First Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 23-0226.01 Yelana Love x2295
SENATE BILL 23-083
Senate Committees House Committees
Health & Human Services
A BILL FOR AN ACT
C
ONCERNING AN EXPANSION OF A PHYSICIAN ASSISTANT 'S ABILITY TO101
PRACTICE, AND, IN CONNECTION THEREWITH , CHANGING THE102
RELATIONSHIP BETWEEN A PHYSICIAN ASSISTANT AND A103
PHYSICIAN OR PODIATRIST FROM SUPERVISION TO104
COLLABORATION.105
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
The bill modifies the relationship between a physician assistant
and a physician or podiatrist by removing the requirement that a physician
SENATE SPONSORSHIP
Winter F. and Simpson,
HOUSE SPONSORSHIP
(None),
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. assistant be supervised by a physician or podiatrist. Instead, a physician
assistant must enter into a collaborative agreement with an employer,
physician, or podiatrist.
The collaborative agreement must include:
! The physician assistant's name, license number, and
primary location of practice;
! The signature of the physician assistant and the person with
whom the physician assistant has entered into the
collaborative agreement;
! A general description of the physician assistant's process
for collaboration;
! A description of the performance evaluation process, which
may be completed by the physician assistant's employer in
accordance with a performance evaluation and review
process established by the employer; and
! Any additional requirements specific to the physician
assistant's practice required by the employer, physician, or
podiatrist entering into the collaborative agreement,
including additional levels of oversight, limitations on
autonomous judgment, and the designation of a primary
contact for collaboration.
For a physician assistant with fewer than 3,000 practice hours, the
collaborative agreement must also:
! Require that collaboration during the first 160 practice
hours be completed in person or through technology;
! Incorporate elements defining the expected nature of
collaboration; and
! Require a performance evaluation and discussion of the
performance evaluation with the physician assistant.
The bill also requires physician assistants who have been
practicing for less than 3 years to satisfy certain financial responsibility
requirements from which such physician assistants are exempt under
current law.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 12-240-107, amend2
(6) as follows:3
12-240-107. Practice of medicine defined - exemptions from4
licensing requirements - unauthorized practice by physician5
assistants and anesthesiologist assistants - penalties - definitions -6
SB23-083-2- rules - repeal. (6) (a) A person licensed under the laws of this state to1
practice medicine may delegate to a physician assistant licensed by the2
board pursuant to section 12-240-113 the authority to perform acts that3
constitute the practice of medicine and acts that physicians are authorized4
by law to perform to the extent and in the manner authorized by rules5
promulgated by the board, including the authority to prescribe6
medication, including controlled substances, and dispense only the drugs7
designated by the board. The acts must be consistent with sound medical8
practice. Each prescription for a controlled substance, as defined in9
section 18-18-102 (5), issued by a physician assistant licensed by the10
board shall be imprinted with the name of the physician assistant's11
supervising physician. For all other prescriptions issued by a physician12
assistant, the name and address of the health facility and, if the health13
facility is a multi-speciality organization, the name and address of the14
speciality clinic within the health facility where the physician assistant is15
practicing must be imprinted on the prescription. Nothing in this16
