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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
1
An act relating to the medical use of marijuana; 2
amending s. 381.986, F.S.; requiring qualified 3
physicians to perform in -person physical patient 4
examinations before issuing initial physician 5
certifications for the medical use of marijuana; 6
authorizing such qualified physicians to perform 7
patient examinations and evaluations through 8
telehealth for renewals of physician certifications 9
for the medical use of marijuana under certain 10
circumstances; defining the term "in -person physical 11
examination"; authorizing the Department of Health to 12
suspend the registration of a qualified physician in 13
the medical marijuana use registry for a specified 14
timeframe under certain circumstances; requiring the 15
department to issue medical marijuana treatment center 16
licenses to certain applicants as soon as practicable; 17
requiring the department to grant certain applicants a 18
specified timeframe to cure cited deficiencies; 19
requiring the department to issue a license to such 20
applicants if the deficiencies are cured within the 21
specified timeframe; requiring the department to issue 22
such licenses to the estate of certain applicants 23
under certain circumstances; requiring a specified 24
number of available licenses to be reduced by the 25
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award of such licenses; providing effective dates. 26
27
Be It Enacted by the Legislature of the State of Florida: 28
29
Section 1. Paragraphs (a), (g), and (i) of subsection (4) 30
of section 381.986, Florida Statutes, are amended to read: 31
381.986 Medical use of marijuana. — 32
(4) PHYSICIAN CERTIFICATION. — 33
(a) A qualified physician may issue a physician 34
certification only if the qualified physician: 35
1. Conducted an a physical examination of while physically 36
present in the same room as the patient and a full assessment of 37
the medical history of the patient. Before issuing an initial 38
certification to a patient, the qualified physician must conduct 39
an in-person physical examination of the patient. For 40
certification renewals, a qualified physician who has issued a 41
certification to a patient after conducting an in -person 42
physical examination may conduct subsequent examinations of that 43
patient through telehealth as defined in s. 456.47. For the 44
purposes of this subparagraph, the term "in -person physical 45
examination″ means an examination conducted by a qualified 46
physician while the physician is physically present in the same 47
room as the patient. 48
2. Diagnosed the patient with at least one qualifying 49
medical condition. 50
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3. Determined that the medical use of marijuana would 51
likely outweigh the potential health risks for the patient, and 52
such determination must be documented in the patient's medical 53
record. If a patient is younger than 18 years of age, a second 54
physician must concur with this determination, and such 55
concurrence must be documented in the patient's medical record. 56
4. Determined whether the patient is pregnant and 57
documented such determination in the patient's medical record. A 58
physician may not issue a physician certification, except for 59
low-THC cannabis, to a patient who is pregnant. 60
5. Reviewed the patient's controlled drug prescription 61
history in the prescription drug monitoring program database 62
established pursuant to s. 893.055. 63
6. Reviews the medical marijuana use registry and 64
confirmed that the patient does not have an active physician 65
certification from another qualified physician. 66
7. Registers as the issuer of the physician certification 67
for the named qualified patient on the medical marij uana use 68
registry in an electronic manner determined by the department, 69
and: 70
a. Enters into the registry the contents of the physician 71
certification, including the patient's qualifying condition and 72
the dosage not to exceed the daily dose amount determin ed by the 73
department, the amount and forms of marijuana authorized for the 74
patient, and any types of marijuana delivery devices needed by 75
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the patient for the medical use of marijuana. 76
b. Updates the registry within 7 days after any change is 77
made to the original physician certification to reflect such 78
change. 79
c. Deactivates the registration of the qualified patient 80
and the patient's caregiver when the physician no longer 81
recommends the medical use of marijuana for the patient. 82
8. Obtains the voluntary and informed written consent of 83
the patient for medical use of marijuana each time the qualified 84
physician issues a physician certification for the patient, 85
which shall be maintained in the patient's medical record. The 86
patient, or the patient's parent or legal guardian if the 87
patient is a minor, must sign the informed consent acknowledging 88
that the qualified physician has sufficiently explained its 89
content. The qualified physician must use a standardized 90
informed consent form adop ted in rule by the Board of Medicine 91
and the Board of Osteopathic Medicine, which must include, at a 92
minimum, information related to: 93
a. The Federal Government's classification of marijuana as 94
a Schedule I controlled substance. 95
b. The approval and over sight status of marijuana by the 96
