Florida Senate - 2019                        COMMITTEE AMENDMENT
       Bill No. SB 182
       
       
       
       
       
       
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                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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       The Committee on Health Policy (Harrell) recommended the
       following:
       
    1         Senate Amendment (with directory and title amendments)
    2  
    3         Between lines 50 and 51
    4  insert:
    5         (4) PHYSICIAN CERTIFICATION.—
    6         (a) A qualified physician may issue a physician
    7  certification only if the qualified physician:
    8         1. Conducted a physical examination while physically
    9  present in the same room as the patient and a full assessment of
   10  the medical history of the patient.
   11         2. Diagnosed the patient with at least one qualifying
   12  medical condition.
   13         3. Determined that the medical use of marijuana would
   14  likely outweigh the potential health risks for the patient, and
   15  such determination must be documented in the patient’s medical
   16  record. If a patient is younger than 18 years of age, a second
   17  physician must concur with this determination, and such
   18  concurrence must be documented in the patient’s medical record.
   19         4. Determined whether the patient is pregnant and
   20  documented such determination in the patient’s medical record. A
   21  physician may not issue a physician certification, except for
   22  low-THC cannabis, to a patient who is pregnant.
   23         5. Reviewed the patient’s controlled drug prescription
   24  history in the prescription drug monitoring program database
   25  established pursuant to s. 893.055.
   26         6. Reviews the medical marijuana use registry and confirmed
   27  that the patient does not have an active physician certification
   28  from another qualified physician.
   29         7. Registers as the issuer of the physician certification
   30  for the named qualified patient on the medical marijuana use
   31  registry in an electronic manner determined by the department,
   32  and:
   33         a. Enters into the registry the contents of the physician
   34  certification, including the patient’s qualifying condition and
   35  the dosage not to exceed the daily dose amount determined by the
   36  department, the amount and forms of marijuana authorized for the
   37  patient, and any types of marijuana delivery devices needed by
   38  the patient for the medical use of marijuana.
   39         b. Updates the registry within 7 days after any change is
   40  made to the original physician certification to reflect such
   41  change.
   42         c. Deactivates the registration of the qualified patient
   43  and the patient’s caregiver when the physician no longer
   44  recommends the medical use of marijuana for the patient.
   45         8. Obtains the voluntary and informed written consent of
   46  the patient for medical use of marijuana each time the qualified
   47  physician issues a physician certification for the patient,
   48  which shall be maintained in the patient’s medical record. The
   49  patient, or the patient’s parent or legal guardian if the
   50  patient is a minor, must sign the informed consent acknowledging
   51  that the qualified physician has sufficiently explained its
   52  content. The qualified physician must use a standardized
   53  informed consent form adopted in rule by the Board of Medicine
   54  and the Board of Osteopathic Medicine, which must include, at a
   55  minimum, information related to:
   56         a. The Federal Government’s classification of marijuana as
   57  a Schedule I controlled substance.
   58         b. The approval and oversight status of marijuana by the
   59  Food and Drug Administration.
   60         c. The current state of research on the efficacy of
   61  marijuana to treat the qualifying conditions set forth in this
   62  section.
   63         d. The potential for addiction.
   64         e. The potential effect that marijuana may have on a
   65  patient’s coordination, motor skills, and cognition, including a
   66  warning against operating heavy machinery, operating a motor
   67  vehicle, or engaging in activities that require a person to be
   68  alert or respond quickly.
   69         f. The potential side effects of marijuana use.
   70         g. The risks, benefits, and drug interactions of marijuana.
   71         h. The risks specifically associated with smoking
   72  marijuana.
   73         i.h. That the patient’s de-identified health information
   74  contained in the physician certification and medical marijuana
   75  use registry may be used for research purposes.
   76  
   77  For a patient not diagnosed with a terminal condition, if the
   78  certifying physician intends to certify the patient’s medical
   79  use of marijuana by way of smoking, the certifying physician
   80  must determine that smoking is the only means of administering
   81  medical marijuana that is likely to benefit the patient and a
   82  second physician must concur with that determination. The second
   83  physician must not be registered with the department as a
   84  certifying physician for any qualified patients. Such
   85  determination and concurrence must be documented in the
   86  patient’s medical record.
   87  
   88  ====== D I R E C T O R Y  C L A U S E  A M E N D M E N T ======
   89  And the directory clause is amended as follows:
   90         Delete lines 13 - 14
   91  and insert:
   92         Section 1. Paragraph (j) of subsection (1), paragraph (a)
   93  of subsection (4), and paragraph (e) of subsection (8) of
   94  section 381.986, Florida Statutes, are
   95  
   96  ================= T I T L E  A M E N D M E N T ================
   97  And the title is amended as follows:
   98         Between lines 6 and 7
   99  insert:
  100         requiring a patient’s informed consent form to include
  101         the risks specifically associated with smoking
  102         marijuana; requiring a certifying physician to make a
  103         determination in concurrence with a second physician
  104         who meets specified requirements before certifying a
  105         patient not diagnosed with a terminal condition to
  106         smoke marijuana for medical use;