Senate Bill 25-032 Introduced

A Bill for an Act

• Page 1, Line 101Concerning requirements for naturopathic doctors

• Page 1, Line 102registered under the "Naturopathic Doctor Act", and,

• Page 1, Line 103in connection therewith, making changes to the

• Page 1, Line 104naturopathic doctor formulary.

Bill Summary

(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)

The bill clarifies that the existing naturopathic doctor formulary (existing formulary) includes prescription classes of medicines and clarifies what the practice of naturopathic medicine includes. In addition, the bill creates a new formulary for certain naturopathic doctors, which new formulary includes:

• All legend drugs, other than schedule I or II controlled substances or devices identified in the federal "Controlled Substances Act";
• For a naturopathic doctor with a federal drug enforcement administration registration, anabolic steroids listed on schedule III of the "Uniform Controlled Substances Act of 2013"; and
• All drugs listed on schedules IV and V of the "Uniform Controlled Substances Act of 2013", except for benzodiazepines, oncological chemotherapeutics, and narcotics (new formulary).
• Completion of 12 hours of pharmacological continuing education pertinent to or reflective of the naturopathic formulary;
• Passage of the elective pharmacology examination of the Naturopathic Physicians Licensing Examinations; or
• Licensure in good standing in another state that has equivalent prescribing authority.
• A medicine or device to an individual under 18 years of age; or
• Antipsychotics or ketamine to an individual of any age unless recommended by the naturopathic medicine advisory committee and approved by the director of the division of professions and occupations in the department (director).

Before obtaining, dispensing, administering, injecting, ordering, or prescribing any of the medicines or devices included in the new formulary, a naturopathic doctor who is registered with the department of regulatory agencies (department) must provide proof of:

A naturopathic doctor who does not provide such proof is limited to the medicines and devices contained within the existing formulary.

The bill prohibits a naturopathic doctor from prescribing:

The bill requires an individual applying for issuance, renewal, or reinstatement of a registration as a naturopathic doctor on or after September 1, 2025, to pass a pharmacology examination administered by the North American Board of Naturopathic Examiners or a nationally recognized, director-approved successor entity. Upon passage of the exam, the individual is able to obtain, dispense, administer, inject, order, or prescribe any of the medicines or devices included in the new formulary.

For the renewal of a naturopathic doctor's registration on or after June 1, 2026, the bill requires a naturopathic doctor to complete 8 hours per year of continuing education in pharmacology.

Lastly, the bill prohibits a naturopathic doctor from administering intravenous therapy without first being certified by a nationally recognized, director-approved entity.

• Page 3, Line 1Be it enacted by the General Assembly of the State of Colorado:

• Page 3, Line 2SECTION 1.  In Colorado Revised Statutes, 12-250-103, amend (12); and add (14) as follows:

• Page 3, Line 312-250-103.  Definitions. As used in this article 250, unless the context otherwise requires:

• Page 3, Line 4(12)  "Naturopathic formulary" means the list of prescription

• Page 3, Line 5and nonprescription classes of medicines and devices determined by the

• Page 3, Line 6director that naturopathic doctors use in the practice of naturopathic

• Page 3, Line 7medicine. "Naturopathic formulary" also includes any prescription and

• Page 3, Line 8nonprescription substance or device that is authorized under this article 250.

• Page 3, Line 9(14)  "NPLEX" means the Naturopathic Physicians

• Page 3, Line 10Licensing Examinations, or a nationally recognized,

• Page 3, Line 11director-approved successor examination, administered by the

• Page 3, Line 12North American Board of Naturopathic Examiners, or a nationally recognized, director-approved successor entity.

• Page 3, Line 13SECTION 2.  In Colorado Revised Statutes, 12-250-104, amend (2)(c)(II) as follows:

• Page 3, Line 1412-250-104.  Naturopathic medicine advisory committee -

• Page 3, Line 15creation - membership - duties. (2)  The advisory committee shall meet at least once each year to:

• Page 3, Line 16(c) (II)  Make recommendations to the director on whether there

• Page 3, Line 17should be additions to the naturopathic formulary, other than

• Page 3, Line 18schedule I or II controlled substances to the naturopathic formulary.