Food and Drug Administration. 97
c. The current state of research on the efficacy of 98
marijuana to treat the qualifying conditions set forth in this 99
section. 100
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d. The potential for addiction. 101
e. The potential effect that ma rijuana may have on a 102
patient's coordination, motor skills, and cognition, including a 103
warning against operating heavy machinery, operating a motor 104
vehicle, or engaging in activities that require a person to be 105
alert or respond quickly. 106
f. The potential side effects of marijuana use, including 107
the negative health risks associated with smoking marijuana. 108
g. The risks, benefits, and drug interactions of 109
marijuana. 110
h. That the patient's deidentified health information 111
contained in the physician certifica tion and medical marijuana 112
use registry may be used for research purposes. 113
(g) A qualified physician must evaluate an existing 114
qualified patient at least once every 30 weeks before issuing a 115
new physician certification. A qualified physician who has 116
issued a certification to the patient after conducting an in -117
person physical examination as defined in subparagraph (a)1. may 118
conduct the evaluation through telehealth as defined in s. 119
456.47. A physician must: 120
1. Determine if the patient still meets the req uirements 121
to be issued a physician certification under paragraph (a). 122
2. Identify and document in the qualified patient's 123
medical records whether the qualified patient experienced either 124
of the following related to the medical use of marijuana: 125
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a. An adverse drug interaction with any prescription or 126
nonprescription medication; or 127
b. A reduction in the use of, or dependence on, other 128
types of controlled substances as defined in s. 893.02. 129
3. Submit a report with the findings required pursuant to 130
subparagraph 2. to the department. The department shall submit 131
such reports to the Consortium for Medical Marijuana Clinical 132
Outcomes Research established pursuant to s. 1004.4351. 133
(i) The department shall monitor physician registration in 134
the medical marijuana use registry and the issuance of physician 135
certifications for practices that could facilitate unlawful 136
diversion or misuse of marijuana or a marijuana delivery device 137
and shall take disciplinary action as appropriate. The 138
department may suspend the reg istration of a qualified physician 139
in the medical marijuana use registry for a period of up to 2 140
years if the qualified physician: 141
1. Fails to comply with this section; or 142
2. Provides, advertises, or markets telehealth services 143
before July 1, 2023. 144
Section 2. (1) Notwithstanding any provision of s. 145
381.986(8)(a)2.b., Florida Statutes, to the contrary, the 146
Department of Health shall, as soon as practicable, license all 147
applicants that applied for licensure during the application 148
window created by th e department to accept applications for 149
licensure pursuant to s. 381.986(8)(a)2.b., Florida Statutes, 150
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and received: 151
(a) A notice from the department regarding the applicant′s 152
application for licensure indicating the department′s intent to 153
approve or deny the application which did not cite any 154
deficiencies with the application, regardless of the applicant′s 155
final score; or 156
(b) A final determination from the department as a result 157
of a challenge to the application process, initiated pursuant to 158
s. 120.569, Florida Statutes, determining that the applicant met 159
all requirements for licensure pursuant to s. 381.986(8)(a)2.b., 160
Florida Statutes, and applicable rules, regardless of the 161
applicant′s final score. 162
(2) Upon this section becoming a law, the departmen t shall 163
grant each applicant referenced in subsection (1) 90 days to 164
cure, pursuant to the errors and omissions process established 165
in department Form DH8035 -OMMU-10/2021 as incorporated by the 166
department in Rule 64ER21 -16, F.A.C., any deficiencies cited i n 167
a notice referenced in paragraph (1)(a). If such applicant cures 168
the deficiencies within that 90 -day timeframe, the department 169
shall issue a license to the applicant. 170
(3) If an applicant who was alive at the time he or she 171
received the notice referred to in paragraph (1)(a) dies during 172
the challenge referred to in paragraph (1)(b), the death of the 173
applicant may not be a reason to deny the challenge. In such a 174
case and in the event of a successful challenge pursuant to 175
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paragraph (1)(b), the department m ust issue the license to the 176
estate of the applicant. 177
(4) The number of licenses made available for issuance 178
under s. 381.986(8)(a)4., Florida Statutes, must be reduced by 179
the number of licenses awarded under this section, except that 180
the number of licenses awarded under this section may not be 181
deducted from the number of licenses available for the 182
application window held between April 24, 2023, and April 28, 183
2023. 184
(5) This section shall take effect upon becoming a law. 185
Section 3. Except as otherwis e expressly provided in this 186
act and except for this section, which shall take effect upon 187
this act becoming a law, this act shall take effect July 1, 188
2023. 189