Amendments for SB24-141
Senate Journal, May 1
After consideration on the merits, the Committee recommends that SB24-141 be amended
as follows, and as so amended, be referred to the Committee of the Whole with favorable
recommendation and with a recommendation that it be placed on the Consent Calendar.
Amend printed bill, strike everything below the enacting clause and substitute:
"SECTION 1. In Colorado Revised Statutes, add 12-30-123 as
follows:
12-30-123. Out-of-state telehealth providers - registration -
financial responsibility - discipline - emergency protocol - disclosures -
prescriptions - rules - applicability - definitions. (1) AS USED IN THIS
SECTION, UNLESS THE CONTEXT OTHERWISE REQUIRES:
(a) "APPLICANT" MEANS AN INDIVIDUAL WHO PERFORMS HEALTH-CARE
SERVICES IN ANOTHER STATE AND APPLIES TO THE DIVISION TO PROVIDE
TELEHEALTH SERVICES IN THIS STATE.
(b) "DISTANT SITE" HAS THE MEANING SET FORTH IN SECTION 10-16-123
(4)(a).
(c) "ORIGINATING SITE" HAS THE MEANING SET FORTH IN SECTION
10-16-123 (4)(b).
(d) "OUT-OF-STATE CREDENTIAL" MEANS A LICENSE, CERTIFICATE,
REGISTRATION, OR OTHER APPROVAL AS A HEALTH-CARE PROVIDER IN ANOTHER
STATE.
(e) "REGISTERED PROVIDER" MEANS A HEALTH-CARE PROVIDER
REGISTERED TO PROVIDE TELEHEALTH SERVICES IN THIS STATE PURSUANT TO
SUBSECTION (3) OF THIS SECTION.
(f) "STORE-AND-FORWARD TRANSFER" HAS THE MEANING SET FORTH IN
SECTION 10-16-123 (4)(c).
(g) "TELEHEALTH" MEANS THE DELIVERY OF MEDICAL SERVICES
THROUGH TECHNOLOGIES THAT ARE USED IN A MANNER THAT IS COMPLIANT
WITH THE FEDERAL "HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY
ACT OF 1996", PUB.L. 104-191, INCLUDING INFORMATION, ELECTRONIC, AND
COMMUNICATION TECHNOLOGIES, REMOTE MONITORING TECHNOLOGIES, AND
STORE-AND-FORWARD TRANSFERS, TO FACILITATE THE ASSESSMENT, DIAGNOSIS,
CONSULTATION, OR TREATMENT OF A PATIENT WHILE THE PATIENT IS LOCATED
AT AN ORIGINATING SITE AND THE PERSON WHO PROVIDES THE SERVICES IS
LOCATED AT A DISTANT SITE.
(2) ON AND AFTER JANUARY 1, 2026, AN APPLICANT WHO POSSESSES AN
OUT-OF-STATE CREDENTIAL MAY PROVIDE HEALTH-CARE SERVICES THROUGH
TELEHEALTH TO PATIENTS LOCATED IN THIS STATE IF THE APPLICANT IS
REGISTERED WITH A REGULATOR, AS APPLICABLE TO THE APPLICANT'S PRACTICE,
AND PROVIDES HEALTH-CARE SERVICES WITHIN THE SCOPE OF PRACTICE
ESTABLISHED UNDER THE LAWS AND RULES OF THIS STATE THAT APPLY TO THE
APPLICANT'S PRACTICE.