subsection (6) limits the ability of otherwise licensed health personnel to17
perform delegated acts. The dispensing of prescription medication by a18
physician assistant is subject to section 12-280-120 (6) A PHYSICIAN19
ASSISTANT MAY NOT PROVIDE CARE UNLESS THE PHYSICIAN ASSISTANT20
HAS ENTERED INTO A COLLABORATIVE AGREEMENT WITH AN EMPLOYER OR21
A PHYSICIAN.22
(b) (I) If the authority to perform an act is delegated pursuant to23
subsection (6)(a) of this section, the physician assistant to whom the act24
is delegated shall not perform the act except under the personal and25
responsible direction and supervision of a person licensed under the laws26
of this state to practice medicine. A licensed physician may be responsible27
SB23-083
-3- for the direction and supervision of up to eight physician assistants at any1
one time. A licensed physician shall not be made responsible for the2
direction and supervision of more than four physician assistants unless the3
licensed physician agrees to assume the responsibility. A licensed4
physician has sole discretion to assume or refuse such responsibility, and5
an employer shall not require a licensed physician to assume such6
responsibility as a condition of employment. The board, by rule, may7
define what constitutes appropriate direction and supervision of a8
physician assistant; except that the board shall not promulgate a rule that9
is inconsistent with section 12-240-114.5 WITH A COLLABORATIVE10
AGREEMENT IN PLACE, A PHYSICIAN ASSISTANT LICENSED BY THE BOARD11
PURSUANT TO SECTION 12-240-113 MAY PERFORM ACTS THAT CONSTITUTE12
THE PRACTICE OF MEDICINE AND ACTS THAT PHYSICIANS ARE AUTHORIZED13
BY LAW TO PERFORM TO THE EXTENT AND IN THE MANNER AUTHORIZED BY14
RULES PROMULGATED BY THE BOARD , INCLUDING PRESCRIBING AND15
DISPENSING MEDICATION, INCLUDING CONTROLLED SUBSTANCES .16
(II) For purposes of this subsection (6), "personal and responsible17
direction and supervision" means that the direction and supervision of a18
physician assistant is personally rendered by a licensed physician19
practicing in the state of Colorado and is not rendered through20
intermediaries. The extent of direction and supervision shall be21
determined by rules promulgated by the board and as otherwise provided22
in this subsection (6)(b); except that, when a physician assistant is23
performing a delegated medical function in an acute care hospital, the24
board shall allow supervision and direction to be performed without the25
physical presence of the physician during the time the delegated medical26
functions are being implemented if:27
SB23-083
-4- (A) The medical functions are performed where the supervising1
physician regularly practices or in a designated health manpower shortage2
area;3
(B) The licensed supervising physician reviews the quality of4
medical services rendered by the physician assistant by reviewing the5
medical records to assure compliance with the physicians' directions; and6
(C) The performance of the delegated medical function otherwise7
complies with the board's rules and any restrictions and protocols of the8
licensed supervising physician and hospital.9
(c) Pursuant to section 12-240-135 (7), the board may apply for10
an injunction to enjoin any person from performing delegated medical11
acts that are in violation of this section or of any rules promulgated by the12
board THE COLLABORATIVE AGREEMENT MUST BE KEPT ON FILE AT THE13
PHYSICIAN ASSISTANT'S PRIMARY LOCATION OF PRACTICE AND BE MADE14
AVAILABLE TO THE BOARD UPON REQUEST .15
(d) This subsection (6) shall not apply to any person who performs16
delegated medical tasks within the scope of the exemption contained in17
subsection (3)(l) of this section AN ACT BY A PHYSICIAN ASSISTANT THAT18
CONSTITUTES THE PRACTICE OF MEDICINE MUST BE CONSISTENT WITH19
SOUND MEDICAL PRACTICE. A PHYSICIAN ASSISTANT SHALL COLLABORATE20
