Prescribing Marijuana in Maryland

The Maryland Medical Marijuana Commission has released proposed regulations for physicians and doctors interested in prescribing marijuana in Maryland.

These are the proposed regulations for prescribing marijuana in Maryland as of February 7, 2015 and are subject to change.  These regulations have yet to be approved and any doctor interested in prescribing marijuana in Maryland should consult a Maryland lawyer or more information.

10.62.03 Certifying Physicians

Authority: Health General Article, §§13-3301, 13-3302, and 13-3307, Annotated Code of Maryland

.01 Physician Application for Approval.

  1. A physician seeking approval as a certifying physician shall submit an application provided by the Commission that includes:

(1) The physician’s:

(a) Full name;

(b) Office addresses and phone numbers;

(c) Current email address;

(d) Maryland Board of Physicians license number;

(e) Plan to screen patients for dependence on substances of abuse before and after a patient is issued a written certification; and

(f) Plan to assess patient outcomes, provide follow-up care, and to collect and analyze data;

(2) An attestation that the:

(a) Physician’s Maryland license to practice medicine is active and in good standing;

(b) Physician is authorized to prescribe controlled substances by the State; and

(c) Physician has completed a Commission-approved training course;

(3) The medical conditions for which the physician may issue written certifications for medical marijuana;

(4) The physician’s other inclusion criteria; and

(5) The reasons the physician may deny issuing a written certification of medical marijuana.

  1. The Commission encourages physicians to apply to be approved as a certifying physician to treat patients who:

(1) Have a chronic or debilitating disease or medical condition that results in the patient being admitted into hospice or receiving palliative care;

(2) Have a chronic or debilitating disease or medical condition or are receiving treatment for a chronic or debilitating disease or medical condition that causes:

(a) Cachexia;

(b) Anorexia;

(c) Wasting syndrome;

(d) Severe pain;

(e) Severe nausea;

(f) Seizures; or

(g) Severe or persistent muscle spasms;

(3) Have the following diseases and conditions:

(a) Glaucoma, if the certifying physician is a board certified ophthalmologist; or

(b) Post traumatic stress disorder (PTSD), if the certifying physician is a board certified psychiatrist.

  1. A physician may be approved as a certifying physician to treat a patient who has a condition this is:

(1) Severe;

(2) For which other medical treatments have been ineffective; and

(3) If the symptoms reasonably can be expected to be relieved by the medical use of marijuana.

  1. A certifying physician may apply to amend the approval at any time.
  2. The Commission:

(1) Shall approve an application that is complete and satisfactory; and

(2) May deny an incomplete, fraudulent or unsatisfactory application.

  1. The Commission shall notify the applicant that the application has been approved.

.02 Written Certification.

  1. A certifying physician may determine that a patient qualifies for a written certification only:

(1) With a patient whom the certifying physician has a bona fide physician-patient relationship;

(2) If the qualifying patient meets the certifying physician’s inclusion criteria;

(3) If the qualifying patient does not meet the certifying physician’s exclusion criteria;

(4) If the qualifying patient has been screened for dependence on substances of abuse, including chemical testing, if appropriate, and has been determined by the physician to be of low risk for addiction, dependence, or diversion; and

(5) If the certifying physician has determined that the potential benefits of the medical use of marijuana likely outweigh the health risks for the patient.

  1. The certifying physician shall:

(1) Transmit the written certification to the Commission in the manner determined by the Commission; and

(2) Provide a copy of the written certification to the qualifying patient.

  1. A written certification shall include the:

(1) Physician’s name, Maryland Board of Physicians license number, and office telephone number;

(2) Qualifying patient’s name, date of birth, address, and county of residence;

(3) Medical condition requiring medical marijuana; and

(4) The date of qualification as a qualifying patient.

  1. A certifying physician may discuss the use of medical marijuana with a qualifying patient.
  2. A certifying physician shall terminate a written certification if:

(1) The qualifying patient meets the physician’s exclusion criteria;

(2) Treatment with medical marijuana is no longer necessary for the qualifying patient;

(3) Adverse effects of medical marijuana outweigh the benefits to the qualifying patient’s health; or

(4) There is evidence that the qualifying patient engaged in diversion of medical marijuana.

