Colorado 2023 Regular Session

Colorado Senate Bill SB083 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	First Regular Session
	2	+	Seventy-fourth General Assembly
	3	+	STATE OF COLORADO
	4	+	REREVISED
	5	+	This Version Includes All Amendments
	6	+	Adopted in the Second House
	7	+	LLS NO. 23-0226.01 Yelana Love x2295
1	8		SENATE BILL 23-083
2		-	BY SENATOR(S) Winter F. and Simpson, Cutter, Exum, Jaquez Lewis,
3		-	Pelton B., Pelton R., Priola, Will;
4		-	also REPRESENTATIVE(S) Winter T. and Michaelson Jenet, Amabile,
5		-	Bockenfeld, Bradley, Brown, deGruy Kennedy, Dickson, Duran, English,
6		-	Epps, Frizell, Froelich, Hamrick, Jodeh, Lieder, Lindsay, Marshall,
7		-	McCormick, Parenti, Ricks, Titone, Velasco, Weissman, McCluskie.
	9	+	Senate Committees House Committees
	10	+	Health & Human Services Public & Behavioral Health & Human Services
	11	+	A BILL FOR AN ACT
8	12		C
9		-	ONCERNING AN EXPANSION OF A PHYSICIAN ASSISTANT 'S ABILITY TO
10		-	PRACTICE
11		-	, AND, IN CONNECTION THEREWITH , CHANGING THE
12		-	RELATIONSHIP BETWEEN A PHYSICIAN ASSISTANT AND A PHYSICIAN
13		-	OR PODIATRIST FROM SUPERVISION TO COLLABORATION
14		-	.
15		-	Be it enacted by the General Assembly of the State of Colorado:
16		-	SECTION 1. In Colorado Revised Statutes, 12-240-107, amend (6)
17		-	as follows:
18		-	12-240-107. Practice of medicine defined - exemptions from
19		-	licensing requirements - unauthorized practice by physician assistants
20		-	and anesthesiologist assistants - penalties - definitions - rules - repeal.
21		-	(6) (a) A person licensed under the laws of this state to practice medicine
22		-	may delegate to a physician assistant licensed by the board pursuant to
23		-	NOTE: This bill has been prepared for the signatures of the appropriate legislative
24		-	officers and the Governor. To determine whether the Governor has signed the bill
25		-	or taken other action on it, please consult the legislative status sheet, the legislative
26		-	history, or the Session Laws.
27		-	________
28		-	Capital letters or bold & italic numbers indicate new material added to existing law; dashes
29		-	through words or numbers indicate deletions from existing law and such material is not part of
30		-	the act. section 12-240-113 the authority to perform acts that constitute the practice
31		-	of medicine and acts that physicians are authorized by law to perform to the
32		-	extent and in the manner authorized by rules promulgated by the board,
33		-	including the authority to prescribe medication, including controlled
34		-	substances, and dispense only the drugs designated by the board. The acts
35		-	must be consistent with sound medical practice. Each prescription for a
36		-	controlled substance, as defined in section 18-18-102 (5), issued by a
37		-	physician assistant licensed by the board shall be imprinted with the name
38		-	of the physician assistant's supervising physician. For all other prescriptions
39		-	issued by a physician assistant, the name and address of the health facility
40		-	and, if the health facility is a multi-speciality organization, the name and
41		-	address of the speciality clinic within the health facility where the physician
42		-	assistant is practicing must be imprinted on the prescription. Nothing in this
43		-	subsection (6) limits the ability of otherwise licensed health personnel to
44		-	perform delegated acts. The dispensing of prescription medication by a
45		-	physician assistant is subject to section 12-280-120 (6) A PHYSICIAN
46		-	ASSISTANT MAY NOT PROVIDE CARE UNLESS THE PHYSICIAN ASSISTANT HAS
47		-	ENTERED INTO A COLLABORATIVE AGREEMENT WITH A PHYSICIAN LICENSED
48		-	IN GOOD STANDING PURSUANT TO THIS ARTICLE
49		-	240 OR ARTICLE 290 OF THIS
50		-	TITLE
51		-	12 OR A PHYSICIAN GROUP.
52		-	(b) (I) If the authority to perform an act is delegated pursuant to
53		-	subsection (6)(a) of this section, the physician assistant to whom the act is
54		-	delegated shall not perform the act except under the personal and
55		-	responsible direction and supervision of a person licensed under the laws
56		-	of this state to practice medicine. A licensed physician may be responsible
57		-	for the direction and supervision of up to eight physician assistants at any
58		-	one time. A licensed physician shall not be made responsible for the
59		-	direction and supervision of more than four physician assistants unless the
60		-	licensed physician agrees to assume the responsibility. A licensed physician
61		-	has sole discretion to assume or refuse such responsibility, and an employer
62		-	shall not require a licensed physician to assume such responsibility as a
63		-	condition of employment. The board, by rule, may define what constitutes
64		-	appropriate direction and supervision of a physician assistant; except that
65		-	the board shall not promulgate a rule that is inconsistent with section
66		-	12-240-114.5 WITH A COLLABORATIVE AGREEMENT IN PLACE , A PHYSICIAN
67		-	ASSISTANT LICENSED BY THE BOARD PURSUANT TO SECTION
68		-	12-240-113 MAY
69		-	PERFORM ACTS WITHIN THE PHYSICIAN ASSISTANT
70		-	'S EDUCATION,
71		-	EXPERIENCE, AND COMPETENCY THAT CONSTITUTE THE PRACTICE OF
72		-	MEDICINE AND ACTS THAT PHYSICIANS ARE AUTHORIZED BY LAW TO
73		-	PAGE 2-SENATE BILL 23-083 PERFORM TO THE EXTENT AND IN THE MANNER AUTHORIZED BY RULES
74		-	PROMULGATED BY THE BOARD
75		-	, INCLUDING PRESCRIBING AND DISPENSING
76		-	MEDICATION
77		-	, INCLUDING CONTROLLED SUBSTANCES .
78		-	(II) For purposes of this subsection (6), "personal and responsible
79		-	direction and supervision" means that the direction and supervision of a
80		-	physician assistant is personally rendered by a licensed physician practicing
81		-	in the state of Colorado and is not rendered through intermediaries. The
82		-	extent of direction and supervision shall be determined by rules
83		-	promulgated by the board and as otherwise provided in this subsection
84		-	(6)(b); except that, when a physician assistant is performing a delegated
85		-	medical function in an acute care hospital, the board shall allow supervision
86		-	and direction to be performed without the physical presence of the physician
87		-	during the time the delegated medical functions are being implemented if:
88		-	(A) The medical functions are performed where the supervising
89		-	physician regularly practices or in a designated health manpower shortage
90		-	area;
91		-	(B) The licensed supervising physician reviews the quality of
92		-	medical services rendered by the physician assistant by reviewing the
93		-	medical records to assure compliance with the physicians' directions; and
94		-	(C) The performance of the delegated medical function otherwise
95		-	complies with the board's rules and any restrictions and protocols of the
96		-	licensed supervising physician and hospital.
97		-	(c) Pursuant to section 12-240-135 (7), the board may apply for an
98		-	injunction to enjoin any person from performing delegated medical acts that
99		-	are in violation of this section or of any rules promulgated by the board THE
100		-	COLLABORATIVE AGREEMENT MUST BE KEPT ON FILE AT THE PHYSICIAN
101		-	ASSISTANT
102		-	'S PRIMARY LOCATION OF PRACTICE AND BE MADE AVAILABLE TO
103		-	THE BOARD UPON REQUEST
104		-	.
105		-	(d) This subsection (6) shall not apply to any person who performsdelegated medical tasks within the scope of the exemption contained in
106		-	subsection (3)(l) of this section AN ACT BY A PHYSICIAN ASSISTANT THAT
107		-	CONSTITUTES THE PRACTICE OF MEDICINE MUST BE CONSISTENT WITH
108		-	GENERALLY ACCEPTED STANDARDS OF MEDICAL PRACTICE
109		-	. A PHYSICIAN
110		-	ASSISTANT SHALL COLLABORATE WITH THE APPROPRIATE HEALTH
111		-	-CARE
112		-	PAGE 3-SENATE BILL 23-083 PROVIDER AS INDICATED BY THE CONDITION OF THE PATIENT , THE STANDARD
113		-	OF CARE
114		-	, AND THE PHYSICIAN ASSISTANT'S EDUCATION, EXPERIENCE, AND
115		-	COMPETENCE
116		-	.
117		-	(e) A
118		-	N EMPLOYER SHALL NOT REQUIRE A LICENSED PHYSICIAN TO
119		-	ENTER INTO A COLLABORATIVE AGREEMENT AS A CONDITION OF THE
120		-	PHYSICIAN
121		-	'S EMPLOYMENT.
	13	+	ONCERNING AN EXPANSION OF A PHYSICIAN ASSISTANT 'S ABILITY TO101
	14	+	PRACTICE, AND, IN CONNECTION THEREWITH , CHANGING THE102
	15	+	RELATIONSHIP BETWEEN A PHYSICIAN ASSISTANT AND A103
	16	+	PHYSICIAN OR PODIATRIST FROM SUPERVISION TO104
	17	+	COLLABORATION.105
	18	+	Bill Summary
	19	+	(Note: This summary applies to this bill as introduced and does
	20	+	not reflect any amendments that may be subsequently adopted. If this bill
	21	+	passes third reading in the house of introduction, a bill summary that
	22	+	applies to the reengrossed version of this bill will be available at
	23	+	http://leg.colorado.gov
	24	+	.)
	25	+	The bill modifies the relationship between a physician assistant
	26	+	and a physician or podiatrist by removing the requirement that a physician
	27	+	HOUSE
	28	+	3rd Reading Unamended
	29	+	March 27, 2023
	30	+	HOUSE
	31	+	Amended 2nd Reading
	32	+	March 23, 2023
	33	+	SENATE
	34	+	Amended 3rd Reading
	35	+	March 9, 2023
	36	+	SENATE
	37	+	Amended 2nd Reading
	38	+	March 7, 2023
	39	+	SENATE SPONSORSHIP
	40	+	Winter F. and Simpson, Cutter, Exum, Jaquez Lewis, Pelton B., Pelton R., Priola, Will
	41	+	HOUSE SPONSORSHIP
	42	+	Winter T. and Michaelson Jenet, Amabile, Bockenfeld, Bradley, Brown, deGruy
	43	+	Kennedy, Dickson, Duran, English, Epps, Frizell, Froelich, Hamrick, Jodeh, Lieder, Lindsay,
	44	+	Marshall, McCluskie, McCormick, Parenti, Ricks, Titone, Velasco, Weissman
	45	+	Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
	46	+	Capital letters or bold & italic numbers indicate new material to be added to existing law.
