Section 12-255-112 - Prescriptive authority - advanced practice registered nurses - certified midwives - limits on prescriptions - rules - financial benefit for prescribing prohibited(1) The board may authorize the following licensees to prescribe controlled substances or prescription drugs, as those terms are defined in section 12-280-103: (a) An advanced practice registered nurse who is listed on the advanced practice registry, who has a license in good standing without disciplinary sanctions issued pursuant to section 12-255-110, and who has fulfilled the requirements of this section and requirements established by the board pursuant to this section; or(b) A certified midwife who has a license issued pursuant to section 12-255-111.5 that is in good standing without disciplinary sanctions and who has fulfilled the requirements of this section and requirements established by the board pursuant to this section.(2)(a) The board shall adopt rules to implement this section.(b) Rules adopted pursuant to this section shall reflect current, accepted professional standards for the safe and effective use of controlled substances and prescription drugs.(3)(a) An advanced practice registered nurse or a certified midwife may be granted authority to prescribe prescription drugs and controlled substances to provide treatment to clients within the role and population focus of the advanced practice registered nurse or certified midwife, as applicable.(b)(I) An advanced practice registered nurse or a certified midwife who has been granted authority to prescribe prescription drugs and controlled substances under this part 1 may advise the nurse's or certified midwife's patients of their option to have the symptom or purpose for which a prescription is being issued included on the prescription order.(II) A nurse's or certified midwife's failure to advise a patient under subsection (3)(b)(I) of this section is neither:(A) Grounds for any disciplinary action against the nurse's or certified midwife's professional license issued under this part 1; nor(B) Grounds for any civil action against a nurse or certified midwife in a negligence or tort action; nor(C) Evidence in any civil action against a nurse or certified midwife.(4)(a) An advanced practice registered nurse applying for prescriptive authority shall provide evidence to the board of the following: (I) An appropriate graduate degree as determined by the board pursuant to section 12-255-111 (3)(a);(II) Satisfactory completion of specific educational requirements in the use of controlled substances and prescription drugs, as established by the board, either as part of a degree program or in addition to a degree program;(III) National certification from a nationally recognized accrediting agency, as defined by the board by rule pursuant to section 12-255-111 (3)(b), unless the board grants an exception;(IV) Professional liability insurance as required by section 12-255-113;(V) Inclusion on the advanced practice registry pursuant to section 12-255-111; and(VI) A signed attestation stating that the advanced practice registered nurse has completed at least three years of combined clinical work experience as a professional nurse or as an advanced practice registered nurse.(a.5) A certified midwife applying for prescriptive authority shall provide evidence to the board that the certified midwife has obtained and maintains:(I) A midwife certification in good standing from the American Midwifery Certification Board or its successor entity; and(II) Professional liability insurance as required by section 12-255-113.(b) The board may grant provisional prescriptive authority to an advanced practice registered nurse, upon satisfaction of the requirements set forth in subsection (4)(a) of this section, or to a certified midwife, upon satisfaction of the requirements set forth in subsection (4)(a.5) of this section. The provisional prescriptive authority that is granted is limited to those patients and medications appropriate to the advanced practice registered nurse's or certified midwife's role and population focus. In order to retain provisional prescriptive authority and obtain and retain full prescriptive authority pursuant to this subsection (4) for patients and medications appropriate for the advanced practice registered nurse's or certified midwife's role and population focus, an advanced practice registered nurse or a certified midwife shall satisfy the following requirements:(I)(A) Once the provisional prescriptive authority is granted, the advanced practice registered nurse or certified midwife must obtain seven hundred fifty hours of documented experience in a mutually structured prescribing mentorship either with a physician or with an advanced practice registered nurse or a certified midwife who has full prescriptive authority and experience in prescribing medications. The mentor must be practicing in Colorado and have education, training, experience, and an active practice that corresponds with the role and population focus of the advanced practice registered nurse or certified midwife.(B) Remote communication with the mentor is permissible within the mentorship as long as the communication is synchronous. Synchronous communication does not include communication by e-mail.(C) The physician or advanced practice registered nurse serving as a mentor shall not require payment or employment as a condition of entering into the mentorship relationship, but the mentor may request reimbursement of reasonable expenses and time spent as a result of the mentorship relationship.(D) Upon successful completion of the mentorship period, the mentor shall provide the mentor's signature and attestation to verify that the advanced practice registered nurse or certified midwife has successfully completed the mentorship within the required period after the provisional prescriptive authority was granted.(E) If an advanced practice registered nurse or a certified midwife with provisional prescriptive authority fails to complete the mentorship required by this subsection (4)(b)(I) within three years or otherwise fails to demonstrate competence as determined by the board, the advanced practice registered nurse's or certified midwife's provisional prescriptive authority expires for failure to comply with the statutory requirements.