(3) A REGULATOR MAY REGISTER AN APPLICANT WHO DOES NOT
POSSESS A LICENSE, CERTIFICATE, OR REGISTRATION IN THIS STATE AS A
REGISTERED PROVIDER UNDER THIS SECTION IF THE APPLICANT SATISFIES ALL OF
THE FOLLOWING:
(a) THE APPLICANT SUBMITS AN APPLICATION ON A FORM PRESCRIBED
BY THE DIVISION AND PAYS THE APPLICABLE FEE ESTABLISHED BY THE DIVISION
PURSUANT TO SECTION 12-20-105;
(b) THE APPLICANT POSSESSES AN OUT-OF-STATE CREDENTIAL ISSUED
BY A GOVERNMENTAL AUTHORITY IN ANOTHER STATE, THE DISTRICT OF
COLUMBIA, OR A POSSESSION OR TERRITORY OF THE UNITED STATES AND THE
CREDENTIAL IS ACTIVE; UNENCUMBERED; HAS EDUCATIONAL AND SUPERVISORY
STANDARDS EQUIVALENT TO OR EXCEEDING THE EDUCATIONAL AND
SUPERVISORY STANDARDS REQUIRED FOR THE EQUIVALENT CREDENTIAL,
LICENSE, CERTIFICATE, OR REGISTRATION IN THIS STATE OR THE INTERSTATE
COMPACT LICENSE FOR THE APPLICABLE CREDENTIAL TYPE; AND ENTITLES THE
APPLICANT TO PERFORM HEALTH-CARE SERVICES THAT ARE THE SAME AS OR
EQUIVALENT TO HEALTH-CARE SERVICES THAT MAY BE PERFORMED BY A
LICENSEE, CERTIFICATE HOLDER, OR REGISTRANT IN THIS STATE;
(c) THE APPLICANT HAS NOT BEEN SUBJECT TO ANY DISCIPLINARY
ACTION RESULTING IN A LIMITATION, SUSPENSION, OR REVOCATION OF THE
APPLICANT'S OUT-OF-STATE CREDENTIAL DURING THE FIVE-YEAR PERIOD
IMMEDIATELY PRECEDING THE SUBMISSION OF THE APPLICANT'S APPLICATION
PURSUANT TO SUBSECTION (3)(a) OF THIS SECTION, UNLESS THE DISCIPLINARY
ACTION PERTAINS TO AN ACTION, BEHAVIOR, OR TREATMENT PERMITTED UNDER
COLORADO LAW;
(d) THE APPLICANT DEMONSTRATES PASSAGE OF A JURISPRUDENCE
EXAMINATION ADMINISTERED BY THE DIVISION IF PASSAGE OF A JURISPRUDENCE
EXAMINATION IS REQUIRED FOR SUBSTANTIALLY SIMILAR CREDENTIALING AS A
LICENSEE, CERTIFICATE HOLDER, OR REGISTRANT IN THIS STATE;
(e) THE APPLICANT DESIGNATES AN AGENT UPON WHOM SERVICE OF
PROCESS MAY BE MADE IN THIS STATE ON A FORM PRESCRIBED BY THE DIVISION;
AND
(f) THE APPLICANT DEMONSTRATES TO THE DIVISION THAT THE
APPLICANT IS IN COMPLIANCE WITH SUBSECTION (5) OF THIS SECTION.
(4) (a) A REGISTERED PROVIDER SHALL NOTIFY THE APPLICABLE
REGULATOR OF:
(I) RESTRICTIONS PLACED ON THE REGISTERED PROVIDER'S
OUT-OF-STATE CREDENTIAL IN ANY STATE OR JURISDICTION;
(II) ANY DISCIPLINARY ACTION TAKEN OR PENDING AGAINST THE
REGISTERED PROVIDER IN ANY STATE OR JURISDICTION; AND
(III) ANY FINAL JUDGMENT AGAINST, SETTLEMENT ENTERED INTO BY,
OR ARBITRATION AWARD PAID ON BEHALF OF THE REGISTERED PROVIDER FOR
MALPRACTICE.
(b) THE REGISTERED PROVIDER SHALL PROVIDE NOTIFICATION
PURSUANT TO THIS SUBSECTION (4) WITHIN FIVE BUSINESS DAYS AFTER THE
RESTRICTION IS PLACED OR DISCIPLINARY ACTION IS INITIATED OR TAKEN.
(5) A REGISTERED PROVIDER SHALL MAINTAIN THE METHOD AND
AMOUNT OF FINANCIAL RESPONSIBILITY THAT COVERS SERVICES PROVIDED TO
PATIENTS IN THIS STATE AS REQUIRED BY THE APPLICABLE REGULATOR.
(6) A REGISTERED PROVIDER PROVIDING HEALTH-CARE SERVICES
THROUGH TELEHEALTH TO A PATIENT LOCATED IN THIS STATE SHALL PROVIDE
HEALTH-CARE SERVICES IN COMPLIANCE WITH THE PROFESSIONAL PRACTICE
STANDARDS APPLICABLE TO A LICENSEE, CERTIFICATE HOLDER, OR REGISTRANT
WHO PROVIDES COMPARABLE IN-PERSON HEALTH-CARE SERVICES IN THIS STATE.
