Marijuana Insurance Programs Hit an Obstacle
Posted by Marijuana Doctors on 01/11/2014 in Medical Marijuana Laws
With the increasing use of medical marijuana, in both legal and non legal capacities, a lot of questions are being raised and many are starting to wonder if, or when, health plans will begin covering medical marijuana in the states where it has been legalized.
Unfortunately insurers still have a number of obstacles to overcome before they will even be in a position to consider the idea further. Firstly because marijuana remains federally illegal, and this in itself has created a significant amount of confusion in states that have ever legalized for medical or recreational purposes. Secondly the majority of health plans do not cover any medications that are not FDA approved, and before medical marijuana can be approved by the FDA it would require expensive and timely clinical studies with a focus on safety and efficacy. In addition, marijuana remains a Schedule 1 controlled substance, due to the belief that it has no accepted medical use. But until the scheduling is changed, the clinical studies will not legally be allowed to take place.The American Medical Association (AMA) doesnt necessarily agree, and are open to considering the idea of marijuana as a potentially beneficial medicine for their patients. So much so that the AMA has requested a change in marijuana’s classification, so that the necessary studies can be done to determine the facts, and definitively answer the questions surrounding efficacy and safety. But this isn’t the first time these issues have been brought before the United States Court of Appeals. In 2012, there was an attempt to change the Schedule 1 classification in the DC circuit. The appeal, although unsuccessful, started the conversation of reclassification which continues to gain momentum and seems to be going mainstream.
The next issue, is that of quality and consistency. To date, there are no standards associated with consistency in quality or strength, when it comes marijuana. This becomes a problem in both areas, of safety and efficacy, because the prescribing physician and patient dont know how much medicine is required with each dose, or the required intervals between each dose. This is an important subject that needs to be factually understood for the benefit of the patient, and continued education and medical practice of the physician.
Another factor is that medical marijuana can be costly. However, many of the medications that it would be replacing are also costly, and as some patients only require a small amount of marijuana to address their medical needs, it can lead to a potential saving of money. But, before the drug will be covered by health care, cost regulations would most likely need to be put in place. At present the cost of medical marijuana is not regulated, leaving each dispensary to charge what the market will bear.
There is also a complication in terms of the dispensing itself, in that all medications are dispensed by pharmacy’s. And when Pharmacy.com put out a questionnaire, 70% of the respondents indicated that, if given the choice, they would choose to buy their medical marijuana from a retail pharmacy. However, like medical doctors who can not actually prescribe marijuana, only recommend it, pharmacists are prohibited from dispensing marijuana. Like other state and federal laws, this would require a pharmacist licensure to change.
In order to over come these obstacles, States will need to adopt rules governing a patients ongoing relationship to a physician, by enforcing a bonafide doctor patient relationship, and requiring that physicians receive special training in the uses of marijuana. Jason Draizin, CEO of MarijuanaDoctors.Com, said that, “ For this reason we have spent the last few months preparing for the medical future of this plant in regards to federal reimbursements, and how to make them a reality. Marijuanadoctors.com coaches and trains its physicians on how to create bonafide relationships over time, where the applied cpt code is submitted through our billing platform in order to be reimbursed from health care companies, while establishing the initial relationship between patients and doctors. Based on the disease the patient is applying to the clinician and state under, we also offer the codes and time allowances which will ultimately maximize the doctors reimbursement on the basis of time and ailments, in addition to the primary and palliative care, which should also be considered for each patient as an individual case. Lastly, to stay ahead of this changing atmosphere, we instituted medical malpractice gap insurance to cover doctors ability to recommend cannabis, which has been a major dilemma for many physicians and medical recruiting firms, until now!”