What Doctors Should Know About Recommending Marijuana in New York
Posted by Marijuana Doctors on 06/08/2018 in Doctor Resources
Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
Currently, medical marijuana is legal in 29 U.S. states. New York joined the crusade in July 2014, when Gov. Andrew M. Cuomo and the New York State Legislature passed the Compassionate Care Act. The law aims to regulate the “manufacture, sale and use of medical marijuana.” The act also strives to strike a balance between helping residents relieve symptoms of severe conditions and protecting the public.
As of May 2018, there are 1,644 registered medical marijuana practitioners and 56,204 certified patients in the state of New York. With so many patients in need of treatment, there is a high demand for registered physicians in the state. In fact, according to survey results released by the Drug Policy Alliance, more than half of patients and caregivers have not been able to find a physician to certify them in the state of New York.
If you are interested in joining the growing community of registered physicians and helping fill a need, let this be your doctor’s guide to medical marijuana in NY. We’ll show how to recommend medical marijuana in NY and how to help your patients get certified.
What Is Medical Cannabis?
Medical cannabis uses the chemicals in the marijuana plant to treat illness or disease. Medical marijuana can help relieve the symptoms of a wide range of conditions, from Alzheimer’s disease to glaucoma. Patients also often use it to help themselves cope with symptoms associated with life-threatening illnesses. The active chemicals in medical marijuana, cannabinoids, have been shown to reduce anxiety, relax muscles, improve appetite and even kill cancer cells.
Not anyone can grow marijuana for medical purposes under state law. According to New York regulations, approved marijuana must represent a specific brand with a defined cannabinoid content, and registered manufacturers must adhere to strict guidelines. Physicians do not dispense medical marijuana. A registered physician is only responsible for recommending a specific dosage and form and certifying patients.
Registered manufacturers shall only manufacture medical marijuana products that have been approved by the New York commissioner of health. The following forms are currently approved:
- Chewable tablets
- Effervescent tablets
- Topical forms
- Transdermal patches
New York law prohibits smoking marijuana, as smoking the plant carries known health risks.
Certifying a Patient Into the Medical Cannabis Program in New York
Physicians must only certify patients who meet the right criteria as established by law. Any patients with severe or life-threatening conditions might qualify for the medical marijuana program. Qualifying conditions include:
- HIV or AIDS
- Parkinson’s disease
- Multiple Sclerosis
- Inflammatory bowel disease
- Post-traumatic stress disorder
- Huntington’s disease
- Severe or debilitating chronic pain
- Amyotrophic lateral sclerosis
Patients must also have one of the following related conditions:
- Wasting syndrome
- Debilitating chronic pain
- Severe nausea
- Severe or persistent muscle spasms
New York’s Medical Cannabis Program and Legal Risks
Before you consider recommending marijuana in New York, read the following summarized points taken from the bill for the Compassionate Care Act:
- The New York State Department of Health (NYSDOH) oversees the implementation of medical cannabis rules and regulations.
- The governor has the final say when it comes to protecting public safety and health, and he or she has the power to discontinue the program.
- The commissioner of health may add additional conditions to the list of qualifying conditions.
- Patients must be certified by a practitioner to obtain medical marijuana.
- A practitioner needs to be trained, registered with the NYSDOH and licensed by the state to treat serious conditions to certify patients.
- The patient is required to remain under the prescribing physician’s continuing care.
- The practitioner must consider the appropriate form and dosage of medical marijuana for their patients.
- Patients must keep marijuana in its original packaging.
- Patients and caregivers must separately apply with the NYSDOH for a registry identification card.
- The registry identification card expires one year after the date of certification.
- Patients must carry their card when in possession of medical marijuana.
- Only NYSDOH-registered organizations can manufacture, sell, deliver, transport, distribute or dispense medical marijuana.
If you are concerned about the legal risks of recommending medical marijuana treatment and certifying patients, consider the following practitioner prohibitions. As you will see, there are rules to follow, but the risks are not as abundant as one might think. As a registered practitioner, you may not:
- Directly or indirectly solicit, receive or accept any item of value from a registered organization.
- Offer a discount or other item of value to a certified patient due to a patient’s agreement to use a particular practitioner, brand, registered organization or form of approved medical cannabis product.
