N.H. Admin. Code § He-C 401.06

Current through Register No. 45, November 7, 2024

Section He-C 401.06 - Provider Requirements

(a) The department shall accept written certifications for the therapeutic use of cannabis only from providers who possess, at the time of signing the certification, the following:

(1) For providers in New Hampshire, an active license, in good standing, pursuant to RSA 329 for physicians, pursuant to RSA 326-B:18 for advanced practice registered nurses, or pursuant to RSA 328-D for physician assistants;

(2) For providers in Maine, Massachusetts, and Vermont, an active license, in good standing, pursuant to the relevant state licensing laws in Maine, Massachusetts, or Vermont, except that a license for a naturopathic doctor shall not be acceptable; and

(3) For all providers in (1) and (2) above, an active registration from the United States Drug Enforcement Administration to prescribe controlled substances.

(b) A provider issuing a written certification shall:

(1) Have a provider-patient relationship with the patient, as defined in He-C 401.02(j);

(2) If a provider licensed in Maine, Massachusetts, or Vermont, be primarily responsible for the patient's care related to the patient's qualifying medical condition, pursuant to RSA 126-:1, VII(a)(3)X;

(3) If a physician assistant, have the express consent of the supervising physician, pursuant to RSA 126-:1, VII(a)(4)X;

(4) Conduct a full assessment of the patient's medical history and current medical condition which includes:

a. An in-person physical examination of the patient, which shall not be via telemedicine, except that telemedicine shall be allowed for New Hampshire providers for follow-up visits related to cannabis certification and treatment and for recertifications completed by the same certifying provider;

b. A medical history of the patient, including a prescription history;

c. A review of laboratory testing, imaging, and other relevant tests;

d. Appropriate consultations;

e. A documented diagnosis of the patient's current medical condition; and

f. The development or documentation of a treatment plan for the patient appropriate for the provider's specialty;

(5) Explain the potential health effects of the therapeutic use of cannabis:

a. To the patient; or

b. In the case of a patient who is a minor, to the minor's custodial parent or legal guardian with responsibility for health care decisions for the patient, which shall be inclusive of potential risks and benefits of the therapeutic use of cannabis;

(6) Follow the patient clinically at appropriate intervals at the discretion of the provider to provide follow-up care and treatment to the patient for the patient's qualifying medical condition including, but not limited to, physical examinations, to determine the health effects of cannabis for treating the patient's qualifying medical condition or associated symptom for which the written certification was issued;

(7) Maintain medical records for all patients for whom the provider has issued a written certification which support the written certification;

(8) Make a copy of such records which support the written certification available to the department, and otherwise provide information to the department upon request about the patient's qualifying medical condition, to ensure compliance with RSA 126-X and He-C 401; and

(9) If the provider has recommendations or instructions for the therapeutic use of cannabis for the patient, be permitted to send such recommendations or instructions to the patient's designated ATC. Such recommendations shall be securely transmitted.

(c) A provider shall not consider a patient to have a qualifying medical condition if a patient who has had a diagnosis of a qualifying medical condition in the past no longer actively has a qualifying medical condition, unless the symptoms related to such qualifying medical condition are mitigated by the therapeutic use of cannabis.

(d) Providers shall not issue a written certification for themselves or for the provider's immediate family members.

(e) A provider shall not:

(1) Offer a discount or other thing of value to a patient who uses or agrees to use a particular ATC;

(2) Examine a patient in relation to issuing a written certification at a location where cannabis is sold or distributed; or

(3) Hold any economic interest in an ATC, including but not limited to employment at an ATC, if the provider issues written certifications to patients.

(f) Providers may rescind or otherwise withdraw a written certification which they have previously issued, for cause, including, but not limited to, the provider making a determination that the patient:

(1) No longer has a qualifying medical condition;

(2) Should discontinue using cannabis;

(3) Falsified information that was the basis of the provider's written certification;

(4) Did not adhere to the provider's treatment plan for the patient; or

(5) Should no longer be certified for the therapeutic use of cannabis for another compelling reason.

(g) To rescind or otherwise withdraw a previously issued written certification, the certifying provider shall submit the following information on the "Written Certification Withdrawal" form:

(1) Qualifying patient name;

(2) Qualifying patient date of birth;

(3) Certifying provider name;

(4) Medical practice phone number;

(5) Reason for withdrawal of the written certification; and

(6) Certifying provider's dated signature of a statement of withdrawal for the reason in (5) above.

(h) Providers may extend the duration of a written certification, as follows:

(1) Providers may extend the duration of a written certification that they previously issued which has a duration of less than one year, per He-C 401.07(b)(7);

(2) The extension period shall not be for a duration longer than the maximum duration of a registry identification card established in RSA 126-:4, IVX;

(3) An extension request shall be submitted prior to the expiration of the qualifying patient's registry identification card; and

(4) An extension request shall not require the submission of a new written certification, a new patient application, or a new fee.

(i) To extend the duration of a written certification, the certifying provider shall submit written notice to the department by submitting the following information on the "Written Certification Extension" form:

(1) Qualifying patient name;

(2) Qualifying patient date of birth;

(3) Certifying provider name;

(4) Medical practice phone number;

(5) Length of extension; and

(6) Certifying provider's dated signature.

(j) Upon receipt of the completed written notice in (i) above, the department shall issue a new registry identification card with a new expiration date.

N.H. Admin. Code § He-C 401.06

Adopted byVolume XXXIV Number 33, Filed August 14,2014, Proposed by #10646, Effective 8/1/2015.

Amended by Volume XXXV Number 45, Filed November 12, 2015, Proposed by #10964, Effective 11/2/2015, Expires 11/2/2025.

Amended by Volume XLI Number 32, Filed August 12, 2021, Proposed by #13220, Effective 7/1/2021, Expires 7/1/2031.