First Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
ENGROSSED
This Version Includes All Amendments Adopted
on Second Reading in the House of Introduction
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
Amended 2nd Reading
March 7, 2023
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
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 A PHYSICIAN21
LICENSED IN GOOD STANDING PURSUANT TO THIS ARTICLE 240 OR ARTICLE22
290
OF THIS TITLE 12 OR A PHYSICIAN GROUP.
23
(b) (I) If the authority to perform an act is delegated pursuant to24
subsection (6)(a) of this section, the physician assistant to whom the act25
is delegated shall not perform the act except under the personal and26
responsible direction and supervision of a person licensed under the laws27
083
-3- of this state to practice medicine. A licensed physician may be responsible1
for the direction and supervision of up to eight physician assistants at any2
one time. A licensed physician shall not be made responsible for the3
direction and supervision of more than four physician assistants unless the4
licensed physician agrees to assume the responsibility. A licensed5
physician has sole discretion to assume or refuse such responsibility, and6
an employer shall not require a licensed physician to assume such7
responsibility as a condition of employment. The board, by rule, may8
define what constitutes appropriate direction and supervision of a9
physician assistant; except that the board shall not promulgate a rule that10
is inconsistent with section 12-240-114.5 WITH A COLLABORATIVE11
AGREEMENT IN PLACE, A PHYSICIAN ASSISTANT LICENSED BY THE BOARD12
PURSUANT TO SECTION 12-240-113 MAY PERFORM ACTS THAT CONSTITUTE13
THE PRACTICE OF MEDICINE AND ACTS THAT PHYSICIANS ARE AUTHORIZED14
BY LAW TO PERFORM TO THE EXTENT AND IN THE MANNER AUTHORIZED BY15
RULES PROMULGATED BY THE BOARD , INCLUDING PRESCRIBING AND16
DISPENSING MEDICATION, INCLUDING CONTROLLED SUBSTANCES .17
(II) For purposes of this subsection (6), "personal and responsible18
direction and supervision" means that the direction and supervision of a19
physician assistant is personally rendered by a licensed physician20
practicing in the state of Colorado and is not rendered through21
intermediaries. The extent of direction and supervision shall be22
determined by rules promulgated by the board and as otherwise provided23
in this subsection (6)(b); except that, when a physician assistant is24
performing a delegated medical function in an acute care hospital, the25
board shall allow supervision and direction to be performed without the26
physical presence of the physician during the time the delegated medical27
083
-4- functions are being implemented if:1
(A) The medical functions are performed where the supervising2
physician regularly practices or in a designated health manpower shortage3
area;4
(B) The licensed supervising physician reviews the quality of5
medical services rendered by the physician assistant by reviewing the6
medical records to assure compliance with the physicians' directions; and7
(C) The performance of the delegated medical function otherwise8
complies with the board's rules and any restrictions and protocols of the9
licensed supervising physician and hospital.10
(c) Pursuant to section 12-240-135 (7), the board may apply for11
an injunction to enjoin any person from performing delegated medical12
acts that are in violation of this section or of any rules promulgated by the13
board THE COLLABORATIVE AGREEMENT MUST BE KEPT ON FILE AT THE14
PHYSICIAN ASSISTANT'S PRIMARY LOCATION OF PRACTICE AND BE MADE15
AVAILABLE TO THE BOARD UPON REQUEST .16
(d) This subsection (6) shall not apply to any person who performs17
delegated medical tasks within the scope of the exemption contained in18
subsection (3)(l) of this section AN ACT BY A PHYSICIAN ASSISTANT THAT19
CONSTITUTES THE PRACTICE OF MEDICINE MUST BE CONSISTENT WITH20
GENERALLY ACCEPTED STANDARDS OF MEDICAL PRACTICE . A PHYSICIAN21
ASSISTANT SHALL COLLABORATE WITH THE APPROPRIATE HEALTH -CARE22