WITH THE APPROPRIATE HEALTH -CARE PROVIDER AS INDICATED BY THE21
CONDITION OF THE PATIENT, THE STANDARD OF CARE, AND THE PHYSICIAN22
ASSISTANT'S EDUCATION, EXPERIENCE, AND COMPETENCE.23
(e) A
N EMPLOYER SHALL NOT REQUIRE A LICENSED PHYSICIAN TO24
ENTER INTO A COLLABORATIVE AGREEMENT AS A CONDITION OF THE25
PHYSICIAN'S EMPLOYMENT.26
(f) A
LL PRESCRIPTIONS ISSUED BY A PHYSICIAN ASSISTANT MUST27
SB23-083
-5- INCLUDE THE PHYSICIAN ASSISTANT'S NAME, THE NAME AND ADDRESS OF1
THE HEALTH FACILITY, AND, IF THE HEALTH FACILITY IS A MULTISPECIALTY2
ORGANIZATION, THE NAME AND ADDRESS OF THE SPECIALITY CLINIC3
WITHIN THE HEALTH FACILITY WHERE THE PHYSICIAN ASSISTANT IS4
PRACTICING. THE DISPENSING OF PRESCRIPTION MEDICATION BY A5
PHYSICIAN ASSISTANT IS SUBJECT TO SECTION 12-280-120 (6)(a).6
(g) W
HILE PERFORMING ACTS INCLUDED IN THE PRACTICE OF7
MEDICINE, AS DEFINED IN SUBSECTION (1) OF THIS SECTION, A PHYSICIAN8
ASSISTANT SHALL CLEARLY IDENTIFY ONESELF , BOTH VISUALLY AND9
VERBALLY, AS A PHYSICIAN ASSISTANT.10
(h) P
URSUANT TO SECTION 12-240-135 (7), THE BOARD MAY APPLY11
FOR AN INJUNCTION TO ENJOIN ANY PERSON FROM PERFORMING MEDICAL12
ACTS THAT ARE IN VIOLATION OF THIS SECTION OR OF ANY RULES13
PROMULGATED BY THE BOARD .14
(i) T
HIS SUBSECTION (6) DOES NOT APPLY TO ANY PERSON WHO15
PERFORMS MEDICAL TASKS WITHIN THE SCOPE OF THE EXEMPTION16
SPECIFIED IN SUBSECTION (3)(l) OF THIS SECTION.17
(j) A
PHYSICIAN ASSISTANT IS RESPONSIBLE FOR THE CARE18
PROVIDED BY THE PHYSICIAN ASSISTANT .19
(k) A
PHYSICIAN ASSISTANT SHALL COMPLY WITH THE FINANCIAL20
RESPONSIBILITY REQUIREMENTS SPECIFIED IN SECTION 13-64-301 (1) AND21
RULES ADOPTED BY THE BOARD PURSUANT TO THAT SECTION .22
(l) P
URSUANT TO SECTION 12-240-138 (1)(d)(I), A PHYSICIAN23
ASSISTANT IS NOT AUTHORIZED TO OWN A MAJORITY OF A MEDICAL24
PRACTICE.25
SECTION 2. In Colorado Revised Statutes, amend 12-240-114.526
as follows:27
SB23-083
-6- 12-240-114.5. Physician assistants - collaboration1
requirements - proof of practice hours from another jurisdiction -2
liability - definitions. (1) As used in this section, unless the context3
otherwise requires:4
(a) "C
OLLABORATION" MEANS, AS INDICATED BY THE PATIENT'S5
CONDITION, COMMUNITY STANDARDS OF CARE , AND A PHYSICIAN6
ASSISTANT'S EDUCATION, TRAINING, AND EXPERIENCE:7
(I) C
ONSULTATION BETWEEN THE PHYSICIAN ASSISTANT AND AN8
EMPLOYER OR A PHYSICIAN; OR9
(II) R
EFERRAL BY THE PHYSICIAN ASSISTANT TO A PHYSICIAN , OR,10
IF THE REFERRAL IS TO A PHYSICIAN PRACTICING IN A DIFFERENT PRACTICE11
AREA THAN THE PHYSICIAN ASSISTANT , A PHYSICIAN'S PRACTICE GROUP.12
(b) "C
OLLABORATIVE AGREEMENT " MEANS A WRITTEN13
AGREEMENT THAT DESCRIBES THE MANNER IN WHICH A PHYSICIAN14
ASSISTANT COLLABORATES WITH AN EMPLOYER OR A PHYSICIAN .15
(a)
(c) "Performance evaluation" means a document that includes16
domains of competency relevant to the practice of a physician assistant,17
uses more than one modality of assessment to evaluate the domains, and18
includes consideration of the physician assistant's education, training,19
experience, competency, and knowledge of the specialty PRACTICE AREA20
in which the physician assistant is engaged.21
(b) "Practice agreement" means a written agreement between a22
physician assistant and a supervising physician that defines the23
communication and decision-making process by which the physician24
assistant and the supervising physician provide care to patients.25
(c) "Supervisory plan" means a document that allows a26
supervising physician to follow the ongoing professional development of27
SB23-083
-7- a physician assistant's clinical practice, promotes a collaborative1
relationship between a physician assistant and his or her supervising2
physicians, and allows a supervising physician to address any deficiencies3
that have been identified in the physician assistant's clinical competencies4
during the initial performance period.5
