Florida Senate - 2023                              CS for SB 344
       By the Committee on Health Policy; and Senator Brodeur
       588-03213-23                                           2023344c1
    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, subject to certain conditions;
    8         authorizing the Department of Health to suspend the
    9         registration of a qualified physician in the medical
   10         marijuana use registry for a specified timeframe for
   11         noncompliance with the act; providing an effective
   12         date.
   14  Be It Enacted by the Legislature of the State of Florida:
   16         Section 1. Paragraphs (a) and (g) of subsection (4) of
   17  section 381.986, Florida Statutes, are amended to read:
   18         381.986 Medical use of marijuana.—
   20         (a) A qualified physician may issue a physician
   21  certification only if the qualified physician:
   22  1. Conducted an a physical examination of while physically
   23  present in the same room as the patient and a full assessment of
   24  the medical history of the patient. For an initial
   25  certification, the examination must be a physical examination
   26  conducted in person with the patient. For a certification
   27  renewal, the examination may be conducted through telehealth as
   28  defined in s. 456.47, provided it is with the qualified
   29  physician who performed the initial in-person examination.
   30         2. Diagnosed the patient with at least one qualifying
   31  medical condition.
   32         3. Determined that the medical use of marijuana would
   33  likely outweigh the potential health risks for the patient, and
   34  such determination must be documented in the patient’s medical
   35  record. If a patient is younger than 18 years of age, a second
   36  physician must concur with this determination, and such
   37  concurrence must be documented in the patient’s medical record.
   38         4. Determined whether the patient is pregnant and
   39  documented such determination in the patient’s medical record. A
   40  physician may not issue a physician certification, except for
   41  low-THC cannabis, to a patient who is pregnant.
   42         5. Reviewed the patient’s controlled drug prescription
   43  history in the prescription drug monitoring program database
   44  established pursuant to s. 893.055.
   45         6. Reviews the medical marijuana use registry and confirmed
   46  that the patient does not have an active physician certification
   47  from another qualified physician.
   48         7. Registers as the issuer of the physician certification
   49  for the named qualified patient on the medical marijuana use
   50  registry in an electronic manner determined by the department,
   51  and:
   52         a. Enters into the registry the contents of the physician
   53  certification, including the patient’s qualifying condition and
   54  the dosage not to exceed the daily dose amount determined by the
   55  department, the amount and forms of marijuana authorized for the
   56  patient, and any types of marijuana delivery devices needed by
   57  the patient for the medical use of marijuana.
   58         b. Updates the registry within 7 days after any change is
   59  made to the original physician certification to reflect such
   60  change.
   61         c. Deactivates the registration of the qualified patient
   62  and the patient’s caregiver when the physician no longer
   63  recommends the medical use of marijuana for the patient.
   64         8. Obtains the voluntary and informed written consent of
   65  the patient for medical use of marijuana each time the qualified
   66  physician issues a physician certification for the patient,
   67  which shall be maintained in the patient’s medical record. The
   68  patient, or the patient’s parent or legal guardian if the
   69  patient is a minor, must sign the informed consent acknowledging
   70  that the qualified physician has sufficiently explained its
   71  content. The qualified physician must use a standardized
   72  informed consent form adopted in rule by the Board of Medicine
   73  and the Board of Osteopathic Medicine, which must include, at a
   74  minimum, information related to:
   75         a. The Federal Government’s classification of marijuana as
   76  a Schedule I controlled substance.
   77         b. The approval and oversight status of marijuana by the
   78  Food and Drug Administration.
   79         c. The current state of research on the efficacy of
   80  marijuana to treat the qualifying conditions set forth in this
   81  section.
   82         d. The potential for addiction.
   83         e. The potential effect that marijuana may have on a
   84  patient’s coordination, motor skills, and cognition, including a
   85  warning against operating heavy machinery, operating a motor
   86  vehicle, or engaging in activities that require a person to be
   87  alert or respond quickly.
   88         f. The potential side effects of marijuana use, including
   89  the negative health risks associated with smoking marijuana.
   90         g. The risks, benefits, and drug interactions of marijuana.
   91         h. That the patient’s deidentified health information
   92  contained in the physician certification and medical marijuana
   93  use registry may be used for research purposes.
   94         (g) A qualified physician must evaluate an existing
   95  qualified patient at least once every 30 weeks before issuing a
   96  new physician certification. The evaluation may be conducted
   97  through telehealth as defined in s. 456.47, provided it is with
   98  the qualified physician who performed the initial in-person
   99  examination of the qualified patient. A physician must:
  100         1. Determine if the patient still meets the requirements to
  101  be issued a physician certification under paragraph (a).
  102         2. Identify and document in the qualified patient’s medical
  103  records whether the qualified patient experienced either of the
  104  following related to the medical use of marijuana:
  105         a. An adverse drug interaction with any prescription or
  106  nonprescription medication; or
  107         b. A reduction in the use of, or dependence on, other types
  108  of controlled substances as defined in s. 893.02.
  109         3. Submit a report with the findings required pursuant to
  110  subparagraph 2. to the department. The department shall submit
  111  such reports to the Consortium for Medical Marijuana Clinical
  112  Outcomes Research established pursuant to s. 1004.4351.
  113         (i) The department shall monitor physician registration in
  114  the medical marijuana use registry and the issuance of physician
  115  certifications for practices that could facilitate unlawful
  116  diversion or misuse of marijuana or a marijuana delivery device
  117  and shall take disciplinary action as appropriate. The
  118  department may suspend the registration of a qualified physician
  119  in the medical marijuana use registry for a period of up to 2
  120  years if the qualified physician:
  121         1.Fails to comply with this section; or
  122         2.Provides, advertises, or markets telehealth services
  123  before July 1, 2023.
  124         Section 2. This act shall take effect July 1, 2023.