Florida Senate - 2022 SB 164 By Senator Brandes 24-00117-22 2022164__ 1 A bill to be entitled 2 An act relating to physician certifications for the 3 medical use of marijuana; amending s. 381.986, F.S.; 4 authorizing qualified physicians to perform patient 5 examinations and evaluations through telehealth for 6 renewals of physician certifications for the medical 7 use of marijuana; providing an effective date. 8 9 Be It Enacted by the Legislature of the State of Florida: 10 11 Section 1. Paragraphs (a) and (g) of subsection (4) of 12 section 381.986, Florida Statutes, are amended to read: 13 381.986 Medical use of marijuana.— 14 (4) PHYSICIAN CERTIFICATION.— 15 (a) A qualified physician may issue a physician 16 certification only if the qualified physician: 17 1. Conducted ana physicalexamination ofwhile physically18present in the same room asthe patient and a full assessment of 19 the medical history of the patient. For an initial 20 certification, the examination must be a physical examination 21 conducted while physically present in the same room as the 22 patient. For a certification renewal, the examination may be 23 conducted through telehealth as defined in s. 456.47. 24 2. Diagnosed the patient with at least one qualifying 25 medical condition. 26 3. Determined that the medical use of marijuana would 27 likely outweigh the potential health risks for the patient, and 28 such determination must be documented in the patient’s medical 29 record. If a patient is younger than 18 years of age, a second 30 physician must concur with this determination, and such 31 concurrence must be documented in the patient’s medical record. 32 4. Determined whether the patient is pregnant and 33 documented such determination in the patient’s medical record. A 34 physician may not issue a physician certification, except for 35 low-THC cannabis, to a patient who is pregnant. 36 5. Reviewed the patient’s controlled drug prescription 37 history in the prescription drug monitoring program database 38 established pursuant to s. 893.055. 39 6. Reviews the medical marijuana use registry and confirmed 40 that the patient does not have an active physician certification 41 from another qualified physician. 42 7. Registers as the issuer of the physician certification 43 for the named qualified patient on the medical marijuana use 44 registry in an electronic manner determined by the department, 45 and: 46 a. Enters into the registry the contents of the physician 47 certification, including the patient’s qualifying condition and 48 the dosage not to exceed the daily dose amount determined by the 49 department, the amount and forms of marijuana authorized for the 50 patient, and any types of marijuana delivery devices needed by 51 the patient for the medical use of marijuana. 52 b. Updates the registry within 7 days after any change is 53 made to the original physician certification to reflect such 54 change. 55 c. Deactivates the registration of the qualified patient 56 and the patient’s caregiver when the physician no longer 57 recommends the medical use of marijuana for the patient. 58 8. Obtains the voluntary and informed written consent of 59 the patient for medical use of marijuana each time the qualified 60 physician issues a physician certification for the patient, 61 which shall be maintained in the patient’s medical record. The 62 patient, or the patient’s parent or legal guardian if the 63 patient is a minor, must sign the informed consent acknowledging 64 that the qualified physician has sufficiently explained its 65 content. The qualified physician must use a standardized 66 informed consent form adopted in rule by the Board of Medicine 67 and the Board of Osteopathic Medicine, which must include, at a 68 minimum, information related to: 69 a. The Federal Government’s classification of marijuana as 70 a Schedule I controlled substance. 71 b. The approval and oversight status of marijuana by the 72 Food and Drug Administration. 73 c. The current state of research on the efficacy of 74 marijuana to treat the qualifying conditions set forth in this 75 section. 76 d. The potential for addiction. 77 e. The potential effect that marijuana may have on a 78 patient’s coordination, motor skills, and cognition, including a 79 warning against operating heavy machinery, operating a motor 80 vehicle, or engaging in activities that require a person to be 81 alert or respond quickly. 82 f. The potential side effects of marijuana use, including 83 the negative health risks associated with smoking marijuana. 84 g. The risks, benefits, and drug interactions of marijuana. 85 h. That the patient’s de-identified health information 86 contained in the physician certification and medical marijuana 87 use registry may be used for research purposes. 88 (g) A qualified physician must evaluate an existing 89 qualified patient at least once every 30 weeks before issuing a 90 new physician certification. The evaluation may be conducted 91 through telehealth as defined in s. 456.47. A physician must: 92 1. Determine if the patient still meets the requirements to 93 be issued a physician certification under paragraph (a). 94 2. Identify and document in the qualified patient’s medical 95 records whether the qualified patient experienced either of the 96 following related to the medical use of marijuana: 97 a. An adverse drug interaction with any prescription or 98 nonprescription medication; or 99 b. A reduction in the use of, or dependence on, other types 100 of controlled substances as defined in s. 893.02. 101 3. Submit a report with the findings required pursuant to 102 subparagraph 2. to the department. The department shall submit 103 such reports to the Consortium for Medical Marijuana Clinical 104 Outcomes Research established pursuant to s. 1004.4351. 105 Section 2. This act shall take effect July 1, 2022.