantially equivalent to or exceed the requirements established in the Commonwealth of Pennsylvania.[1]

Denial by the Board

The Board denied this application on the finding that New York’s dental licensing requirements were not substantially equivalent to Pennsylvania’s requirements because New York did not require dental applicants to pass a clinical examination. In his appeal, Dr. Haentges noted that while New York did not require its applicants to pass a dental clinical examination, it did require the successful completion of a clinically-based postdoctoral general practice or specialty dental residency program, of at least one year’s duration, as well as a formal outcome assessment evaluation of the resident’s competence to practice dentistry, which, collectively, Dr. Haentges asserted was at least substantially equivalent to a clinical examination. Dr. Haentges further asserted that though New York law requires residents to perform a specific list of procedures (resulting in 9 total procedures), Dr. Haentges not only met the requirements but actually completed a total of 250 procedures, a number well over the minimum required. Dr. Haentges further argued the superiority of a 1 year residency with live patients in comparison to a 2 to 3 day course on manikins.

Despite these persuasive arguments, the Board rejected Dr. Haentges, reasoning that given the objective nature of the examination in comparison to a residency program, the “clinical examination is an additional measurement of competency in the practice of dentistry that is absent in New York.” The Board further, in making its determination, refused to consider public policy considerations or anything other than the plain letter of the licensing laws of both Pennsylvania and New York.

Reversal by the Court

The Court reversed and remanded the Board’s denial, finding that “New York’s licensing requirements were substantially equivalent to, or exceeded, Pennsylvania’s licensing requirements by any reasonable measure.” Specifically, the Court stated that the Board made an erroneous interpretation of Section 3111(a)(1)’s statutory language for “substantially equivalent” by interpreting it to mean “the same.” The Court reasoned the substantially equivalent element was met because (i) both New York and Pennsylvania required applicants to complete a written examination and a clinical component (whether residency or a clinical examination); and (ii) the clinical components served the same purpose and were functionally interchangeable because they both sought to ensure that only applicants with established clinical skills received licensure.

The Court found it significant that Section 3111(a)(2) required a further review of an applicant’s competency separate from the substantial equivalency determination. The Court reasoned that though the Board is granted broad discretion in licensure determinations, the Board’s decision was an abuse of that discretion because the Board (i) looked beyond Pennsylvania law to justify a decision that New York’s licensing requirements were not substantially equivalent; and (ii) did not consider the other safeguards contemplated in Section 3111(a).[2] Accordingly, the Court reversed the Board’s denial and remanded for the Board to consider the remaining factors in Sections 3111(a)(2) through (5).

This case represents that though the Board has broad discretion as to its licensing decisions, a denial of licensure by endorsement is not always binding.

If you have any questions regarding dental licensure by endorsement, please feel free to contact Bill Kalogredis, Esq. or Sonal Parekh, Esq.

*This alert is for educational purposes only and is not intended to be legal advice. Should you require legal advice on this topic or have any questions or concerns, please contact Vasilios J. (Bill) Kalogredis, Esq. or Sonal Parekh, Esq.

[1] 63 Pa.C.S. § 3111(a)(1) (hereinafter referred to as “Section 3111(a)”).

[2] The Court pointed out that the critical qualities of a dental clinical examination on which the Board relied, grading criteria and objectivity, do not appear in Pennsylvania’s licensing statute and regulations.

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Vasilios J. (Bill) Kalogredis, Esq. has been advising physicians, dentists, and other healthcare professionals and their businesses as to contractual, regulatory and transactional matters for over 45 years. He is Chairman of Lamb McErlane PC’s Health Law Department. Bill can be reached by email at bkalogredis@lambmcerlane.com or by phone at 610-701-4402.

Sonal Parekh, Esq., is an associate at Lamb McErlane PC who focuses on healthcare transactional matters and a broad range of healthcare regulatory-related issues on behalf of healthcare systems, physicians, dentists, and other healthcare providers, and is a pharmacist by education and training. Sonal can be reached by email at sparekh@lambmcerlane.com or by phone at 610-701-4416.