HLS 18RS-974 REENGROSSED
2018 Regular Session
HOUSE BILL NO. 579
BY REPRESENTATIVES JAMES AND COX
PHARMACISTS: Provides relative to the authorization for therapeutic use of marijuana
1 AN ACT
2To amend and reenact R.S. 40:1046(A), (G), and (J) and R.S. 40:1046(A), (G), and (J) as
3 amended and reenacted by Section 2 of Act No. 96 of the 2016 Regular Session of
4 the Legislature of Louisiana and to enact R.S. 40:1046(K) and R.S. 40:1046(K) of
5 Section 2 of Act No. 96 of the 2016 Regular Session of the Legislature of Louisiana,
6 relative to the authorization of marijuana for therapeutic use; to provide for the duties
7 and authorization of the Louisiana State Board of Medical Examiners and the
8 Louisiana Board of Pharmacy with respect to the therapeutic use of marijuana; to
9 provide for definitions; and to provide for related matters.
10Be it enacted by the Legislature of Louisiana:
11 Section 1. R.S. 40:1046(A) and (G) are hereby amended and and reenacted to read
12as follows:
13 §1046. Recommendation of marijuana for therapeutic use; rules and regulations;
14 Louisiana Board of Pharmacy and the adoption of rules and regulations
15 relating to the dispensing of recommended marijuana for therapeutic use; the
16 Department of Agriculture and Forestry and the licensure of a production
17 facility
18 A.(1) Notwithstanding any other provision of this Part, a physician licensed
19 by and in good standing with the Louisiana State Board of Medical Examiners to
20 practice medicine in this state and who is domiciled in this state may recommend,
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1 in any form as permitted by the rules and regulations of the Louisiana Board of
2 Pharmacy except for inhalation, and raw or crude marijuana, tetrahydrocannabinols,
3 or a chemical derivative of tetrahydrocannabinols for therapeutic use by patients
4 clinically diagnosed as suffering from a debilitating medical condition.
5 (2)(a) For purposes of this Subsection, "debilitating medical condition"
6 means cancer, glaucoma, Parkinson's disease, positive status for human
7 immunodeficiency virus, acquired immune deficiency syndrome, cachexia or
8 wasting syndrome, seizure disorders, epilepsy, spasticity, severe muscle spasms,
9 intractable pain, Crohn's disease, muscular dystrophy, or multiple sclerosis, or post-
10 traumatic stress disorder.
11 (b) Intractable pain means a pain state in which the cause of the pain cannot
12 be removed or otherwise treated with the consent of the patient and which, in the
13 generally accepted course of medical practice, no relief or cure of the cause of the
14 pain is possible, or none has been found after reasonable efforts. It is pain so chronic
15 and severe as to otherwise warrant an opiate prescription.
16 (c) The Louisiana State Board of Medical Examiners shall adopt rules
17 relating to the approval or denial of additional qualifying conditions.
18 (d) If the United States Food and Drug Administration approves the use of
19 medical marijuana in the same form provided for in this Part for any debilitating
20 medical condition specifically identified in this Paragraph, that medical condition
21 shall no longer be covered by the provisions of this Part.
22 (c)(e) If the United States Food and Drug Administration approves the use
23 of medical marijuana in a form or derivative different than provided for in this Part
24 for any debilitating medical condition specifically identified in this Paragraph, the
25 disease state shall remain covered by the provisions of this Part. The patient shall
26 first be treated by the approved form or derivative of medical marijuana through
27 utilization of step therapy or fail first protocols. If, after use of the United States
28 Food and Drug Administration approved form or derivative of medical marijuana,
29 the physician determines that the preferred treatment required under step therapy or
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1 fail first protocol has been ineffective in the treatment of the patient's debilitating
2 medical condition, he may recommend the form of medical marijuana provided for
3 in this Part for use by the patient as medically necessary.
4 (3) For purposes of this Part, "recommend" or "recommended" means an
5 order from a physician domiciled in Louisiana and licensed and in good standing
6 with the Louisiana State Board of Medical Examiners and authorized by the board
7 to recommend medical marijuana that is patient-specific and disease-specific in
8 accordance with Paragraph (2) of this Subsection, and is communicated by any
9 means allowed by the Louisiana Board of Pharmacy to a Louisiana-licensed
10 pharmacist in a Louisiana-permitted dispensing pharmacy as described in Subsection
11 G of this Section, and is preserved on file as required by Louisiana law or federal law
12 regarding medical marijuana.
13 (4) Physicians shall may recommend use of medical marijuana for treatment
14 of debilitating medical conditions in accordance with rules and regulations
15 promulgated by the Louisiana State Board of Medical Examiners.
