(1) This section shall be known and may be cited as the "Colorado Natural Health Consumer Protection Act".
(2) The general assembly hereby finds and declares that:
(a) According to a July 2009 report from the national institute of health's national center for complementary and alternative medicine, which was based on 2007 survey data:
Thirty-eight percent of Americans use complementary and alternative medicine; and
Americans spent nearly thirty-four billion dollars in out-of-pocket costs in a twelvemonth period for complementary and alternative medicine;
It is estimated that more than one million five hundred thousand Coloradans currently receive a substantial volume of health care services from complementary and alternative health care practitioners;
Those studies further indicate that individuals who use complementary and alternative health care services represent a wide variety of age, ethnic, socioeconomic, and other demographic categories;
Although complementary and alternative health care practitioners are not regulatedby the state and are not required to obtain a state-issued license, certification, or registration, the provision of alternative health care services in some circumstances may be interpreted as the provision of a health care service that only a professional who is licensed or otherwise regulated by the state may perform, thereby subjecting complementary and alternative health care practitioners to potential fines, penalties, and restrictions of their practices even though their practices do not pose an imminent and discernable risk of significant harm to public health and safety;
Because the state recognizes and values the freedom of consumers to choose theirhealth care providers, including the ability to choose a person who is not regulated by the state, the intent of this section is to protect consumer choice and, in consideration of the public's health and safety, to remove technical barriers to access to unregulated health care practitioners and include appropriate consumer protections and disclosures as required in this section; and (f) Nothing in this section:
Requires a person engaged in complementary and alternative health care to obtain alicense, certification, or registration from the state as long as the person practices within the parameters of this section;
Limits the public's right to access complementary and alternative health care practitioners or the right of an unregulated complementary and alternative health care practitioner to practice.
(3) As used in this section, unless the context otherwise requires:
"Complementary and alternative health care practitioner" means a person who provides complementary and alternative health care services in accordance with this section and who is not licensed, certified, or registered by the state as a health care professional.
(I) "Complementary and alternative health care services" means advice and services:
Within the broad domain of health care and healing arts therapies and methods thatare based on complementary and alternative theories of health and wellness, including those that are traditional, cultural, religious, or integrative; and
That are not prohibited by subsection (6) of this section.
(II) "Complementary and alternative health care services" include:
Healing practices using food; food extracts; dietary supplements, as defined in thefederal "Dietary Supplement Health and Education Act of 1994", Pub.L. 103-417; nutrients; homeopathic remedies and preparations; and the physical forces of heat, cold, water, touch, sound, and light;
Stress reduction healing practices; and(C) Mind-body and energetic healing practices.
(c) "Health care professional" means a person engaged in a health care profession for which the state requires the person to obtain a license, certification, or registration under title 12, C.R.S., in order to engage in the health care profession.
This section applies to any person who is not licensed, certified, or registered by thestate as a health care professional and who is practicing complementary and alternative health care services.
(a) A person who is not licensed, certified, or registered by the state as a health care professional and who is practicing complementary and alternative health care services consistent with this section does not violate any statute relating to a health care profession or professional practice act unless the person:
Engages in an activity prohibited in subsection (6) of this section; or
Fails to fulfill the disclosure duties specified in subsection (7) of this section.
A complementary and alternative health care practitioner who engages in an activityprohibited by subsection (6) of this section is subject to the enforcement provisions, civil penalties, and damages specified in part 1 of this article, is no longer exempt from laws regulating the practice of health care professionals under title 12, C.R.S., and may be subject to penalties for unauthorized practice of a state-regulated health care profession.
A person who fails to comply with subsection (7) of this section is subject to theenforcement provisions, civil penalties, and damages specified in part 1 of this article.
(6) A complementary and alternative health care practitioner providing complementary and alternative health care services under this section who is not licensed, certified, or registered by the state shall not:
Perform surgery or any invasive procedure, including a procedure that requires entryinto the body through skin, puncture, mucosa, incision, or other intrusive method, except as permitted under paragraph (g) of this subsection (6);
Administer or prescribe X ray radiation to another person;
Prescribe, administer, inject, dispense, suggest, or recommend a prescription or legend drug or a controlled substance or device identified in the federal "Controlled Substances
Act", 21 U.S.C. sec. 801 et seq., as amended;
Use general or spinal anesthetics, other than topical anesthetics;
Administer ionizing radioactive substances for therapeutic purposes;
Use a laser device that punctures the skin, incises the body, or is otherwise used as aninvasive instrument. If a complementary and alternative health care practitioner uses a laser device as a noninvasive instrument, the laser device must be cleared by the federal food and drug administration for over-the-counter use.