• Page 3, Line 19Possible additions may include only biological substances including

• Page 4, Line 1vitamins, minerals, nutritive substances, extracts, and their products and

• Page 4, Line 2residues or devices identified in the federal "Controlled Substances Act", 21 U.S.C. sec. 801 et seq.

• Page 4, Line 3SECTION 3.  In Colorado Revised Statutes, 12-250-105, add (1)(d.5) as follows:

• Page 4, Line 412-250-105.  Director powers and duties - rules. (1)  In addition

• Page 4, Line 5to any other powers and duties granted or imposed on the director under this article 250 or articles 20 and 30 of this title 12, the director shall:

• Page 4, Line 6(d.5)  Consult with the advisory committee at least once

• Page 4, Line 7each calendar year to discuss revisions to the naturopathic formulary; and

• Page 4, Line 8SECTION 4.  In Colorado Revised Statutes, 12-250-106, amend

• Page 4, Line 9(1)(b), (1)(c)(I) introductory portion, and (2)(a); and add (1)(c.5), (1.5), (2)(a.3), and (2)(a.5) as follows:

• Page 4, Line 1012-250-106.  Practice of naturopathic medicine by

• Page 4, Line 11naturopathic doctors - exclusions - protected activities - definition -

• Page 4, Line 12rules. (1)  The practice of naturopathic medicine by a naturopathic doctor includes the following:

• Page 4, Line 13(b)  The use of For the purpose of diagnosing and evaluating injuries, diseases, and conditions in the human body:

• Page 4, Line 14(I)  Performing physical examinations, orificial examinations,

• Page 4, Line 15ultrasounds, phlebotomies, therapeutic phlebotomies, and other

• Page 4, Line 16diagnostic procedures commonly used in general practice; and the

• Page 4, Line 17(II)  Ordering of clinical, laboratory, and radiological diagnostic

• Page 4, Line 18procedures, clinical laboratory tests or examinations, and

• Page 4, Line 19physiological function tests from licensed or certified health-care

• Page 5, Line 1facilities or laboratories; for the purpose of diagnosing and evaluating injuries, diseases, and conditions in the human body;

• Page 5, Line 2(c) (I)  Obtaining, dispensing, administering, injecting, ordering,

• Page 5, Line 3or prescribing as specified, medicines and devices listed in the

• Page 5, Line 4naturopathic formulary, which, includes for naturopathic doctors

• Page 5, Line 5who do not provide the proof required in subsection (1)(c.5)(II) of this section, include:

• Page 5, Line 6(c.5) (I)  Obtaining, dispensing, administering, ordering, or

• Page 5, Line 7prescribing medicines and devices listed in the naturopathic

• Page 5, Line 8formulary, which, on and after September 1, 2025, for

• Page 5, Line 9naturopathic doctors who comply with subsection (1)(c.5)(II) of

• Page 5, Line 10this section or are registered pursuant to section 12-250-107 on or after September 1, 2025, include:

• Page 5, Line 11(A)  All legend drugs not identified as schedule I or II

• Page 5, Line 12controlled substances or devices in the federal "Controlled Substances Act", 21 U.S.C. sec. 801 et seq.;

• Page 5, Line 13(B)  With a valid registration from the federal drug

• Page 5, Line 14enforcement administration, schedule III anabolic steroids, as listed in section 18-18-205;

• Page 5, Line 15(C)  All drugs in schedules IV and V, as listed in sections

• Page 5, Line 1618-18-206 and 18-18-207, respectively, excluding all benzodiazepines, oncological chemotherapeutics, and narcotics;

• Page 5, Line 17(D)  Barrier contraceptives, excluding intrauterine devices;

• Page 5, Line 18(E)  Oxygen;

• (F)  Vitamins, minerals, trace minerals, enzymes, and food;

• Page 5, Line 19(G)  Biological substances, including extracts and their products and residues;