PROVIDER AS INDICATED BY THE CONDITION OF THE PATIENT , THE23
STANDARD OF CARE , AND THE PHYSICIAN ASSISTANT 'S EDUCATION,24
EXPERIENCE, AND COMPETENCE.25
(e) A
N EMPLOYER SHALL NOT REQUIRE A LICENSED PHYSICIAN TO26
ENTER INTO A COLLABORATIVE AGREEMENT AS A CONDITION OF THE27
083
-5- PHYSICIAN'S EMPLOYMENT.1
(f) A
LL PRESCRIPTIONS ISSUED BY A PHYSICIAN ASSISTANT MUST2
INCLUDE THE PHYSICIAN ASSISTANT'S NAME, THE NAME AND ADDRESS OF3
THE HEALTH FACILITY, AND, IF THE HEALTH FACILITY IS A MULTISPECIALTY4
ORGANIZATION, THE NAME AND ADDRESS OF THE SPECIALITY CLINIC5
WITHIN THE HEALTH FACILITY WHERE THE PHYSICIAN ASSISTANT IS6
PRACTICING. THE DISPENSING OF PRESCRIPTION MEDICATION BY A7
PHYSICIAN ASSISTANT IS SUBJECT TO SECTION 12-280-120 (6)(a).8
(g) W
HILE PERFORMING ACTS INCLUDED IN THE PRACTICE OF9
MEDICINE, AS DEFINED IN SUBSECTION (1) OF THIS SECTION, A PHYSICIAN10
ASSISTANT SHALL CLEARLY IDENTIFY ONESELF , BOTH VISUALLY AND11
VERBALLY, AS A PHYSICIAN ASSISTANT. AN EMPLOYER, PHYSICIAN, OR
12
PHYSICIAN GROUP MUST IDENTIFY TO PATIENTS THAT A PHYSICIAN13
ASSISTANT PROVIDING CARE IS A PHYSICIAN ASSISTANT .14
(h) P
URSUANT TO SECTION 12-240-135 (7), THE BOARD MAY APPLY15
FOR AN INJUNCTION TO ENJOIN ANY PERSON FROM PERFORMING MEDICAL16
ACTS THAT ARE IN VIOLATION OF THIS SECTION OR OF ANY RULES17
PROMULGATED BY THE BOARD .18
(i) T
HIS SUBSECTION (6) DOES NOT APPLY TO ANY PERSON WHO19
PERFORMS MEDICAL TASKS WITHIN THE SCOPE OF THE EXEMPTION20
SPECIFIED IN SUBSECTION (3)(l) OF THIS SECTION.21
(j) A
PHYSICIAN ASSISTANT IS LIABLE
FOR THE CARE PROVIDED BY22
THE PHYSICIAN ASSISTANT.23
(k) A
PHYSICIAN ASSISTANT SHALL COMPLY WITH THE FINANCIAL24
RESPONSIBILITY REQUIREMENTS SPECIFIED IN SECTION 13-64-301 (1) AND25
RULES ADOPTED BY THE BOARD PURSUANT TO THAT SECTION .26
(l) P
URSUANT TO SECTION 12-240-138 (1)(d)(I), A PHYSICIAN27
083
-6- ASSISTANT IS NOT AUTHORIZED TO OWN A MAJORITY OF A MEDICAL1
PRACTICE.2
SECTION 2. In Colorado Revised Statutes, amend 12-240-114.53
as follows:4
12-240-114.5. Physician assistants - collaboration5
requirements - proof of practice hours from another jurisdiction -6
liability - definitions. (1) As used in this section, unless the context7
otherwise requires:8
(a) "C
OLLABORATION" MEANS, AS INDICATED BY THE PATIENT'S9
CONDITION, COMMUNITY STANDARDS OF CARE , AND A PHYSICIAN10
ASSISTANT'S EDUCATION, TRAINING, AND EXPERIENCE:11
(I) C
ONSULTATION BETWEEN THE PHYSICIAN ASSISTANT AND
A12
PHYSICIAN; OR13
(II) R
EFERRAL BY THE PHYSICIAN ASSISTANT TO A PHYSICIAN , OR,14
IF THE REFERRAL IS TO A PHYSICIAN PRACTICING IN A DIFFERENT PRACTICE15
AREA THAN THE PHYSICIAN ASSISTANT , A PHYSICIAN'S PRACTICE GROUP.16
(b) "C
OLLABORATIVE AGREEMENT " MEANS A WRITTEN17
AGREEMENT THAT DESCRIBES THE MANNER IN WHICH A PHYSICIAN18
ASSISTANT COLLABORATES WITH AN EMPLOYER OR A PHYSICIAN .19
(a)
(c) "Performance evaluation" means a document that includes20
domains of competency relevant to the practice of a physician assistant,21
uses more than one modality of assessment to evaluate the domains, and22
includes consideration of the physician assistant's education, training,23
experience, competency, and knowledge of the specialty PRACTICE AREA24
in which the physician assistant is engaged.25
(b) "Practice agreement" means a written agreement between a26
physician assistant and a supervising physician that defines the27
083
-7- communication and decision-making process by which the physician1
assistant and the supervising physician provide care to patients.2
(c) "Supervisory plan" means a document that allows a3
supervising physician to follow the ongoing professional development of4
a physician assistant's clinical practice, promotes a collaborative5
relationship between a physician assistant and his or her supervising6
physicians, and allows a supervising physician to address any deficiencies7
that have been identified in the physician assistant's clinical competencies8
during the initial performance period.9
(d) "P
HYSICIAN" MEANS A PHYSICIAN LICENSED IN GOOD STANDING
