Update below: Our William Breathes has been closely following the fate of approximately 4,000 medical marijuana applications put on hold by the Colorado Department of Public Health and Environment, reportedly over concerns that physician assistants, not doctors, conducted examinations. The CDPHE is now confirming this fact. And the kicker? Patients whose applications are denied for this reason must wait six months to reapply.
This delay will undoubtedly anger many patients who've already been waiting for months to get their red card renewed -- and all because a number of doctors are accused of failing to conduct examinations themselves, thereby rendering their recommendations "fraudulent."
The agency's rationale for this conclusion? As explained in a release on view below, Amendment 20, which legalized MMJ in Colorado, calls for examinations by physicians, and SB 109, passed by the state legislature last year, requires a bona fide doctor-patient relationship, as opposed to one in which docs merely sign a recommendation for a fee and provide no opportunity for followup care.
But even if one accepts the argument that such applications should be denied, why must patients be forced to wait six months to reapply? Does the CDPHE believe they colluded with the doctors to scam the agency, and therefore deserve to be punished in some way? If so, what evidence does it have to support this contention? If not, why make patients who have tried to follow the rules in order to obtain medication to treat their ailments go without for half a year?
When asked these questions, CDPHE spokesman Mark Salley deferred to Dr. Chris Urbina, executive director and chief medical officer at the Colorado Department of Public Health and Environment, who is not available for comment at this writing. Once we're able to connect with him, we'll update this post.
Update, 4:15 p.m. December 12: Still haven't been able to connect with Dr. Urbina on this topic. However, CDPHE spokesman Mark Salley reached out to answer one of the rhetorical questions posed above: "But even if one accepts the argument that such applications should be denied, why must patients be forced to wait six months to reapply?" He points out specific language in Amendment 20, which legalized medical marijuana in Colorado. It reads:
0-4-287 -- ARTICLE XVIII -- Miscellaneous Art. XVIII -- Miscellaneous
Section 14. Medical use of marijuana for persons suffering from debilitating medical conditions. (1) As used in this section, these terms are defined as follows:
(e) A patient whose application has been denied by the state health agency may not reapply during the six months following the date of the denial.
In other words, the six-month delay is constitutionally mandated if an application is denied, at least as the CDPHE interprets it. We hope to follow up on this question and others in the near future. In the meantime, here's the CDPHE release issued last week.
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Potentially fraudulent forms delay approval of medical marijuana applications
DENVER -- Following notification by law enforcement agencies of potentially fraudulent physician certification forms, the Medical Marijuana Registry at the Colorado Department of Public Health and Environment began holding registry applications from certain identified physicians for further verification. Approximately 2,600 applications received between Sept. 5 and Oct. 14 initially were delayed, followed by another approximately 1,600 applications received between Oct. 15 and Dec. 5.
Law enforcement representatives had been present in two locations where applicants were being seen by someone other than a physician. Applications received by the department were consistent with this information.
The amendment to the Colorado Constitution passed by the voters in 2000, which established the registry, allows only physicians to evaluate patients for the purpose of diagnosing a debilitating medical condition and recommending medical marijuana. Additionally, legislation passed in 2010 provided further clarifying language about what constitutes a bona fide patient-physician relationship for purposes of the registry. The 2010 language established that the patient-physician relationship must include a personal physical examination, recordkeeping and an offer of follow up appointments with the physician. Consequently, an applicant who sees a non-physician does not meet the legal requirements of the registry.
Due to concerns about potential fraud, registry officials contacted the physicians whose names and signatures appeared on the registry certification forms for applicants who were believed to have been seen by someone other than the physician. The physicians were asked to verify whether or not they had seen specific patients and had signed their certification forms.
For the initial group of 2,600, the department has received responses from the identified physicians and reviewed all of the relevant information -- and based on that information will notify applicants whether their applications were accepted, denied or rejected. Denials of applications will be issued when the totality of the information indicates the physician did not see the patient. If it is unclear if the physician or some other individual saw the applicant, the application will be rejected. Applicants in the original group of 2,600 applications should receive notification from the registry by Dec. 23.
Denied applicants must wait six months from the date of denial before reapplying for the registry. Rejected applicants can resubmit a new application without delay and without the additional application processing fee of $90 through December 29, 2011 or $35 effective December 30, 2011.
The remaining 1,600 delayed applications received between Oct. 14 and Dec. 5 should complete the verification process around the first of the year, with notification of application status to those patients by the end of January.
Dr. Chris Urbina, executive director and chief medical officer at the Colorado Department of Public Health and Environment, said, "We recognize many applicants have been impacted by the extended verification process, but the investigation was necessary to maintain the integrity of the Medical Marijuana Registry. The enabling legislation requires physicians to verify a patient has one of the qualifying debilitating medical conditions to receive medical marijuana -- and the legislation also requires personal, physical medical exams. The department has the responsibility to deny applications that don't meet those criteria."
Urbina further commented, "The exposure of this fraud should lead marijuana registry applicants to take care to ensure that they are seen and examined by a physician if they intend to apply to the medical marijuana registry."
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More from our Marijuana archive: "Marijuana: 2 guvs petition feds to reclassify pot, but John Hickenlooper not ready to do so -- yet."