Colorado Medical Board: News
- New Legislation 2019
- Emergency Rulemaking Hearing 7/23/2019
- Stakeholder Meeting 7/15/2019
- Stakeholder Meeting 5/16/2019
- Revised Opioid Guidelines Adopted
- New Law Affects Colorado Prescribers, Limits Opioid Prescriptions
- New Law Affects Physicians
- Revised Opioid Guidelines
- PDMP Delegate Training Video
- Changes to Disciplinary Procedures
- Mandatory Reporting Reminder
- Important PDMP Updates
- Cost-Benefit Analysis
- Free Access to PainNET System for Colorado Providers
- Serve as a Board Consultant
- Colorado Consortium for Prescription Drug Abuse Prevention
On May 31, 2019, Governor Jared Polis signed SB19-193 Sunset Continue Colorado Medical Practice Act. The new law goes into effect on July 1, 2019, and continues the Colorado Medical Board in the Department of Regulatory Agencies until September 1, 2026. It also implements the following recommendations from the Sunset Review:
- Eliminates the 60-day limit on a physician pro-bono license.
- Removes the requirement for the Board to send a letter of admonition through certified mail.
- Adds “resorting to fraud in order to obtain a license” as unprofessional conduct for an anesthesiologist assistant.
- Allows the Colorado Medical Board to suspend a medical license if the licensee has been formally charged with a crime, and the Board finds the crime is a continuing threat to patient safety.
The Colorado Medical Board’s new sunset date is September 1, 2026.
On May 31, 2019, Governor Jared Polis signed HB19-1129 Prohibit Conversion Therapy for a Minor. The new law goes into effect on August 2,2019, and prohibits a licensed physician specializing in psychiatry or a licensed, certified, or registered mental health care provider from engaging in conversion therapy with a patient under 18 years of age. Any licensee who engages in these practices is subject to disciplinary action by the appropriate mental health licensing board or the Colorado Medical Board, respectively.
On May 29, 2019, Governor Jared Polis signed SB19-218 Sunset Medical Marijuana Program. This bill extends the Medical Marijuana Program in the Department of Public Health and Environment (CDPHE) until September 1, 2028, implements recommendations from the Department of Regulatory Agencies sunset review, and makes a number of other changes. Specifically, the bill clarifies that:
- Clarifies that if the patient is a minor, the physician must consult with the patient and the patient's parents and clarifies that a parent can serve as a primary caregiver for a child with a disabling medical condition.
- Specifies that doctor-patient consultations include explaining the possible risks and benefits of the use of medical marijuana
- Clarifies that caregivers for patients with debilitating medical conditions are extended the same confidentiality protections as caregivers for patients with disabling medical conditions.
- Clarifies that medical marijuana registry cards are subject to revocation if a patient is convicted of a drug crime.
- Specifies that only a physician can make a medical marijuana recommendation, except for recommendations for patients with disabling medical conditions, which may be made by a physician, dentist, or advanced practice practitioner with prescriptive authority who holds a license in good standing and who is acting within his or her scope of practice.
- Directs CDPHE to promulgate rules related to the length of time that a medical marijuana registry card is valid.
- Requires financial disclosures from members of the Retail Marijuana Public Health Advisory Committee and expands the expertise that must be represented on the committee.
- Allows CDPHE to inquire about collecting Colorado-specific data from the All-Payer Claims Database, hospital discharge data, and available peer-reviewed research studies
On May 23, 2019, Governor Jared Polis signed SB19-228 Substance Use Disorders Prevention. The law went into effect immediately upon the Governor’s signature and requires certain health care providers with prescriptive authority to complete substance use disorder training as part of the continuing education requirement for professional license renewal on or after October 1, 2019. The new requirements apply to podiatrists, physicians, physician assistants, dentists, advanced practice nurses, optometrists, and veterinarians, and prescribers must be able to demonstrate competency regarding:
- Best practices for opioid prescribing, according to the most recent version of the Division’s Guidelines for Prescribing and Dispensing Opioids;
- Recognition of substance use disorders;
- Referral of patients with substance use disorders for treatment; and,
- Use of the Electronic Prescription Drug Monitoring Program.
