Colorado § 25-38-102 - Legislative declaration.

§ 25-38-102. Legislative declaration.

(1) The general assembly hereby finds, determines, and declares that:

(a) Health-care entities have instituted or are instituting quantitative and qualitative designations of physicians and dentists;

(b) Physician and dentist designations are disclosed and represented to consumers and others as part of marketing, sales, and other efforts, and such designations may be used by consumers in selecting the physicians and dentists from whom they receive care;

(c) Designations are based on claims data, practice criteria or guidelines, and other criteria, not all of which are made known to consumers or to the physicians and dentists designated;

(d) Health-care entities differ in the extent to which they provide access to some or all of the data, criteria, and methodologies;

(e) Regulatory agencies in other states have taken action against health-care entities to require disclosure of designation information and to set certain criteria by which designations may be used;

(f) For the protection of consumers, physicians, and dentists and to avoid improper profiling of physicians and dentists, health-care entities must ensure that they are using designations that are fair and accurate and must accord physicians and dentists the right to challenge and correct erroneous designations, data, and methodologies;

(g) Full disclosure of the data and methodologies by which physicians and dentists are designated will encourage, to the fullest extent possible, the accuracy, fairness, and usefulness of such designations. Disclosures will help keep patients from being exposed to inaccurate, misleading, and incorrect information about the nature and quality of the care of physicians and dentists. The disclosure required by this article will encourage the use of guidelines and criteria from well-recognized professional societies and groups using evidence-based and consensus practice recommendations. Disclosure will allow health-care consumers and physicians and dentists an opportunity to better understand the criteria, basis, and methods by which physicians and dentists are evaluated, and disclosure will foster competition among health-care entities to improve the way in which designations are used. Accordingly, the general assembly finds that requiring full disclosure of designation data and methodologies and setting certain minimum standards for making such designations will help improve the quality and efficiency of health care delivered in Colorado.

(h) The general assembly intends this article to serve as the initial stage of a multipart process to increase transparency of information about health-care quality and costs in Colorado. Future actions may include, but are not limited to, creation of a multistakeholder work group, comprised of health-care entities, health plans, businesses, consumer groups, and others as identified, to develop a system for aggregating cost and quality information across health-care entities and consumers. The ultimate goal is to develop standardized quality reporting arrangements, consistent with national standards and subject to evaluation by an independent entity, that are accessible and meaningful to consumers and other stakeholders.

Source: L. 2008: Entire article added, p. 2012, § 1, effective September 1. L. 2015: (1)(a), (1)(b), (1)(c), (1)(f), and (1)(g) amended, (HB 15-1191), ch. 95, p. 270, § 2, effective August 5.