	47	+	Dashes through the words or numbers indicate deletions from existing law. assistant be supervised by a physician or podiatrist. Instead, a physician
	48	+	assistant must enter into a collaborative agreement with an employer,
	49	+	physician, or podiatrist.
	50	+	The collaborative agreement must include:
	51	+	! The physician assistant's name, license number, and
	52	+	primary location of practice;
	53	+	! The signature of the physician assistant and the person with
	54	+	whom the physician assistant has entered into the
	55	+	collaborative agreement;
	56	+	! A general description of the physician assistant's process
	57	+	for collaboration;
	58	+	! A description of the performance evaluation process, which
	59	+	may be completed by the physician assistant's employer in
	60	+	accordance with a performance evaluation and review
	61	+	process established by the employer; and
	62	+	! Any additional requirements specific to the physician
	63	+	assistant's practice required by the employer, physician, or
	64	+	podiatrist entering into the collaborative agreement,
	65	+	including additional levels of oversight, limitations on
	66	+	autonomous judgment, and the designation of a primary
	67	+	contact for collaboration.
	68	+	For a physician assistant with fewer than 3,000 practice hours, the
	69	+	collaborative agreement must also:
	70	+	! Require that collaboration during the first 160 practice
	71	+	hours be completed in person or through technology;
	72	+	! Incorporate elements defining the expected nature of
	73	+	collaboration; and
	74	+	! Require a performance evaluation and discussion of the
	75	+	performance evaluation with the physician assistant.
	76	+	The bill also requires physician assistants who have been
	77	+	practicing for less than 3 years to satisfy certain financial responsibility
	78	+	requirements from which such physician assistants are exempt under
	79	+	current law.
	80	+	Be it enacted by the General Assembly of the State of Colorado:1
	81	+	SECTION 1. In Colorado Revised Statutes, 12-240-107, amend2
	82	+	(6) as follows:3
	83	+	12-240-107. Practice of medicine defined - exemptions from4
	84	+	licensing requirements - unauthorized practice by physician5
	85	+	assistants and anesthesiologist assistants - penalties - definitions -6
	86	+	083-2- rules - repeal. (6) (a) A person licensed under the laws of this state to1
	87	+	practice medicine may delegate to a physician assistant licensed by the2
	88	+	board pursuant to section 12-240-113 the authority to perform acts that3
	89	+	constitute the practice of medicine and acts that physicians are authorized4
	90	+	by law to perform to the extent and in the manner authorized by rules5
	91	+	promulgated by the board, including the authority to prescribe6
	92	+	medication, including controlled substances, and dispense only the drugs7
	93	+	designated by the board. The acts must be consistent with sound medical8
	94	+	practice. Each prescription for a controlled substance, as defined in9
	95	+	section 18-18-102 (5), issued by a physician assistant licensed by the10
	96	+	board shall be imprinted with the name of the physician assistant's11
	97	+	supervising physician. For all other prescriptions issued by a physician12
	98	+	assistant, the name and address of the health facility and, if the health13
	99	+	facility is a multi-speciality organization, the name and address of the14
	100	+	speciality clinic within the health facility where the physician assistant is15
	101	+	practicing must be imprinted on the prescription. Nothing in this16
	102	+	subsection (6) limits the ability of otherwise licensed health personnel to17
	103	+	perform delegated acts. The dispensing of prescription medication by a18
	104	+	physician assistant is subject to section 12-280-120 (6) A PHYSICIAN19
	105	+	ASSISTANT MAY NOT PROVIDE CARE UNLESS THE PHYSICIAN ASSISTANT20
	106	+	HAS ENTERED INTO A COLLABORATIVE AGREEMENT WITH A PHYSICIAN21
	107	+	LICENSED IN GOOD STANDING PURSUANT TO THIS ARTICLE 240 OR ARTICLE22
	108	+	290
	109	+	OF THIS TITLE 12 OR A PHYSICIAN GROUP.
	110	+	23
	111	+	(b) (I) If the authority to perform an act is delegated pursuant to24
	112	+	subsection (6)(a) of this section, the physician assistant to whom the act25
	113	+	is delegated shall not perform the act except under the personal and26
	114	+	responsible direction and supervision of a person licensed under the laws27
	115	+	083
	116	+	-3- of this state to practice medicine. A licensed physician may be responsible1
	117	+	for the direction and supervision of up to eight physician assistants at any2
	118	+	one time. A licensed physician shall not be made responsible for the3
	119	+	direction and supervision of more than four physician assistants unless the4
	120	+	licensed physician agrees to assume the responsibility. A licensed5
	121	+	physician has sole discretion to assume or refuse such responsibility, and6
	122	+	an employer shall not require a licensed physician to assume such7
	123	+	responsibility as a condition of employment. The board, by rule, may8
	124	+	define what constitutes appropriate direction and supervision of a9
	125	+	physician assistant; except that the board shall not promulgate a rule that10
	126	+	is inconsistent with section 12-240-114.5 WITH A COLLABORATIVE11
	127	+	AGREEMENT IN PLACE, A PHYSICIAN ASSISTANT LICENSED BY THE BOARD12
	128	+	PURSUANT TO SECTION 12-240-113 MAY PERFORM ACTS WITHIN THE13
	129	+	PHYSICIAN ASSISTANT'S EDUCATION, EXPERIENCE, AND COMPETENCY THAT14
	130	+	CONSTITUTE THE PRACTICE OF MEDICINE AND ACTS THAT PHYSICIANS ARE15
	131	+	AUTHORIZED BY LAW TO PERFORM TO THE EXTENT AND IN THE MANNER16
	132	+	AUTHORIZED BY RULES PROMULGATED BY THE BOARD , INCLUDING17
	133	+	PRESCRIBING AND DISPENSING MEDICATION , INCLUDING CONTROLLED18
	134	+	SUBSTANCES.19
	135	+	(II) For purposes of this subsection (6), "personal and responsible20
	136	+	direction and supervision" means that the direction and supervision of a21
	137	+	physician assistant is personally rendered by a licensed physician22
	138	+	practicing in the state of Colorado and is not rendered through23
	139	+	intermediaries. The extent of direction and supervision shall be24
	140	+	determined by rules promulgated by the board and as otherwise provided25
	141	+	in this subsection (6)(b); except that, when a physician assistant is26
	142	+	performing a delegated medical function in an acute care hospital, the27
	143	+	083
	144	+	-4- board shall allow supervision and direction to be performed without the1
	145	+	physical presence of the physician during the time the delegated medical2
	146	+	functions are being implemented if:3
	147	+	(A) The medical functions are performed where the supervising4
	148	+	physician regularly practices or in a designated health manpower shortage5
	149	+	area;6
	150	+	(B) The licensed supervising physician reviews the quality of7
	151	+	medical services rendered by the physician assistant by reviewing the8
	152	+	medical records to assure compliance with the physicians' directions; and9
	153	+	(C) The performance of the delegated medical function otherwise10
	154	+	complies with the board's rules and any restrictions and protocols of the11
	155	+	licensed supervising physician and hospital.12
	156	+	(c) Pursuant to section 12-240-135 (7), the board may apply for13
	157	+	an injunction to enjoin any person from performing delegated medical14
	158	+	acts that are in violation of this section or of any rules promulgated by the15
	159	+	board THE COLLABORATIVE AGREEMENT MUST BE KEPT ON FILE AT THE16
	160	+	PHYSICIAN ASSISTANT'S PRIMARY LOCATION OF PRACTICE AND BE MADE17
	161	+	AVAILABLE TO THE BOARD UPON REQUEST .18
	162	+	(d) This subsection (6) shall not apply to any person who performs19
	163	+	delegated medical tasks within the scope of the exemption contained in20
	164	+	subsection (3)(l) of this section AN ACT BY A PHYSICIAN ASSISTANT THAT21
	165	+	CONSTITUTES THE PRACTICE OF MEDICINE MUST BE CONSISTENT WITH22
	166	+	GENERALLY ACCEPTED STANDARDS OF MEDICAL PRACTICE . A PHYSICIAN23
	167	+	ASSISTANT SHALL COLLABORATE WITH THE APPROPRIATE HEALTH -CARE24
	168	+	PROVIDER AS INDICATED BY THE CONDITION OF THE PATIENT , THE25
	169	+	STANDARD OF CARE , AND THE PHYSICIAN ASSISTANT 'S EDUCATION,26
	170	+	EXPERIENCE, AND COMPETENCE.27
	171	+	083
	172	+	-5- (e) AN EMPLOYER SHALL NOT REQUIRE A LICENSED PHYSICIAN TO1
	173	+	ENTER INTO A COLLABORATIVE AGREEMENT AS A CONDITION OF THE2
	174	+	PHYSICIAN'S EMPLOYMENT.3
122	175		(f) A
123		-	LL PRESCRIPTIONS ISSUED BY A PHYSICIAN ASSISTANT MUST
124		-	INCLUDE THE PHYSICIAN ASSISTANT
125		-	'S NAME, THE NAME AND ADDRESS OF
126		-	THE HEALTH FACILITY
127		-	, AND, IF THE HEALTH FACILITY IS A MULTISPECIALTY
128		-	ORGANIZATION
129		-	, THE NAME AND ADDRESS OF THE SPECIALITY CLINIC WITHIN
130		-	THE HEALTH FACILITY WHERE THE PHYSICIAN ASSISTANT IS PRACTICING
131		-	. THE
132		-	DISPENSING OF PRESCRIPTION MEDICATION BY A PHYSICIAN ASSISTANT IS
133		-	SUBJECT TO SECTION
134		-	12-280-120 (6)(a).
