Florida Senate - 2023                        COMMITTEE AMENDMENT
       Bill No. SB 344
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/28/2023           .                                

       The Committee on Health Policy (Brodeur) recommended the
    1         Senate Substitute for Amendment (889518) (with directory
    2  and title amendments)
    4         Delete lines 23 - 104
    5  and insert:
    6  defined in s. 456.47, provided it is with the qualified
    7  physician who performed the initial in-person examination.
    8         2. Diagnosed the patient with at least one qualifying
    9  medical condition.
   10         3. Determined that the medical use of marijuana would
   11  likely outweigh the potential health risks for the patient, and
   12  such determination must be documented in the patient’s medical
   13  record. If a patient is younger than 18 years of age, a second
   14  physician must concur with this determination, and such
   15  concurrence must be documented in the patient’s medical record.
   16         4. Determined whether the patient is pregnant and
   17  documented such determination in the patient’s medical record. A
   18  physician may not issue a physician certification, except for
   19  low-THC cannabis, to a patient who is pregnant.
   20         5. Reviewed the patient’s controlled drug prescription
   21  history in the prescription drug monitoring program database
   22  established pursuant to s. 893.055.
   23         6. Reviews the medical marijuana use registry and confirmed
   24  that the patient does not have an active physician certification
   25  from another qualified physician.
   26         7. Registers as the issuer of the physician certification
   27  for the named qualified patient on the medical marijuana use
   28  registry in an electronic manner determined by the department,
   29  and:
   30         a. Enters into the registry the contents of the physician
   31  certification, including the patient’s qualifying condition and
   32  the dosage not to exceed the daily dose amount determined by the
   33  department, the amount and forms of marijuana authorized for the
   34  patient, and any types of marijuana delivery devices needed by
   35  the patient for the medical use of marijuana.
   36         b. Updates the registry within 7 days after any change is
   37  made to the original physician certification to reflect such
   38  change.
   39         c. Deactivates the registration of the qualified patient
   40  and the patient’s caregiver when the physician no longer
   41  recommends the medical use of marijuana for the patient.
   42         8. Obtains the voluntary and informed written consent of
   43  the patient for medical use of marijuana each time the qualified
   44  physician issues a physician certification for the patient,
   45  which shall be maintained in the patient’s medical record. The
   46  patient, or the patient’s parent or legal guardian if the
   47  patient is a minor, must sign the informed consent acknowledging
   48  that the qualified physician has sufficiently explained its
   49  content. The qualified physician must use a standardized
   50  informed consent form adopted in rule by the Board of Medicine
   51  and the Board of Osteopathic Medicine, which must include, at a
   52  minimum, information related to:
   53         a. The Federal Government’s classification of marijuana as
   54  a Schedule I controlled substance.
   55         b. The approval and oversight status of marijuana by the
   56  Food and Drug Administration.
   57         c. The current state of research on the efficacy of
   58  marijuana to treat the qualifying conditions set forth in this
   59  section.
   60         d. The potential for addiction.
   61         e. The potential effect that marijuana may have on a
   62  patient’s coordination, motor skills, and cognition, including a
   63  warning against operating heavy machinery, operating a motor
   64  vehicle, or engaging in activities that require a person to be
   65  alert or respond quickly.
   66         f. The potential side effects of marijuana use, including
   67  the negative health risks associated with smoking marijuana.
   68         g. The risks, benefits, and drug interactions of marijuana.
   69         h. That the patient’s deidentified health information
   70  contained in the physician certification and medical marijuana
   71  use registry may be used for research purposes.
   72         (g) A qualified physician must evaluate an existing
   73  qualified patient at least once every 30 weeks before issuing a
   74  new physician certification. The evaluation may be conducted
   75  through telehealth as defined in s. 456.47, provided it is with
   76  the qualified physician who performed the initial in-person
   77  examination of the qualified patient. A physician must:
   78         1. Determine if the patient still meets the requirements to
   79  be issued a physician certification under paragraph (a).
   80         2. Identify and document in the qualified patient’s medical
   81  records whether the qualified patient experienced either of the
   82  following related to the medical use of marijuana:
   83         a. An adverse drug interaction with any prescription or
   84  nonprescription medication; or
   85         b. A reduction in the use of, or dependence on, other types
   86  of controlled substances as defined in s. 893.02.
   87         3. Submit a report with the findings required pursuant to
   88  subparagraph 2. to the department. The department shall submit
   89  such reports to the Consortium for Medical Marijuana Clinical
   90  Outcomes Research established pursuant to s. 1004.4351.
   91         (i) The department shall monitor physician registration in
   92  the medical marijuana use registry and the issuance of physician
   93  certifications for practices that could facilitate unlawful
   94  diversion or misuse of marijuana or a marijuana delivery device
   95  and shall take disciplinary action as appropriate. The
   96  department may suspend the registration of a qualified physician
   97  in the medical marijuana use registry for a period of up to 2
   98  years if the qualified physician:
   99         1.Fails to comply with this section; or
  100         2.Provides, advertises, or markets telehealth services
  101  before July 1, 2023.
  103  ====== D I R E C T O R Y  C L A U S E  A M E N D M E N T ======
  104  And the directory clause is amended as follows:
  105         Delete line 11
  106  and insert:
  107         Section 1. Paragraphs (a), (g), and (i) of subsection (4)
  108  of
  110  ================= T I T L E  A M E N D M E N T ================
  111  And the title is amended as follows:
  112         Delete line 7
  113  and insert:
  114         use of marijuana, subject to certain conditions;
  115         authorizing the Department of Health to suspend the
  116         registration of a qualified physician in the medical
  117         marijuana use registry for a specified timeframe for
  118         noncompliance with the act; providing an effective
  119         date.