House Bill 25-1255 Introduced

A Bill for an Act

• Page 1, Line 101Concerning protecting a health-care provider's right to

• Page 1, Line 102exercise their conscience in providing health care.

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 creates the "Medical Ethics Defense Act" (act). The act recognizes that a health-care professional, health-care institution, and health-care payer (health-care provider) has a right of conscience. The act:

• Defines "conscience" to mean the ethical, moral, or religious beliefs or principles held by a health-care provider and recognizes institutional entities or corporate bodies as also having a conscience as determined by reference to the governing documents of the entity or body; and
• Allows a health-care provider to refuse to participate in or pay for a medical procedure, treatment, or service that violates the health-care provider's conscience.
• Shall not be discriminated against in any manner as a result of the health-care provider exercising its right of conscience; and
• Is immune from civil, criminal, or administrative liability for exercising its right of conscience.
• Administrative agencies from denying or revoking a license, certification, or registration, or threatening to do so, based upon an individual health-care professional engaging in free speech under the United States constitution (constitution) or section 10 of article II of the state constitution; or
• The state from contracting with, recognizing, approving, or requiring an individual to obtain certifications or credentials from a specialty board or other recognizing agency that refuses to certify or revokes credentials based upon an individual's engagement in free speech under the constitution.

The right of conscience is limited to a particular medical procedure, treatment, or service. Further, a health-care payer is prohibited from refusing to pay for services that are specified in the health-care payer's contract. The act shall not be construed to conflict with the requirement to provide emergency medical treatment.

A health-care provider:

The act authorizes a religious health-care provider to make employment staffing, contracting, and administrative decisions consistent with its religious beliefs if it holds itself out to the public as religious and has internal operating procedures that implement its religious purpose or mission. The act provides protection against discrimination to a health-care provider that provides information about a violation of the act or other law to an employer or a state or federal agency or official or that testifies or participates in proceedings relating to the violation.

Additionally, the act prohibits:

A state entity that regulates the provision of medical treatments, procedures, or services shall promptly notify a health-care provider of any complaint received by the entity that is based on an exercise of free speech and that may result in revocation of the health-care provider's license, certification, or registration.

A party aggrieved by a violation of the act may commence a civil action and, if a violation has occurred, is entitled to injunctive and declaratory relief and an award of monetary damages and attorney fees.

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

• Page 3, Line 2SECTION 1.  In Colorado Revised Statutes, add article 60 to title 25 as follows:

• Page 3, Line 3ARTICLE 60

• Medical Ethics Defense Act

• Page 3, Line 425-60-101.  Short title.The short title of this article 60 is the "Medical Ethics Defense Act".

• Page 3, Line 525-60-102.  Legislative declaration - purpose. (1)  The general assembly finds and determines that:

• Page 3, Line 6(a)  The right of conscience is a fundamental and

• Page 3, Line 7unalienable right central to the founding of the United States

• Page 3, Line 8and has been deeply rooted in the nation's history and tradition for centuries;

• Page 3, Line 9(b)  Through the Hippocratic oath, which is a sworn

• Page 3, Line 10agreement by physicians to do no harm, the right of conscience has been enshrined in the practice of medicine for millennia;

• Page 3, Line 11(c)  However, despite its preeminent importance, threats to

• Page 3, Line 12the right of conscience of health-care professionals,

• Page 3, Line 13health-care institutions, and health-care payers have become increasingly common and severe in recent years; and

• Page 3, Line 14(d)  The swift pace of scientific advancement and the

• Page 3, Line 15expansion of medical capabilities, along with the creation of

• Page 3, Line 16new rights for patients to access certain procedures and the

• Page 3, Line 17mistaken notion that health-care professionals, health-care

• Page 3, Line 18institutions, and health-care payers are mere public utilities,

• Page 4, Line 1promises to make the current crisis worse, unless something is done to secure the right of conscience.

• Page 4, Line 2(2)  Therefore, the general assembly declares that:

• Page 4, Line 3(a)  It is the public policy of the state to protect the right

• Page 4, Line 4of conscience for health-care professionals, health-care institutions, and health-care payers;

• Page 4, Line 5(b)  As the conscience is fundamental, a health-care

• Page 4, Line 6professional, health-care institution, or health-care payer

• Page 4, Line 7shall not be required to participate in nor pay for any medical

• Page 4, Line 8procedure, treatment, or service, or prescribe or pay for any

• Page 4, Line 9medication to which they object on the basis of conscience,

• Page 4, Line 10whether such conscience is informed by religious, moral, or ethical beliefs or principles; and

• Page 4, Line 11(c)  It is the purpose of this article 60 to protect

• Page 4, Line 12health-care professionals, health-care institutions, and

• Page 4, Line 13health-care payers from discrimination, punishment, and

• Page 4, Line 14retaliation as a result of any instance of engaging in conscientious medical objection.