(2) (a) A physician assistant licensed pursuant to this article 2406
who has practiced for less than three years is subject to the following7
supervisory requirements SHALL ENTER INTO A COLLABORATIVE8
AGREEMENT WITH AN EMPLOYER OR A PHYSICIAN . THE COLLABORATIVE9
AGREEMENT MUST INCLUDE :10
(a) (I) The physician assistant's first one hundred sixty working11
hours shall be supervised by a supervising physician who works at the12
same location as the physician assistant. The physician assistant's primary13
supervising physician shall provide at least forty hours of supervision, and14
the remaining hours may be provided by a secondary supervising15
physician who is designated by the primary supervising physician. THE16
PHYSICIAN ASSISTANT'S NAME, LICENSE NUMBER, AND PRIMARY LOCATION17
OF PRACTICE;18
(b) (II) After the physician assistant completes one hundred sixty19
working hours, a supervising physician must remain available to the20
physician assistant via a telecommunication device at all times when the21
physician assistant is working. THE SIGNATURE OF THE PHYSICIAN22
ASSISTANT AND THE PHYSICIAN, OR A REPRESENTATIVE OF THE EMPLOYER23
WITH WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO THE24
COLLABORATIVE AGREEMENT ;25
(c) (III) Not more than thirty days after the physician assistant26
completes one hundred sixty working hours, the primary supervising27
SB23-083
-8- physician shall complete an initial performance assessment and a1
supervisory plan for the physician assistant. A GENERAL DESCRIPTION OF2
THE PHYSICIAN ASSISTANT'S PROCESS FOR COLLABORATION, THE DEGREE3
OF WHICH MUST BE DETERMINED AT THE PHYSICIAN ASSISTANT 'S PRIMARY4
LOCATION OF PRACTICE AND MAY INCLUDE :5
(A) D
ECISIONS MADE BY THE EMPLOYER OR PHYSICIAN WITH6
WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO A COLLABORATIVE7
AGREEMENT; AND8
(B) T
HE CREDENTIALING OR PRIVILEGING REQUIREMENTS OF THE9
PHYSICIAN ASSISTANT'S PRIMARY LOCATION OF PRACTICE;10
(IV) A
DESCRIPTION OF THE PERFORMANCE EVALUATION PROCESS ,11
WHICH MAY BE COMPLETED BY THE PHYSICIAN ASSISTANT 'S EMPLOYER IN12
ACCORDANCE WITH A PERFORMANCE EVALUATION AND REVIEW PROCESS13
ESTABLISHED BY THE EMPLOYER ; AND14
(V) A
NY ADDITIONAL REQUIREMENTS SPECIFIC TO THE PHYSICIAN15
ASSISTANT'S PRACTICE REQUIRED BY THE EMPLOYER OR PHYSICIAN16
ENTERING INTO THE COLLABORATIVE AGREEMENT , INCLUDING17
ADDITIONAL LEVELS OF OVERSIGHT , LIMITATIONS ON AUTONOMOUS18
JUDGMENT, AND THE DESIGNATION OF A PRIMARY CONTACT FOR19
COLLABORATION.20
(b) (I) F
OR A PHYSICIAN ASSISTANT WITH FEWER THAN THREE21
THOUSAND PRACTICE HOURS , THE COLLABORATIVE AGREEMENT MUST22
ALSO:23
(A) R
EQUIRE THAT COLLABORATION DURING THE FIRST ONE24
HUNDRED SIXTY PRACTICE HOURS BE COMPLETED IN PERSON OR THROUGH25
TECHNOLOGY, AS PERMITTED BY THE PHYSICIAN OR EMPLOYER WITH26
WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO THE COLLABORATIVE27
SB23-083
-9- AGREEMENT;1
(B) I
NCORPORATE ELEMENTS DEFINING THE EXPECTED NATURE OF2
COLLABORATION, INCLUDING: THE PHYSICIAN ASSISTANT'S EXPECTED3
AREA OF PRACTICE ; EXPECTATIONS REGARDING SUPPORT AND4
CONSULTATION FROM THE PHYSICIAN OR EMPLOYER WITH WHOM THE5
PHYSICIAN ASSISTANT HAS ENTERED INTO A COLLABORATIVE AGREEMENT ;6
METHODS AND MODES OF COMMUNICATION AND COLLABORATION ; AND7
ANY OTHER PERTINENT ELEMENTS OF COLLABORATIVE , TEAM-BASED8
PRACTICE APPLICABLE TO THE PHYSICIAN ASSISTANT 'S PRACTICE OR9
ESTABLISHED BY THE EMPLOYER ; AND10
(C) R
EQUIRE A PERFORMANCE EVALUATION AND DISCUSSION OF11
THE PERFORMANCE EVALUATION WITH THE PHYSICIAN ASSISTANT AFTER12
THE PHYSICIAN ASSISTANT HAS WORKED WITH THE EMPLOYER FOR SIX13
MONTHS, AGAIN AFTER THE PHYSICIAN ASSISTANT HAS WORKED WITH THE14
EMPLOYER FOR TWELVE MONTHS , AND ADDITIONAL EVALUATION15
THEREAFTER AS DETERMINED BY THE PHYSICIAN OR EMPLOYER WITH16
WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO THE COLLABORATIVE17
AGREEMENT.18
(II) T
