Provisions Applicable to Health-Care Professions and Occupations

C.R.S. tit. 12, art. 30

in effect

C.R.S. § 12-30-101 Scope

12-30-101. Scope. This article 30 applies to articles 200 to 315 of this title 12 except to the extent otherwise specified in this article 30 or another part or article of this title 12. The requirements of this article 30 are in addition to the requirements established in any other part or article of this title 12.

C.R.S. § 12-30-102 Medical transparency act of 2010 - disclosure of information about health-care providers - fines - rules - short title - legislative declaration - review of functions - repeal

12-30-102. Medical transparency act of 2010 - disclosure of information about health-care providers - fines - rules - short title - legislative declaration - review of functions - repeal. (1) The short title of this section is the "Michael Skolnik Medical Transparency Act of 2010". (2) (a) The general assembly hereby finds and determines that: (I) The people of Colorado need to be fully informed about the past practices of persons practicing a health-care profession in this state in order to make informed decisions when choosing a health-care provider and determining whether to proceed with a particular regimen of care recommended by a health-care provider; (II) The purpose of this section is to provide transparency to the public regarding the competency of persons engaged in the practice of certain health-care professions in this state to assist citizens in making informed health-care decisions. (b) The general assembly further finds and declares that it is important to make information about persons engaged in the practice of a health-care profession available to the public in a manner that is efficient, cost-effective, and maintains the integrity of the information, and to that end, the general assembly encourages persons to file the required information with the division electronically, to the extent possible. (3) (a) As used in this section, "applicant" means a person applying for a new, active license, certification, or registration or to renew, reinstate, or reactivate an active license, certification, or registration to practice: (I) Audiology pursuant to article 210 of this title 12; (II) As a licensed hearing aid provider pursuant to part 2 of article 230 of this title 12; (III) Acupuncture pursuant to article 200 of this title 12; (IV) Podiatry pursuant to article 290 of this title 12; (V) Chiropractic pursuant to article 215 of this title 12; (VI) Dentistry pursuant to article 220 of this title 12; (VII) Dental therapy or dental hygiene pursuant to article 220 of this title 12; (VIII) Medicine pursuant to article 240 of this title 12 or part 36 of article 60 of title 24; (IX) As a physician assistant or an anesthesiologist assistant pursuant to article 240 of this title 12; (X) Direct-entry midwifery pursuant to article 225 of this title 12; (XI) Practical nursing, professional nursing, advanced practice registered nursing, or as a certified midwife pursuant to article 255 of this title 12; (XII) Optometry pursuant to article 275 of this title 12; (XIII) Physical therapy pursuant to article 285 of this title 12; (XIV) Psychology pursuant to part 3 of article 245 of this title 12; (XV) Social work pursuant to part 4 of article 245 of this title 12; (XVI) Marriage and family therapy pursuant to part 5 of article 245 of this title 12; (XVII) Professional counseling pursuant to part 6 of article 245 of this title 12; (XVIII) Psychotherapy pursuant to part 7 of article 245 of this title 12; (XIX) Addiction counseling pursuant to part 8 of article 245 of this title 12; (XX) Speech-language pathology pursuant to article 305 of this title 12; (XXI) Athletic training pursuant to article 205 of this title 12; (XXII) Massage therapy pursuant to article 235 of this title 12; (XXIII) As a certified nurse aide pursuant to article 255 of this title 12; (XXIV) Occupational therapy pursuant to article 270 of this title 12; (XXV) Respiratory therapy pursuant to article 300 of this title 12; (XXVI) Pharmacy pursuant to article 280 of this title 12; (XXVII) As a psychiatric technician pursuant to article 295 of this title 12; (XXVIII) As a surgical assistant or surgical technologist pursuant to article 310 of this title 12; and (XXIX) Naturopathic medicine pursuant to article 250 of this title 12. f this title 12; (XXV) Respiratory therapy pursuant to article 300 of this title 12; (XXVI) Pharmacy pursuant to article 280 of this title 12; (XXVII) As a psychiatric technician pursuant to article 295 of this title 12; (XXVIII) As a surgical assistant or surgical technologist pursuant to article 310 of this title 12; and (XXIX) Naturopathic medicine pursuant to article 250 of this title 12. (b) A person who is an applicant under this subsection (3) is not, by virtue of inclusion in this section, a health-care provider for purposes of any other provision of Colorado law. (4) When applying for a new license, certification, or registration or to renew, reinstate, or reactivate a license, certification, or registration in this state, each applicant shall provide the following information to the director, in a form and manner determined by the director, as applicable to each profession: (a) (I) The applicant's full name, including any known aliases; (II) The applicant's current address of record and telephone number; (III) The applicant's location of practice, if different than the address of record; (IV) The applicant's education and training related to the applicant's profession; (V) Information pertaining to any license, certification, or registration to practice in the profession for which the applicant seeks licensure, certification, or registration, issued or held during the immediately preceding ten years, including the license, certification, or registration status and year of issuance; (VI) Any board certifications and specialties, if applicable; (VII) Any affiliations with or clinical privileges held in hospitals or health-care facilities; (VIII) Any health-care-related business ownership interests; (IX) Information pertaining to the applicant's employer, if any, including name, current address, and telephone number; and (X) Information pertaining to any health-care-related employment contracts or contracts establishing an independent contractor relationship with any entities if the annual aggregate value of the contracts exceeds five thousand dollars, as adjusted by the director during each license, certification, or registration renewal cycle to reflect changes in the United States department of labor, bureau of labor statistics, consumer price index for Denver-Aurora-Lakewood for all items and all urban consumers, or its applicable predecessor or successor index. Nothing in this subsection (4)(a)(X) requires an applicant to report such information regarding contracts with insurance carriers for reimbursement of health-care services provided to patients. (b) Any public disciplinary action taken against the applicant by the applicable regulator or the board or licensing agency of any other state or country. The applicant shall provide a copy of the action to the director at the time the application is made. (c) Any agreement or stipulation entered into between the applicant and the regulator or the board or licensing agency of any other state or country whereby the applicant agrees to temporarily cease or restrict the applicant's practice, or any regulator's order restricting or suspending the applicant's license, certification, or registration. The applicant shall provide a copy of the agreement, stipulation, or order to the director at the time the application is made. the regulator or the board or licensing agency of any other state or country whereby the applicant agrees to temporarily cease or restrict the applicant's practice, or any regulator's order restricting or suspending the applicant's license, certification, or registration. The applicant shall provide a copy of the agreement, stipulation, or order to the director at the time the application is made. (d) (I) Any final action that results in an involuntary limitation or probationary status on, or a reduction, nonrenewal, denial, revocation, or suspension of, the applicant's medical staff membership or clinical privileges at any hospital or health-care facility occurring on or after September 1, 1990. The applicant shall not be required to report a precautionary or administrative suspension of medical staff membership or clinical privileges, as defined by the director by rule, unless the applicant resigns the applicant's medical staff membership or clinical privileges while the precautionary or administrative suspension is pending. To report the information required by this subsection (4)(d), the applicant shall complete a form developed by the director that requires the applicant to report only the following information regarding the action: (A) The name of the facility or entity that took the action; (B) The date the action was taken; (C) The type of action taken, including any terms and conditions of the action; (D) The duration of the action; and (E) Whether the applicant has fulfilled the terms or conditions of the action, if applicable. (II) Notwithstanding part 2 of this article 30, article 3 of title 25, and any provision of law to the contrary, the form completed by the applicant pursuant to this subsection (4)(d) is a public record and is not confidential. Compliance with this subsection (4)(d) does not constitute a waiver of any privilege or confidentiality conferred by any applicable state or federal law. (e) Any final action of an employer that results in the applicant's loss of employment where the grounds for termination constitute a violation of the laws governing the applicant's practice. To report the information required by this subsection (4)(e), the applicant shall complete a form developed by the director that requires the applicant to report only the following information regarding the action: (I) The name of the employer that terminated the employment; and (II) The date the termination occurred or became effective. (f) Any involuntary surrender of the applicant's federal drug enforcement administration registration. The applicant shall provide a copy of the order requiring the surrender of the registration to the director at the time the application is made. (g) Any final criminal conviction or plea arrangement resulting from the commission or alleged commission of a felony or crime of moral turpitude in any jurisdiction at any time after the applicant has been issued a license, certification, or registration to practice the applicant's health-care profession in any state or country. The applicant shall provide a copy of the final conviction or plea arrangement to the director at the time the application is made. from the commission or alleged commission of a felony or crime of moral turpitude in any jurisdiction at any time after the applicant has been issued a license, certification, or registration to practice the applicant's health-care profession in any state or country. The applicant shall provide a copy of the final conviction or plea arrangement to the director at the time the application is made. (h) Any final judgment against, settlement entered into by, or arbitration award paid on behalf of the applicant on or after September 1, 1990, for malpractice. To report the information required by this subsection (4)(h), the applicant shall complete a form developed by the director that requires the applicant to report only the following information regarding the malpractice action: (I) Whether the action was resolved by a final judgment against, settlement entered into by, or arbitration award paid on behalf of the applicant; (II) The date of the judgment, settlement, or arbitration award; (III) The location or jurisdiction in which the action occurred or was resolved; and (IV) The court in which the final judgment was ordered, the mediator that aided in the settlement, if applicable, or the arbitrator that granted the arbitration award. (i) Any refusal by an issuer of professional liability insurance to issue a policy to the applicant due to past claims experience. The applicant shall provide a copy of the refusal to the director at the time the application is made. (5) In addition to the information required by subsection (4) of this section, an applicant may submit information regarding awards and recognitions the applicant has received or charity care the applicant has provided. The director may remove information regarding awards and recognitions that the director finds to be unrelated to the applicant's profession or offensive or inappropriate. (6) The director shall make the information specified in subsections (4) and (5) of this section that is submitted by an applicant readily available to the public in a manner that allows the public to search the information by name, license number, board certification or specialty area, if applicable, or city of the applicant's address of record. The director may satisfy this requirement by posting and allowing the ability to search the information on the director's website or on the website for the applicable regulator that oversees the applicant's practice. If the information is made available on either website, the director shall ensure that the website is updated at least monthly and that the date on which the update occurs is indicated on the website. If the information made available pursuant to this subsection (6) is the same or substantially similar to information the director must make available pursuant to section 12-310-103 (3), the director may elect to use this database as the exclusive means for making the information required by section 12-310-103 (3) publicly available. the date on which the update occurs is indicated on the website. If the information made available pursuant to this subsection (6) is the same or substantially similar to information the director must make available pursuant to section 12-310-103 (3), the director may elect to use this database as the exclusive means for making the information required by section 12-310-103 (3) publicly available. (7) When disclosing information regarding an applicant to the public, the applicable regulator shall include the following statement or a similar statement that communicates the same meaning: Some studies have shown that there is no significant correlation between malpractice history and a [insert applicable type of health-care provider]'s competence. At the same time, the [insert name of applicable regulator] believes that consumers should have access to malpractice information. To make the best health-care decisions, you should view this information in perspective. You could miss an opportunity for high-quality care by selecting a health-care provider based solely on malpractice history. When considering malpractice data, please keep in mind: Malpractice histories tend to vary by profession and, as applicable, by specialty. Some professions or specialties are more likely than others to be the subject of litigation. You should take into account how long the health-care provider has been in practice when considering malpractice averages. The incident causing the malpractice claim may have happened years before a malpractice action is finally resolved. Sometimes, it takes a long time for a malpractice lawsuit to move through the legal system. Some health-care providers work primarily with high-risk patients. These health-care providers may have malpractice histories that are higher than average because they specialize in cases or patients who are at very high risk for problems. Settlement of a claim may occur for a variety of reasons that do not necessarily reflect negatively on the professional competence or conduct of the health-care provider. A payment in settlement of a malpractice action or claim should not be construed as creating a presumption that malpractice has occurred. You may wish to discuss information provided by the [insert name of applicable regulator], and malpractice generally, with your health-care provider. The information posted on the [applicable regulator's] website was provided by applicants for a license and applicants for renewal, reinstatement, or reactivation of a license. (8) (a) Except as specified in subsection (8)(b) of this section, an applicant, licensee, certificate holder, or registrant shall ensure that the information required by subsection (4) of this section is current and shall report any updated information and provide copies of the required documentation to the director within thirty days after the date of the action described in said subsection (4) or as otherwise provided in the part or article of this title 12 that regulates the applicant's, licensee's, certificate holder's, or registrant's profession to ensure that the information provided to the public is as accurate as possible. (b) An applicant shall report updated information regarding the applicant's employer, any health-care-related business ownership interests, and any health-care-related employment contracts or contracts establishing an independent contractor relationship, as required by subsection (4)(a) of this section, within one year after a change in that information. (9) (a) The director may impose an administrative fine not to exceed five thousand dollars against an applicant, licensee, certificate holder, or registrant who fails to comply with this section. The director shall notify the applicable regulator when the director imposes a fine pursuant to this subsection (9). Any fine imposed pursuant to this subsection (9) shall be deposited in the general fund. 9) (a) The director may impose an administrative fine not to exceed five thousand dollars against an applicant, licensee, certificate holder, or registrant who fails to comply with this section. The director shall notify the applicable regulator when the director imposes a fine pursuant to this subsection (9). Any fine imposed pursuant to this subsection (9) shall be deposited in the general fund. (b) The imposition of an administrative fine pursuant to this subsection (9) shall not constitute a disciplinary action pursuant to the laws governing the applicant's, licensee's, certificate holder's, or registrant's practice area and shall not preclude the applicable regulator from taking disciplinary action against an applicant, licensee, certificate holder, or registrant for failure to comply with this section. A license, certification, or registration shall not be issued, renewed, reinstated, or reactivated if the applicant has failed to pay a fine imposed pursuant to this subsection (9). (c) Failure of an applicant, licensee, certificate holder, or registrant to comply with this section constitutes unprofessional conduct or grounds for discipline under the specific part or article of this title 12 that regulates the applicant's, licensee's, certificate holder's, or registrant's profession. (10) Nothing in this section relieves an applicant, licensee, certificate holder, or registrant from the obligation to report adverse actions to the applicable regulator, as required by the applicable laws in this title 12 regulating that profession. (11) The director may adopt rules, as necessary, to implement this section. (12) This section is repealed, effective September 1, 2028. Before the repeal, the functions of the program under this section are scheduled for review in accordance with section 24-34-104.

C.R.S. § 12-30-103 Solicitation of accident victims - waiting period - definitions

12-30-103. Solicitation of accident victims - waiting period - definitions. (1) Except as permitted by subsection (2) of this section, neither a health-care practitioner nor an agent of a health-care practitioner shall engage in solicitation for professional employment concerning a personal injury unless the incident for which employment is sought occurred more than thirty days before the solicitation. (2) This section does not apply to any person providing emergency health care at the time of the incident or follow-up referrals to physicians from the emergency health-care providers. (3) Any agreement made in violation of this section is voidable at the option of the individual suffering the personal injury or the individual's authorized representative. (4) As used in this section: (a) "Health-care practitioner" means: (I) An acupuncturist licensed under article 200 of this title 12; (II) An audiologist licensed under article 210 of this title 12; (III) A chiropractor licensed under article 215 of this title 12; (IV) A dentist, dental therapist, or dental hygienist licensed under article 220 of this title 12; (V) A massage therapist licensed under article 235 of this title 12; (VI) A physician, physician assistant, or anesthesiologist assistant licensed under article 240 of this title 12; (VII) A psychologist, social worker, marriage and family therapist, professional counselor, or addiction counselor licensed under part 3, 4, 5, 6, or 8 of article 245 of this title 12; (VIII) A practical or professional nurse licensed under article 255 of this title 12; (IX) A nursing home administrator licensed under article 265 of this title 12; (X) An occupational therapist or occupational therapy assistant licensed under article 270 of this title 12; (XI) An optometrist licensed under article 275 of this title 12; (XII) A pharmacist licensed under article 280 of this title 12; (XIII) A physical therapist or physical therapist assistant licensed under article 285 of this title 12; (XIV) A podiatrist licensed under article 290 of this title 12; (XV) A psychiatric technician licensed under article 295 of this title 12; or (XVI) A respiratory therapist licensed under article 300 of this title 12. (b) "Solicitation" means an initial contact initiated in person, through any form of electronic or written communication, or by telephone, telegraph, or facsimile, any of which is directed to a specific individual, unless the contact is requested by the individual, a member of the individual's family, or the individual's authorized representative. "Solicitation" does not include radio, television, newspaper, or yellow pages advertisements.

