DEPARTMENT OF REGULATORY AGENCIES
Division of Professions and Occupations
3 CCR 716-1
CHAPTER 22 – RULES FOR PROFESSIONAL REVIEW OF PERSONS LICENSED TO PRACTICE NURSING AND GRANTED AUTHORITY AS AN ADVANCED PRACTICE NURSE
BASIS: The authority for promulgation of rules and regulations by the Colorado State Board of Nursing is set forth in Section 12-38-104(1)(a), C.R.S. and 12-36.5-104, C.R.S.
PURPOSE: These rules have been adopted by the Colorado State Board of Nursing to:
A. Specialty Societies
1. Establish standards for the designation of specialty societies by the State Board of Nursing in order that such societies will be entitled to the immunities provided by Section 12-36.5-101, et seq., C.R.S.;
2. Effectuate the legislative policy set forth in Section 12-36.5-101, et seq., C.R.S., by encouraging members of nursing specialty societies to openly, honestly, and effectively study and review the conduct of practice by members of those societies, including the quality of service rendered by those members;
3. Enable the Colorado State Board of Nursing to more effectively regulate the conduct of the practice of advanced practice nursing by encouraging the prompt, accurate, and complete reporting of instances of unprofessional conduct by peers in the advance nursing practice profession.
In order to be designated a nursing specialty society or association entitled to the immunities provided by Section 12-36.5-101, et seq., C.R.S., such nursing society or association must show:
1. The members of the society or association have an authority to practice advanced practice nursing and residing in the State of Colorado;
2. The members of the society or association specialize in a distinct and recognizable discipline of advanced practice nursing. Such specialization may be shown by establishing that such group:
a. Is recognized by the Advanced Practice Certifying bodies; or
b. Is recognized as an Advanced Nursing Practice Specialty by the Colorado Nurses Association, American Nurses Association, or National Council of State Boards of Nursing; or
c. Practices an area of advanced practice of nursing that is materially distinguishable from any other such area.
3. The specialty society or association is representative of practitioners in that discipline. Therefore the society or association must show that its membership is open to all advanced practice practitioners in the State of Colorado, and that such membership consists of 50% or more of the practitioners of that discipline in this state. The society must provide the Board with a description of that society’s or association’s requirements for membership at the time it seeks designation.
4. The society or association must establish that the action it takes against the membership status of its members is taken in conformity with state and federal law, including the procedures set forth in the Colorado Peer Review Statutes, Sections 12-36.5-104(7) and (8), C.R.S., and the Health Care Quality Improvement Act of 1986, 42 U.S.C. 11101, et seq.
5. The society or association must acknowledge and agree to comply with a standing request on the part of the State Board of Nursing for a complete record of all professional review proceedings, pursuant to Section 12-36.5-104(11), C.R.S. Said record of proceedings shall be sent to the Board of Nursing not later than sixty (60) days following the final action of the governing board or the surrender of membership.
6. In the event that the Board determines, after initial review, consideration or investigation, that the alleged conduct leading to the discipline of the advanced practice nurse member of the society or association does not involve a violation of the provisions of the Colorado Nurse Practice Act, C.R.S. 12-38-101, et seq., the reports or information submitted pursuant to paragraph 5 and related documents or proceedings of the Board shall be confidential and not subject to public inspection or disclosure.
B. Professional Liability Insurers
1. Establish standards for the designation of professional liability insurers by the State Board of Nursing in order that such insurers will be entitled to the immunities provided by Section 12-36.5-101, et seq., C.R.S.;
2. Effectuate the legislative policy set forth in Section 12-36.5--101, et seq., C.R.S., by encouraging professional liability insurers to openly, honestly, and effectively study and review the conduct of practice of advanced nurse practitioners who are, or seek to be, provided professional liability coverage by the insurer;
3. Enable the Colorado State Board of Nursing to more effectively regulate the conduct of the practice of advanced practice nursing by encouraging the prompt, accurate, and complete reporting of instances of unprofessional conduct by professional liability insurers.