- Examine a qualifying patient for purposes of diagnosing a severe medical condition at any location owned or operated by a registered organization.
- Directly or indirectly benefit from a patient obtaining a written certification, not including charging an appropriate fee for a patient’s visit.
- Have a co-worker, spouse or a family member who has a direct or indirect financial interest in a registered organization that might benefit from a certified patient’s or caregiver’s medical marijuana purchase.
- Issue a certification for yourself, family members, employees or co-workers.
- Receive or provide product samples containing marijuana.
- Be a designated caregiver for any patients you have certified.
As a registered physician, you will also have certain reporting requirements, which include reporting:
- The death of a certified patient or change in their condition which may affect their eligibility within five days of learning of these facts.
- Re-issuing a patient’s certification to terminate the certification on an earlier date.
- A patient’s adverse events.
Other provisions to be aware of include:
- Health insurers are not required to cover medical marijuana.
- The commissioner of health has the authority to set the price and issue any necessary regulations.
- To avoid a class E felony, practitioners must not issue a certification to patients who do not need one.
According to survey results published by the Drug Policy Alliance, 29 percent of patients stated their doctors named legal concerns about certifying patients for medical marijuana. In reality, the legal risks are minimal for doctors regarding medical marijuana, because they only certify patients. As long as you follow the few rules of being a registered medical marijuana doctor, there should not be legal issues to worry about.
How Can a Physician in New York Participate in the Medical Marijuana Program?
To participate in New York’s medical marijuana program, you only need to complete a few steps. Here’s what it takes to be a registered medical marijuana physician in the state of New York:
- You must be qualified to treat patients with one or more serious conditions.
- You must be licensed and in good standing as a physician in the state.
- You must have completed a four-hour course approved by the commissioner of health.
- You must be registered with the NYSDOH.
You can fulfill the requirements to become registered in the following three easy steps.
- Educate: Complete an approved online course and submit completed course certificate to the NYSDOH.
- Register online: Register using the online Health Commerce System.
- Certify: After completing registration, certify patients with qualifying conditions.
The approved four-hour course must provide the following content:
- Cannabis pharmacology
- Side effects
- Overdose prevention
- Drug interactions
- Methods of administration
- Adverse reactions
Where can you take the approved online course? The NYSDOH has approved the following two education providers:
- TheAnswerPage: This online course, which costs $249, provides continuing education credits upon successful completion.
- The Medical Cannabis Institute: This online course, developed by the Society of Cannabis Clinicians, costs $229 to take and does not provide continuing education credits at this time.
How Does an NY Physician Issue Medical Marijuana Certificates to Patients?
Once you have completed the registration process, you will be able to issue certificates. Certification involves:
- Diagnose your patient with a qualifying medical condition.
- Consult the Prescription Monitoring Program (PMP) registry to review your patient’s controlled substance history and determine if they are a good candidate for the medical marijuana program.
- Submit an online form to certify your patient.
You can access the PMP registry through the Health Commerce System (HCS). Within the HCS, you will fill in patient information and submit the form to certify the patient. You will need to submit the following information:
- Your name, business address, telephone number and email address
- Your license number, as issued by the New York State Department of Education
- Your Drug Enforcement Administration (DEA) number
- A statement that you are on good terms and licensed in New York, and have an active registration with the DEA
- A statement that you are registered with the NYSDOH to issue a certification
You will need to fill in the following patient information:
- Name, date of birth, address, telephone number and email address
- A statement that you are qualified to treat the patient’s condition
- A statement that, in your professional opinion, the patient will benefit from medical marijuana treatment
- Any recommendations you make to the patient and caregivers regarding the authorized brand and use of the approved medical marijuana
- The total amount of approved medical marijuana product that may be dispensed to the patient, which does not exceed a 30-day supply
- A statement that you have explained the potential risks and benefits of the treatment, and have recorded the explanation in the patient’s medical records
- A statement that the patient or patient’s guardian has provided informed consent
- A valid form of identification such as a New York driver’s license or non-driver ID.
For patients who are temporary residents of New York, you shall state:
- Expiration of the certification
- The date which the certification will expire, which should be no longer than one year after the date of issuance, unless the patient is terminally ill.