• Page 4, Line 1525-60-103.  Definitions.As used in this article 60, unless the context otherwise requires:

• Page 4, Line 16(1) (a)   "Conscience" means the ethical, moral, or religious beliefs or principles held by a health-care provider.

• Page 4, Line 17(b)  With respect to institutional entities or corporate

• Page 4, Line 18bodies, as opposed to individuals, "conscience" is determined by

• Page 4, Line 19reference to the governing documents of the entity or body,

• Page 4, Line 20including any ethical, moral, or religious guidelines, directives,

• Page 4, Line 21mission statements, constitutions, articles of incorporation, bylaws, policies, or regulations.

• Page 5, Line 1(2) (a)  "Discrimination" or "discriminated against" means

• Page 5, Line 2any adverse action taken against, or threat of adverse action

• Page 5, Line 3communicated to, a health-care provider as a result of the

• Page 5, Line 4health-care provider exercising their right protected in section 25-60-104.

• Page 5, Line 5(b)  "Discrimination" includes any penalty, disciplinary, or retaliatory action, whether executed or threatened.

• Page 5, Line 6(c)  "Discrimination" does not include the negotiation or

• Page 5, Line 7purchase of, or the refusal to use or purchase, insurance or

• Page 5, Line 8medical procedures, treatments, or services by an individual or

• Page 5, Line 9nongovernmental entity or good faith efforts to accommodate conscientious objections of a health-care provider.

• Page 5, Line 10(3) (a)  "Health-care institution" means any organization,

• Page 5, Line 11corporation, partnership, association, agency, network, sole

• Page 5, Line 12proprietorship, joint venture, or other entity that provides medical procedures, treatments, or services.

• Page 5, Line 13(b)  "Health-care institution" includes a hospital or

• Page 5, Line 14health facility licensed or certified pursuant to section 25-1.5-103 (1), article 3 of this title 25, or both.

• Page 5, Line 15(4)  "Health-care payer" means an employer, a health

• Page 5, Line 16benefit plan, a health maintenance organization, an insurance

• Page 5, Line 17company, a management services organization, or any other

• Page 5, Line 18entity that pays for a medical procedure, treatment, or service

• Page 5, Line 19provided to a patient or client, including to contract for,

• Page 5, Line 20arrange for payment of, reimburse, or remunerate, whether

• Page 5, Line 21payment is made in whole or in part.

• Page 6, Line 1(5)  "Health-care professional" means an individual who is

• Page 6, Line 2authorized to participate in any way in a medical procedure,

• Page 6, Line 3treatment, or service, including an individual licensed,

• Page 6, Line 4certified, or registered pursuant to articles 200 to 310 of title

• Page 6, Line 512; an employee of a hospital, clinic, nursing home, or pharmacy;

• Page 6, Line 6faculty and students of a medical school, nursing school, or

• Page 6, Line 7school of psychology or counseling; medical researchers; and laboratory technicians.

• Page 6, Line 8(6)  "Health-care provider" means a health-care professional, health-care insititution, or health-care payer.

• Page 6, Line 9(7)  "Medical procedure, treatment, or service" means

• Page 6, Line 10medical research or health-care services provided to a patient

• Page 6, Line 11or client at any time over the course of the procedure,

• Page 6, Line 12treatment, or service and includes testing; diagnosing;

• Page 6, Line 13record-making; referring; prescribing, dispensing, or

• Page 6, Line 14administering a drug, medication, or device; therapy or

• Page 6, Line 15counseling; or preparing, arranging, or performing a surgical procedure.

• Page 6, Line 16(8)  "Participate" means, with respect to a medical

• Page 6, Line 17procedure, treatment, or service, to provide, perform, assist

• Page 6, Line 18with, facilitate, refer for, counsel for, advise with regard to, or

• Page 6, Line 19admit for the purposes of providing or taking part in any way in providing a medical procedure, treatment, or service.

• Page 6, Line 2025-60-104.  Right of conscience of health-care providers.

• Page 6, Line 21(1)  Right of conscience.A health-care provider shall not be

• Page 6, Line 22required to participate in or pay for a medical procedure,

• Page 6, Line 23treatment, or service that violates the health-care provider's conscience.

• Page 7, Line 1(2)  Limited to specific medical procedures, treatments, or

• Page 7, Line 2services or when contractually obligated to pay.The right of conscience protected under this section:

• Page 7, Line 3(a)  Is limited to a particular medical procedure,

• Page 7, Line 4treatment, or service that violates the conscience of the health-care provider;

• Page 7, Line 5(b)  Does not waive or modify a duty that a health-care

• Page 7, Line 6provider has to provide or pay for medical procedures,

• Page 7, Line 7treatments, or services that do not violate the health-care provider's conscience; and

• Page 7, Line 8(c)  Does not allow a health-care payer to decline

• Page 7, Line 9payment for a medical procedure, treatment, or service that the

• Page 7, Line 10health-care payer is contractually obligated to pay for under the terms of a contract with an insured party.

