Colorado § 25-38-104 - Minimum requirements for designations - disclaimer required.

§ 25-38-104. Minimum requirements for designations - disclaimer required.

(1) Any designation of a physician or dentist shall include, at a minimum, the following:

(a) A quality of care component that may be satisfied by incorporating a practice guideline or performance measure pursuant to paragraph (f) of this subsection (1), and a clear representation of the weight given to quality of care in comparison with other designation factors;

(b) Statistical analyses that are accurate, valid, and reliable and, where reasonably possible, that appropriately adjust for patient population, case mix, severity of patient condition, comorbidity, outlier events, or other known statistical anomalies;

(c) A period of assessment of data, pertinent to the designation, that shall be updated by the health-care entity at appropriate intervals;

(d) If claims data are used in the designation process, accurate claims data appropriately attributed to the physician or dentist. When reasonably available, the health-care entity shall use aggregated data to supplement its own claims data.

(e) The physician's or dentist's responsibility for health-care decisions and the financial consequences of those decisions, which shall be fairly and accurately attributed to the physician or dentist;

(f) If practice guidelines or performance measures are used in the designation process:

(I) Practice guidelines or performance measures that are promulgated or endorsed by nationally recognized health-care organizations that establish or promote guidelines and performance measures emphasizing quality of health care, such as the national quality forum or the AQA alliance, or their successors, or other such national physician or dentist specialty organizations, or the Colorado clinical guidelines collaborative or its successor;

(II) Practice guidelines or performance measures that are:

(A) Evidence-based, whenever possible;

(B) Consensus-based, whenever possible; and

(C) Pertinent to the area of practice, location, and characteristics of the patient population of the physician or dentist being designated.

(2) (a) Any disclosure of a designation to a physician, dentist, or consumer shall be accompanied by a conspicuous disclaimer written in bold-faced type. The disclaimer shall state that designations are intended only as a guide to choosing a physician or dentist, that designations should not be the sole factor in selecting a physician or dentist, that designations have a risk of error, and that consumers should discuss designations with a physician or dentist before choosing him or her.

(b) Failure to include the disclaimer makes the use of the designation a violation of this article.

Source: L. 2008: Entire article added, p. 2014, § 1, effective September 1. L. 2015: IP(1), (1)(d), (1)(e), (1)(f)(I), (1)(f)(II)(C), and (2)(a) amended, (HB 15-1191), ch. 95, p. 271, § 4, effective August 5.