In order to be designated a professional liability insurer under C.R.S. 12-36.5-104(4)(f) and enjoy the immunities provided by Section 12-36.5-101, et seq., C.R.S., such insurer must show that:
a. it is a professional liability insurer authorized to do business in Colorado under the provisions of Section 10-3-105, C.R.S.;
b. its procedures for professional reviews conform with state and federal law, including the procedures set forth in the Colorado Peer Review Statutes, Sections 12-36.5-101, et seq., C.R.S., and the Health Care Quality Improvement Act of 1986, 42 U.S.C. 11101, et seq.; and
c. it acknowledges and agrees to comply with a standing request on the part of the State Board of Nursing, pursuant to C.R.S. 12-36.5-104(11), for a complete record of all professional review proceedings in which an allegation of substandard practice, as defined in C.R.S. 12-38-117, has been made. Said record of proceedings shall be sent to the State Board of Nursing not later than sixty (60) days following the final action of the governing board or the insured’s withdrawal of any request for professional liability coverage.
5. In the event that the Board determines, after initial review, consideration or investigation, that the alleged conduct of the physician under review does not involve a violation of the provisions of the Colorado Nurse Practice Act, C.R.S. 12-36-101, et seq the reports or information submitted pursuant to paragraph 3 and related documents or proceedings of the Board shall be confidential and not subject to public inspection or disclosure.
C. Health Maintenance Organizations
1. Establish standards for the designation of a professional review committee composed of Advanced Nurse Practitioners by a health maintenance organization as authorized by the State Board of Nursing to establish professional review committees in order that such committee and health maintenance organization will be entitled to the immunities and confidentiality provided by Section 12-36.5-101, et seq., C.R.S.;
2. Effectuate the legislative policy set forth in Section 12-36.5-101, et seq., C.R.S., by encouraging members of a professional review committee established by a health maintenance organization to openly, honestly and effectively study and review the conduct of practice by advanced practice nurses who contract with a health maintenance organization and subject themselves to the authority of the professional review committee, including the quality of service rendered by those advanced practice nurses; and
3. Enable the Colorado State Board of Nursing to more effectively regulate the conduct of the practice of advanced practice nursing by encouraging the prompt, accurate and complete reporting or instances of substandard care by peers in the medical profession.
In order for a health maintenance organization to be authorized to establish a professional review committee pursuant to Section 12-36.5-104(5), C.R.S., and to be entitled to the immunities provided by section 12-36.5-101, et seq., C.R.S., such health maintenance organization and committee must comply with the following:
a. The health maintenance organization must be federally qualified OR STATE QUALIFIED, and MUST have a certificate of authority to operate as a health maintenance organization in the State of Colorado.
b. Except as set forth below with regard to a medical director of the health maintenance organization, the professional review committee established by the health maintenance organization must be composed only of advanced practice nurses who are licensed to practice advanced practice nursing in the State of Colorado and who have entered into a contract or subcontract to provide medical services to enrollees of the health maintenance organization. A medical director of the health maintenance organization may be a non-voting member of the professional review committee.
c. The committee shall have jurisdiction to review only advanced nurse practitioners and licensed health care providers (a) who have entered into a contract or subcontract to provide nursing services to enrollees of the health maintenance organization; and (b) who have agreed to be subject to the authority of such committee.
d. Any professional review action taken by the professional review committee and the health maintenance organization affecting the affiliation of a advanced nurse practitioner with the health maintenance organization will be taken in conformity with state and federal law, including the procedures set forth in the Colorado Peer Review Statutes, Section 12-36.5-101, et seq., C.R.S.
e. Upon issuing its recommendation to the health maintenance organization’s governing board for final action, the professional review committee shall also forward a copy of its recommendation to the State Board of Nursing in accordance with Section 12-36.5-104(7)(f). If the Board determines, after initial review, consideration or investigations that the alleged conduct of the physician does not involve a violation of the Colorado Nurse Practice Act, Section 12-36-101, et seq., C.R.S., the reports of information submitted by the professional review committee and related documents or proceedings of the Board shall be confidential and not subject to public inspection or disclosure.
Proposed: January 22, 2012