State Law

Colorado Rev. Statutes-Title 25-Article 38. Physician and Dentist Designation and Disclosure

07/31/2023 Colorado Section 25-38-103



As used in this article, unless the context otherwise requires:

(1) “Carrier” shall have the same meaning as set forth in section 10-16-102, C.R.S.

(2) “Commissioner” means the commissioner of insurance.

(3) “Consumer” includes members of the public, health care consumers and potential health care consumers, purchasers of health insurance plans, or patients.

(3.5)”Dentist” means a dentist licensed under the “Dental Practice Act”, article 35 of title 12, C.R.S.

(4) “Designation” means an award, assignment, characterization, or representation of the cost efficiency, quality, or other assessment or measurement of the care or clinical performance of any physician or dentist that is disclosed or intended for disclosure to the public or persons actually or potentially covered by a health plan, by use of a grade, star, tier, rating, profile, or any other form of designation. “Designation” does not include:

(a) Information that is derived solely from health plan member feedback such as satisfaction ratings; or

(b) Information for programs designed to assist health plan members with estimating a physician’s or dentist’s routine fees or costs.

(5) “Health care entity” means any carrier or other entity that provides a plan of health care coverage to beneficiaries under a plan.

(6) “Methodology” means the method by which a designation is determined, including, but not limited to, the use of algorithms or studies, evaluation of data, application of guidelines, or performance measures.

(7) “Physician” means any physician licensed under the “Colorado Medical Practice Act”, article 36 of title 12, C.R.S.