Florida Senate - 2025 SB 552 By Senator Gruters 22-00413A-25 2025552__ 1 A bill to be entitled 2 An act relating to medical marijuana; amending s. 3 381.986, F.S.; specifying additional medical 4 conditions that qualify an individual to receive 5 medical marijuana and medical marijuana delivery 6 devices; authorizing qualified physicians to use 7 telehealth to perform the initial certification 8 examination of patients for the medical use of 9 marijuana; conforming provisions related to 10 documentation a qualified physician is required to 11 submit to the Board of Medicine or Board of 12 Osteopathic Medicine, as applicable, to conform to 13 changes made by the act; increasing the number of 14 supply limits of marijuana a qualified physician may 15 issue in a single physician certification for the 16 medical use of marijuana; revising the frequency with 17 which qualified physicians must evaluate existing 18 qualified patients for a physician certification for 19 the medical use of marijuana; conforming provisions to 20 changes made by the act; deleting obsolete language; 21 revising the frequency with which qualified patient 22 and caregiver identification cards must be renewed, 23 from annually to biennially; requiring the Department 24 of Health to establish procedures and processes for 25 certain nonresidents to register as visiting qualified 26 patients and be issued identification cards within a 27 specified timeframe; providing that a visiting 28 qualified patient may engage in all conduct authorized 29 for qualified patients in this state; requiring the 30 department to waive all fees associated with 31 identification cards for certain veterans of the 32 United States Armed Forces; prohibiting medical 33 marijuana treatment center dispensing facilities from 34 being located on the same parcel of land as retail 35 outlets; providing an effective date. 36 37 Be It Enacted by the Legislature of the State of Florida: 38 39 Section 1.Present paragraph (d) of subsection (11) of 40 section 381.986, Florida Statutes, is redesignated as paragraph 41 (e), a new paragraph (d) is added to that subsection, and 42 paragraph (k) of subsection (2), paragraphs (a), (b), (f), (g), 43 and (i) of subsection (4), and paragraphs (a) and (d) of 44 subsection (7) of that section are amended, to read: 45 381.986Medical use of marijuana. 46 (2)QUALIFYING MEDICAL CONDITIONS.A patient must be 47 diagnosed with at least one of the following conditions to 48 qualify to receive marijuana or a marijuana delivery device: 49 (k)Medical conditions of the same kind or class as or 50 comparable to those enumerated in paragraphs (a)-(j) or medical 51 conditions for which the patient has been prescribed an opioid 52 drug listed as a Schedule II controlled substance in s. 893.03 53 or 21 U.S.C. s. 812. 54 (4)PHYSICIAN CERTIFICATION. 55 (a)A qualified physician may issue a physician 56 certification only if the qualified physician: 57 1.Conducted an examination of the patient and a full 58 assessment of the medical history of the patient. Before issuing 59 or renewing a an initial certification to a patient, the 60 qualified physician must conduct an in-person physical 61 examination of the patient in person or. For certification 62 renewals, a qualified physician who has issued a certification 63 to a patient after conducting an in-person physical examination 64 may conduct subsequent examinations of that patient through 65 telehealth as defined in s. 456.47. For the purposes of this 66 subparagraph, the term in-person physical examination means an 67 examination conducted by a qualified physician while the 68 physician is physically present in the same room as the patient. 69 2.Diagnosed the patient with at least one qualifying 70 medical condition. 71 3.Determined that the medical use of marijuana would 72 likely outweigh the potential health risks for the patient, and 73 such determination must be documented in the patients medical 74 record. If a patient is younger than 18 years of age, a second 75 physician must concur with this determination, and such 76 concurrence must be documented in the patients medical record. 77 4.Determined whether the patient is pregnant and 78 documented such determination in the patients medical record. A 79 physician may not issue a physician certification, except for 80 low-THC cannabis, to a patient who is pregnant. 81 5.Reviewed the patients controlled drug prescription 82 history in the prescription drug monitoring program database 83 established pursuant to s. 893.055. 84 6.Reviews the medical marijuana use registry and confirmed 85 that the patient does not have an active physician certification 86 from another qualified physician. 