1. What are the requirements to become a medical provider who may recommend patients for a medical cannabis card?
- Be a Utah-licensed medical doctor (MD), osteopathic physician (DO), advanced practice registered nurse (ARPN), or physician assistant (PA) with a Utah controlled substance license;
- Complete least 4 hours of department-approved education on medical cannabis;
- Submit an application to the Utah Department of Health (UDOH); and
- Pay a $100 application fee to the UDOH.
2. Why would a patient need a medical cannabis card if they already have a “recommendation letter”?
Since December 2018, qualifying patients have obtained “recommendation letters” from certain medical providers. For a period, these letters will protect qualifying patients in possession of medical cannabis from prosecution as long as the patient has a qualifying condition and the product is in the “medicinal dosage form” and the legal amount. This protection ends on December 31, 2020. HB 425 became effective on March 18, 2020 and it allowed qualifying patients with recommendation letters to purchase product from one medical cannabis pharmacy until December 31, 2020.
A patient with a recommendation letter may want a medical cannabis card because it allows them to purchase product from any medical cannabis pharmacy licensed in Utah, not just one pharmacy. It also provides the patient legal protection beyond December 31, 2020 if they continue to renew it.
3. How often must a qualified medical provider (QMP) participating in Utah’s medical cannabis program renew their registration with the Utah Department of Health?
To keep their registration active, a QMP must renew their registration every two years from the date they first registered. To be eligible for renewal, the provider must complete another four hours of department-approved education on medical cannabis. The renewal fee is $50.
The application process takes less than 15 days. When a card is issued, a QMP will be emailed an electronically issued card and they can begin completing recommendations for patients applying for medical cannabis cards as soon as they receive the email.
5. Is there a limit on the number of medical cannabis cardholders to whom a qualified medical provider (QMP) can recommend medical cannabis to at one time?
Yes. A QMP may not recommend medical cannabis treatment to more than 275 of the QMP’s patients at one time, or to more than 600 patients if the QMP is certified by the appropriate American medical board in anesthesiology, neurology, oncology, pain, hospice and palliative medicine, physical medicine and rehabilitation, endocrinology, rheumatology, or psychiatry or if a licensed business employs or contracts the QMP for the specific purpose of providing hospice and palliative care.
A QMP may not advertise that the QMP recommends medical cannabis treatment except a QMP may communicate the following through a website:
- a green cross;
- a qualifying condition that the QMP treats; and
- a scientific study regarding medical cannabis use.
7. How does the law limit qualified medical providers (QMPs) in their relationships with cannabis-related businesses?
A QMP may not:
- act as a medical cannabis pharmacy agent;
- have a financial or voting interest of 2% or greater in a medical cannabis pharmacy;
- have the power to direct or cause the management or control of a medical cannabis pharmacy; or
- receive any compensation or benefit for the qualified medical provider’s medical cannabis treatment recommendation from a:
- cannabis production establishment or an owner, officer, director, board member, employee, or agent of a cannabis production establishment;
- medical cannabis pharmacy or an owner, officer, director, board member, employee, or agent of a medical cannabis pharmacy; or
- qualified medical provider or pharmacy medical provider.
8. What if a qualified medical provider (QMP) wants to recommend a patient for a medical cannabis card but does not want to specify a dosage type and dosing amount?
A QMP may recommend medical cannabis to a patient and not specify a medical cannabis dosage type and dosing amount to their patient. A recommendation is only the act of suggesting the use of medical cannabis treatment which certifies the patient’s eligibility for a medical cannabis card. When a QMP does not specify the dosing type and amount, this will be done by the pharmacy medical provider (PMP) at the medical cannabis pharmacy. In these cases, a QMP must provide the patient’s current medication list. This medication list could be a document that is uploaded to the electronic verification system (EVS) or text that is cut and pasted into the “Comment” box in the Notes tab. This is the minimum additional information that is required.
9. May a patient without a “qualifying condition” still obtain a medical cannabis card if their qualified medical provider (QMP) believes they may benefit from the use of medical cannabis?
Yes. In these cases, a patient may submit a petition for a medical cannabis card to the Compassionate Use Board that must include information from their QMP. The Board reviews the petition and makes a recommendation (approve, disapprove, require more information) to the Department of Health within 90 days from the date the application was complete.