The law exempts any provider from the continuing education requirements who meets the following criteria:
- Maintains a national board certification that requires equivalent substance use prevention training; or
- Attests to the appropriate board that the health care provider does not prescribe opioids.
In addition to the continuing education requirements, the new law includes the following provisions:
- Restricts a physician, physician assistant, or advanced practice nurse from accepting any direct or indirect benefits for prescribing a specific medication,
- Allows pharmacies to charge enhanced dispensing fees if they provide counseling concerning the risks of opioids to patients who have not previously received opioid prescriptions,
- Allows medical examiners and coroners to access the prescription drug monitoring program (PDMP) under specified circumstances,
- Requires opioid prescriptions for outpatient use to bear a warning label, and,
- Provides funding for the implementation of several programs for the prevention of opioid and other substance use disorders in the Department of Human Services (DHS), the Department of Public Health and Environment (CDPHE) and local public health agencies (LPHAs), and the University of Colorado.
On May 6, 2019, Governor Jared Polis signed SB 19-201 Open Discussions About Adverse Health Care Incidents. This new law creates the "Colorado Candor Act” and establishes a process for the communication between a patient and a healthcare provider or health facility after an adverse health care incident. Under the new law, if an adverse health care incident occurs, a health care provider involved with the incident, either individually or jointly with the facility involved, may request that the patient enter into an open discussion concerning the incident. The request must include certain components listed in the law.
If an offer of compensation is made, the new law requires certain processes for payment and financial resolution to be followed. If a health care provider or health facility determines that no offer of compensation is warranted, the health care provider or health facility shall orally communicate that decision with the patient.
A health care provider or facility may provide de-identified information about an adverse health care incident to any patient safety centered nonprofit organization.
The Colorado Medical Board will have an Emergency Rulemaking Hearing to implement Colorado House Bill 19-1095. It is critical that the Board considers adopting revisions to Rule 400 because it conflicts with HB19-1095, as it is currently written. HB19-1095 has a mandated effective date of August 2, 2019.
- A copy of the proposed rule changes and House Bill 19-1095 is available for download.
- Tuesday, July 23, 2019, 9:00 a.m. (MDT)
Ways to Participate
- In Person: Civic Center Plaza, 1560 Broadway, Room 100A (1st Floor), Denver, CO 80202
- By Webinar: Register Here
Interested parties are able to attend the Emergency Rulemaking Hearing in-person or via webinar, however, no public testimony or comments will be accepted during the Hearing. If you have any questions or concerns, please send them to email@example.com.
The Colorado Medical Board will hold a stakeholder meeting to receive input regarding the implementation of Colorado House Bill 19-1095 and the resulting, proposed changes to Board Rule 400.
- A copy of the proposed rule changes and House Bill 19-1095 is available for download.
Listen to the meeting held on July 15, 2019.
The Division of Professions and Occupations and the Colorado Medical Board are seeking input regarding the Board’s future peer assistance services. We invite you to share your thoughts and recommendations as we consider the issuance of a Request for Proposals (RFP) to provide Medical Peer Assistance Services to physicians, physician assistants and anesthesiologist assistants
- Thursday, May 16, 2019. 2 p.m.
Three Ways to Participate
- In Person: Civic Center Plaza, 1560 Broadway, Room 100C (1st Floor), Denver. CO 80202
- By Webinar: You may join the meeting from your computer, tablet or smartphone here.
- Submit Comments: You may email your written comments to Holli.Weaver@state.co.us. To ensure consideration of your comments at the stakeholder meeting, we must receive your comments by 5 p.m. on May 15, 2019.
We need your help to identify the medical community’s peer assistance needs, peer assistance best practices, and opportunities for improvement with peer assistance programs - from the perspective of licensees and as viewed through a public protection lens. Overall, your opinions and recommendations may help shape the upcoming Request for Proposals (RFP). If you have any questions or concerns about stakeholder input for this RFP, please contact Paula Martinez, Program Director, at 303-894-7716 or firstname.lastname@example.org. Additional information will be posted on the Colorado Medical Board website, prior to the meeting.