	176	+	LL PRESCRIPTIONS ISSUED BY A PHYSICIAN ASSISTANT MUST4
	177	+	INCLUDE THE PHYSICIAN ASSISTANT'S NAME, THE NAME AND ADDRESS OF5
	178	+	THE HEALTH FACILITY, AND, IF THE HEALTH FACILITY IS A MULTISPECIALTY6
	179	+	ORGANIZATION, THE NAME AND ADDRESS OF THE SPECIALITY CLINIC7
	180	+	WITHIN THE HEALTH FACILITY WHERE THE PHYSICIAN ASSISTANT IS8
	181	+	PRACTICING. THE DISPENSING OF PRESCRIPTION MEDICATION BY A9
	182	+	PHYSICIAN ASSISTANT IS SUBJECT TO SECTION 12-280-120 (6)(a).10
135	183		(g) W
136		-	HILE PERFORMING ACTS INCLUDED IN THE PRACTICE OF
137		-	MEDICINE
138		-	, AS DEFINED IN SUBSECTION (1) OF THIS SECTION, A PHYSICIAN
139		-	ASSISTANT SHALL CLEARLY IDENTIFY ONESELF
140		-	, BOTH VISUALLY AND
141		-	VERBALLY
142		-	, AS A PHYSICIAN ASSISTANT. AN EMPLOYER, PHYSICIAN, OR
143		-	PHYSICIAN GROUP MUST IDENTIFY TO PATIENTS THAT A PHYSICIAN
144		-	ASSISTANT PROVIDING CARE IS A PHYSICIAN ASSISTANT
145		-	.
	184	+	HILE PERFORMING ACTS INCLUDED IN THE PRACTICE OF11
	185	+	MEDICINE, AS DEFINED IN SUBSECTION (1) OF THIS SECTION, A PHYSICIAN12
	186	+	ASSISTANT SHALL CLEARLY IDENTIFY ONESELF , BOTH VISUALLY AND13
	187	+	VERBALLY, AS A PHYSICIAN ASSISTANT. AN EMPLOYER, PHYSICIAN, OR
	188	+	14
	189	+	PHYSICIAN GROUP MUST IDENTIFY TO PATIENTS THAT A PHYSICIAN15
	190	+	ASSISTANT PROVIDING CARE IS A PHYSICIAN ASSISTANT .16
146	191		(h) P
147		-	URSUANT TO SECTION 12-240-135 (7), THE BOARD MAY APPLY
148		-	FOR AN INJUNCTION TO ENJOIN ANY PERSON FROM PERFORMING MEDICAL
149		-	ACTS THAT ARE IN VIOLATION OF THIS SECTION OR OF ANY RULES
150		-	PROMULGATED BY THE BOARD
151		-	.
	192	+	URSUANT TO SECTION 12-240-135 (7), THE BOARD MAY APPLY17
	193	+	FOR AN INJUNCTION TO ENJOIN ANY PERSON FROM PERFORMING MEDICAL18
	194	+	ACTS THAT ARE IN VIOLATION OF THIS SECTION OR OF ANY RULES19
	195	+	PROMULGATED BY THE BOARD .20
152	196		(i) T
153		-	HIS SUBSECTION (6) DOES NOT APPLY TO ANY PERSON WHO
154		-	PERFORMS MEDICAL TASKS WITHIN THE SCOPE OF THE EXEMPTION SPECIFIED
155		-	IN SUBSECTION
156		-	(3)(l) OF THIS SECTION.
	197	+	HIS SUBSECTION (6) DOES NOT APPLY TO ANY PERSON WHO21
	198	+	PERFORMS MEDICAL TASKS WITHIN THE SCOPE OF THE EXEMPTION22
	199	+	SPECIFIED IN SUBSECTION (3)(l) OF THIS SECTION.23
157	200		(j) A
158		-	PHYSICIAN ASSISTANT IS LIABLE ~~FOR THE CARE PROVIDED BY~~
159		-	THE ~~PHYSICIAN ASSISTANT~~
160		-	.
	201	+	PHYSICIAN ASSISTANT IS LIABLE
	202	+	FOR THE CARE PROVIDED BY24
	203	+	THE PHYSICIAN ASSISTANT.25
161	204		(k) A
162		-	PHYSICIAN ASSISTANT SHALL COMPLY WITH THE FINANCIAL
163		-	RESPONSIBILITY REQUIREMENTS SPECIFIED IN SECTION
164		-	13-64-301 (1) AND
165		-	RULES ADOPTED BY THE BOARD PURSUANT TO THAT SECTION
166		-	.
	205	+	PHYSICIAN ASSISTANT SHALL COMPLY WITH THE FINANCIAL26
	206	+	RESPONSIBILITY REQUIREMENTS SPECIFIED IN SECTION 13-64-301 (1) AND27
	207	+	083
	208	+	-6- RULES ADOPTED BY THE BOARD PURSUANT TO THAT SECTION .1
167	209		(l) P
168		-	URSUANT TO SECTION 12-240-138 (1)(d)(I), A PHYSICIAN
169		-	PAGE 4-SENATE BILL 23-083 ASSISTANT IS NOT AUTHORIZED TO OWN A MAJORITY OF A MEDICAL
170		-	PRACTICE
171		-	.
172		-	SECTION 2. In Colorado Revised Statutes, amend 12-240-114.5
173		-	as follows:
174		-	12-240-114.5. Physician assistants - collaboration requirements
175		-	- proof of practice hours from another jurisdiction - liability -
176		-	definitions. (1) As used in this section, unless the context otherwise
177		-	requires:
	210	+	URSUANT TO SECTION 12-240-138 (1)(d)(I), A PHYSICIAN2
	211	+	ASSISTANT IS NOT AUTHORIZED TO OWN A MAJORITY OF A MEDICAL3
	212	+	PRACTICE.4
	213	+	SECTION 2. In Colorado Revised Statutes, amend 12-240-114.55
	214	+	as follows:6
	215	+	12-240-114.5. Physician assistants - collaboration7
	216	+	requirements - proof of practice hours from another jurisdiction -8
	217	+	liability - definitions. (1) As used in this section, unless the context9
	218	+	otherwise requires:10
178	219		(a) "C
179		-	OLLABORATION" MEANS, AS INDICATED BY THE PATIENT'S
180		-	CONDITION
181		-	, COMMUNITY STANDARDS OF CARE , AND A PHYSICIAN
182		-	ASSISTANT
183		-	'S EDUCATION, TRAINING, AND EXPERIENCE:
	220	+	OLLABORATION" MEANS, AS INDICATED BY THE PATIENT'S11
	221	+	CONDITION, COMMUNITY STANDARDS OF CARE , AND A PHYSICIAN12
	222	+	ASSISTANT'S EDUCATION, TRAINING, AND EXPERIENCE:13
184	223		(I) C
185		-	ONSULTATION BETWEEN THE PHYSICIAN ASSISTANT AND A
186		-	~~PHYSICIAN OR PHYSICIAN GROUP~~
187		-	; OR
188		-	(II) ~~REFERRAL BY THE PHYSICIAN ASSISTANT TO A PHYSICIAN , OR, IF~~
189		-	THE ~~REFERRAL IS~~ TO A PHYSICIAN ~~PRACTICING IN A DIFFERENT PRACTICE~~
190		-	~~AREA THAN~~ THE PHYSICIAN ~~ASSISTANT~~
191		-	, A PHYSICIAN'S PRACTICE GROUP.
	224	+	ONSULTATION BETWEEN THE PHYSICIAN ASSISTANT AND
	225	+	A14
	226	+	PHYSICIAN OR PHYSICIAN GROUP; OR15
	227	+	(II) R
	228	+	EFERRAL BY THE PHYSICIAN ASSISTANT TO A PHYSICIAN , OR,16
	229	+	IF THE REFERRAL IS TO A PHYSICIAN PRACTICING IN A DIFFERENT PRACTICE17
	230	+	AREA THAN THE PHYSICIAN ASSISTANT , A PHYSICIAN'S PRACTICE GROUP.18
192	231		(b) "C
193		-	OLLABORATIVE AGREEMENT " MEANS A WRITTEN AGREEMENT
194		-	THAT DESCRIBES THE MANNER IN WHICH A PHYSICIAN ASSISTANT
195		-	COLLABORATES WITH A PHYSICIAN OR A PHYSICIAN GROUP
196		-	.
197		-	(a)
198		-	(c) "Performance evaluation" means a document that includes
199		-	domains of competency relevant to the practice of a physician assistant,
200		-	uses more than one modality of assessment to evaluate the domains, and
201		-	includes consideration of the physician assistant's education, training,
202		-	experience, competency, and knowledge of the specialty
203		-	PRACTICE AREA in
204		-	which the physician assistant is engaged.
205		-	(b) "Practice agreement" means a written agreement between a
206		-	physician assistant and a supervising physician that defines the
207		-	communication and decision-making process by which the physician
208		-	assistant and the supervising physician provide care to patients.
209		-	(c) "Supervisory plan" means a document that allows a supervising
210		-	physician to follow the ongoing professional development of a physician
211		-	PAGE 5-SENATE BILL 23-083 assistant's clinical practice, promotes a collaborative relationship between
212		-	a physician assistant and his or her supervising physicians, and allows a
213		-	supervising physician to address any deficiencies that have been identified
214		-	in the physician assistant's clinical competencies during the initial
215		-	performance period.
216		-	(d) "PHYSICIAN" MEANS A PHYSICIAN LICENSED IN GOOD STANDING
217		-	PURSUANT TO THIS ARTICLE
218		-	240 OR ARTICLE 290 OF THIS TITLE 12,
219		-	INCLUDING A PHYSICIAN IN A PHYSICIAN GROUP .