10
PURSUANT TO THIS ARTICLE 240 OR ARTICLE 290 OF THIS TITLE 12,11
INCLUDING A PHYSICIAN IN A PHYSICIAN GROUP .12
(2) (a) A physician assistant licensed pursuant to this article 24013
who has practiced for less than three years is subject to the following14
supervisory requirements SHALL ENTER INTO A COLLABORATIVE15
AGREEMENT WITH AN EMPLOYER OR A PHYSICIAN . THE PHYSICIAN16
ENTERING INTO A COLLABORATIVE AGREEMENT MUST BE ACTIVELY17
PRACTICING IN COLORADO WITH A REGULAR AND RELIABLE PHYSICAL18
PRESENCE IN COLORADO. THE COLLABORATIVE AGREEMENT MUST19
INCLUDE:20
(a) (I) The physician assistant's first one hundred sixty working21
hours shall be supervised by a supervising physician who works at the22
same location as the physician assistant. The physician assistant's primary23
supervising physician shall provide at least forty hours of supervision, and24
the remaining hours may be provided by a secondary supervising25
physician who is designated by the primary supervising physician. THE26
PHYSICIAN ASSISTANT'S NAME, LICENSE NUMBER, AND PRIMARY LOCATION27
083
-8- OF PRACTICE;1
(b) (II) After the physician assistant completes one hundred sixty2
working hours, a supervising physician must remain available to the3
physician assistant via a telecommunication device at all times when the4
physician assistant is working. THE SIGNATURE OF THE PHYSICIAN5
ASSISTANT AND THE PHYSICIAN, OR PHYSICIAN GROUP WITH WHOM THE6
PHYSICIAN ASSISTANT HAS ENTERED INTO THE COLLABORATIVE7
AGREEMENT;8
(c) (III) Not more than thirty days after the physician assistant9
completes one hundred sixty working hours, the primary supervising10
physician shall complete an initial performance assessment and a11
supervisory plan for the physician assistant. A DESCRIPTION OF THE12
PHYSICIAN ASSISTANT'S PROCESS FOR COLLABORATION , THE DEGREE OF13
WHICH MUST BE DETERMINED AT THE PHYSICIAN ASSISTANT 'S PRIMARY14
LOCATION OF PRACTICE AND MAY INCLUDE :15
(A) D
ECISIONS MADE BY THE EMPLOYER OR PHYSICIAN WITH16
WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO A COLLABORATIVE17
AGREEMENT; AND18
(B) T
HE CREDENTIALING OR PRIVILEGING REQUIREMENTS OF THE19
PHYSICIAN ASSISTANT'S PRIMARY LOCATION OF PRACTICE;20
(IV) A
DESCRIPTION OF THE PERFORMANCE EVALUATION PROCESS ,21
WHICH MAY BE COMPLETED BY THE PHYSICIAN ASSISTANT 'S EMPLOYER IN22
ACCORDANCE WITH A PERFORMANCE EVALUATION AND REVIEW PROCESS23
ESTABLISHED BY THE EMPLOYER ; AND24
(V) A
NY ADDITIONAL REQUIREMENTS SPECIFIC TO THE PHYSICIAN25
ASSISTANT'S PRACTICE REQUIRED BY THE EMPLOYER OR PHYSICIAN26
ENTERING INTO THE COLLABORATIVE AGREEMENT , INCLUDING27
083
-9- ADDITIONAL LEVELS OF OVERSIGHT , LIMITATIONS ON AUTONOMOUS1
JUDGMENT, AND THE DESIGNATION OF A PRIMARY CONTACT FOR2
COLLABORATION.3
(b) (I) F
OR A PHYSICIAN ASSISTANT WITH FEWER THAN FIVE
4
THOUSAND PRACTICE HOURS , OR A PHYSICIAN ASSISTANT CHANGING5
PRACTICE AREAS WITH FEWER THAN THREE THOUSAND PRACTICE HOURS6
IN THE NEW PRACTICE AREA , THE COLLABORATIVE AGREEMENT IS A7
SUPERVISORY AGREEMENT THAT MUST INCLUDE THE PROVISIONS8
DESCRIBED IN SUBSECTIONS (2)(a)(III)(A), (2)(a)(III)(B), (2)(a)(IV), AND9
(2)(a)(V)
OF THIS SECTION AND
MUST ALSO:10
(A) R
EQUIRE THAT COLLABORATION DURING THE FIRST ONE11
HUNDRED SIXTY PRACTICE HOURS BE COMPLETED IN PERSON OR THROUGH12
TECHNOLOGY, AS PERMITTED BY THE PHYSICIAN OR PHYSICIAN GROUP
OR13
EMPLOYER WITH WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO THE14
COLLABORATIVE AGREEMENT ;15
(B) I
NCORPORATE ELEMENTS DEFINING THE EXPECTED NATURE OF16
COLLABORATION, INCLUDING: THE PHYSICIAN ASSISTANT'S EXPECTED17
AREA OF PRACTICE ; EXPECTATIONS REGARDING SUPPORT AND18
CONSULTATION FROM THE PHYSICIAN OR PHYSICIAN GROUP
WITH WHOM19
THE PHYSICIAN ASSISTANT HAS ENTERED INTO A COLLABORATIVE20
AGREEMENT; METHODS AND MODES OF COMMUNICATION AND21
COLLABORATION; AND ANY OTHER PERTINENT ELEMENTS OF22
COLLABORATIVE, TEAM-BASED PRACTICE APPLICABLE TO THE PHYSICIAN23
ASSISTANT'S PRACTICE OR ESTABLISHED BY THE EMPLOYER ; AND24
(C) R
EQUIRE A PERFORMANCE EVALUATION AND DISCUSSION OF25
