This document includes House Floor Amendments incorporated into the bill on Fri, Mar 5, 2021 at 3:47 PM by pflowers.
Senator Luz Escamilla proposes the following substitute bill:


1     
CONSUMER PROTECTION FOR CANNABIS PATIENTS

2     
2021 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Luz Escamilla

5     
House Sponsor: Raymond P. Ward

6     

7     LONG TITLE
8     General Description:
9          This bill amends provisions relating to patient access to medical cannabis
10     recommendations from medical providers.
11     Highlighted Provisions:
12          This bill:
13          ▸     defines terms;
14          ▸     amends a labeling requirement for consistency;
15          ▸     allows a licensed podiatrist to recommend medical cannabis within the course and
16     scope of a practice of podiatry;
17          ▸     requires the state electronic verification system to allow a medical cannabis
18     pharmacy to record a medical cannabis recommendation from a limited medical
19     provider;
20          ▸     allows certain medical providers to operate as limited medical providers to
21     recommend cannabis to a limited number of the provider's patients without
22     registering with the Department of Health (department) as a qualified medical
23     provider (QMP);
24          ▸     requires QMPs, entities that employ QMPs, and applicants for a QMP registration
25     to provide certain information to the department regarding fees charged to a patient

26     for a medical cannabis recommendation;
27          ▸     requires the department to provide certain information, in coordination with a health
28     care transparency tool that the state auditor maintains, regarding fees charged to a
29     patient for a medical cannabis recommendations;
30          ▸     amends provisions to accommodate the allowance for limited medical providers;
31          ▸     allows a licensed podiatrist to become a qualified medical provider;
32          ▸     requires the department to issue an electronic conditional medical cannabis card to
33     allow certain medical cannabis card applicants access to medical cannabis;
34          ▸     requires medical cannabis pharmacies to record information in an order from a
35     limited medical provider in the state electronic verification system;
36          ▸     imposes certain verification requirements on a medical cannabis pharmacy before
37     entering certain orders from a limited medical provider or processing a transaction
38     for certain conditional medical cannabis cardholders;
39          ▸     requires a medical cannabis component in required continuing education for
40     controlled substance prescribers;
41          ▸     extends a deadline that imposes a limitation on an individual's use or possession of
42     medical cannabis from outside the state; and
43          ▸     makes technical and conforming changes.
44     Money Appropriated in this Bill:
45          None
46     Other Special Clauses:
47          This bill provides a special effective date.
48          This bill provides revisor instructions.
49     Utah Code Sections Affected:
50     AMENDS:
51          4-41a-102, as last amended by Laws of Utah 2020, Chapters 12, 148 and last amended
52     by Coordination Clause, Laws of Utah 2020, Chapter 148
53          4-41a-602, as last amended by Laws of Utah 2020, Chapter 12
54          26-61a-102, as last amended by Laws of Utah 2020, Chapters 12, 148 and last amended
55     by Coordination Clause, Laws of Utah 2020, Chapter 148
56          26-61a-103, as last amended by Laws of Utah 2020, Chapter 12

57          26-61a-106, as last amended by Laws of Utah 2020, Chapter 12
58          26-61a-107, as last amended by Laws of Utah 2020, Chapters 12, 148 and last amended
59     by Coordination Clause, Laws of Utah 2020, Chapter 148
60          26-61a-201, as last amended by Laws of Utah 2020, Chapters 12 and 148
61          26-61a-202, as last amended by Laws of Utah 2020, Chapter 12
62          26-61a-401, as last amended by Laws of Utah 2019, First Special Session, Chapter 5
63          26-61a-403, as last amended by Laws of Utah 2019, First Special Session, Chapter 5
64          26-61a-501, as last amended by Laws of Utah 2020, Chapter 12
65          26-61a-502, as last amended by Laws of Utah 2020, Chapters 12, 148 and last amended
66     by Coordination Clause, Laws of Utah 2020, Chapter 148
67          26-61a-503, as last amended by Laws of Utah 2019, First Special Session, Chapter 5
68          26-61a-601, as last amended by Laws of Utah 2020, Chapter 12
69          58-5a-102, as last amended by Laws of Utah 2020, Chapter 25
70          58-31b-502, as last amended by Laws of Utah 2020, Fifth Special Session, Chapter 4
71          58-37-3.7, as last amended by Laws of Utah 2020, Chapter 12
72          58-37-6.5, as last amended by Laws of Utah 2018, Chapter 318
73          58-67-502, as last amended by Laws of Utah 2020, Chapter 25
74          58-68-502, as last amended by Laws of Utah 2020, Chapter 25
75          58-70a-503, as last amended by Laws of Utah 2020, Chapter 25
76          62A-4a-404, as last amended by Laws of Utah 2020, Chapter 193
77          67-3-11, as enacted by Laws of Utah 2019, Chapter 370
78          78A-2-231, as last amended by Laws of Utah 2020, Chapter 12
79          78A-6-115, as last amended by Laws of Utah 2020, Chapters 12, 132, 250, and 354
80     Utah Code Sections Affected by Revisor Instructions:
81          26-61a-201, as last amended by Laws of Utah 2020, Chapters 12 and 148
82          58-37-3.7, as last amended by Laws of Utah 2020, Chapter 12
83     