PROFESSIONAL PRACTICE STANDARDS AND LAWS APPLICABLE TO THE PROVISION
OF IN-PERSON HEALTH-CARE SERVICES IN THIS STATE, INCLUDING STANDARDS
AND LAWS RELATING TO PRESCRIBING MEDICATION OR TREATMENT, IDENTITY
VERIFICATION, DOCUMENTATION, INFORMED CONSENT, CONFIDENTIALITY,
DISCLOSURES, PRIVACY, AND SECURITY, APPLY TO THE PROVISION OF
HEALTH-CARE SERVICES THROUGH TELEHEALTH IN COLORADO.
(7) (a) A REGISTERED PROVIDER WHO PROVIDES TELEHEALTH SERVICES
TO A PATIENT SHALL:
(I) PROVIDE THE PATIENT WITH GUIDANCE ON APPROPRIATE FOLLOW-UP
CARE AS REQUIRED BY THE LAWS, RULES, AND STANDARD OF CARE FOR
COLORADO;
(II) IN THE EVENT OF AN EMERGENCY SITUATION, MAKE A GOOD FAITH
EFFORT TO:
(A) DIRECTLY CONTACT AND COORDINATE WITH EMERGENCY SERVICES
LOCATED NEAR THE ORIGINATING SITE; OR
(B) IF THE URGENT, EMERGENT, OR EMERGENCY SITUATION IS RELATED
TO THE PATIENT'S MENTAL HEALTH OR A SUBSTANCE USE CONDITION,
FACILITATE CONTACT WITH THE APPROPRIATE LOCAL MENTAL AND BEHAVIORAL
HEALTH SERVICES TO INCLUDE LOCAL CRISIS SERVICES, SUCH AS CRISIS
STABILIZATION UNITS, CRISIS WALK-IN CENTERS, MOBILE CRISIS RESPONSE
SERVICES, AND WITHDRAWAL MANAGEMENT FACILITIES; AND
(C) REMAIN ON A SYNCHRONOUS CONNECTION WITH THE PATIENT, IF
THE EMERGENCY ARISES DURING A SYNCHRONOUS CONNECTION, UNTIL
EMERGENCY SERVICES HAVE REACHED THE ORIGINATING SITE OR THE SITUATION
IS RESOLVED IN THE REGISTERED PROVIDER'S CLINICAL JUDGMENT; AND
(III) MAINTAIN A WRITTEN EMERGENCY PROTOCOL THAT IS
APPROPRIATE TO THE APPLICABLE STANDARD OF CARE FOR COLORADO. THE
WRITTEN EMERGENCY PROTOCOL MUST INCLUDE GOOD FAITH METHODS OF
ACCOMPLISHING THE FOLLOWING:
(A) PROVIDING THE NAME AND LOCATION OF THE PATIENT TO
EMERGENCY SERVICES IN ORAL, WRITTEN, OR DIGITAL FORM;
(B) DETERMINING THE ORIGINATING SITE IF A PATIENT IS UNAWARE OF
THE LOCATION; AND
(C) PROVIDING THE CONTACT INFORMATION OF THE PATIENT TO
EMERGENCY SERVICES.
(b) A REGISTERED PROVIDER MUST MAINTAIN A CURRENT LIST OF
HOSPITALS, URGENT CARE CENTERS OR CLINICS, AND CRISIS PROVIDERS, SUCH
AS CRISIS STABILIZATION UNITS, CRISIS WALK-IN CENTERS, MOBILE CRISIS
RESPONSE SERVICES, AND WITHDRAWAL MANAGEMENT FACILITIES, IN THE AREA
WHERE THE PATIENT RESIDES.
(8) (a) A REGISTERED PROVIDER SHALL NOT OPEN AN OFFICE IN THIS
STATE AND SHALL NOT PROVIDE IN-PERSON HEALTH-CARE SERVICES TO
PATIENTS LOCATED IN THIS STATE UNLESS THE REGISTERED PROVIDER OBTAINS
THE LICENSE, CERTIFICATION, OR REGISTRATION THAT THE APPLICABLE
REGULATOR REQUIRES FOR THE PERFORMANCE OF THE RELEVANT HEALTH-CARE
SERVICES IN THIS STATE.
(b) A REGISTERED PROVIDER PROVIDING TELEHEALTH SERVICES TO A
PATIENT IN THIS STATE SHALL DISCLOSE THE FOLLOWING INFORMATION TO THE
PATIENT, AS APPLICABLE:
(I) THE LOCATION OF THE REGISTERED PROVIDER; AND
(II) THAT THE REGISTERED PROVIDER DOES NOT HAVE A PHYSICAL
LOCATION IN COLORADO.
