State Overview: Colorado

State law or statute prohibits or limits the use of prior authorization for buprenorphine containing products by either the state Medicaid plan or private insurance companies.

Once in a 12-month period, health benefit plans must cover a 5-day supply of at least one FDA-approved opioid use disorder treatment medication, without prior authorization. Colo. Rev. Stat. § 10-16-104

Carriers may not impose prior authorization for any FDA-approved SUD medications on the plan's formulary. Colo. Rev. Stat. § 10-16-148

Medicaid managed care plans may not require prior authorization for any FDA-approved medications for SUD covered by the plan. Colo. Rev. Stat. § 25.5-5-422

Colorado credentials three types of addiction counselors. A licensed addiction counselor (LAC) must have a master's or doctorate degree in the behavioral health sciences, passed the master addiction counselor examination administered by the National Association for Alcoholism and Drug Abuse Counselors, completed the number of clock hours of addiction-specific training, as specified by the board by rule, including training in evidence-based treatment approaches, clinical supervision, ethics, and co-occurring disorders and completed at least 2,000 direct clinical hours of clinically supervised work experience in the addiction field.

A certified addiction specialist (CAS) must have a bachelor's degree in a behavioral health concentration or human services equivalent, completed at least 3,000 hours of supervised clinic work hours over a minimum of 18 months, passed an examination and passed the national certification addiction counselor level II examination administered by the National Association for Alcoholism and Drug Abuse Counselors.

A certified addiction technician (CAT) must have a high school diploma, completed at least 1,000 hours of supervised clinical experience over a minimum of six months, passed an examination and passed the national certification addiction counselor level I examination administered by the National Association for Alcoholism and Drug Abuse Counselors.

An individual may receive a certification as an addiction counselor if they have met the requirements for certification as a certified addiction technician or a certified addiction specialist.

Colo. Rev. Stat. §12-245-804 and 2 Colo. Code of Regs. §502-1-21.330 and 4 Colo. Code of Regs. §744-1-21.330 and Colorado State Board of Addiction Counselor Examiners

Licensed professional counselors may provide mental health, psychological, or human development services through cognitive, affective, behavioral, or systematic intervention strategies that address wellness, personal growth, or career development, as well as pathology. A licensed professional counselor may render the application of these principles to individuals, couples, families, or groups. Services may also include, but is not limited to, evaluation, assessment, testing, diagnosis, treatment and psychotherapy. Colo. Rev. Stat. §12-245-603

As outlined in Colorado state law, peer support specialists self-identify as having experienced the process of recovery from a mental health disorder, substance use disorder, trauma, or one or all of such conditions, either as a consumer of recovery services or as the parent or a family member of the consumer. They have successfully completed formal training covering all content areas outlined in the core competencies for peer support professionals established by either the state department or the federal Substance Abuse and Mental Health Services Administration (SAMHSA). They also provide nonclinical support services that align with recommendations from SAMHSA, including engaging individuals in peer-to-peer relationships that support healing, personal growth, life skills development, self-care, and crisis-strategy development to help achieve recovery, wellness, and life goals.

Training, credentialing, and certification for peer specialists are not set out by state law and the process is currently provided by third-party, nonprofit certification providers. Colo. Rev. Stat. §27-60-108

Full independent practice authority but transition to independent prescribing period required.

An APRN shall practice in accordance with the standards of the appropriate national professional nursing organization and have a safe mechanism for consultation or collaboration with a physician or, when appropriate, referral to a physician. Colo. Rev. Stat. §12-255-111

An NM is authorized by the State Board of Nursing to prescribe drugs after certain requirements are met, including educational classes and a preceptorship. Upon conclusion of meeting the requirements, provisional authority may be granted and the NM may prescribe drugs and Schedule II-V controlled substances. A mentorship with a physician or NP with full prescriptive authority must be completed within three years after receiving provisional authority. Colo. Rev. Stat. §12-255-112 and Colo. Board of Nursing Rules Chapter 15

Full independent practice authority but transition to independent prescribing period required.