220		-	(2) (a) A physician assistant licensed pursuant to this article 240
221		-	who has practiced for less than three years is subject to the followingsupervisory requirements SHALL ENTER INTO A COLLABORATIVE AGREEMENT
222		-	WITH A PHYSICIAN OR A PHYSICIAN GROUP
223		-	. THE PHYSICIAN ENTERING INTO
224		-	A COLLABORATIVE AGREEMENT MUST BE ACTIVELY PRACTICING IN
225		-	COLORADO WITH A REGULAR AND RELIABLE PHYSICAL PRESENCE IN
226		-	COLORADO. THE COLLABORATIVE AGREEMENT MUST INCLUDE :
227		-	(a)
228		-	(I) The physician assistant's first one hundred sixty working
229		-	hours shall be supervised by a supervising physician who works at the same
230		-	location as the physician assistant. The physician assistant's primary
231		-	supervising physician shall provide at least forty hours of supervision, and
232		-	the remaining hours may be provided by a secondary supervising physician
233		-	who is designated by the primary supervising physician. THE PHYSICIAN
234		-	ASSISTANT
235		-	'S NAME, LICENSE NUMBER, AND PRIMARY LOCATION OF PRACTICE;
236		-	(b)
237		-	(II) After the physician assistant completes one hundred sixty
238		-	working hours, a supervising physician must remain available to the
239		-	physician assistant via a telecommunication device at all times when the
240		-	physician assistant is working. THE SIGNATURE OF THE PHYSICIAN
241		-	ASSISTANT AND THE PHYSICIAN OR PHYSICIAN GROUP WITH WHOM THE
242		-	PHYSICIAN ASSISTANT HAS ENTERED INTO THE COLLABORATIVE AGREEMENT
243		-	;
244		-	(c) (III) Not more than thirty days after the physician assistant
245		-	completes one hundred sixty working hours, the primary supervising
246		-	physician shall complete an initial performance assessment and a
247		-	supervisory plan for the physician assistant. A DESCRIPTION OF THE
248		-	PHYSICIAN ASSISTANT
249		-	'S PROCESS FOR COLLABORATION , THE DEGREE OF
250		-	WHICH MUST BE BASED ON THE PHYSICIAN ASSISTANT
251		-	'S PRIMARY LOCATION
252		-	AND AREA OF PRACTICE AND MAY INCLUDE
253		-	:
254		-	PAGE 6-SENATE BILL 23-083 (A) DECISIONS MADE BY THE PHYSICIAN OR PHYSICIAN GROUP WITH
255		-	WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO A COLLABORATIVE
256		-	AGREEMENT
257		-	; AND
258		-	(B) THE CREDENTIALING OR PRIVILEGING REQUIREMENTS OF THE
259		-	PHYSICIAN ASSISTANT
260		-	'S PRIMARY LOCATION OF PRACTICE;
	232	+	OLLABORATIVE AGREEMENT " MEANS A WRITTEN19
	233	+	AGREEMENT THAT DESCRIBES THE MANNER IN WHICH A PHYSICIAN20
	234	+	ASSISTANT COLLABORATES WITH
	235	+	A PHYSICIAN OR A PHYSICIAN GROUP.21
	236	+	(a) (c) "Performance evaluation" means a document that includes22
	237	+	domains of competency relevant to the practice of a physician assistant,23
	238	+	uses more than one modality of assessment to evaluate the domains, and24
	239	+	includes consideration of the physician assistant's education, training,25
	240	+	experience, competency, and knowledge of the specialty PRACTICE AREA26
	241	+	in which the physician assistant is engaged.27
	242	+	083
	243	+	-7- (b) "Practice agreement" means a written agreement between a1
	244	+	physician assistant and a supervising physician that defines the2
	245	+	communication and decision-making process by which the physician3
	246	+	assistant and the supervising physician provide care to patients.4
	247	+	(c) "Supervisory plan" means a document that allows a5
	248	+	supervising physician to follow the ongoing professional development of6
	249	+	a physician assistant's clinical practice, promotes a collaborative7
	250	+	relationship between a physician assistant and his or her supervising8
	251	+	physicians, and allows a supervising physician to address any deficiencies9
	252	+	that have been identified in the physician assistant's clinical competencies10
	253	+	during the initial performance period.11
	254	+	(d) "P
	255	+	HYSICIAN" MEANS A PHYSICIAN LICENSED IN GOOD STANDING
	256	+	12
	257	+	PURSUANT TO THIS ARTICLE 240 OR ARTICLE 290 OF THIS TITLE 12,13
	258	+	INCLUDING A PHYSICIAN IN A PHYSICIAN GROUP .14
	259	+	(2) (a) A physician assistant licensed pursuant to this article 24015
	260	+	who has practiced for less than three years is subject to the following16
	261	+	supervisory requirements SHALL ENTER INTO A COLLABORATIVE17
	262	+	AGREEMENT WITH A PHYSICIAN OR A PHYSICIAN GROUP . THE PHYSICIAN18
	263	+	ENTERING INTO A COLLABORATIVE AGREEMENT MUST BE ACTIVELY19
	264	+	PRACTICING IN COLORADO WITH A REGULAR AND RELIABLE PHYSICAL20
	265	+	PRESENCE IN COLORADO. THE COLLABORATIVE AGREEMENT MUST21
	266	+	INCLUDE:22
	267	+	(a) (I) The physician assistant's first one hundred sixty working23
	268	+	hours shall be supervised by a supervising physician who works at the24
	269	+	same location as the physician assistant. The physician assistant's primary25
	270	+	supervising physician shall provide at least forty hours of supervision, and26
	271	+	the remaining hours may be provided by a secondary supervising27
	272	+	083
	273	+	-8- physician who is designated by the primary supervising physician. THE1
	274	+	PHYSICIAN ASSISTANT'S NAME, LICENSE NUMBER, AND PRIMARY LOCATION2
	275	+	OF PRACTICE;3
	276	+	(b) (II) After the physician assistant completes one hundred sixty4
	277	+	working hours, a supervising physician must remain available to the5
	278	+	physician assistant via a telecommunication device at all times when the6
	279	+	physician assistant is working. THE SIGNATURE OF THE PHYSICIAN7
	280	+	ASSISTANT AND THE PHYSICIAN OR PHYSICIAN GROUP WITH WHOM THE8
	281	+	PHYSICIAN ASSISTANT HAS ENTERED INTO THE COLLABORATIVE9
	282	+	AGREEMENT;10
	283	+	(c) (III) Not more than thirty days after the physician assistant11
	284	+	completes one hundred sixty working hours, the primary supervising12
	285	+	physician shall complete an initial performance assessment and a13
	286	+	supervisory plan for the physician assistant. A DESCRIPTION OF THE14
	287	+	PHYSICIAN ASSISTANT'S PROCESS FOR COLLABORATION , THE DEGREE OF15
	288	+	WHICH MUST BE BASED ON THE PHYSICIAN ASSISTANT 'S PRIMARY16
	289	+	LOCATION AND AREA OF PRACTICE AND MAY INCLUDE :17
	290	+	(A) D
	291	+	ECISIONS MADE BY THE PHYSICIAN OR PHYSICIAN GROUP
	292	+	18
	293	+	WITH WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO A19
	294	+	COLLABORATIVE AGREEMENT ; AND20
	295	+	(B) T
	296	+	HE CREDENTIALING OR PRIVILEGING REQUIREMENTS OF THE21
	297	+	PHYSICIAN ASSISTANT'S PRIMARY LOCATION OF PRACTICE;22
261	298		(IV) A
262		-	DESCRIPTION OF THE PERFORMANCE EVALUATION PROCESS ,
263		-	WHICH MAY BE COMPLETED BY THE PHYSICIAN ASSISTANT 'S EMPLOYER IN
264		-	ACCORDANCE WITH A PERFORMANCE EVALUATION AND REVIEW PROCESS
265		-	ESTABLISHED BY THE EMPLOYER
266		-	; AND
267		-	(V) ANY ADDITIONAL REQUIREMENTS SPECIFIC TO THE PHYSICIAN
268		-	ASSISTANT
269		-	'S PRACTICE REQUIRED BY THE PHYSICIAN ENTERING INTO THE
270		-	COLLABORATIVE AGREEMENT
271		-	, INCLUDING ADDITIONAL LEVELS OF
272		-	OVERSIGHT
273		-	, LIMITATIONS ON AUTONOMOUS JUDGMENT , AND THE
274		-	DESIGNATION OF A PRIMARY CONTACT FOR COLLABORATION
275		-	.
276		-	(b) (I) E
277		-	XCEPT AS PROVIDED IN SUBSECTION (2)(b)(IV) OF THIS
278		-	SECTION
279		-	, FOR A PHYSICIAN ASSISTANT WITH FEWER THAN FIVE THOUSAND
280		-	PRACTICE HOURS
281		-	, OR A PHYSICIAN ASSISTANT CHANGING PRACTICE AREAS
282		-	WITH FEWER THAN THREE THOUS AND PRACTICE HOURS IN THE NEW PRACTICE
283		-	AREA
284		-	, THE COLLABORATIVE AGREEMENT IS A SUPERVISORY AGREEMENT
285		-	THAT MUST INCLUDE THE PROVISIONS DESCRIBED IN SUBSECTIONS
286		-	(2)(a)(III)(A), (2)(a)(III)(B), (2)(a)(IV), AND (2)(a)(V) OF THIS SECTION AND
287		-	MUST ALSO
288		-	:
	299	+	DESCRIPTION OF THE PERFORMANCE EVALUATION PROCESS ,23
	300	+	WHICH MAY BE COMPLETED BY THE PHYSICIAN ASSISTANT 'S EMPLOYER IN24
	301	+	ACCORDANCE WITH A PERFORMANCE EVALUATION AND REVIEW PROCESS25
	302	+	ESTABLISHED BY THE EMPLOYER ; AND26
	303	+	(V) A
	304	+	NY ADDITIONAL REQUIREMENTS SPECIFIC TO THE PHYSICIAN27
	305	+	083
	306	+	-9- ASSISTANT'S PRACTICE REQUIRED BY THE PHYSICIAN ENTERING INTO1
	307	+	THE COLLABORATIVE AGREEMENT , INCLUDING ADDITIONAL LEVELS OF2
	308	+	OVERSIGHT, LIMITATIONS ON AUTONOMOUS JUDGMENT , AND THE3
	309	+	DESIGNATION OF A PRIMARY CONTACT FOR COLLABORATION .4
	310	+	(b) (I) EXCEPT AS PROVIDED IN SUBSECTION (2)(b)(IV) OF THIS5
	311	+	SECTION, FOR A PHYSICIAN ASSISTANT WITH FEWER THAN FIVE THOUSAND6
	312	+	PRACTICE HOURS, OR A PHYSICIAN ASSISTANT CHANGING PRACTICE AREAS7
	313	+	WITH FEWER THAN THREE THOUSAND PRACTICE HOURS IN THE NEW8
	314	+	PRACTICE AREA, THE COLLABORATIVE AGREEMENT IS A SUPERVISORY9
	315	+	AGREEMENT THAT MUST INCLUDE THE PROVISIONS DESCRIBED IN10
	316	+	SUBSECTIONS (2)(a)(III)(A), (2)(a)(III)(B), (2)(a)(IV), AND (2)(a)(V) OF11
	317	+	THIS SECTION AND MUST ALSO:12
289	318		(A) R
290		-	EQUIRE THAT COLLABORATION DURING THE FIRST ONE
291		-	HUNDRED SIXTY PRACTICE HOURS BE COMPLETED IN PERSON OR THROUGH
292		-	TECHNOLOGY
293		-	, AS PERMITTED BY THE PHYSICIAN OR PHYSICIAN GROUP WITH
294		-	WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO THE COLLABORATIVE
295		-	AGREEMENT
296		-	;
	319	+	EQUIRE THAT COLLABORATION DURING THE FIRST ONE13
	320	+	HUNDRED SIXTY PRACTICE HOURS BE COMPLETED IN PERSON OR THROUGH14
	321	+	TECHNOLOGY, AS PERMITTED BY THE PHYSICIAN OR PHYSICIAN GROUP
	322	+	15
	323	+	WITH WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO THE16
	324	+	COLLABORATIVE AGREEMENT ;17
297	325		(B) I
298		-	NCORPORATE ELEMENTS DEFINING THE EXPECTED NATURE OF
299		-	COLLABORATION
300		-	, INCLUDING: THE PHYSICIAN ASSISTANT'S EXPECTED AREA
301		-	OF PRACTICE
302		-	; EXPECTATIONS REGARDING SUPPORT AND CONSULTATION
303		-	FROM THE PHYSICIAN OR PHYSICIAN GROUP WITH WHOM THE PHYSICIAN
304		-	ASSISTANT HAS ENTERED INTO A COLLABORATIVE AGREEMENT
305		-	; METHODS
306		-	AND MODES OF COMMUNICATION AND COLLABORATION
307		-	; AND ANY OTHER
308		-	PERTINENT ELEMENTS OF COLLABORATIVE
309		-	, TEAM-BASED PRACTICE
310		-	PAGE 7-SENATE BILL 23-083 APPLICABLE TO THE PHYSICIAN ASSISTANT'S PRACTICE OR ESTABLISHED BY
311		-	THE EMPLOYER
312		-	; AND
313		-	(C) REQUIRE A PERFORMANCE EVALUATION AND DISCUSSION OF THE
314		-	PERFORMANCE EVALUATION WITH THE PHYSICIAN ASSISTANT AFTER THE
315		-	PHYSICIAN ASSISTANT HAS WORKED WITH THE EMPLOYER FOR SIX MONTHS
316		-	,
317		-	AGAIN AFTER THE PHYSICIAN ASSISTANT HAS WORKED WITH THE EMPLOYER
318		-	FOR TWELVE MONTHS
319		-	, AND ADDITIONAL EVALUATION THEREAFTER AS
320		-	DETERMINED BY THE PHYSICIAN OR PHYSICIAN GROUP WITH WHOM THE
321		-	PHYSICIAN ASSISTANT HAS ENTERED INTO THE COLLABORATIVE AGREEMENT
322		-	.