(9) (a) THE DIVISION OR THE APPLICABLE REGULATOR MAY TAKE
DISCIPLINARY ACTION AGAINST A REGISTERED PROVIDER IF ANY OF THE
FOLLOWING APPLIES TO THE REGISTERED PROVIDER:
(I) THE REGISTERED PROVIDER FAILS TO NOTIFY THE REGULATOR OF
ANY ADVERSE ACTIONS TAKEN AGAINST THE REGISTERED PROVIDER'S
OUT-OF-STATE CREDENTIAL AS REQUIRED UNDER SUBSECTION (4) OF THIS
SECTION;
(II) THE REGISTERED PROVIDER HAS RESTRICTIONS PLACED ON THE
REGISTERED PROVIDER'S OUT-OF-STATE CREDENTIAL OR DISCIPLINARY ACTION
HAS BEEN COMMENCED AGAINST THE REGISTERED PROVIDER IN ANY STATE OR
JURISDICTION;
(III) THE REGISTERED PROVIDER VIOLATES ANY OF THE REQUIREMENTS
UNDER THIS SECTION; OR
(IV) THE REGISTERED PROVIDER COMMITS AN ACT THAT CONSTITUTES
GROUNDS FOR DISCIPLINARY ACTION UNDER THE LAW GOVERNING THE
APPLICABLE PROFESSION IN COLORADO.
(b) THE DEPARTMENT OF REGULATORY AGENCIES MAY NOTIFY OTHER
STATES IN WHICH THE REGISTERED PROVIDER IS LICENSED, REGISTERED, OR
CERTIFIED TO PRACTICE OF ANY DISCIPLINARY ACTIONS TAKEN AGAINST THE
REGISTERED PROVIDER IN THIS STATE.
(c) IF A REGULATOR DETERMINES THAT A REGISTERED PROVIDER HAS
COMMITTED AN ACT OR ENGAGED IN CONDUCT THAT CONSTITUTES GROUNDS
FOR DISCIPLINE OR UNPROFESSIONAL CONDUCT UNDER THE LAW GOVERNING
THE APPLICABLE PROFESSION IN COLORADO, THE DIVISION OR THE RELEVANT
REGULATOR MAY TAKE DISCIPLINARY OR OTHER ACTION PURSUANT TO SECTION
12-20-404.
(10) FOR A REGISTERED PROVIDER PROVIDING HEALTH-CARE SERVICES
THROUGH TELEHEALTH TO A PATIENT LOCATED IN THIS STATE, THIS SECTION
PROVIDES AN ALTERNATIVE TO LICENSURE, CERTIFICATION, OR REGISTRATION
THAT THE APPLICABLE REGULATOR REQUIRES FOR THE PERFORMANCE OF THE
RELEVANT HEALTH-CARE SERVICES IN THIS STATE, AND A REGISTERED PROVIDER
MUST OTHERWISE ADHERE TO THE LAWS AND RULES THAT APPLY TO THE
REGISTERED PROVIDER'S PRACTICE.
(11) A REGISTERED PROVIDER SHALL NOT PRESCRIBE A CONTROLLED
SUBSTANCE, AS DEFINED IN SECTION 12-280-402 (1).
(12) ALL REGISTRATIONS ISSUED PURSUANT TO THIS SECTION ARE
SUBJECT TO THE RENEWAL, EXPIRATION, REINSTATEMENT, AND DELINQUENCY
FEE PROVISIONS SPECIFIED IN SECTION 12-20-202.
(13) THE DIVISION MAY PROMULGATE RULES NECESSARY TO IMPLEMENT
AND ADMINISTER THIS SECTION.
(14) A REGULATOR MAY PROMULGATE RULES NECESSARY TO
IMPLEMENT AND ADMINISTER THIS SECTION.
(15) ARTICLES 1 AND 20 OF THIS TITLE 12 AND THIS ARTICLE 30 APPLY,
ACCORDING TO THEIR TERMS, TO THIS SECTION.
SECTION 2. Safety clause. The general assembly finds, determines,
and declares that this act is necessary for the immediate preservation of the
public peace, health, or safety or for appropriations for the support and
maintenance of the departments of the state and state institutions.".
Appro-
priations