HE PERFORMANCE EVALUATION MAY BE COMPLETED BY THE19
PHYSICIAN ASSISTANT'S EMPLOYER IN ACCORDANCE WITH THE20
PERFORMANCE EVALUATION AND REVIEW PROCESS ESTABLISHED BY THE21
EMPLOYER; EXCEPT THAT THE PERFORMANCE EVALUATION MUST BE22
COMPLETED WITH AT LEAST THE MINIMUM FREQUENCY REQUIRED IN23
SECTION (2)(b)(I)(C) OF THIS SECTION.24
(III) A
FTER A PHYSICIAN ASSISTANT HAS COMPLETED THREE25
THOUSAND PRACTICE HOURS , THE ADDITIONAL COLLABORATIVE26
AGREEMENT REQUIREMENTS DESCRIBED IN THIS SUBSECTION (2)(b) NO27
SB23-083
-10- LONGER APPLY.1
(3) (a) The supervision of a physician assistant licensed pursuant2
to this article 240 who has practiced in this state for three years or more3
is determined by a practice agreement that shall be created by the4
physician assistant and his or her primary supervising physician not later5
than thirty days after the physician assistant begins practicing under the6
supervision of the primary supervising physician. A practice agreement7
must include A PHYSICIAN ASSISTANT MAY PROVIDE THE BOARD WITH A8
SIGNED AFFIDAVIT OUTLINING PRACTICE EXPERIENCE FOR THE PURPOSES9
OF MEETING THE REQUIREMENTS DESCRIBED IN SUBSECTION (2)(b) OF THIS10
SECTION, AS APPLICABLE, IF THE PHYSICIAN ASSISTANT:11
(a) H
ELD AN UNENCUMBERED LICENSE IN ANOTHER STATE OR12
TERRITORY OF THE UNITED STATES BEFORE BECOMING LICENSED IN THIS13
STATE PURSUANT TO SECTION 12-240-113; OR14
(b) W
AS INITIALLY LICENSED IN THIS STATE PRIOR TO THE15
EFFECTIVE DATE OF THIS SUBSECTION (3), AS AMENDED.16
(I) A process by which a physician assistant and a supervising
17
physician communicate and make decisions concerning patients' medical18
treatment, which process utilizes the knowledge and skills of the19
physician assistant and the supervising physician based on their respective20
education, training, and experience;21
(II) A protocol for designating an alternative physician for22
consultation when the supervising physician is unavailable for23
consultation;24
(III) The signatures of the physician assistant and supervising25
physician; and26
(IV) A termination provision that allows the physician assistant27
SB23-083
-11- or the supervising physician to terminate the practice agreement after1
providing written notice of his or her intent to do so at least thirty days2
before the date of termination. If a practice agreement is terminated, the3
physician assistant and the physician assistant's primary supervising4
physician shall create a new practice agreement within forty-five days5
after the date the previous practice agreement was terminated.6
(b) In addition to the components described in subsection (3)(a)7
of this section, a practice agreement may impose conditions concerning8
specific duties, procedures, or drugs.9
(c) If the terms or conditions of a practice agreement change, both10
the physician assistant and the supervising physician shall sign and date11
the updated practice agreement.12
(4) A physician assistant licensed pursuant to this article 240 who13
has practiced for at least twelve months and who is making a substantive14
change in his or her scope of practice or practice area is subject to the15
following supervisory requirements:16
(a) The physician assistant's first eighty working hours shall be17
supervised by a supervising physician who works at the same location as18
the physician assistant. The physician assistant's primary supervising19
physician shall provide at least twenty hours of supervision, and the20
remaining hours may be provided by a secondary supervising physician21
who is designated by the primary supervising physician.22
(b) After the physician assistant completes eighty working hours,23
a supervising physician shall remain available to the physician assistant24
via a telecommunication device at all times when the physician assistant25
is working.26
(c) After the physician assistant has worked for six months, and27