16 (5) Any member of the public may petition the Louisiana State Board of
17 Medical Examiners for the addition of serious medical conditions and medical
18 marijuana treatment options.
19 (6) The Louisiana State Board of Medical Examiners shall submit to the
20 Senate and House committees on health and welfare on an annual basis not less than
21 sixty days prior to the beginning of the regular session of the legislature a report as
22 to any additional diseases or medical conditions that should will be added to the list
23 of eligible diseases and conditions for recommendation pursuant to review of public
24 notice and comment.
25 * * *
26 G.(1) The Louisiana Board of Pharmacy shall develop an annual,
27 nontransferable specialty license for a pharmacy to dispense recommended
28 marijuana for therapeutic use and shall limit the number of such licenses granted in
29 the state to no more than ten licensees. The Louisiana Board of Pharmacy shall
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1 develop rules and regulations regarding the geographical locations of dispensing
2 pharmacies in Louisiana.
3 (2) Pharmacists licensed pursuant to this Section may dispense medical
4 marijuana to patients enrolled in the state-sponsored medical marijuana program in
5 Louisiana, their caregivers, and minor patients' domiciliary parents.
6 (3) Licensed dispensing pharmacies may not dispense raw or crude
7 marijuana to a patient or a parent or caregiver of a patient.
8 * * *
9 J. Notwithstanding any other provision of law to the contrary, employers and
10 their worker's compensation insurers shall not be obliged or ordered to pay for
11 medical marijuana in claims arising under Title 23 of the Louisiana Revised Statutes
12 of 1950, the Louisiana Workers' Compensation Law.
13 K. The provisions of this Section shall terminate on January 1, 2020.
14 Section 2. R.S. 40:1046(A) and (G) as amended and reenacted by Section 2 of Act
15No. 96 of the 2016 Regular Session of the Legislature of Louisiana are hereby amended and
16reenacted to read as follows:
17 Section 2. R.S. 40:1046 is hereby amended and reenacted to read as follows:
18 §1046. Prescription of marijuana for therapeutic use; rules and regulations;
19 Louisiana Board of Pharmacy and the adoption of rules and
20 regulations relating to the dispensing of prescribed marijuana for
21 therapeutic use; the Department of Agriculture and Forestry and the
22 licensure of a production facility
23 A.(1) Notwithstanding any other provision of this Part, a physician
24 licensed by and in good standing with the Louisiana State Board of
25 Medical Examiners to practice medicine in this state and who is domiciled
26 in this state may prescribe, in any form as permitted by the rules and
27 regulations of the Louisiana Board of Pharmacy except for inhalation, and
28 raw or crude marijuana, tetrahydrocannabinols, or a chemical derivative of
29 tetrahydrocannabinols for therapeutic use by patients clinically diagnosed as
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1 suffering from a debilitating medical condition glaucoma, symptoms
2 resulting from the administration of chemotherapy cancer treatment, and
3 spastic quadriplegia in accordance with rules and regulations promulgated by
4 the Louisiana State Board of Medical Examiners. The Louisiana State Board
5 of Medical Examiners shall submit to the Senate and House committees on
6 health and welfare on an annual basis not less than sixty days prior to the
7 beginning of the regular session of the legislature a report as to any
8 additional diseases or medical conditions that should be added to the list of
9 eligible diseases and conditions for prescription.
10 (2)(a) For purposes of this Subsection, "debilitating medical
11 condition" means cancer, glaucoma, positive status for human
12 immunodeficiency virus, acquired immune deficiency syndrome,
13 cachexia or wasting syndrome, seizure disorders, epilepsy, spasticity,
14 severe muscle spasms, intractable pain, Crohn's disease, muscular
15 dystrophy, or multiple sclerosis, or post-traumatic stress disorder.
16 (b) Intractable pain means a pain state in which the cause of the
17 pain cannot be removed or otherwise treated with the consent of the
18 patient and which, in the generally accepted course of medical practice,
19 no relief or cure of the cause of the pain is possible, or none has been
20 found after reasonable efforts. It is pain so chronic and severe as to
21 otherwise warrant an opiate prescription.
22 (c) The Louisiana State Board of Medical Examiners shall adopt
23 rules relating to the approval or denial of additional qualifying
24 conditions.
25 (b) (d) If the United States Food and Drug Administration
26 approves the use of medical marijuana in the same form provided for in
27 this Part for any debilitating medical condition specifically identified in
28 this Paragraph, that medical condition shall no longer be covered by the
29 provisions of this Part.
