This overview is provided for informational purposes only
and is not authoritative. Readers are strongly encouraged to read the
full text of the regulations (.pdf, 52 pages).
Patient Eligibility
- A patient may use marijuana for medical purposes
only after receiving written certification from a physician that the patient
has a debilitating medical condition, which is defined as cancer, glaucoma,
positive status for HIV, AIDS, hepatitis C, ALS, Crohn’s disease, Parkinson’s
disease, multiple sclerosis, and other debilitating conditions as determined
in writing by a qualifying patient’s certifying physician.”
- The condition must be debilitating, which is
defined as “causing weakness, cachexia, wasting syndrome, intractable pain,
nausea, impairing strength or ability, and progressing to such an extent that
one or more of patient’s major life activities is substantially limited.”
- Patients who received a diagnosis of a
debilitating medical condition in the past, but do not have an active condition
and are not undergoing treatment for such condition, are not eligible for
certification. This does not apply to patients whose symptoms are mitigated by
using marijuana for medical purposes.
- A patient under age 18 seeking certification
must have written consent of his or her parent or guardian. Other rules for
minors:
- At least two physicians must diagnose that such
a minor patient has a debilitating condition that is life-limiting. At least
one of these physicians must be board-certified in pediatrics or a pediatric
subspecialty.
- “Life-limiting” is defined as “a debilitating
medical condition that does not respond to curative treatments, where
reasonable estimates of prognosis suggest death may occur within two years.”
- The possible effects of marijuana on
neurological development must be discussed with the patient’s parent or legal
guardian.
- Documentation of the rationale for certification
must be provided in the medical record and the written certification.
Physician
Requirements
- Physicians are not required to issue
certifications to any patient.
- Physicians who certify patients for medical
marijuana must:
- Have a full active Massachusetts license
- Have at least one established place of practice
in Massachusetts
- Register as a certifying physician with the
Department of Public Health. The physician retains the registration indefinitely;
unless the registration is revoked for reasons outlined in the regulations (see
below)
- The state has not proposed to assess a fee to
physicians for such registrations.
- Physicians who provide certifications must have a
bona fide physician-patient relationship with the patient. This means:
- While acting in the usual course of his or her
professional practice, the physician must conduct a clinical visit before
issuing a certification.
- The physician must complete and document a full
assessment of the patient’s medical history and current medical condition.
- The physician must explain the potential
benefits and risks of marijuana use.
- The physician must have a role in the ongoing
care and treatment of the patient.
- Certification must not be for less than 15 days or
longer than one year. It must be issued in a form and manner determined by the
Department of Public Health.
- Physicians may certify for up to a 60-day
supply, which is defined as 10 ounces of marijuana. If a physician determines
that a patient needs more than 10 ounces during that 60-day period, the
physician must document the amount and rationale in the medical record and in
the written certification.
- Physicians must utilize the state Prescription
Monitoring Program before issuing a written certification.
- To issue certifications on or after July 1,
2014, physicians must complete at least 2.0 hours of Category I Continuing
Medical Education credits relating to medical marijuana.
- A physician may not issue a certification for
himself or herself, or for his or her immediate family members.
- A certifying physician, co-worker, employee or
family member may not:
- Have a direct or indirect financial interest in
a dispensary
- Receive directly or indirectly anything of value
from a dispensary, or any person related to the dispensary
- Offer a discount to a qualifying patient for
using a particular caregiver or dispensary
- Grounds for revoking a physician’s right to
certify patients:
- The physician fraudulently issues a written
certification to a patient
- The physician’s license to practice is suspended
or revoked
- The physician voluntarily agrees not to practice
medicine in Massachusetts
- The physician’s license to prescribe controlled
substances is suspended, revoked or restricted
- The physician fails to complete the required CME
requirements after July 1, 2014.
- The physician fails to comply with the medical
marijuana law or its regulations
- Any other grounds that serves the purposes” of
these regulations or the medical marijuana law
Patients’ Rights and
Responsibilities after Certification
- After receiving a certification letter from a
physician, the patient must apply to the Department of Public Health for a
registration card before obtaining marijuana from a dispensary. The
registration card is valid for one year. The state is proposing to assess a $50
annual fee for patient registration cards.
- The patient may designate up to two “personal
caregivers” who may assist patients in traveling to dispensaries, or
cultivating, preparing or administering marijuana for patient. The regulations have
detailed requirements regarding personal caregivers (pages 10-12).
- Patients may cultivate their own marijuana if
they receive a “hardship cultivation registration” from the state due to:
- Financial hardship
- Physical incapacity to access “reasonable
transportation”
- Doesn’t have a personal caregiver
- Doesn’t live within a “reasonable distance” from
a dispensary
