CO Code § 25-3-103.7 (2021)
2021 Colorado Code|Title 25 - Public Health and Environment|Article 3 - Hospitals|Part 1 - Hospitals|§ 25-3-103.7. Employment of Physicians - When Permissible - Conditions - Definitions

  For purposes of this section:   “Community mental health center” means a community mental health center, as defined in section 25-1.5-103 (2), that is currently licensed and regulated by the department pursuant to the department's authority under section 25-1.5-103 (1)(a).    “Department” means the department of public health and environment.    “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).    “Health-care facility” means a hospital, hospice, community mental health center, federally qualified health center, school-based health center, rural health clinic, PACE organization, or long-term care facility.    “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).    “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:   A nursing facility as defined by section 25.5-4-103, C.R.S., and licensed pursuant to section 25-1.5-103;    An assisted living residence as defined by section 25-27-102 and licensed pursuant to section 25-27-103; or    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.     An acute treatment unit shall be assessed a fee as set forth in paragraph (c) of this subsection (1), an assisted living residence shall be assessed a fee as set forth in section 25-27-107, and a separate fee shall be collected pursuant to section 25-3-704 to meet the costs incurred by the department in completing the requirements of part 7 of this article.    A license issued by the department may be revoked at any time by the state board of health for any of the causes set forth in section 25-3-103 or for a licensee's failure to comply with any of the rules of the state board or to make the reports required by section 25-3-104. Any person, partnership, association, company, or corporation opening, conducting, or maintaining any facility for the treatment and care of the sick or injured who does not have a provisional or regular license authorizing such person or entity to open, conduct, or maintain the facility is guilty of a misdemeanor and, upon conviction thereof, shall be punished by a fine of not less than fifty dollars nor more than five hundred dollars.       “Physician” means a person duly licensed to practice under article 220, 240, or 290 of title 12.    “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).    “School-based health center” shall have the same meaning as set forth in section 25-20.5-502.         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.    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.       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.    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.    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.    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.    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.    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.      History. 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.    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.   ANNOTATION   Law reviews. For article, “The Physician as the Hospital's Employee: SB 95-212”, see 24 Colo. Law. 2345 (1995).   No exposure to vicarious liability. Since a hospital may employ a physician but cannot limit or otherwise exercise control over the physician's independent professional judgment, this section does not expose the hospital to vicarious liability with respect to negligent or tortious acts committed by the physician employee. Estate of Harper ex rel. Al-Hamim v. Denver Health & Hosp. Auth., 140 P.3d 273 (Colo. App. 2006).   Corporate practice of medicine doctrine is statutorily altered, but not abolished, in Colorado. Daly v. Aspen Ctr. for Women's Health, Inc., 134 P.3d 450 (Colo. App. 2005).