C.R.S. § 12-30-104 Health-care prescriber boards - disciplinary procedures - definitions

12-30-104. Health-care prescriber boards - disciplinary procedures - definitions. (1) As used in this section, unless the context otherwise requires: (a) "Health-care prescriber board" or "board" means: (I) The Colorado podiatry board created in section 12-290-105; (II) The Colorado dental board created in section 12-220-105; (III) The Colorado medical board created in section 12-240-105; (IV) The state board of nursing created in section 12-255-105; (V) The state board of optometry created in section 12-275-107; and (VI) The state board of veterinary medicine created in section 12-315-106. (b) "Licensee" means an individual who is licensed or otherwise regulated by a board. (2) Except as specified in subsection (4) of this section, notwithstanding any other provision of law in title 24 or this title 12, each health-care prescriber board shall: (a) Within fifteen days after receipt of a complaint, provide the complainant with a written notice providing contact information for the board and a summary of the regulatory and statutory procedures, timelines, and complainant and respondent rights that apply to the processing and resolution of complaints, including, if the complainant is the patient of the licensee who is the subject of the complaint, a notice of the patient's right to receive from the licensee a copy of the complainant's patient records pursuant to sections 25-1-801 and 25-1-802; (b) If an investigation was initiated by a complaint and the board took public formal action regarding the alleged misconduct, provide the complainant, within thirty days after the action, with written notice of the action taken by the board; (c) If a complaint is still pending after six months, notify the complainant that the complaint remains pending, subject to applicable restrictions in the board's governing law; and (d) Update its website within thirty days after suspending or revoking a license to separately list each licensee subject to the suspension or revocation. (3) If patient records are potentially relevant to resolution of a complaint against a licensee and the licensee is the custodian of the records, the licensee shall provide the board with the patient records within thirty days after the board requests the records. (4) If any provision of article 4 of title 24, part 1 of article 255 of this title 12, or article 220, 240, 275, 290, or 315 of this title 12 is more protective of complainants' rights or results in a more expeditious resolution of disciplinary proceedings than a corresponding provision of this section, that provision applies rather than the corresponding provision of this section.

C.R.S. § 12-30-105 Nurse-physician advisory task force for Colorado health care - creation - duties - definition - repeal

12-30-105. Nurse-physician advisory task force for Colorado health care - creation - duties - definition - repeal. (1) There is hereby created, within the division, the nurse-physician advisory task force for Colorado health care, referred to in this section as "NPATCH". The purpose of the NPATCH is to promote public safety and improve health care in Colorado by supporting collaboration and communication between the practice of nursing, the practice as a certified midwife, and the practice of medicine. The NPATCH shall: (a) Promote patient safety and quality care; (b) Address issues of mutual concern at the interface of the practice of nursing, the practice as a certified midwife, and the practice of medicine; (c) Inform public policy-making; and (d) Make consensus recommendations to policy-making and rule-making entities, including recommendations to the executive director. (2) (a) The NPATCH consists of twelve members appointed as follows: (I) One member of the state board of nursing, appointed by the president of the board; (II) One member of the Colorado medical board, appointed by the president of the board; (III) Ten members appointed by the governor as follows: (A) Three members recommended by and representing a statewide professional nursing organization; (B) Three licensed physicians recommended by and representing a statewide physicians' organization that represents multi-specialty physicians and whose membership includes at least one-third of the doctors of medicine and osteopathy licensed in the state; (C) One member representing the nursing community who may or may not be a member of a statewide professional nursing organization; (D) One member representing the physician community who may or may not be a member of a statewide physicians' organization; and (E) Two members representing consumers. (b) The members of the NPATCH shall serve on a voluntary basis without compensation and shall serve three-year terms; except that, in order to ensure staggered terms of office, four of the initial appointees shall serve initial one-year terms and four of the initial appointees shall serve initial two-year terms. (3) (a) Except as provided in subsection (3)(b) of this section, the NPATCH may develop its own bylaws and procedures to govern its operations. (b) A recommendation of the NPATCH requires the consensus of the members of the task force. For purposes of this section, "consensus" means an agreement, decision, or recommendation that all members of the task force can actively support and that no member actively opposes. (4) The division shall staff the NPATCH. The division's costs for administering and staffing the NPATCH shall be funded by an increase in fees for professional and advanced practice registered nursing, certified midwife, and medical license renewal fees, as authorized in sections 12-240-130 and 12-255-107 (1)(b)(I), with fifty percent of the funding derived from the physician license renewal fees and fifty percent derived from the professional and advanced practice registered nursing and certified midwife license renewal fees. (5) The NPATCH shall prioritize consideration of and make recommendations on the following topics: (a) and (b) Repealed. (c) Quality assurance mechanisms for all medication prescribers; (d) Evidence-based guidelines; (e) Decision support tools; (f) Safe prescribing metrics for all medication prescribers; (g) Methods to foster effective communication between health professions; (h) Health-care delivery system integration and related improvements; (i) Physician standards, processes, and metrics to ensure appropriate consultation, collaboration, and referral regarding advanced practice registered nurse and certified midwife prescriptive authority; (j) Prescribing issues regarding providers other than physicians, advanced practice registered nurses, and certified midwives; (k) Alignment of health-care licensing with federal statutory minimums; Physician standards, processes, and metrics to ensure appropriate consultation, collaboration, and referral regarding advanced practice registered nurse and certified midwife prescriptive authority; (j) Prescribing issues regarding providers other than physicians, advanced practice registered nurses, and certified midwives; (k) Alignment of health-care licensing with federal statutory minimums; (l) Identification of unnecessary regulatory burdens or barriers; (m) Regulatory reforms that support health-care licensees to work at their full scope of practice; and (n) Feasibility of temporary candidate licenses for students nearing the completion of an accredited health-care program. At a minimum, the NPATCH must consider reimbursement, liability, and health and safety issues in its analysis. (6) The NPATCH shall make recommendations pursuant to this section to the executive director. (7) This section is repealed, effective September 1, 2027. Before the repeal, the functions of the NPATCH are scheduled for review in accordance with section 2-3-1203.

C.R.S. § 12-30-106 Health-care work force data collection

12-30-106. Health-care work force data collection. (1) The director of the division shall implement a system to collect health-care work force data from health-care professionals who are eligible for the Colorado health service corps pursuant to part 5 of article 1.5 of title 25, from practical and professional nurses and certified midwives licensed pursuant to part 1 of article 255 of this title 12, and from pharmacists licensed pursuant to article 280 of this title 12, collectively referred to in this section as "health-care professionals". Each health-care professional shall submit the data as part of the initial licensure process and upon the renewal of the health-care professional's license. Neither an executive department nor a board in an executive department is responsible for verifying the data or disciplining a health-care professional for noncompliance with this section. (2) (a) The director of the division shall request each health-care professional to provide data recommended by the director of the primary care office created pursuant to section 25-1.5-403 in the department of public health and environment. The director of the division has final approval authority regarding the form and manner of the data collected. The data collected concerns: (I) Each practice address of the health-care professional; (II) The number of hours the health-care professional provides direct patient care at each practice location; (III) Any specialties of the health-care professional, if applicable; (IV) Information about each practice setting type; (V) The health-care professional's education and training related to the health-care professional's profession; and (VI) The year of birth of the health-care professional. (b) The director of the division shall ensure that the data provided by health-care professionals is available to the primary care office in electronic format for analysis. A member of the public may request, in writing, unanalyzed data from the primary care office. Data available to the public must be limited to unique records that do not include names or other identifying information. (3) Repealed. (4) The director of the division may seek and accept gifts, grants, or donations from private or public sources for the purposes of this section; except that the director may not accept a gift, grant, or donation that is subject to conditions that are inconsistent with this section or any other law of the state. The director shall transmit all private and public money received through gifts, grants, or donations to the state treasurer, who shall credit the money to the division of professions and occupations cash fund created in section 12-20-105. The money in the fund is subject to annual appropriation by the general assembly to the director for the direct and indirect costs associated with implementing this section.

C.R.S. § 12-30-107 Mammography report - dense breast tissue - required notice

12-30-107. Mammography report - dense breast tissue - required notice. (1) Each person who is required by 42 U.S.C. sec. 263b to provide a patient, the patient's physician, or a medical institution with a mammography report and who has determined that the patient has dense breast tissue, as determined by the interpreting physician based on breast imaging reporting and data system standards promulgated by the American College of Radiology, shall include the following notice with the mammography report: Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the results of your mammogram and may also be associated with an increased risk of breast cancer. This information about the results of your mammogram is given to you to raise your awareness and to inform your conversations with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your physician. (2) Notwithstanding any other law, this section does not create a cause of action or create a standard of care, obligation, or duty that provides a basis for a cause of action.

C.R.S. § 12-30-108 Confidential agreement to limit practice - violation grounds for discipline

12-30-108. Confidential agreement to limit practice - violation grounds for discipline. (1) (a) If a licensee, registrant, or certificate holder has a physical illness, physical condition, or behavioral or mental health disorder that renders the person unable to practice the applicable health-care profession or occupation with reasonable skill and safety to patients or clients, the licensee, registrant, or certificate holder shall notify the regulator that regulates the person's profession or occupation of the physical illness, physical condition, or behavioral or mental health disorder in a manner and within a period determined by the regulator. (b) The regulator may require the licensee, registrant, or certificate holder to submit to an examination or refer the licensee, registrant, or certificate holder to a peer health assistance program, if one exists, to evaluate the extent of the physical illness, physical condition, or behavioral or mental health disorder and its effect on the licensee's, registrant's, or certificate holder's ability to practice with reasonable skill and safety to patients or clients. (2) (a) Upon determining that a licensee, registrant, or certificate holder with a physical illness, physical condition, or behavioral or mental health disorder is able to render limited services with reasonable skill and safety to patients or clients, the regulator may enter into a confidential agreement with the licensee, registrant, or certificate holder in which the licensee, registrant, or certificate holder agrees to limit the person's practice based on the restrictions imposed by the physical illness, physical condition, or behavioral or mental health disorder, as determined by the regulator. (b) As part of the agreement, the licensee, registrant, or certificate holder is subject to periodic reevaluations or monitoring as determined appropriate by the regulator. The regulator may refer the licensee, registrant, or certificate holder to a peer assistance health program, if one exists, for reevaluation or monitoring. (c) The parties may modify or dissolve the agreement as necessary based on the results of a reevaluation or of monitoring. (3) By entering into an agreement with the regulator pursuant to this section, the licensee, registrant, or certificate holder is not engaging in activities that constitute grounds for discipline. The agreement does not constitute a restriction or discipline by the regulator. However, if the licensee, registrant, or certificate holder fails to comply with the terms of an agreement entered into pursuant to this section, the failure constitutes grounds for discipline or unprofessional conduct, as applicable, and the licensee, registrant, or certificate holder is subject to discipline in accordance with section 12-20-404 and the part or article of this title 12 that governs the particular profession or occupation. (4) (a) This section does not apply to: (I) The following health-care professionals: (A) Repealed. (B) Hearing aid providers regulated pursuant to article 230 of this title 12; (C) Repealed. (D) Nurse aides regulated pursuant to article 255 of this title 12; or (E) Nursing home administrators regulated pursuant to article 265 of this title 12; or (F) to (H) Repealed. (II) A licensee, registrant, or certificate holder subject to discipline for habitual or excessive use or abuse of alcohol beverages, a habit-forming drug, or a controlled substance as defined in section 18-18-102 (5). (b) Repealed.

C.R.S. § 12-30-109 Prescriptions - limitations - definition - rules

12-30-109. Prescriptions - limitations - definition - rules. (1) (a) A prescriber shall not prescribe more than a seven-day supply of an opioid to a patient who has not obtained an opioid prescription from that prescriber within the last twelve months and may exercise discretion to include a second fill for a seven-day supply. The limits on initial prescribing do not apply if, in the judgment of the prescriber, the patient: (I) Has chronic pain that typically lasts longer than ninety days or past the time of normal healing, as determined by the prescriber, or following transfer of care from another prescriber who practices the same profession and who prescribed an opioid to the patient; (II) Has been diagnosed with cancer and is experiencing cancer-related pain; (III) Is experiencing post-surgical pain that, because of the nature of the procedure, is expected to last more than fourteen days; or (IV) Is undergoing palliative care or hospice care focused on providing the patient with relief from symptoms, pain, and stress resulting from a serious illness in order to improve quality of life; except that this subsection (1)(a)(IV) applies only if the prescriber is a physician, a physician assistant, or an advanced practice registered nurse. (b) Prior to prescribing any opioid or benzodiazepine prescription pursuant to this section, a prescriber must comply with section 12-280-404 (4). Failure to comply with section 12-280-404 (4) constitutes unprofessional conduct or grounds for discipline, as applicable, under section 12-220-201, 12-240-121, 12-245-224, 12-255-120, 12-275-120, 12-290-108, or 12-315-112, as applicable to the particular prescriber, only if the prescriber repeatedly fails to comply. (2) A prescriber licensed pursuant to article 315 of this title 12 may prescribe opioids and benzodiazepines electronically. (3) A violation of this section does not create a private right of action or serve as the basis of a cause of action. A violation of this section does not constitute negligence per se or contributory negligence per se and does not alone establish a standard of care. Compliance with this section does not alone establish an absolute defense to any alleged breach of the standard of care. (4) As used in this section, "prescriber" means: (a) A dentist licensed pursuant to article 220 of this title 12; (b) A physician or physician assistant licensed pursuant to article 240 of this title 12; (c) An advanced practice registered nurse or certified midwife with prescriptive authority pursuant to section 12-255-112; (d) An optometrist licensed pursuant to article 275 of this title 12; (e) A podiatrist licensed pursuant to article 290 of this title 12; or (f) Repealed. (g) A licensed psychologist with prescriptive authority pursuant to section 12-245-309. (5) Repealed. (6) On or before November 1, 2021, the applicable board for each prescriber shall, by rule, limit the supply of a benzodiazepine that a prescriber may prescribe to a patient who has not obtained a benzodiazepine prescription from a prescriber within the last twelve months; except that the rules must not limit the supply of a benzodiazepine prescribed to treat epilepsy, a seizure or seizure disorder, a suspected seizure disorder, spasticity, alcohol withdrawal, or a neurological condition, including a posttraumatic brain injury or catatonia. The rules must allow for appropriate tapering off of benzodiazepines and must not require or encourage abrupt discontinuation or withdrawal of benzodiazepines. (7) Each prescriber licensed in this state who holds a current registration issued by the federal drug enforcement administration shall register and maintain a user account as specified in section 12-280-403.

