EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW. [Brackets] indicate matter deleted from existing law. *hb1172* HOUSE BILL 1172 J1 3lr2555 CF SB 671 By: Delegate Kelly Introduced and read first time: February 10, 2023 Assigned to: Health and Government Operations and Economic Matters A BILL ENTITLED AN ACT concerning 1 Medical Cannabis – Visiting Qualifying Patients 2 FOR the purpose of prohibiting a visiting qualifying patient from being required to have a 3 written certification issued by a certifying provider or an identification card issued 4 by the Natalie M. LaPrade Medical Cannabis Commission; including a visiting 5 qualifying patient among the individuals with respect to whom the Commission is 6 required to allow a licensed dispensary or registered dispensary agent to take certain 7 actions related to medical cannabis; including a visiting qualifying patient among 8 the individuals with respect to whom a licensed dispensary or registered dispensary 9 agent may take certain actions related to medical cannabis without being subject to 10 certain penalties or arrest; including a visiting qualifying patient among the persons 11 that may not be subject to certain discipline or penalties or be denied certain rights 12 or privileges for the medical use or possession of medical cannabis under certain 13 circumstances; and generally relating to visiting qualifying patients and medical 14 cannabis. 15 BY repealing and reenacting, without amendments, 16 Article – Health – General 17 Section 13–3301(a) 18 Annotated Code of Maryland 19 (2019 Replacement Volume and 2022 Supplement) 20 BY repealing and reenacting, with amendments, 21 Article – Health – General 22 Section 13–3301(f) and (q), 13–3304, 13–3307(f), (g), and (l), and 13–3313(a) 23 Annotated Code of Maryland 24 (2019 Replacement Volume and 2022 Supplement) 25 BY adding to 26 Article – Health – General 27 Section 13–3301(q) 28 2 HOUSE BILL 1172 Annotated Code of Maryland 1 (2019 Replacement Volume and 2022 Supplement) 2 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 3 That the Laws of Maryland read as follows: 4 Article – Health – General 5 13–3301. 6 (a) In this subtitle the following words have the meanings indicated. 7 (f) “Dispensary” means an entity licensed under this subtitle that acquires, 8 possesses, transfers, transports, sells, distributes, dispenses, or administers cannabis, 9 products containing cannabis, related supplies, related products containing cannabis 10 including edible cannabis products, tinctures, aerosols, oils, or ointments, or educational 11 materials for use by a qualifying patient, VISITING QUALIFYING PATIENT, or caregiver. 12 (Q) “VISITING QUALIFYING P ATIENT” MEANS AN INDIVIDUAL WHO 13 PROVIDES TO A DISPEN SARY: 14 (1) DOCUMENTATION THAT TH E INDIVIDUAL HAS A V ALID MEDICAL 15 CANNABIS CERTIFICATI ON ISSUED BY THE IND IVIDUAL’S STATE OF RESIDENCE ; AND 16 (2) PHOTOGRAPH IC IDENTIFICATION OR A VALID DRIVER’S LICENSE 17 ISSUED BY THE INDIVI DUAL’S STATE OF RESIDENCE . 18 [(q)] (R) “Written certification” means a certification that: 19 (1) Is issued by a certifying provider to a qualifying patient with whom the 20 provider has a bona fide provider–patient relationship; 21 (2) Includes a written statement certifying that, in the provider’s 22 professional opinion, after having completed an assessment of the patient’s medical history 23 and current medical condition, the patient has a condition: 24 (i) That meets the inclusion criteria and does not meet the exclusion 25 criteria of the certifying provider’s application; and 26 (ii) For which the potential benefits of the medical use of cannabis 27 would likely outweigh the health risks for the patient; and 28 (3) May include a written statement certifying that, in the provider’s 29 professional opinion, a 30–day supply of medical cannabis would be inadequate to meet the 30 medical needs of the qualifying patient. 31 HOUSE BILL 1172 3 13–3304. 1 (a) The Commission shall register as a certifying provider an individual who: 2 (1) Meets the requirements of this subtitle; and 3 (2) Submits application materials that meet the requirements of this 4 subtitle. 5 (b) To be registered as a certifying provider, a provider shall submit a proposal to 6 the Commission that includes: 7 (1) The reasons for including a patient under the care of the provider for 8 the purposes of this subtitle, including the patient’s qualifying medical conditions; 9 (2) An attestation that a standard patient evaluation will be completed, 10 including a history, a physical examination, a review of symptoms, and other pertinent 11 medical information; and 12 (3) The provider’s plan for the ongoing assessment and follow–up care of a 13 patient and for collecting and analyzing data. 14 (c) The Commission may not require an individual to meet requirements in 15 addition to the requirements listed in subsections (a) and (b) of this section to be registered 16 as a certifying provider. 17 (d) (1) The Commission is encouraged to approve provider applications for the 18 following medical conditions: 19 (i) A chronic or debilitating disease or medical condition that results 20 in a patient being admitted into hospice or receiving palliative care; or 21 (ii) A chronic or debilitating disease or medical condition or the 22 treatment of a chronic or debilitating disease or medical condition that produces: 23 1. Cachexia, anorexia, or wasting syndrome; 24 2. Severe or chronic pain; 25 3. Severe nausea; 26 4. Seizures; or 27 5. Severe or persistent muscle spasms. 28 (2) The Commission may not limit treatment of a particular medical 29 condition to one class of providers. 30 4 HOUSE BILL 1172 (e) The Commission may approve applications that include any other condition 1 that is severe and for which other medical treatments have been ineffective if the symptoms 2 reasonably can be expected to be relieved by the medical use of cannabis. 3 (f) (1) A certifying provider or the spouse of a certifying provider may not 4 receive any gifts from or have an ownership interest in a medical cannabis grower, a 5 processor, or a dispensary. 6 (2) A certifying provider may receive compensation from a medical 7 cannabis grower, a processor, or a dispensary if the certifying provider: 8 (i) Obtains the approval of the Commission before receiving the 9 compensation; and 10 (ii) Discloses the amount of compensation received from the medical 11 cannabis grower, processor, or dispensary to the Commission. 12 (g) (1) (i) Subject to subparagraph (ii) of this paragraph, a qualifying 13 patient may be a patient of the certifying provider or may be referred to the certifying 14 provider. 15 (ii) A referral of a patient to a certifying provider under 16 subparagraph (i) of this paragraph may not be made by any person or entity employed, 17 contracted, volunteering, or compensated by any form of remuneration, gift, donation, or 18 bartering to register individuals as qualifying patients, to complete application forms, or to 19 assist individuals in completing application forms to become qualifying patients, or to 20 transport or deliver to the Commission application forms for individuals seeking to become 21 qualifying patients. 22 (2) A certifying provider shall provide each written certification to the 23 Commission. 24 (3) On receipt of a written certification provided under paragraph (2) of this 25 subsection, the Commission shall issue an identification card to each qualifying patient or 26 caregiver named in the written certification. 27 (4) A certifying provider may discuss medical cannabis with a patient. 28 (5) (i) Except as provided in subparagraph (ii) of this paragraph, a 29 qualifying patient, VISITING QUALIFYING PATIENT, or caregiver may obtain medical 30 cannabis only from a medical cannabis grower licensed by the Commission or a dispensary 31 licensed by the Commission. 32 (ii) A qualifying patient OR VISITING QUALIFYI NG PATIENT under 33 the age of 18 years may obtain medical cannabis only through: 34 HOUSE BILL 1172 5 1. The qualifying PATIENT’S OR VISITING QUALIF YING 1 patient’s caregiver; or 2 2. Any designated school personnel authorized to administer 3 medical cannabis to a student in accordance with the guidelines established under § 7–446 4 of the Education Article. 5 (6) (i) A caregiver may serve no more than five qualifying patients OR 6 VISITING QUALIFYING PATIENTS at any time. 7 (ii) Except as provided in subparagraph (iii) of this paragraph, a 8 qualifying patient OR VISITING QUALIFYI NG PATIENT may have no more than two 9 caregivers. 10 (iii) A qualifying patient OR VISITING QUALIFYI NG PATIENT under 11 the age of 18 years may have no more than four caregivers. 12 (7) Any designated school personnel described in paragraph (5)(ii) of this 13 subsection: 14 (i) May administer to a student only medical cannabis: 15 1. That is obtained through the student’s caregiver; and 16 2. In accordance with dosing, timing, and delivery route 17 instructions as provided by the certifying provider’s written instructions; and 18 (ii) Are not required to register with the Commission under this 19 subtitle. 20 (8) [Beginning June 1, 2020, a] A caregiver may administer medical 21 cannabis to a student who is a qualifying patient of the caregiver on school property, during 22 school–sponsored activities, and while on a school bus. 23 (h) (1) A certifying provider may register biennially. 