	326	+	NCORPORATE ELEMENTS DEFINING THE EXPECTED NATURE OF18
	327	+	COLLABORATION, INCLUDING: THE PHYSICIAN ASSISTANT'S EXPECTED19
	328	+	AREA OF PRACTICE ; EXPECTATIONS REGARDING SUPPORT AND20
	329	+	CONSULTATION FROM THE PHYSICIAN OR PHYSICIAN GROUP
	330	+	WITH WHOM21
	331	+	THE PHYSICIAN ASSISTANT HAS ENTERED INTO A COLLABORATIVE22
	332	+	AGREEMENT; METHODS AND MODES OF COMMUNICATION AND23
	333	+	COLLABORATION; AND ANY OTHER PERTINENT ELEMENTS OF24
	334	+	COLLABORATIVE, TEAM-BASED PRACTICE APPLICABLE TO THE PHYSICIAN25
	335	+	ASSISTANT'S PRACTICE OR ESTABLISHED BY THE EMPLOYER ; AND26
	336	+	(C) R
	337	+	EQUIRE A PERFORMANCE EVALUATION AND DISCUSSION OF27
	338	+	083
	339	+	-10- THE PERFORMANCE EVALUATION WITH THE PHYSICIAN ASSISTANT AFTER1
	340	+	THE PHYSICIAN ASSISTANT HAS WORKED WITH THE EMPLOYER FOR SIX2
	341	+	MONTHS, AGAIN AFTER THE PHYSICIAN ASSISTANT HAS WORKED WITH THE3
	342	+	EMPLOYER FOR TWELVE MONTHS , AND ADDITIONAL EVALUATION4
	343	+	THEREAFTER AS DETERMINED BY THE PHYSICIAN OR PHYSICIAN GROUP5
	344	+	WITH WHOM THE PHYSICIAN ASSISTANT HAS ENTERED INTO THE6
	345	+	COLLABORATIVE AGREEMENT .7
323	346		(II) T
324		-	HE PERFORMANCE EVALUATION MAY BE COMPLETED BY THE
325		-	PHYSICIAN ASSISTANT
326		-	'S EMPLOYER IN ACCORDANCE WITH THE
327		-	PERFORMANCE EVALUATION AND REVIEW PROCESS ESTABLISHED BY THE
328		-	EMPLOYER
329		-	; EXCEPT THAT THE PERFORMANCE EVALUATION MUST BE
330		-	COMPLETED WITH AT LEAST THE MINIMUM FREQUENCY REQUIRED IN SECTION
331		-	(2)(b)(I)(C) OF THIS SECTION.
332		-	(III) E
333		-	XCEPT AS PROVIDED IN SUBSECTION (2)(b)(IV) OF THIS
334		-	SECTION
335		-	, AFTER A PHYSICIAN ASSISTANT HAS COMPLETED THE NUMBER OF
336		-	PRACTICE HOURS REQUIRED PURSUANT TO THIS SUBSECTION
337		-	(2), THE
338		-	ADDITIONAL COLLABORATIVE AGREEMENT REQUIREMENTS DESCRIBED IN
339		-	THIS SUBSECTION
340		-	(2)(b) NO LONGER APPLY.
341		-	(IV) N
342		-	OTWITHSTANDING THE PROVISIONS OF THIS SUBSECTION (2):
343		-	(A) F
344		-	OR A PHYSICIAN ASSISTANT ENTERING INTO A COLLABORATIVE
345		-	AGREEMENT WITH A PHYSICIAN OR PHYSICIAN GROUP IN THE EMERGENCY
346		-	DEPARTMENT OF A HOSPITAL WITH A LEVEL
347		-	I OR LEVEL II TRAUMA CENTER,
348		-	THE COLLABORATIVE AGREEMENT REMAINS A SUPERVISORY AGREEMENT
349		-	AND CONTINUES INDEFINITELY
350		-	.
351		-	(B) F
352		-	OR A PHYSICIAN ASSISTANT CHANGING PRACTICE AREAS TO
353		-	PRACTICE IN AN EMERGENCY DEPARTMENT OF A HOSPITAL THAT IS NOT A
354		-	LEVEL
355		-	I OR LEVEL II TRAUMA CENTER, THE SUPERVISING PHYSICIAN OR
356		-	PHYSICIAN GROUP MAY INCREASE THE NUMBER OF HOURS FOR WHICH THE
357		-	COLLABORATIVE AGREEMENT IS A SUPERVISORY AGREEMENT PURSUANT TO
358		-	THIS SUBSECTION
359		-	(2)(b).
360		-	(3) (a) The supervision of a physician assistant licensed pursuant to
361		-	PAGE 8-SENATE BILL 23-083 this article 240 who has practiced in this state for three years or more is
362		-	determined by a practice agreement that shall be created by the physician
363		-	assistant and his or her primary supervising physician not later than thirty
364		-	days after the physician assistant begins practicing under the supervision of
365		-	the primary supervising physician. A practice agreement must include A
366		-	PHYSICIAN ASSISTANT MAY PROVIDE THE BOARD WITH A SIGNED AFFIDAVIT
367		-	OUTLINING PRACTICE EXPERIENCE FOR THE PURPOSES OF MEETING THE
368		-	REQUIREMENTS DESCRIBED IN SUBSECTION
369		-	(2)(b) OF THIS SECTION, AS
370		-	APPLICABLE
371		-	, IF THE PHYSICIAN ASSISTANT:
	347	+	HE PERFORMANCE EVALUATION MAY BE COMPLETED BY THE8
	348	+	PHYSICIAN ASSISTANT'S EMPLOYER IN ACCORDANCE WITH THE9
	349	+	PERFORMANCE EVALUATION AND REVIEW PROCESS ESTABLISHED BY THE10
	350	+	EMPLOYER; EXCEPT THAT THE PERFORMANCE EVALUATION MUST BE11
	351	+	COMPLETED WITH AT LEAST THE MINIMUM FREQUENCY REQUIRED IN12
	352	+	SECTION (2)(b)(I)(C) OF THIS SECTION.13
	353	+	(III)
	354	+	EXCEPT AS PROVIDED IN SUBSECTION (2)(b)(IV) OF THIS14
	355	+	SECTION, AFTER A PHYSICIAN ASSISTANT HAS COMPLETED THE NUMBER OF15
	356	+	PRACTICE HOURS REQUIRED PURSUANT TO SUBSECTION (2) OF THIS16
	357	+	SECTION, THE ADDITIONAL COLLABORATIVE AGREEMENT REQUIREMENTS17
	358	+	DESCRIBED IN THIS SUBSECTION (2)(b) NO LONGER APPLY.18
	359	+	(IV) NOTWITHSTANDING THE PROVISIONS OF SUBSECTION (2) OF19
	360	+	THIS SECTION:20
	361	+	(A) FOR A PHYSICIAN ASSISTANT ENTERING INTO A21
	362	+	COLLABORATIVE AGREEMENT WITH A PHYSICIAN OR PHYSICIAN GROUP IN22
	363	+	THE EMERGENCY DEPARTMENT OF A HOSPITAL WITH A LEVEL I OR LEVEL23
	364	+	II TRAUMA CENTER, THE COLLABORATIVE AGREEMENT REMAINS A24
	365	+	SUPERVISORY AGREEMENT AND CONTINUES INDEFINITELY .25
	366	+	(B) FOR A PHYSICIAN ASSISTANT CHANGING PRACTICE AREAS TO26
	367	+	PRACTICE IN AN EMERGENCY DEPARTMENT OF A HOSPITAL THAT IS NOT A27
	368	+	083
	369	+	-11- LEVEL I OR LEVEL II TRAUMA CENTER, THE SUPERVISING PHYSICIAN OR1
	370	+	PHYSICIAN GROUP MAY INCREASE THE NUMBER OF HOURS FOR WHICH THE2
	371	+	COLLABORATIVE AGREEMENT IS A SUPERVISORY AGREEMENT PURSUANT3
	372	+	TO SUBSECTION (2)(b) OF THIS SECTION.4
	373	+	(3) (a) The supervision of a physician assistant licensed pursuant5
	374	+	to this article 240 who has practiced in this state for three years or more6
	375	+	is determined by a practice agreement that shall be created by the7
	376	+	physician assistant and his or her primary supervising physician not later8
	377	+	than thirty days after the physician assistant begins practicing under the9
	378	+	supervision of the primary supervising physician. A practice agreement10
	379	+	must include A PHYSICIAN ASSISTANT MAY PROVIDE THE BOARD WITH A11
	380	+	SIGNED AFFIDAVIT OUTLINING PRACTICE EXPERIENCE FOR THE PURPOSES12
	381	+	OF MEETING THE REQUIREMENTS DESCRIBED IN SUBSECTION (2)(b) OF THIS13
	382	+	SECTION, AS APPLICABLE, IF THE PHYSICIAN ASSISTANT:14
372	383		(a) H
373		-	ELD AN UNENCUMBERED LICENSE IN ANOTHER STATE OR
374		-	TERRITORY OF THE
375		-	UNITED STATES BEFORE BECOMING LICENSED IN THIS
376		-	STATE PURSUANT TO SECTION
377		-	12-240-113; OR
378		-	(b) WAS INITIALLY LICENSED IN THIS STATE PRIOR TO THE EFFECTIVE
379		-	DATE OF THIS SUBSECTION
380		-	(3), AS AMENDED.