C.R.S. § 12-30-109.5 Prescription drugs for treatment of chronic pain - patients - prescribers - definitions

12-30-109.5. Prescription drugs for treatment of chronic pain - patients - prescribers - definitions. (1) As used in this section, unless the context otherwise requires: (a) "Carrier" has the same meaning as set forth in section 10-16-102 (8). (b) (I) "Chronic pain" means a pain that typically lasts three months or longer and may be the result of an underlying medical disease or condition, injury, medical treatment, inflammation, or unknown cause. "Chronic pain" is a pain state in which the cause of the pain often cannot be removed with reasonable medical efforts at the consent of the patient, or pain for which no cure can be found after reasonable medical efforts. Chronic pain may restrict the ability of individuals to work, care for themselves, and engage in basic life, social, and physical activities. (II) Conditions associated with chronic pain may include, but are not limited to, cancer and the recovery period, sickle cell disease, noncancer pain, rare diseases, severe injuries, and health conditions requiring the provision of palliative care or hospice care. (III) Reasonable efforts for relieving or curing the cause of the chronic pain may be determined on the basis of, but are not limited to, the following: (A) When treating a nonterminally ill patient for chronic pain, an evaluation conducted by the treating health-care provider or a health-care provider specializing in pain medicine or treatment of the area, system, or organ of the body confirmed or perceived as the source of the chronic pain; or (B) When treating a terminally ill patient, an evaluation conducted by the treating health-care provider who conducts the evaluation in accordance with the standard of care and the level of care, skill, and treatment that would be recognized by a health-care provider under similar conditions and circumstances. (c) "Drug diversion" means the unlawful transfer of prescription drugs from a licit medical purpose to the illicit marketplace. (d) "Health-care provider" means a physician, a physician assistant, or an advanced practice registered nurse licensed pursuant to this title 12. (e) "Rare disease" means a disease, disorder, or condition that affects fewer than two hundred thousand individuals in the United States and is chronic, serious, life-altering, or life-threatening. (f) "Schedule II, III, IV, or V controlled substance" means a controlled substance as described in section 18-18-204, 18-18-205, 18-18-206, or 18-18-207, respectively. (2) Criteria for the evaluation and treatment of chronic pain. When treating a nonterminally ill patient, the evaluation of the patient and the treatment of the patient's chronic pain is governed by the following criteria: (a) A diagnosis of a condition causing chronic pain by the treating health-care provider or a health-care provider specializing in pain medicine or treatment of the area, system, or organ of the body confirmed or perceived as the source of the pain that is sufficient to meet the definition of chronic pain; and and the treatment of the patient's chronic pain is governed by the following criteria: (a) A diagnosis of a condition causing chronic pain by the treating health-care provider or a health-care provider specializing in pain medicine or treatment of the area, system, or organ of the body confirmed or perceived as the source of the pain that is sufficient to meet the definition of chronic pain; and (b) The cause of the diagnosis of chronic pain must not interfere with medically necessary treatment, including but not limited to prescribing or administering a schedule II, III, IV, or V controlled substance. (3) Prescription and administration of controlled substances for chronic pain. (a) Notwithstanding any other provision of law, a health-care provider may prescribe, dispense, or administer a schedule II, III, IV, or V controlled substance to a patient in the course of the health-care provider's treatment of the patient for a diagnosed condition causing chronic pain. A health-care provider is not subject to disciplinary action by the regulator for appropriately prescribing, dispensing, or administering a schedule II, III, IV, or V controlled substance in the course of treatment of a patient for chronic pain if the health-care provider keeps accurate records of the purpose, use, prescription, and disposal of the controlled substance, writes accurate prescriptions, and prescribes medications in accordance with a legitimate medical purpose in the usual course of professional practice. (b) A health-care provider acting in good faith and based on the needs of the patient with a diagnosed condition causing chronic pain is not subject to discipline from the regulator solely for prescribing a dosage that equates to an upward deviation from morphine milligram equivalent dosage recommendations or from thresholds specified in state or federal opioid prescribing guidelines or policies. (c) A health-care provider treating a patient with chronic pain by prescribing, dispensing, or administering one or more schedule II, III, IV, or V controlled substances that include, but are not limited to, opioid analgesics shall not be required to taper a patient's medication dosage solely to meet a predetermined morphine milligram equivalent dosage recommendation or threshold if the patient is stable and compliant with the treatment plan and is not experiencing serious harm from the level of medication currently being prescribed or previously prescribed. A decision to taper or maintain medication must include an individualized assessment of the patient's current medical condition and treatment plan, the risks and benefits of maintaining or tapering the patient's medication, and a discussion with the patient. (d) (I) A pharmacy, carrier, or pharmacy benefit manager shall not have a policy in place that requires the pharmacist to refuse to fill a prescription for an opiate issued by a health-care provider with the authority to prescribe opiates solely because the prescription is for an opiate or because the prescription order exceeds a predetermined morphine milligram equivalent dosage recommendation or threshold. (II) A health-care practice or clinic in which a health-care provider is authorized to prescribe schedule II, III, IV, or V controlled substances shall not have a policy in place that requires the health-care provider to refuse to prescribe, administer, or dispense a prescription for an opiate solely because the prescription exceeds a predetermined morphine milligram equivalent dosage recommendation or threshold. re practice or clinic in which a health-care provider is authorized to prescribe schedule II, III, IV, or V controlled substances shall not have a policy in place that requires the health-care provider to refuse to prescribe, administer, or dispense a prescription for an opiate solely because the prescription exceeds a predetermined morphine milligram equivalent dosage recommendation or threshold. (e) Before treating a patient for chronic pain in accordance with this subsection (3), a health-care provider shall discuss with the patient or the patient's legal guardian, if applicable, the risks associated with the schedule II, III, IV, or V controlled substance to be prescribed or administered in the course of the health-care provider's treatment of the patient and document the discussion in the patient's record. (4) Limits on applicability. (a) This section does not apply to: (I) A health-care provider's treatment of a patient for a substance use disorder resulting from the use of a schedule II, III, IV, or V controlled substance; (II) The prescription or administration of a schedule II, III, IV, or V controlled substance to a patient whom the health-care provider knows to be using the controlled substance for nontherapeutic or drug diversion purposes; (III) The prescription, dispensing, or administration of a schedule II, III, IV, or V controlled substance for the purpose of terminating the life of a patient with chronic pain; or (IV) The prescription, dispensing, or administration of a schedule II, III, IV, or V controlled substance that is not a controlled substance approved by the federal food and drug administration for pain relief. (b) This section does not limit the powers and duties of the Colorado medical board pursuant to section 12-240-106 or the state board of nursing pursuant to section 12-255-107.

C.R.S. § 12-30-110 Prescribing or dispensing opioid antagonists - authorized recipients - definitions

12-30-110. Prescribing or dispensing opioid antagonists - authorized recipients - definitions. (1) (a) A prescriber may prescribe or dispense, directly or in accordance with standing orders and protocols, an opioid antagonist to: (I) An individual at risk of experiencing an opioid-related drug overdose event; (II) A family member, friend, or other person in a position to assist an individual at risk of experiencing an opioid-related drug overdose event; (III) An employee or volunteer of a harm reduction organization; (IV) A law enforcement agency or first responder; (V) A school district, school, or employee or agent of a school or an employee or agent of the school district, a district school, the charter school institute, an institute charter school, or a nonpublic school who operates or is on a school bus; (VI) A person described in section 25-20.5-1001; (VII) A unit of local government; (VIII) An institution of higher education or an employee or agent of the institution of higher education; (IX) A library or an employee or agent of the library; (X) A community service organization or an employee or agent of the community service organization; (XI) A religious organization or an employee or agent of the religious organization; (XII) A local jail or an employee or agent of the local jail; (XIII) A multijurisdictional jail or an employee or agent of the multijurisdictional jail; (XIV) A municipal jail or an employee or agent of the municipal jail; (XV) A correctional facility or an employee or agent of the correctional facility; (XVI) A private contract prison or an employee or agent of the private contract prison; (XVII) A community corrections program or an employee or agent of the community corrections program; (XVIII) A pretrial services program or an employee or agent of the pretrial services program; (XIX) A probation department or an employee or agent of the probation department; (XX) A local public health agency or an employee or agent of the local public health agency; or (XXI) A mental health professional. (b) A person or entity described in subsection (1)(a) of this section may, pursuant to an order or standing orders and protocols: (I) Possess an opioid antagonist; (II) Furnish an opioid antagonist to a family member, friend, or other person who is in a position to assist an individual who is at risk of experiencing an opioid-related drug overdose event; or (III) Administer an opioid antagonist to an individual experiencing, or who a reasonable person would believe is experiencing, an opioid-related drug overdose event. (2) (a) A prescriber who prescribes or dispenses an opioid antagonist pursuant to this section is strongly encouraged to educate persons receiving the opioid antagonist on the use of an opioid antagonist for overdose, including instruction concerning risk factors for overdose, recognizing an overdose, calling emergency medical services, rescue breathing, and administering an opioid antagonist. (b) An entity described in subsection (1)(a) of this section is strongly encouraged to educate employees, agents, and volunteers, as well as persons receiving an opioid antagonist from the entity described in subsection (1)(a) of this section, on the use of an opioid antagonist for overdose, including instruction concerning risk factors for overdose, recognizing an overdose, calling emergency medical services, rescue breathing, and administering an opioid antagonist. (3) A prescriber described in subsection (7)(h) of this section does not engage in unprofessional conduct or is not subject to discipline pursuant to section 12-240-121, 12-255-120, or 12-280-126, as applicable, if the prescriber issues standing orders and protocols regarding opioid antagonists or prescribes or dispenses, pursuant to an order or standing orders and protocols, an opioid antagonist in a good faith effort to assist: section (7)(h) of this section does not engage in unprofessional conduct or is not subject to discipline pursuant to section 12-240-121, 12-255-120, or 12-280-126, as applicable, if the prescriber issues standing orders and protocols regarding opioid antagonists or prescribes or dispenses, pursuant to an order or standing orders and protocols, an opioid antagonist in a good faith effort to assist: (a) An individual who is at risk of experiencing an opioid-related drug overdose event; (b) A family member, friend, or other person who is in a position to assist an individual who is at risk of experiencing an opioid-related drug overdose event; or (c) A person or entity described in subsection (1)(a) of this section in responding to, treating, or otherwise assisting an individual who is experiencing or is at risk of experiencing an opioid-related drug overdose event or a friend, family member, or other person in a position to assist an at-risk individual. (3.5) (a) Notwithstanding any provision of this title 12 or rules implementing this title 12, a prescriber prescribing or dispensing an opioid antagonist in accordance with this section, other than a pharmacist or other prescriber prescribing and dispensing from a prescription drug outlet or pharmacy, is not required to comply with laws relating to labeling, storage, or record keeping for the opioid antagonist. (b) A prescriber prescribing or dispensing an opioid antagonist exempted from labeling, storage, or record-keeping requirements pursuant to this subsection (3.5): (I) Does not engage in unprofessional conduct or is not subject to discipline pursuant to section 12-240-121 or 12-255-120, as applicable; and (II) Is not subject to civil liability or criminal prosecution, as specified in sections 13-21-108.7 (4) and 18-1-712 (3), respectively. (4) (a) A prescriber who prescribes or dispenses an opioid antagonist in accordance with this section is not subject to civil liability or criminal prosecution, as specified in sections 13-21-108.7 (4) and 18-1-712 (3), respectively. (b) A person or entity described in subsection (1)(a) of this section acting in accordance with this section is not subject to civil liability or criminal prosecution, as specified in sections 13-21-108.7 (3) and 18-1-712 (2), respectively. (5) This section does not establish a duty or standard of care for prescribers regarding the prescribing, dispensing, or administering of an opioid antagonist. (6) Nothing in this section limits or otherwise affects the prescriptive authority of a health-care professional licensed under article 220, 275, 290, or 315 of this title 12. (7) As used in this section: (a) "Community corrections program" has the same meaning as set forth in section 17-27-102 (3). (a.3) "Community service organization" means a nonprofit organization that is in good standing and registered with the federal internal revenue service and the Colorado secretary of state's office that provides services to an individual at risk of experiencing an opioid-related drug overdose event or to the individual's family members, friends, or other persons in a position to assist the individual. (a.5) "Correctional facility" has the same meaning as set forth in section 17-1-102 (1.7). (a.7) "First responder" means: (I) A peace officer, as defined in section 16-2.5-101; (II) A firefighter, as defined in section 29-5-203 (10); (III) A volunteer firefighter, as defined in section 31-30-1102 (9); or (IV) An emergency medical service provider, as defined in section 25-3.5-103 (8). idual. (a.5) "Correctional facility" has the same meaning as set forth in section 17-1-102 (1.7). (a.7) "First responder" means: (I) A peace officer, as defined in section 16-2.5-101; (II) A firefighter, as defined in section 29-5-203 (10); (III) A volunteer firefighter, as defined in section 31-30-1102 (9); or (IV) An emergency medical service provider, as defined in section 25-3.5-103 (8). (b) "Harm reduction organization" means an organization that provides services, including medical care, counseling, homelessness services, or drug treatment, to individuals at risk of experiencing an opioid-related drug overdose event or to the friends and family members of an at-risk individual. (b.2) "Institution of higher education" means a public or nonpublic institution that awards any type of postsecondary certificate, degree, or other credential and is located in Colorado. (b.3) "Local jail" has the same meaning as set forth in section 17-1-102 (7). (b.4) "Local public health agency" means an agency established pursuant to section 25-1-506. (b.5) "Mental health professional" means a psychologist, social worker, marriage and family therapist, licensed professional counselor, unlicensed psychotherapist, or addiction counselor licensed, registered, or certified under article 245 of this title 12. (b.7) "Multijurisdictional jail" has the same meaning as described in section 17-26.5-101. (b.8) "Municipal jail" has the same meaning as described in section 31-15-401 (1)(j). (c) "Opioid" has the same meaning as "opiate", as set forth in section 18-18-102 (21). (d) "Opioid antagonist" means naloxone hydrochloride or any similarly acting drug that is not a controlled substance and that is approved by the federal food and drug administration for the treatment of a drug overdose. "Opioid antagonist" includes an expired opioid antagonist. (e) "Opioid-related drug overdose event" means an acute condition, including a decreased level of consciousness or respiratory depression, that: (I) Results from the consumption or use of a controlled substance or another substance with which a controlled substance was combined; (II) A layperson would reasonably believe to be caused by an opioid-related drug overdose event; and (III) Requires medical assistance. (f) "Order" has the same meaning as set forth in section 12-280-103 (31). (g) "Pharmacist" means an individual licensed by the state pursuant to article 280 of this title 12 to engage in the practice of pharmacy. (h) "Prescriber" means: (I) A physician or physician assistant licensed pursuant to article 240 of this title 12; (II) An advanced practice registered nurse, as defined in section 12-255-104 (1), or a certified midwife, as defined in section 12-255-104 (3.2), with prescriptive authority pursuant to section 12-255-112; or (III) A pharmacist. (h.3) "Pretrial services program" has the same meaning as described in section 16-4-106. (h.7) "Private contract prison" has the same meaning as set forth in section 17-1-102 (7.3). (i) "Protocol" means a specific written plan for a course of medical treatment containing a written set of specific directions created by a physician, group of physicians, hospital medical committee, pharmacy and therapeutics committee, or other similar practitioners or groups of practitioners with expertise in the use of opioid antagonists. (i.5) "School" means an elementary or secondary public or nonpublic school whose governing authority has adopted and implemented a policy pursuant to section 22-1-119.1. (j) "Standing order" means a prescription order written by a prescriber that is not specific to and does not identify a particular patient. (k) "Unit of local government" has the same meaning as set forth in section 29-3.5-101 (4).

