Florida Senate - 2025                                     SB 552
       
       
        
       By Senator Gruters
       
       
       
       
       
       22-00413A-25                                           2025552__
    1                        A bill to be entitled                      
    2         An act relating to medical marijuana; amending s.
    3         381.986, F.S.; specifying additional medical
    4         conditions that qualify an individual to receive
    5         medical marijuana and medical marijuana delivery
    6         devices; authorizing qualified physicians to use
    7         telehealth to perform the initial certification
    8         examination of patients for the medical use of
    9         marijuana; conforming provisions related to
   10         documentation a qualified physician is required to
   11         submit to the Board of Medicine or Board of
   12         Osteopathic Medicine, as applicable, to conform to
   13         changes made by the act; increasing the number of
   14         supply limits of marijuana a qualified physician may
   15         issue in a single physician certification for the
   16         medical use of marijuana; revising the frequency with
   17         which qualified physicians must evaluate existing
   18         qualified patients for a physician certification for
   19         the medical use of marijuana; conforming provisions to
   20         changes made by the act; deleting obsolete language;
   21         revising the frequency with which qualified patient
   22         and caregiver identification cards must be renewed,
   23         from annually to biennially; requiring the Department
   24         of Health to establish procedures and processes for
   25         certain nonresidents to register as visiting qualified
   26         patients and be issued identification cards within a
   27         specified timeframe; providing that a visiting
   28         qualified patient may engage in all conduct authorized
   29         for qualified patients in this state; requiring the
   30         department to waive all fees associated with
   31         identification cards for certain veterans of the
   32         United States Armed Forces; prohibiting medical
   33         marijuana treatment center dispensing facilities from
   34         being located on the same parcel of land as retail
   35         outlets; providing an effective date.
   36          
   37  Be It Enacted by the Legislature of the State of Florida:
   38  
   39         Section 1. Present paragraph (d) of subsection (11) of
   40  section 381.986, Florida Statutes, is redesignated as paragraph
   41  (e), a new paragraph (d) is added to that subsection, and
   42  paragraph (k) of subsection (2), paragraphs (a), (b), (f), (g),
   43  and (i) of subsection (4), and paragraphs (a) and (d) of
   44  subsection (7) of that section are amended, to read:
   45         381.986 Medical use of marijuana.—
   46         (2) QUALIFYING MEDICAL CONDITIONS.—A patient must be
   47  diagnosed with at least one of the following conditions to
   48  qualify to receive marijuana or a marijuana delivery device:
   49         (k) Medical conditions of the same kind or class as or
   50  comparable to those enumerated in paragraphs (a)-(j) or medical
   51  conditions for which the patient has been prescribed an opioid
   52  drug listed as a Schedule II controlled substance in s. 893.03
   53  or 21 U.S.C. s. 812.
   54         (4) PHYSICIAN CERTIFICATION.—
   55         (a) A qualified physician may issue a physician
   56  certification only if the qualified physician:
   57         1. Conducted an examination of the patient and a full
   58  assessment of the medical history of the patient. Before issuing
   59  or renewing a an initial certification to a patient, the
   60  qualified physician must conduct an in-person physical
   61  examination of the patient in person or. For certification
   62  renewals, a qualified physician who has issued a certification
   63  to a patient after conducting an in-person physical examination
   64  may conduct subsequent examinations of that patient through
   65  telehealth as defined in s. 456.47. For the purposes of this
   66  subparagraph, the term “in-person physical examination” means an
   67  examination conducted by a qualified physician while the
   68  physician is physically present in the same room as the patient.
   69         2. Diagnosed the patient with at least one qualifying
   70  medical condition.
   71         3. Determined that the medical use of marijuana would
   72  likely outweigh the potential health risks for the patient, and
   73  such determination must be documented in the patient’s medical
   74  record. If a patient is younger than 18 years of age, a second
   75  physician must concur with this determination, and such
   76  concurrence must be documented in the patient’s medical record.
   77         4. Determined whether the patient is pregnant and
   78  documented such determination in the patient’s medical record. A
   79  physician may not issue a physician certification, except for
   80  low-THC cannabis, to a patient who is pregnant.
   81         5. Reviewed the patient’s controlled drug prescription
   82  history in the prescription drug monitoring program database
   83  established pursuant to s. 893.055.
   84         6. Reviews the medical marijuana use registry and confirmed
   85  that the patient does not have an active physician certification