• Page 6, Line 1(H)  Vaccines, in accordance with the ACIP guidelines, for patients who are eighteen years of age or older;

• Page 6, Line 2(I)  Topical preparations;

• (J)  Continuous positive airway pressure devices;

• Page 6, Line 3(K)  Continuous glucose monitoring devices;

• (L)  Homeopathic preparations;

• Page 6, Line 4(M)  All amino acids and amino acid combinations;

• (N)  All botanical extracts and their derivatives;

• Page 6, Line 5(O)  Electrolytes and fluid replacements;

• (P)  Hormones; and

• Page 6, Line 6(Q)  Any additions to the naturopathic formulary as determined by the director by rule.

• Page 6, Line 7(II)  A naturopathic doctor who is registered pursuant to

• Page 6, Line 8this article 250 on or before September 1, 2025, shall not obtain,

• Page 6, Line 9dispense, administer, inject, order, or prescribe medicines or

• Page 6, Line 10devices listed in subsection (1)(c.5)(I) of this section unless the

• Page 6, Line 11naturopathic doctor provides proof to the director, in the form and manner determined by the director, of one of the following:

• Page 6, Line 12(A)  Completion of twelve hours of pharmacological

• Page 6, Line 13continuing education pertinent to or reflective of the naturopathic formulary;

• Page 6, Line 14(B)  Passage, on or after August 2017, of the elective

• Page 6, Line 15pharmacology examination of the NPLEX or an alternative

• Page 6, Line 16clinical pharmacology examination administered by a

• Page 6, Line 17nationally recognized, director-approved successor entity, as

• Page 6, Line 18determined by the director by rule; or

• Page 7, Line 1(C)  Licensure in good standing in another state and who has equivalent prescribing authority.

• Page 7, Line 2(III)  A naturopathic doctor who complies with subsection

• Page 7, Line 3(1)(c.5)(II) of this section may obtain medications described in

• Page 7, Line 4subsection (1)(c.5)(I) of this section from a manufacturer,

• Page 7, Line 5wholesaler, or in-state prescription drug outlet registered or

• Page 7, Line 6licensed by the state board of pharmacy pursuant to article 280

• Page 7, Line 7of this title 12. An entity that provides a medication described

• Page 7, Line 8in subsection (1)(c.5)(I) of this section to a naturopathic doctor

• Page 7, Line 9in accordance with this section, and that relies in good faith

• Page 7, Line 10upon the registration information provided by the naturopathic doctor, is not subject to liability for providing the medication.

• Page 7, Line 11(1.5)  On and after September 1, 2025, a naturopathic

• Page 7, Line 12doctor who is registered pursuant to this article 250, including

• Page 7, Line 13those registered on or before September 1, 2025, shall not

• Page 7, Line 14administer intravenous therapy unless the naturopathic doctor

• Page 7, Line 15is certified by a nationally recognized, director-approved

• Page 7, Line 16entity, as determined by the director by rule, as qualified to administer intravenous therapy.

• Page 7, Line 17(2)  A naturopathic doctor shall not:

• Page 7, Line 18(a)  Prescribe, dispense, administer, or inject a schedule I or II

• Page 7, Line 19controlled substance or device identified in the federal "Controlled Substances Act", 21 U.S.C. sec. 801 et seq., as amended;

• Page 7, Line 20(a.3)  Prescribe medicine or a device to an individual under eighteen years of age;

• Page 7, Line 21(a.5)  Prescribe antipsychotics or ketamine to an individual

• Page 7, Line 22of any age unless recommended by the advisory committee and approved by the director;

• Page 8, Line 1SECTION 5.  In Colorado Revised Statutes, 12-250-107, amend (2)(d) and (2)(e); and add (2)(f) as follows:

• Page 8, Line 212-250-107.  Registration required - qualifications -

• Page 8, Line 3examination - registration by endorsement - rules. (2)  An applicant

• Page 8, Line 4for a registration to practice as a naturopathic doctor in this state shall

• Page 8, Line 5submit an application to the director in a form and manner determined by

• Page 8, Line 6the director by rule, accompanied by the fee required pursuant to section