C.R.S. § 12-30-111 Electronic prescribing of controlled substances - exceptions - rules - definitions

12-30-111. Electronic prescribing of controlled substances - exceptions - rules - definitions. (1) (a) Except as provided in subsection (1)(b) of this section, on and after July 1, 2021, a prescriber shall prescribe a controlled substance, as defined in section 18-18-102 (5), that is included in schedule II, III, or IV pursuant to part 2 of article 18 of title 18, only by electronic prescription transmitted to a pharmacy unless: (I) At the time of issuing the prescription, electronic prescribing is not available due to technological or electrical failure; (II) The prescription is to be dispensed at a pharmacy that is located outside of this state; (III) The prescriber is dispensing the controlled substance to the patient; (IV) The prescription includes elements that are not supported by the most recent version of the National Council for Prescription Drug Programs SCRIPT Standard and 21 CFR 1311; (V) The federal food and drug administration or drug enforcement administration requires the prescription for the particular controlled substance to contain elements that cannot be satisfied with electronic prescribing; (VI) The prescription is not specific to a patient and allows dispensing of the prescribed controlled substance: (A) Pursuant to a standing order, approved protocol of drug therapy, or collaborative drug management or comprehensive medication management plan; (B) In response to a public health emergency; or (C) Under other circumstances that permit the prescriber to issue a prescription that is not patient-specific; (VII) The prescription is for a controlled substance under a research protocol; (VIII) The prescriber writes twenty-four or fewer prescriptions for controlled substances per year; (IX) The prescriber is prescribing a controlled substance to be administered to a patient in a hospital, nursing care facility, hospice care facility, dialysis treatment clinic, or assisted living residence or to a person who is in the custody of the department of corrections; (X) The prescriber reasonably determines that the patient would be unable to obtain controlled substances prescribed electronically in a timely manner and that the delay would adversely affect the patient's medical condition; or (XI) The prescriber demonstrates economic hardship in accordance with rules adopted by the regulator pursuant to subsection (2)(b) of this section. (b) A prescriber who is a licensed dentist or who is practicing in a rural area of the state or in a practice consisting of only one prescriber shall comply with this subsection (1) on and after July 1, 2023. (2) The regulator for each prescriber subject to this section shall adopt rules: (a) Defining what constitutes a temporary technological or electrical failure for purposes of subsection (1)(a)(I) of this section; and (b) Defining economic hardship for purposes of subsection (1)(a)(XI) of this section and establishing: (I) The process for a prescriber to demonstrate economic hardship, including the information required to be submitted to allow the regulator to make a determination; (II) The period during which the economic hardship exception is effective, which period must not exceed one year; and (III) A process for a prescriber to apply to renew an economic hardship exception, including the information required to be submitted that demonstrates the prescriber's continuing need for the exception. (3) (a) This section does not: (I) Create a private right of action; (II) Serve as the basis of a cause of action; or (III) Establish a standard of care. (b) A violation of this section does not constitute negligence per se or contributory negligence per se. (4) As used in this section: information required to be submitted that demonstrates the prescriber's continuing need for the exception. (3) (a) This section does not: (I) Create a private right of action; (II) Serve as the basis of a cause of action; or (III) Establish a standard of care. (b) A violation of this section does not constitute negligence per se or contributory negligence per se. (4) As used in this section: (a) "Prescriber" means: (I) A dentist licensed pursuant to article 220 of this title 12; (II) A physician or physician assistant licensed pursuant to article 240 of this title 12; (III) An advanced practice registered nurse or certified midwife with prescriptive authority pursuant to section 12-255-112; (IV) An optometrist licensed pursuant to article 275 of this title 12; or (V) A podiatrist licensed pursuant to article 290 of this title 12. (b) "Rural area" means a county located in a nonmetropolitan area in the state that either: (I) Has no municipality within its territorial boundaries with fifty thousand or more permanent residents based upon the most recent population estimates published by the United States census bureau; or (II) Satisfies alternate criteria for the designation of a rural area as may be promulgated by the federal office of management and budget.

C.R.S. § 12-30-112 Health-care providers - required disclosures - balance billing - deceptive trade practice - rules - definitions

12-30-112. Health-care providers - required disclosures - balance billing - deceptive trade practice - rules - definitions. (1) As used in this section and section 12-30-113: (a) "Ancillary services" means: (I) Diagnostic services, including radiology and laboratory services, unless excluded by rule of the secretary of the United States department of health and human services pursuant to 42 U.S.C. sec. 300gg-132 (b)(3); (II) Items and services related to emergency medicine, anesthesiology, pathology, radiology, and neonatology, whether or not provided by a physician or nonphysician provider, unless excluded by rule of the secretary of the United States department of health and human services pursuant to section 2799B-2 (b)(3) of the federal "No Surprises Act"; (III) Items and services provided by assistant surgeons, hospitalists, and intensivists, unless excluded by rule of the secretary of the United States department of health and human services pursuant to section 2799B-2 (b)(3) of the federal "No Surprises Act"; (IV) Items and services provided by an out-of-network provider if there is no in-network provider who can furnish the needed services at the facility; and (V) Any other items and services provided by specialty providers as established by rule of the commissioner of insurance. (a.3) "Balance bill" has the same meaning as set forth in section 10-16-704 (19)(c). (a.5) "Carrier" has the same meaning as set forth in section 10-16-102 (8). (b) "Covered person" has the same meaning as defined in section 10-16-102 (15). (c) "Emergency services" has the same meaning as set forth in section 10-16-704 (19)(e). (c.5) "Federal 'No Surprises Act'" means the federal "No Surprises Act", Pub.L. 116-260, as amended. (d) "Geographic area" has the same meaning as set forth in section 10-16-704 (19)(h). (e) "Health benefit plan" has the same meaning as defined in section 10-16-102 (32). (f) "Medicare reimbursement rate" has the same meaning as set forth in section 10-16-704 (19)(k). (g) "Out-of-network provider" means a health-care provider that is not a participating provider. (h) "Participating provider" has the same meaning as set forth in section 10-16-102 (46). (2) On and after January 1, 2020, health-care providers shall develop and provide disclosures to consumers about the potential effects of receiving emergency or nonemergency services from an out-of-network provider. The disclosures must comply with the rules adopted pursuant to subsection (3) of this section. (3) The regulator, in consultation with the commissioner of insurance and the state board of health created in section 25-1-103, shall adopt rules that specify the requirements for health-care providers to develop and provide consumer disclosures in accordance with this section. The regulator shall ensure that the rules, at a minimum, comply with the notice and consent requirements in subsection (3.5) of this section and the federal "No Surprises Act". (3.5) (a) An out-of-network provider may balance bill a covered person for post-stabilization services in accordance with section 10-16-704 and covered nonemergency services in an in-network facility that are not ancillary services if: (I) The out-of-network provider provides written notice that the provider will balance bill a covered person at least seventy-two hours in advance of the date of service, if the appointment was scheduled at least seventy-two hours in advance, or at least three hours before the scheduled appointment, if the appointment was made less than seventy-two hours in advance, in either paper or electronic format as selected by the covered person. The notice must be available in the fifteen most common languages in the geographic region in which the out-of-network provider is located. The notice must state: (A) If applicable, that the health-care provider is out of network with respect to the covered person's health benefit plan; less than seventy-two hours in advance, in either paper or electronic format as selected by the covered person. The notice must be available in the fifteen most common languages in the geographic region in which the out-of-network provider is located. The notice must state: (A) If applicable, that the health-care provider is out of network with respect to the covered person's health benefit plan; (B) Effective upon the implementation date of the applicable federal rules, a good-faith estimate of the amount of the charges for which the covered person may be responsible; (C) That the estimate or consent to treatment does not constitute a contract for services; (D) If the facility is a participating provider and the health-care provider is an out-of-network provider, a list of participating providers at the facility who are able to provide the same services; (E) Information about whether prior authorization or other care management limitations may be required in advance of receiving the requested services; and (F) That consent to receive the services from an out-of-network provider is optional and that the covered person may seek services from a participating provider, in which case the cost-sharing responsibility of the covered person would not exceed the responsibility for in-network benefits under the covered person's health benefit plan; (II) The out-of-network provider obtains signed consent from the covered person that acknowledges that the covered person has been: (A) Provided with written notice of the covered person's financial responsibility, in the format and language selected by the covered person and within the applicable periods specified in subsection (3.5)(a)(I) of this section; and (B) Provided written notice that the payment by the covered person for health-care services provided by the out-of-network provider may not accrue toward meeting any limitation that the health benefit plan places on cost sharing, including an explanation that the payment may not apply to an in-network deductible. (b) If the notice in subsection (3.5)(a)(I) of this section is received within ten days before a scheduled service, the covered person may elect to use the out-of-network provider at the in-network benefit level, and the provider must be reimbursed for the services in accordance with section 10-16-704 (3)(d)(II). (c) The notice and consent required by this subsection (3.5) must include the date and the time at which the covered person received the written notice and the date on which the consent form was signed. The out-of-network provider shall provide a signed copy of the consent form to the covered person through regular or electronic mail. (d) An out-of-network provider that obtains a signed consent with respect to furnishing an item or service shall retain the signed consent for at least a seven-year period after the date on which such item or service is furnished. (3.7) An out-of-network provider shall not balance bill a covered person for services if the provisions of section 10-16-705 (4.5)(c)(II) apply. (4) Receipt of the disclosures required by this section does not waive a consumer's protections under section 10-16-704 (3) or (5.5) or the consumer's right to benefits under the consumer's health benefit plan at the in-network benefit level for all covered services and treatment received. (5) This section does not apply to service agencies, as defined in section 25-3.5-103 (11.5), that are publicly funded fire agencies. (6) A violation of this section is a deceptive trade practice pursuant to section 6-1-105 (1)(xxx).

C.R.S. § 12-30-113 Out-of-network health-care providers - out-of-network services - billing - payment - deceptive trade practice

12-30-113. Out-of-network health-care providers - out-of-network services - billing - payment - deceptive trade practice. (1) If an out-of-network health-care provider provides emergency services or covered nonemergency services to a covered person at an in-network facility, the out-of-network provider shall: (a) Submit a claim for the entire cost of the services to the covered person's carrier; and (b) Not bill or collect payment from a covered person for any outstanding balance for covered services not paid by the carrier, except for the applicable in-network coinsurance, deductible, or copayment amount required to be paid by the covered person. (2) (a) If an out-of-network health-care provider provides covered nonemergency services at an in-network facility or emergency services at an out-of-network or in-network facility and the health-care provider receives payment from the covered person for services for which the covered person is not responsible pursuant to section 10-16-704 (3)(b) or (5.5), the health-care provider shall reimburse the covered person within sixty calendar days after the date that the overpayment was reported to the provider. (b) An out-of-network health-care provider that fails to reimburse a covered person as required by subsection (2)(a) of this section for an overpayment shall pay interest on the overpayment at the rate of ten percent per annum beginning on the date the provider received the notice of the overpayment. The covered person is not required to request the accrued interest from the out-of-network health-care provider in order to receive interest with the reimbursement amount. (3) An out-of-network health-care provider shall provide a covered person a written estimate of the amount for which the covered person may be responsible for covered nonemergency services within three business days after a request from the covered person. (4) (a) An out-of-network health-care provider must send a claim for a covered service to the carrier within one hundred eighty days after the receipt of insurance information in order to receive reimbursement as specified in this subsection (4)(a). The reimbursement rate is the greater of: (I) One hundred ten percent of the carrier's median in-network rate of reimbursement for that service provided in the same geographic area; or (II) The sixtieth percentile of the in-network rate of reimbursement for the same service in the same geographic area for the prior year based on claims data from the all-payer health claims database described in section 25.5-1-204. (b) If the out-of-network health-care provider submits a claim for covered services after the one-hundred-eighty-day period specified in subsection (4)(a) of this section, the carrier shall reimburse the health-care provider one hundred twenty-five percent of the medicare reimbursement rate for the same services in the same geographic area. (c) The health-care provider shall not bill a covered person any outstanding balance for a covered service not paid for by the carrier, except for any coinsurance, deductible, or copayment amount required to be paid by the covered person. (5) A health-care provider may initiate arbitration pursuant to section 10-16-704 (15) if the health-care provider believes the payment made pursuant to subsection (4) of this section is not sufficient. (6) A violation of this section is a deceptive trade practice pursuant to section 6-1-105 (1)(xxx).

C.R.S. § 12-30-114 Demonstrated competency - opiate prescribers - rules - definition

12-30-114. Demonstrated competency - opiate prescribers - rules - definition. (1) (a) The regulator for each licensed health-care provider, in consultation with the center for research into substance use disorder prevention, treatment, and recovery support strategies created in section 27-80-118, shall promulgate rules that require each licensed health-care provider, as a condition of renewing, reactivating, or reinstating a license on or after October 1, 2022, to complete up to four credit hours of training per licensing cycle in order to demonstrate competency regarding: (I) Best practices for opioid prescribing, according to the most recent version of the division's guidelines for the safe prescribing and dispensing of opioids; (II) The potential harm of inappropriately limiting prescriptions to chronic pain patients; (III) Best practices for prescribing benzodiazepines; (IV) Recognition of substance use disorders; (V) Referral of patients with substance use disorders for treatment; and (VI) The use of the electronic prescription drug monitoring program created in part 4 of article 280 of this title 12. (b) The rules promulgated by each regulator shall exempt a licensed health-care provider who: (I) Maintains a national board certification that requires equivalent substance use prevention training; or (II) Attests to the regulator that the health-care provider does not prescribe opioids. (2) For the purposes of this section, "licensed health-care provider" includes any of the following providers who are licensed pursuant to this title 12: (a) A physician; (b) A physician assistant; (c) A podiatrist; (d) A dentist; (e) An advanced practice registered nurse or certified midwife with prescriptive authority; (f) An optometrist; and (g) A veterinarian.