	384	+	ELD AN UNENCUMBERED LICENSE IN ANOTHER STATE OR15
	385	+	TERRITORY OF THE UNITED STATES BEFORE BECOMING LICENSED IN THIS16
	386	+	STATE PURSUANT TO SECTION 12-240-113; OR17
	387	+	(b) W
	388	+	AS INITIALLY LICENSED IN THIS STATE PRIOR TO THE18
	389	+	EFFECTIVE DATE OF THIS SUBSECTION (3), AS AMENDED.19
381	390		(I) A process by which a physician assistant and a supervising
382		-	physician communicate and make decisions concerning patients' medical
383		-	treatment, which process utilizes the knowledge and skills of the physician
384		-	assistant and the supervising physician based on their respective education,
385		-	training, and experience;
386		-	(II) A protocol for designating an alternative physician for
387		-	consultation when the supervising physician is unavailable for consultation;
388		-	(III) The signatures of the physician assistant and supervising
389		-	physician; and
390		-	(IV) A termination provision that allows the physician assistant or
391		-	the supervising physician to terminate the practice agreement after
392		-	providing written notice of his or her intent to do so at least thirty days
393		-	before the date of termination. If a practice agreement is terminated, the
394		-	physician assistant and the physician assistant's primary supervising
395		-	physician shall create a new practice agreement within forty-five days after
396		-	the date the previous practice agreement was terminated.
397		-	(b) In addition to the components described in subsection (3)(a) of
398		-	this section, a practice agreement may impose conditions concerning
399		-	specific duties, procedures, or drugs.
400		-	PAGE 9-SENATE BILL 23-083 (c) If the terms or conditions of a practice agreement change, both
401		-	the physician assistant and the supervising physician shall sign and date the
402		-	updated practice agreement.
403		-	(4) A physician assistant licensed pursuant to this article 240 who
404		-	has practiced for at least twelve months and who is making a substantive
405		-	change in his or her scope of practice or practice area is subject to the
406		-	following supervisory requirements:
407		-	(a) The physician assistant's first eighty working hours shall be
408		-	supervised by a supervising physician who works at the same location as the
409		-	physician assistant. The physician assistant's primary supervising physician
410		-	shall provide at least twenty hours of supervision, and the remaining hours
411		-	may be provided by a secondary supervising physician who is designated
412		-	by the primary supervising physician.
413		-	(b) After the physician assistant completes eighty working hours, a
414		-	supervising physician shall remain available to the physician assistant via
415		-	a telecommunication device at all times when the physician assistant is
416		-	working.
417		-	(c) After the physician assistant has worked for six months, and
418		-	again after the physician assistant has worked for twelve months, the
419		-	primary supervising physician shall complete a performance assessment and
420		-	discuss the performance assessment with the physician assistant.
421		-	(5) (a) A physician assistant licensed pursuant to this article 240
422		-	who has practiced for at least three years may be liable for damages
423		-	resulting from negligence in providing care to a patient; except that a
424		-	physician assistant is not liable for any damages that occur as a result of the
425		-	physician assistant following a direct order from a supervising physician.
426		-	(b) A physician assistant who has been practicing for at least three
427		-	years shall comply with the financial responsibility requirements specified
428		-	in section 13-64-301 (1) and rules adopted by the board pursuant to that
429		-	section.
430		-	(c) A physician assistant's supervising physician may be liable for
431		-	damages resulting from the physician assistant's negligence in providing
432		-	care to a patient if the physician assistant has not practiced for at least three
433		-	PAGE 10-SENATE BILL 23-083 years as described in subsection (5)(a) of this section.
434		-	SECTION 3. In Colorado Revised Statutes, 12-240-119, amend
435		-	(2)(c) as follows:
436		-	12-240-119. Reentry license - period of inactivity - international
437		-	medical graduate - competency assessment - board rules - conversion
438		-	to full license. (2) (c) If, based on the assessment and,
439		-	IF PRESCRIBED, after
440		-	completion of an educational program, if prescribed,
441		-	the board determines
442		-	that the applicant is competent and qualified to practice medicine without
443		-	supervision, or
444		-	practice as a physician assistant, or PRACTICE as an
445		-	anesthesiologist assistant with supervision, as specified in this article 240,
446		-	the board may convert the reentry license to a full license to practice
447		-	medicine, practice as a physician assistant, or practice as an anesthesiologist
448		-	assistant, as applicable, under this article 240.
449		-	SECTION 4. In Colorado Revised Statutes, 12-240-122, amend (1)
450		-	as follows:
451		-	12-240-122. Prescriptions - requirement to advise patients. (1) A
452		-	physician
453		-	OR PHYSICIAN ASSISTANT licensed under this article 240 or a
454		-	physician assistant licensed by the board who has been delegated the
455		-	authority to prescribe medication, may advise the physician's or the
456		-	physician assistant's patients of their option to have the symptom or purpose
457		-	for which a prescription is being issued included on the prescription order.
458		-	SECTION 5. In Colorado Revised Statutes, 12-240-128, amend
459		-	(7)(c) as follows:
460		-	12-240-128. Physician training licenses. (7) A physician training
461		-	licensee may practice medicine as defined by this article 240 with the
462		-	following restrictions:
463		-	(c) A physician training licensee shall not: have the authority to
464		-	(I) Delegate the rendering of medical services to a person who is not
465		-	licensed to practice medicine pursuant to section 12-240-107 (3)(l);
466		-	OR
	391	+	20
	392	+	physician communicate and make decisions concerning patients' medical21
	393	+	treatment, which process utilizes the knowledge and skills of the22
	394	+	physician assistant and the supervising physician based on their respective23
	395	+	education, training, and experience;24
	396	+	(II) A protocol for designating an alternative physician for25
	397	+	consultation when the supervising physician is unavailable for26
	398	+	consultation;27
	399	+	083
	400	+	-12- (III) The signatures of the physician assistant and supervising1
	401	+	physician; and2
	402	+	(IV) A termination provision that allows the physician assistant3
	403	+	or the supervising physician to terminate the practice agreement after4
	404	+	providing written notice of his or her intent to do so at least thirty days5
	405	+	before the date of termination. If a practice agreement is terminated, the6
	406	+	physician assistant and the physician assistant's primary supervising7
	407	+	physician shall create a new practice agreement within forty-five days8
	408	+	after the date the previous practice agreement was terminated.9
	409	+	(b) In addition to the components described in subsection (3)(a)10
	410	+	of this section, a practice agreement may impose conditions concerning11
	411	+	specific duties, procedures, or drugs.12
	412	+	(c) If the terms or conditions of a practice agreement change, both13
	413	+	the physician assistant and the supervising physician shall sign and date14
	414	+	the updated practice agreement.15
	415	+	(4) A physician assistant licensed pursuant to this article 240 who16
	416	+	has practiced for at least twelve months and who is making a substantive17
	417	+	change in his or her scope of practice or practice area is subject to the18
	418	+	following supervisory requirements:19
	419	+	(a) The physician assistant's first eighty working hours shall be20
	420	+	supervised by a supervising physician who works at the same location as21
	421	+	the physician assistant. The physician assistant's primary supervising22
	422	+	physician shall provide at least twenty hours of supervision, and the23
	423	+	remaining hours may be provided by a secondary supervising physician24
	424	+	who is designated by the primary supervising physician.25
	425	+	(b) After the physician assistant completes eighty working hours,26
	426	+	a supervising physician shall remain available to the physician assistant27
	427	+	083
	428	+	-13- via a telecommunication device at all times when the physician assistant1
	429	+	is working.2
	430	+	(c) After the physician assistant has worked for six months, and3
	431	+	again after the physician assistant has worked for twelve months, the4
	432	+	primary supervising physician shall complete a performance assessment5
	433	+	and discuss the performance assessment with the physician assistant.6
	434	+	(5) (a) A physician assistant licensed pursuant to this article 2407
	435	+	who has practiced for at least three years may be liable for damages8
	436	+	resulting from negligence in providing care to a patient; except that a9
	437	+	physician assistant is not liable for any damages that occur as a result of10
	438	+	the physician assistant following a direct order from a supervising11
	439	+	physician.12
	440	+	(b) A physician assistant who has been practicing for at least three13
	441	+	years shall comply with the financial responsibility requirements specified14
	442	+	in section 13-64-301 (1) and rules adopted by the board pursuant to that15
	443	+	section.16
	444	+	(c) A physician assistant's supervising physician may be liable for17
	445	+	damages resulting from the physician assistant's negligence in providing18
	446	+	care to a patient if the physician assistant has not practiced for at least19
	447	+	three years as described in subsection (5)(a) of this section.20
	448	+	SECTION 3. In Colorado Revised Statutes, 12-240-119, amend21
	449	+	(2)(c) as follows:22
	450	+	12-240-119. Reentry license - period of inactivity -23
	451	+	international medical graduate - competency assessment - board24
	452	+	rules - conversion to full license. (2) (c) If, based on the assessment25
	453	+	and,
	454	+	IF PRESCRIBED, after completion of an educational program, if
	455	+	26
	456	+	prescribed, the board determines that the applicant is competent and27
	457	+	083
	458	+	-14- qualified to practice medicine without supervision, or practice as a1
	459	+	physician assistant, or
	460	+	PRACTICE as an anesthesiologist assistant with2
	461	+	supervision, as specified in this article 240, the board may convert the3
	462	+	reentry license to a full license to practice medicine, practice as a4
	463	+	physician assistant, or practice as an anesthesiologist assistant, as5
	464	+	applicable, under this article 240.6
	465	+	SECTION 4. In Colorado Revised Statutes, 12-240-122, amend7
	466	+	(1) as follows:8
	467	+	12-240-122. Prescriptions - requirement to advise patients.9
	468	+	(1) A physician
	469	+	OR PHYSICIAN ASSISTANT licensed under this article 24010
	470	+	or a physician assistant licensed by the board who has been delegated the
	471	+	11
	472	+	authority to prescribe medication, may advise the physician's or the12
	473	+	physician assistant's patients of their option to have the symptom or13
	474	+	purpose for which a prescription is being issued included on the14
	475	+	prescription order.15
	476	+	SECTION 5. In Colorado Revised Statutes, 12-240-128, amend16
	477	+	(7)(c) as follows:17
	478	+	12-240-128. Physician training licenses. (7) A physician18
	479	+	training licensee may practice medicine as defined by this article 240 with19
	480	+	the following restrictions:20
	481	+	(c) A physician training licensee shall not: have the authority to21
	482	+	(I) Delegate the rendering of medical services to a person who is22
	483	+	not licensed to practice medicine pursuant to section 12-240-107 (3)(l);23
	484	+	OR24
467	485		(II) and shall not have the authority to supervise
468		-	ENTER INTO A
469		-	COLLABORATIVE AGREEMENT WITH
470		-	physician assistants as provided by
471		-	PAGE 11-SENATE BILL 23-083 section 12-240-107 (6) DESCRIBED IN SECTIONS 12-240-107 (6) AND
472		-	12-240-114.5.