On March 14, 2019, the revised Guidelines for Prescribing and Dispensing Opioids were adopted by all six of Colorado’s prescribing and dispensing Boards: the Colorado Dental Board, the Colorado Medical Board, the State Board of Nursing, the State Board of Optometry, the Colorado Podiatry Board, and the State Board of Pharmacy, and endorsed by the State Board of Veterinary Medicine.
Note: The prescribing and dispensing Boards are reviewing Senate Bill 18-22 Clinical Practice for Opioid Prescribing, and considering its impact, if any, on the Guidelines for Prescribing and Dispensing Opioids. Please check back for updates.
On Monday, May 21, 2018, Governor John Hickenlooper signed Senate Bill 18-22 Clinical Practice for Opioid Prescribing. The bill went into effect immediately upon the Governor’s signature. This new state law limits the number of opioid pills a healthcare provider can prescribe and affects physicians, physician assistants, advanced practice registered nurses with prescriptive authority, dentists, optometrists, podiatrists, and veterinarians.
Under the new law, a prescriber must limit a patient’s initial prescription of an opioid to a seven-day supply, if the prescriber has not written an opioid prescription for the patient in the last 12 months. The prescriber may exercise discretion in including a second fill for a seven-day supply. These limits do not apply, if, in the judgment of the prescriber, the patient:
- Has chronic pain that typically lasts longer than 90 days or past the time of normal healing, as determined by the prescriber, or following transfer of care from another prescriber who prescribed an opioid to the patient;
- Has been diagnosed with cancer and is experiencing cancer related pain; or
- Is experiencing post-surgical pain, that, because of the nature of the procedure, is expected to last more than 14 days.
- Is undergoing palliative care or hospice care focused on providing the patient with relief from symptoms, pain and stress resulting from a serious illness in order to improve quality of life. (This exemption is allowed for physicians, physician assistants and advanced practice registered nurses only.)
After the first prescription, the prescriber is required to check the Prescription Drug Monitoring Program (PDMP) database before prescribing any additional opioids for the same patient. Failure to check the PDMP constitutes unprofessional conduct if the prescriber repeatedly fails to comply with this new requirement. The second fill requirement to check the PDMP does not apply when a patient:
- Is receiving the opioid in a hospital, skilled nursing facility, residential facility, or correctional facility;
- Has been diagnosed with cancer and is experiencing cancer related pain; or
- Is undergoing palliative care or hospice care;
- Is experiencing post-surgical pain, that, because of the nature of the procedure, is expected to last more than 14 days;
- Is receiving treatment during a natural disaster or during an incident where mass casualties have taken place; or has received only a single dose to relieve pain for a single test or procedure.
After the second opioid prescription, the law has no further restrictions on the healthcare provider’s prescribing practices. The new law does require a healthcare provider, or the provider’s designee, to specify the provider’s specialty upon the initial query of the PDMP. It also states a violation of the new requirements does not constitute negligence or contributory negligence per se and does not create a private right of action or serve as the basis of a cause of action.
On April 2, 2018, Governor John Hickenlooper signed Senate Bill 18-082 Physician Non-compete Exemption for Rare Disorder. The bill went into effect immediately upon the Governor’s signature. Under current law, a non-competition agreement may prohibit a physician from treating former or prospective patients after he or she leaves a group practice. This bill excludes physicians treating patients with rare disorders from such non-competition agreements and outlines the process for continuing or offering to continue treatment of patients with rare disorders. We encourage you to read the bill and become familiar with this new state law. If you have any questions, please send them to email@example.com.
On March 16, 2018, the revised Guidelines for Prescribing and Dispensing Opioids were adopted by all six of Colorado’s prescribing and dispensing Boards: the Colorado Dental Board, the Colorado Medical Board, the State Board of Nursing, the State Board of Optometry, the Colorado Podiatry Board, and the State Board of Pharmacy, and endorsed by the State Board of Veterinary Medicine.