C.R.S. § 12-30-115 Required disclosure to patients - conviction of or discipline based on sexual misconduct - signed agreement to treatment - exceptions - violation grounds for discipline - rules - definitions

12-30-115. Required disclosure to patients - conviction of or discipline based on sexual misconduct - signed agreement to treatment - exceptions - violation grounds for discipline - rules - definitions. (1) As used in this section: (a) "Patient" means a person who is seeking or receiving health-care services from a provider. The term includes the parent, legal guardian, or custodian of a patient who is a minor under eighteen years of age or a patient who lacks the legal capacity to consent. (b) "Provider" means a licensee, certificate holder, or registrant who is subject to the requirements of section 12-30-102. (2) On or after March 1, 2021, a provider shall disclose to patients any: (a) Final conviction of or acceptance of a guilty plea by a court for a sex offense, as defined in section 16-11.7-102 (3); or (b) Final agency action by a regulator that results in probationary status or other limitation on the provider's ability to practice the provider's health-care profession when the final agency action is based in whole or in part on any of the following: (I) A conviction of or acceptance of a guilty plea by a court for a sex offense, as defined in section 16-11.7-102 (3), or a finding that the provider committed a sex offense as defined in said section; or (II) A finding that the provider engaged in unprofessional conduct or other conduct that is grounds for discipline under the part or article of this title 12 that regulates the provider's health-care profession, where the failure or conduct is related to, includes, or involves sexual misconduct that results in harm to a patient or presents a significant risk of public harm to patients. (3) (a) Except as provided in subsection (4) of this section, a provider shall provide the disclosure specified in subsection (2) of this section to the patient in writing, in the form and manner specified by the regulator by rule, before providing professional services to the patient. (b) For a disclosure of final agency action, the provider shall include the following information, at a minimum, in the written disclosure: (I) The type, scope, and duration of the agency action imposed, including whether: (A) The regulator and provider entered into a stipulation; (B) The agency action resulted from an adjudication decision; (C) The provider was placed on probation and, if so, the duration and terms of the probation; and (D) The regulator imposed any limitations on the provider's practice and, if so, a description of the specific limitations and the duration of the limitations; (II) The nature of the offense or conduct, including the grounds for probation or practice limitations specified in the final agency action; (III) The date the final agency action was issued; (IV) The date the probation status or practice limitation ends; and (V) The contact information for the regulator that imposed the agency action on the provider for the patient to obtain additional information, including information on how to file a complaint. (c) For a disclosure of a final conviction of or acceptance of a guilty plea by a court for a sex offense, as defined in section 16-11.7-102 (3), the provider shall include the following information, at a minimum, in the written disclosure: (I) The date that the final judgment of conviction or acceptance of a guilty plea was entered; (II) The nature of the offense or conduct that led to the final conviction or guilty plea; (III) The type, scope, and duration of the sentence or other penalty imposed as a result of the final conviction or guilty plea, including whether: (A) The provider entered a guilty plea or was convicted pursuant to a criminal adjudication; and (B) The provider was placed on probation and, if so, the duration and terms of the probation and the date the probation ends; and (IV) The jurisdiction that imposed the final conviction or issued an order approving the guilty plea. a result of the final conviction or guilty plea, including whether: (A) The provider entered a guilty plea or was convicted pursuant to a criminal adjudication; and (B) The provider was placed on probation and, if so, the duration and terms of the probation and the date the probation ends; and (IV) The jurisdiction that imposed the final conviction or issued an order approving the guilty plea. (d) Before treating a patient after a final conviction, guilty plea, or final agency action described in subsection (2) of this section has been imposed or accepted by a court, as applicable, the provider shall obtain the patient's agreement to treatment and acknowledgment of receipt of the disclosure in a form prescribed by the regulator by rule and signed by the provider and the patient. The patient's acknowledgment of receipt of the disclosure does not waive any future claims against the provider. (e) If a provider is placed on probation as part of a final conviction or acceptance of a guilty plea by a court for a sex offense, as defined in section 16-11.7-102 (3), or on probationary status or other limitation on the provider's ability to practice pursuant to a final agency action described in subsection (2) of this section, the requirement to disclose the conviction, guilty plea, or agency action ends when the provider has satisfied the requirements of the probation or other limitation and is no longer on probation or otherwise subject to a limitation on the ability to practice the provider's profession. (4) (a) A provider need not make the disclosure required by this section before providing professional services to a patient if any of the following applies: (I) The patient is unconscious or otherwise unable to comprehend the disclosure and sign an acknowledgment of receipt of the disclosure pursuant to subsection (3)(d) of this section and a guardian of the patient is unavailable to comprehend the disclosure and sign the acknowledgment; (II) The visit occurs in an emergency room or freestanding emergency department or the visit is unscheduled, including consultations in inpatient facilities; or (III) The provider who will be treating the patient during the visit is not known to the patient until immediately prior to the start of the visit. (b) A provider who does not have a direct treatment relationship or have direct contact with the patient is not required to make the disclosure required by this section. (5) (a) Failure to comply with the requirements of this section: (I) Constitutes unprofessional conduct or grounds for discipline, as applicable, under the article or part of this title 12 that regulates the provider's health-care profession; and (II) Does not create a private right of action. (b) Nothing in this section prevents the discovery of records, reports, or other information, or the admissibility of evidence, related to a provider's failure to comply with the requirements of this section in any civil, criminal, or administrative proceeding.

C.R.S. § 12-30-116 Protection for administering medical marijuana at school

12-30-116. Protection for administering medical marijuana at school. A person licensed pursuant to this title 12 is not subject to any disciplinary action related to the administration of medical marijuana in a nonsmokeable form in a school to a student with a valid medical marijuana recommendation pursuant to section 22-1-119.3.

C.R.S. § 12-30-117 Acceptance of patients enrolled in standardized plan - acceptance of reimbursement rate requirements

12-30-117. Acceptance of patients enrolled in standardized plan - acceptance of reimbursement rate requirements. The commissioner of insurance may require a health-care provider, after a hearing pursuant to section 10-16-1306, to participate in a standardized plan, as defined in section 10-16-1303 (14), and accept the reimbursement rate described in section 10-16-1306.

C.R.S. § 12-30-118 Acceptance of transfers from home and birthing centers

12-30-118. Acceptance of transfers from home and birthing centers. (1) A person regulated under this title 12 who regularly provides health-care services related to labor and delivery shall: (a) Be able to identify when to transmit and receive patient information, and transfer and receive patients, across the facility's levels of care; and (b) Coordinate with other providers to effectuate services across the facility's levels of care in a way that prevents patients losing access to care. (2) This section does not prohibit health-care providers from billing for health-care services rendered. (3) The acceptance of a transferred pregnant person does not establish an employment or consultation relationship between the accepting health-care provider and the transferring health-care provider or establish grounds for vicarious liability.

C.R.S. § 12-30-119 Culturally relevant and affirming health-care training - health-care providers - grants - definition

12-30-119. Culturally relevant and affirming health-care training - health-care providers - grants - definition. (1) As used in this section, "health-care provider" means an individual licensed, certified, or registered pursuant to this title 12 to provide health-care services. "Health-care provider" does not include a veterinarian. (2) Each regulator of health-care providers shall provide each health-care provider with the information that the regulator receives from the office of health equity pursuant to section 25-4-2209 regarding the culturally relevant and affirming health-care training courses that are available to each licensee, certificate holder, and registrant. Each regulator shall provide the information to each health-care provider at the time the health-care provider is issued or renews a license, certificate, or registration and shall encourage participation in the training courses.

C.R.S. § 12-30-120 Unprofessional conduct - grounds for discipline - offering medication abortion reversal - definitions - rules

12-30-120. Unprofessional conduct - grounds for discipline - offering medication abortion reversal - definitions - rules. (1) As used in this section: (a) "Abortion" has the meaning set forth in section 25-6-402 (1). (b) "Medication abortion" means an abortion conducted solely through the use of one or more prescription drugs. (c) "Medication abortion reversal" means administering, dispensing, distributing, or delivering a drug with the intent to interfere with, reverse, or halt a medication abortion. (2) (a) A licensee, registrant, or certificant engages in unprofessional conduct or is subject to discipline pursuant to this title 12 if the licensee, registrant, or certificant provides, prescribes, administers, or attempts medication abortion reversal in this state, unless the Colorado medical board created in section 12-240-105 (1), the state board of pharmacy created in section 12-280-104 (1), and the state board of nursing created in section 12-255-105 (1), in consultation with each other, each have in effect rules finding that it is a generally accepted standard of practice to engage in medication abortion reversal. (b) The boards specified in subsection (2)(a) of this section shall promulgate applicable rules no later than October 1, 2023, in consultation with each other, concerning whether engaging in medication abortion reversal is a generally accepted standard of practice.

C.R.S. § 12-30-121 Legally protected health-care activity - prohibit adverse action against regulated professionals and applicants - definitions

12-30-121. Legally protected health-care activity - prohibit adverse action against regulated professionals and applicants - definitions. (1) As used in this section, unless the context otherwise requires: (a) "Civil judgment" means a final court decision and order resulting from a civil lawsuit or a settlement in lieu of a final court decision. (b) "Criminal judgment" means a guilty verdict, a plea of guilty, a plea of nolo contendere, pretrial diversion, or a deferred judgment or sentence resulting from criminal charges or criminal proceedings or the dismissal of charges or the decision not to prosecute charges. (c) "Gender-affirming health-care services" means all supplies, care, and services of a medical, behavioral health, mental health, psychiatric, habilitative, surgical, therapeutic, diagnostic, preventive, rehabilitative, or supportive nature relating to the treatment of gender dysphoria. (d) "Legally protected health-care activity" means seeking, providing, receiving, or referring for; assisting in seeking, providing, or receiving; or providing material support for or traveling to obtain gender-affirming health-care services or reproductive health care that is not unlawful in this state, including on any theory of vicarious, joint, several, or conspiracy liability. As it relates to the provision of or referral for gender-affirming health-care services or reproductive health by a health-care provider licensed in this state and physically present in this state, the services and care are considered a "legally protected health-care activity" if the service or care is lawful in this state, regardless of the patient's location. (e) "Reproductive health care" means health care and other medical services related to the reproductive processes, functions, and systems at all stages of life. It includes, but is not limited to, family planning and contraceptive care; gender-affirming health-care services; abortion care; prenatal, postnatal, and delivery care; fertility care; sterilization services; and treatments for sexually transmitted infections and reproductive cancers. (2) A regulator shall not deny licensure, certification, or registration to an applicant or impose disciplinary action against an individual's license, certificate, or registration based solely on: (a) The applicant's, licensee's, certificant's, or registrant's provision of, or assistance in the provision of, a legally protected health-care activity in this state or any other state or United States territory, so long as the care provided was consistent with generally accepted standards of practice under Colorado law and did not otherwise violate Colorado law; (b) A civil judgment or criminal judgment against the applicant, licensee, certificant, or registrant arising from the provision of, or assistance in the provision of, a legally protected health-care activity in this state or any other state or United States territory, so long as the care provided was consistent with generally accepted standards of practice under Colorado law and did not otherwise violate Colorado law; (c) A professional disciplinary action or any other sanction against or suspension, revocation, surrender, or relinquishment of the applicant's, licensee's, certificant's, or registrant's professional license, certification, or registration in this state or any other state or United States territory, so long as: (I) The professional disciplinary action is based solely on the applicant's, licensee's, certificant's, or registrant's provision of, or assistance in the provision of, a legally protected health-care activity; and (II) The care provided was consistent with generally accepted standards of practice under Colorado law and did not otherwise violate Colorado law; (d) The applicant's, licensee's, certificant's, or registrant's own personal effort to seek or engage in a legally protected health-care activity in this state or any other state or United States territory; or gally protected health-care activity; and (II) The care provided was consistent with generally accepted standards of practice under Colorado law and did not otherwise violate Colorado law; (d) The applicant's, licensee's, certificant's, or registrant's own personal effort to seek or engage in a legally protected health-care activity in this state or any other state or United States territory; or (e) A civil or criminal judgment against the applicant, licensee, certificant, or registrant arising from the individual's own personal legally protected health-care activity in this state or any other state or United States territory.

C.R.S. § 12-30-122 Intimate examination of sedated or unconscious patient - informed consent required - definitions

12-30-122. Intimate examination of sedated or unconscious patient - informed consent required - definitions. (1) (a) (I) Except as provided in subsection (1)(b) of this section, neither a licensee nor a student or trainee under the supervision of a licensee shall perform an intimate examination of a sedated or unconscious patient unless the patient has provided specific informed consent to the examination in accordance with subsection (2) of this section. (II) In addition to the requirement to obtain a patient's specific informed consent, a student or trainee may perform an intimate examination of a sedated or unconscious patient for educational or training purposes only if: (A) The examination is related to the planned procedure to be performed on the patient; (B) The student or trainee has been introduced to the patient as part of the patient's care team, and the student's or trainee's role in performing an intimate examination for educational or training purposes has been shared with the patient; and (C) The student or trainee is under the direct supervision of the licensee responsible for supervising the student or trainee. (b) The requirements of subsection (1)(a) of this section do not apply to: (I) A licensee who performs an intimate examination of a patient who is sedated or unconscious without obtaining the patient's specific informed consent in emergency situations when the intimate examination is medically necessary for the life or well-being of the patient, but the licensee must make a record of performing the examination without obtaining the patient's specific informed consent, including an explanation of the reason for not obtaining the patient's consent, and the record must be provided to the patient prior to discharge; or (II) A licensee who has obtained the patient's consent to provide health care that includes an intimate examination if the licensee has informed the patient of the intimate examination in the course of obtaining the patient's consent to the health care. (2) To obtain specific informed consent to perform an intimate examination on a sedated or unconscious patient, a licensee shall, during a preoperative appointment before the procedure at which the examination will be performed or, in the absence of a preoperative appointment, as soon as possible before the intimate examination occurs: (a) Provide a written or electronic document to the patient, separate from any other notice or agreement, that: (I) Includes the following heading at the top of the document, in no smaller than eighteen-point, bold-faced type: "CONSENT FOR EXAMINATION OF BREASTS, PELVIC REGION, RECTUM, AND/OR PROSTATE"; (II) Specifies the nature and purpose of the intimate examination; (III) Names one or more licensees whom the patient may authorize to perform the intimate examination; (IV) States whether there may be one or more students or trainees whom the patient may authorize to perform an intimate examination for educational or training purposes or to observe or otherwise be present at the examination, either in person or through electronic means, and identifies the students or trainees by name; and (V) Provides the patient the ability to consent to or decline the following: (A) An intimate examination for diagnosis or treatment, to be performed by a licensee; (B) An intimate examination for educational or training purposes, to be performed by a licensee; and (C) One or more, but no more than three, additional intimate examinations for educational or training purposes, to be performed by up to three different students or trainees; (b) Obtain the signature of the patient on the written or electronic document; and atment, to be performed by a licensee; (B) An intimate examination for educational or training purposes, to be performed by a licensee; and (C) One or more, but no more than three, additional intimate examinations for educational or training purposes, to be performed by up to three different students or trainees; (b) Obtain the signature of the patient on the written or electronic document; and (c) Sign the written or electronic document. (3) (a) For purposes of complying with subsection (2) of this section, a licensee may: (I) Develop and use its own written or electronic document, so long as the document satisfies the requirements of subsection (2) of this section; or (II) Use a written or electronic document developed by the licensed health-care facility where the licensee will be performing the intimate examination or developed by the department of public health and environment, in accordance with section 25-3-130 (3), for use by health-care providers, so long as the document satisfies the requirements of subsection (2) of this section. (b) The licensee shall make the completed, signed specific informed consent document available to the patient. (4) (a) A licensee, student, or trainee who violates this section, or who retaliates against an individual, including a whistleblower, for filing a complaint regarding a violation of this section with the regulator of the licensee, student, or trainee or with the department of public health and environment or for otherwise complaining to the licensed health-care facility where the patient received an intimate examination or to any other person, engages in unprofessional conduct, commits an act that is grounds for discipline, and is subject to discipline pursuant to section 12-225-109, 12-240-121, or 12-255-120, as applicable. (b) A patient who has been subjected to an intimate examination in violation of this section may file a civil action for damages in a court of competent jurisdiction. Such action is not a medical malpractice action, and the limitation on damages for noneconomic loss or injury established pursuant to section 13-21-102.5 applies to any award to the patient for noneconomic damages. (5) Nothing in this section affects the ability to perform a medical forensic examination, including the collection of evidence, in connection with an alleged sexual assault or other crime or the investigation of an alleged sexual assault or other crime, pursuant to applicable laws. (6) As used in this section: (a) "Health-care provider" means a licensee or a licensed health-care facility where a patient is receiving care. (b) (I) "Intimate examination" means palpation of a breast or an internal pelvic, prostate, or rectal examination. (II) "Intimate examination" does not include a visual examination of a part of the body specified in subsection (6)(b)(I) of this section that occurs incidental to the care being provided. (c) "Licensed health-care facility" means a health-care facility licensed or certified by the department of public health and environment pursuant to section 25-1.5-103 (1)(a) and includes an individual authorized to act on behalf of the health-care facility. sual examination of a part of the body specified in subsection (6)(b)(I) of this section that occurs incidental to the care being provided. (c) "Licensed health-care facility" means a health-care facility licensed or certified by the department of public health and environment pursuant to section 25-1.5-103 (1)(a) and includes an individual authorized to act on behalf of the health-care facility. (d) "Licensee" means: (I) A physician or physician assistant licensed pursuant to article 240 of this title 12; (II) A person who holds a physician training license issued pursuant to section 12-240-128 and is: (A) A resident enrolled in an approved residency, as defined in section 12-240-104 (4); (B) An intern enrolled in an approved internship, as defined in section 12-240-104 (2); or (C) A fellow enrolled in an approved fellowship, as defined in section 12-240-104 (1); (III) An advanced practice registered nurse, as defined in section 12-255-104 (1); a registered nurse, as defined in section 12-255-104 (11); or a midwife, other than a direct-entry midwife or certified nurse midwife, practicing in this state whose scope of practice includes performing intimate examinations; or (IV) A direct-entry midwife registered pursuant to article 225 of this title 12. (e) "Patient" means an individual under the care of a health-care provider or the patient's authorized representative. (f) "Patient's authorized representative" means an individual who is authorized to make health-care decisions for or exercise rights on behalf of the patient, including, for a patient who is under eighteen years of age, the parent or legal guardian of, or the individual standing in loco parentis to, the patient. (g) "Regulator" means: (I) For licensees described in subsections (6)(d)(I) and (6)(d)(II) of this section, the Colorado medical board created in section 12-240-105; (II) For licensees described in subsection (6)(d)(III) of this section, the state board of nursing created in section 12-255-105; and (III) For licensees described in subsection (6)(d)(IV) of this section, the director. (h) "Student" means an individual currently enrolled in: (I) An approved medical college, as defined in section 12-240-104 (3); (II) An approved education program, as defined in section 12-255-104 (2), for professional nursing; or (III) A training program approved by the director, as described in section 12-225-104 (4)(c). (i) "Trainee" means an individual enrolled in or otherwise participating in training, practical experience, practicum, or any other experiential or clinical program that is required pursuant to article 225, 240, or 255 of this title 12 for the individual to become a licensee. (j) "Whistleblower" means an individual who has knowledge of an alleged violation of this section.

