(1) All fees collected pursuant to this article shall be transmitted to the state treasurer, who shall credit the same to the health facilities general licensure cash fund, which fund is hereby created.
(2) The general assembly shall make annual appropriations from the health facilities general licensure cash fund to partially reimburse the department of public health and environment for the direct and indirect costs of the department incurred in the performance of its duties pursuant to this article 3. No appropriation shall be made out of the cash fund for expenditures incurred by the department pursuant to section 25-1.5-103 (1)(a)(II) in carrying out duties relating to health facilities wholly owned and operated by a governmental unit or agency.
Source: L. 95: Entire section added, p. 1024, � 5, effective July 1. L. 2003: (2) amended, p. 709, � 37, effective July 1. L. 2008: (2) amended, p. 1948, � 2, effective June 2. L. 2022: (2) amended, (HB 22-1278), ch. 222, p. 1508, � 56, effective July 1.
25-3-103.5. Nondiscrimination - hospital surgical privileges - hospital rules and regulations. (1) The bylaws of any hospital licensed pursuant to the provisions of part 3 of this article or established pursuant to section 32-1-1003, C.R.S., which does not limit staff privileges to employees or contracting physicians of such hospital, shall include provisions for the use of the facility by, and staff privileges for, duly licensed doctors of medicine, osteopathy, dentistry, and podiatry within the scope of their respective licenses. Such bylaws shall not discriminate on the basis of the staff member's holding a degree of doctor of medicine, doctor of osteopathy, doctor of dental science, or doctor of podiatric medicine within the scope of their respective licensure. Provision shall be made in the bylaws for the right to pursue and practice full surgical privileges for holders of a degree of doctor of medicine, doctor of osteopathy, doctor of dental science, or doctor of podiatric medicine within the scope of their respective licensure. Such rights and privileges may be limited or restricted upon the basis of an individual practitioner's demonstrated training, experience, current competence, professional ethics, health status, or failure to abide by the hospital's rules, regulations, and procedures.
(2) Nothing in this section shall be construed to require a hospital to offer a specific service or services not otherwise offered or to buy, construct, or renovate facilities, to purchase equipment, hire additional staff, or to comply with other requirements of law concerning its planning, financing, or operation. If a health service is offered, the hospital shall not discriminate between persons holding a degree of doctor of medicine, doctor of osteopathy, or doctor of podiatric medicine who are authorized by law to perform such services.
(3) A hospital may require the coadmittance by a medical doctor or doctor of osteopathy for any patient admitted for surgical treatment by a podiatrist or dentist. The responsibility for obtaining such coadmittance shall be that of the podiatrist or dentist admitting said patient and not of the hospital. Patients admitted for podiatric or dental care shall receive the same basic medical appraisal as patients admitted for other services. Such appraisal shall include an admission history and physical examination by a medical doctor, doctor of osteopathy, or qualified, hospital-credentialed and -privileged podiatrist, who is either on the medical staff or approved by the medical staff of such hospital. The findings of such appraisal shall be recorded on the patient's medical record. The admitting podiatrist or dentist shall be responsible for that part of the history and examination that is related to podiatry or dentistry. The medical doctor or doctor of osteopathy shall be responsible for the treatment of any medical problem that may be present on admission or arise during hospitalization of such podiatric or dental patient. Such doctor shall evaluate the general medical condition of the podiatric or dental patient and determine, after consultation if necessary, the overall risk of the pending surgical treatment to the patient's health.
(4) Within one hundred eighty days after May 25, 1983, the governing body of every hospital subject to the provisions of part 3 of this article or established pursuant to section 32-1-1003, C.R.S., which does not limit staff privileges to employees or contracting physicians of such hospital, shall provide in its bylaws reasonable standards and procedures to be applied by such hospital and its staff in considering and acting upon applications for staff membership or privileges by a person holding a Colorado license to practice as a doctor of medicine, doctor of osteopathic medicine, podiatrist, or dentist in conformance with the requirements of any national accrediting body to which the hospital subscribes. Such standards and procedures shall be available for public inspection and shall be based on an applicant's individual training, experience, current competence, professional ethics, health status, and the hospital's rules of professional conduct applied equally to all persons holding a Colorado license to practice as a doctor of medicine, doctor of osteopathic medicine, podiatrist, or dentist.
(5) Hospital rules and regulations shall be reasonable, necessary, and applied in good faith equally and in a nondiscriminatory manner to all staff members, or applicants seeking to become staff members, holding a degree of doctor of medicine, doctor of osteopathic medicine, doctor of dental science, or doctor of podiatric medicine.
Source: L. 83: Entire section added, p. 1053, � 1, effective May 25. L. 2007: (3) amended, p. 436, � 1, effective August 3.
25-3-103.7. Employment of physicians - when permissible - conditions - definitions. (1) As used in this section:
(a) Repealed.
(b) Department means the department of public health and environment.
(c) Federally qualified health center or FQHC has the same meaning as set forth in the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(4).
(d) Health-care facility means a hospital, hospice, behavioral health safety net provider, as defined in section 27-50-101 (7), federally qualified health center, school-based health center, rural health clinic, PACE organization, or long-term care facility.
(e) Hospice means an entity that administers services to a terminally ill person utilizing palliative care or treatment and that is currently licensed and regulated by the department pursuant to the department's authority under section 25-1.5-103 (1)(a).
(f) Hospital means a hospital currently licensed or certified by the department pursuant to the department's authority under section 25-1.5-103 (1)(a).
(f.3) Long-term care facility means:
(I) A nursing facility as defined by section 25.5-4-103, C.R.S., and licensed pursuant to section 25-1.5-103;
(II) An assisted living residence as defined by section 25-27-102 and licensed pursuant to section 25-27-103; or
(III) An independent living facility or a residence for seniors that provides assistance to its residents in the performance of their daily living activities.
