There are currently 46,300 patients, 950 doctors, and 1,850 caregivers participating in the NJ Medicinal Marijuana Program (NJMMP). In an effort to expand the NJMMP to more NJ residents in the absence of updated legislation, Governor Murphy announced new changes to the NJ Medicinal Marijuana Program on May 13, 2019. Some of the changes were already in effect based on Executive Order 6 Report issued on March 23, 2018. Other rule changes will go into effect on May 20, 2019, upon their publication in the NJ Register. And, there’s likely more rule changes and legislation to come in the weeks and months ahead. All NJ providers should be aware of the new rules, regardless of whether you participate in the NJMMP, because your patients and/or staff may be participating in the program.
Rule Changes Currently in Effect
- Revision to reflect the addition of seven “debilitating medical conditions” to include: PTSD; anxiety; chronic pain of visceral origin; chronic pain related to musculoskeletal disorders; migraines; Tourette Syndrome and; Opioid Use Disorder (OUD). Patients with OUD must be concurrently in a Medication Assisted Treatment (MAT) Program to be eligible for participation in the NJMMP. Since the addition of these conditions, The NJ Department of Health’s statistics show that the top five qualifying medical conditions are: chronic pain due to musculoskeletal disorders (25.4%); anxiety (20.2%); intractable skeletal spasticity (19.9%); PTSD (8.8%) and; severe or chronic pain due to cancer or HIV (6.85%).
- Allowing physicians to opt out of inclusion on a public list of participating physicians.
- Authorizing qualifying patients to designate up to two primary caregivers instead of only one.
- Expanding the forms of medicinal marijuana available to include oil-based formulations, like vape cartridges.
- Reducing the registration fee for qualifying patients and their caregivers from $200 to $100, which is renewable every two years.
- Adding seniors and military veterans to those eligible for the reduced registration fee of $20.
- Elevating the NJMMP to division status within the Department of Health.
Rule Changes Effective May 20, 2019
- Removing the requirement for psychiatric evaluation as a condition of physician certification for minors as qualifying patients.
- Streamlining the process to petition for the review of additional debilitating medical conditions by removing the requirement to first be referred to the Medicinal Marijuana Review Panel, which required a six month public comment period.
- Emphasizing the advisory role of the medicinal marijuana Review Panel to include provision of guidance and recommendations to the State Health Commissioner regarding the medical use of marijuana.
- Creating a separate permitting system for cultivation, manufacturing and dispensing of marijuana for medical purposes, which would increase the available supply of, and patient access to, usable marijuana and allow for specialization in the market.
The Future of NJ Medicinal and Recreational Marijuana Legislation
Although the NJ recreational marijuana legislation is currently not being brought to a vote, state Senate President Stephen Sweeny announced that lawmakers will likely move forward with two related bills expanding the medicinal marijuana program and expunging of the records of residents with past convictions for possessing small amounts of recreational marijuana. Recreational marijuana will most likely be brought to a NJ voter ballot in November 2020.
Risk Reduction Strategies to Consider
- Understand and comply with the NJ Board of Medical Examiners (NJBME) regulations on the Compassionate Use of Medicinal Marijuana, including qualifying and certifying a patient as eligible for medicinal marijuana, comprehensive medical evaluation, history and physical, establishing treatment goals and objectives, monitoring and follow up, medical record documentation requirements, and written instructions provided to the patient. Please note that a provider is not prescribing medicinal marijuana, but only certifying for patient eligibility. Written instructions must at least include the amount of medicinal marijuana in a 30, 60, or 90-day supply.
- Keep up-to-date with any NJBME regulation changes regarding the Compassionate Use of Medicinal Marijuana and any other rule and legislative updates.
- If you would like to participate in the NJMMP, follow the Physician Checklist and instructions provided by the NJ Department of Health.
- If you are a provider that is registered and participates in the NJMMP, you must provide the patient with an informed consent that is documented in your medical records and/or through an informed consent form that at least includes: lack of scientific consensus; sedative properties and; risk of addiction. It is also suggested that you inform the patient that use of medicinal marijuana can affect drug screening, which may be used for job employment or other reasons. Refer the patient to their own legal counsel for any questions in this regard.
- You may want to revise medical record documentation forms and templates to include whether your patient uses medicinal marijuana.
- If you perform drug screens before or after hire, you may wish to revisit any “zero tolerance” office policies in the event a prospective or current employee participates in the NJMMP. It is suggested that you consult with an employment attorney or your personal legal counsel for further guidance.
Conventus will continue to monitor changes in marijuana legislation, rules, and regulations for our insured members. Conventus members may contact the Practice Resources Department at (877) 444-0484 x7466 with any questions.