87 7.Registers as the issuer of the physician certification 88 for the named qualified patient on the medical marijuana use 89 registry in an electronic manner determined by the department, 90 and: 91 a.Enters into the registry the contents of the physician 92 certification, including the patients qualifying condition and 93 the dosage not to exceed the daily dose amount determined by the 94 department, the amount and forms of marijuana authorized for the 95 patient, and any types of marijuana delivery devices needed by 96 the patient for the medical use of marijuana. 97 b.Updates the registry within 7 days after any change is 98 made to the original physician certification to reflect such 99 change. 100 c.Deactivates the registration of the qualified patient 101 and the patients caregiver when the physician no longer 102 recommends the medical use of marijuana for the patient. 103 8.Obtains the voluntary and informed written consent of 104 the patient for medical use of marijuana each time the qualified 105 physician issues a physician certification for the patient, 106 which shall be maintained in the patients medical record. The 107 patient, or the patients parent or legal guardian if the 108 patient is a minor, must sign the informed consent acknowledging 109 that the qualified physician has sufficiently explained its 110 content. The qualified physician must use a standardized 111 informed consent form adopted in rule by the Board of Medicine 112 and the Board of Osteopathic Medicine, which must include, at a 113 minimum, information related to: 114 a.The Federal Governments classification of marijuana as 115 a Schedule I controlled substance. 116 b.The approval and oversight status of marijuana by the 117 Food and Drug Administration. 118 c.The current state of research on the efficacy of 119 marijuana to treat the qualifying conditions set forth in this 120 section. 121 d.The potential for addiction. 122 e.The potential effect that marijuana may have on a 123 patients coordination, motor skills, and cognition, including a 124 warning against operating heavy machinery, operating a motor 125 vehicle, or engaging in activities that require a person to be 126 alert or respond quickly. 127 f.The potential side effects of marijuana use, including 128 the negative health risks associated with smoking marijuana. 129 g.The risks, benefits, and drug interactions of marijuana. 130 h.That the patients deidentified health information 131 contained in the physician certification and medical marijuana 132 use registry may be used for research purposes. 133 (b)If a qualified physician issues a physician 134 certification for a qualified patient diagnosed with a 135 qualifying medical condition pursuant to paragraph (2)(k), the 136 physician must submit the following to the applicable board 137 within 14 days after issuing the physician certification: 138 1.Documentation supporting the qualified physicians 139 opinion that the medical condition is of the same kind or class 140 as the conditions in paragraphs (2)(a)-(j) or is a condition for 141 which the patient was prescribed an opioid drug listed as a 142 Schedule II controlled substance in s. 893.03 or 21 U.S.C. s. 143 812. 144 2.Documentation that establishes the efficacy of marijuana 145 as treatment for the condition. 146 3.Documentation supporting the qualified physicians 147 opinion that the benefits of medical use of marijuana would 148 likely outweigh the potential health risks for the patient. 149 4.Any other documentation as required by board rule. 150 151 The department must submit such documentation to the Consortium 152 for Medical Marijuana Clinical Outcomes Research established 153 pursuant to s. 1004.4351. 154 (f)A qualified physician may not issue a physician 155 certification for more than 10 three 70-day supply limits of 156 marijuana or more than 20 six 35-day supply limits of marijuana 157 in a form for smoking. The department shall quantify by rule a 158 daily dose amount with equivalent dose amounts for each 159 allowable form of marijuana dispensed by a medical marijuana 160 treatment center. The department shall use the daily dose amount 161 to calculate a 70-day supply. 162 1.A qualified physician may request an exception to the 163 daily dose amount limit, the 35-day supply limit of marijuana in 164 a form for smoking, and the 4-ounce possession limit of 165 marijuana in a form for smoking established in paragraph 166 (14)(a). The request must shall be made electronically on a form 167 adopted by the department in rule and must include, at a 168 minimum: 169 a.The qualified patients qualifying medical condition. 170 b.The dosage and route of administration that was 171 insufficient to provide relief to the qualified patient. 172 c.A description of how the patient will benefit from an 173 increased amount. 174 d.The minimum daily dose amount of marijuana that would be 175 sufficient for the treatment of the qualified patients 176 qualifying medical condition. 177 2.A qualified physician must provide the qualified 178 patients records upon the request of the department. 