   86  from another qualified physician.
   87         7. Registers as the issuer of the physician certification
   88  for the named qualified patient on the medical marijuana use
   89  registry in an electronic manner determined by the department,
   90  and:
   91         a. Enters into the registry the contents of the physician
   92  certification, including the patient’s qualifying condition and
   93  the dosage not to exceed the daily dose amount determined by the
   94  department, the amount and forms of marijuana authorized for the
   95  patient, and any types of marijuana delivery devices needed by
   96  the patient for the medical use of marijuana.
   97         b. Updates the registry within 7 days after any change is
   98  made to the original physician certification to reflect such
   99  change.
  100         c. Deactivates the registration of the qualified patient
  101  and the patient’s caregiver when the physician no longer
  102  recommends the medical use of marijuana for the patient.
  103         8. Obtains the voluntary and informed written consent of
  104  the patient for medical use of marijuana each time the qualified
  105  physician issues a physician certification for the patient,
  106  which shall be maintained in the patient’s medical record. The
  107  patient, or the patient’s parent or legal guardian if the
  108  patient is a minor, must sign the informed consent acknowledging
  109  that the qualified physician has sufficiently explained its
  110  content. The qualified physician must use a standardized
  111  informed consent form adopted in rule by the Board of Medicine
  112  and the Board of Osteopathic Medicine, which must include, at a
  113  minimum, information related to:
  114         a. The Federal Government’s classification of marijuana as
  115  a Schedule I controlled substance.
  116         b. The approval and oversight status of marijuana by the
  117  Food and Drug Administration.
  118         c. The current state of research on the efficacy of
  119  marijuana to treat the qualifying conditions set forth in this
  120  section.
  121         d. The potential for addiction.
  122         e. The potential effect that marijuana may have on a
  123  patient’s coordination, motor skills, and cognition, including a
  124  warning against operating heavy machinery, operating a motor
  125  vehicle, or engaging in activities that require a person to be
  126  alert or respond quickly.
  127         f. The potential side effects of marijuana use, including
  128  the negative health risks associated with smoking marijuana.
  129         g. The risks, benefits, and drug interactions of marijuana.
  130         h. That the patient’s deidentified health information
  131  contained in the physician certification and medical marijuana
  132  use registry may be used for research purposes.
  133         (b) If a qualified physician issues a physician
  134  certification for a qualified patient diagnosed with a
  135  qualifying medical condition pursuant to paragraph (2)(k), the
  136  physician must submit the following to the applicable board
  137  within 14 days after issuing the physician certification:
  138         1. Documentation supporting the qualified physician’s
  139  opinion that the medical condition is of the same kind or class
  140  as the conditions in paragraphs (2)(a)-(j) or is a condition for
  141  which the patient was prescribed an opioid drug listed as a
  142  Schedule II controlled substance in s. 893.03 or 21 U.S.C. s.
  143  812.
  144         2. Documentation that establishes the efficacy of marijuana
  145  as treatment for the condition.
  146         3. Documentation supporting the qualified physician’s
  147  opinion that the benefits of medical use of marijuana would
  148  likely outweigh the potential health risks for the patient.
  149         4. Any other documentation as required by board rule.
  150  
  151  The department must submit such documentation to the Consortium
  152  for Medical Marijuana Clinical Outcomes Research established
  153  pursuant to s. 1004.4351.
  154         (f) A qualified physician may not issue a physician
  155  certification for more than 10 three 70-day supply limits of
  156  marijuana or more than 20 six 35-day supply limits of marijuana
  157  in a form for smoking. The department shall quantify by rule a
  158  daily dose amount with equivalent dose amounts for each
  159  allowable form of marijuana dispensed by a medical marijuana
  160  treatment center. The department shall use the daily dose amount
  161  to calculate a 70-day supply.
  162         1. A qualified physician may request an exception to the
  163  daily dose amount limit, the 35-day supply limit of marijuana in
  164  a form for smoking, and the 4-ounce possession limit of
  165  marijuana in a form for smoking established in paragraph
  166  (14)(a). The request must shall be made electronically on a form
  167  adopted by the department in rule and must include, at a
  168  minimum:
  169         a. The qualified patient’s qualifying medical condition.
  170         b. The dosage and route of administration that was
  171  insufficient to provide relief to the qualified patient.
  172         c. A description of how the patient will benefit from an
  173  increased amount.
  174         d. The minimum daily dose amount of marijuana that would be
  175  sufficient for the treatment of the qualified patient’s
  176  qualifying medical condition.
  177         2. A qualified physician must provide the qualified
