In March 2008, Governor Ritter signed three bills that will help end years of ineffective redundancy in health care delivery. Several of the statutes will not officially take effect until next January and July. The following information is offered as a guide to help guide your practice and patient

HB 1060 Insurance Empanelment for APNs Effective January 1, 2009.

APNs must be considered for network membership by insurance carrier on an objective basis, be given a specific reason for any refusal, and be listed in the carriers network membership directory. The goal of this change is to foster greater healthcare access by opening up availability to new providers. Please contact specific insurance companies for applications or speak with a credentialing specialist.

HB 1061 Signature Recognition on Forms within APN Scope of Practice

Effective Date: January 1, 2009 and Involuntary Commitments for Drug and Alcohol, effective July 1, 2009

Perhaps the most anticipated new law, these changes will remove barriers that have long stood in the way of efficient care by providing that the clinician that treats the patient, also treats the paperwork. While HB 1061 has removed many of the barriers that patients and APNs have faced on a daily basis, these updated statutes may not cover every area of practice. Charlie Hebeler, the CNA lobbyist, has compiled this listing for rapid review.

APNs may sign forms and documents that provide for:

* Disabled as reason for cancellation of health club membership

* Prescribe during cancer treatment within scope of practice

* Documents current health status

* Authorizes continuing treatment, tests, services, or equipment

* Gives advance directives for end-of-life care

* Jury duty excuse forms

* Verification of lack of decisional capacity of patient to consent to medical treatment (after collaborating with physician either in person, by phone, or electronically)

* Verification of local of decisional capacity of patient to make decisions about health care benefits (after collaboration as noted in previous item)

* Advance directives for health care

* Authorize use of physical force in patient treatment in an emergency

* Verify signatures of husband and wife during assisted reproduction

* Certify the need for involuntary commitment for alcoholism treatment (effective July 1, 2009)

* Certify the need for involuntary commitment for drug abuse (effective July 1, 2009)

* Prescribe for venereal disease

* Authorize examination of tuberculosis

* Verification forms for Immunization, and for exemptions from immunization for health reasons

* Family planning services

* Authorize home treatment for HIV/AIDS

* Authorize home care for disabled children

* Authorize self-direction in home care for disabled persons

* Certify disability for applications for public assistance

* Justification for use of chemical restraints

* Certifies permanent disability and exempts from military service

* Need for emergency absentee voting

* Disabled parking placard application

HB 1094 Updating Medicaid Statute to encompass all APNs

Effective Date: July 1, 2008

Amends Medicaid statute to authorize direct payment to all advanced practice nurses. [Note: this program is still subject to the limitations of federal and federal rules and regulations]

Obtaining access to non-emergent healthcare services has been an issue for individuals with Medicaid. Colorado's APN community has the opportunity to help these individuals get timely access now that Medicaid statute recognizes all APNs to be eligible for credentialing and reimbursement. Application for Medicaid credentialing is available at the State of Colorado's Department of Health Care Policy and Financing website or, alternately, speak with a credentialing specialist. (www.chcpf.state.co.us/ACS/Enrollment/ Nurse_Practitioner_Enrollment_Docs.asp)

Copies of the full laws are available through the Colorado General Assembly webpage. Colorado Nurses Association strongly recommends that all APNs be familiar with these new statutes and their application within the context of scope of practice.