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1 (c) (e) If the United States Food and Drug Administration
2 approves the use of medical marijuana in a form or derivative different
3 than provided for in this Part for any debilitating medical condition
4 specifically identified in this Paragraph, the disease state shall remain
5 covered by the provisions of this Part. The patient shall first be treated
6 by the approved form or derivative of medical marijuana through
7 utilization of step therapy or fail first protocols. If, after use of the
8 United States Food and Drug Administration approved form or
9 derivative of medical marijuana, the physician determines that the
10 preferred treatment required under step therapy or fail first protocol
11 has been ineffective in the treatment of the patient's debilitating medical
12 condition, he may prescribe the form of medical marijuana provided for
13 in this Part for use by the patient as medically necessary.
14 (3) For purposes of this Part, "prescribe" or "prescription"
15 means an order from a physician domiciled in Louisiana and licensed
16 and in good standing with the Louisiana Board of Medical Examiners
17 and authorized by the board to prescribe medical marijuana that is
18 patient-specific and disease-specific in accordance with Paragraph (2) of
19 this Subsection, and is communicated by any means allowed by the
20 Louisiana Board of Pharmacy to a Louisiana-licensed pharmacist in a
21 Louisiana-permitted dispensing pharmacy as described in Subsection G
22 of this Section, and is preserved on file as required by Louisiana law or
23 federal law regarding medical marijuana.
24 (4) Physicians shall may prescribe the use of medical marijuana
25 for treatment of debilitating medical conditions in accordance with rules
26 and regulations promulgated by the Louisiana State Board of Medical
27 Examiners.
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1 (5) Any member of the public may petition the Louisiana State
2 Board of Medical Examiners for the addition of serious medical
3 conditions and medical marijuana treatment options.
4 (5) (6) The Louisiana State Board of Medical Examiners shall
5 submit to the Senate and House committees on health and welfare on an
6 annual basis not less than sixty days prior to the beginning of the regular
7 session of the legislature a report as to any additional diseases or medical
8 conditions that should will be added to the list of eligible diseases and
9 conditions for recommendation pursuant to review of public notice and
10 comment.
11 * * *
12 I.G.(1) The Louisiana Board of Pharmacy shall develop an annual,
13 nontransferable specialty license for a pharmacy to dispense prescribed
14 marijuana for therapeutic use and shall limit the number of such licenses
15 granted in the state to no more than ten licensees. The Louisiana Board of
16 Pharmacy shall develop rules and regulations regarding the geographical
17 locations of dispensing pharmacies in Louisiana.
18 (2) Pharmacists licensed pursuant to this Section may dispense
19 medical marijuana to patients enrolled in the state-sponsored medical
20 marijuana program in Louisiana, their caregivers, and minor patients'
21 domiciliary parents.
22 (3) Licensed dispensing pharmacies may not dispense raw or
23 crude marijuana to a patient or a parent or caregiver of a patient.
24 * * *
25 J. Notwithstanding any other provision of law to the contrary, employers and
26 their worker's compensation insurers shall not be obliged or ordered to pay for
27 medical marijuana in claims arising under Title 23 of the Louisiana Revised Statutes
28 of 1950, the Louisiana Workers' Compensation Law.
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1 K. The provisions of this Section shall terminate on January 1, 2020.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 579 Reengrossed 2018 Regular Session James
Abstract: Provides relative to the conditions for which medical marijuana may be
recommended or prescribed.
Recommendation of Medical Marijuana
Present law authorizes physicians who are domiciled in La. and licensed by and in good
standing with the La. State Board of Medical Examiners to recommend
tetrahydrocannabinols (commonly referred to as "medical marijuana"), or chemical
derivatives thereof, for therapeutic use by patients clinically diagnosed as suffering from a
debilitating medical condition. Defines "debilitating medical condition" to mean cancer,
positive status for human immunodeficiency virus, acquired immune deficiency syndrome,
cachexia or wasting syndrome, seizure disorders, epilepsy, spasticity, Crohn's disease,
muscular dystrophy, or multiple sclerosis.
Proposed law adds the following to the set of conditions for which medical marijuana may
be recommended:
(1)Glaucoma.
(2)Severe muscle spasms.
(3)Intractable pain.
(4)Post-traumatic stress disorder.
(5)Parkinson's disease.
Proposed law defines "intractable pain" as a pain state in which the cause of the pain cannot
be removed or otherwise treated with the consent of the patient and which, in the generally
accepted course of medical practice, no relief or cure of the cause of the pain is possible, or
none has been found after reasonable efforts. Provides further that intractable pain is pain
so chronic and severe as to otherwise warrant an opiate prescription.