(III) The advanced practice registered nurse or certified midwife shall maintain professional liability insurance as required by section 12-255-113.(IV) The advanced practice registered nurse or certified midwife shall maintain national certification, as specified in subsection (4)(a)(III) or (4)(a.5)(I) of this section, unless the board grants an exception.(V) The certified midwife must complete at least three years of clinical work experience as a certified midwife.(c) An advanced practice registered nurse who was granted prescriptive authority prior to July 1, 2010, shall satisfy the following requirements in order to retain prescriptive authority:(I) (Deleted by amendment, L. 2020.)(II) The advanced practice registered nurse shall maintain professional liability insurance as required by section 12-255-113.(III) The advanced practice registered nurse shall maintain national certification, as specified in subsection (4)(a)(III) of this section, unless:(A) The advanced practice registered nurse was included on the advanced practice registry prior to July 1, 2010, and has not obtained national certification;(B) The advanced practice registered nurse was included on the advanced practice registry prior to July 1, 2008, and has not completed a graduate degree as specified in section 12-255-111 (3)(a); or(C) The board grants an exception.(d) In order to obtain provisional prescriptive authority and obtain and retain full prescriptive authority in this state, an advanced practice registered nurse or a certified midwife from another state must meet the requirements of this section or substantially equivalent requirements, as determined by the board.(5) An advanced practice registered nurse or a certified midwife who obtains prescriptive authority pursuant to this section shall be assigned a specific identifier by the state board of nursing. This identifier shall be available to the Colorado medical board and the state board of pharmacy. The state board of nursing shall establish a mechanism to assure that the prescriptive authority of an advanced practice registered nurse or a certified midwife may be readily verified.(6) An advanced practice registered nurse or a certified midwife with prescriptive authority pursuant to this section is subject to the limitations on prescriptions specified in section 12-30-109.(7)(a) The scope of practice for an advanced practice registered nurse or a certified midwife may be determined by the board in accordance with this part 1.(b) The board may consider information provided by nursing, medical, midwifery, or other health professional organizations, associations, or regulatory boards.(c)(I) Prescriptive authority by an advanced practice registered nurse or a certified midwife is limited to those patients appropriate to the nurse's or certified midwife's scope of practice. Prescriptive authority may be limited or withdrawn and the advanced practice registered nurse or certified midwife may be subject to further disciplinary action in accordance with this part 1 if the nurse or certified midwife has prescribed outside the nurse's or certified midwife's scope of practice or for other than a therapeutic purpose.(II) Nothing in this section shall be construed to require a registered nurse or certified midwife to obtain prescriptive authority to deliver anesthesia care.(8) All prescriptions must comply with applicable federal and state laws, including article 280 of this title 12 and part 2 of article 18 of title 18.(9) Nothing in this section shall be construed to permit dispensing or distribution, as defined in section 12-280-103 (14) and (15), by an advanced practice registered nurse or a certified midwife, except for samples, under article 280 of this title 12 and the federal "Prescription Drug Marketing Act of 1987", Pub.L. 100-293, as amended.(10) An advanced practice registered nurse registered pursuant to section 12-255-111 or a certified midwife is not required to apply for or obtain prescriptive authority.(11) Nothing in this section limits: (a) The practice of nursing by any nurse, including advanced practice registered nurses; or(b) The practice as a certified midwife by any certified midwife.(12) An advanced practice registered nurse or a certified midwife shall not accept any direct or indirect benefit from a pharmaceutical manufacturer or pharmaceutical representative for prescribing a specific medication to a patient. For the purposes of this section, a direct or indirect benefit does not include a benefit offered to an advanced practice registered nurse or certified midwife regardless of whether the specific medication is being prescribed.Amended by 2023 Ch. 261,§ 6, eff. 5/25/2023.Amended by 2021 Ch. 364, § 11, eff. 7/1/2021.Amended by 2020 Ch. 190, § 14, eff. 7/1/2020.Amended by 2020 Ch. 157, § 10, eff. 7/1/2020.Amended by 2019 Ch. 276, § 16, eff. 10/1/2019.Renumbered from C.R.S. § 12-38-111.6 and amended by 2019 Ch. 136, § 1, eff. 10/1/2019.Amended by 2019 Ch. 86, § 9, eff. 8/2/2019.Amended by 2019 Ch. 276, § 3, eff. 5/23/2019.Amended by 2018 Ch. 221, § 4, eff. 5/21/2018.Amended by 2015 Ch. 197, § 3, eff. 9/1/2015.(1) This section is similar to former § 12-38-111.6 as it existed prior to 2019.
(2) (a) Before its relocation in 2019, this section was amended in SB 19-228. Those amendments were superseded by the repeal and reenactment of this title 12, effective October 1, 2019. For those amendments to the former section in effect from May 23, 2019, to October 1, 2019, see SB 19-228, chapter 276, Session Laws of Colorado 2019. (b) Before its relocation in 2019, this section was amended in SB 19-079. Those amendments were superseded by the repeal and reenactment of this title 12, effective October 1, 2019. For those amendments to the former section in effect from August 2, 2019, to October 1, 2019, see SB 19-079, chapter 86, Session Laws of Colorado 2019.
(3) Amendments to subsections (3)(b)(I), (7)(a), and (7)(c)(I) of this section by HB 20-1183 and HB 20-1216 were harmonized.
For the legislative declaration in HB 20-1216, see section 1 of chapter 190, Session Laws of Colorado 2020. For the legislative declaration in HB 21-1276, see section 1 of chapter 364, Session Laws of Colorado 2021.