(f.5) PACE organization means an organization providing a program of all-inclusive care for the elderly pursuant to section 25.5-5-412, C.R.S.
(g) Physician means a person duly licensed to practice under article 220, 240, or 290 of title 12.
(h) Rural health clinic shall have the same meaning as set forth in section 1861 (aa)(2) of the federal Social Security Act, 42 U.S.C. sec. 1395x (aa)(2).
(i) School-based health center shall have the same meaning as set forth in section 25-20.5-502.
(2) (a) A health-care facility may employ physicians, subject to the limitations set forth in subsections (3) to (6) of this section. The employment of physicians at a long-term care facility may be direct or through a separate entity authorized to conduct business in this state that has common or overlapping ownership as an affiliate or subsidiary of an entity, including a foreign entity, that owns, controls, or manages the long-term care facility, subject to the limitations set forth in subsections (3) to (6) of this section.
(b) Nothing in this subsection (2) allows any person who is not licensed pursuant to article 240 of title 12 to practice or direct the practice of medicine at a long-term care facility.
(3) Nothing in this section shall be construed to allow any health-care facility that employs a physician to limit or otherwise exercise control over the physician's independent professional judgment concerning the practice of medicine or diagnosis or treatment or to require physicians to refer exclusively to the health-care facility or to the health-care facility's employed physicians. Any health-care facility that knowingly or recklessly so limits or controls a physician in such manner or attempts to do so shall be deemed to have violated standards of operation for the particular type of health-care facility and may be held liable to the patient or the physician, or both, for such violations, including proximately caused damages. Nothing in this section shall be construed to affect any health-care facility's decisions with respect to the availability of services, technology, equipment, facilities, or treatment programs, or as requiring any health-care facility to make available to patients or physicians additional services, technology, equipment, facilities, or treatment programs.
(4) Nothing in this section shall be construed to allow a health-care facility that employs a physician to offer the physician any percentage of fees charged to patients by the health-care facility or other financial incentive to artificially increase services provided to patients.
(5) The medical staff bylaws or policies or the policies of any health-care facility that employs physicians shall not discriminate with regard to credentials or staff privileges on the basis of whether a physician is an employee of, a physician with staff privileges at, or a contracting physician with, the health-care facility. Any health-care facility that discriminates with regard to credentials or staff privileges on the basis of whether a physician is an employee of, a physician with staff privileges at, or a contracting physician with, the health-care facility shall be deemed to have violated standards of operation for the particular type of health-care facility and may be held liable to the physician for such violations, including proximately caused damages. This subsection (5) shall not affect the terms of any contract or written employment arrangement that provides that the credentials or staff and clinical privileges of any practitioner are incident to or coterminous with the contract or employment arrangement or the individual's association with a group holding the contract.
(6) When applying for initial facility licensure and upon each application for license renewal, every health-care facility licensed or certified by the department that employs a physician shall report to the department the number of physicians on the health-care facility's medical staff. The report shall separately identify the number of those physicians who are employed by the health-care facility under separate contract to the health-care facility and independent of the health-care facility.
(7) The medical staff bylaws or policies or the policies of any health-care facility that employs physicians shall contain a procedure by which complaints by physicians alleging a violation of subsection (3), (4), or (5) of this section may be heard and resolved, which procedure shall ensure that the due process rights of the parties are protected. A physician who believes he or she has been the subject of a violation of subsection (3), (4), or (5) of this section has a right to complain and request review of the matter pursuant to such procedure.
(8) Nothing in this section shall preclude a physician or a patient from seeking other remedies available to the physician or to the patient at law or in equity.
Source: L. 93: Entire section added, p. 721, � 2, effective May 6. L. 94: (1)(a) and (6) amended, p. 2751, � 407, effective July 1. L. 95: (1)(a), (3), and (5) amended and (7) and (8) added, p. 977, � 2, effective July 1. L. 2003: (1)(a) amended, p. 709, � 38, effective July 1. L. 2007: (1) to (7) amended, p. 452, � 1, effective April 11. L. 2008: Entire section amended, p. 932, � 1, effective August 5. L. 2009: (1)(d) and (6) amended and (1)(f.5) added, (HB 09-1004), ch. 26, p. 115, � 1, effective March 19. L. 2011: (1)(d) and (2) amended and (1)(f.3) added, (SB 11-084), ch. 112, p. 346, � 2, effective August 10. L. 2012: (6) amended, (HB 12-1052), ch. 228, p. 1006, � 4, effective July 1. L. 2019: (1)(g) and (2)(b) amended, (HB 19-1172), ch. 136, p. 1700, � 151, effective October 1. L. 2020: (1)(c) amended, (SB 20-136), ch. 70, p. 288, � 23, effective September 14. L. 2022: (1)(d) amended (HB 22-1278), ch. 222, p. 1592, � 229, effective July 1, 2024; (1)(a)(II) added by revision, (HB 22-1278), ch. 222, pp. 1592, 1605; �� 229, 263(1)(b).
Editor's note: Subsection (1)(a)(II) provided for the repeal of subsection (1)(a), effective July 1, 2024. (See L. 2022, pp. 1592, 1605.)
Cross references: For the legislative declaration contained in the 1994 act amending subsections (1)(a) and (6), see section 1 of chapter 345, Session Laws of Colorado 1994. For the legislative declaration contained in the 1995 act amending subsections (1)(a), (3), and (5) and adding subsections (7) and (8), see section 1 of chapter 201, Session Laws of Colorado 1995. For the legislative declaration in the 2012 act amending subsection (6), see section 1 of chapter 228, Session Laws of Colorado 2012. For the legislative declaration in SB 20-136, see section 1 of chapter 70, Session Laws of Colorado 2020.