  178  patient’s records upon the request of the department.
  179         3. The department shall approve or disapprove the request
  180  within 14 days after receipt of the complete documentation
  181  required by this paragraph. The request is shall be deemed
  182  approved if the department fails to act within this time period.
  183         (g) A qualified physician must evaluate an existing
  184  qualified patient at least once every 104 30 weeks before
  185  issuing a new physician certification. A qualified physician who
  186  has issued a certification to the patient after conducting an
  187  in-person physical examination as defined in subparagraph (a)1.
  188  may conduct the evaluation through telehealth as defined in s.
  189  456.47. A physician must:
  190         1. Determine whether if the patient still meets the
  191  requirements to be issued a physician certification under
  192  paragraph (a).
  193         2. Identify and document in the qualified patient’s medical
  194  records whether the qualified patient experienced either of the
  195  following related to the medical use of marijuana:
  196         a. An adverse drug interaction with any prescription or
  197  nonprescription medication; or
  198         b. A reduction in the use of, or dependence on, other types
  199  of controlled substances as defined in s. 893.02.
  200         3. Submit a report with the findings required pursuant to
  201  subparagraph 2. to the department. The department shall submit
  202  such reports to the Consortium for Medical Marijuana Clinical
  203  Outcomes Research established pursuant to s. 1004.4351.
  204         (i) The department shall monitor physician registration in
  205  the medical marijuana use registry and the issuance of physician
  206  certifications for practices that could facilitate unlawful
  207  diversion or misuse of marijuana or a marijuana delivery device
  208  and shall take disciplinary action as appropriate. The
  209  department may suspend the registration of a qualified physician
  210  in the medical marijuana use registry for a period of up to 2
  211  years if the qualified physician:
  212         1. fails to comply with this section; or
  213         2. Provides, advertises, or markets telehealth services
  214  before July 1, 2023.
  215         (7) IDENTIFICATION CARDS.—
  216         (a) The department shall issue medical marijuana use
  217  registry identification cards for qualified patients and
  218  caregivers who are residents of this state, which must be
  219  renewed biennially annually. Additionally, the department shall
  220  establish procedures and processes for nonresidents who are
  221  actively enrolled in the medical marijuana program of another
  222  jurisdiction recognized by the department to register as
  223  visiting qualified patients and be issued medical marijuana use
  224  registry identification cards within 1 business day after such
  225  request to register. A visiting qualified patient may engage in
  226  all conduct authorized for a qualified patient in this state.
  227  The identification cards must be resistant to counterfeiting and
  228  tampering and must include, at a minimum, include the following:
  229         1. The name, address, and date of birth of the qualified
  230  patient or caregiver.
  231         2. A full-face, passport-type, color photograph of the
  232  qualified patient or caregiver taken within the 90 days
  233  immediately preceding registration or the Florida driver license
  234  or Florida identification card photograph of the qualified
  235  patient or caregiver obtained directly from the Department of
  236  Highway Safety and Motor Vehicles.
  237         3. Identification as a qualified patient or a caregiver.
  238         4. The unique numeric identifier used for the qualified
  239  patient in the medical marijuana use registry.
  240         5. For a caregiver, the name and unique numeric identifier
  241  of the caregiver and the qualified patient or patients that the
  242  caregiver is assisting.
  243         6. The expiration date of the identification card.
  244         (d) Applications for identification cards must be submitted
  245  on a form prescribed by the department. The department may
  246  charge a reasonable fee associated with the issuance,
  247  replacement, and renewal of identification cards. However, the
  248  department shall waive all such fees for any veteran who was
  249  honorably discharged from the United States Armed Forces. The
  250  department shall allocate $10 of the identification card fee to
  251  the Division of Research at Florida Agricultural and Mechanical
  252  University for the purpose of educating minorities about
  253  marijuana for medical use and the impact of the unlawful use of
  254  marijuana on minority communities. The department shall contract
  255  with a third-party vendor to issue identification cards. The
  256  vendor selected by the department must have experience
  257  performing similar functions for other state agencies.
  258         (11) PREEMPTION.—Regulation of cultivation, processing, and
  259  delivery of marijuana by medical marijuana treatment centers is
  260  preempted to the state except as provided in this subsection.
  261         (d)A medical marijuana treatment center dispensing
  262  facility may not be located on the same parcel of land as a
  263  retail outlet as defined in s. 526.303.
  264         Section 2. This act shall take effect July 1, 2025.