Physician Requirements

 What is a qualified physician?

 

  • An active, unrestricted license under 458 or 459
  • Complies with education requirements of 381.986(3)

 

 How to become a qualified physician:

 

  • Have an active and unrestricted license as a medical doctor or osteopathic physician in Florida.
  • Take the 2-hour course and examination offered by the Florida Medical Association or Florida Osteopathic Medical Association, depending on your license type.
    • If a physician took the previously offered course, they must take the 2-hour course on or before December 26, 2017, in order to remain a qualified physician.
  • You must re-take this course each time you renew your license if you wish to remain a physician qualified to order medical marijuana and low-THC cannabis.
  • Physicians ineligible to be qualified physicians
    • Physicians holding a restricted license
    • Physicians that are employed by an MMTC or Marijuana Testing Laboratory, including physicians that are a medical director for those companies
    • Physicians that have a direct economic interest in an MMTC or Marijuana Testing Laboratory
    • Physicians that have any indirect economic interest in an MMTC or Marijuana Testing Laboratory
  • The Office of Medical Marijuana Use will publish a list of all physicians meeting these qualifications on its website as required under 381.986(10)(e). This list is published regardless of whether the physician has a profile in the Medical Marijuana Use Registry or has placed, or intends to place, any orders.

 

 What is a physician certification?

 

  • A qualified physician’s authorization for a qualified patient to receive medical marijuana and a medical marijuana delivery device from an approved MMTC.

 

 How to know if a patient is qualified:

 

  • They are a resident of Florida
  • They are a seasonal resident of Florida (residing in Florida for at least 31 consecutive days each year, maintains a temporary residence in Florida, returns to the state in which they reside at least once per year, and is registered to vote or pays income tax in another state or jurisdiction)
  • The physician diagnoses the patient with a qualifying medical condition:
    • Cancer
    • Epilepsy
    • Glaucoma
    • Positive status for human immunodeficiency virus
    • Acquired immune deficiency syndrome
    • Post-traumatic stress disorder
    • Amyotrophic lateral sclerosis
    • Crohn’s disease
    • Parkinson’s disease
    • Multiple sclerosis
    • Medical conditions of the same kind or class as or comparable to those listed above
    • A terminal condition diagnosed by a qualifying physician and confirmed by a second physician
    • Chronic nonmalignant pain – pain caused by a qualifying medical condition, or that originates from a qualifying medical condition above and persists beyond the usual course of that qualifying medical condition.

 

 Prerequisites to physician certification:

 

  • Physical examination while present in the same room as the patient
  • Full assessment of patient’s medical history
  • Diagnose patient with a qualifying condition
  • Determine the medical use of marijuana likely outweighs health risks and document that in the record.
  • For patients under 18 years of age, have a second physician agree in writing that medical use of marijuana likely outweighs the health risks for that minor patient.
  • Determine if the patient is pregnant. If the patient is pregnant, it must be documented in that patient’s medical record and only low-THC cannabis certification can be given to that patient during the pregnancy.
  • Review the patient’s history in the PDMP database
  • Confirm the patient does not already have an active certification from another physician in the Medical Marijuana Use Registry.
  • Physician must register as the physician issuing the certification to that qualified patient in the registry.
  • Obtain voluntary and informed written consent each time a physician certification is provided to the patient and keep that with the patient’s medical record. The approved informed consent form containing all legal requirements is available from the Board of Medicine and Board of Osteopathic Medicine.

 

 How to issue physician certification:

 

  • After the physician registers as the patient's certifying physician in the registry, the physician can enter the contents of the certification into the registry for that qualified patient.
  • The contents include:
    • the qualifying condition of the patient
    • dosage of medical marijuana not to exceed the daily dose amount determined by Department rule
    • the amount of medical marijuana or low-THC cannabis authorized for the qualified patient
    • the form of medical marijuana or low-THC cannabis authorized for the qualified patient
    • the medical marijuana delivery devices the patient needs for the medical use of the physician’s certification
  • The physician can place no more than 3 orders for a maximum of 70-days per order as part of a physician certification for the qualified patient. Thereafter, the physician must issue a new certification, complying with all of the initial certification requirements and additional requirements required by 381.986(4)(d).

 

 What physicians must do after issuing the first physician certification:

 

  • If the physician wishes to make a change to the original certification for the patient, they must update the registry within 7 days of making that change.
  • For subsequent certifications for the qualified patient which must occur at least once every 30 weeks:
    • Conduct an in person physical exam while in the same room as the qualified patient
    • Determine if the patient still meets all the requirements to be issued a physician certification as the physician determined at the time of the first certification.
    • Identify and document in the medical record for the patient whether the patient experienced an adverse drug interaction with any prescription or nonprescription medication with medical marijuana.
    • Identify and document in the medical record for the patient whether the patient experienced a reduction in use of, or dependence on, other types of controlled substances.
    • Submit a report to the Department including the information obtained from the patient regarding adverse reactions or reduction in use or dependence on controlled substances as a result of the patient’s medical use of marijuana.
  • If the physician no longer recommends the medical use of marijuana for the patient, they must deactivate that patient’s registration and the registration of any caregiver for the patient.
  • Submit to the Board within 14 days after issuing the certification for the qualified patient documentation required under 381.986(4)(b). The Board of Medicine and the Board of Osteopathic Medicine have created a form that is available for qualified physicians to use and submit to the Boards containing all of the required documentation.

 

 Penalties for physicians operating outside of the requirements of 381.986:

 

  • A qualified physician who issues a physician certification for marijuana or a marijuana delivery device and receives compensation from a medical marijuana treatment center related to the issuance of a physician certification for marijuana or a marijuana delivery device is subject to disciplinary action under the applicable practice act and s. 456.072(1)(n).
  • First Degree Misdemeanor for physician to issue a certification for the medical use of marijuana for a patient without a reasonable belief that the patient is suffering from a qualifying medical condition.
  • Possession or manufacturing of a blank, forged, stolen, fictitious, fraudulent, counterfeit or unlawfully issued registry ID card is a Third Degree Felony.
  • Physicians must continue to meet the standard of care and refrain from violating provisions of Chapter 456, 458 and 459 in their practice as a qualified physician certifying patients for medical use of marijuana.
  • Physicians may also be subject to criminal penalties under Chapter 893 and other appropriate civil or administrative penalties if they violate section 381.986.