DEPARTMENT OF REGULATORY AGENCIES RULE 120 - DEMONSTRATION OF CONTINUED COMPETENCY BY PHYSICIAN APPLICANTS FOR LICENSURE PURSUANT TO THE OCCUPATIONAL CREDENTIAL PORTABILITY PROGRAM, REINSTATEMENT OF AN EXPIRED LICENSE, OR REACTIVATION OF A LICENSE 3 CCR 713-22 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________

22.1 INTRODUCTION

A. Basis: The authority for promulgation of these rules and regulations by the Colorado Medical Board (“Board”) is set forth in sections 12-20-202, 12-20-204(1), 12-240-106(1)(a), 12-240-110, 12-240-119, 12-240-120(1)(d), and 12-240-141(5), C.R.S.

B. Purpose: The purpose of these rules and regulations is to set forth the process by which a physician may demonstrate qualifications substantially equivalent for licensure by endorsement in this state pursuant to the Occupational Credential Portability Program as set forth in section 12- 20-202, C.R.S., reinstatement of an expired license, or reactivation of an existing license. These rules apply to physicians who are applying for licensure by endorsement through the Occupational Credential Portability Program, physicians seeking reactivation of an inactive Colorado license, physicians seeking a reentry license, or physicians seeking the reinstatement of an expired Colorado license who have not established that they have actively practiced medicine for the two year period immediately preceding the filing of the application (hereinafter: “applicant(s)”).

C. This Rule does not apply to physicians applying for licensure in Colorado via the Interstate Medical Licensure Compact.

22.2 RULES AND REGULATIONS

A. LICENSURE BY ENDORSEMENT PURSUANT TO THE OCCUPATIONAL CREDENTIAL PORTABILITY PROGRAM PURSUANT TO SECTION 12-20-202(3), C.R.S.

1. Definitions:

1. a. For the purpose of licensure by endorsement through the occupational credential portability program, “substantially equivalent experience or credentials” means the applicant holds a current, valid, and unrestricted license in another U.S. jurisdiction that requires qualifications substantially equivalent to the qualifications for licensure in this state; the applicant submits written verification they have actively practiced medicine in another jurisdiction for the last year or has otherwise maintained continued competency as determined by the Board; and submits proof satisfactory to the board and attests that they have not been and are not subject to final or pending disciplinary or other action by any state or jurisdiction in which the applicant is or has been previously licensed except that, if the applicant is or has been subject to action, the board may review the action to determine whether the underlying conduct warrants refusal of a license pursuant to section 12-240-120, C.R.S.
2. b. For the purpose of licensure by endorsement through the occupational credential portability program, an applicant may demonstrate “continued competency” by establishing that they have maintained an active, continuous, and unrestricted license in another state, have actively practiced medicine for the last year in a jurisdiction with a scope of practice that is substantially similar to the scope of practice for physicians in Colorado, and have not been subject to any disciplinary action during that time period. The active practice of medicine includes the practice of administrative medicine, so long as such practice is not the result of a limitation or restriction by another state licensing board or credentialing entity. Alternatively, an applicant may demonstrate “continued competency” through participation in numerous professional activities, including but not limited to: maintenance of certification (MOC) activities; successful completion and maintenance of board certification exams for ABME or AOA member boards; category 1 approved CME educational courses with relevance to practice; teaching/lecturing/mentoring activities; non-patient care hospital or organization committee participation, including quality, safety, pharmacy and therapeutics, peer review, tumor board or other clinically relevant activities; clinically applicable research; surveying on behalf of accreditation organizations; reentry to practice programs, or volunteer medical care provided overseas or in other jurisdictions. The Board’s Licensing Panel shall have discretion to consider an applicant’s activities on a case-by-case basis and may determine an applicant has met continued competency through a combination of any of the above activities or other relevant professional activities.
3. c. For the purpose of licensure by endorsement through the occupational credential portability program, “substantially similar scope of practice” means the scope of practice for physicians in another state that is substantially similar to the practice of medicine as defined in section 12-240-107, C.R.S.