SB23-083
-12- again after the physician assistant has worked for twelve months, the1
primary supervising physician shall complete a performance assessment2
and discuss the performance assessment with the physician assistant.3
(5) (a) A physician assistant licensed pursuant to this article 2404
who has practiced for at least three years may be liable for damages5
resulting from negligence in providing care to a patient; except that a6
physician assistant is not liable for any damages that occur as a result of7
the physician assistant following a direct order from a supervising8
physician.9
(b) A physician assistant who has been practicing for at least three10
years shall comply with the financial responsibility requirements specified11
in section 13-64-301 (1) and rules adopted by the board pursuant to that12
section.13
(c) A physician assistant's supervising physician may be liable for14
damages resulting from the physician assistant's negligence in providing15
care to a patient if the physician assistant has not practiced for at least16
three years as described in subsection (5)(a) of this section.17
SECTION 3. In Colorado Revised Statutes, 12-240-119, amend18
(2)(c) as follows:19
12-240-119. Reentry license - period of inactivity -20
international medical graduate - competency assessment - board21
rules - conversion to full license. (2) (c) If, based on the assessment22
and,
IF PRESCRIBED, after completion of an educational program, if
23
prescribed, the board determines that the applicant is competent and24
qualified to practice medicine without supervision, or practice as a25
physician assistant, or
PRACTICE as an anesthesiologist assistant with26
supervision, as specified in this article 240, the board may convert the27
SB23-083
-13- reentry license to a full license to practice medicine, practice as a1
physician assistant, or practice as an anesthesiologist assistant, as2
applicable, under this article 240.3
SECTION 4. In Colorado Revised Statutes, 12-240-122, amend4
(1) as follows:5
12-240-122. Prescriptions - requirement to advise patients.6
(1) A physician
OR PHYSICIAN ASSISTANT licensed under this article 2407
or a physician assistant licensed by the board who has been delegated the
8
authority to prescribe medication, may advise the physician's or the9
physician assistant's patients of their option to have the symptom or10
purpose for which a prescription is being issued included on the11
prescription order.12
SECTION 5. In Colorado Revised Statutes, 12-240-128, amend13
(7)(c) as follows:14
12-240-128. Physician training licenses. (7) A physician15
training licensee may practice medicine as defined by this article 240 with16
the following restrictions:17
(c) A physician training licensee shall not: have the authority to18
(I) Delegate the rendering of medical services to a person who is19
not licensed to practice medicine pursuant to section 12-240-107 (3)(l);20
OR21
(II) and shall not have the authority to supervise
ENTER INTO A22
COLLABORATIVE AGREEMENT WITH physician assistants as provided by23
section 12-240-107 (6) DESCRIBED IN SECTIONS 12-240-107 (6) AND24
12-240-114.5.25
SECTION 6. In Colorado Revised Statutes, 12-280-103, amend26
(39)(c)(II)(B) as follows:27
SB23-083
-14- 12-280-103. Definitions - rules. As used in this article 280, unless1
the context otherwise requires or the term is otherwise defined in another2
part of this article 280:3
(39) "Practice of pharmacy" means:4
(c) The provision of a therapeutic interchange selection or a5
therapeutically equivalent selection to a patient if, during the patient's stay6
at a nursing care facility or a long-term acute care hospital licensed under7
part 1 of article 3 of title 25, the selection has been approved for the8
patient:9
(II) By one of the following health-care providers:10
(B) A physician assistant licensed under section 12-240-113; if the11