10. Where can I find a list of qualified medical providers (QMPs) who can recommend medical cannabis cards to patients?
The Utah Department of Health (UDOH) has a list of QMPs who have registered with the UDOH as “qualified medical providers” (QMPs). This list only includes those QMPs who have authorized the UDOH to post their name, specialty, and contact information on the UDOH website. This list is updated twice a week.
11. What must a qualified medical provider (QMP) do with a patient before recommending them for a medical cannabis card?
A QMP must first establish a physician-patient relationship during at least one in-person appointment with the patient. During an appointment, the QMP must complete and document in the patient’s medical record a thorough assessment of the patient’s condition and medical history based on the appropriate standard of care for the patient’s condition.
To recommend a medical cannabis card to a patient, a QMP must also:
- verify the patient’s and, for a minor patient, the minor patient’s parent or legal guardian’s valid form of identification;
- review any record related to the patient and, for a minor patient, the patient’s parent or legal guardian in the state medical cannabis electronic verification system (EVS); and the controlled substance database;
- consider the recommendation in light of the patient’s qualifying condition and history of medical cannabis and controlled substance use; and
- state in the qualified medical provider’s recommendation in the (EVS) that the patient:
- suffers from a qualified condition, including the type of condition; and
- may benefit from treatment with medical cannabis
12. What if a patient’s current medical provider won’t register with the Utah Department of Health?
Participation in the medical cannabis program as a medical provider is voluntary, so a patient may need to establish a relationship with a new medical provider who is registered with the Utah Department of Health as qualified medical provider (QMP) in order to get a medical cannabis card.
Qualifying conditions under the Utah Medical Cannabis Act are listed below:
- HIV or acquired immune deficiency syndrome
- Alzheimer’s disease
- amyotrophic lateral sclerosis
- persistent nausea that is not significantly responsive to traditional treatment, except for nausea related to:
- cannabis-induced cyclical vomiting syndrome
- cannabinoid hyperemesis syndrome
- Crohn’s disease or ulcerative colitis
- epilepsy or debilitating seizures
- multiple sclerosis or persistent and debilitating muscle spasms
- post-traumatic stress disorder (PTSD) that is being treated and monitored by a licensed health therapist (defined here), and that:
- has been diagnosed by a healthcare provider by the Veterans Administration and documented in the patient’s record; or
- has been diagnosed or confirmed by evaluation from a psychiatrist, doctorate psychologist, a doctorate licensed clinical social worker, or a psychiatric APRN
- a terminal illness when the patient’s life expectancy is less than six months
- a condition resulting in the individual receiving hospice care
- a rare condition or disease that affects less than 200,000 individuals in the U.S., as defined in federal law, and that is not adequately managed despite treatment attempts using conventional medications (other than opioids or opiates) or physical interventions
- pain lasting longer than two weeks that is not adequately managed, in the qualified medical provider’s opinion, despite treatment attempts using conventional medications other than opioids or opiates or physical interventions
- a condition that the compassionate use board approves (once established) on a case-by-case basis
Yes. To qualify, a patient with PTSD must be treated and monitored by a Utah licensed mental health therapist (defined here). Additionally, a patient’s PTSD must:
- have been diagnosed by a healthcare provider or a mental health provider employed or contracted by the Veterans Administration and documented in the patient’s record; or
- have been diagnosed or confirmed by evaluation by a psychiatrist, or a psychologist with at least a master’s level degree, a licensed clinical social worker with a least a master’s level degree, or a psychiatric APRN.
15. What forms of medical cannabis and medical cannabis devices are medical cannabis patient cardholders allowed to purchase and use?
Medical cannabis will only be available in the following forms under the Utah Medical Cannabis Act:
- Concentrated liquid or viscous oil
- Liquid suspension
- Transdermal, sublingual, or topical preparation
- Gelatinous cube
- Unprocessed cannabis flower in a in tamper evident and resistant container that is opaque that contains a quantity that varies no more than 10% from the stated weight at the time of packaging
- Wax or resin
- Medical cannabis device such as a vaping pen that warms cannabis material into a vapor without the use of a flame and that delivers cannabis to an individual’s respiratory system
Smoking of cannabis is not permitted.