473		-	SECTION 6. In Colorado Revised Statutes, 12-280-103, amend
474		-	(39)(c)(II)(B) as follows:
475		-	12-280-103. Definitions - rules. As used in this article 280, unless
476		-	the context otherwise requires or the term is otherwise defined in another
477		-	part of this article 280:
478		-	(39) "Practice of pharmacy" means:
479		-	(c) The provision of a therapeutic interchange selection or a
480		-	therapeutically equivalent selection to a patient if, during the patient's stay
481		-	at a nursing care facility or a long-term acute care hospital licensed under
482		-	part 1 of article 3 of title 25, the selection has been approved for the patient:
483		-	(II) By one of the following health-care providers:
484		-	(B) A physician assistant licensed under section 12-240-113; if the
485		-	physician assistant is under the supervision of a licensed physician; or
486		-	SECTION 7. In Colorado Revised Statutes, 12-280-502, amend
487		-	(1)(b)(II) as follows:
488		-	12-280-502. Therapeutic interchange and therapeutically
489		-	equivalent selections for nursing care facility or long-term acute care
490		-	hospital patients - rules. (1) A pharmacy used by a nursing care facility
491		-	or a long-term acute care hospital licensed under part 1 of article 3 of title
492		-	25 may make a therapeutic interchange or a therapeutically equivalent
493		-	selection for a patient if, during the patient's stay at the facility, the selection
494		-	has been approved for the patient:
495		-	(b) By one of the following health-care providers:
496		-	(II) A physician assistant licensed under section 12-240-113; if the
497		-	physician assistant is under the supervision of a licensed physician; or
498		-	SECTION 8. In Colorado Revised Statutes, 12-290-110, amend (5)
499		-	as follows:
500		-	PAGE 12-SENATE BILL 23-083 12-290-110. Podiatry training license. (5) A person with a
501		-	podiatric training license shall only practice podiatry ONLY under the
502		-	supervision of a licensed podiatrist or a physician licensed to practice
503		-	medicine within the residency program. A person with a podiatry training
504		-	license shall not delegate podiatric or medical services to a person who is
505		-	not licensed to practice podiatry or medicine and shall not have the
506		-	authority to supervise
507		-	COLLABORATE WITH physician assistants.
508		-	SECTION 9. In Colorado Revised Statutes, amend 12-290-117 as
509		-	follows:
510		-	12-290-117. Use of physician assistants - collaboration
511		-	requirements - affidavits of practice experience - rules - definitions.
512		-	(1) A person licensed under the laws of this state to practice podiatry may
513		-	delegate to a physician assistant licensed by the Colorado medical board
514		-	pursuant to section 12-240-113 the authority to A PHYSICIAN ASSISTANT
515		-	LICENSED PURSUANT TO ARTICLE
516		-	240 OF THIS TITLE 12 MAY perform acts
517		-	that constitute the practice of podiatry to the extent and in the manner
518		-	authorized by rules promulgated by the Colorado podiatry
519		-	board. The acts
520		-	shall be consistent with sound practices of podiatry. Each prescription for
521		-	a controlled substance, as defined in section 18-18-102 (5), issued by a
522		-	physician assistant must have the name of the physician assistant's
523		-	supervising podiatrist printed on the prescription. For all other ALL
524		-	prescriptions issued by a physician assistant MUST INCLUDE THE PHYSICIAN
525		-	ASSISTANT
526		-	'S NAME, the name and address of the health facility, and, if the
527		-	health facility is a multi-speciality
528		-	MULTISPECIALTY organization, the name
529		-	and address of the speciality SPECIALTY clinic within the health facility
530		-	where the physician assistant is practicing. must be imprinted on the
531		-	prescription. Nothing in this section limits the ability of otherwise licensed
532		-	health personnel to perform delegated acts. The dispensing of prescription
533		-	medication by a physician assistant is subject to section 12-280-120 (6).
534		-	(2) If the authority to perform an act is delegated pursuant to
535		-	subsection (1) of this section, the act shall not be performed except under
536		-	the personal and responsible direction and supervision of a person licensed
537		-	under the laws of this state to practice podiatry, and the person shall not be
538		-	responsible for the direction and supervision of more than four physician
539		-	assistants at any one time without specific approval of the Colorado
540		-	podiatry board. The board may define appropriate direction and supervision
541		-	pursuant to rules PRIOR TO PRACTICING PODIATRY, A PHYSICIAN ASSISTANT
542		-	PAGE 13-SENATE BILL 23-083 MUST ENTER INTO A COLLABORATIVE AGREEMENT WITH A LICENSED
543		-	PODIATRIST
544		-	.
545		-	(3) The provisions of sections 12-240-107 (6), and
546		-	12-240-113, AND
547		-	12-240-114.5 governing physician assistants under the "Colorado Medical
548		-	Practice Act" shall apply to physician assistants under this section.
549		-	SECTION 10. In Colorado Revised Statutes, 13-64-301, amend (1)
550		-	introductory portion as follows:
551		-	13-64-301. Financial responsibility. (1) As a condition of active
552		-	licensure or authority to practice in this state, every physician, dentist,
553		-	dental therapist, or dental hygienist; every physician assistant; who has been
554		-	practicing for at least three years; and every health-care institution as
555		-	defined in section 13-64-202, except as provided in section 13-64-303.5,
556		-	that provides health-care services shall establish financial responsibility, as
557		-	follows:
558		-	SECTION 11. In Colorado Revised Statutes, 15-18.7-103, amend
559		-	(1) introductory portion and (1)(i) as follows:
560		-	15-18.7-103. Medical orders for scope of treatment forms - form
561		-	contents. (1) A medical orders for scope of treatment form shall
562		-	MUST
563		-	include the following information concerning the adult whose medical
564		-	treatment is the subject of the medical orders for scope of treatment form:
565		-	(i) The signature of the adult's physician, advanced practice
566		-	registered nurse, or if under the supervision or authority of the physician,
567		-	physician assistant.
568		-	SECTION 12. In Colorado Revised Statutes, 15-18.7-104, amend
569		-	(5) as follows:
570		-	15-18.7-104. Duty to comply with medical orders for scope of
571		-	treatment form - immunity - effect on criminal charges against another
572		-	person - transferability. (5) An adult's physician, advanced practice
573		-	registered nurse, or if under the supervision of the physician,
574		-	physician
575		-	assistant may provide an oral confirmation to a health-care provider who
576		-	shall annotate on the medical orders for scope of treatment form the time
577		-	and date of the oral confirmation and the name and license number of the
578		-	PAGE 14-SENATE BILL 23-083 physician, advanced practice registered nurse, or physician assistant. The
579		-	physician, advanced practice registered nurse, or physician assistant shall
580		-	countersign the annotation of the oral confirmation on the medical orders
581		-	for scope of treatment form within a time period that satisfies any applicable
582		-	state law or within thirty days, whichever period is less, after providing the
583		-	oral confirmation. The signature of the physician, advanced practice
584		-	registered nurse, or physician assistant may be provided by photocopy, fax,
585		-	or electronic means. A medical orders for scope of treatment form with
586		-	annotated oral confirmation, and a photocopy, fax, or other electronic
587		-	reproduction thereof
588		-	OF THE FORM, shall be given the same force and effect
589		-	as the original form signed by the physician, advanced practice registered
590		-	nurse, or physician assistant.
591		-	SECTION 13. In Colorado Revised Statutes, 23-21-803, amend (6)
592		-	as follows:
593		-	23-21-803. Definitions. As used in this part 8, unless the context
594		-	otherwise requires:
595		-	(6) "Physician assistant" means a person licensed as a physician
596		-	assistant by the Colorado medical board in accordance with section
597		-	12-240-113 who is authorized, in accordance with section 12-240-107 (6),
598		-	to perform acts constituting the practice of medicine, including prescribing
599		-	controlled substances. and who is under the supervision of a physician
600		-	trained in MAT.