THE PERFORMANCE EVALUATION WITH THE PHYSICIAN ASSISTANT AFTER26
THE PHYSICIAN ASSISTANT HAS WORKED WITH THE EMPLOYER FOR SIX27
083
-10- MONTHS, AGAIN AFTER THE PHYSICIAN ASSISTANT HAS WORKED WITH THE1
EMPLOYER FOR TWELVE MONTHS , AND ADDITIONAL EVALUATION2
THEREAFTER AS DETERMINED BY THE PHYSICIAN OR PHYSICIAN GROUP3
WITH WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO THE4
COLLABORATIVE AGREEMENT .5
(II) T
HE PERFORMANCE EVALUATION MAY BE COMPLETED BY THE6
PHYSICIAN ASSISTANT'S EMPLOYER IN ACCORDANCE WITH THE7
PERFORMANCE EVALUATION AND REVIEW PROCESS ESTABLISHED BY THE8
EMPLOYER; EXCEPT THAT THE PERFORMANCE EVALUATION MUST BE9
COMPLETED WITH AT LEAST THE MINIMUM FREQUENCY REQUIRED IN10
SECTION (2)(b)(I)(C) OF THIS SECTION.11
(III) A
FTER A PHYSICIAN ASSISTANT HAS COMPLETED THE NUMBER
12
OF PRACTICE HOURS REQUIRED PURSUANT TO SUBSECTION (2) OF THIS13
SECTION, THE ADDITIONAL COLLABORATIVE AGREEMENT REQUIREMENTS14
DESCRIBED IN THIS SUBSECTION (2)(b) NO LONGER APPLY.15
(3) (a) The supervision of a physician assistant licensed pursuant16
to this article 240 who has practiced in this state for three years or more17
is determined by a practice agreement that shall be created by the18
physician assistant and his or her primary supervising physician not later19
than thirty days after the physician assistant begins practicing under the20
supervision of the primary supervising physician. A practice agreement21
must include A PHYSICIAN ASSISTANT MAY PROVIDE THE BOARD WITH A22
SIGNED AFFIDAVIT OUTLINING PRACTICE EXPERIENCE FOR THE PURPOSES23
OF MEETING THE REQUIREMENTS DESCRIBED IN SUBSECTION (2)(b) OF THIS24
SECTION, AS APPLICABLE, IF THE PHYSICIAN ASSISTANT:25
(a) H
ELD AN UNENCUMBERED LICENSE IN ANOTHER STATE OR26
TERRITORY OF THE UNITED STATES BEFORE BECOMING LICENSED IN THIS27
083
-11- STATE PURSUANT TO SECTION 12-240-113; OR1
(b) W
AS INITIALLY LICENSED IN THIS STATE PRIOR TO THE2
EFFECTIVE DATE OF THIS SUBSECTION (3), AS AMENDED.3
(I) A process by which a physician assistant and a supervising
4
physician communicate and make decisions concerning patients' medical5
treatment, which process utilizes the knowledge and skills of the6
physician assistant and the supervising physician based on their respective7
education, training, and experience;8
(II) A protocol for designating an alternative physician for9
consultation when the supervising physician is unavailable for10
consultation;11
(III) The signatures of the physician assistant and supervising12
physician; and13
(IV) A termination provision that allows the physician assistant14
or the supervising physician to terminate the practice agreement after15
providing written notice of his or her intent to do so at least thirty days16
before the date of termination. If a practice agreement is terminated, the17
physician assistant and the physician assistant's primary supervising18
physician shall create a new practice agreement within forty-five days19
after the date the previous practice agreement was terminated.20
(b) In addition to the components described in subsection (3)(a)21
of this section, a practice agreement may impose conditions concerning22
specific duties, procedures, or drugs.23
(c) If the terms or conditions of a practice agreement change, both24
the physician assistant and the supervising physician shall sign and date25
the updated practice agreement.26
(4) A physician assistant licensed pursuant to this article 240 who27
083
-12- has practiced for at least twelve months and who is making a substantive1
change in his or her scope of practice or practice area is subject to the2
following supervisory requirements:3
(a) The physician assistant's first eighty working hours shall be4
supervised by a supervising physician who works at the same location as5
the physician assistant. The physician assistant's primary supervising6
physician shall provide at least twenty hours of supervision, and the7
remaining hours may be provided by a secondary supervising physician8