physician assistant is under the supervision of a licensed physician; or12
SECTION 7. In Colorado Revised Statutes, 12-280-502, amend13
(1)(b)(II) as follows:14
12-280-502. Therapeutic interchange and therapeutically15
equivalent selections for nursing care facility or long-term acute care16
hospital patients - rules. (1) A pharmacy used by a nursing care facility17
or a long-term acute care hospital licensed under part 1 of article 3 of title18
25 may make a therapeutic interchange or a therapeutically equivalent19
selection for a patient if, during the patient's stay at the facility, the20
selection has been approved for the patient:21
(b) By one of the following health-care providers:22
(II) A physician assistant licensed under section 12-240-113; if the23
physician assistant is under the supervision of a licensed physician; or24
SECTION 8. In Colorado Revised Statutes, 12-290-110, amend25
(5) as follows:26
12-290-110. Podiatry training license. (5) A person with a27
SB23-083
-15- podiatric training license shall only practice podiatry ONLY under the1
supervision of a licensed podiatrist or a physician licensed to practice2
medicine within the residency program. A person with a podiatry training3
license shall not delegate podiatric or medical services to a person who4
is not licensed to practice podiatry or medicine and shall not have the5
authority to supervise COLLABORATE WITH physician assistants.6
SECTION 9. In Colorado Revised Statutes, amend 12-290-1177
as follows:8
12-290-117. Use of physician assistants - collaboration9
requirements - affidavits of practice experience - rules - definitions.10
(1) A person licensed under the laws of this state to practice podiatry may11
delegate to a physician assistant licensed by the Colorado medical board12
pursuant to section 12-240-113 the authority to A PHYSICIAN ASSISTANT13
LICENSED PURSUANT TO ARTICLE 240 OF THIS TITLE 12 MAY perform acts14
that constitute the practice of podiatry to the extent and in the manner15
authorized by rules promulgated by the Colorado podiatry board. The acts16
shall be consistent with sound practices of podiatry. Each prescription for17
a controlled substance, as defined in section 18-18-102 (5), issued by a18
physician assistant must have the name of the physician assistant's19
supervising podiatrist printed on the prescription. For all other ALL20
prescriptions issued by a physician assistant
MUST INCLUDE THE21
PHYSICIAN ASSISTANT'S NAME, the name and address of the health facility,22
and, if the health facility is a multi-speciality
MULTISPECIALTY23
organization, the name and address of the speciality SPECIALTY clinic24
within the health facility where the physician assistant is practicing. must25
be imprinted on the prescription. Nothing in this section limits the ability26
of otherwise licensed health personnel to perform delegated acts. The27
SB23-083
-16- dispensing of prescription medication by a physician assistant is subject1
to section 12-280-120 (6).2
(2) If the authority to perform an act is delegated pursuant to3
subsection (1) of this section, the act shall not be performed except under4
the personal and responsible direction and supervision of a person5
licensed under the laws of this state to practice podiatry, and the person6
shall not be responsible for the direction and supervision of more than7
four physician assistants at any one time without specific approval of the8
Colorado podiatry board. The board may define appropriate direction and9
supervision pursuant to rules PRIOR TO PRACTICING PODIATRY , A10
PHYSICIAN ASSISTANT MUST ENTER INTO A COLLABORATIVE AGREEMENT11
WITH A LICENSED PODIATRIST.12
(3) The provisions of sections 12-240-107 (6), and 12-240-113,13
AND 12-240-114.5 governing physician assistants under the "Colorado14
Medical Practice Act" shall apply to physician assistants under this15
section.16