Proposed law provides that any member of the public may petition the La. State Board of
Medical Examiners for the addition of serious medical conditions and medical marijuana
treatment options.
Present law requires the La. Board of Pharmacy to develop an annual, nontransferable
specialty license for a pharmacy to dispense recommended marijuana for therapeutic use.
Provides that the number of such licenses shall be no more than ten. Proposed law retains
present law and authorizes pharmacists licensed pursuant to present law to dispense medical
marijuana to patients, their caregivers, and minor patients' domiciliary parents.
Proposed law prohibits licensed marijuana dispensing pharmacies from dispensing raw or
crude marijuana to a patient or their parent or caregiver.
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Proposed law stipulates that employers and their worker's compensation insurers shall not
be obliged or ordered to pay for recommended medical marijuana in claims arising under
present law relative to worker's compensation.
Prescription of Medical Marijuana
Present law authorizes physicians who are domiciled in La. and licensed by and in good
standing with the La. State Board of Medical Examiners to prescribe, rather than
recommend, medical marijuana for therapeutic use by patients clinically diagnosed as
suffering from a debilitating medical condition if and when the U.S. Drug Enforcement
Administration reclassifies marijuana from a Schedule I drug to a Schedule II drug, thereby
allowing the drug to be legally prescribed. Defines "debilitating medical condition" to mean
cancer, positive status for human immunodeficiency virus, acquired immune deficiency
syndrome, cachexia or wasting syndrome, seizure disorders, epilepsy, spasticity, Crohn's
disease, muscular dystrophy, or multiple sclerosis.
Proposed law revises present law to authorize physicians who are domiciled in La. and
licensed by and in good standing with the La. State Board of Medical Examiners to prescribe
marijuana or marijuana preparations for therapeutic use by patients clinically diagnosed as
suffering from a debilitating medical condition. Adds the following to the set of conditions
for which medical marijuana may be prescribed:
(1)Glaucoma.
(2)Severe muscle spasms.
(3)Intractable pain.
(4)Post-traumatic stress disorder.
Proposed law defines "intractable pain" as a pain state in which the cause of the pain cannot
be removed or otherwise treated with the consent of the patient and which, in the generally
accepted course of medical practice, no relief or cure of the cause of the pain is possible, or
none has been found after reasonable efforts. Provides further that intractable pain is pain
so chronic and severe as to otherwise warrant an opiate prescription.
Proposed law provides that any member of the public may petition the La. State Board of
Medical Examiners for the addition of serious medical conditions and medical marijuana
treatment options.
Present law requires the La. Board of Pharmacy to develop an annual, nontransferable
specialty license for a pharmacy to dispense prescribed marijuana for therapeutic use.
Provides that the number of such licenses shall be no more than ten. Proposed law retains
present law and authorizes pharmacists licensed pursuant to present law to dispense medical
marijuana to patients, their caregivers, and minor patients' domiciliary parents.
Proposed law prohibits licensed marijuana dispensing pharmacies from dispensing raw or
crude marijuana to a patient or their parent or caregiver.
Proposed law stipulates that employers and their worker's compensation insurers shall not
be obliged or ordered to pay for recommended medical marijuana in claims arising under
present law relative to worker's compensation.
(Amends R.S. 40:1046(A), (G), and (J) and R.S. 40:1046(A), (G), (J) and as amended and
reenacted by §2 of Act No. 96 of the 2016 R.S.; Adds R.S. 40:1046(K) and R.S. 40:1046(K)
of §2 of Act No. 96 of the 2016 R.S.)
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Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Health and Welfare to
the original bill:
1. Revise proposed law defining "marijuana preparations" to provide that such
preparations can be any form authorized by and consistent with the rules adopted
by the La. Board of Pharmacy.
2. Amend present law relative to prescription of medical marijuana to reflect
amendments proposed law makes in present law relative to recommendation of
medical marijuana.
3. Make technical changes.
The House Floor Amendments to the engrossed bill:
1. Restore present law authorizing physicians to recommend or prescribe marijuana
for therapeutic use in any form as permitted by rules and regulations of the La.
Board of Pharmacy except for inhalation, and except for raw or crude marijuana.
2. Delete proposed law referring to marijuana preparations, marijuana
paraphernalia, and vaporization of marijuana.
3. Add Parkinson's disease to the set of conditions for which medical marijuana
may be recommended.
4. Stipulate that employers and their worker's compensation insurers shall not be
obliged or ordered to pay for recommended or prescribed medical marijuana in
claims arising under present law relative to worker's compensation.
5. Make technical changes.
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