This revised Policy is a product of the collaboration between the seven Boards and a robust stakeholder engagement process. Stakeholder views, opinions and comments were essential in the revision of the 2014 Policy for Prescribing and Dispensing Opioids.
A training video is available to show prescribers and pharmacists how to set up delegate accounts for the PDMP. Any prescriber or pharmacist can create up to three delegate accounts for trained individuals who can check the PDMP on the prescriber or pharmacist's behalf. You can utilize the PDMP more frequently to get the most complete medical history possible.
On June 6, 2017, Governor John Hickenlooper signed House Bill 17-1165 (HB17-1165) Department of Regulatory Agencies Boards Disciplinary Action Resolution Process. The new law became effective upon the Governor’s signature on June 6, 2017, and modifies the disciplinary procedures for six healthcare boards (prescriber boards) within the Division of Professions and Occupations in the Department of Regulatory Agencies (DORA). The prescriber boards affected include:
- Colorado Dental Board;
- Colorado Medical Board;
- State Board of Nursing;
- State Board of Optometry;
- Colorado Podiatry Board; and
- State Board of Veterinary Medicine.
As part of the bill’s implementation, we want to make sure you are aware of certain deadlines that affect the prescriber boards’ complaint processes and how you may need to respond to a board request. The following deadlines now apply unless a prescriber board has more protective provisions in current state law:
- Within 15 days of receipt of a complaint, the boards must provide the complainant with a written notice that includes contact information for the board, a summary of the complaint process and the complainant's rights, including a patient's right to receive a copy of his or her patient records.
- If relevant to a complaint, licensees must provide the board with patient records within 30 days of a board request for the records in the form of the response to a 30-day letter.
- If an investigation was initiated as a result of a complaint, and the board took public, formal action, the board must provide the complainant with written notice of the action within 30 days of the action.
- If a complaint is still pending after six months, the board must notify the complainant that the complaint is still pending, subject to applicable restrictions in state law.
- Each prescriber board is required to update its website within 30 days after suspending or revoking a license, listing each licensee subject to the suspension or revocation separately.
Finally, insurance carriers must now update their participating provider lists every 30 days to remove providers whose licenses have been suspended or revoked.
These deadlines are now in effect as required by state law. If you have questions about the new requirement or any other aspect of House Bill 17-1165, please contact Jo Donlin at firstname.lastname@example.org or 303-894-7434.
Did you know you are a mandatory reporter? Under Colorado law, more than 40 professions are required to report suspected child abuse and elder abuse. These professions include many regulated through the Division of Professions and Occupations (DPO) at DORA, such as:
- Physicians (including physician assistants and physicians in training);
- Dentists and dental hygienists;
- Nurses (including registered nurses, licensed practical nurses, and nurse practitioners);
- Nursing home administrators;
- Occupational therapists;
- Physical therapists;
- Mental health professionals (including psychologists, social workers, professional counselors, marriage and family therapists, registered psychotherapists and all candidates for licensure);
Online trainings help mandatory reporters recognize and report abuse, neglect and exploitation. Licensees of the regulatory boards at DPO may accrue credit towards continuing education and continuing competency requirements for completing the trainings (should they exist for their profession).
Section 19-3-304, C.R.S. outlines the persons required by law to report child abuse and/or neglect. To assist mandatory reporters, a training is available on the Colorado Department of Human Services website at http://coloradocwts.com/mandated-reporter-training.
Section 18-6.5-108, C.R.S outlines the persons required by law to report abuse and exploitation of at-risk elders and at-risk adults with intellectual and developmental disabilities. Further information and an online training can be found on the Colorado Department of Human Services website at http://www.coloradoaps.com/about-mandatory-reporting-update.html.
If you have further questions regarding these requirements, please contact the Colorado Department of Human Services.
For questions regarding mandatory reporting of at-risk elders and at-risk adults with intellectual and developmental disabilities, please contact the Office of Community Access and Independence’s Division of Aging and Adult Services at email@example.com.