For a patient who is not a resident of New York but receiving care and treatment in the state, the certificate should be valid for a period no longer than the patient expects to be receiving treatment in New York, and should not be valid for more than one year.
Once the form is complete, you will click the submit button and print one copy to give to your patient and another to keep in your practice for five years. Date and include a handwritten signature on the printed certification.
How Can Your Patient or Patient’s Caregiver Get Medical Marijuana?
Once you certify a patient, they must obtain a registry identification card by completing an NYSDOH application. During the application process, they will need to designate up to two caregivers to possess and monitor medical marijuana on their behalf. Designated caregivers must also apply separately and register with the NYSDOH to obtain a registry identification card.
To become a designated caregiver, a person must complete the following steps:
- Successfully apply and receive a designated caregiver registry identification card
- Pay the nonrefundable application fee of $50 unless financial hardship is determined
- Prove they are a resident with a valid driver’s license or non-driver identification card
Within 30 days of receipt, the NYSDOH shall approve, deny or determine the application is incomplete. They will notify the caregiver in writing, by email or phone if the application is inaccurate or incomplete, and explain what documents are necessary to continue. Once they have completed their application, the caregiver will receive a registry identification card.
If the NYSDOH requests more information, the applicant will have 30 days to submit required documents. Otherwise, the department will deny their application. Likewise, the NYSDOH may deny registry if the applicant is already a designated caregiver for five currently certified patients or fails to provide accurate information.
Medical Marijuana Identification Cards
Once certified patients and designated caregivers have obtained their registry identification cards, they may visit one of the registered dispensaries in the state to buy approved products. Each registered organization can have up to four dispensing clinics. Below is a list of registered dispensaries in New York:
- Columbia Care NY, LLC
- Etain, LLC
- MedMen, Inc.
- PharmaCann, LLC
- Vireo Health of New York, LLC
- NYCANNA, LLC, DBA Terradiol New York
- Fiorello Pharmaceuticals, Inc.
- Valley Agriceuticals, LLC
- Citiva Medical, LLC
- PallaTech NY, LLC, DBA Curaleaf
Primary Benefits of Acquiring an NY Marijuana Card
When a patient acquires a registry identification card, they can reap the benefits of medical marijuana treatment without legal repercussions. As long as a patient follows the rules and carries their card on them when they are in possession of medical marijuana, they can:
- Possess marijuana without risking arrest
- Save money as opposed to illegally purchasing recreational weed to ease symptoms
- Enjoy the health benefits of marijuana products which have been manufactured especially to treat medical conditions
- Safely use marijuana products under their physician’s care
- Consume marijuana products that do not require dangerous and unhealthy smoking
What a Doctor Can and Cannot Do When Issuing a Certificate in NY
As a registered physician, there are certain things you can and cannot do regarding certification. It is essential to avoid certifying patients who do not have qualifying conditions. In general, you will have the authority and responsibility to:
- Certify a patient
- Report adverse effects
- Recertify a patient
- Identify registered organizations
- Take courses solely for continuing education credits without registering with the medical marijuana program
- Recommend dose and form
As a registered physician, you cannot:
- Issue certificates to those who do not need it
- Certify yourself, co-workers or family members
- Assign multiple certifications at one time
- Dispense marijuana
- Certify patients for medical marijuana without going through the New York State registration process
Register With Us Today
Are you ready to help your patients with difficult symptoms and join the exciting frontier of medical marijuana? Are you already a registered physician? If so, do not forget to register here, with the most trusted source for doctors and patients seeking medical marijuana guidance and information.
With medical marijuana being relatively new, you want to stay informed about any changes that are made. Our site will help you stay on top of the latest news regarding medical marijuana in the state of New York. When you register as a certified physician with us, you’ll enjoy the following benefits.
- Exposure: Thousands of patients who need medical marijuana treatment will be able to find your practice.
- Easy communication: You’ll receive pre-qualified patient appointment requests delivered directly to your email inbox for convenience and security.
- Compliance: We value the security of your information and respect HIPAA regulations. Our service is payment card industry-compliant.
- Resources: Access dozens of resources to help you get started certifying patients.