Massachusetts Medical Society Adopts New Policy on Medical Marijuana in Wake of New Law

Contact:
Richard Gulla, 781-434-7101
rgulla@mms.org      

Physicians outline considerations, criteria for new regulations

Waltham, Mass. - Dec. 2, 2012 - Physicians of the Massachusetts Medical Society (MMS)  have approved an extensive new resolution on medical marijuana, outlining considerations and criteria for regulations governing the implementation of the law, following voter approval of the ballot initiative in November that allows the use of medical marijuana the state.

The resolution, which now becomes official policy of the Society, was adopted unanimously by the MMS House of Delegates, its policy making body, at the organization's 2012 Interim Meeting on December 1 in Waltham.

The new policy adopted over the weekend covers such issues as the nature of the physician-patient relationship under the law,  patient certification under the law, implications on occupational health and safety, the relationship of medical marijuana to the state's Prescription Monitoring Program, and physician peer reporting requirements under regulations of the Board of Registration in Medicine, which licenses physicians to practice.

"We recognize that the law is binding as a result of the vote," said MMS President Richard Aghababian, M.D., "but as written, the law poses many unanswered questions. Of particular concern are issues that bear directly on a physician's practice of medicine under the regulations of the Massachusetts Board of Registration in Medicine and those that could affect the physician-patient relationship.

"As the law requires physician participation to certify patients, it is imperative that we provide perspective and input on these issues as regulations are developed to govern the full implementation of the medical marijuana law."

Specifically, the new policy targets seven areas with respect to the new law and states that the MMS:

  • Work with the Board of Registration in Medicine to define the nature of the physician-patient relationship required under the law, including required parent or guardian permission for those under 18 years of age
  • Advocate for the development of appropriate standards for certification by physicians, including that physicians must have an active license from the Massachusetts Board of Registration in Medicine, a Massachusetts Department of Public Health Control Substance Registration, and a Federal Drug Enforcement Agency Registration - elements not specified in the law
  • Advocate that the certifications for registration cards be based on a patient's diagnosis and the physician's assessment that the patient's pain or symptoms can not be controlled with conventional medical therapy.
  • Advocate that the regulations consider the implications of marijuana use on occupational health and safety
  • Advocate to the Board of Registration in Medicine and the Department of Public Health that regulations include a number of  recommendations from the American Society on Addiction Medicine relevant to patient care
  • Advocate with the Department of Public Health and the Legislature that marijuana dispensing be integrated with and become part of the state's Prescription Monitoring Program
  • Work with the Board of Registration in Medicine to clarify the mandated peer reporting requirements that do not apply to physicians who choose to provide certifications under the law.

The MMS had opposed the ballot initiative and the legalization of medicinal marijuana until such time that scientific studies demonstrate its safety and efficacy, and it has asked the U.S. Drug Enforcement Administration to reclassify marijuana so that its potential medicinal use by human may be further studied and potentially regulated by the U.S. Food and Drug Administration.

The resolution on medical marijuana was one of many adopted by delegates at the meeting. Resolutions approved on other major topics:

Related Content: Medical Use of Marijuana: Considerations for Massachusetts Physicians 

Electronic Medical Records: A resolution was adopted stating that the MMS research and develop clear guidelines, best practices, and ongoing education regarding the effective use of electronic health records (EHR)and health information exchange technologies, to include such items as time management before and after EHR adoption, quality of practice after EHR implementation, legal and liability issues surrounding the exchange of protected health information, and guidelines for communicating electronically with patients.

Prior Authorization: Delegates approved the conduct of a statewide survey of physicians to ascertain the extent of actual work encountered in providing care beyond face-to-face time with patients, to include time spent on authorizations and pre-authorizations and the identification of legislative, regulatory, and third-party requirements and strategies that are the most burdensome on physicians.

Principles for Health Plan Coverage Decisions: The Society adopted a set of Principles for Health Plan Coverage Decisions, stating that a health plan's processes for designing and determining coverage decisions should be evidence-based, transparent, participatory, equitable and consistent, sensitive to value and companies, and assure that the plan's clinical policies and treatment approval decisions are responsive to patient concerns and that physicians in the plan can provide input into the plan's policies affecting coverage.

In addition, delegates adopted a number of other resolutions related to health systems, health policy and public health, and organizational administration. A complete listing of the resolutions adopted by the delegates will be available at the MMS website at qa.massmed.org/interim2012

The Massachusetts Medical Society, with more than 24,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country.

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