935 CMR, § 501.010 - Written Certification of a Debilitating Medical Condition for a Qualifying Patient
(1) A
Certifying Healthcare Provider shall complete a program that explains the
proper use of Marijuana , including side effects, dosage, and contraindications,
including with psychotropic drugs, as well as on substance abuse recognition,
diagnosis, and treatment related to Marijuana , which includes, but is not
limited to, the following:
(a) A Certifying
Physician issuing a Written Certification shall have completed a minimum of 2.0
Category 1 continuing professional development credits as defined in
243
CMR 2.06(6)(a)1.
(b) A Certifying CNP issuing a Written
Certification shall have completed a minimum of one program meeting the
requirements of 244 CMR 5.00: Continuing Education and 244 CMR
6.00: Approval of Nursing Education Programs and the General Conduct
Thereof.
(c) A Certifying
Physician Assistant issuing a Written Certification shall have completed a
minimum of one program meeting the requirements of
263
CMR 3.05(3).
(2) A Certifying Healthcare
Provider shall issue a Written Certification that complies with generally
accepted standards of medical practice including, but not limited to, the
following:
(a) A Certifying Physician issuing
a Written Certification shall comply with generally accepted standards of
medical practice, including regulations of the Board of Registration in
Medicine at 243 CMR 1.00 through 3.00, pursuant to M.G.L. c. 112, § 5, and
M.G.L. c. 111, § 203.
(b) A
Certifying CNP issuing a Written Certification shall comply with generally
accepted standards of nursing practice, including the regulations of the Board
of Registration in Nursing at 244 CMR 9.00: Standards of
Conduct.
(c) A Certifying
Physician Assistant issuing a Written Certification shall comply with generally
accepted standards of practice for physician assistants, including regulations
of the Board of Registration of Physician Assistants at
263
CMR 5.09: Standards of Conduct for
Physician Assistants.
(3) A Certifying Healthcare Provider may not
delegate to any other healthcare professional or any other person , authority to
diagnose a patient as having a Debilitating Medical Condition .
(4) A Certifying Healthcare Provider shall
have a program to provide a discount to patients with documented Verified
Financial Hardship . The plan shall outline the goals, programs, and
measurements the Certifying Healthcare Provider will pursue as part of the
plan. A Certifying Healthcare Provider may apply for a waiver under
935
CMR 501.850 to waive this requirement by
demonstrating that the Certifying Healthcare Provider does not have control
over the costs to its patients.
(5)
A Certifying Healthcare Provider may issue a Written Certification only for a
Qualifying Patient with whom the healthcare provider has a
Bona
Fide Healthcare Provider Patient Relationship.
(6) Before issuing a Written Certification , a
Certifying Healthcare Provider shall utilize the Massachusetts Prescription
Monitoring Program, unless otherwise specified by the Commission, to review the
Qualifying Patient's prescription history.
(7) A patient who has had a diagnosis of a
Debilitating Medical Condition in the past, but does not have an active
condition, unless the symptoms related to such condition are mitigated by
Marijuana for medical use, and is not undergoing treatment for such condition,
is not suffering from a Debilitating Medical Condition for which the medical
use of Marijuana is authorized.
(8)
An initial or renewal Written Certification submitted before a Clinical Visit
is prohibited.
(a) A Clinical Visit may occur
in-person or by telehealth means, provided that a Clinical Visit for issuing an
initial Certificate of Registration must be conducted in-person or, upon
request of the patient,
via a telehealth visit that includes a
synchronous face-to-face encounter between the Certifying Healthcare provider
and patient. Synchronous telehealth happens in live, real-time settings where
the patient interacts with a provider , usually via phone or video.
(b) If a Clinical Visit is conducted by
telehealth means, the Certifying Healthcare Provider shall ensure that there is
an ability to deliver the service using telehealth with the same standard of
care and in compliance with licensure and registration requirements as is
applicable to in-person services to patients and shall comply with any
additional requirements established by the Commission.
(9) A certification shall indicate the time
period for which the certification is valid, and may not be less than 15
calendar days or longer than one year, except that in the following
circumstances, the certification may be valid for two years:
(a) A Certifying Healthcare Provider verifies
and represents to the Commission that a Qualifying Patient is receiving Social
Security Disability Insurance or Supplemental Security Income; or
(b) A Certifying Healthcare Provider
diagnoses a Qualifying Patient after an in-person Clinical Visit with a
terminal illness, or permanent disability and certifies the patient for two
years.
(10) A Certifying
Healthcare Provider may determine and certify that a Qualifying Patient
requires an amount of Marijuana other than 2.5 ounces as a 14-day Supply or ten
ounces as a 60-day Supply and shall document the amount and the rationale in
the medical record and in the Written Certification . For that Qualifying
Patient, that amount of Marijuana constitutes a 14-day Supply or 60-day
Supply .
(11) A Qualifying Patient
who is younger than 18 years old and has been diagnosed by two Massachusetts
licensed Certifying Physicians, at least one of whom is a board certified
pediatrician, pediatric subspecialist, oncologist, neurologist, or family
physician, with a debilitating Life-limiting Illness, may receive a Written
Certification ; provided however, that the physicians may certify a Qualifying
Patient who is younger than 18 years old who has a Debilitating Medical
Condition that is not a Life-limiting Illness if those physicians determine
that the benefits of the medical use of Marijuana outweigh the risks. This
shall include a discussion of the potential negative impacts on neurological
development with the parent or legal guardian of the Qualifying Patient,
written consent of the parent or legal guardian, and documentation of the
rationale in the medical record and the Written Certification .
(12) A Certifying Healthcare Provider , and
such healthcare provider 's co-worker, employee , or Immediate Family Member , may
not:
(a) Have ever directly or indirectly
accepted or solicited from, or offered to an MTC, a board member or Executive
of an MTC, any MTC personnel, or any other individual associated with an MTC,
or a Personal Caregiver , anything of value;
(b) Offer a discount or any other thing of
value to a Qualifying Patient based on the patient's agreement or decision to
use a particular Personal Caregiver or MTC;
(c) Examine or counsel a patient, or issue a
Written Certification , at an MTC;
(d) Be a Person or Entity Having Direct or
Indirect Control for an MTC; or
(e)
Directly or indirectly benefit from a patient obtaining a Written
Certification , which may not prohibit the healthcare provider from charging an
appropriate fee for the Clinical Visit.
(13) A Certifying Healthcare Provider may not
issue a Written Certification for himself or herself or for his or her
Immediate Family Members.
(14) A
Certifying Healthcare Provider issuing a Written Certification for their
employees or coworkers shall do so in accordance with
935
CMR 501.010 of a Debilitating Medical
Condition for a Qualifying Patient, including conducting a Clinical Visit,
completing and documenting a full assessment of the patient's medical history
and current medical condition, explaining the potential benefits and risks of
Marijuana use, and maintaining a role in the ongoing care and treatment of the
patient.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.