• Page 7, Line 11(3)  Discrimination prohibited.A health-care provider shall

• Page 7, Line 12not be discriminated against in any manner as a result of the

• Page 7, Line 13health-care provider exercising the health-care provider's right of conscience.

• Page 7, Line 14(4) (a)  Immunity from liability for right of conscience.A

• Page 7, Line 15health-care provider is not civilly, criminally, or

• Page 7, Line 16administratively liable for exercising the health-care provider's right of conscience described in this section.

• Page 7, Line 17(b)  A health-care institution is not civilly, criminally, or

• Page 7, Line 18administratively liable for the exercise of the right of

• Page 7, Line 19conscience by a health-care professional employed by,

• Page 7, Line 20contracted with, or granted admitting privileges by the health-care institution.

• Page 8, Line 1(5) (a)  This article 60 shall not be interpreted to

• Page 8, Line 2undermine the right of a religious health-care provider to make

• Page 8, Line 3employment staffing, contracting, administrative, and

• Page 8, Line 4admitting privilege decisions consistent with its religious beliefs if the religious health-care provider:

• Page 8, Line 5(I)  Holds itself out to the public as religious; and

• Page 8, Line 6(II)  Has internal operating policies or procedures that implement its religious purpose or mission.

• Page 8, Line 7(b)  This article 60 shall not be construed to conflict with

• Page 8, Line 8the requirements of the federal "Emergency Medical Treatment and Labor Act", 42 U.S.C. sec. 1395dd.

• Page 8, Line 925-60-105.  Whistleblower protections. (1)  A health-care

• Page 8, Line 10provider shall not be discriminated against because the health-care provider:

• Page 8, Line 11(a)  Provided, caused to be provided, or is about to provide

• Page 8, Line 12or cause to be provided information relating to an act or

• Page 8, Line 13omission that the health-care provider reasonably believes to be a violation of this article 60 to:

• Page 8, Line 14(I)  The health-care provider's employer;

• (II)  The attorney general;

• Page 8, Line 15(III)  A state agency charged with protecting the right of conscience under this article 60;

• Page 8, Line 16(IV)  The office for civil rights in the federal department of health and human services; or

• Page 8, Line 17(V)  Any other federal agency charged with protecting

• Page 8, Line 18the right of conscience; or

• Page 9, Line 1(b)  Testified, assisted, or participated in or is preparing to

• Page 9, Line 2testify, assist, or participate in a proceeding concerning a violation of this article 60.

• Page 9, Line 3(2) (a)  Unless disclosure is specifically prohibited by law,

• Page 9, Line 4a health-care provider shall not be discriminated against

• Page 9, Line 5because the health-care provider disclosed information, by

• Page 9, Line 6formal or informal communication, transmission, or discussion,

• Page 9, Line 7that the health-care provider reasonably believes demonstrates:

• Page 9, Line 8(I)  A violation of a law, rule, or regulation;

• Page 9, Line 9(II)  A violation of an ethical guideline for the provision of medical treatment; or

• Page 9, Line 10(III)  Gross mismanagement, gross waste of funds, an abuse

• Page 9, Line 11of authority, a practice or method of treatment that may put

• Page 9, Line 12patient health at risk, or a substantial and specific danger to public health or safety.

• Page 9, Line 13(b)  Notwithstanding subsection (2)(a) of this section, the

• Page 9, Line 14whistleblower protection described in subsection (2)(a) of this

• Page 9, Line 15section does not apply if the disclosure concerns the lawful

• Page 9, Line 16exercise of discretionary decision-making authority, unless the

• Page 9, Line 17health-care provider reasonably believes that the disclosure

• Page 9, Line 18demonstrates a violation or misconduct listed in subsections(2)(a)(I) to (2)(a)(III) of this section.

• Page 9, Line 1925-60-106.  Free speech protections. (1)  Free speech protected

• Page 9, Line 20from state violation.A state subdivision, agency, department, or

• Page 9, Line 21board created in articles 200 to 310 of title 12 that regulates

• Page 9, Line 22the practice of medical treatment shall not reprimand or

• Page 10, Line 1sanction, deny or revoke, or threaten to deny or revoke the

• Page 10, Line 2license, certification, or registration of, or otherwise

• Page 10, Line 3discriminate against, a health-care provider for engaging in

• Page 10, Line 4speech, expression, or association that is protected from

• Page 10, Line 5government interference by the first amendment to the United

• Page 10, Line 6States constitution or section 10 of article II of the state

• Page 10, Line 7constitution, unless the subdivision, agency, department, or

• Page 10, Line 8board demonstrates by clear and convincing evidence that the

• Page 10, Line 9health-care provider's speech, expression, or association was the

• Page 10, Line 10direct cause of physical harm to an individual with whom the

• Page 10, Line 11health-care provider had a practitioner-patient relationship

• Page 10, Line 12within the three years immediately preceding the incident of physical harm.

