The CTR newsletter is distributed to physicians with an active CTR and provides important updates for the Ohio Medical Marijuana Control Program. 

The State Medical Board of Ohio has approved 9 new certificate to recommend medical marijuana (CTR) applications since the February board meeting. As of March 11, 2020, the total number of active certified physicians is 615.

Changes to the Patient and Caregiver Process
Telemedicine

On March 18, 2020 the State Medical Board of Ohio met and voted to suspend enforcement of telemedicine regulations for licensees during the COVID-19 pandemic. This will allow physicians with a CTR to use telemedicine in place of in-person visits to make recommendations and renewals for medical marijuana.

Physicians must document their use of telemedicine and meet minimal standards of care. The Medical Board will provide advance notice before resuming enforcement of the above regulation when the state emergency orders are lifted.

Click here to view the current state and federal Telemedicine Guidance.

 
Temporary Expansion of Caregiver Registration

CTR physicians are also encouraged to add caregivers for their medical marijuana patients, as many patients may be at higher risk for illness and should not be visiting dispensaries to purchase their medical marijuana.

To expedite the caregiver registration process and reduce exposure to higher risk patients, the State of Ohio Board of Pharmacy issued guidance for caregiver registration that authorizes a patient to have up to three caregivers. Caregivers may now be registered in one of two ways:

• The patient's recommending physician, which can be completed using telemedicine in place of in-person visits
• Submission of a Caregiver Registration Application directly to the Board of Pharmacy

This guidance, along with the Board of Pharmacy's new Caregiver Registration Application, can be accessed here.

In order to address patient access and closures of BMVs around the state, the State of Ohio Board of Pharmacy has adopted the following guidance to permit medical marijuana patients and caregivers to renew patient/caregiver registrations and recommendations using an expired method of identification under certain conditions.

This guidance is being issued in accordance with a Board of Pharmacy's resolution adopted on March 2, 2020. To be considered valid, the patient or caregiver’s identification must comply with the following:

• The identification must be one of the authorized forms under rule 3796:7-2-01 of the Administrative Code.
• The method of identification expired on or after February 1, 2020.
• The patient/caregiver’s information is still legible, including a recognizable image of the patient/caregiver.

This guidance will remain in effect until rescinded by the Board of Pharmacy. 

Authorize Use of Birth Certificates as Acceptable Identification for Minor Patients

In order to address patient access and closures of BMVs around the state, the State of Ohio Board of Pharmacy has adopted the following guidance to permit minors (i.e. those under the age of 18) to utilize a birth certificate to register as a medical marijuana patient.

The patient’s birth certificate number (if applicable) or the last four digits of the patient’s social security number should be used in “State-Issued ID” drop down option of the patient registry.

Dispensaries shall also be required to honor birth certificates as a form of identification for minors to enter a dispensary and purchase medical marijuana.   

This guidance is being issued in accordance with a board resolution adopted on March 2, 2020 and will remain in effect until rescinded by the Board of Pharmacy. Minor patients will have to sixty days from the rescission of this guidance to obtain a valid form of photo identification as required by rule 3796:7-2-01 of the Administrative Code. The board will provide notification upon the formal rescission of this guidance. 

Click here to view the guidance on medicalmarijuana.ohio gov.

CTR Physician Survey

The State Medical Board of Ohio has emailed a survey to physicians with a certificate to recommend that meets the annual report requirement in Ohio Revised Code 4731.30 and Ohio Administrative Code 4731-32-03. The survey asks physicians to describe their observations regarding the effectiveness of medical marijuana in treating patients and provide information about patient interactions. By law, every physician with a certificate to recommend must complete the survey.

*Physicians who have already taken the survey do not need to take further action.

Indigent Status Definition Update

On March 2, 2020, the State of Ohio Board of Pharmacy passed a resolution that extends the criteria for indigent status under rule 3796:7-3-01 of the Administrative Code by recognizing persons currently receiving monthly disability income from a state retirement system (ex. OPERS, STRS, etc.). Patients qualifying for indigent status under these new criteria are eligible for a 50 percent fee reduction for annual registration fees. This resolution will remain in effect until the Board of Pharmacy makes corresponding updates to rule 3796:7-3-01 of the Administrative Code. 

This means a patient enrolled in the federal "Social Security Disability Income" (SSDI) or "Supplemental Security Income" (SSI) disability programs, or a patient currently receiving monthly disability income from a state retirement system (ex. OPERS, STRS, etc.) is eligible to qualify for “Indigent Status.”

Physicians with a certificate to recommend must register the patient in the Patient & Caregiver Registry and indicate that the patient is registering with special status.

Patients currently registered that meet the new criteria may apply to request indigent status. To update their status or register with an indigent status, patients will need to provide the following:

For Social Security Disability Income (SSDI) or Supplemental Security Income (SSI):

(a) Identity of the patient; and

(b) Amount of monthly SSDI and SSI benefits to be received by the prospective patient during the current year of the registration submission.

For patients receiving monthly disability income from a state retirement system:

A copy of a letter or other documentation showing enrollment in a state retirement system that includes all of the following:

(a) Identity of the patient; and

(b) Amount of monthly disability benefits to be received by the prospective patient during the current year of the registration submission.

Physicians are also reminded that there are reduced registration fees available to veterans. To qualify for a reduced registration fee due to veteran status, the prospective patient must submit a copy of any of the documents listed in this guidance document.

Registration & Recommendation Renewals

Now that we are over one year into the program, we will see a number of patient registrations expiring at the end of each month. In order to renew their registrations, patients must be issued a recommendation (a renewal of their current recommendation, or a new one) within 90 days of their registration’s expiration date. After that happens, a button will appear on their Registry profile. They can sign into their profile, pay their registration fee, and renew their registration. More information on this process can be found here.

When attempting to renew a patient’s current recommendation, the “Renew Recommendation” button will only appear to the physician who issued the recommendation in the first place. However, all CTR physicians can terminate a recommendation and/or issue a new recommendation to any patient. More information on recommendation renewals can be found here.

Please note: if a registrant does not pay their registration fee before their card expires, their registration does not go away. The card will lapse, making them unable to purchase medical marijuana until they renew their registration. Even if the registration expiration date passes without them paying their fee, they can still log onto their Registry profile and pay for their registration. Once the fee is paid, the Registry card will update accordingly and become active once again.

Expiration Dates

Please note that the expiration dates on patients’ registrations and recommendation will likely not match. The expiration dates for the two parts of a patient’s profile are calculated in the following ways:

• Registration: One year from the date when the payment is made, at the end the end of that month.
• Recommendation: Depending upon how many refills are issued, it will be 90 days (zero refills), 180 days (one refill), 270 days (two refills) or 360 days (three refills) from the date the recommendation is issued.