179 3.The department shall approve or disapprove the request 180 within 14 days after receipt of the complete documentation 181 required by this paragraph. The request is shall be deemed 182 approved if the department fails to act within this time period. 183 (g)A qualified physician must evaluate an existing 184 qualified patient at least once every 104 30 weeks before 185 issuing a new physician certification. A qualified physician who 186 has issued a certification to the patient after conducting an 187 in-person physical examination as defined in subparagraph (a)1. 188 may conduct the evaluation through telehealth as defined in s. 189 456.47. A physician must: 190 1.Determine whether if the patient still meets the 191 requirements to be issued a physician certification under 192 paragraph (a). 193 2.Identify and document in the qualified patients medical 194 records whether the qualified patient experienced either of the 195 following related to the medical use of marijuana: 196 a.An adverse drug interaction with any prescription or 197 nonprescription medication; or 198 b.A reduction in the use of, or dependence on, other types 199 of controlled substances as defined in s. 893.02. 200 3.Submit a report with the findings required pursuant to 201 subparagraph 2. to the department. The department shall submit 202 such reports to the Consortium for Medical Marijuana Clinical 203 Outcomes Research established pursuant to s. 1004.4351. 204 (i)The department shall monitor physician registration in 205 the medical marijuana use registry and the issuance of physician 206 certifications for practices that could facilitate unlawful 207 diversion or misuse of marijuana or a marijuana delivery device 208 and shall take disciplinary action as appropriate. The 209 department may suspend the registration of a qualified physician 210 in the medical marijuana use registry for a period of up to 2 211 years if the qualified physician: 212 1.fails to comply with this section; or 213 2.Provides, advertises, or markets telehealth services 214 before July 1, 2023. 215 (7)IDENTIFICATION CARDS. 216 (a)The department shall issue medical marijuana use 217 registry identification cards for qualified patients and 218 caregivers who are residents of this state, which must be 219 renewed biennially annually. Additionally, the department shall 220 establish procedures and processes for nonresidents who are 221 actively enrolled in the medical marijuana program of another 222 jurisdiction recognized by the department to register as 223 visiting qualified patients and be issued medical marijuana use 224 registry identification cards within 1 business day after such 225 request to register. A visiting qualified patient may engage in 226 all conduct authorized for a qualified patient in this state. 227 The identification cards must be resistant to counterfeiting and 228 tampering and must include, at a minimum, include the following: 229 1.The name, address, and date of birth of the qualified 230 patient or caregiver. 231 2.A full-face, passport-type, color photograph of the 232 qualified patient or caregiver taken within the 90 days 233 immediately preceding registration or the Florida driver license 234 or Florida identification card photograph of the qualified 235 patient or caregiver obtained directly from the Department of 236 Highway Safety and Motor Vehicles. 237 3.Identification as a qualified patient or a caregiver. 238 4.The unique numeric identifier used for the qualified 239 patient in the medical marijuana use registry. 240 5.For a caregiver, the name and unique numeric identifier 241 of the caregiver and the qualified patient or patients that the 242 caregiver is assisting. 243 6.The expiration date of the identification card. 244 (d)Applications for identification cards must be submitted 245 on a form prescribed by the department. The department may 246 charge a reasonable fee associated with the issuance, 247 replacement, and renewal of identification cards. However, the 248 department shall waive all such fees for any veteran who was 249 honorably discharged from the United States Armed Forces. The 250 department shall allocate $10 of the identification card fee to 251 the Division of Research at Florida Agricultural and Mechanical 252 University for the purpose of educating minorities about 253 marijuana for medical use and the impact of the unlawful use of 254 marijuana on minority communities. The department shall contract 255 with a third-party vendor to issue identification cards. The 256 vendor selected by the department must have experience 257 performing similar functions for other state agencies. 258 (11)PREEMPTION.Regulation of cultivation, processing, and 259 delivery of marijuana by medical marijuana treatment centers is 260 preempted to the state except as provided in this subsection. 261 (d)A medical marijuana treatment center dispensing 262 facility may not be located on the same parcel of land as a 263 retail outlet as defined in s. 526.303. 264 Section 2.This act shall take effect July 1, 2025.