who is designated by the primary supervising physician.9
(b) After the physician assistant completes eighty working hours,10
a supervising physician shall remain available to the physician assistant11
via a telecommunication device at all times when the physician assistant12
is working.13
(c) After the physician assistant has worked for six months, and14
again after the physician assistant has worked for twelve months, the15
primary supervising physician shall complete a performance assessment16
and discuss the performance assessment with the physician assistant.17
(5) (a) A physician assistant licensed pursuant to this article 24018
who has practiced for at least three years may be liable for damages19
resulting from negligence in providing care to a patient; except that a20
physician assistant is not liable for any damages that occur as a result of21
the physician assistant following a direct order from a supervising22
physician.23
(b) A physician assistant who has been practicing for at least three24
years shall comply with the financial responsibility requirements specified25
in section 13-64-301 (1) and rules adopted by the board pursuant to that26
section.27
083
-13- (c) A physician assistant's supervising physician may be liable for1
damages resulting from the physician assistant's negligence in providing2
care to a patient if the physician assistant has not practiced for at least3
three years as described in subsection (5)(a) of this section.4
SECTION 3. In Colorado Revised Statutes, 12-240-119, amend5
(2)(c) as follows:6
12-240-119. Reentry license - period of inactivity -7
international medical graduate - competency assessment - board8
rules - conversion to full license. (2) (c) If, based on the assessment9
and,
IF PRESCRIBED, after completion of an educational program, if
10
prescribed, the board determines that the applicant is competent and11
qualified to practice medicine without supervision, or practice as a12
physician assistant, or
PRACTICE as an anesthesiologist assistant with13
supervision, as specified in this article 240, the board may convert the14
reentry license to a full license to practice medicine, practice as a15
physician assistant, or practice as an anesthesiologist assistant, as16
applicable, under this article 240.17
SECTION 4. In Colorado Revised Statutes, 12-240-122, amend18
(1) as follows:19
12-240-122. Prescriptions - requirement to advise patients.20
(1) A physician
OR PHYSICIAN ASSISTANT licensed under this article 24021
or a physician assistant licensed by the board who has been delegated the
22
authority to prescribe medication, may advise the physician's or the23
physician assistant's patients of their option to have the symptom or24
purpose for which a prescription is being issued included on the25
prescription order.26
SECTION 5. In Colorado Revised Statutes, 12-240-128, amend27
083
-14- (7)(c) as follows:1
12-240-128. Physician training licenses. (7) A physician2
training licensee may practice medicine as defined by this article 240 with3
the following restrictions:4
(c) A physician training licensee shall not: have the authority to5
(I) Delegate the rendering of medical services to a person who is6
not licensed to practice medicine pursuant to section 12-240-107 (3)(l);7
OR8
(II) and shall not have the authority to supervise
ENTER INTO A9
COLLABORATIVE AGREEMENT WITH physician assistants as provided by10
section 12-240-107 (6) DESCRIBED IN SECTIONS 12-240-107 (6) AND11
12-240-114.5.12
SECTION 6. In Colorado Revised Statutes, 12-280-103, amend13
(39)(c)(II)(B) as follows:14
12-280-103. Definitions - rules. As used in this article 280, unless15
the context otherwise requires or the term is otherwise defined in another16
part of this article 280:17
(39) "Practice of pharmacy" means:18
(c) The provision of a therapeutic interchange selection or a19
therapeutically equivalent selection to a patient if, during the patient's stay20
at a nursing care facility or a long-term acute care hospital licensed under21
