Florida Legalizes Medical Marijuana (2016)
In 2016, Florida legalized medical marijuana following a second attempt at a medical cannabis initiative, which was approved with 71.3% of the vote. However, the bill did not elaborate on whether telehealth appointments could be conducted for medical marijuana patients, leaving a gap in the legislation.
Senate Bill 8A: A Step Backwards for Telehealth (2017)
The following year, on June 23, 2017, Florida passed Senate Bill 8A, which outlined more rules for medical marijuana use in the state. Notably, this bill included a ban on telehealth appointments for medical marijuana patients, stating that all medical marijuana appointments needed to be conducted in person only. This was a significant setback for the integration of telemedicine in the medical marijuana sector.
COVID-19: Temporary Legalization of Telehealth (2020)
The COVID-19 pandemic in 2020 brought about a temporary change in Florida’s stance on telehealth for medical marijuana patients. In March 2020, Florida temporarily legalized medical marijuana telehealth appointments, allowing health care professionals to provide medical services to patients using telehealth. This was a significant step forward, reflecting the necessity of remote healthcare services during the pandemic.
However, as with many things during the pandemic, this time period was characterized by uncertainty. For that reason, emergency orders were issued in short spans (usually 60 days) and routinely updated. The list below outlines each Emergency Order, originally tied to Executive Order 20-52:
- The State Surgeon General, Scott A. Rivkees, M.D., issued Emergency Order 20-002 (granted authority by Governor Ron DeSantis signing Executive Order No. 20-52) on March 16, 2020, which – for the first time – allowed medical cannabis physicians to conduct telehealth appointments with “existing qualified patients with an existing certification that was issued by that qualified physician.”
- This initial Emergency Order was then extended by Emergency Order 20-004 on April 15, 2020 (issued by State Surgeon General, Scott A. Rivkees, M.D.).
- Another extension was issued on May 8, 2020: Emergency Order 20-007 (issued by State Surgeon General, Scott A. Rivkees, M.D.).
- Another extension was issued on May 31, 2020: Emergency Order 20-009 (issued by State Surgeon General, Scott A. Rivkees, M.D.).
An important extension came on June 30, 2020: Emergency Order 20-011. Also issued by State Surgeon General, Scott A. Rivkees, M.D., Emergency Order 20-011 effectively removed the State Surgeon General from the COVID-telehealth-renewal picture. As long as the overarching ‘state of emergency’ order (Executive Order 20-52) gets extended, telehealth gets extended. In other words: Telehealth ends when the state emergency ends.
The following list tracks each subsequent Executive Order after 20-52:
- Executive Order 20-52, signed by Governor Ron DeSantis, was extended on September 4, 2020 by Executive Order 20-213.
- Executive Order 20-52 was extended again on November 3, 2020 with the signing of Executive Order 20-276 (issued by Governor Ron DeSantis)
- Executive Order 20-52 was extended again on December 29, 2020 with the signing of Executive Order 20-316 (issued by Governor Ron DeSantis)
- Executive Order 20-52 was extended again on February 26, 2021 with the signing of Executive Order 21-45 (issued by Governor Ron DeSantis)
- Executive Order 20-52 was extended again on April 27, 2021 with the signing of Executive Order 21-94 (issued by Governor Ron DeSantis)
- When Executive Order 21-94 expired, it marked the last day of COVID-19-related medical marijuana telehealth appointments on June 26, 2021.
The End of Emergency Telehealth Renewals (2021)
However, this temporary legalization of telehealth appointments for medical marijuana patients ended on June 26, 2021 with the expiration of Executive Order 21-94. The emergency telehealth waivers were allowed to expire, and the Florida Department of Health issued a guidance update on how the expiration of these Emergency Orders affects telehealth services. This meant that qualified physicians were required to conduct an in-person physical examination to issue a physician certification for any patient, including those for medical marijuana purposes.
Temporary Reinstatement of Telehealth Appointments (2022)
In 2022, Florida issued another temporary Emergency Order.
Signed on October 5, 2022 in response to Hurricane Ian, Emergency Order 22-005 – issued by the State Surgeon General – allowed medical marijuana physicians to provide telehealth recertification until November 30, 2022 for the following Florida counties: Charlotte, Collier, DeSoto, Flagler, Hardee, Hendry, Highlands, Hillsborough, Lake, Lee, Manatee, Orange, Osceola, Pinellas, Polk, Putnam, St. Johns, Sarasota, Seminole, and Volusia.
However, as with the COVID Emergency Orders: as soon as Emergency Order 22-005, medical marijuana physicians were required to see patients in person again.
The Most Recent Update: H.B. 387 (2023)
The most recent update to the law came on July 1, 2023, when Florida passed House Bill 387. This bill allows for telehealth appointments for medical marijuana patients as long as their first exam was in-person and conducted by the same physician. This is a significant development, as it provides a more permanent integration of telehealth services into the medical marijuana sector in Florida.
The exact language reads:
For certification renewals, a qualified physician who has issued a certification to a patient after conducting an in-person physical examination may conduct subsequent examinations of that patient through telehealth as defined in s. 456.47. For the purposes of this subparagraph, the term ‘in-person physical examination’ means an examination conducted by a qualified physician while the physician is physically present in the same room as the patient.
House Bill 387 states that “telehealth” is defined by s. 456.47 (which explicitly states that “the term does not include audio-only telephone calls, e-mail messages, or facsimile transmissions”). However a separate piece of (non-marijuana) legislation also went into effect July 1, 2023: House Bill 267.
Prior to House Bill 267, s. 456.47 stated:
“Telehealth” means the use of synchronous or asynchronous telecommunications technology by a telehealth provider to provide health care services, including, but not limited to, assessment, diagnosis, consultation, treatment, and monitoring of a patient; transfer of medical data; patient and professional health-related education; public health services; and health administration. The term does not include audio-only telephone calls, e-mail messages, or facsimile transmissions.
House Bill 267 updates s. 456.47. to remove the “audio-only telephone calls” exclusion – which, since House Bill 387 bases its definition on s. 456.47 – directly affects medical cannabis practitioners (meaning qualified physicians can now use audio-only telephone calls as part of our telehealth practice).
Medical Marijuana Telehealth Next Steps
BOOK A TELEHEALTH APPOINTMENT
The history of medical marijuana telemedicine in Florida has been marked by significant changes and developments. From the initial legalization of medical marijuana to the recent passing of House Bill 387, Florida’s journey reflects the evolving landscape of telemedicine and its increasing importance in healthcare.
And, as always, CannaMD stands ready to lead the charge in this new and exciting phase of medical marijuana treatment. Our qualified doctors have been specifically trained to administer telehealth appointments. At CannaMD, we welcome the opportunity to bring medical cannabis care to as many patients as possible – and, with telehealth, that dream becomes more of a reality each day.
As Florida’s leading network of medical cannabis physicians, we proudly offer services statewide and are committed to providing high-quality, personalized, and discreet telehealth services. We have built our reputation on ensuring our patients’ comfort, safety, and accessibility to this important treatment. So why wait? Contact us today and take the first step toward your wellness journey with the assistance of Florida’s most trusted telemedicine provider in the medical marijuana field.