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 has approved 10 new certificate to recommend medical marijuana (CTR) applications since the November board meeting. As of December 9, 2021, the total number of active certified physicians is 644.

2021 Petition Window Open

The submission period is open for anyone to submit a petition requesting a condition be added to the Ohio Medical Marijuana Control Program. If a condition has been previously rejected by the board, the new petition must contain new scientific information that supports the request. The window is open from November 1 to December 31.

Petitions can be filed electronically through the state's website here. Petitions need to include (per Ohio Administrative Code 4731-32-05):

• The name and contact information
• Specific disease or condition requested to be added
• Information from experts who specialize in the study of the disease or condition
• Relevant medical or scientific evidence
• Consideration of whether conventional medical therapies are insufficient to treat or alleviate the disease or condition
• Evidence supporting the use of medical marijuana to treat or alleviate the disease or condition and other types of medical or scientific documentation
• Letters of support provided by physicians

Ohio Administrative Code 4731-32-03 and Ohio Revised Code 4731.30 require an in-person visit to make an initial recommendation and an in-person examination at least once a year.

In response to the COVID-19 pandemic, the Medical Board suspended enforcement of regulations that required in-person visits, until the expiration of Executive Order 2020-01D. This allowed the use of telemedicine in situations that previously required in-person visits, including for physicians with a CTR to use telemedicine for initial visits and renewals.

The board voted to extend the enforcement of these regulations until March 31, 2022.

The Medical Board approved telemedicine FAQs that provide guidance on telemedicine in Ohio and the Medical Board’s resumption of enforcement. Click here to view the FAQs.

Program Update (As of October 30, 2021)

• 376,736 Recommendations
• 224,681 Registered patients
  • 15,067 Patients with Veteran Status
  • 16,662 Patients with Indigent Status
  • 938 Patients with a Terminal Diagnosis
• 133,196 Patients with both an active registration and an active recommendation
• 205,832 Unique patients who purchased medical marijuana (as reported to OARRS by licensed dispensaries)
• 25,993 Registered Caregivers

State of Ohio Board of Pharmacy Updates

Recommendation Renewals Clarification 

In last month’s newsletter, the Board of Pharmacy provided guidance regarding CTR physicians early renewing patient recommendations. Based on feedback received from CTR physicians, the Board of Pharmacy would like to correct and clarify this guidance.

During the last 90 days of a patient’s recommendation, the same CTR physician has the ability to enter a renewal for an existing patient by clicking the “RENEW RECOMMENDATION” button. These recommendation renewals should be made as close as possible to the recommendation expiration date in order to: (1) minimize the gap between the recommendation expiration date and the card expiration date; and (2) minimize the potential for days lost in the current fill period or, alternatively, the purchase of more medical marijuana than permitted by law. This will also permit physicians who are renewing recommendations to access the patient experience survey.

CTR physicians should review the patient’s utilization of medical marijuana during the prior 45-day fill period and ensure that the patient understands if there will be an impact on their ability to purchase based on the renewal date, e.g. if a patient has remaining days’ supply under the original recommendation that will be “lost” once the renewal recommendation is entered. Likewise, CTR physicians should ensure that patients are not early renewing as a mechanism to reset their fill periods and purchase more medical marijuana than permitted by law, e.g. a patient who has purchased their full 45 days’ supply in the first 10 days and is now attempting to early renew in order to reset their fill periods to permit immediate purchase.

As a reminder, patients can access their fill periods and information related to their recommendations, including the expiration date of the recommendation, by logging into their accounts at ohiomedicalmarijuanaregistry.com.

Elimination of Tier System and Update to 90-Day Supply of Plant Material

The Board of Pharmacy previously approved changes to Ohio Administrative Code Rule 3796:8-2-04 that will eliminate the current tier system distinguishing plant material based on THC percentage. More recently, the Board of Pharmacy approved additional changes that will establish the 90-day supply of plant material as 9 ounces, regardless of THC percentage. Patients diagnosed with a terminal illness will continue to have a 90-day supply limit of 10 ounces of plant material.

At the December Board meeting, the Board of Pharmacy approved a resolution whereby these changes will go into effect on January 3, 2022, prior to the finalization of the amendments to Rule 3796:8-2-04.

Physicians will see a new category of product in OARRS and the Registry which will reflect plant material dispensations as “Plant Mat” rather than “Tier1 Vap” or “Tier2 Vap.” However, cultivators will continue to be able to use previously approved product IDs under “Tier1 Vap” and “Tier2 Vap.”

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.