part 1 of article 3 of title 25, the selection has been approved for the22
patient:23
(II) By one of the following health-care providers:24
(B) A physician assistant licensed under section 12-240-113; if the25
physician assistant is under the supervision of a licensed physician; or26
SECTION 7. In Colorado Revised Statutes, 12-280-502, amend27
083
-15- (1)(b)(II) as follows:1
12-280-502. Therapeutic interchange and therapeutically2
equivalent selections for nursing care facility or long-term acute care3
hospital patients - rules. (1) A pharmacy used by a nursing care facility4
or a long-term acute care hospital licensed under part 1 of article 3 of title5
25 may make a therapeutic interchange or a therapeutically equivalent6
selection for a patient if, during the patient's stay at the facility, the7
selection has been approved for the patient:8
(b) By one of the following health-care providers:9
(II) A physician assistant licensed under section 12-240-113; if the10
physician assistant is under the supervision of a licensed physician; or11
SECTION 8. In Colorado Revised Statutes, 12-290-110, amend12
(5) as follows:13
12-290-110. Podiatry training license. (5) A person with a14
podiatric training license shall only practice podiatry ONLY under the15
supervision of a licensed podiatrist or a physician licensed to practice16
medicine within the residency program. A person with a podiatry training17
license shall not delegate podiatric or medical services to a person who18
is not licensed to practice podiatry or medicine and shall not have the19
authority to supervise COLLABORATE WITH physician assistants.20
SECTION 9. In Colorado Revised Statutes, amend 12-290-11721
as follows:22
12-290-117. Use of physician assistants - collaboration23
requirements - affidavits of practice experience - rules - definitions.24
(1) A person licensed under the laws of this state to practice podiatry may25
delegate to a physician assistant licensed by the Colorado medical board26
pursuant to section 12-240-113 the authority to A PHYSICIAN ASSISTANT27
083
-16- LICENSED PURSUANT TO ARTICLE 240 OF THIS TITLE 12 MAY perform acts1
that constitute the practice of podiatry to the extent and in the manner2
authorized by rules promulgated by the Colorado podiatry board. The acts3
shall be consistent with sound practices of podiatry. Each prescription for4
a controlled substance, as defined in section 18-18-102 (5), issued by a5
physician assistant must have the name of the physician assistant's6
supervising podiatrist printed on the prescription. For all other ALL7
prescriptions issued by a physician assistant
MUST INCLUDE THE8
PHYSICIAN ASSISTANT'S NAME, the name and address of the health facility,9
and, if the health facility is a multi-speciality
MULTISPECIALTY10
organization, the name and address of the speciality SPECIALTY clinic11
within the health facility where the physician assistant is practicing. must12
be imprinted on the prescription. Nothing in this section limits the ability13
of otherwise licensed health personnel to perform delegated acts. The14
dispensing of prescription medication by a physician assistant is subject15
to section 12-280-120 (6).16
(2) If the authority to perform an act is delegated pursuant to17
subsection (1) of this section, the act shall not be performed except under18
the personal and responsible direction and supervision of a person19
licensed under the laws of this state to practice podiatry, and the person20
shall not be responsible for the direction and supervision of more than21
four physician assistants at any one time without specific approval of the22
Colorado podiatry board. The board may define appropriate direction and23
supervision pursuant to rules PRIOR TO PRACTICING PODIATRY , A24
PHYSICIAN ASSISTANT MUST ENTER INTO A COLLABORATIVE AGREEMENT25
WITH A LICENSED PODIATRIST.26
(3) The provisions of sections 12-240-107 (6), and 12-240-113,27
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-17- AND 12-240-114.5 governing physician assistants under the "Colorado1
