This post originally appeared on Crain’s Cleveland Business on July 13, 2018.
The Ohio Medical Marijuana Control Program is slated to be fully operational this September. From a legal perspective, we recommend that all Ohio physicians and other health care providers take steps to understand the impact upon their practices now.
By way of background, under Ohio law, a patient may only legally purchase medical marijuana if that patient has received a recommendation for medical marijuana from a physician who has obtained a Certificate to Recommend from the State Medical Board of Ohio and the physician has registered with the State of Ohio Board of Pharmacy.
Physicians do not write prescriptions for medical marijuana, but instead provide the patient with a recommendation for medical marijuana. With this recommendation, patients will be able to purchase marijuana legally from State approved dispensaries. Hospitals and other health care providers are not authorized to dispense medical marijuana, but they may treat patients who are regularly using medical marijuana.
All Ohio physicians and health care providers will likely be impacted in some way by the Ohio medical marijuana laws, whether they like it or not. Physicians who elect not to obtain a Certificate to Recommend medical marijuana may have patients who use medical marijuana; and it is also likely that they will have patients with questions about medical marijuana and the potential implications of using it. Physicians who have not obtained a Certificate to Recommend may need to discuss medical marijuana with their patients, and if appropriate, make referrals to a physician who has a Certificate to Recommend. Ohio physicians and other health care providers will need to have a base level of knowledge regarding medical marijuana in order to obtain sufficient informed consent and comply with the standard of care.
For starters, here are three things that all Ohio physicians should understand about medical marijuana in Ohio:
- All physicians should understand how the Ohio Medical Marijuana Control Program works from the patient perspective. As stated above, in order to lawfully use medical marijuana in Ohio, a patient must obtain a written recommendation from a physician with a Certificate to Recommend and then the physician recommending the marijuana registers the patient (and any caregiver) with the Pharmacy Board.
The recommendation must show a diagnosis of one of the qualifying conditions and evidence the physician-patient relationship. Patients will be required to obtain medical marijuana from Ohio licensed dispensaries; physicians are prohibited from possessing medical marijuana in the course of their practices. Patients may only use medical marijuana in the forms and by the methods permitted under Ohio law. Physicians should also understand that use of medical marijuana can have an adverse impact upon patients as employees, tenants, non-citizens with immigration status, drivers and otherwise.
- The Medical Board imposes specific and detailed requirements upon physicians who recommend medical marijuana pursuant to a Certificate to Recommend. Failure to comply with such requirements can result in a failure to satisfy the applicable standard of care, professional disciplinary action, professional liability exposure and an increased risk of criminal prosecution.
Because of the importance of strict compliance in this area, we urge physicians who recommend medical marijuana to review the actual Medical Board rules and not to rely solely upon a secondary source or broad summary of the requirements alone. In order to obtain a Certificate to Recommend, physicians must complete at least two hours of CME in certain Ohio State Medical Association or Ohio Osteopathic Association approved courses. The CME courses may be helpful even for those physicians who do not obtain a Certificate to Recommend when they encounter patients who use medical marijuana or have questions about such use.
- Physicians and other health care providers should adopt compliance policies and procedures to address medical marijuana. Physicians who recommend medical marijuana pursuant to a Certificate to Recommend should update their compliance policies and procedures to reflect the Medical Board documentation and other requirements that must be satisfied in connection with such activity.
Even practices that do not obtain Certificates to Recommend and other health care providers should bolster their patient intake forms, employee handbooks, employment agreements and other documents to address how they are going to obtain information regarding their patient’s marijuana usage, whether their employees will be able to use and/or validly recommended medical marijuana and, if so, under what circumstances.