3 CCR 711-2
DEPARTMENT OF REGULATORY AGENCIES AUDIOLOGY RULES AND REGULATIONS 3 CCR 711-2 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ AUTHORITY Basis: These rules are promulgated and adopted by the Director of the Division of Professions and Occupations pursuant to section 12-210-109(4), C.R.S.
Purpose These rules are adopted by the Director in order to clarify statutory requirements pursuant to Article 210 of Title 12.
1.1 Original Licensure
The purpose of this Rule is to clarify the requirements for licensure pursuant to section 12-210-105, C.R.S.
A. To qualify for licensure as an audiologist a person must have:
1.2 Licensure by Endorsement
The purpose of this Rule is to clarify licensure by endorsement requirements pursuant to section 12-210- 107, C.R.S.
A. To qualify for licensure by endorsement an applicant must:
B. Substantially equivalent qualifications may be determined by the Director and may include the following:
C. The Director may consider substituting either:
D. The practice of audiology as part of military service, including a clinical audiology externship, shall be credited towards the requirements of active practice of section (C) of this Rule.
1.3 Requirement for Reinstatement
The purpose of this Rule is to clarify the requirements for reinstatement of an audiologist license that has expired pursuant to section 12-210-106, C.R.S.
A. A licensee applying for reinstatement of an expired license shall complete a reinstatement application, pay a reinstatement fee, and attest to the appropriate malpractice/professional liability insurance coverage as required by Rule 1.5.
B. If the license has been expired for more than two years from the date of receipt of the reinstatement application, a licensee applying for reinstatement of an expired license shall establish “competency to practice” under sections 12-20-202(2)(c)(II)(A) and (D), and 12-20-105, C.R.S. as follows:
C. An applicant seeking to reinstate a license that has been expired for more than five years is not eligible to complete (B)(2) of this Rule.
1.4 Patient Medical Records
The purpose of this Rule is to clarify the requirements for maintaining patient medical records pursuant to section 12-210-114, C.R.S., by a licensed audiologist (licensee).
A. Each licensee shall develop a written plan to ensure the security of patient records pursuant to section 12-210-114, C.R.S., and must address at least the following:
B. The licensee or licensee’s supervisor or licensee designated by licensee’s employer shall maintain all medical records for at least seven years. These records shall identify the patient’s name, the goods and services provided to each patient (excluding minor accessories and batteries), and the date and price of each transaction.
1.5 Malpractice Coverage/Professional Liability Insurance
The purpose of the following Rule is to clarify the amount of malpractice coverage/professional liability insurance that must be maintained by an audiologist who provides services to patients as required by sections 12-210-105(4)(e), 12-210-109(3), and 12-210-111, C.R.S.
A. For purposes of this Rule, malpractice coverage pursuant to section 12-210-109(3), C.R.S., and professional liability insurance pursuant to sections 12-210-105(4)(e) and 12-210-111, C.R.S., are synonymous and the same requirement.
B. An audiologist shall maintain malpractice coverage/professional liability insurance of at least $1,000,000 per incident and $3,000,000 aggregate per year.
1.6 Written Disclosures to Purchasers
The purpose of this Rule is to clarify the type of written disclosures to be provided to purchasers of hearing aids pursuant to sections 12-210-109(4), 12-210-202(1)(e) and 6-1-701(1)(c)(I)(A), C.R.S., that will protect such purchasers and that are necessary for the enforcement and administration of Article 210 of Title 12.
Licensees shall identify themselves by listing their name, license type (i.e., audiologist), license number, business address and telephone number on every contract or purchase agreement for the sale of a hearing aid.
A.
B. Licensees shall include provisions on all contracts and purchase agreements stating the following:
C. If any part of the purchase price of a hearing aid, including any fees for services, is to be non- refundable, the following disclosures of all non-refundable charges are required on the contract or purchase agreement and must be clearly stated as non-refundable:
1.7 Hearing Aid Provider Trainees/Apprentices
The purpose of this Rule is to clarify the transition of a trainee license type, establish the time period during which an apprentice license shall be valid, and to specify the components of the training required to be completed by apprentices pursuant to sections 12-210-102(3)(b), 12-210-108(2)(l), 12-230- 201(3)(b)(I), C.R.S.