An APRN shall practice in accordance with the standards of the appropriate national professional nursing organization and have a safe mechanism for consultation or collaboration with a physician or, when appropriate, referral to a physician. Colo. Rev. Stat. §12-255-111

An NP is authorized by the State Board of Nursing to prescribe drugs after certain requirements are met, including educational classes and a preceptorship. Upon conclusion of meeting the requirements, provisional authority may be granted and the NP may prescribe drugs and Schedule II-V controlled substances. A mentorship with a physician or NP with full prescriptive authority must be completed within three years after receiving provisional authority. Colo. Rev. Stat. §12-255-112 and Colo. Board of Nursing Rules Chapter 15

NPs are authorized to sign medical orders for scope of treatment forms. Colo. Rev. Stat. §15-18.7-103(i)

NPs are recognized in state policy as primary care providers. The NP must practice within a specific population focus (e.g. neonatal, pediatric, women's health, adult, family, mental health). Colo. Board of Nursing Rules Chapter XIV 1.10

Optometrists may perform procedures related to foreign body removal, certain laser procedures (laser capsulotomy, laser peripheral iridotomy, laser trabeculoplasty) and the examination, evaluation, diagnosis and treatment of the human eye. Colo. Rev. Stat. §12-275-103(1)

Optometrists may use injections for the treatment of conditions or diseases of the eye or eyelid, excluding intraocular injections penetrating the globe. Their authority also includes injections to counter anaphylactic reactions as well as the administration of the COVID-19 vaccine. Colo. Rev. Stat. §12-275-103(1) and Executive Order D 2021 008

Optometrists may prescribe Schedule III-V controlled substances and also Schedule II hydrocodone or hydrocodone combination medications. Colo. Rev. Stat. §12-275-103(1)

Dental hygienists may perform most of their authorized procedures without supervision. However, dental hygienists must be supervised by a licensed dentist when preparing study casts, administering local anesthesia, or placing interim therapeutic restorations. Colorado law also allows dental hygienist to own a dental hygiene practice and authorizes unsupervised dental hygienists to prescribe fluoride supplements, some topical anti-carries treatments, and some topical anti-infectives in collaboration with a dentist. A dental hygienist may prescribe and apply silver diamine fluoride after meeting certain requirements. Colo. Rev. Stat. §12-220

As of May 2023, Licensed Dental Therapists will be able to practice in Colorado. Dental Therapists may only practice under the supervision of a dentist. Colo. Rev. Stat. §12-220-104

Colorado Medicaid allows for the practice and reimbursement of an interim therapeutic restoration in teledentistry. Colo. Rev. Stat. §25.5-5-321.5

Colorado has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act allowed pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Pharmacists may make minor prescriptions adaptions including changes to prescribed dosages and quantities if the change achieves the intent of the original prescriptions. The pharmacist must document the adaption, the justification for the change and notify the prescribing practitioner. Colo. Rev. Stat. §12-280-125.3

A pharmacist must complete a training course in the subject area of hormonal contraception drug therapy and must include instruction in specific content areas. A written protocol for hormonal contraception drug therapy must be approved by the Board of Pharmacy. Colo. Rev. Stat. §25.5-2-103

A pharmacist must complete a training course in the subject area of tobacco cessation drug therapy and must include instruction in specific content areas. A written protocol for tobacco cessation drug therapy must be approved by the Board of Pharmacy. Colo. Rev. Stat. §10-16-144

Collaboration with a physician allowed for practice and prescriptive authority.

"Collaboration" means, as indicated by the patient's condition, community standards of care and a physician assistant's education, training and experience.

1. Consultation between the physician assistant and a physician or physician group; or
2. Referral by the physician assistant to a physician, or, if the referral is to a physician practicing in a different practice area than the physician assistant, a physician's practice group.

"Collaboration agreement" means a written agreement that describes the manner in which a physician assistant collaborates with a physician or a physician group.

Colo. Rev. Stat. 12-240-107

Statute limits the number of PAs a physician may supervise.

A licensed physician may be responsible for the direction and supervision of up to eight PAs at any one time. Colo. Code Regs. §3-713-7, Rule 400, Sec. 7.1(C)(3)

Chart co-signatures may be determined at the practice level.

Chart review may be used as one of the assessments of competency. Colo. Code Regs. §3-713-7, Rule 400, Sec. 7.1(D)(6)(d)(3)

Colorado does not currently have any provisions surrounding adaptable proximity requirements.

The supervising physician delegates medical procedures and services to a PA. Delegated services must be consistent with the physician's education, training, experience and active practice. Colo. Code Regs. §3-713, Rule 400, Sec. 2