HLS 22RS-398 ORIGINAL 2022 Regular Session HOUSE BILL NO. 190 BY REPRESENTATIVE TRAVIS JOHNSON MEDICAL MARIJUANA: Authorizes certain nurse practitioners to recommend medical marijuana to patients 1 AN ACT 2To amend and reenact R.S. 40:966(F)(1), (7), and (8)(a), 1046(A)(1), (2)(a)(xviii), (xxii), 3 and (b), (3), (4), (5)(b), (6), and (C)(1), 1168.2(2) through (5), and 4 1168.3(A)(1)(b)(iii), (iv), and (2)(b) and to enact R.S. 40:1046(B), relative to the 5 recommendation to patients of marijuana for therapeutic use, known also as medical 6 marijuana; to provide relative to licensed health professionals who may recommend 7 medical marijuana to patients; to authorize nurse practitioners with prescriptive 8 authority to recommend medical marijuana to patients; to revise references to 9 licensed health professionals who may recommend medical marijuana to patients 10 within laws providing for immunity from prosecution for possession of marijuana; 11 to revise references to licensed health professionals who may recommend medical 12 marijuana to patients within laws providing for a data system for the collection and 13 analysis of clinical information associated with use of medical marijuana; and to 14 provide for related matters. 15Be it enacted by the Legislature of Louisiana: 16 Section 1. R.S. 40:966(F)(1), (7), and (8)(a), 1046(A)(1), (2)(a)(xviii), (xxii), and 17(b), (3), (4), (5)(b), (6), and (C)(1), 1168.2(2) through (5), and 1168.3(A)(1)(b)(iii), (iv), and 18(2)(b) are hereby amended and reenacted and R.S. 40:1046(B) is hereby enacted to read as 19follows: Page 1 of 7 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 22RS-398 ORIGINAL HB NO. 190 1 §966. Penalty for distribution or possession with intent to distribute narcotic drugs 2 listed in Schedule I; possession of marijuana, synthetic cannabinoids, and 3 heroin 4 * * * 5 F. Immunity from prosecution. (1) Any person who is a patient of the 6 state-sponsored medical marijuana program in Louisiana, and possesses medical 7 marijuana in a form permissible under R.S. 40:1046 for a condition enumerated 8 therein, a caregiver as defined in R.S. 15:1503, or any person who is a domiciliary 9 parent of a minor child who possesses medical marijuana on behalf of his minor 10 child in a form permissible under R.S. 40:1046 for a condition enumerated therein 11 pursuant to a legitimate medical marijuana prescription or recommendation issued 12 by a physician licensed by and in good standing with the Louisiana State Board of 13 Medical Examiners licensed health professional authorized by R.S. 40:1046(B) to 14 recommend medical marijuana to patients, shall be exempt from the provisions of 15 this Section. This Paragraph shall not prevent the arrest or prosecution of any person 16 for diversion of marijuana or any of its derivatives or other conduct outside the scope 17 of the state-sponsored medical marijuana program. 18 * * * 19 (7) Any physician licensed health professional authorized by R.S. 20 40:1046(B) to recommend medical marijuana to patients who provides information 21 on marijuana for therapeutic use within a bona fide doctor-patient clinician-patient 22 relationship or who issues a recommendation to a patient for marijuana for 23 therapeutic use pursuant to R.S. 40:1046 shall be exempt from the prohibitions 24 provided in this Section for possession and distribution of marijuana. This Paragraph 25 shall not prohibit the arrest or prosecution of any person for diversion of medical 26 marijuana or any other conduct outside the scope of the state-sanctioned medical 27 marijuana program provided for in R.S. 40:1046. 28 (8)(a) The defenses in Paragraph (1) of this Subsection shall be raised by 29 reproducing a patient's medical records that have been created by his attending Page 2 of 7 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 22RS-398 ORIGINAL HB NO. 190 1 physician, that contain the legitimate recommendation to possess marijuana for 2 therapeutic use in a form permissible under R.S. 40:1046 issued by a licensed health 3 professional authorized by R.S. 40:1046(B) to recommend medical marijuana to 4 patients. 5 * * * 6 §1046. Recommendation and dispensing of marijuana for therapeutic use; rules and 7 regulations of the Louisiana State Board of Medical Examiners and 8 Louisiana Board of Pharmacy; production facility licensing by the 9 Department of Agriculture and Forestry 10 A.