A. Unlicensed Trainees
B. Licensed Apprentices
1.8 Reporting Convictions and Other Adverse Actions
The purpose of this Rule is to clarify the procedures for reporting convictions and other adverse actions to include judgments and administrative proceedings pursuant to sections 12-210-105(5), 12-210-108(2)(c) and (u), 12-210-108(4), and 12-30-102, C.R.S. A Licensee, as defined in section 12-20-102(10), C.R.S., shall inform the Office of Audiology Licensure, in a manner set forth by the Director, within thirty days of any adverse action. For purposes of this Rule, “adverse action” includes the following:
A. Conviction or acceptance of a plea of guilty or nolo contendere or receipt of a deferred sentence in any court to a felony, or a crime involving fraud, deception, false pretense, theft, misrepresentation, false advertising, or dishonest dealing.
B. A disciplinary action imposed upon the licensee by another jurisdiction which would or could reasonably be considered to be a violation of Article 210, Title 12, C.R.S. For purposes of this Rule any disciplinary action by another jurisdiction includes, but is not limited to, a revocation, suspension, probation, fine, sanction, or a denial of a license or authorization to practice.
C. Any judgment, award, or settlement of a civil action or arbitration in which there was a final judgment or settlement against the licensee for failing to practice according to generally accepted professional standards.
D. The notice to the Director shall include the following information:
E. The licensee may submit a written statement with any notice under this Rule to be included in the licensee records.
F. This rule shall apply to any adverse action as described in section (A) of this Rule that occurs on or after the effective date of this rule.
1.9 Duty to Report Information
The purpose of this Rule is to clarify the requirement of licensees to notify the Director of a change in submitted information pursuant to sections 12-30-102 and 12-210-108(2)(b), C.R.S.
A. The licensee shall inform the Office of Audiology Licensure in a clear, explicit and unambiguous written statement of any name, address, telephone, or email change within thirty days of the change. The Office of Audiology Licensure will not change a licensee’s information without explicit written notification from the licensee. Notification by any manner approved by the Division is acceptable.
B. The Office of Audiology Licensure requires one of the following forms of documentation to change a licensee’s name or social security number:
1.10 Declaratory Orders
The purpose of this Rule is to clarify procedures for the handling of requests for declaratory orders filed pursuant to the Colorado Administrative Procedures Act at section 24-4-105(11), C.R.S.
A. Any person or entity may petition the Director for a declaratory order to terminate controversies or remove uncertainties as to the applicability of any statutory provision or of any rule or order of the Director.
B. The Director will determine, at her or his discretion and without notice to petitioner, whether to rule upon any such petition. If the Director determines that she or he will not rule upon such a petition, the Director shall promptly notify the petitioner of her or his action and state the reasons for such decision.
C. In determining whether to rule upon a petition filed pursuant to this rule, the Director will consider the following matters, among others:
D. Any petition filed pursuant to this rule shall set forth the following:
E. If the Director determines that she or he will rule on the petition, the following procedures shall apply:
F. The parties to any proceeding pursuant to this rule shall be the Director and the petitioner. Any other person may seek leave of the Director to intervene in such a proceeding, and leave to intervene will be granted at the sole discretion of the Director. A petition to intervene shall set forth the same matters as are required by section D of this rule. Any reference to a “petitioner” in this Rule also refers to any person who has been granted leave to intervene by the Director.
G. Any declaratory order or other order disposing of a petition pursuant to this rule shall constitute an agency action subject to judicial review pursuant to the Colorado Administrative Procedures Act at section 24-4-106, C.R.S.
1.11 Credit for Military Education, Training, or Experience and Pathways to Licensure for Veterans and Members of the Military The purpose of this Rule is to provide pathways to licensure for individuals with training, education, or experience gained during military service pursuant to sections 12-20-202(4) and 24-4-201 et seq., C.R.S.
A. An applicant for licensure may submit information about the applicant’s education, training, or experience acquired during military service. It is the applicant’s responsibility to provide timely and complete information for the Director’s review.
B. In order to meet the requirements for licensure, such education, training, or experience must be substantially equivalent to the required qualifications that are otherwise applicable at the time the application is received by the Director.
C. The Director will determine, on a case-by-case basis, whether the applicant’s military education, training, or experience meet the requirements for licensure.
