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Colorado Orthopaedic Society 2023 Legislative Impact

Your Colorado Orthopaedic Society was involved in 50 proposed bills in the 2023 Legislative Session.  Here is a closer look at five pieces of legislation and how COS’ work impacts your practice and delivers value to our membership.

Bill # and TitleAs Originally ProposedFinal Language(After COS Involvement)IMPACT ON YOUR PRACTICE
 HB23-1116 Contracts between Carriers and Providers  Requires carriers to provide at least one method of reimbursement to physicians that does not have an associated fee, as is the case with reimbursement via virtual credit cards.  COS supported this bill and worked to grant the Insurance Commissioner the ability to enforce this new law and funded such enforcement. Fights a national insurance trend of reimbursing physicians through “virtual credit cards”, which pass transaction fees on to the physician.  Saved you up to 3-8% on payments you receive from an insurance company and ensures physician consent to e-payment methods. 
 HB23-1192 Additional Protections in Consumer Code Increased your liability exposure by lowering the burden of proof for plaintiffs to receive significantly increased civil awards.  Intensive opposition and lobbying led to the removal of all components of the bill that would have impacted physicians. Protected you from liability legislation which would have fundamentally changed the risks of daily practice, exposing physicians to more inappropriate lawsuits.
 SB23-083 Physician Assistant Collaboration Requirements  The PA national organization is pursuing independent practice of medicine with no limit on scope of practice.   This bill was the third attempt towards that goal here in Colorado. Physicians would have been vicariously liable for bad outcomes.  “Employers” could collaborate with PAs allowing private equity firms to establish Colorado based medical practices and fully staff those practices with PA’s, effectively bypassing physician supervision and creating incentives to avoid employing/partnering with physicians in clinical care. PAs must work within a collaborative practice with a physician. Collaborating physician may require additional hours and/or ongoing supervision as well as “team-based practice” elements. The “Employer” signing a collaborative agreement must be Colorado licensed physician actively practicing in Colorado or group of such physicians. The PA’s scope of practice is limited by their education, experience and competency as determined by the collaborating physician. PA’s are liable for their care and must maintain the same level of liability insurance coverage as a physician or NP.  Ensured you can collaborate with your PA’s as you deem appropriate. Ensured that PA care must involve physicians, regardless of the terminology “collaboration” vs “supervision”. Eliminated burdensome paperworkwhen working with a PA. Shielded you from liability exposurefor care you do not personally provide. Protected patient care quality by ensuring that employers cannot as easily prioritize profits over care by using PA’s exclusive of physician involvement. 
 SB23-093 Increase Consumer Protections in Medical Transactions  Required lawsuits collecting medical debt from patients to be filed by physicians as individuals (not as practice). Capped interest on medical debt at 3% while the cap on all other areas debt is 8%. Eliminated physicians’ ability to assign medical debt to a collection agency.   Allows physicians to use third parties for the collection of medical debt. Removed the unjust 3% cap on interest for medical debt thereby treating it as any other debt.   Protected your ability to assign the collection of your accounts receivable to the person/agencies of your choice without capping the interest you are due on your practice’s medical debt.
 SB23-144 Prescription Drugs for Chronic Pain  Prohibited a physician from refusing to accept or treat a patient based on the dosage of drug a patient requires for chronic pain.  Prohibited physicians from tapering pain medications to meet a predetermined dosage recommendation.  Allows physicians to prescribe opioids in accordance with their professional opinion and at doses that may exceed MME guidelines as determined appropriate by the physicians. Provides immunity from disciplinary action when prescribing for legitimate medical purposes.  Removed artificial prescribing limitsfor the treatment of chronic pain. Protected you from disciplinary action by the medical board. Protected your right to determine your practice’s patient population without being mandated to deliver care for patients in ways you do not wish.

View the full list of bills with COS involvement: