This newsletter is distributed to physicians with an active Certificate to Recommend Medical Marijuana (CTR) and provides important updates for the Ohio Medical Marijuana Control Program (OMMCP). 

The State Medical Board of Ohio approved 6 new CTR applications since the March board meeting. As of May 12, 2021, the total number of active certified physicians is 675.

The board's Medical Marijuana Committee met on May 12 and voted to recommend the full board reject the petitions for autism spectrum disorder, panic disorder with agoraphobia and restless leg syndrome. Based on the expert’s testimony, the committee decided to split the petition for spasticity and spasms into two separate petitions; it voted to recommend rejection of spasms as a condition and acceptance of spasticity. The committee also voted to recommend the full board accept the petitions for Huntington’s disease and terminal illness. The recording of the committee meeting can be viewed here.

The committee's votes are not the final determination for the petitions; the full Medical Board will discuss the petitions and make a decision during an upcoming monthly board meeting. 

Board agendas, including agendas for the Medical Marijuana Committee, will be available on the board’s website.

Physician Annual Report 

The board has emailed a CTR physician survey to all certified physicians to meet the annual report requirement in Ohio Revised Code 4731.30 and Ohio Administrative Code 4731-32-03. Each physician is being asked to give their professional opinion on the effectiveness of medical marijuana for the conditions for which it has been recommended. Completion of the survey is a statutory requirement for all physicians with a certificate to recommend. All responses are due by Friday, May 21, 2021.

Please be aware, completion of the survey is a statutory requirement for all physicians with a CTR. If the board does not receive your survey response as requested, you may be contacted directly.

During the February 10 meeting, the board’s Medical Marijuana Committee determined that the petitions submitted for arthritis, migraines (chronic), and complex regional pain syndrome were already covered by the existing qualifying condition of pain that is either chronic or intractable. The board has created a position statement about these conditions which is available on med.ohio.gov. The board will update the document as needed. 

If a patient with a condition that has been determined by the Medical Board to be covered by an existing qualifying condition seeks a recommendation, the certified physician must follow the standard of care requirements in OAC 4731-32-03.

OARRS Account Update and Delegate Reverification Workflow

As a reminder, since September 30, 2020, OARRS users are prompted to update or confirm their PMP AWARxE profile information on a biannual basis. The purpose of this verification requirement is to ensure that all OARRS profile information is up to date and accurate.

Additionally, OARRS will also be requiring semi-annual confirmation of all linked delegates to protect the security of the patient data in the system. Account holders will receive emails indicating that they have 45 days to complete this verification process.

State of Ohio Board of Pharmacy Updates

Special Status

If a physician or delegate indicates that a patient is eligible for special status (either indigent or veteran) on their registration, the patient will be unable to activate their card until the status is approved by the Board of Pharmacy or the status request is removed. The Board of Pharmacy routinely receives inquiries from patients who have a “special status” marked on their registration but have not provided the board with the requisite documentation for status review, either directly or through their physician. Please only mark this status if the patient has provided the appropriate documentation and that documentation has been forwarded to the Board of Pharmacy via mmcpregistry@pharmacy.ohio.gov.

Indigent Status

Those applying for indigent status must provide a copy of a letter or other documentation from one of the following program types:

1. Enrolled in the federal "Social Security Disability Income" (SSDI) or the "Supplemental Security Income" (SSI) disability programs.  Provide documentation showing:
2. The identity of the patient; and
3. The amount of monthly Social Security Disability Income or Supplemental Security Income benefits the individual will receive during the calendar year they register with the Ohio Medical Marijuana Control Program.

-OR-

1. Enrolled in a State Retirement System and receiving monthly disability benefits. Examples: a state public employees retirement system, a state teacher retirement system, and a police or fire retirement system.

Provide documentation showing:

1. Identity of the patient; and
2. Amount of monthly disability benefits to be received by the prospective patient during the current year of the registration submission.

Creating Patient Profiles

Physicians and delegates must not create patient profiles prior to the patient’s visit. Physicians must be certain that the patient they are registering qualifies and is going to participate in the Medical Marijuana Control Program prior to creating a patient profile. Profiles that are created cannot be deleted out of the Patient & Caregiver Registry.

Additionally, patients should be provided with a timeline of when their patient profile will be created. Physicians and delegates should check the Patient & Caregiver Registry to ensure that a patient profile has been created, using the correct email address, before directing patients to contact the Board of Pharmacy requesting a new registration email.

Password Reset Instructions

Physicians and delegates can assist patients with password resets without contacting the Board of Pharmacy for assistance. If a patient is requesting a password reset, please visit ohiomedicalmarijuanaregistry.com and click the “Reset Password” button. NOTE: This will not reset your password. The window in the image below will appear. Physicians and delegates can then enter the patient’s email address as it appears in the Patient & Caregiver Registry and a password reset email will be sent to the patient. Patients will not receive a password reset if the email address entered does not match the email address attached to their patient profile.

Recommendation Renewals 

A patient and patient’s caregiver may, collectively, purchase no more than a 90-day supply of medical marijuana within a 90-day period per OAC 3796:8-2-04(B). If a CTR physician renews or issues a new recommendation before the patient’s current recommendation expires, the patient may be at risk of violating this rule because the patient’s “fill period” dates will reset in the Registry based on the new recommendation date. As a result, the patient may be denied medical marijuana by the dispensary to prevent a violation of this rule.

Therefore, CTR physicians must wait until the patient’s recommendation expires before entering a new recommendation. By doing so, patients will retain the same fill period schedule and no violation of OAC 3796:8-2-04(B) will occur.

Caregiver Registration

Registered caregivers may only purchase medical marijuana following the successful completion of a caregiver background check. This check includes a review of the following databases:

(1) The system for award management (SAM) maintained by the United States general services administration;

(2) The list of excluded individuals and entities maintained by the office of inspector general in the United States department of health and human services pursuant to 42 U.S.C. part 1320a-7 (as effective on January 3, 2017) and 42 U.S.C. part 1320c-5 (as effective on January 3, 2017);

(3) The Ohio department of developmental disabilities (DODD) online abuser registry established under section 5123.52 of the Revised Code;

(4) The internet-based sex offender and child-victim offender database established under division (A)(11) of section 2950.13 of the Revised Code;

(5) The national sex offender public website established under 18 United States Code 16918;

(6) The internet-based database of department of rehabilitation and correction inmates established under section 5120.66 of the Revised Code; or 

(7) The state nurse aide registry established under section 3721.32 of the Revised Code, and there is a statement detailing findings by the director of health that the provider applicant or employee neglected or abused a long-term care facility or residential care facility resident or misappropriated property of such a resident.

The caregiver background check will not be completed until AFTER the caregiver: 

(1) is “linked” to the appropriate patient (NOTE: If the caregiver logs in and does not see the patient listed under the patient tab or if the patient logs in and does not see the caregiver under the caregiver tab, the accounts have not been “linked.” If the accounts are not “linked,” the patient or caregiver must contact the registering physician to “link” the accounts.); 

(2) has activated or renewed their registration; and 

(3) has paid the required fee. 

The caregiver will then remain in “PENDING” status on the registry until the caregiver background check is successfully completed. The caregiver will receive an email notification once approval has been made and the status will change to “APPROVED.”

If a caregiver registration has been activated/renewed and a patient is unable to purchase medical marijuana without a caregiver or has terminal status, please email mmcpregistry@pharmacy.ohio.gov and the Board of Pharmacy will make every effort to expedite caregiver review.

To help inform physicians choosing to include instructions for use, the types of products currently available through the Medical Marijuana Control Program are listed below.