(1) Notwithstanding any other provision of this Part, any physician 11 licensed by and in good standing with the Louisiana State Board of Medical 12 Examiners to practice medicine in this state clinician authorized by the provisions 13 of Subsection B of this Section to recommend medical marijuana, referred to in this 14 Section as an "authorized clinician", may recommend, in any form as permitted by 15 the rules and regulations of the Louisiana Board of Pharmacy, raw or crude 16 marijuana, tetrahydrocannabinols, or a chemical derivative of tetrahydrocannabinols 17 for therapeutic use by any patient clinically diagnosed as suffering from a 18 debilitating medical condition. Nothing in this Paragraph shall be construed to 19 prevent the Louisiana Board of Pharmacy from permitting, by rule, medical 20 marijuana in a form to be administered by metered-dose inhaler. For purposes of this 21 Section, "metered-dose inhaler" means a device that delivers a specific amount of 22 medication to the lungs, in the form of a short burst of medicine that is usually 23 self-administered by the patient via inhalation. 24 (2)(a) For purposes of this Subsection, "debilitating medical condition" 25 means any of the following: 26 * * * 27 (xviii) A concussion diagnosed by a physician an authorized clinician. 28 * * * Page 3 of 7 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 22RS-398 ORIGINAL HB NO. 190 1 (xxii) Any condition not otherwise specified in this Subparagraph that a 2 physician an authorized clinician, in his medical clinical opinion, considers 3 debilitating to an individual patient and is qualified through his medical clinical 4 education and training to treat. 5 (b) No physician authorized clinician shall recommend medical marijuana 6 for treatment of any condition associated with autism spectrum disorder for a patient 7 who is under the age of eighteen unless the physician clinician complies with the 8 provisions of this Section and consults with a pediatric subspecialist. For purposes 9 of this Subparagraph a pediatric subspecialist is an individual licensed to practice 10 medicine in any state in the United States who provides care to patients with autism 11 spectrum disorder. 12 * * * 13 (3) For purposes of this Part, "recommend" or "recommended" means an 14 opinion of any physician licensed by and in good standing with the Louisiana State 15 Board of Medical Examiners authorized clinician, provided within a bona fide 16 doctor-patient or nurse-patient relationship, that, in the sincere judgment of the 17 physician clinician, therapeutic cannabis may be helpful to the patient's condition or 18 symptoms and is communicated by any means allowed by the Louisiana Board of 19 Pharmacy. 20 (4) Any physician licensed by and in good standing with the Louisiana State 21 Board of Medical Examiners to practice medicine in Louisiana authorized clinician 22 may recommend medical marijuana to any patient suffering from a debilitating 23 medical condition with whom he shares a bona fide doctor-patient or nurse-patient 24 relationship. 25 (5) 26 * * * 27 (b) No pharmacy authorized to dispense marijuana for therapeutic use in 28 accordance with the provisions of this Section shall dispense raw or crude marijuana 29 to any person under twenty-one years of age without a recommendation from a Page 4 of 7 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 22RS-398 ORIGINAL HB NO. 190 1 physician an authorized clinician specifically recommending marijuana in raw or 2 crude form for that person. 3 (6) Physicians Authorized clinicians shall report adverse events and health 4 outcomes associated with a patient's use of medical marijuana to the data system 5 provided for in R.S. 40:1168.1 et seq. 6 B. All of the following licensed health professionals are hereby authorized 7 to recommend medical marijuana to patients and, for purposes of this Part, shall be 8 deemed "authorized clinicians": 9 (1) Any physician licensed by and in good standing with the Louisiana State 10 Board of Medical Examiners to practice medicine in this state. 11 (2) Any nurse practitioner licensed by and in good standing with the 12 Louisiana State Board of Nursing to practice advanced practice registered nursing 13 in this state and who has prescriptive authority conferred by the Louisiana State 14 Board of Nursing. 15 C.(1) The Louisiana Board of Pharmacy shall adopt rules relating to the 16 dispensing of recommended marijuana for therapeutic use. Any rules published by 17 the Louisiana Board of Pharmacy on or before January 1, 2016, that describe the 18 pharmacist as dispensing medical marijuana based on a physician's prescription 19 should be repromulgated to indicate that the physician or other authorized clinician 20 is "recommending" use of therapeutic marijuana. 