The State Medical Board of Ohio announced new rules related to the process for a physician to obtain a certificate to recommend medical marijuana to patients. These rules were adopted in accordance with Ohio’s medical marijuana law that was enacted in 2016, and they take effect Sept. 8, 2017.

The medical marijuana law passed last year allows Ohio physicians to recommend medical marijuana to patients who suffer from one of the enumerated qualifying medical conditions. These conditions include, among others, AIDS/HIV, cancer, Crohn’s disease, fibromyalgia, glaucoma, multiple sclerosis, chronic pain, Parkinson’s disease, sickle cell anemia, spinal cord injury and traumatic brain injury. Before a physician recommends medical marijuana, the physician will have to obtain a certificate as set forth in the new rules released by the Medical Board.

The new rules mandate that a physician meet the following requirements in order to obtain a certificate to recommend marijuana:

• Hold an unrestricted active medical license in Ohio.
• Have OARRS database access.
• Have an active DEA registration.
• Never have been denied a license to prescribe, possess, dispense, administer, supply or sell a controlled substance by the DEA due to the physician’s inappropriate prescribing, furnishing, dispensing, administering, supplying or selling a controlled substance, or never have had a DEA or state prescribing license restricted for the same.
• Never have been subject to disciplinary action by any licensing entity based on the physician’s prescribing, furnishing, dispensing, diverting, administering, supplying or selling a controlled substance or other dangerous drug.
• Have completed at least two hours of continuing medical education in courses that assist in the diagnosing of a qualifying medical condition for medical marijuana and treating such a qualifying condition with medical marijuana.
• Have no ownership or investment interest in or compensation agreement with a medical marijuana entity licensed or seeking licensure in Ohio.

When reviewing a physician’s application for a certificate to recommend medical marijuana, the Medical Board has broad power to request information it deems necessary from individuals, agencies or organizations for information about the physician. In addition, the Medical Board can require the applicant or a representative to appear before the board in order to provide additional information and answer questions. If the Medical Board denies the issuance of the certificate, the physician will be entitled to a hearing on such denial under the current rules. 

Once the Medical Board has issued a physician a certificate to recommend medical marijuana, the certificate will be renewed when the holder’s license to practice medicine is renewed, so long as the physician continues to meet the aforementioned requirements and has completed at least two hours of approved medical marijuana continuing medical education annually.

The rules also set forth a new standard of care for physicians to follow when recommending medical marijuana. In order to meet this minimum standard of care, the physician must:

• Establish and maintain a bona fide physician-patient relationship established by an in-person visit, and have an expectation of providing care to the patient on an ongoing basis.
• Maintain a medical record for the patient that documents the provision of medical services, including:
  • Patient’s name and dates of office visits.
  • Description of current medical condition.
  • Medical history, prescriptive history and substance use disorder history.
  • Review of diagnostic test results, prior treatment and current medications.
  • A drug screen at the physician’s discretion if there is evidence of drug abuse.
  • Physician’s performance of a physician exam and diagnosis of the patient’s medical condition.
  • Diagnosis or confirmation of prior diagnosis of a qualifying medical condition for medical marijuana.
• When recommending medical marijuana treatment, document in the medical record:
  • A treatment plan.
  • A review of the OARRS report covering at least the preceding 12 months.
  • A discussion with the patient regarding possible abuse or drug diversion of any drugs listed in the OARRS report.
  • An explanation of the risks and benefits of medical marijuana treatment.
  • The patient’s consent (or consent of a legal representative).
  • Whether the patient needs a caregiver to assist in the administration of medical marijuana.
• Confirm that the patient has an active registration for medical marijuana with the Board of Pharmacy registry.
• Be available to provide follow-up care relevant to determine the efficacy of the medical marijuana.
• Retain records for the medical marijuana recommendation for at least three years.

Lastly, the new rules encourage ongoing medical marijuana related dialogue between physicians and the Medical Board. Physicians are required to submit an annual report to the Medical Board describing their observations regarding the effectiveness of medical marijuana in treatment of their patients. In addition, physicians can make a request to the Medical Board that a condition or disease be designated as a qualifying medical condition for medical marijuana. No later than Oct. 15 of each year, the Medical Board will designate a period in the following calendar year in which physicians may make such requests that must include information specified by the Medical Board, such as relevant medical and scientific evidence, information from experts, journals and peer review studies. The Medical Board will have 180 days after the annual submission period closes to issue a decision of the acceptance of any new qualifying medical conditions. 

See: Ohio Administrative Code §§4331-32-01 – 4731-32-05