D. Documentation of military experience, education, or training may include, but is not limited to, the applicant’s Certificate of Release or Discharge from Active Duty (DD-214), Verification of Military Experience and Training (DD-2586), military transcript, training records, evaluation reports, or letters from commanding officers describing the applicant’s practice.
1.12 Concerning Health Care Provider Disclosures to Consumers about the Potential Effects of Receiving Emergency or Nonemergency Services from an Out-of-Network Provider This Rule is promulgated and adopted by the Director of the Division of Professions and Occupations (“Director”), pursuant to the rulemaking authority in sections 12-20-204, 12-210-109(4), and 24-34-113(3), C.R.S., in consultation with the Commissioner of Insurance and the State Board of Health under the authority of section 24-34-113(2), C.R.S.
The purpose of this Rule is to establish requirements for health care providers to provide disclosures to consumers about the potential effects of receiving emergency or non-emergency services from an out-of- network provider as required by section 24-34-113(2), C.R.S. This Rule applies to health care providers as defined in sections 24-34-113(1)(f) and 10-16-102(56), C.R.S.
A. Disclosure requirements. If a consumer has incurred a claim for emergency or nonemergency health care services from an out-of-network provider, the health care provider shall provide the disclosures contained in Appendix. The health care provider shall provide the disclosure contained in Appendix A at all of the following occasions:
B. Noncompliance with this Rule may result in the imposition of any of discipline made available by section 12-210-108(2)(d), C.R.S.
APPENDIX A Surprise Billing – Know Your Rights Beginning January 1, 2020, Colorado state law protects you from “surprise billing,” also known as balance billing.
What is surprise/balance billing, and when does it happen? You are responsible for the cost-sharing amounts required by your health plan, including copayments, deductibles, and/or coinsurance. If you are seen by a provider or use services in a facility or agency that are not in your health plan’s network, you may have to pay additional costs associated with that care. These providers or services at facilities or agencies are sometimes referred to as “out-of-network.” Out-of-network facilities or agencies often bill you the difference between what your insurer decides is the eligible charge and what the out-of-network provider bills as the total charge. This is called “surprise” or “balance” billing.
When you CANNOT be balance-billed:
Emergency Services Not every service provided in an emergency department is an emergency service. If you are receiving emergency services, in most circumstances, the most you can be billed for is your plan’s in-network cost- sharing amounts. You cannot be balance-billed for any other amount. This includes both the emergency facility and any providers that see you for emergency care. Nonemergency Services at an In-Network or Out-of-Network Health Care Provider The health care provider must tell you if you are at an out-of-network location or at an in-network location that is using out-of-network providers. They must also tell you what types of services may be provided by any out-of-network provider.
You have the right to request that in-network providers perform all covered medical services. However, you may have to receive medical services from an out-of-network provider if an in-network provider is not available. In this case, the most you can be billed for covered services is your in-network cost-sharing amount (copayments, deductibles, and/or coinsurance). These providers cannot balance bill you. Additional Protections • Your insurer will pay out-of-network providers and facilities directly. Again, you are only responsible for paying your in-network cost-sharing for covered services. • Your insurer must count any amount you pay for emergency services or certain out-of-network services (described above) toward your in-network deductible and out-of-pocket limit. • Your provider or facility must refund any amount you overpay within sixty days of being notified. • A provider, hospital, or outpatient surgical facility cannot ask you to limit or give up these rights. If you receive services from an out-of-network provider or facility or agency OTHER situation, you may still be balance billed, or you may be responsible for the entire bill. If you intentionally receive non-emergency services from an out-of-network provider or facility, you may also be balance billed.
If you want to file a complaint against your health care provider, you can submit an online complaint by visiting this website: https://www.colorado.gov/pacific/dora/DPO_File_Complaint. _________________________________________________________________________ Editor’s Notes History Entire rule eff. 09/01/2010.
Entire rule emer. rule eff. 07/01/2013.
Entire rule eff. 10/15/2013.
Entire rule eff. 12/30/2013.
Rules 2, 11 eff. 07/30/2019.
Rule 1.12, Appendix A emer. rules eff. 01/01/2020; expired 04/29/2020. Rule 1.12, Appendix A eff. 04/30/2020.
Rule 1.6 emer. rule eff. 10/21/2020.