Perform enemas or colonic irrigation unless the complementary and alternative health care practitioner:
Maintains board certification through the international association of colon hydrotherapy or the national board for colon hydrotherapy or their successor entities;
Discloses that he or she is not a physician licensed pursuant to article 240 of title 12;
and
Recommends that the client have a relationship with a licensed physician;
Practice midwifery;
Practice psychotherapy, as defined in section 12-245-202 (14);
Perform spinal adjustment, manipulation, or mobilization;
Provide optometric procedures or interventions that constitute the practice of optometry, as defined in article 275 of title 12;
Directly administer medical protocols to a pregnant woman or to a client who hascancer;
Treat a child who is under two years of age;
Treat a child who is two years of age or older but less than eight years of age unlessthe complementary and alternative health care practitioner:
Obtains the written, signed consent of the child's parent or legal guardian;
Discloses that he or she is not a physician licensed pursuant to article 240 of title 12;
Recommends that the child have a relationship with a licensed pediatric health careprovider; and
Requests permission from the parent or legal guardian for the complementary andalternative health care practitioner to attempt to develop and maintain a collaborative relationship with the child's licensed pediatric health care provider, if the child has a relationship with a licensed pediatric health care provider;
Provide dental procedures or interventions that constitute the practice of dentistry, asdefined in article 220 of title 12;
Set fractures;
Practice or represent that he or she is practicing massage or massage therapy as defined in article 235 of title 12;
Provide a conventional medical disease diagnosis to a client;
Recommend the discontinuation of a course of care, including a prescription drug,that was recommended or prescribed by a health care professional; or
Hold oneself out as, state, indicate, advertise, or imply to a client or prospective clientthat he or she is a physician, surgeon, or both, or that he or she is a health care professional who is licensed, certified, or registered by the state.
(7) (a) Any person providing complementary and alternative health care services in this state who is not licensed, certified, or registered by the state as a health care professional is not regulated by a professional board or the division of professions and occupations in the department of regulatory agencies pursuant to title 12, C.R.S., and is advertising or charging a fee for health care services shall provide to each client during the initial client contact the following information in a plainly worded written statement:
The complementary and alternative health care practitioner's name, business address,telephone number, and any other contact information for the practitioner;
The fact that the complementary and alternative health care practitioner is not licensed, certified, or registered by the state as a health care professional;
The nature of the complementary and alternative health care services to be provided;
A listing of any degrees, training, experience, credentials, or other qualifications theperson holds regarding the complementary and alternative health care services he or she provides;
A statement that the client should discuss any recommendations made by the complementary and alternative health care practitioner with the client's primary care physician, obstetrician, gynecologist, oncologist, cardiologist, pediatrician, or other board-certified physician; and
A statement indicating whether or not the complementary and alternative healthcare practitioner is covered by liability insurance applicable to any injury caused by an act or omission of the complementary and alternative health care practitioner in providing complementary and alternative health care services pursuant to this section.
Before a complementary and alternative health care practitioner provides complementary and alternative health care services for the first time to a client, the complementary and alternative health care practitioner shall obtain a written, signed acknowledgment from the client stating that the client has received the information described in paragraph (a) of this subsection (7). The complementary and alternative health care practitioner shall give a copy of the acknowledgment to the client and shall retain the original or a copy of the acknowledgment for at least two years after the last date of service.
A complementary and alternative health care practitioner shall not represent in anyadvertisement for complementary and alternative health care services that the complementary and alternative health care practitioner is licensed, certified, or registered by the state as a health care professional.
(8) The following persons shall not provide complementary and alternative health care services pursuant to this section:
A health care professional whose state-issued license, certification, or registration hasbeen revoked or suspended by the state and has not been reinstated;
A person who has been convicted of a felony for a crime against a person or a felonyrelated to health care and who has not satisfied the terms of the sentence imposed for the crime. As used in this paragraph (b), "convicted" includes entering a plea of guilty or nolo contendere or the imposition of a deferred sentence.
A person who has been deemed mentally incompetent by a court of law.
(9) (a) A complementary and alternative health care practitioner who renders complementary and alternative health care services consistent with this section is not engaging in the practice of medicine, as defined in article 240 of title 12, and is not violating the "Colorado Medical Practice Act", article 240 of title 12, as long as the complementary and alternative health care practitioner does not engage in an act prohibited in subsection (6) of this section.
(b) Nothing otherwise authorizes a complementary and alternative health care practitioner practicing within the scope of practice in this section to engage in the practice of medicine.
(10) This section does not apply to or prohibit:
Any licensed, certified, or registered health care professional from practicing his orher regulated profession;
The practice of health care services that are exempt from state regulation or the provision of health care services by a person who is exempt from state regulation; or
A person from selling dietary supplements as stipulated under the federal "DietarySupplement Health and Education Act of 1994", Pub.L. 103-417, or other natural health care products or advising, educating, or counseling about the structure and function of the human body and the use of natural health care products to support health and wellness.
This section does not limit the right of any person to seek relief under this article orany other available civil or common law remedy for damages resulting from the negligence of a person providing complementary and alternative health care services.
Nothing in this section relieves a licensed, certified, or registered health care professional from liability arising from any injury caused by the health care professional in the course of providing complementary or alternative health care services.
Nothing in this section prevents a consumer from obtaining nutritional informationfrom a nutritionist employed by or under contract with a health food store or wellness center or the nutritionist from providing nutritional information to the consumer.
A violation of this section constitutes a deceptive trade practice under this article.
Source: L. 2013: Entire section added, (SB 13-215), ch. 399, p. 2328, § 1, effective June
5. L. 2016: (6)(q) amended, (HB 16-1320), ch. 265, p. 1101, § 9, effective June 8. L. 2019: (6)(g)(II), (6)(i), (6)(k), (6)(n)(II), (6)(o), (6)(q), and (9)(a) amended, (HB 19-1172), ch. 136, p. 1644, § 12, effective October 1.
Cross references: For the legislative declaration in HB 16-1320, see section 1 of chapter 265, Session Laws of Colorado 2016.