C.R.S. § 12-30-123 Health-care providers - on-site administered topical medication - use for continued treatment - definition

12-30-123. Health-care providers - on-site administered topical medication - use for continued treatment - definition. (1) As used in this section, "facility-provided medication" or "medication" means a topical medication that a health-care provider or medical office has on hand or that is retrieved from a dispensing system for a specified patient for use during a surgical procedure or a visit to a health-care provider. (2) (a) A health-care provider may offer any unused portion of a facility-provided medication to a patient if the medication is required for continued treatment, the medication does not contain a controlled substance, and the medication was administered to the patient during the patient's visit to the health-care provider. The health-care provider shall document within the patient's medical record that the patient must continue the medication at home, including the patient's dosage and directions for use. (b) A health-care provider shall label a facility-provided medication as required pursuant to article 280 of this title 12. (3) If a facility-provided medication is used for a patient during a visit to a health-care provider and the facility-provided medication is provided to the patient for continuity of treatment, the health-care provider is responsible for counseling the patient on the proper use of the medication, and a pharmacist's requirement to counsel the patient concerning the medication pursuant to section 12-280-138 is waived.

C.R.S. § 12-30-124 Out-of-state telehealth providers - registration - financial responsibility - discipline - emergency protocol - disclosures - prescriptions - rules - applicability - definitions

12-30-124. Out-of-state telehealth providers - registration - financial responsibility - discipline - emergency protocol - disclosures - prescriptions - rules - applicability - definitions. (1) As used in this section, unless the context otherwise requires: (a) "Applicant" means an individual who performs health-care services in another state and applies to the division to provide telehealth services in this state. (b) "Distant site" has the meaning set forth in section 10-16-123 (4)(a). (c) "Originating site" has the meaning set forth in section 10-16-123 (4)(b). (d) "Out-of-state credential" means a license, certificate, registration, or other approval as a health-care provider in another state. (e) "Registered provider" means a health-care provider registered to provide telehealth services in this state pursuant to subsection (3) of this section. (f) "Store-and-forward transfer" has the meaning set forth in section 10-16-123 (4)(c). (g) "Telehealth" means the delivery of medical services through technologies that are used in a manner that is compliant with the federal "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191, including information, electronic, and communication technologies, remote monitoring technologies, and store-and-forward transfers, to facilitate the assessment, diagnosis, consultation, or treatment of a patient while the patient is located at an originating site and the person who provides the services is located at a distant site. (2) On and after January 1, 2026, an applicant who possesses an out-of-state credential may provide health-care services through telehealth to patients located in this state if the applicant is registered with a regulator, as applicable to the applicant's practice, and provides health-care services within the scope of practice established under the laws and rules of this state that apply to the applicant's practice. (3) A regulator may register an applicant who does not possess a license, certificate, or registration in this state as a registered provider under this section if the applicant satisfies all of the following: (a) The applicant submits an application on a form prescribed by the division and pays the applicable fee established by the division pursuant to section 12-20-105; (b) The applicant possesses an out-of-state credential issued by a governmental authority in another state, the District of Columbia, or a possession or territory of the United States and the credential is active; unencumbered; has educational and supervisory standards equivalent to or exceeding the educational and supervisory standards required for the equivalent credential, license, certificate, or registration in this state or the interstate compact license for the applicable credential type; and entitles the applicant to perform health-care services that are the same as or equivalent to health-care services that may be performed by a licensee, certificate holder, or registrant in this state; (c) The applicant has not been subject to any disciplinary action resulting in a limitation, suspension, or revocation of the applicant's out-of-state credential during the five-year period immediately preceding the submission of the applicant's application pursuant to subsection (3)(a) of this section, unless the disciplinary action pertains to an action, behavior, or treatment permitted under Colorado law; (d) The applicant demonstrates passage of a jurisprudence examination administered by the division if passage of a jurisprudence examination is required for substantially similar credentialing as a licensee, certificate holder, or registrant in this state; (e) The applicant designates an agent upon whom service of process may be made in this state on a form prescribed by the division; and o law; (d) The applicant demonstrates passage of a jurisprudence examination administered by the division if passage of a jurisprudence examination is required for substantially similar credentialing as a licensee, certificate holder, or registrant in this state; (e) The applicant designates an agent upon whom service of process may be made in this state on a form prescribed by the division; and (f) The applicant demonstrates to the division that the applicant is in compliance with subsection (5) of this section. (4) (a) A registered provider shall notify the applicable regulator of: (I) Restrictions placed on the registered provider's out-of-state credential in any state or jurisdiction; (II) Any disciplinary action taken or pending against the registered provider in any state or jurisdiction; and (III) Any final judgment against, settlement entered into by, or arbitration award paid on behalf of the registered provider for malpractice. (b) The registered provider shall provide notification pursuant to this subsection (4) within five business days after the restriction is placed or disciplinary action is initiated or taken. (5) A registered provider shall maintain the method and amount of financial responsibility that covers services provided to patients in this state as required by the applicable regulator. (6) A registered provider providing health-care services through telehealth to a patient located in this state shall provide health-care services in compliance with the professional practice standards applicable to a licensee, certificate holder, or registrant who provides comparable in-person health-care services in this state. Professional practice standards and laws applicable to the provision of in-person health-care services in this state, including standards and laws relating to prescribing medication or treatment, identity verification, documentation, informed consent, confidentiality, disclosures, privacy, and security, apply to the provision of health-care services through telehealth in Colorado. (7) (a) A registered provider who provides telehealth services to a patient shall: (I) Provide the patient with guidance on appropriate follow-up care as required by the laws, rules, and standard of care for Colorado; (II) In the event of an emergency situation, make a good faith effort to: (A) Directly contact and coordinate with emergency services located near the originating site; or (B) If the urgent, emergent, or emergency situation is related to the patient's mental health or a substance use condition, facilitate contact with the appropriate local mental and behavioral health services to include local crisis services, such as crisis stabilization units, crisis walk-in centers, mobile crisis response services, and withdrawal management facilities; and (C) Remain on a synchronous connection with the patient, if the emergency arises during a synchronous connection, until emergency services have reached the originating site or the situation is resolved in the registered provider's clinical judgment; and (III) Maintain a written emergency protocol that is appropriate to the applicable standard of care for Colorado. The written emergency protocol must include good faith methods of accomplishing the following: (A) Providing the name and location of the patient to emergency services in oral, written, or digital form; (B) Determining the originating site if a patient is unaware of the location; and (C) Providing the contact information of the patient to emergency services. cable standard of care for Colorado. The written emergency protocol must include good faith methods of accomplishing the following: (A) Providing the name and location of the patient to emergency services in oral, written, or digital form; (B) Determining the originating site if a patient is unaware of the location; and (C) Providing the contact information of the patient to emergency services. (b) A registered provider must maintain a current list of hospitals, urgent care centers or clinics, and crisis providers, such as crisis stabilization units, crisis walk-in centers, mobile crisis response services, and withdrawal management facilities, in the area where the patient resides. (8) (a) A registered provider shall not open an office in this state and shall not provide in-person health-care services to patients located in this state unless the registered provider obtains the license, certification, or registration that the applicable regulator requires for the performance of the relevant health-care services in this state. (b) A registered provider providing telehealth services to a patient in this state shall disclose the following information to the patient, as applicable: (I) The location of the registered provider; and (II) That the registered provider does not have a physical location in Colorado. (9) (a) The division or the applicable regulator may take disciplinary action against a registered provider if any of the following applies to the registered provider: (I) The registered provider fails to notify the regulator of any adverse actions taken against the registered provider's out-of-state credential as required under subsection (4) of this section; (II) The registered provider has restrictions placed on the registered provider's out-of-state credential or disciplinary action has been commenced against the registered provider in any state or jurisdiction; (III) The registered provider violates any of the requirements under this section; or (IV) The registered provider commits an act that constitutes grounds for disciplinary action under the law governing the applicable profession in Colorado. (b) The department of regulatory agencies may notify other states in which the registered provider is licensed, registered, or certified to practice of any disciplinary actions taken against the registered provider in this state. (c) If a regulator determines that a registered provider has committed an act or engaged in conduct that constitutes grounds for discipline or unprofessional conduct under the law governing the applicable profession in Colorado, the division or the relevant regulator may take disciplinary or other action pursuant to section 12-20-404. (10) For a registered provider providing health-care services through telehealth to a patient located in this state, this section provides an alternative to licensure, certification, or registration that the applicable regulator requires for the performance of the relevant health-care services in this state, and a registered provider must otherwise adhere to the laws and rules that apply to the registered provider's practice. (11) A registered provider shall not prescribe a controlled substance, as defined in section 12-280-402 (1). (12) All registrations issued pursuant to this section are subject to the renewal, expiration, reinstatement, and delinquency fee provisions specified in section 12-20-202. (13) The division may promulgate rules necessary to implement and administer this section. (14) A regulator may promulgate rules necessary to implement and administer this section. (15) Articles 1 and 20 of this title 12 and this article 30 apply, according to their terms, to this section.

C.R.S. § 12-30-201 Legislative declaration

12-30-201. Legislative declaration. (1) The general assembly hereby finds, determines, and declares that the Colorado medical board created in article 240 of this title 12 and the state board of nursing created in article 255 of this title 12 act for the state in their sovereign capacity to govern licensure, discipline, and professional review of persons licensed to practice medicine, persons licensed as physician assistants, advanced practice registered nurses, and certified midwives, respectively, in this state. The general assembly further finds, determines, and declares that: (a) The authority to provide health care in this state is a privilege granted by the legislative authority of the state; and (b) It is necessary for the health, safety, and welfare of the people of this state that the appropriate regulatory boards exercise their authority to protect the people of this state from unauthorized practice and unprofessional conduct by persons licensed to provide health care under article 240 of this title 12 and part 1 of article 255 of this title 12. (2) The general assembly recognizes that: (a) Many patients of persons licensed to provide health care in this state have restricted choices of health-care providers under a variety of circumstances and conditions; (b) Many patients lack the knowledge, experience, or education to properly evaluate the quality of medical, nursing, or certified midwife practice or the professional conduct of persons licensed to practice medicine, persons licensed as physician assistants, advanced practice registered nurses, and certified midwives; and (c) It is necessary and proper that the respective regulatory boards exercise their regulatory authority to protect the health, safety, and welfare of the people of this state. (3) The general assembly recognizes that, in the proper exercise of their authority and responsibilities under this part 2, the Colorado medical board and the state board of nursing must, to some extent, replace competition with regulation, and that the replacement of competition by regulation, particularly with regard to persons licensed under article 240 of this title 12, to advanced practice registered nurses, or to certified midwives, is related to a legitimate state interest in the protection of the health, safety, and welfare of the people of this state.

C.R.S. § 12-30-202 Definitions

12-30-202. Definitions. As used in this part 2, unless the context otherwise requires: (1) "Advanced practice registered nurse" has the same meaning as set forth in section 12-255-104 (1). (2) "Authorized entity" means a corporation, organization, or entity that is authorized to establish a professional review committee under section 12-30-204 (5) or (6) or under rules of the medical board or nursing board adopted pursuant to section 12-30-204 (6). (2.5) "Certified midwife" has the same meaning as set forth in section 12-255-104 (3.2). (3) "CMS" means the federal centers for medicare and medicaid services. (4) "Governing board" means a board, board of trustees, governing board, or other body, or duly authorized subcommittee thereof, of an authorized entity, which board or body has final authority pursuant to the entity's written bylaws, policies, or procedures to take final action regarding the recommendations of a professional review committee. (5) "Joint Commission" means the Joint Commission or its successor entity. (6) "Medical board" means the Colorado medical board created in section 12-240-105 (1). (6.5) "Original source document" means any separate written document created or prepared in the ordinary course of business that is not otherwise privileged or confidential, including electronic records and electronic communications, containing factual information relating solely to the individual patient in interest in a civil action that is not created or prepared as part of the professional review activities or created by or at the direction of a professional review committee. (7) "Professional review committee" means any committee authorized under this part 2 to review and evaluate the competence of, professional conduct of, or the quality and appropriateness of patient care provided by any person licensed under article 240 of this title 12, an advanced practice registered nurse, or a certified midwife. "Professional review committee" includes a governing board, a hearing panel appointed by a governing board to conduct a hearing under section 12-30-204 (8)(a), and an independent third party designated by a governing board under section 12-30-204 (9)(b). (8) (a) "Records" means any and all written, electronic, or oral communications by any person arising from any activities of a professional review committee, including a governing board, established by an authorized entity under this part 2 or by the agent or staff thereof, including any: (I) Letters of reference; (II) Complaint, response, or correspondence related to the complaint or response; (III) Interviews or statements, reports, memoranda, assessments, and progress reports developed to assist in professional review activities; (IV) Assessments and progress reports to assist in professional review activities, including reports and assessments developed by independent consultants in connection with professional review activities; and (V) Recordings or transcripts of proceedings, minutes, formal recommendations, decisions, exhibits, and other similar items or documents related to professional review activities and typically constituting the records of administrative proceedings. (b) "Records" does not include any written, electronic, or oral communications by any person that are otherwise available from a source outside the scope of professional review activities, including medical records and other health information, incident reports prepared in the ordinary course of business, and relevant hospital or facility policies, procedures, and protocols, or other original source documents. (9) "State board of nursing" or "nursing board" means the state board of nursing created in section 12-255-105.