The law prohibits candies, cookies, brownies, and other edible products.
Qualifying patients may not possess:
- More than 113 grams of unprocessed cannabis (flower); and
- More than 20 grams of total composite THC in all other medicinal dosage forms.
Within a 30-day period, qualifying patients may not purchase:
- more than 113 grams of unprocessed cannabis (flower); and
- more than 20 grams of total composite THC in all other medicinal dosage forms.
No, cannabis is not legal under federal law.
Because medical cannabis users are not a protected class, there are no renter protections for those who choose to possess and use medical cannabis.
There are some limited protections for state and local government employees. The Utah Medical Cannabis Act allows these employers to treat medical cannabis use in the same fashion as opioids or opiates, meaning that disciplinary action and/or termination may occur due to impairment or poor job performance.
Private employees are subject to their employers’ policies, which may include zero-tolerance for cannabis and/or drug testing.
20. Can individuals without a medical cannabis card purchase CBD oil with low a percentage of THC and similar products at retail outlets?
Yes. It is legal under Utah law for anyone to purchase and possess hemp extract, or CBD oil, if it contains less than 0.3% tetrahydrocannabinol (THC). These products must be registered with the Utah Department of Agriculture and Food.
21. What are legal protections for a medical provider who recommends medical cannabis to a qualifying patient?
As long as a medical provider meets requirements outlined the Title 26, Chapter 61a, Utah Medical Cannabis Act, the provider is not subject to the following solely for violating a federal law or regulation that would otherwise prohibit recommending, prescribing, or dispensing medical cannabis, a medical cannabis product, or a cannabis-based drug that the United States Food and Drug Administration has not approved:
- Civil or criminal liability; or
- Licensure sanctions for a profession as described under the Pharmacy Practice Act, Nurse Practice Act, Utah Medical Practice Act, Utah Osteopathic Medical Practice Act, or Physician Assistant Act.
22. How will medical providers determine the dose and form of the medical cannabis for their patients?
Qualified medical providers (QMPs) may submit a recommended dose and form of the medical cannabis in the electronic verification system (EVS) for their patient or they have the option of leaving that up to the pharmacy medical provider at the medical cannabis pharmacy to determine.
If a QMP chooses to not make a specific dosage or form recommendation, the QMP must electronically document in the recommendation the patient’s current medication list.
Using this information, the pharmacy medical provider (a pharmacist or physician) at a medical cannabis pharmacy will counsel with the patient and determine the dosing guidelines.
The Compassionate Use Board is responsible to review all card applications from patients under the age of 21 and patients with conditions not listed in statute. These patients must petition the Board and be approved by the Board and the Utah Department of Health before a medical cannabis card can be issued. The Board consists of seven providers who meet to review applications for medical cannabis cards on a case-by-case basis.
The state central patient portal is an online tool that will allow cardholders to order medical cannabis online. Orders will be filled by a local medical cannabis pharmacy and will be made available for pick-up at the pharmacy or delivered to the cardholder’s home. Medical cannabis pharmacies will not offer online ordering and home delivery service until after July 2020.
25. Can a medical provider licensed in another state recommend a Utah patient for a medical cannabis card or become a qualified medical provider?
A medical provider licensed out of state cannot recommend a medical cannabis card to a patient unless the medical provider also holds a Utah license.
26. Where can a medical provider obtain information about the medical cannabis products sold at medical cannabis pharmacies in Utah?
A medical provider may contact the medical cannabis pharmacies and see if they would be willing to share a list of product sold at their facility. Here is a link to contact information for the medical cannabis pharmacies.
27. How must an applicant for registration as a qualified medical provider (QMP) seeking to qualify to recommend up to 600 patients document to the Department that they qualify to recommend to this maximum number of patients?
The applicant must submit at least one of the following:
(1) Documentation verifying that the applicant is employed or contracted by a business for the specific purpose of providing hospice and palliative care. This may include publicly available information from the business’ website or a letter from the business; or
(2) A copy of a certificate from the American Board of Medical Specialties (ABMS) or the American Osteopathic Association Board verifying that the MD or DO is Board certified in anesthesiology, neurology, oncology, pain, hospice and palliative medicine, physical medicine and rehabilitation, endocrinology, rheumatology, or psychiatry.