As we work together to tackle prescription drug misuse, abuse and diversion, we see PDMP utilization rates continue to increase as the database continues to serve as an important tool for meeting the standard of care for safe prescribing.
We are pleased to announce a new and improved PDMP website: colorado.gov/dora-pdmp. We listened to your challenges and ideas and hope you’ll find the new website easier to navigate and more relevant to your needs. You will be able to link to your PDMP account and access other information directly from the homepage. We also selected a new vendor, APPRISS, and will be utilizing the PMP AWARxE system. The database interface will look different and make PDMP queries easier and quicker. We encourage your continued feedback for ongoing improvement efforts.
New State Law Improves Access to PDMP
To make the PDMP more accessible and easier for health professionals to incorporate into daily use, the Colorado General Assembly passed legislation in 2017. On April 6, 2017, Governor John Hickenlooper signed Senate Bill 17-146 Access To Prescription Drug Monitoring Program, which clarifies health professionals' access to the PDMP database by:
- Allowing a health care provider with prescribing authority to query the PDMP about a current patient, including checking on drug interactions and side effects, thus making the PDMP an even more useful tool for health professionals in their clinical decision-making for patients;
- Allowing a veterinarian with prescribing authority to query the PDMP about a current client if the veterinarian has a reasonable basis to suspect the client has committed drug abuse or has mistreated an animal; and
- Allowing a pharmacist to query the PDMP about a current patient for whom the pharmacist is dispensing any prescription drug, rather than only patients receiving controlled substances.
The law became effective immediately, and the Division is working with the appropriate Boards to implement the new law including rulemaking, outreach and education. If you have questions about the Colorado PDMP, please contact Division staff at 303-894-5957 or firstname.lastname@example.org. If you need technical assistance with the PMP AWARxE system, please contact the vendor help desk at 1-855-263-6403.
A member of the public may email the Office of Policy, Research and Regulatory Reform to request a cost-benefit analysis from the agency proposing rule changes, which is made publicly available when completed. In performing a cost-benefit analysis, each rulemaking entity must provide the information requested for the cost-benefit analysis to be considered a good faith effort. The cost-benefit analysis must be submitted to the Office of Policy, Research and Regulatory Reform at least ten (10) days before the administrative hearing on the proposed rule and posted on the agency's website. For all questions, please attach all underlying data that supports the statements or figures stated in this cost-benefit analysis.
The Colorado Department of Health Care Policy and Financing (HCPF) has worked with the vendor of its Project ECHO Pain Management Program, Community Health Center, to expand access to the program website known as PainNET.
The PainNet website is an online learning community that aims to improve pain care expertise among primary care providers. The website is also now available to other Health First Colorado (Colorado’s Medicaid Program) primary care medical providers (PCMPs) for free.
The PainNET learning community enables PCMPs to develop expertise to treat patients with complex chronic pain through a combination of archived Project ECHO Pain case presentations, resource libraries, community forums and expert consultations. Providers and specialists are able to communicate through discussion boards, chat rooms and direct messaging.
This is a great resource for Colorado providers to access resources that can increase their knowledge on how to manage chronic pain more effectively.
Learn More About PainNET
- Download the PainNET Access flyer.
- Watch the Introduction to PainNET video.
- Sign up for access by contacting Agi Erickson at email@example.com.
- Contact JD Belshe, Consultant/Policy & Program Analyst for HCPF, at firstname.lastname@example.org for any other questions about the PainNET program.
Experts assist the Board by providing reviews and opinions on Board cases. This is an excellent opportunity to give back to your profession, help your community, and gain valuable experience. To learn more about the application process, contact email@example.com or download the Consultant Application.
Stay up to date on the latest guidelines, training and resources for the management of chronic pain patients, and the safe use, safe storage, and safe disposal of prescription medications to help reduce prescription drug abuse in Colorado.
- Colorado Consortium for Prescription Drug Abuse Prevention
- Pain Management Online Course for Providers
- Department of Health Care Policy & Financing (HCPF) Pain Management Resources and Opioid Use