For healthcare providers, the reclassification of state-licensed medical marijuana from Schedule I to Schedule III raises important questions about prescribing and fulfillment authority, clinical responsibility, patient safety, insurance coverage and reimbursement, and institutional compliance concerning two classes of medical cannabis.
The first, referred to in the Order as FDA-approved marijuana products such as Epidiolex, continues to be highly regulated by the U.S. Controlled Substances Act. There are very few of these products, but more may be developed as a result of rescheduling, which permits easier paths to conducting research on marijuana in the drugs. The second class is comprised of medical marijuana and medical marijuana products that are subject to regulation by a state agency whose program requires licensure and oversight of dispensaries, cultivators, transporters and manufacturers. The rescheduling Order put great faith in the breadth and operational functionality of the existing forty state medical marijuana programs and essentially incorporated those state programs into the federal cannabis regime.
Critically, the Order finds that marijuana has a medical use, is relied upon by practitioners in treating numerous medical conditions such as persistent pain and chemotherapy-induced nausea, and has a moderate to low potential for dependence, acknowledging growing scientific and clinical evidence supporting marijuana’s therapeutic potential. For healthcare providers, rescheduling will likely reshape both clinical practice and healthcare operations.
Not only should we see new formulations of medical marijuana drug applications, but we should also see increased institutional prescription of such drugs in nursing homes, rehabilitation clinics, and post-surgery therapies. Medicare, Medicaid, and private insurance programs may voluntarily, or through further legislative or administrative action, provide coverage of medical marijuana products in their insurance programs. Wellness clinics may thrive with the expansion of their product portfolio. And researchers will now be permitted to conduct their research on products already being sold in dispensaries across the U.S.
In response to the Order, healthcare providers should begin preparing now by monitoring DEA and FDA developments, updating their cannabis-related treatment and employment policies, expanding clinician and university education, developing interdisciplinary guidance, and reviewing controlled-substance compliance procedures. Please consult with a healthcare compliance attorney for guidance.
Author: Heather Macre is a director in Fennemore’s litigation department in Phoenix where her work focuses in the areas of business litigation, healthcare and bankruptcy.
