Stay up-to-date on laws and regulations that may impact your practice. The following information is meant as a starting place and should not be considered legal advice.
What does the law do? Under current law, death certificates must be filed with the state registrar 5 days after a death occurs. The law changes that time frame to 72 hours, however, allows a physician to indicate they require more time to complete the death certificate or conduct additional inquiry into the manner of death.
The law generally requires a decedent’s established primary care physician (PCP) to complete the medical certification for the death certificate if the death appears to be due to natural causes – determined as such with a reasonable degree of medical certainty, the decedent received medical care from the PCP within a year of the death, the death occurred when the decedent was not under the direct care of another physician charged with the decedent’s care during the illness or condition that resulted in death, and an inquiry into the death is not required. However, if within a year of the death, the decedent had been treated by a physician other than their established PCP for a chronic condition or terminal illness related to their death, that physician is responsible for completing the medical certification for the death certificate.
Demonstrated repeated and willful failure to comply with the law could constitute unprofessional conduct at the discretion of the Colorado Medical Board.
How does this impact my practice? In addition to the new timeline, death certificates must also be filed using the Electronic Death Registration System (EDRS) after March 1, 2024. The online form for physicians to request an account is here. This site is for physicians only.
Who should I share this with? With the new requirement that death certificates be signed as soon as practicable, it’s important to share this information with your colleagues and staff.
The Colorado Department of Public Health and Environment hosted a webinar for CAFP members to discuss these changes and answer questions in September. The recording can be found here. FAQ document below.
What does the law do? The bill modifies the relationship between a physician assistant (PA) and a physician by replacing the current requirement that a PA be supervised by a physician with a ‘collaborative agreement’, except in certain circumstances (more on that below). A collaborative agreement must be with a Colorado-licensed physician, podiatrist, or physician group and includes the following:
- PA’s name, license number, and primary location of practice,
- A description of the PA’s process for collaboration, the degree of which must be based on the PA’s primary location and area of practice. It may include:
- Decisions made by the physician or group,
- The credentialing or privileging requirements of the PA’s primary location.
- A description of the performance evaluation process, and
- Any additional requirements specific to the PA’s practice required by the physician or group, including additional levels of oversight, limitations on autonomous judgment, and designation of a primary contact for collaboration.
For a PA with fewer than 5,000 practice hours, or who changed practice areas with fewer than 3,000 practice hours in the new area, the collaborative agreement is a more traditional supervisory agreement which must include the above requirements as well as the following:
- Require that collaboration during the first 160 practice hours occur in person or through technology,
- Incorporate elements defining the specific nature of collaboration, including a PA’s expected area of practice, expectations for support and consultation, methods and modes of communication, and any other pertinent elements of collaboration or team-based practice the supervising physician or group deem appropriate, and
- A more regular schedule for performance evaluations, specifically after the first six months and again after the first twelve.
How does this impact my practice? Physicians are not required to enter into these collaborative agreements and an employer is prohibited from requiring such as a condition of employment. Should physicians and PAs establish agreements following the criteria above, keep them on file at the PA’s primary location and be prepared to make them available to the Colorado Medical Board upon request.
Who should I share this with? The Colorado Board of Medicine recently finalized regulations to operationalize the law (changing what was Rule 400 to the new Rule 1.15 [starting on page 21]). The Colorado Medical Board Frequently Asked Questions provides further information.
What does the law do? Under current law, a family or household member and a law enforcement officer or agency can petition for an extreme risk protection order (ERPO), which temporarily restricts access to guns for individuals at an elevated risk of harming themselves or others. This bill added physicians and other healthcare and mental healthcare providers to the list of people who can petition for an ERPO.
How does this impact my practice? If you feel a patient is a risk to themselves or others should they obtain a firearm or use one already in their possession, file a petition with the Colorado Judicial Branch. ERPO petitions can be made without notice to the respondent of who filed the petition.
Who should I share this with? It may be helpful to share this information with your colleagues and staff. Additionally, the law also expands the right to petition to educators and district attorneys. Even more information on filing an ERPO can be found here.
What does the law do? SB 144 shields providers from discipline solely for prescribing opioid doses that fall outside recommended numeric thresholds recommended in guidelines. The law also states that providers are not required to taper opioid doses in stable, compliant patients. These protections safeguard patients from dangerous opioid tapering practices that studies show increase their risks of suicide and overdose and can destabilize their health and lives.
How does this impact my practice? SB 144’s goal is to address the widespread misapplication of opioid dose thresholds in one-size-fits-all guidelines in ways that risked patient harm by defining chronic pain, removing disciplinary action against physicians, and eliminating barriers to care. The new law also prohibits clinics and pharmacies from discriminating against chronic pain patients who use opioids. Its goal is to strike a balance between promoting safe prescribing and protecting the care of people with chronic pain.
Where can I find more information? The Colorado Cross Disability Coalition has partnered with the Colorado Medical Society to develop this fact sheet for physicians to learn more about the bill. Listen to this episode of the Stethoscope podcast for additional information.