Following a special session, the Florida Legislature on June 9, 2017 passed two important bills regarding medical marijuana in the Sunshine State: SB 8A and SB 6A. Together, these bills implement Article X, section 29 of the Florida Constitution, which was added after voters approved Amendment 2, expanding the medical use of marijuana for qualifying patients. Florida Governor Rick Scott is expected to sign both bills into law. The new laws would become effective immediately upon signature.
Among the more than 80 pages of legislation, there is one small sentence with big implications for telemedicine and virtual care providers. Under the new law, the physician issuing a medical marijuana certification must be physically present in the same room as the patient when conducting the certification examination – meaning physicians may not issue a certification for medical marijuana via a telemedicine exam. For the foreseeable future, Florida residents seeking medical marijuana prescriptions will be limited to in-person examinations.
The statutory language is as follows:
(4) PHYSICIAN CERTIFICATION.—
(a) A qualified physician may issue a physician certification only if the qualified physician:
1. Conducted a physical examination while physically present in the same room as the patient and a full assessment of the medical history of the patient.
Since last year, the Florida Board of Medicine has been considering prohibiting physicians from ordering medical marijuana via telemedicine. In December 2016, the Board issued a proposed amendment to its telemedicine regulations to clarify that physicians may not order medical cannabis or low-THC cannabis via telemedicine. The Board subsequently held public hearings on the issue, with a third hearing scheduled for August 4, 2017. It is unclear how the Board will proceed on its proposed regulation, as the new statute also charges the Department of Health, the Board of Medicine, and the Board of Osteopathic Medicine to adopt rules underneath the law.
Some states, like California, do not prohibit telemedicine-based examinations for medical marijuana, while others, like Colorado, require an in-person examination prior to recommending medical marijuana. Even in states that allow telemedicine-based examinations for medical marijuana, providers should keep in mind that the examination for the condition for which medical marijuana is being recommended must be an appropriate prior examination and meet the standard of care.
It is also important to note federal law still criminalizes the possession, use, and sale of marijuana. The new Florida law does not immunize violations of such federal law or any non-medical use, possession, or production of marijuana. We will continue to monitor changes to Florida regulations on this issue.