California, Hashish and Telehealth: Half I

California, Cannabis and Telehealth: Part I

The relief companies that provide goods and services for the cannabis industry are legion. From equipment, real estate, legal services and technology to packaging, labeling, intellectual property, hardware and apparel, the list of options that abound in the cannabis-related ancillary sector is basically endless. One of the cooler side areas that doesn’t have much to offer is the cross-section of telemedicine and medical cannabis, especially where medical cannabis was largely viewed as an essential service during the COVID.

Just like state cannabis regulations, telehealth regulations vary from state to state. Telemedicine (also known as telemedicine) is “. . . the diffusion of health-related services and information via electronic information and telecommunication technologies. “The use of telemedicine has seen a significant increase during the pandemic. Securing cannabis recommendations from doctors via telemedicine apps or platforms is no exception. There are, of course, some limitations to making and securing a recommendation in this way. In this post, I will focus specifically on California’s current relationship with telehealth and cannabis, which thankfully has evolved.

Telehealth compliance in California is governed by the Business & Professions Code, Section 2290.5, among others. The Medical Board of California (“MBC”) also provides comprehensive guides on telehealth as well as guides for doctors recommending cannabis to their patients. In particular, the MBC guidelines on cannabis and telehealth provide that “[t]The use of telemedicine in accordance with section 2290.5 of the B&P Code and use in a manner consistent with the standard of care is permitted. “Does that mean California doctors can use telemedicine to virtually distribute cannabis recommendations after recommendations? Definitely not. Let’s start with the cannabis side of things.

Proposal 215, adopted in 1996 (also known as Health and Safety Code Section 11362.5), allows qualified patients to acquire and use cannabis for specific medical needs through recommendations from their attending physician (cannabis cannot be prescribed because it is illegal nationwide , Schedule I Controlled Substance). According to MBC:

Physicians should document that an appropriate physician-patient relationship has been established before giving the patient any recommendation, certification, or approval for cannabis. In accordance with applicable standard of care, doctors should not recommend, certify, or otherwise approve cannabis for themselves or family members.

Further, under Section 2525.2 of the Business and Professions Code, a physician cannot recommend cannabis for medical purposes to a patient unless the physician is the patient’s attending physician and “attending physician” means a “physician who is responsible for an aspect von has taken over the medical care, treatment, diagnosis, advice or referral of a patient. “

The doctor must also conduct and document a medical examination of the patient before deciding whether or not medicinal cannabis is suitable for a recommendation. According to MBC, this physical exam (which could now potentially be done remotely due to COVID) should include at least the following:

the history of the patient’s current illness; Social history; medical and surgical history; History of alcohol and substance use; Family history with an emphasis on addiction, psychotic disorders, or mental illness; Documentation of therapies with inadequate response; and diagnosis that the cannabis recommendation requires.

Section 2525.3 of the Business and Professions Code states that physicians who recommend cannabis for a medical purpose to a patient without prior examination and without medical indication is unprofessional behavior. All of this is in the context of the exercise of an adequate standard of care by a physician, which includes maintaining a treatment plan, ongoing patient monitoring, and maintaining compliant records.

How can a cannabis telemedicine company use Prop. 215?

There are two types of telemedicine business models. Synchronous (use of video conferencing or a telemedicine app or platform to restore a personal experience) and asynchronous (with no virtual interaction between doctor and patient, but the patient later provides all medical information via an app or a technical platform from the treating person Doctor checked). Usually, a third party company (consisting of non-doctors) provides the app or the tech platform, while the doctors who use the platform treat the patients accordingly. When we receive inquiries from telehealth companies about cannabis recommendations in California, they want to know if this is even possible (“yes”) and if they can have a financial relationship with a pharmacy or other cannabis licensee who will provide cannabis to those patients who access their app or tech platform.

And this is where things get interesting. In my next post, I’ll analyze whether a telehealth company can legally set up such a facility in California. So stay tuned.