C.R.S. § 12-30-203 Use of professional review committees

12-30-203. Use of professional review committees. (1) (a) The general assembly recognizes that: (I) The medical board and the nursing board, while assuming and retaining ultimate authority for licensure and discipline in accordance with article 240 of this title 12 and part 1 of article 255 of this title 12, respectively, and in accordance with this part 2, cannot practically and economically assume responsibility over every single allegation or instance of purported deviation from the standards of quality for the practice of medicine, the practice of nursing, or the practice as a certified midwife; from the standards of professional conduct; or from the standards of appropriate care; and (II) An attempt to exercise this oversight would result in extraordinary delays in the determination of the legitimacy of the allegations and would result in the inappropriate and unequal exercise of their authority to license and discipline persons licensed under article 240 of this title 12, advanced practice registered nurses, or certified midwives. (b) It is therefore the intent of the general assembly that the medical board and the nursing board utilize and allow professional review committees and governing boards to assist them in meeting their responsibilities under article 240 of this title 12 and part 1 of article 255 of this title 12, respectively, and under this part 2. (2) Persons licensed under article 240 of this title 12, advanced practice registered nurses, and certified midwives are encouraged to serve upon professional review committees when called to do so and to study and review in an objectively reasonable manner the professional conduct of persons licensed under article 240 of this title 12, advanced practice registered nurses, or certified midwives, including the competence of, professional conduct of, or the quality and appropriateness of patient care provided by those persons. (3) (a) The use of professional review committees is an extension of the authority of the medical board and nursing board. However, except as otherwise provided in this part 2, nothing in this part 2 limits the authority of professional review committees properly constituted under this part 2. (b) Professional review committees, the members who constitute the committees, governing boards, authorized entities, and persons who participate directly or indirectly in professional review activities are granted certain immunities from liability arising from actions that are within the scope of their activities as provided in section 12-30-207. These grants of immunity from liability are necessary to ensure that professional review committees and governing boards can exercise their professional knowledge and judgment.

C.R.S. § 12-30-204 Establishment of professional review committees - function - rules

12-30-204. Establishment of professional review committees - function - rules. (1) A professional review committee may be established pursuant to this section to review and evaluate the competence of, the quality and appropriateness of patient care provided by, or the professional conduct of any person licensed under article 240 of this title 12, any advanced practice registered nurse, or any certified midwife. (2) Licensed physicians who are actively engaged in the practice of medicine in this state must constitute a majority of the voting members of any professional review committee established pursuant to this section for physicians and physician assistants; except that physicians need not constitute the majority of the voting members of a governing board authorized by subsection (5)(i) of this section or an independent third party designated by a governing board under subsection (9)(b) of this section. (3) (a) A professional review committee that is reviewing the competence of, the quality and appropriateness of patient care provided by, or the professional conduct of an advanced practice registered nurse must either: (I) Have, as a voting member, at least one advanced practice registered nurse with a scope of practice similar to that of the person who is the subject of the review; or (II) Engage, to perform an independent review as appropriate, an independent person who is an advanced practice registered nurse with a scope of practice similar to that of the person who is the subject of the review. The person conducting the independent review must be a person who was not previously involved in the review. (b) A professional review committee that is reviewing the competence of, the quality and appropriateness of patient care provided by, or the professional conduct of a certified midwife must either: (I) Have, as a voting member, at least one certified midwife or advanced practice registered nurse with a scope of practice similar to that of the person who is the subject of the review; or (II) Engage, to perform an independent review as appropriate, an independent person who is a certified midwife with a scope of practice similar to that of the person who is the subject of the review. The person conducting the independent review must be a person who was not previously involved in the review. (3.5) A professional review committee of a hospital licensed or certified by the department of public health and environment pursuant to section 25-1.5-103 (1)(a) is encouraged to appoint a consumer to serve as a nonvoting member of the professional review committee, so long as the consumer complies with the hospital's conflict of interest policies, enters into a confidentiality agreement acceptable to the hospital, and enters into a business associate agreement in accordance with the federal "Health Insurance Portability and Accountability Act of 1996", Pub.L. 104-191, as amended. (4) A quality improvement organization, as defined pursuant to 42 U.S.C. sec. 1320c-1, or any other organization performing similar review services under federal or state law is an approved professional review committee under this part 2. (5) A professional review committee established by any of the following authorized entities is an approved professional review committee under this part 2 if it operates in compliance with written bylaws, policies, or procedures that are in compliance with this part 2 and that have been approved by the authorized entity's governing board and if it is registered with the division in accordance with section 12-30-206: (a) The medical staff of a hospital licensed pursuant to part 1 of article 3 of title 25 or certified pursuant to section 25-1.5-103 (1)(a)(II); ates in compliance with written bylaws, policies, or procedures that are in compliance with this part 2 and that have been approved by the authorized entity's governing board and if it is registered with the division in accordance with section 12-30-206: (a) The medical staff of a hospital licensed pursuant to part 1 of article 3 of title 25 or certified pursuant to section 25-1.5-103 (1)(a)(II); (b) The medical staff of a hospital-related corporation. For the purposes of this subsection (5)(b), an entity is a "hospital-related corporation" if the licensed or certified hospital or holding company of the licensed or certified hospital has ownership or control of the entity. (c) A society or association of physicians whose membership includes not less than one-third of the doctors of medicine or doctors of osteopathy licensed to practice and residing in this state, if the physician whose services are the subject of the review is a member of the society or association; (d) A society or association of advanced practice registered nurses whose members reside in this state, if the advanced practice registered nurse whose services are the subject of the review is a member of the society or association; (d.5) A society or association of certified midwives whose members reside in this state, if the certified midwife whose services are the subject of the review is a member of the society or association; (e) A society or association of physicians licensed to practice and residing in this state and specializing in a specific discipline of medicine, whose society or association has been designated by the medical board as a specialty society or association representative of physicians practicing the specific discipline of medicine, if the physician whose services are the subject of the review is a member of the specialty society or association; (f) A society or association of advanced practice registered nurses or certified midwives whose members practice in a specified nursing or midwifery role and population focus, as defined by the nursing board, which society or association has been designated by the nursing board as the specific nursing or midwifery society or association representative of those advanced practice registered nurses or certified midwives practicing in that nursing or midwifery role and population focus, if the advanced practice registered nurse or certified midwife whose services are the subject of the review is a member of the designated nursing or midwifery society or association; (g) An individual practice association or a preferred provider organization consisting of persons licensed under article 240 of this title 12, of advanced practice registered nurses, or of certified midwives or a medical group that predominantly serves members of a health maintenance organization licensed pursuant to parts 1 and 4 of article 16 of title 10. A professional review committee established pursuant to this subsection (5)(g) has jurisdiction to review persons licensed under article 240 of this title 12, advanced practice registered nurses, or certified midwives only if the persons licensed under said article, the advanced practice registered nurses, or the certified midwives are members of the association or organization creating and authorizing that committee; except that the professional review committee may review the care provided to a particular patient referred by a member of the association or organization to another person who is not a member of the association or organization and is licensed under article 240 of this title 12, is an advanced practice registered nurse, or is a certified midwife. ganization creating and authorizing that committee; except that the professional review committee may review the care provided to a particular patient referred by a member of the association or organization to another person who is not a member of the association or organization and is licensed under article 240 of this title 12, is an advanced practice registered nurse, or is a certified midwife. (h) A corporation authorized pursuant to article 3 of title 10 to insure persons licensed under article 240 of this title 12, advanced practice registered nurses, or certified midwives or any other organization authorized to insure such persons in this state when designated by the medical board or nursing board under subsection (6) of this section; (i) The governing board of any authorized entity that has a professional review committee established pursuant to article 240 of this title 12 or part 1 of article 255 of this title 12; (j) Any professional review committee established or created by a combination or pooling of any authorized entities; (k) (I) A nonprofit corporation or association consisting of representatives from a statewide professional society and a statewide hospital association. The association must consist of persons licensed under article 240 of this title 12, advanced practice registered nurses, or certified midwives, as applicable, and hospital administrators and hospital trustees, subject to the following requirements: (A) When the subject of the investigation is a person licensed under article 240 of this title 12, a majority of the representatives must be persons licensed under article 240 of this title 12; (B) When the subject of the investigation is an advanced practice registered nurse, at least one of the representatives must be an advanced practice registered nurse; and (C) When the subject of the investigation is a certified midwife, at least one of the representatives must be a certified midwife. (II) The association may establish, or contract for, one or more professional review committees to review the care by hospital staff personnel who are licensed under article 240 of this title 12, are advanced practice registered nurses, or are certified midwives, with priority given to small rural hospital staffs. These professional review services must be available statewide on a fee-for-service basis to licensed or certified hospitals at the joint request of the governing board and the medical, nursing, or certified midwife staff of the hospital or at the sole request of the governing board of the hospital. If a member being reviewed specializes in a generally recognized specialty of medicine, nursing, or midwifery, at least one of the health-care providers on the professional review committee must be a person who is licensed under article 240 of this title 12, is an advanced practice registered nurse, or is a certified midwife and who practices such specialty. (III) For purposes of the introductory portion to this subsection (5) and this subsection (5)(k), the bylaws, policies, or procedures must be in compliance with this part 2 and approved by the nonprofit corporation or association. (l) The medical, nursing, or certified midwife staff of an ambulatory surgical center licensed pursuant to part 1 of article 3 of title 25; (m) A professional services entity organized pursuant to section 12-240-138; (n) A provider network that is organized pursuant to part 3 of article 18 of title 6 and includes persons licensed under article 240 of this title 12, advanced practice registered nurses, or certified midwives; (o) A health system that includes two or more authorized entities with a common governing board; (p) A trust organization established under article 70 of title 11; (q) An entity licensed pursuant to parts 1 and 4 of article 16 of title 10; part 3 of article 18 of title 6 and includes persons licensed under article 240 of this title 12, advanced practice registered nurses, or certified midwives; (o) A health system that includes two or more authorized entities with a common governing board; (p) A trust organization established under article 70 of title 11; (q) An entity licensed pursuant to parts 1 and 4 of article 16 of title 10; (r) An accountable care organization established under the federal "Patient Protection and Affordable Care Act", Pub.L. 111-148, as amended, or other organization with a similar function; (s) A hospital licensed pursuant to part 1 of article 3 of title 25 or certified pursuant to section 25-1.5-103 (1)(a)(II); and (t) An ambulatory surgical center licensed pursuant to part 1 of article 3 of title 25. (6) The medical board and the nursing board, with respect to the licensees subject to their jurisdiction, may establish by rule procedures necessary to authorize other health-care or physician organizations or professional societies as authorized entities that may establish professional review committees. (7) (a) A professional review committee acting pursuant to this part 2 may investigate or cause to be investigated: (I) The qualifications and competence of any person licensed under article 240 of this title 12, any advanced practice registered nurse, or any certified midwife who seeks to subject themselves to the authority of any authorized entity; or (II) The quality or appropriateness of patient care rendered by, or the professional conduct of, any person licensed under article 240 of this title 12, any advanced practice registered nurse, or any certified midwife who is subject to the authority of the authorized entity. (b) The professional review committee shall conduct the investigation in conformity with written bylaws, policies, or procedures adopted by the authorized entity's governing board. (8) The written bylaws, policies, or procedures of any professional review committee for persons licensed under article 240 of this title 12, advanced practice registered nurses, or certified midwives must provide for at least the following: (a) (I) Except as provided in subsection (8)(a)(II) of this section, if the findings of any investigation indicate that a person licensed under article 240 of this title 12, an advanced practice registered nurse, or a certified midwife who is the subject of the investigation is lacking in qualifications or competency, has provided substandard or inappropriate patient care, or has exhibited inappropriate professional conduct and the professional review committee takes or recommends an action to adversely affect the person's membership, affiliation, or privileges with the authorized entity, the professional review committee shall hold a hearing to consider the findings and recommendations unless the person waives, in writing, the right to a hearing or is given notice of a hearing and fails to appear. (II) If the professional review committee is submitting its findings and recommendations to another professional review committee for review, only one hearing is necessary prior to any appeal before the governing board. (b) A person who has participated in the course of an investigation is disqualified as a member of the professional review committee that conducts a hearing pursuant to subsection (8)(a) of this section, but the person may participate as a witness in the hearing. (c) The authorized entity shall give to the subject of any investigation under this subsection (8) reasonable notice of the hearing and of any finding or recommendation that would adversely affect the person's membership, affiliation, or privileges with the authorized entity, and the subject of the investigation has a right to be present, to be represented by legal counsel at the hearing, and to offer evidence in the person's own behalf. he subject of any investigation under this subsection (8) reasonable notice of the hearing and of any finding or recommendation that would adversely affect the person's membership, affiliation, or privileges with the authorized entity, and the subject of the investigation has a right to be present, to be represented by legal counsel at the hearing, and to offer evidence in the person's own behalf. (d) After the hearing, the professional review committee that conducted the hearing shall make any recommendations it deems necessary to the governing board, unless otherwise provided by federal law or regulation. (e) The professional review committee shall give a copy of the recommendations to the subject of the investigation, who then has the right to appeal to the governing board to which the recommendations are made with regard to any finding or recommendation that would adversely affect his or her membership, affiliation, or privileges with the authorized entity. (f) Repealed. (9) (a) All governing boards shall adopt written bylaws, policies, or procedures under which a person who is licensed under article 240 of this title 12, is an advanced practice registered nurse, or is a certified midwife and who is the subject of an adverse recommendation by a professional review committee may appeal to the governing board following a hearing in accordance with subsection (8) of this section. The bylaws, policies, or procedures must provide that the person be given reasonable notice of the person's right to appeal and, unless waived by the person, has the right to appear before the governing board, to be represented by legal counsel, and to offer the argument on the record that the person deems appropriate. (b) The bylaws may provide that a committee of not fewer than three members of the governing board may hear the appeal. Also, the bylaws may allow for an appeal to be heard by an independent third party designated by a governing board under this subsection (9)(b). (10) All governing boards that are required to report their final actions to the medical board or the nursing board, as appropriate, are not otherwise relieved of their obligations by virtue of this part 2. (11) (a) Except as specified in subsection (11)(b) of this section, the records of an authorized entity, its professional review committee, and its governing board are not subject to subpoena or discovery and are not admissible in any civil suit. (b) Subject to subsection (14) of this section, the records are subject to subpoena and available for use: (I) By either party in an appeal or de novo proceeding brought pursuant to this part 2; (II) By a person licensed under article 240 of this title 12, an advanced practice registered nurse, or a certified midwife in a suit seeking judicial review of an action by the governing board; (III) By the department of public health and environment in accordance with its authority to issue or continue a health facility license or certification for an authorized entity; (IV) By CMS in accordance with its authority over federal health-care program participation by an authorized entity; (V) By an authorized entity or governing board seeking judicial review; (VI) By the medical board within the scope of its authority over licensed physicians and physician assistants; and (VII) By the nursing board within the scope of its authority over advanced practice registered nurses and certified midwives. ts authority over federal health-care program participation by an authorized entity; (V) By an authorized entity or governing board seeking judicial review; (VI) By the medical board within the scope of its authority over licensed physicians and physician assistants; and (VII) By the nursing board within the scope of its authority over advanced practice registered nurses and certified midwives. (12) (a) Except as provided in subsection (12)(b) of this section, the records of an authorized entity or its professional review committee may be disclosed to: (I) The medical board, as requested by the medical board acting within the scope of its authority or as required or appropriate under this part 2 or article 240 of this title 12; (II) The nursing board, as requested by the nursing board acting within the scope of its authority or as required or appropriate under this part 2 or part 1 of article 255 of this title 12; (III) The department of public health and environment acting within the scope of its health facility licensing authority or as the agent of CMS; (IV) CMS, in connection with the survey and certification processes for federal health-care program participation by an authorized entity; and (V) The Joint Commission or other entity granted deeming authority by CMS, in connection with a survey or review for accreditation. (b) The medical board, nursing board, and department of public health and environment shall not make further disclosures of any records disclosed by an authorized entity or its professional review committee under this section. (13) The records of an authorized entity or its professional review committee or governing board may be shared by and among authorized entities and their professional review committees and governing boards concerning the competence of, professional conduct of, or the quality and appropriateness of patient care provided by, a health-care provider who seeks to subject himself or herself to, or is currently subject to, the authority of the authorized entity. (14) Responding to a subpoena or disclosing or sharing of otherwise privileged records and information pursuant to subsection (11), (12), or (13) of this section does not constitute a waiver of the privilege specified in subsection (11)(a) of this section or a violation of the confidentiality requirements of subsection (16) of this section. Records provided to any governmental agency, including the department of public health and environment, the medical board, and the nursing board pursuant to subsection (11) or (12) of this section are not public records subject to the "Colorado Open Records Act", part 2 of article 72 of title 24. A person providing the records to an authorized entity or its professional review committee or governing board, the department of public health and environment, the medical board, the nursing board, CMS, the Joint Commission, or other governmental agency is entitled to the same immunity from liability as provided under section 12-30-207 for the disclosure of the records. (15) Investigations, examinations, hearings, meetings, and other proceedings of a professional review committee or governing board conducted pursuant to this part 2 are exempt from any law requiring that proceedings be conducted publicly or that the records, including any minutes, be open to public inspection. (16) Except as otherwise provided in subsection (11), (12), or (13) of this section, all proceedings, recommendations, records, and reports involving professional review committees or governing boards are confidential. (17) A professional review committee or governing board that is constituted and conducts its reviews and activities in accordance with this part 2 is not an unlawful conspiracy in violation of section 6-4-104 or 6-4-105. section (11), (12), or (13) of this section, all proceedings, recommendations, records, and reports involving professional review committees or governing boards are confidential. (17) A professional review committee or governing board that is constituted and conducts its reviews and activities in accordance with this part 2 is not an unlawful conspiracy in violation of section 6-4-104 or 6-4-105. (18) (a) Original source documents are not protected from subpoena, discovery, or use in any civil action merely because they were considered by or presented to a professional review committee. Original source documents are subject to subpoena or discovery only from the original sources and are protected from subpoena or discovery from the professional review files of a professional review committee of an authorized entity except as provided below: (I) Upon subpoena or request for discovery for original source documents, an authorized entity shall provide a log of all original source documents contained in the authorized entity's professional review files including the source and nature of each original source document. (II) The individual patient in interest in a civil action by such person, next friend, or legal representative may subpoena or seek discovery of any original source document identified on the authorized entity's professional review committee log only if the original source document was not produced in response to a prior subpoena or discovery request to the original source. (b) This subsection (18) does not relieve any party of their obligation under the Colorado rules of civil procedure.

