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Medical marijuana: 4,200 patients seen by physician assistants being denied and rejected

The Colorado Department of Public Health and Environment has finally started denying and rejecting the 4,200 medical marijuana patients who were evaluated by a physician assistants and have been waiting for as long as four months for an answer. And as if the delay so far wasn't bad enough, many patients must wait another six months before they can get a license, because the state says they sent in a fraudulent application.

Back in December, the CDPHE announced that it would begin processing the applications, with the first round being sent back by year's end and the second round sent out later this month. Based on e-mails we've received from patients so far, it breaks down to this: If the physician assistant is the only person who signed off on the paperwork, the patient will be denied. If both a doctor and a physician assistant signed the paperwork, the patient will be rejected -- apparently even if the physician assistant was the one who performed the exam. CDPHE officials have confirmed as much in past conversations.

The difference in wording is subtle, but rejected applicants can reapply right away, while denied patients who thought they were submitting a valid application will essentially be punished by having to wait six months before applying again, or else go through a lengthy appeal process. CDPHE officials have said in the past that they aren't assessing blame, but the patients who are being denied don't see it that way.

Richard Hart is a 58-year-old retired nurse with severe back and neck pain and mounds of paperwork to back up his injuries. Like thousands of other patients, Hart went to a doctor's office for his medical marijuana evaluation this past fall and was seen by a physician assistant instead of a doctor. As I've said in the past, most patients who have dealt with chronic health issues have seen physician assistants as well as doctors over the course of their care. PAs are an integral part of the health-care process and it's not out of the ordinary for them to take on tasks that doctors traditionally handled. In short, it was just another day at the doctor's office for Hart, who says he figured the doctor entrusted with his care knew what he was doing.

Does he feel he deserves some blame? Hardly. "Using [the CDPHE's] argument that it's me, isn't it ironic that every person that went through this company all have been flagged and told they were defrauding the system?" Hart asks. "Clearly, we had nothing to do with it."

But not according to the CDPHE. "The department denies applications for which information has been received that confirms the patient was not seen by the physician for the marijuana recommendation," said CDPHE spokesman Mark Salley. "The department is responsible for operating the medical marijuana registry as created by Amendment 20, and as further refined by the state legislature. The law says the bona fide patient-physician relationship required for a medical marijuana recommendation includes an exam by a physician."

Rejected applications can reapply immediately and do not need to re-send in the application fee, now $35. Patients who are denied have to resubmit the application fee. According to Salley, the fee pays for the processing of the applications. But considering the MMJ registry has millions in surplus funding from applications fees being too high in the past, that's a hard pill to swallow. For patients like Hart, that $90 check was a sizable chunk of his already small budget.

Denied applicants can appeal the decision within thirty days. Marijuana attorney Robert Corey has created a form letter for patients to use, available at the Medical Marijuana Assistance Program of America website. MMAPA has collected several other resources for patients. Also, the Cannabis Business Alliance has partnered with attorney Warren Edson to provide free representation for patients during the hearing process.

More from our Marijuana archives: "Medical marijuana: CDPHE's Dr. Chris Urbina on physician assistants, patient denials" and " Med. marijuana patients must wait 6 months to reapply if applications found to be "fraudulent.'"