1. A. Issuing a Written Certification.

   1. (1) A certifying provider may determine that a patient qualifies for a written certification only if the:

      1. (a) Qualifying patient:

         1. (i) Has registered with the Administration;
         2. (ii) Meets the certifying provider’s inclusion criteria; and
         3. (iii) Does not meet the certifying provider's exclusion criteria; and

      2. (b) Certifying provider:

         1. (i) Has a bona fide provider-patient relationship with the qualifying patient; and
         2. (ii) Has determined that the potential benefits of the medical use of cannabis likely outweigh the health risks for the patient.

   2. (2) If a certifying provider determines that a patient qualifies for a written certification, the certifying provider shall:

      1. (a) Issue a written certification in the form required by the Administration;
      2. (b) Transmit the written certification to the Administration using the designated online process; and
      3. (c) If requested, provide a copy of the written certification to the qualifying patient.

   3. (3) A written certification shall include the:

      1. (a) Provider’s name, Maryland Board of Physicians, Board of Dental Examiners, Board of Podiatric Medical Examiners, or Board of Nursing license number, and office telephone number;
      2. (b) Qualifying patient’s name, date of birth, address, and county of residence;
      3. (c) Medical condition requiring medical cannabis; and
      4. (d) The date of qualification as a qualifying patient.
   4. (4) A written certification may contain, if applicable, a written statement certifying that, in the provider’s professional opinion, a 30-day supply of medical cannabis would be inadequate to meet the medical needs of the qualifying patient.

   5. (5) A certifying provider shall terminate a written certification if:

      1. (a) The qualifying patient meets the provider’s exclusion criteria;
      2. (b) Treatment with medical cannabis is no longer necessary for the qualifying patient;
      3. (c) Adverse effects of medical cannabis outweigh the benefits to the qualifying patient’s health; or
      4. (d) There is evidence that the qualifying patient engaged in diversion of medical cannabis.
   6. (6) A certifying provider may terminate a written certification if the qualifying patient demonstrates misuse of any substance.
   7. (7) A certifying provider shall notify the Administration within 1 business day of the termination of a written certification.
   8. (8) A qualifying patient shall have only one certifying provider at any time.

2. B. Written Certification Renewal.

   1. (1) A qualifying patient may seek renewal of a written certification not less than 30 calendar days after it was issued by notifying the patient’s certifying provider.
   2. (2) A certifying provider may renew the written certification for a qualifying patient if the certifying provider determines the patient still meets the criteria set forth in §A(1) of this regulation.
   3. (3) Upon renewing a written certification for a qualifying patient, a certifying provider shall notify the Administration.
   4. (4) Prior to renewing a written certification, a certifying provider shall conduct a full assessment of the qualifying patient within 365 days before the reissuance.
   5. (5) The full assessment in §B(4) of this regulation may be conducted via telehealth as defined by the certifying provider’s licensing board.

Authority: Alcoholic Beverages and Cannabis Article, §§36-201, 36-301, 36-302, 36-410, and 36-601, Annotated Code of Maryland

Effective date:

Regulations .01—.10 adopted as an emergency provision effective July 1, 2023 (50:14 Md. R. 559); emergency status expired June 30, 2024

Regulations .01—.09 adopted as an emergency provision effective June 7, 2024 (51:14 Md. R. 676)

Regulations .01—.09 adopted effective July 22, 2024 (51:14 Md. R. 678)

Regulation .07 repealed effective April 14, 2025 (52:7 Md. R. 324)

Regulation .08 amended and recodified to be Regulation .07 effective April 14, 2025 (52:7 Md. R. 324)

Regulation .09 amended and recodified to be Regulation .08 effective April 14, 2025 (52:7 Md. R. 324)

Regulation .09 adopted effective April 14, 2025 (52:7 Md. R. 324)