On Fox’s In the Weeds blog, associate Richard Holzworth discussed the influx of patients registering for the Pennsylvania Medical Marijuana Program, and provided an overview of key policy and procedure updates that PA’s healthcare facilities, including hospitals and long-term care providers, should adopt:

Illustration of Rod of Asclepius on marijuana leafDespite Pennsylvania’s medical marijuana industry being in its infancy, more than 17,000 patients have registered for the program, and more than 4,000 already have received their medical marijuana card from the Department of Health. Now that cannabis products have burst onto the scene, hospitals and other residential healthcare facilities are struggling with what to do when patients present medical marijuana cards and attempt to use marijuana in the facilities. Indeed, it is high time for the healthcare providers to update their policies and procedures to address these growing concerns.

Policy Considerations

In developing a medical marijuana policy, it is important for healthcare administrators to remember that medical marijuana, although legal in most states, is still classified by the federal government as a Schedule I Controlled Substance. With medical marijuana laws varying from state to state, hospitals, healthcare associations, and other stakeholders have developed and implemented a wide range of policies addressing the use and possession of medical marijuana products. These policies range from strict, categorical prohibitions to sanctioned self-therapy during hospital admission. Regardless of a healthcare facility’s philosophy (either from a political or medicinal perspective) on medical marijuana, it is important for each institution to develop and implement a comprehensive set of policies and procedures to address the inevitable circumstance of a patient presenting with a medical marijuana ID card or cannabis products in hand.

Due to the large volume of patient registrants to the Commonwealth’s medical marijuana program, PA physicians and their staff may see local healthcare facilities make changes to their policies and procedures with respect to medical marijuana in the coming months.

We invite you to read Richard’s full informative piece and stay tuned for our coverage of further developments.

This piece originally appeared in the February 2018 issue of the Allegheny County Medical Society Bulletin.

Richard L. Holzworth writes:

In April 2016, Gov. Tom Wolf signed into law Pennsylvania’s compassionate medical cannabis legislation (Act 16), effectively legalizing medical marijuana in the Commonwealth. Since that time, the Pennsylvania Department of Health (DOH) has awarded 12 licenses to grow medical marijuana and 27 licenses to operate medical marijuana dispensaries. It is anticipated that the grow operations and dispensaries will be open for business in early 2018. Although the proponents of medical marijuana have enjoyed widespread support (as evidenced by the 29 states that have enacted a medical marijuana law, including six since 2016), those in the industry are left to trust that Pennsylvania physicians will register with the DOH and send patients to the dispensaries. In other words, now that the legal medical marijuana system is in place, the onus is on physicians to ensure that patients have access to treatment.

Patient and physician registration

It is important for medical professionals to understand that they are not permitted to “prescribe” medical cannabis products. Rather, physicians who have met the registration requirements of Act 16 are permitted to issue “certifications” to patients who qualify for medical marijuana treatment.

In order for a patient to qualify for medical marijuana treatment, the patient must obtain a certification from a registered physician stating that the patient suffers from one of the 17 “serious medical conditions” identified in Act 16. These conditions include:

  • Amyotrophic Lateral Sclerosis;
  • Autism;
  • Cancer;
  • Crohn’s Disease;
  • Damage to the nervous tissue of the spinal cord with objective neurological indication of intractable spasticity;
  • Epilepsy;
  • Glaucoma;
  • Huntington’s Disease;
  • Inflammatory Bowel Disease;
  • Intractable Seizures;
  • Multiple Sclerosis;
  • Neuropathies;
  • Parkinson’s Disease;
  • Post-Traumatic Stress Disorder;
  • Severe chronic or intractable pain of neuropathic origin or severe chronic or intractable pain in which conventional therapeutic intervention and opiate therapy is contraindicated or ineffective; and
  • Sickle Cell Anemia.

Once a patient obtains a certification, then the patient must apply for a medical marijuana ID card through DOH. If the application is accepted, the patient (or a qualified, registered caregiver) may take the medical marijuana ID card to a state-licensed dispensary to obtain marijuana products.

In order for physicians to issue medical marijuana “certifications,” they must register with the DOH and complete a four-hour training course offered by DOH-approved providers. The DOH training course covers the following areas:

  • Summary of Act 16;
  • General information about medical marijuana under state and federal law;
  • Scientific research on medical marijuana;
  • Recommendations for medical marijuana, including pain management, risk management, palliative care, misuse of opioids and medical marijuana, and informed consent.

Physicians also are required to be licensed to practice medicine in Pennsylvania and be qualified, by training or experience, to treat at least one of the 17 serious medical conditions.

Once registered, the DOH will place the physician’s name, business address and medical credentials on the physician medical marijuana registry. The registry does not include contact information (telephone numbers or email addresses).

Importantly, registered physicians are not permitted to advertise that they are credentialed to certify patients for medical marijuana use. The DOH regulations have not provided much guidance in the way of what constitutes “advertising” or what is actually permitted, including whether physicians may list medical cannabis certification on their “menu” of services.

Continue Reading A Physician’s Guide to Navigating Medical Marijuana Registration

On October 9, the Pennsylvania Department of Health (PA DOH) announced that it has changed the Pennsylvania rules regarding the J-1 Physician Waiver Program. DOH has established three filing periods, which could result in the Conrad 30 numbers being assigned earlier in the fiscal year. Read the entire text: http://immigrationview.foxrothschild.com/j-1-waiver/j-1-physician-waivers-in-pennsylvania-change-in-processing-times/


According to a new report from the Pennsylvania Health Care Cost Containment Counsel (also known as PHC4), 19 new ambulatory surgery centers (ASCs) opened up in Pennsylvania in the past year. This bring the total number of ASCs in Pennsylvania to 262.  According to the report, ASCs generally remain profitable.

Although growth of ASCs means more independence for physicians and more choices for patients, acute care hospitals in the state are likely not thrilled with this news.  Undoubtedly lobbying pressure to stem the growth of outpatient centers will continue, so physicians who are considering investing in or developing an ASC should move quickly before Certificate of Need or other regulatory hurdles are put in place.