C.R.S. § 12-30-205 Hospital professional review committees

12-30-205. Hospital professional review committees. (1) The quality and appropriateness of patient care rendered by persons licensed under article 240 of this title 12, advanced practice registered nurses, certified midwives, and other licensed health-care professionals so influence the total quality of patient care that a review of care provided in a hospital is ineffective without concomitantly reviewing the overall competence of, professional conduct of, or the quality and appropriateness of care rendered by these persons. (2) (a) (I) Whenever a professional review committee created pursuant to section 12-30-204 reasonably believes that the quality or appropriateness of care provided by other licensed health-care professionals may have adversely affected the outcome of patient care, the professional review committee shall: (A) Refer the matter to a hospital quality management program created pursuant to section 25-3-109; or (B) Consult with a representative of the other licensed health-care professional's profession. (II) A professional review committee established pursuant to this part 2 may meet and act in collaboration with a hospital quality management program established pursuant to section 25-3-109. (b) All matters considered in collaboration with or referred to a committee pursuant to this subsection (2) and all records and proceedings related thereto shall remain confidential, and the committee members, governing board, witnesses, and complainants are subject to the immunities and privileges as set forth in this part 2. (3) Nothing in this section is deemed to extend the authority or jurisdiction of the medical board to any individual not otherwise subject to the jurisdiction of the board.

C.R.S. § 12-30-206 Governing boards to register with division - annual reports - aggregation and publication of data - definition - rules

12-30-206. Governing boards to register with division - annual reports - aggregation and publication of data - definition - rules. (1) As used in this section, "adversely affecting" has the same meaning as set forth in 45 CFR 60.3; except that it does not include a precautionary suspension or any professional review action affecting, for a period of thirty or fewer days, a person licensed under article 240 of this title 12, an advanced practice registered nurse, or a certified midwife. (2) Each governing board that establishes or uses one or more professional review committees to review the practice of persons licensed under article 240 of this title 12, of advanced practice registered nurses, or of certified midwives shall: (a) Register with the division in a form satisfactory to the division on or before July 1, 2013, if the governing board has one or more existing professional review committees, or, if the governing board first establishes a professional review committee on or after July 1, 2013, within thirty days after approving the written bylaws, policies, or procedures for the professional review committee; (a.5) Update the governing board's information, as specified by the division by rule in accordance with subsection (4)(a) of this section, with the division annually, including whether the governing board is currently engaged in a professional review activity or intends to engage in a professional review activity in the future; (b) In addition to any other state or federal reporting requirements: (I) Report annually to the medical board, in a form satisfactory to the medical board, the number of final professional review actions in each of the following categories relating to individuals licensed under article 240 of this title 12: (A) Adversely affecting the individual; (B) In which an authorized entity accepted the individual's surrender of clinical privileges, membership, or affiliation while the individual was under investigation; (C) In which an authorized entity accepted the individual's surrender of clinical privileges, membership, or affiliation in return for not conducting an investigation; and (D) In which the professional review committee made recommendations regarding the individual following a hearing pursuant to section 12-30-204 (8)(d); (II) Report annually to the nursing board, in a form satisfactory to the nursing board, the number of final professional review actions in each of the following categories relating to advanced practice registered nurses and certified midwives: (A) Adversely affecting the individual; (B) In which an authorized entity accepted the individual's surrender of clinical privileges, membership, or affiliation while the individual was under investigation; (C) In which an authorized entity accepted the individual's surrender of clinical privileges, membership, or affiliation in return for not conducting an investigation; and (D) In which the professional review committee made recommendations regarding the individual following a hearing pursuant to section 12-30-204 (8)(d); s, membership, or affiliation while the individual was under investigation; (C) In which an authorized entity accepted the individual's surrender of clinical privileges, membership, or affiliation in return for not conducting an investigation; and (D) In which the professional review committee made recommendations regarding the individual following a hearing pursuant to section 12-30-204 (8)(d); (c) (I) Report to the division, in a de-identified manner, on its professional review activities during the immediately preceding calendar year in a form satisfactory to the division. These reports must include aggregate data, which is limited to the following: (A) The number of investigations completed during the year; (B) The number of investigations that resulted in no action; (C) The number of investigations that resulted in written involuntary requirements for improvement sent to the subject of the investigation by the authorized entity; and (D) The number of investigations that resulted in written agreements for improvement between the subject of the investigation and the authorized entity. (II) (A) The medical board and the nursing board shall forward the reports received pursuant to subsections (2)(b)(I) and (2)(b)(II) of this section, respectively, to the division in a de-identified manner. (B) The division shall not publish any information identifying the governing board or authorized entity making a report under subsection (2)(b) of this section or this subsection (2)(c), and the reports and information are not public records under the "Colorado Open Records Act", part 2 of article 72 of title 24. (III) Reports submitted pursuant to this subsection (2)(c) must include only investigations in which no final action adversely affecting the subject of the investigation was taken or recommended. (IV) The identity of the governing board reporting the data and the data reported pursuant to this subsection (2)(c) or subsection (2)(b) of this section may be known to the division. (3) (a) The division shall publish the data provided pursuant to subsections (2)(b) and (2)(c) of this section in aggregate form and without individually identifiable information concerning the governing board, the authorized entity, or any person who was subject to review and is licensed under article 240 of this title 12, is an advanced practice registered nurse, or is a certified midwife. (b) The division shall maintain and shall publish online, through its website, a current list of all governing boards that are registered in accordance with this section and that otherwise are in compliance with this part 2. (4) The division: (a) Shall adopt rules to: (I) Implement this section; (II) Determine the de-identified information regarding investigations and outcomes a governing board is required to report; and (III) Establish a process to remove a governing board from the registry when the governing board is no longer required to register with the division pursuant to this section; and (b) May collect a reasonable registration fee to recover its direct and indirect costs of administering the registration and publication systems required by this section. (5) For purposes of this section, an investigation occurs when the authorized entity or its professional review committee notifies the subject of the investigation in writing that an investigation has commenced. (6) The medical board and the nursing board shall not initiate an investigation or issue a subpoena based solely on the data reported pursuant to subsection (2)(c) of this section. (7) (a) A governing board that fails to register with the division pursuant to subsection (2)(a) of this section is not entitled to any immunity afforded under this part 2 until the date that the governing board so registers. A governing board's failure to register does not affect any immunity, confidentiality, or privilege afforded to an individual participating in professional review activities. (7) (a) A governing board that fails to register with the division pursuant to subsection (2)(a) of this section is not entitled to any immunity afforded under this part 2 until the date that the governing board so registers. A governing board's failure to register does not affect any immunity, confidentiality, or privilege afforded to an individual participating in professional review activities. (b) A governing board's failure to report as required by this section does not affect any immunity, confidentiality, or privilege afforded to the governing board under this part 2.

C.R.S. § 12-30-207 Immunity from liability

12-30-207. Immunity from liability. (1) A member of a professional review committee, a governing board, or any committee or third party designated by the governing board under section 12-30-204 (9)(b); any person serving on the staff of that committee, board, panel, or third party; a witness or consultant before a professional review committee; and any person who files a complaint or otherwise participates in the professional review process is immune from suit and liability for damages in any civil or criminal action, including antitrust actions, brought by a person licensed under article 240 of this title 12, an advanced practice registered nurse, or a certified midwife who is the subject of the review by the professional review committee unless, in connection with the professional review process, the person provided false information and knew that the information was false. (2) The governing board and the authorized entity that has established a professional review committee pursuant to section 12-30-204 is immune from suit and liability for damages in any civil or criminal action, including antitrust actions, brought by a person licensed under article 240 of this title 12, an advanced practice registered nurse, or a certified midwife who is the subject of the review by such professional review committee if the professional review action was taken within the scope of the professional review process and was taken: (a) In the objectively reasonable belief that the action was in the furtherance of quality health care; (b) After an objectively reasonable effort to obtain the facts of the matter; (c) In the objectively reasonable belief that the action taken was warranted by the facts; and (d) In accordance with procedures that, under the circumstances, were fair to the person licensed under article 240 of this title 12, the advanced practice registered nurse, or the certified midwife.

C.R.S. § 12-30-208 Conformance with federal law and regulation - legislative declaration - rules - limitations on liability - definition

12-30-208. Conformance with federal law and regulation - legislative declaration - rules - limitations on liability - definition. (1) The general assembly hereby finds, determines, and declares that the enactment of this section is necessary in order for the state to comply with the provisions of the federal "Health Care Quality Improvement Act of 1986", as amended, 42 U.S.C. secs. 11101 to 11152. It is the intent of the general assembly that the provisions of this section are to be interpreted as being complementary to the other provisions in this part 2. The provisions of this section are intended to be responsive to specific requirements of the federal "Health Care Quality Improvement Act of 1986", as amended. If the provisions of this section conflict with the other provisions of this part 2, other than with respect to the specific requirements of the federal "Health Care Quality Improvement Act of 1986", as amended, the other provisions of this part 2 prevail. (2) The medical board and nursing board may promulgate rules to comply with the reporting requirements of the federal "Health Care Quality Improvement Act of 1986", as amended, and may participate in the federal data bank. (3) (a) The following persons are immune from suit and not liable for damages in any civil action with respect to their participation in, assistance to, or reporting of information to a professional review committee in connection with a professional review action in this state, and such persons are not liable for damages in a civil action with respect to their participation in, assistance to, or reporting of information to a professional review committee that meets the standards of and is in conformity with the federal "Health Care Quality Improvement Act of 1986", as amended: (I) An authorized entity, professional review committee, or governing board; (II) Any person acting as a member of or staff to the authorized entity, professional review committee, or governing board; (III) A witness, consultant, or other person who provided information to the authorized entity, professional review committee, or governing board; and (IV) Any person who participates with or assists the professional review committee or governing board with respect to the professional review activities. (b) (I) Notwithstanding subsection (3)(a) of this section, nothing in this section relieves an authorized entity that is a health-care facility licensed or certified pursuant to part 1 of article 3 of title 25 or certified pursuant to section 25-1.5-103 (1)(a)(II) of liability to an injured person or wrongful death claimant for the facility's independent negligence in the credentialing or privileging process for a person licensed under article 240 of this title 12, an advanced practice registered nurse, or a certified midwife who provided health-care services for the injured or deceased person at the facility. For purposes of this subsection (3), the facility's participation in the credentialing process or the privileging process does not constitute the corporate practice of medicine. (II) Nothing in this subsection (3) affects the confidentiality or privilege of any records subject to section 12-30-204 (11) or of information obtained and maintained in accordance with a quality management program as described in section 25-3-109. The exceptions to confidentiality or privilege as set forth in sections 12-30-204 (11) and 25-3-109 (4) apply. (III) This subsection (3)(b) applies to actions filed on or after July 1, 2012. ts the confidentiality or privilege of any records subject to section 12-30-204 (11) or of information obtained and maintained in accordance with a quality management program as described in section 25-3-109. The exceptions to confidentiality or privilege as set forth in sections 12-30-204 (11) and 25-3-109 (4) apply. (III) This subsection (3)(b) applies to actions filed on or after July 1, 2012. (c) As used in this subsection (3), unless the context otherwise requires, "professional review action" means an action or recommendation of a professional review committee that is taken or made in the conduct of professional review activity and that is based on the quality and appropriateness of patient care provided by, or the competence or professional conduct of, an individual person licensed under article 240 of this title 12, an advanced practice registered nurse, or a certified midwife, which action affects or may affect adversely the person's clinical privileges of or membership in an authorized entity. "Professional review action" includes a formal decision by the professional review committee not to take an action or make a recommendation as provided in this subsection (3)(c) and also includes professional review activities relating to a professional review action. An action is not based upon the competence or professional conduct of a person if the action is primarily based on: (I) The person's association or lack of association with a professional society or association; (II) The person's fees or advertising or engaging in other competitive acts intended to solicit or retain business; (III) The person's association with, supervision of, delegation of authority to, support for, training of, or participation in a private group practice with a member or members of a particular class of health-care practitioners or professionals; (IV) The person's participation in prepaid group health plans, salaried employment, or any other manner of delivering health services whether on a fee-for-service basis or other basis; (V) Any other matter that does not relate to the quality and appropriateness of patient care provided by, or the competence or professional conduct of, a person licensed under article 240 of this title 12, an advanced practice registered nurse, or a certified midwife.

C.R.S. § 12-30-209 Repeal of part - review of functions

12-30-209. Repeal of part - review of functions. This part 2 is repealed, effective September 1, 2030. Before the repeal, the functions of professional review committees are scheduled for review in accordance with section 24-34-104.

Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-12.docxFetched: 10/6/2026