84     Be it enacted by the Legislature of the state of Utah:
85          Section 1. Section 4-41a-102 is amended to read:
86          4-41a-102. Definitions.
87          As used in this chapter:

88          (1) "Active tetrahydrocannabinol" means delta-9-tetrahydrocannabinol and
89     tetrahydrocannabinolic acid.
90          (2) "Cannabis" means the same as that term is defined in Section 26-61a-102.
91          (3) "Cannabis cultivation facility" means a person that:
92          (a) possesses cannabis;
93          (b) grows or intends to grow cannabis; and
94          (c) sells or intends to sell cannabis to a cannabis cultivation facility, a cannabis
95     processing facility, or a medical cannabis research licensee.
96          (4) "Cannabis cultivation facility agent" means an individual who:
97          (a) is an employee of a cannabis cultivation facility; and
98          (b) holds a valid cannabis production establishment agent registration card.
99          (5) "Cannabis processing facility" means a person that:
100          (a) acquires or intends to acquire cannabis from a cannabis production establishment;
101          (b) possesses cannabis with the intent to manufacture a cannabis product;
102          (c) manufactures or intends to manufacture a cannabis product from unprocessed
103     cannabis or a cannabis extract; and
104          (d) sells or intends to sell a cannabis product to a medical cannabis pharmacy or a
105     medical cannabis research licensee.
106          (6) "Cannabis processing facility agent" means an individual who:
107          (a) is an employee of a cannabis processing facility; and
108          (b) holds a valid cannabis production establishment agent registration card.
109          (7) "Cannabis product" means the same as that term is defined in Section 26-61a-102.
110          (8) "Cannabis production establishment" means a cannabis cultivation facility, a
111     cannabis processing facility, or an independent cannabis testing laboratory.
112          (9) "Cannabis production establishment agent" means a cannabis cultivation facility
113     agent, a cannabis processing facility agent, or an independent cannabis testing laboratory agent.
114          (10) "Cannabis production establishment agent registration card" means a registration
115     card that the department issues that:
116          (a) authorizes an individual to act as a cannabis production establishment agent; and
117          (b) designates the type of cannabis production establishment for which an individual is
118     authorized to act as an agent.

119          (11) "Community location" means a public or private elementary or secondary school,
120     a church, a public library, a public playground, or a public park.
121          (12) "Cultivation space" means, quantified in square feet, the horizontal area in which
122     a cannabis cultivation facility cultivates cannabis, including each level of horizontal area if the
123     cannabis cultivation facility hangs, suspends, stacks, or otherwise positions plants above other
124     plants in multiple levels.
125          (13) "Department" means the Department of Agriculture and Food.
126          (14) "Family member" means a parent, step-parent, spouse, child, sibling, step-sibling,
127     uncle, aunt, nephew, niece, first cousin, mother-in-law, father-in-law, brother-in-law,
128     sister-in-law, son-in-law, daughter-in-law, grandparent, or grandchild.
129          (15) (a) "Independent cannabis testing laboratory" means a person that:
130          (i) conducts a chemical or other analysis of cannabis or a cannabis product; or
131          (ii) acquires, possesses, and transports cannabis or a cannabis product with the intent to
132     conduct a chemical or other analysis of the cannabis or cannabis product.
133          (b) "Independent cannabis testing laboratory" includes a laboratory that the department
134     operates in accordance with Subsection 4-41a-201(14).
135          (16) "Independent cannabis testing laboratory agent" means an individual who:
136          (a) is an employee of an independent cannabis testing laboratory; and
137          (b) holds a valid cannabis production establishment agent registration card.
138          (17) "Inventory control system" means a system described in Section 4-41a-103.
139          (18) "Medical cannabis" means the same as that term is defined in Section 26-61a-102.
140          (19) "Medical cannabis card" means the same as that term is defined in Section
141     26-61a-102.
142          (20) "Medical cannabis pharmacy" means the same as that term is defined in Section
143     26-61a-102.
144          (21) "Medical cannabis pharmacy agent" means the same as that term is defined in
145     Section 26-61a-102.
146          (22) "Medical cannabis research license" means a license that the department issues to
147     a research university for the purpose of obtaining and possessing medical cannabis for
148     academic research.
149          (23) "Medical cannabis research licensee" means a research university that the

