§ 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.

Legislative History

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.