SECTION 10. In Colorado Revised Statutes, 13-64-301, amend17
(1) introductory portion as follows:18
13-64-301. Financial responsibility. (1) As a condition of active19
licensure or authority to practice in this state, every physician, dentist,20
dental therapist, or dental hygienist; every physician assistant; who has21
been practicing for at least three years; and every health-care institution22
as defined in section 13-64-202, except as provided in section23
13-64-303.5, that provides health-care services shall establish financial24
responsibility, as follows:25
SECTION 11. In Colorado Revised Statutes, 15-18.7-103,26
amend (1) introductory portion and (1)(i) as follows:27
SB23-083
-17- 15-18.7-103. Medical orders for scope of treatment forms -1
form contents. (1) A medical orders for scope of treatment form shall2
MUST include the following information concerning the adult whose3
medical treatment is the subject of the medical orders for scope of4
treatment form:5
(i) The signature of the adult's physician, advanced practice6
registered nurse, or if under the supervision or authority of the physician,7
physician assistant.8
SECTION 12. In Colorado Revised Statutes, 15-18.7-104,9
amend (5) as follows:10
15-18.7-104. Duty to comply with medical orders for scope of11
treatment form - immunity - effect on criminal charges against12
another person - transferability. (5) An adult's physician, advanced13
practice registered nurse, or if under the supervision of the physician,14
physician assistant may provide an oral confirmation to a health-care15
provider who shall annotate on the medical orders for scope of treatment16
form the time and date of the oral confirmation and the name and license17
number of the physician, advanced practice registered nurse, or physician18
assistant. The physician, advanced practice registered nurse, or physician19
assistant shall countersign the annotation of the oral confirmation on the20
medical orders for scope of treatment form within a time period that21
satisfies any applicable state law or within thirty days, whichever period22
is less, after providing the oral confirmation. The signature of the23
physician, advanced practice registered nurse, or physician assistant may24
be provided by photocopy, fax, or electronic means. A medical orders for25
scope of treatment form with annotated oral confirmation, and a26
photocopy, fax, or other electronic reproduction thereof OF THE FORM,27
SB23-083
-18- shall be given the same force and effect as the original form signed by the1
physician, advanced practice registered nurse, or physician assistant.2
SECTION 13. In Colorado Revised Statutes, 23-21-803, amend3
(6) as follows:4
23-21-803. Definitions. As used in this part 8, unless the context5
otherwise requires:6
(6) "Physician assistant" means a person licensed as a physician7
assistant by the Colorado medical board in accordance with section8
12-240-113 who is authorized, in accordance with section 12-240-1079
(6), to perform acts constituting the practice of medicine, including10
prescribing controlled substances. and who is under the supervision of a11
physician trained in MAT.12
SECTION 14. Act subject to petition - effective date. This act13
takes effect at 12:01 a.m. on the day following the expiration of the14
ninety-day period after final adjournment of the general assembly; except15
that, if a referendum petition is filed pursuant to section 1 (3) of article V16
of the state constitution against this act or an item, section, or part of this17
act within such period, then the act, item, section, or part will not take18
effect unless approved by the people at the general election to be held in19
November 2024 and, in such case, will take effect on the date of the20
official declaration of the vote thereon by the governor.21
SB23-083
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