21 * * * 22 §1168.2. Definitions 23 For purposes of this Subpart, the following terms have the meaning ascribed 24 to them in this Section: 25 * * * 26 (2) "Authorized clinician" means all of the following licensed health 27 professionals authorized pursuant to R.S. 40:1046 to recommend medical marijuana 28 to patients: Page 5 of 7 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 22RS-398 ORIGINAL HB NO. 190 1 (a) Any physician licensed by and in good standing with the Louisiana State 2 Board of Medical Examiners to practice medicine in this state. 3 (b) Any nurse practitioner licensed by and in good standing with the 4 Louisiana State Board of Nursing to practice advanced practice registered nursing 5 in this state and who has prescriptive authority conferred by the Louisiana State 6 Board of Nursing. 7 (2) (3) "Board" means the Louisiana State Board of Medical Examiners. 8 (3) (4) "Data system" means the system authorized and provided for in R.S. 9 40:1168.3. 10 (4) (5) "Medical marijuana" means the therapeutic substance produced under 11 the authority of and in accordance with R.S. 40:1046. 12 (5) "Physician" has the meaning ascribed in R.S. 37:1262. 13 §1168.3. Data system; components; reporting; design in collaboration with medical 14 schools; public records exception 15 A. The board may create and maintain an electronic system for the collection 16 and analysis of clinical information associated with the use of medical marijuana by 17 patients. The system shall include, at minimum, the following components: 18 (1) 19 * * * 20 (b) The board shall design and administer the data system such that any of 21 the following persons may report an adverse event: 22 * * * 23 (iii) A physician An authorized clinician who prescribes or recommends 24 medical marijuana to a patient. 25 (iv) Any physician or advanced practice registered nurse who treats a patient 26 other than a physician an authorized clinician who prescribes or recommends 27 medical marijuana to the patient. 28 (2) 29 * * * Page 6 of 7 CODING: Words in struck through type are deletions from existing law; words underscored are additions. HLS 22RS-398 ORIGINAL HB NO. 190 1 (b) The board shall design and administer the data system such that reporting 2 of health outcomes is limited to physicians authorized clinicians exclusively. 3 * * * 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 190 Original 2022 Regular Session Travis Johnson Abstract: Authorizes nurse practitioners with prescriptive authority to recommend medical marijuana to patients. Present law authorizes licensed physicians to recommend marijuana for therapeutic use, known commonly as "medical marijuana", by patients clinically diagnosed as suffering from any debilitating medical condition defined in present law. Proposed law revises present law to authorize licensed nurse practitioners who have prescriptive authority, in addition to licensed physicians, to recommend medical marijuana to patients. Proposed law replaces "physician" with the term "authorized clinician" in present law relative to medical marijuana. Provides that all of the following licensed health professionals are authorized to recommend medical marijuana to patients and shall be deemed "authorized clinicians": (1)Any physician licensed by and in good standing with the La. State Board of Medical Examiners to practice medicine in this state. (2)Any nurse practitioner licensed by and in good standing with the La. State Board of Nursing to practice advanced practice registered nursing in this state and who has prescriptive authority conferred by the La. State Board of Nursing. Proposed law, for consistency of present law with proposed law, revises references to licensed health professionals who may recommend medical marijuana in the following areas of present law: (1)Law providing for immunity from prosecution for possession of marijuana (R.S. 40:966(F)). (2)Law providing for a data system for the collection and analysis of clinical information associated with use of medical marijuana by patients (R.S. 40:1168.1 et seq.). (Amends R.S. 40:966(F)(1), (7), and (8)(a), 1046(A)(1), (2)(a)(xviii), (xxii), and (b), (3), (4), (5)(b), (6), and (C)(1), 1168.2(2)-(5), and 1168.3(A)(1)(b)(iii), (iv), and (2)(b); Adds R.S. 40:1046(B)) Page 7 of 7 CODING: Words in struck through type are deletions from existing law; words underscored are additions.