• Page 10, Line 13(2)  State protection from specialty board free speech

• Page 10, Line 14violations.A state subdivision, agency, department, or board

• Page 10, Line 15shall not contract with, recognize, approve, or require an

• Page 10, Line 16individual to obtain certifications or credentials issued or

• Page 10, Line 17approved by a specialty board or other recognizing agency that

• Page 10, Line 18revokes the certification of or refuses to issue certification to

• Page 10, Line 19an individual because the individual has engaged in free speech,

• Page 10, Line 20expression, or association that is protected from government

• Page 10, Line 21interference by the first amendment to the United States

• Page 10, Line 22constitution or section 10 of article II of the state constitution,

• Page 10, Line 23where the individual's engagement in free speech was not in the

• Page 10, Line 24context of providing medical advice or treatment to a specific patient.

• Page 10, Line 25(3)  Notice of speech-based complaints. (a)  A state

• Page 11, Line 1subdivision, agency, department, or board that regulates the

• Page 11, Line 2provision of medical treatments, procedures, or services, or a

• Page 11, Line 3speciality department or board approved or recognized by any

• Page 11, Line 4state subdivision, shall give to a health-care provider, within

• Page 11, Line 5twenty-one days after receipt, any complaints received concerning the health-care provider that:

• Page 11, Line 6(I)  Are based on speech, expression, or association that is

• Page 11, Line 7protected from government interference by the first amendment

• Page 11, Line 8to the United States constitution or section 10 of article II of the state constitution; and

• Page 11, Line 9(II)  May result in the revocation of a license, certification, or registration.

• Page 11, Line 10(b)  The state subdivision, agency, department, or board,

• Page 11, Line 11or speciality department or board, shall pay to the health-care

• Page 11, Line 12provider an administrative penalty of five hundred dollars for

• Page 11, Line 13each day in which a complaint is not given to the health-care

• Page 11, Line 14provider after the twenty-one-day deadline set forth in subsection (3)(a) of this section.

• Page 11, Line 1525-60-107.  Civil remedies. (1)  Civil action for a violation of

• Page 11, Line 16right of conscience. (a)  Any party aggrieved by a violation of this

• Page 11, Line 17article 60, upon learning of the violation, may commence a civil action and, upon the finding of a violation, is entitled to:

• Page 11, Line 18(I)  Injunctive and declaratory relief; and

• Page 11, Line 19(II)  Monetary damages, along with costs to bring the action and reasonable attorney fees.

• Page 11, Line 20(b)  Damages sought or awarded pursuant to subsection

• Page 11, Line 21(1)(a)(II) of this section are cumulative and not limited by any

• Page 12, Line 1other remedies available under another federal, state, or municipal law.

• Page 12, Line 2(2)  Additional burden or expense on another health-care

• Page 12, Line 3provider arising from the exercise of the right of conscience

• Page 12, Line 4protected under this article 60 is not a defense to a violation of this article 60.

• Page 12, Line 5(3)  A civil action shall not be brought against an

• Page 12, Line 6individual who declines to use or purchase a medical procedure,

• Page 12, Line 7treatment, or service from a specific health-care provider based

• Page 12, Line 8on the health-care provider exercising the health-care provider's right of conscience granted under this article 60.

• Page 12, Line 925-60-108.  Severability.If any provision of this article 60 or

• Page 12, Line 10the application of this article 60 to any person or circumstance

• Page 12, Line 11is held invalid, the invalidity does not affect other provisions or

• Page 12, Line 12applications of this article 60 that can be given effect without

• Page 12, Line 13the invalid provision or application, and to this end the provisions of this article 60 are declared to be severable.

• Page 12, Line 14SECTION 2.  Act subject to petition - effective date -

• Page 12, Line 15applicability. (1)  This act takes effect at 12:01 a.m. on the day following

• Page 12, Line 16the expiration of the ninety-day period after final adjournment of the

• Page 12, Line 17general assembly; except that, if a referendum petition is filed pursuant

• Page 12, Line 18to section 1 (3) of article V of the state constitution against this act or an

• Page 12, Line 19item, section, or part of this act within such period, then the act, item,

• Page 12, Line 20section, or part will not take effect unless approved by the people at the

• Page 12, Line 21general election to be held in November 2026 and, in such case, will take

• Page 12, Line 22effect on the date of the official declaration of the vote thereon by the

• Page 12, Line 23governor.

• Page 13, Line 1(2)  This act applies to conduct occurring on or after the applicable effective date of this act.