1. (a) In order to certify a patient, a registered certifying physician must diagnose the patient with at least one qualifying medical condition or confirm that the patient has been medically diagnosed with at least one qualifying medical condition.

2. (b) Not later than December 1, 2021, the board shall adopt rules for the issuance of physician certifications for patients to use medical cannabis as recommended by a registered certifying physician. The rules shall include, but not be limited to, all of the following:

   1. (1) Requirements for patient examination and the establishment of a physician-patient relationship.
   2. (2) Requirements for relevant information to be included in the patient’s medical record.
   3. (3) Requirements for review of the patient’s controlled drug prescription history in the controlled substance prescription database established under Article 10 of Chapter 2 of this title.
   4. (4) Requirements for review of the patient registry.

   5. (5) Requirements for obtaining the voluntary and informed written consent from the patient to use medical cannabis, or from the patient’s designated caregiver to assist the patient with the use of medical cannabis, on a form created by the board and accessible at no charge on its website. The form shall include, but not be limited to, information relating to all of the following:

      1. a. The federal and state classification of cannabis as a Schedule I controlled substance.
      2. b. The approval and oversight status of cannabis by the Food and Drug Administration.
      3. c. The current state of research on the efficacy of cannabis to treat the qualifying medical condition or conditions.
      4. d. The potential for addiction.
      5. e. The potential effect that cannabis may have on a patient’s coordination, motor skills, and cognition, including a warning against operating heavy machinery, operating a motor vehicle, or engaging in activities that require an individual to be alert or respond quickly.
      6. f. The potential side effects of cannabis use.
      7. g. The risks, benefits, and drug interactions of cannabis.
      8. h. A statement that the use of medical cannabis could result in termination from employment without recourse and that costs may not be covered by insurance or government programs.
      9. i. That the patient’s de-identified health information contained in the patient’s medical record, physician certification, and patient registry may be used for research purposes or used to monitor compliance with this chapter, as further provided in subsection (c) of Section 20-2A-35.
   6. (6) Requirements for the issuance and reissuance of physician certifications by certifying physicians, the permissible length of duration of a physician certification, and the process and circumstances under which a physician certification may be deactivated, as well as stipulations for timely updating of physician certifications on the patient registry.
3. (c) At the time of physician certification, the registered certifying physician shall enter electronically in the patient registry, in a manner determined by rule by the board, relevant information necessary to appropriately identify the patient; the respective qualifying medical condition or conditions of the patient; the daily dosage and type of medical cannabis recommended for medical use; and any other information the board, by rule, deems relevant.
4. (d) A physician certification does not constitute a prescription for medical cannabis.
5. (e) A physician certification shall be valid for a period of time as determined by the board, but in no event may a physician certification exceed 12 months in duration.

6. (f)

   1. (1) The commission, by rule, shall specify, by form and tetrahydrocannabinol content, a maximum daily dosage of medical cannabis that may be recommended by a registered certifying physician for a particular qualifying medical condition, which may not exceed the limits set forth in subdivision (2).

   2. (2) The maximum daily dosage may not exceed 50 mg of delta-9-tetrahydrocannabinol; provided, however, the maximum daily dosage may be increased under either of the following circumstances:

      1. a. A registered certifying physician may increase a patient’s daily dosage if, after 90 days of continuous care under the physician during which time the patient was using medical cannabis, the physician determines that a higher daily dosage is medically appropriate, provided the maximum daily dosage under this paragraph may not exceed 75 mg of delta-9-tetrahydrocannabinol.
      2. b. A registered certifying physician may increase a patient’s daily dosage if the patient has been diagnosed with a terminal illness, provided, if the recommended daily dosage exceeds 75 mg of delta-9-tetrahydrocannabinol, the physician shall notify the patient that the patient’s driver’s license will be suspended.
7. (g) A registered certifying physician may not lawfully recommend the use of medical cannabis with a potency greater than three percent tetrahydrocannabinol to any minor for any qualifying medical condition. A minor may not legally use medical cannabis with a potency greater than three percent tetrahydrocannabinol, whether or not the minor has a valid medical cannabis card. A parent or legal guardian of a minor who holds a medical cannabis card may not legally possess medical cannabis with a potency greater than three percent tetrahydrocannabinol, unless the parent or guardian holds a valid medical cannabis card for his or her own qualifying medical condition.

(Act 2021-450, §1.)