2. If the Board determines that the applicant has not established continued competency for purposes of complying with section 12-20-202(3), 12-240-110, 12-240-120(1)(d), 12-240- 119, or 12-240-141(5), C.R.S., the Board may require an applicant to submit to any competency assessment(s) or evaluation(s) conducted by a program approved by the Board. Although the Board retains the discretion as to the method of determining continued competency based on the applicant’s specific circumstances, a competency assessment or evaluation conducted by a Board-approved program is the Board’s standard operating procedure. The Board also retains discretion as to whether the Applicant has demonstrated his/her/their qualifications are substantially equivalent to the active practice of medicine.

1. Nothing in this Rule is intended to limit the Board’s Licensing Panel from discretion to deny a license or to otherwise offer a restricted license consistent with the authority in the Medical Practice Act, including those circumstances in which an Applicant holds a restricted license in another jurisdiction or has been subject to disciplinary action.

3. If the Board determines that the applicant requires a period of supervised practice and/or the completion of an educational program (hereinafter “training requirements”), the Board at its discretion may either issue the applicant a license subject to probationary terms or a reentry license.

B. REENTRY LICENSE The Board will consider an applicant to be ineligible for a reentry license if their period of inactive practice resulted from disciplinary action or unprofessional conduct. If a reentry license is issued, such a license is valid only for three years from the date of issue and is not renewable. Failure to complete the training requirements before the end of the three-year period will result in the reentry license being administratively inactivated.

In the discretion of the Board, the physician may be issued a re-entry license for the specific purpose of completing the education and/or training requirements. The re-entry license is valid for a single period of time not greater than three (3) years from the date of issue. Failure to complete the education and/or training requirements before the end of the three-year (3) period for the re- entry license will result in the re-entry license being administratively inactivated.

C. CONVERSION OF REENTRY LICENSE When an applicant has timely and successfully completed the training requirements, the applicant shall apply to the Licensing Panel of the Board to convert the reentry license to full licensure by submitting a letter to the Licensing Panel with documents that clearly establish timely and successful completion of the training requirements. If the Board determines that the applicant is competent and qualified to practice medicine without supervision, the Board will convert the reentry license to a full license to practice medicine. If the Board determines that the applicant is not competent nor qualified to practice medicine without supervision, the Board may require further assessment, training, or period of supervised practice in its discretion.

D. EXPENSES All expenses resulting from the assessment and/or any training requirements are the responsibility of the applicant and not of the Board.

E. ADMINISTRATIVE PRACTICE OF MEDICINE “Administrative medicine” carries the definition set forth in Board Policy 20-06. Administrative medicine shall constitute the active practice of medicine. When an applicant who practices administrative medicine seeks licensure, the Board shall evaluate the applicant’s application to determine whether they meet the criteria for active and unrestricted licensure in Colorado. If the applicant is not subject to a restricted license because of disciplinary action in another jurisdiction, and otherwise meets the criteria for a full, active, and unrestricted license in Colorado, the Licensing Panel may grant the application for a full, active, and unrestricted license.

If the applicant is subject to a restricted license or credentialing because of disciplinary action in another jurisdiction, the Licensing Panel may consider whether to enter into an agreement with the applicant to limit their practice to administrative medicine in the form of a stipulation and final agency order.

F. REINSTATEMENT OR REACTIVATION OF A LICENSE In support of any application for reinstatement or reactivation of a license to practice medicine, for the purpose of complying with sections 12-20-202(2)(c)(II), 12-240-120(1)(d), or 12-240-141(5), C.R.S., a physician may demonstrate continued competency in accordance with the methods identified in Rule 22.2(A), identified above.

Effective 12/1/95, Revised 8/15/02, Effective 10/30/02, Revised 2/13/03, Effective 4/30/03, Revised 4/14/05, Effective 6/30/05; Revised 2/9/06; Effective 3/31/06; Revised 8/19/10; Effective 10/15/10; Revised 11/17/2011; Effective 1/14/2012 _________________________________________________________________________ Editor’s Notes History Entire rule eff. 10/15/2010.

Entire rule eff. 01/14/2012.

Entire rule eff. 04/14/2022.

Rules 22.1 B, 22.2 A.1, 22.2 B, 22.2 F eff. 01/14/2023.