3 CCR 713-30.4 - RULES GOVERNING INDIVIDUALS TO WHOM MEDICAL SERVICES ARE DELEGATED ("DELEGATEES")

A. Persons Who May Serve as Delegatees

1. Qualified by Education, Training or Experience

a. The delegating physician must evaluate and determine that the delegatee has the necessary education, training or experience to perform each delegated medical service.

b. As part of his or her evaluation, the delegating physician shall personally assess and review:

(1) Copies of diplomas, certificates or professional degrees from bona fide training program(s) appropriate to the specific services delegated; and,

(2) Appropriate credentialing by a bona fide agency, Board or institution, if applicable.

(3) In any practice which utilizes a credentialing committee or a human resources department for verification of credentials, a delegating physician may rely on a credentialing committee or a human resources department for verification of Section 30.4(A)(1)(b)(1) and (2).

c. The delegating physician shall perform over-the-shoulder direct observation of the delegatee's performance of any medical service prior to authorizing the delegatee to perform the medical service outside of the delegating physician's physical presence. A delegating physician may rely on another Colorado Medical Board licensee's evaluation of the delegatee's skill to perform medical services.

2. In the event that a delegating physician chooses to delegate medical services to a person holding a license, certificate or registration, and the delegated services are beyond the scope of that person's license, certificate or registration, the delegating physician must ensure that the delegatee is qualified by additional education, training or experience beyond that required for the delegatee's license, certificate or registration. Any delegation described in this paragraph must comply with the requirements of this Rule 800.

3. These Rules apply to individuals who are certified by a national or private body but who do not have Colorado state licensure, registration or certification.

4. Graduates of physician assistant and anesthesiologist assistant programs who have not yet taken the certification examination, and thus, are not qualified for licensure, may perform delegated medical services pursuant to section 12-240-107(3)(l), C.R.S., until such time as they have been notified that they have passed the certification exam and are eligible for a Colorado license. The delegating physician and the unlicensed physician assistant graduate or unlicensed anesthesiologist assistant graduate shall comply with the requirements of these Rules until the physician assistant or anesthesiologist assistant is licensed and subject to Board Rule 400 or 510.

5. Medical aesthetic service instructors at institutions accredited/certified by the Department of Higher Education may serve as delegatees provided the instructor possesses the necessary education, training or experience to perform each delegated medical service.

a. The physician may delegate the medical service to such Instructor and students at the aforementioned institution to be performed by the student under the direct supervision of the instructor.

B. The delegating physician and the delegatee shall take appropriate measures to ensure that delegatees are identified in a manner that prevents confusion as to the delegatees' qualifications and legal authority to provide medical services. Following are examples of situations in which confusion as to the delegatees' qualifications and legal authority to provide medical services is likely and in which the physician and the delegatee shall be responsible for taking effective measures to prevent such confusion. This list is illustrative and not exhaustive.

1. A delegatee who is a "radiology practitioner assistant" uses the acronym "RPA", which is easily confused with the title of a licensed physician assistant or PA;

2. A delegatee uses the word "licensed" as part of a title when the delegatee is not licensed, registered, or certified by the state of Colorado to perform the medical services at issue;

3. A delegatee uses the word "doctor" or the abbreviation "Dr." when acting as a delegatee; or

4. A delegatee who is an "aesthetician" uses the word "medical" as part of a title, such as "medical aesthetician", when the delegatee is not licensed, registered or certified by the state of Colorado to perform medical services.

C. Persons Not Eligible to Serve as Delegatees

1. A physician shall not delegate medical services to any person who is otherwise qualified to be licensed by the Board as a physician, physician assistant or anesthesiologist assistant but who is not so licensed, including, but not limited to:

a. Any physician, physician assistant or anesthesiologist assistant with an inactive, expired, revoked, restricted, limited, suspended or surrendered license;

b. Any physician, physician assistant or anesthesiologist assistant (other than those physician assistants or anesthesiologist assistants authorized pursuant to Section 30.4 of these Rules) who meets all qualifications for licensure but who is not licensed in Colorado; and

c. Any physician, physician assistant or anesthesiologist assistant whose application for licensure in the State of Colorado has been denied unless the denial is pursuant to section 12-240-120(1)(a), C.R.S.

2. Medical services shall not be delegated to any person who holds a physician training license pursuant to section 12-240-128, C.R.S.

D. Exceptions

1. These Rules do not apply to a person performing acts that do not constitute the practice of medicine as defined by section 12-240-107(1), C.R.S.

2. These Rules do not apply to health care providers who are licensed, registered or certified by the state of Colorado and who are acting within their scope of practice.

3. These Rules do not apply to a registered nurse (also known as a professional nurse or an RN). Services provided by a registered nurse, either as an independent nursing function or a delegated medical function, are governed by the Nurse Practice Act.

4. These Rules do not apply to any person who is otherwise exempt pursuant to section 12-240-107, C.R.S. from holding a license to practice medicine and who is acting within the scope of the specific statutory exemption.

Notes

3 CCR 713-30.4

40 CR 10, May 25, 2017, effective 6/14/2017