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           HB 333                                                                                                2022
    1                                          A bill to be entitled
    2               An act relating to physician certifications for the
    3               medical use of marijuana; amending s. 381.986, F.S.;
    4               authorizing qualified physicians to perform patient
    5               examinations and evaluations through telehealth for
    6               renewals of physician certifications for the medical
    7               use of marijuana; providing an effective date.
    8
    9      Be It Enacted by the Legislature of the State of Florida:
10
11                  Section 1.         Paragraphs (a) and (g) of subsection (4) of
12         section 381.986, Florida Statutes, are amended to read:
13                  381.986        Medical use of marijuana.—
14                  (4)         PHYSICIAN CERTIFICATION.—
15                  (a)         A qualified physician may issue a physician
16         certification only if the qualified physician:
17                  1.      Conducted an a physical examination of while physically
18         present in the same room as the patient and a full assessment of
19         the medical history of the patient. For an initial
20         certification, the examination must be a physical examination
21         conducted while physically present in the same room as the
22         patient. For a certification renewal, the examination may be
23         conducted through telehealth as defined in s. 456.47.
24                  2.      Diagnosed the patient with at least one qualifying
25         medical condition.
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26               3.      Determined that the medical use of marijuana would
27      likely outweigh the potential health risks for the patient, and
28      such determination must be documented in the patient's medical
29      record. If a patient is younger than 18 years of age, a second
30      physician must concur with this determination, and such
31      concurrence must be documented in the patient's medical record.
32               4.      Determined whether the patient is pregnant and
33      documented such determination in the patient's medical record. A
34      physician may not issue a physician certification, except for
35      low-THC cannabis, to a patient who is pregnant.
36               5.      Reviewed the patient's controlled drug prescription
37      history in the prescription drug monitoring program database
38      established pursuant to s. 893.055.
39               6.      Reviews the medical marijuana use registry and
40      confirmed that the patient does not have an active physician
41      certification from another qualified physician.
42               7.      Registers as the issuer of the physician certification
43      for the named qualified patient on the medical marijuana use
44      registry in an electronic manner determined by the department,
45      and:
46               a.      Enters into the registry the contents of the physician
47      certification, including the patient's qualifying condition and
48      the dosage not to exceed the daily dose amount determined by the
49      department, the amount and forms of marijuana authorized for the
50      patient, and any types of marijuana delivery devices needed by
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        HB 333                                                                                                2022
51      the patient for the medical use of marijuana.
52               b.      Updates the registry within 7 days after any change is
53      made to the original physician certification to reflect such
54      change.
55               c.      Deactivates the registration of the qualified patient
56      and the patient's caregiver when the physician no longer
57      recommends the medical use of marijuana for the patient.
58               8.      Obtains the voluntary and informed written consent of
59      the patient for medical use of marijuana each time the qualified
60      physician issues a physician certification for the patient,
61      which shall be maintained in the patient's medical record. The
62      patient, or the patient's parent or legal guardian if the
63      patient is a minor, must sign the informed consent acknowledging
64      that the qualified physician has sufficiently explained its
65      content. The qualified physician must use a standardized
66      informed consent form adopted in rule by the Board of Medicine
67      and the Board of Osteopathic Medicine, which must include, at a
68      minimum, information related to:
69               a.      The Federal Government's classification of marijuana as
70      a Schedule I controlled substance.
71               b.      The approval and oversight status of marijuana by the
72      Food and Drug Administration.
73               c.      The current state of research on the efficacy of
74      marijuana to treat the qualifying conditions set forth in this
75      section.
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         HB 333                                                                                                2022
 76               d.      The potential for addiction.
 77               e.      The potential effect that marijuana may have on a
 78      patient's coordination, motor skills, and cognition, including a
 79      warning against operating heavy machinery, operating a motor
 80      vehicle, or engaging in activities that require a person to be
 81      alert or respond quickly.
 82               f.      The potential side effects of marijuana use, including
 83      the negative health risks associated with smoking marijuana.
 84               g.      The risks, benefits, and drug interactions of
 85      marijuana.
 86               h.      That the patient's de-identified health information
 87      contained in the physician certification and medical marijuana
 88      use registry may be used for research purposes.
 89               (g)         A qualified physician must evaluate an existing
 90      qualified patient at least once every 30 weeks before issuing a
 91      new physician certification. The evaluation may be conducted
 92      through telehealth as defined in s. 456.47. A physician must:
 93               1.      Determine if the patient still meets the requirements
 94      to be issued a physician certification under paragraph (a).
 95               2.      Identify and document in the qualified patient's
 96      medical records whether the qualified patient experienced either
 97      of the following related to the medical use of marijuana:
 98               a.      An adverse drug interaction with any prescription or
 99      nonprescription medication; or
100               b.      A reduction in the use of, or dependence on, other
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         HB 333                                                                                                2022
101      types of controlled substances as defined in s. 893.02.
102               3.      Submit a report with the findings required pursuant to
103      subparagraph 2. to the department. The department shall submit
104      such reports to the Consortium for Medical Marijuana Clinical
105      Outcomes Research established pursuant to s. 1004.4351.
106               Section 2.        This act shall take effect July 1, 2022.
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