Yes. A federal appellate court, in a ruling left standing by the Supreme Court in 2002, enjoined the federal government from either revoking a provider's license to prescribe controlled substances or conducting an investigation of a physician that might lead to such revocation, where the basis for the government's action is solely the physician's professional recommendations of the use of medical marijuana. - Conant v. Walters, 309 F. 3d 629, 633-634 (9 Cir. 2002), cert. denied, 540 U.S. 946 (2003).
As per federal constitutional law, doctor-patient consultations are absolutely protected from federal or state interference or punishment as a matter of the fundamental right to free speech. A provider's professional obligations to prospective medical cannabis patients are not different from those for any other patient. A provider is not required to qualify a patient for medical cannabis. The provider is expected to assess a patient’s medical history and medical condition, and recommend treatment that they think is appropriate. Providers must register on the Commission’s website in order to provide patient certifications. Registration must be renewed every two years.
During registration, you will need to provide your Maryland Board license number, your CDS number, specify the conditions or diseases that you plan to treat, and any criteria for including or excluding patients.
You and the patient must have a “bona fide provider-patient relationship.” The patient’s condition must be severe, other medical treatments have been ineffective, and the symptoms reasonably can be expected to be relieved by the medical use of cannabis. Maryland law defines this term. Essentially it is a treatment or counseling relationship between a provider and patient in which the provider reviews the patient’s relevant medical records, completes an in person assessment of the patient’s medical history and current medical condition, creates and maintains medically standardized records, expects to monitor patient program and takes any medically indicated action to follow up. Yes, if the patient has a chronic or debilitating disease or medical condition that results in being admitted into hospice or receiving palliative care.
If the patient has a chronic or debilitating disease or medical condition that causes: cachexia, anorexia, wasting syndrome, severe or chronic pain, severe nausea, seizures, severe or persistent muscle spasms, glaucoma, post-traumatic stress disorder (PTSD), or another chronic medical condition which is severe and for which other treatments have been ineffective. Once you determine that your patient’s treatment, disease, or medical condition qualifies him or her for medical cannabis, you or your staff will go to the Commission website to issue your patient a “written certification.” Patient name, address, date of birth, physician’s name, the date of patient qualification, and medical condition(s). A provider should direct a patient to follow-up as often as medically appropriate.
At minimum, the provider must perform an in-person, evaluation once every 365 days. Yes, a provider may amend or revoke a certification on any medical grounds or if the patient no longer meets the physician’s inclusion criteria or the patient now meets the provider’s exclusion criteria.
Two examples of exclusion criteria are that the provider suspects that the patient is abusing cannabis or the patient is diverting cannabis to others.
Yes, the MMCC database system links the provider and patient registries through the written certifications. Each patient may only have one written certification and one certifying provider at a time. A certifying provider may terminate a written certification. A provider must be registered as a certifying provider before providing a qualifying patient with a written certification. The process for a provider registering with MMCC as a certifying provider can be accomplished in a matter of minutes. Yes, the patient must submit an application to MMCC in order to register before a physician can provide a written certification for the patient. One obvious reason that the provider may deny issuing a written certification is that the condition with which the patient presents is outside the field of practice and specialty of the provider. A reason that a provider may specify as an exclusion criterion, and terminate a written certification is that the provider has, in the course of education and research, determined that medical cannabis is not an appropriate for the patient.
A provider is free to define their exclusion criteria as narrowly or broadly as they deem appropriate for their practice. No, a Maryland Board cannot take any such action and is prohibited by law from doing so as long as the provider is practicing with the parameters outlined under the State's Medical Cannabis Program.
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