24 (2) The Commission shall grant or deny a renewal of a registration for 25 approval based on the provider’s performance in complying with regulations adopted by the 26 Commission. 27 (I) A VISITING QUALIFYING PATIENT MAY NOT BE R EQUIRED TO HAVE A 28 WRITTEN CERTIFICATIO N ISSUED BY A CERTIF YING PROVIDER OR AN 29 IDENTIFICATION CARD ISSUED BY THE COMMISSION UNDER THIS SECTION. 30 13–3307. 31 6 HOUSE BILL 1172 (f) The Commission shall allow a dispensary licensed under this section or a 1 dispensary agent registered under § 13–3308 of this subtitle to acquire, possess, transfer, 2 transport, sell, distribute, or dispense edible cannabis products for use by [a]: 3 (1) A qualifying patient[, a]; 4 (2) A caregiver[, or an]; 5 (3) AN academic research representative purchasing medical cannabis 6 under § 13–3304.1 of this subtitle; OR 7 (4) A VISITING QUALIFYING PATIENT FOR ANY COND ITION 8 RECOGNIZED AS A QUAL IFYING CONDITIO N BY THE STATE THAT ISSUED THE VALID 9 MEDICAL CANNABIS CER TIFICATION FOR THE P ATIENT. 10 (g) A dispensary licensed under this section or a dispensary agent registered 11 under § 13–3308 of this subtitle may not be penalized or arrested under State law for 12 acquiring, possessing, transferring, transporting, selling, distributing, or dispensing 13 medical cannabis, products containing medical cannabis, related supplies, or educational 14 materials for use by [a]: 15 (1) A qualifying patient[, a]; 16 (2) A caregiver[, or an]; 17 (3) AN academic research representative purchasing medical cannabis 18 under § 13–3304.1 of this subtitle; OR 19 (4) A VISITING QUALIFYING PATIENT. 20 (l) (1) Each dispensary licensed under this section shall submit to the 21 Commission a quarterly report. 22 (2) The quarterly report shall include: 23 (i) The number of patients served; 24 (ii) The county of residence of each patient served; 25 (III) THE NUMBER OF VISITIN G QUALIFYING PATIENT S SERVED; 26 (IV) THE STATE OF RESIDENC E OF EACH VISITING QUALIFYING 27 PATIENT SERVED ; 28 HOUSE BILL 1172 7 [(iii)] (V) The medical condition for which medical cannabis was 1 recommended; 2 [(iv)] (VI) The type and amount of medical cannabis dispensed; and 3 [(v)] (VII) If available, a summary of clinical outcomes, including 4 adverse events and any cases of suspected diversion. 5 (3) The quarterly report may not include any personal information that 6 identifies a patient. 7 13–3313. 8 (a) Any of the following persons acting in accordance with the provisions of this 9 subtitle may not be subject to arrest, prosecution, revocation of mandatory supervision, 10 parole, or probation, or any civil or administrative penalty, including a civil penalty or 11 disciplinary action by a professional licensing board, or be denied any right or privilege, for 12 the medical use of or possession of medical cannabis: 13 (1) A qualifying patient: 14 (i) In possession of an amount of medical cannabis determined by 15 the Commission to constitute a 30–day supply; or 16 (ii) In possession of an amount of medical cannabis that is greater 17 than a 30–day supply if the qualifying patient’s certifying provider stated in the written 18 certification that a 30–day supply would be inadequate to meet the medical needs of the 19 qualifying patient; 20 (2) A grower licensed under § 13–3306 of this subtitle or a grower agent 21 registered under § 13–3306 of this subtitle; 22 (3) A certifying provider; 23 (4) A caregiver; 24 (5) An academic research representative purchasing medical cannabis 25 under § 13–3304.1 of this subtitle; 26 (6) A dispensary licensed under § 13–3307 of this subtitle or a dispensary 27 agent registered under § 13–3308 of this subtitle; 28 (7) A processor licensed under § 13–3309 of this subtitle or a processor 29 agent registered under § 13–3310 of this subtitle; 30 (8) A hospital, medical facility, or hospice program where a qualifying 31 patient is receiving treatment; 32 8 HOUSE BILL 1172 (9) A third–party vendor authorized by the Commission to test, transport, 1 or dispose of medical cannabis, medical cannabis products, or medical cannabis waste 2 under the provisions of this subtitle; [or] 3 (10) Designated school personnel authorized to administer medical cannabis 4 to a student in accordance with the guidelines established under § 7–446 of the Education 5 Article unless the act or omission constitutes gross negligence or wanton or willful 6 misconduct; OR 7 (11) A VISITING QUALIFYING PATIENT. 8 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 9 October 1, 2023. 10