Medical Practice Act" shall apply to physician assistants under this2
section.3
SECTION 10. In Colorado Revised Statutes, 13-64-301, amend4
(1) introductory portion as follows:5
13-64-301. Financial responsibility. (1) As a condition of active6
licensure or authority to practice in this state, every physician, dentist,7
dental therapist, or dental hygienist; every physician assistant; who has8
been practicing for at least three years; and every health-care institution9
as defined in section 13-64-202, except as provided in section10
13-64-303.5, that provides health-care services shall establish financial11
responsibility, as follows:12
SECTION 11. In Colorado Revised Statutes, 15-18.7-103,13
amend (1) introductory portion and (1)(i) as follows:14
15-18.7-103. Medical orders for scope of treatment forms -15
form contents. (1) A medical orders for scope of treatment form shall16
MUST include the following information concerning the adult whose17
medical treatment is the subject of the medical orders for scope of18
treatment form:19
(i) The signature of the adult's physician, advanced practice20
registered nurse, or if under the supervision or authority of the physician,21
physician assistant.22
SECTION 12. In Colorado Revised Statutes, 15-18.7-104,23
amend (5) as follows:24
15-18.7-104. Duty to comply with medical orders for scope of25
treatment form - immunity - effect on criminal charges against26
another person - transferability. (5) An adult's physician, advanced27
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-18- practice registered nurse, or if under the supervision of the physician,1
physician assistant may provide an oral confirmation to a health-care2
provider who shall annotate on the medical orders for scope of treatment3
form the time and date of the oral confirmation and the name and license4
number of the physician, advanced practice registered nurse, or physician5
assistant. The physician, advanced practice registered nurse, or physician6
assistant shall countersign the annotation of the oral confirmation on the7
medical orders for scope of treatment form within a time period that8
satisfies any applicable state law or within thirty days, whichever period9
is less, after providing the oral confirmation. The signature of the10
physician, advanced practice registered nurse, or physician assistant may11
be provided by photocopy, fax, or electronic means. A medical orders for12
scope of treatment form with annotated oral confirmation, and a13
photocopy, fax, or other electronic reproduction thereof OF THE FORM,14
shall be given the same force and effect as the original form signed by the15
physician, advanced practice registered nurse, or physician assistant.16
SECTION 13. In Colorado Revised Statutes, 23-21-803, amend17
(6) as follows:18
23-21-803. Definitions. As used in this part 8, unless the context19
otherwise requires:20
(6) "Physician assistant" means a person licensed as a physician21
assistant by the Colorado medical board in accordance with section22
12-240-113 who is authorized, in accordance with section 12-240-10723
(6), to perform acts constituting the practice of medicine, including24
prescribing controlled substances. and who is under the supervision of a25
physician trained in MAT.26
SECTION 14. Act subject to petition - effective date. This act27
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-19- takes effect at 12:01 a.m. on the day following the expiration of the1
ninety-day period after final adjournment of the general assembly; except2
that, if a referendum petition is filed pursuant to section 1 (3) of article V3
of the state constitution against this act or an item, section, or part of this4
act within such period, then the act, item, section, or part will not take5
effect unless approved by the people at the general election to be held in6
November 2024 and, in such case, will take effect on the date of the7
official declaration of the vote thereon by the governor.8
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