601		-	SECTION 14. Act subject to petition - effective date. This act
602		-	takes effect at 12:01 a.m. on the day following the expiration of the
603		-	ninety-day period after final adjournment of the general assembly; except
604		-	that, if a referendum petition is filed pursuant to section 1 (3) of article V
605		-	of the state constitution against this act or an item, section, or part of this act
606		-	within such period, then the act, item, section, or part will not take effect
607		-	unless approved by the people at the general election to be held in
608		-	PAGE 15-SENATE BILL 23-083 November 2024 and, in such case, will take effect on the date of the official
609		-	declaration of the vote thereon by the governor.
610		-	____________________________ ____________________________
611		-	Steve Fenberg Julie McCluskie
612		-	PRESIDENT OF SPEAKER OF THE HOUSE
613		-	THE SENATE OF REPRESENTATIVES
614		-	____________________________ ____________________________
615		-	Cindi L. Markwell Robin Jones
616		-	SECRETARY OF CHIEF CLERK OF THE HOUSE
617		-	THE SENATE OF REPRESENTATIVES
618		-	APPROVED________________________________________
619		-	(Date and Time)
620		-	_________________________________________
621		-	Jared S. Polis
622		-	GOVERNOR OF THE STATE OF COLORADO
623		-	PAGE 16-SENATE BILL 23-083
	486	+	ENTER INTO A25
	487	+	COLLABORATIVE AGREEMENT WITH physician assistants as provided by26
	488	+	section 12-240-107 (6) DESCRIBED IN SECTIONS 12-240-107 (6) AND27
	489	+	083
	490	+	-15- 12-240-114.5.1
	491	+	SECTION 6. In Colorado Revised Statutes, 12-280-103, amend2
	492	+	(39)(c)(II)(B) as follows:3
	493	+	12-280-103. Definitions - rules. As used in this article 280, unless4
	494	+	the context otherwise requires or the term is otherwise defined in another5
	495	+	part of this article 280:6
	496	+	(39) "Practice of pharmacy" means:7
	497	+	(c) The provision of a therapeutic interchange selection or a8
	498	+	therapeutically equivalent selection to a patient if, during the patient's stay9
	499	+	at a nursing care facility or a long-term acute care hospital licensed under10
	500	+	part 1 of article 3 of title 25, the selection has been approved for the11
	501	+	patient:12
	502	+	(II) By one of the following health-care providers:13
	503	+	(B) A physician assistant licensed under section 12-240-113; if the14
	504	+	physician assistant is under the supervision of a licensed physician; or15
	505	+	SECTION 7. In Colorado Revised Statutes, 12-280-502, amend16
	506	+	(1)(b)(II) as follows:17
	507	+	12-280-502. Therapeutic interchange and therapeutically18
	508	+	equivalent selections for nursing care facility or long-term acute care19
	509	+	hospital patients - rules. (1) A pharmacy used by a nursing care facility20
	510	+	or a long-term acute care hospital licensed under part 1 of article 3 of title21
	511	+	25 may make a therapeutic interchange or a therapeutically equivalent22
	512	+	selection for a patient if, during the patient's stay at the facility, the23
	513	+	selection has been approved for the patient:24
	514	+	(b) By one of the following health-care providers:25
	515	+	(II) A physician assistant licensed under section 12-240-113; if the26
	516	+	physician assistant is under the supervision of a licensed physician; or27
	517	+	083
	518	+	-16- SECTION 8. In Colorado Revised Statutes, 12-290-110, amend1
	519	+	(5) as follows:2
	520	+	12-290-110. Podiatry training license. (5) A person with a3
	521	+	podiatric training license shall only practice podiatry ONLY under the4
	522	+	supervision of a licensed podiatrist or a physician licensed to practice5
	523	+	medicine within the residency program. A person with a podiatry training6
	524	+	license shall not delegate podiatric or medical services to a person who7
	525	+	is not licensed to practice podiatry or medicine and shall not have the8
	526	+	authority to supervise COLLABORATE WITH physician assistants.9
	527	+	SECTION 9. In Colorado Revised Statutes, amend 12-290-11710
	528	+	as follows:11
	529	+	12-290-117. Use of physician assistants - collaboration12
	530	+	requirements - affidavits of practice experience - rules - definitions.13
	531	+	(1) A person licensed under the laws of this state to practice podiatry may14
	532	+	delegate to a physician assistant licensed by the Colorado medical board15
	533	+	pursuant to section 12-240-113 the authority to A PHYSICIAN ASSISTANT16
	534	+	LICENSED PURSUANT TO ARTICLE 240 OF THIS TITLE 12 MAY perform acts17
	535	+	that constitute the practice of podiatry to the extent and in the manner18
	536	+	authorized by rules promulgated by the Colorado podiatry board. The acts19
	537	+	shall be consistent with sound practices of podiatry. Each prescription for20
	538	+	a controlled substance, as defined in section 18-18-102 (5), issued by a21
	539	+	physician assistant must have the name of the physician assistant's22
	540	+	supervising podiatrist printed on the prescription. For all other ALL23
	541	+	prescriptions issued by a physician assistant
	542	+	MUST INCLUDE THE24
	543	+	PHYSICIAN ASSISTANT'S NAME, the name and address of the health facility,25
	544	+	and, if the health facility is a multi-speciality
	545	+	MULTISPECIALTY26
	546	+	organization, the name and address of the speciality SPECIALTY clinic27
	547	+	083
	548	+	-17- within the health facility where the physician assistant is practicing. must1
	549	+	be imprinted on the prescription. Nothing in this section limits the ability2
	550	+	of otherwise licensed health personnel to perform delegated acts. The3
	551	+	dispensing of prescription medication by a physician assistant is subject4
	552	+	to section 12-280-120 (6).5
	553	+	(2) If the authority to perform an act is delegated pursuant to6
	554	+	subsection (1) of this section, the act shall not be performed except under7
	555	+	the personal and responsible direction and supervision of a person8
	556	+	licensed under the laws of this state to practice podiatry, and the person9
	557	+	shall not be responsible for the direction and supervision of more than10
	558	+	four physician assistants at any one time without specific approval of the11
	559	+	Colorado podiatry board. The board may define appropriate direction and12
	560	+	supervision pursuant to rules PRIOR TO PRACTICING PODIATRY , A13
	561	+	PHYSICIAN ASSISTANT MUST ENTER INTO A COLLABORATIVE AGREEMENT14
	562	+	WITH A LICENSED PODIATRIST.15
	563	+	(3) The provisions of sections 12-240-107 (6), and 12-240-113,16
	564	+	AND 12-240-114.5 governing physician assistants under the "Colorado17
	565	+	Medical Practice Act" shall apply to physician assistants under this18
	566	+	section.19
	567	+	SECTION 10. In Colorado Revised Statutes, 13-64-301, amend20
	568	+	(1) introductory portion as follows:21
	569	+	13-64-301. Financial responsibility. (1) As a condition of active22
	570	+	licensure or authority to practice in this state, every physician, dentist,23
	571	+	dental therapist, or dental hygienist; every physician assistant; who has24
	572	+	been practicing for at least three years; and every health-care institution25
	573	+	as defined in section 13-64-202, except as provided in section26
	574	+	13-64-303.5, that provides health-care services shall establish financial27
	575	+	083
	576	+	-18- responsibility, as follows:1
	577	+	SECTION 11. In Colorado Revised Statutes, 15-18.7-103,2
	578	+	amend (1) introductory portion and (1)(i) as follows:3
	579	+	15-18.7-103. Medical orders for scope of treatment forms -4
	580	+	form contents. (1) A medical orders for scope of treatment form shall5
	581	+	MUST include the following information concerning the adult whose6
	582	+	medical treatment is the subject of the medical orders for scope of7
	583	+	treatment form:8
	584	+	(i) The signature of the adult's physician, advanced practice9
	585	+	registered nurse, or if under the supervision or authority of the physician,10
	586	+	physician assistant.11
	587	+	SECTION 12. In Colorado Revised Statutes, 15-18.7-104,12
	588	+	amend (5) as follows:13
	589	+	15-18.7-104. Duty to comply with medical orders for scope of14
	590	+	treatment form - immunity - effect on criminal charges against15
	591	+	another person - transferability. (5) An adult's physician, advanced16
	592	+	practice registered nurse, or if under the supervision of the physician,17
	593	+	physician assistant may provide an oral confirmation to a health-care18
	594	+	provider who shall annotate on the medical orders for scope of treatment19
	595	+	form the time and date of the oral confirmation and the name and license20
	596	+	number of the physician, advanced practice registered nurse, or physician21
	597	+	assistant. The physician, advanced practice registered nurse, or physician22
	598	+	assistant shall countersign the annotation of the oral confirmation on the23
	599	+	medical orders for scope of treatment form within a time period that24
	600	+	satisfies any applicable state law or within thirty days, whichever period25
	601	+	is less, after providing the oral confirmation. The signature of the26
	602	+	physician, advanced practice registered nurse, or physician assistant may27
	603	+	083
	604	+	-19- be provided by photocopy, fax, or electronic means. A medical orders for1
	605	+	scope of treatment form with annotated oral confirmation, and a2
	606	+	photocopy, fax, or other electronic reproduction thereof OF THE FORM,3
	607	+	shall be given the same force and effect as the original form signed by the4
	608	+	physician, advanced practice registered nurse, or physician assistant.5
	609	+	SECTION 13. In Colorado Revised Statutes, 23-21-803, amend6
	610	+	(6) as follows:7
	611	+	23-21-803. Definitions. As used in this part 8, unless the context8
	612	+	otherwise requires:9
	613	+	(6) "Physician assistant" means a person licensed as a physician10
	614	+	assistant by the Colorado medical board in accordance with section11
	615	+	12-240-113 who is authorized, in accordance with section 12-240-10712
	616	+	(6), to perform acts constituting the practice of medicine, including13
	617	+	prescribing controlled substances. and who is under the supervision of a14
	618	+	physician trained in MAT.15
	619	+	SECTION 14. Act subject to petition - effective date. This act16
	620	+	takes effect at 12:01 a.m. on the day following the expiration of the17
	621	+	ninety-day period after final adjournment of the general assembly; except18
	622	+	that, if a referendum petition is filed pursuant to section 1 (3) of article V19
	623	+	of the state constitution against this act or an item, section, or part of this20
	624	+	act within such period, then the act, item, section, or part will not take21
	625	+	effect unless approved by the people at the general election to be held in22
	626	+	November 2024 and, in such case, will take effect on the date of the23
	627	+	official declaration of the vote thereon by the governor.24
	628	+	083
	629	+	-20-