• Page 8, Line 712-20-105. The director shall issue a registration to practice as a

• Page 8, Line 8naturopathic doctor to an applicant upon receipt of satisfactory proof that the applicant:

• Page 8, Line 9(d)  Has successfully passed either a director-approved

• Page 8, Line 10examination or a comprehensive competency-based national naturopathic

• Page 8, Line 11licensing examination administered by the North American Board of

• Page 8, Line 12Naturopathic Examiners or a nationally recognized, director-approved successor entity the NPLEX, as determined by the director by rule; and

• Page 8, Line 13(e)  Has not had a license or other authorization to practice as a

• Page 8, Line 14naturopathic doctor or other health-care license, registration, or

• Page 8, Line 15certification denied, revoked, or suspended by Colorado or any other

• Page 8, Line 16jurisdiction for reasons that relate to the applicant's ability to skillfully

• Page 8, Line 17and safely practice naturopathic medicine, unless the license, registration,

• Page 8, Line 18or certification is reinstated to good standing by Colorado or another jurisdiction; and

• Page 8, Line 19(f)  Beginning September 1, 2025, has successfully passed

• Page 8, Line 20the pharmacology portion of the NPLEX or a pharmacology

• Page 8, Line 21examination administered by a nationally recognized,

• Page 8, Line 22director-approved successor entity, as determined by the

• Page 9, Line 1director by rule. This subsection (2)(f) applies to applicants who

• Page 9, Line 2submit an application for issuance, renewal, or reinstatement of a registration on or after September 1, 2025.

• Page 9, Line 3SECTION 6.  In Colorado Revised Statutes, 12-250-109, amend (1)(b)(II) and (1)(b)(III); and add (1)(b)(IV) as follows:

• Page 9, Line 412-250-109.  Continuing professional competency - rules.

• Page 9, Line 5(1) (b)  The director shall adopt rules establishing a continuing

• Page 9, Line 6professional competency program that includes, at a minimum, the following elements:

• Page 9, Line 7(II)  Development, execution, and documentation of a learning plan based on the assessment; and

• Page 9, Line 8(III)  Periodic demonstration of knowledge and skills through

• Page 9, Line 9documentation of activities necessary to ensure continuing competency

• Page 9, Line 10in the profession; except that a naturopathic doctor need not retake any

• Page 9, Line 11examination required by section 12-250-107 (2)(d) for initial registration; and

• Page 9, Line 12(IV)  For registration renewals issued on or after June 1,

• Page 9, Line 132026, eight hours per year of continuing education in

• Page 9, Line 14pharmacology. The director shall not increase the total

• Page 9, Line 15number of hours of continuing professional competency that a naturopathic doctor must complete pursuant to this section.

• Page 9, Line 16SECTION 7.  In Colorado Revised Statutes, 12-30-111, amend (4)(a)(IV) and (4)(a)(V); and add (4)(a)(VI) as follows:

• Page 9, Line 1712-30-111.  Electronic prescribing of controlled substances - exceptions - rules - definitions. (4)  As used in this section:

• Page 9, Line 18(a)  "Prescriber" means:

• Page 9, Line 19(IV)  An optometrist licensed pursuant to article 275 of this title 12; or

• Page 10, Line 1(V)  A podiatrist licensed pursuant to article 290 of this title 12; or

• Page 10, Line 2(VI)  A naturopathic doctor registered pursuant to article 250 of this title 12.

• Page 10, Line 3SECTION 8.  Act subject to petition - effective date. This act

• Page 10, Line 4takes effect at 12:01 a.m. on the day following the expiration of the

• Page 10, Line 5ninety-day period after final adjournment of the general assembly; except

• Page 10, Line 6that, if a referendum petition is filed pursuant to section 1 (3) of article V

• Page 10, Line 7of the state constitution against this act or an item, section, or part of this

• Page 10, Line 8act within such period, then the act, item, section, or part will not take

• Page 10, Line 9effect unless approved by the people at the general election to be held in

• Page 10, Line 10November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.