  1. A certifying physician may terminate a written certification if the qualifying patient demonstrates abuse of any substance of abuse.
  2. A certifying physician shall notify the Commission within 1 business day of the termination of a written certification.
  3. A qualifying patient shall have only one certifying physician at any time.

.03 Written Certification Renewal.

  1. A qualifying patient may seek renewal of their written certification no less than 30 calendar days after it was issued by notifying their certifying physician.
  2. A certifying physician may renew the written certification for a qualifying patient if the certifying physician determines the patient still meets the criteria set forth in Regulation .02A of this chapter.
  3. Upon renewing a written certification for a qualifying patient, a certifying physician shall notify the Commission in the manner the Commission determines.
  4. A certifying physician may not renew a written certification unless the physician has made a full, in-person assessment of the qualifying patient within the 365 days before the reissuance.


.04 Compensation from a Licensed Grower or Licensed Dispensary.

  1. A certifying physician may not receive compensation, including promotion, recommendation, advertising, subsidized rent, or anything of value, from a licensed grower or a licensed dispensary unless the certifying physician submits an application to the Commission for the approval for the compensation.
  2. The application shall disclose the specific type of compensation and specific amount or value of compensation, and the services for which the compensation will be paid.
  3. The Commission shall deny an application for compensation if the compensation is based on any agreement or arrangement for the certifying physician to refer, direct or recommend qualifying patients to the licensed grower or licensed dispensary to obtain medical marijuana.
  4. The Commission may deny an application for compensation if the compensation agreement may create an appearance that the compensation compromises the independent judgment of the certifying physician in the treatment of a patient.
  5. A certifying physician may not serve as the clinical director of a licensed dispensary.
  6. The Commission shall publish the approved compensation on the Commission’s website.

.05 Annual Report.

  1. A certifying physician shall submit an annual report to the Commission in the manner and at the time determined by the Commission.
  2. The annual report shall include:

(1) The number of qualifying patients issued written certification by the certifying physician categorized by gender and by county of residence or Baltimore City;

(2) The medical conditions for which certification was issued;

(3) A summary of the clinical outcomes of the qualifying patients’ use of medical marijuana by age, gender and other relevant criteria as specified by the Commission;

(4) A summary of any adverse effects in the use of medical marijuana experienced by any qualifying patient of the certifying physician; and

(5) A summary of steps taken in response to instances of suspected diversion of medical marijuana.

  1. The annual report may not include any personally identifiable information related to any qualifying patient.

.06 Renewal of Certifying Physician Approval to Certify.

  1. An approval is valid for 2 years.
  2. A certifying physician shall apply to renew an approval to certify at the time of renewal of the physician’s license to practice medicine by the Maryland Board of Physicians.
  3. The Commission shall provide a certifying physician with notice of renewal 90 business days before expiration of the approval.
  4. The Commission shall grant approval of the application for renewal if:

(1) The certifying physician attests that:

(a) The certifying physician’s license to practice medicine in Maryland is active and in good standing; and

(b) The certifying physician’s registration by the State to prescribe controlled dangerous substances is valid;

(2) The certifying physician has submitted annual reports when and in the manner determined by the Commission; and

(3) The certifying physician documents that, within the 2 years before applying to renew an approval to certify, the physician has completed a course approved by the commission of at least 2 hours in the science or use of marijuana in medical practice; and

(4) The certifying physician has otherwise complied with this chapter.

  1. If a certifying physician fails to obtain a renewal of an approval to issue written certifications, the certifying physician may not issue written certifications.

.07 Action Against a Physician.

  1. The Commission may deny a certifying physician’s application for approval to certify if the physician:

(1) Fraudulently applied for approval;

(2) Fraudulently issued a written certification; or

(3) Failed to comply with this chapter.

  1. The Commission shall report to the Maryland Board of Physicians any instance of fraud or conduct that threatens public health by a certifying physician.

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