Florida Senate - 2023                                     SB 344
       By Senator Brodeur
       10-00320-23                                            2023344__
    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.
    9  Be It Enacted by the Legislature of the State of Florida:
   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.—
   15         (a) A qualified physician may issue a physician
   16  certification only if the qualified physician:
   17         1. Conducted an a physical examination of while physically
   18  present in the same room as the 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 in person with the patient. For a certification
   22  renewal, the examination may be conducted through telehealth as
   23  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 deidentified 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, 2023.