June 24, 2026
The Colorado Dental Board has adopted new regulations that formally address how dental services organizations (DSOs) may operate in the state. As Dykema outlines in its analysis of the new rules, the regulations both permit DSO activity and place firm limits on it, with a compliance deadline of January 1, 2027.
What the Regulations Permit
The Board confirmed that DSOs may provide a range of support services to affiliated dental practices. Specifically, the rules allow:
- Administrative, operational, and non-clinical support services
- Business management services, provided the DSO does not influence a licensee's professional judgment or clinical decisions, the licensee has immediate access to all patient records, and the payment arrangement does not constitute improper fee-sharing
- Financial management services, including patient account administration, provided the DSO does not interfere with professional judgment, the licensee reviews the accuracy of all billed procedures, and the licensee retains the ability to correct any errors found in patient accounts
What the Regulations Prohibit
The Board drew clear lines around ownership and property arrangements. The regulations prohibit DSOs from:
- Owning or acting as a "Proprietor" of a dental or dental hygiene practice. The Board defined "Proprietors" to include any person or entity that employs licensees, owns a dental office, or owns dental equipment used to provide dental services. Proprietors are considered to be practicing dentistry under the regulations.
- Leasing real property to a dental practice. The practice itself must hold the lease for its premises.
- Providing dental materials or equipment to a practice for use in delivering dental services. The practice must own its own equipment.
Separately, the regulations confirm that only dentists may own dental practices, and only dentists or dental hygienists may own dental hygiene practices, unless a statutory exception applies, such as for certain nonprofit organizations or political subdivisions.
Consequences for Noncompliance
The Board's regulations carry a notable enforcement dimension. Licensees who practice in DSO-run settings that do not comply with these requirements may themselves be subject to disciplinary action. That means individual dentists and dental hygienists bear exposure alongside the organizations supporting them.
How These Rules Compare to Other States
According to Dykema's analysis, Colorado's new regulations closely resemble those already in place in New Jersey. Dykema has worked with clients navigating the New Jersey framework for several years, and the firm notes that DSOs in Colorado will need to thoroughly review their contractual arrangements and operational protocols with affiliated practices before the January 1, 2027 effective date.
The analysis was authored by Brian A. Colao, Zachary Q. Hoard, Dean Gould, and David Ko. It recommends that DSOs and affiliated practices consult legal counsel to assess compliance with the new requirements.
Adapted from Colorado Dental Board Promulgates Regulations on DSOs Effective January 1, 2027, originally published by Dykema on June 24, 2026.
Related professionals: Brian A. Colao, Zachary Q. Hoard, Dean Gould, David Ko.