Medical marijuana oversight bill advances after Spotlight PA investigations reveal doctor concerns

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HARRISBURG — A series of Spotlight PA investigations has led state lawmakers to intensify their scrutiny of Pennsylvania’s medical marijuana program.

A bill that includes doctor oversight measures prompted by Spotlight PA’s reporting passed out of the state House with large bipartisan support in March. Meanwhile, a Republican state senator used the newsroom’s findings as she questioned top officials in the Shapiro administration.

“What are we doing as far as ensuring that the prescribing habits and the … standard of care for patients is not abused in any way?” state Sen. Rosemary Brown (R., Monroe) asked during a February budget hearing.

The legislative action follows multiple Spotlight PA investigations that have raised questions from experts — including medical marijuana physicians — about the quality of care many patients receive. Records obtained through successful litigation show a small number of doctors approve a disproportionately large share of medical marijuana cards in Pennsylvania. The Department of Health has also rarely blocked doctors from joining the program based on prior discipline, Spotlight PA found last year.

State Rep. Tim Twardzik (R., Schuylkill) cited the investigations while advocating for legislation meant to increase the state health department’s oversight powers. He told his colleagues it’s “necessary we provide the department with clear authority to ensure that patients in the program are properly being cared for.”

Under Pennsylvania’s 2016 medical marijuana law, patients need a doctor’s approval to obtain a medical marijuana card and purchase cannabis at dispensaries. To issue certifications, doctors must complete a four-hour training course and apply to the Pennsylvania Department of Health.

Under Twardzik’s proposal, the department would have explicit authority to impose several conditions on doctors who want to approve patients for medical marijuana. It could place those doctors on probation, limit the number of certifications they are allowed to issue, mandate supervision by another practitioner, and impose reporting requirements. The department could also set any other condition on a doctor it “determines is necessary to protect the health and safety of patients in the program.”

State Rep. Arvind Venkat (D., Allegheny) — a physician who said he does not issue medical marijuana certifications — thanked Twardzik for the proposal.

“I think that there are real concerns with this program, and that there’s a real need for better oversight from the Department of Health,” Venkat said.

“That’s not always the easiest thing to say as a fellow physician,” he added, “but I think we have to look in the mirror on this issue.”

The state House Health Committee unanimously approved Twardzik’s proposal as an amendment to a marijuana lab testing bill sponsored by state Rep. Dan Frankel (D., Allegheny). In a co-sponsorship memo, Frankel said that while labs are required to test products, “the department lacks the authority to oversee the labs and verify the results as accurate.”

During the committee meeting, Frankel referenced the ongoing debate over legalizing recreational cannabis. Given the “significant disagreement” on that issue, Frankel said, “it’s surprising how little disagreement there is that the Department of Health needs more oversight of the labs that test” medical marijuana for safety. He also said the doctor oversight change “fits very neatly into this legislation.”

The amended legislation passed out of the full state House with a 194-8 vote on March 17 and now awaits action in the Senate Law and Justice Committee.

State Sen. Dan Laughlin (R., Erie), a supporter of adult-use cannabis legalization, chairs that committee. He has also endorsed changes to protect the gun rights of medical marijuana card holders and allow patients to grow a limited number of cannabis plants for personal use. In a statement, Laughlin didn’t address the specifics of the oversight proposals but said, “legislation involving cannabis deserves thorough review and I remain committed to using my position as Chairman to achieve this goal.”

Leaders from both parties in the state Senate told Spotlight PA they are interested in making changes to the medical marijuana program.

Commenting on the oversight proposal, state Senate Majority Leader Joe Pittman (R., Indiana) said in a statement that “the language and details of House Bill 33 will require an in-depth review,” but “action by the Senate on the measure is certainly possible at some point during this session.”

“It is clear Pennsylvania’s medical marijuana program was not implemented well and could benefit from potential changes to make the program more airtight, efficient, and productive,” Pittman added.

State Senate Minority Leader Jay Costa (D., Allegheny) said in a statement that his caucus supports the bill, adding that the oversight measures would “protect our medical cannabis patients from bad actors, dishonest laboratory practices, and dangerous contaminants.” But Costa said “our ultimate goal is the creation of an adult-use recreational cannabis program.”

Democratic Gov. Josh Shapiro has pitched legalizing recreational cannabis as part of the budget that is due by the end of June, but similar proposals have failed to clear the Pennsylvania legislature in past years. Spotlight PA reported in February that a lack of state Senate support could again sink Shapiro’s adult-use bid.

The Pennsylvania Cannabis Coalition, a trade group that supports adult-use legalization, has not taken a formal position on the oversight legislation, said Meredith Buettner Schneider, executive director of the group. But she expressed concerns about the potential to “increase costs for patients or … increase barriers to entry to the medical marijuana program for patients.”

Venkat, the Democratic lawmaker and physician, told Spotlight PA he thinks there is probably an appropriate way to legalize adult-use cannabis, but he wants to see details. Still, he said legalization should not happen “through a back door” of the medical program.

“I don’t think it was the intention of the General Assembly for us to have a de facto legalization program, and I’m concerned that that’s what we have set up with the lack of oversight of the medical marijuana program,” he said.

‘Extraordinary’ numbers

During recent state Senate budget hearings, Brown highlighted a handful of doctors who each approved at least 11,000 certifications in a year.

“If you break that down, it’s a crazy amount … per day, per minute that they would prescribe,” she said.

Secretary of the Commonwealth Al Schmidt called the numbers “extraordinary.” Schmidt heads the Pennsylvania Department of State, which oversees physician licensing. He also said the department’s investigations are “complaint-driven.”

A spokesperson for the agency later told Spotlight PA the department is “dedicated to protecting the health and safety of the public” and “reviews every potential license violation of which it becomes aware,” including ones based on notifications from other agencies and media reports.

In a separate budget hearing, Secretary of Health Debra Bogen said in response to questioning that her agency monitors “certification processes,” refers concerns to the Department of State, and investigates complaints. But she also said the department’s “current authority is limited.”

“We’re happy to discuss whether … that should change,” she added.

A health department spokesperson previously told Spotlight PA that the number of certifications for individual doctors “can vary widely due to factors such as the practitioner’s specialty, practice setting, patient population, and geographic location.”

In response to questions following the recent budget hearings, department spokesperson Mark O’Neill described a number of changes under the Shapiro administration, saying the agency has added staff, improved communications, and increased transparency.

Brown is one of the lawmakers who voted in favor of legalizing medical marijuana in 2016, but the program “has not rolled out in the way that I think it should have,” she said.

The lawmaker told Spotlight PA she’s looking into introducing her own medical marijuana legislation to address her concerns. She said the responses she received from Bogen and Schmidt were vague.

“They really didn’t offer me any insight to any actions taken,” Brown said. “It was almost like ping-ponging the concern to each agency.”

Spotlight PA obtained the doctor certification data with assistance from attorney Paula Knudsen Burke of the Reporters Committee for Freedom of the Press. Burke represented the news organization at no cost in separate cases that led to the release of data on why patients qualify for the program and which doctors issue the most certifications.

“The investigations that have resulted from the release of these records clearly illustrate why it is so important for journalists and news organizations to fight back when government agencies try to withhold information from the public,” Burke said earlier this year.

She added: “Spotlight PA’s reporting on Pennsylvania’s medical marijuana program is a huge public service, one that will help guide health officials and lawmakers as they assess the program and consider potential reforms.”

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