150     department licenses to obtain and possess medical cannabis for academic research, in
151     accordance with Section 4-41a-901.
152          (24) "Medical cannabis treatment" means the same as that term is defined in Section
153     26-61a-102.
154          (25) "Medicinal dosage form" means the same as that term is defined in Section
155     26-61a-102.
156          (26) "Qualified medical provider" means the same as that term is defined in Section
157     26-61a-102.
158          (27) "Qualified Production Enterprise Fund" means the fund created in Section
159     4-41a-104.
160          (28) "Recommending medical provider" means the same as that term is defined in
161     Section 26-61a-102.
162          [(28)] (29) "Research university" means the same as that term is defined in Section
163     53B-7-702 and a private, nonprofit college or university in the state that:
164          (a) is accredited by the Northwest Commission on Colleges and Universities;
165          (b) grants doctoral degrees; and
166          (c) has a laboratory containing or a program researching a schedule I controlled
167     substance described in Section 58-37-4.
168          [(29)] (30) "State electronic verification system" means the system described in Section
169     26-61a-103.
170          [(30)] (31) "Tetrahydrocannabinol" means a substance derived from cannabis or a
171     synthetic equivalent as described in Subsection 58-37-4(2)(a)(iii)(AA).
172          [(31)] (32) "Total composite tetrahydrocannabinol" means all detectable forms of
173     tetrahydrocannabinol.
174          Section 2. Section 4-41a-602 is amended to read:
175          4-41a-602. Cannabis product -- Labeling and child-resistant packaging.
176          (1) For any cannabis product that a cannabis processing facility processes or produces
177     and for any raw cannabis that the facility packages, the facility shall:
178          (a) label the cannabis or cannabis product with a label that:
179          (i) clearly and unambiguously states that the cannabis product or package contains
180     cannabis;

181          (ii) clearly displays the amount of total composite tetrahydrocannabinol and
182     cannabidiol in the labeled container;
183          (iii) has a unique identification number that:
184          (A) is connected to the inventory control system; and
185          (B) identifies the unique cannabis product manufacturing process the cannabis
186     processing facility used to manufacture the cannabis product;
187          (iv) identifies the cannabinoid extraction process that the cannabis processing facility
188     used to create the cannabis product;
189          (v) does not display an image, word, or phrase that the facility knows or should know
190     appeals to children; and
191          (vi) discloses each active or potentially active ingredient, in order of prominence, and
192     possible allergen; and
193          (b) package the raw cannabis or cannabis product in a medicinal dosage form in a
194     container that:
195          (i) is tamper evident and tamper resistant;
196          (ii) does not appeal to children;
197          (iii) does not mimic a candy container;
198          (iv) is opaque;
199          (v) complies with child-resistant effectiveness standards that the United States
200     Consumer Product Safety Commission establishes; and
201          (vi) includes a warning label that states:
202          (A) for a container labeled before July 1, 2021, "WARNING: Cannabis has
203     intoxicating effects and may be addictive. Do not operate a vehicle or machinery under its
204     influence. KEEP OUT OF REACH OF CHILDREN. This product is for medical use only. Use
205     only as directed by a qualified medical provider."; or
206          (B) for a container labeled on or after July 1, 2021, "WARNING: Cannabis has
207     intoxicating effects and may be addictive. Do not operate a vehicle or machinery under its
208     influence. KEEP OUT OF REACH OF CHILDREN. This product is for medical use only. Use
209     only as directed by a recommending medical provider.".
210          (2) For any cannabis or cannabis product that the cannabis processing facility processes
211     into a gelatinous cube, gelatinous rectangular cuboid, or lozenge in a cube or rectangular

212     cuboid shape, the facility shall:
213          (a) ensure that the label described in Subsection (1)(a) does not contain a photograph or
214     other image of the content of the container; and
215          (b) include on the label described in Subsection (1)(a) a warning about the risks of
216     over-consumption.
217          (3) The department shall make rules in accordance with Title 63G, Chapter 3, Utah
218     Administrative Rulemaking Act to establish:
219          (a) a standard labeling format that:
220          (i) complies with the requirements of this section; and
221          (ii) ensures inclusion of a pharmacy label; and
222          (b) additional requirements on packaging for cannabis and cannabis products to ensure
223     safety and product quality.
224          Section 3. Section 26-61a-102 is amended to read:
225          26-61a-102. Definitions.
226          As used in this chapter:
227          (1) "Cannabis" means marijuana.
228          (2) "Cannabis cultivation facility" means the same as that term is defined in Section
229     4-41a-102.
230          (3) "Cannabis processing facility" means the same as that term is defined in Section
231     4-41a-102.
232          (4) "Cannabis product" means a product that:
233          (a) is intended for human use; and
234          (b) contains cannabis or tetrahydrocannabinol.
235          (5) "Cannabis production establishment" means the same as that term is defined in
236     Section 4-41a-102.
237          (6) "Cannabis production establishment agent" means the same as that term is defined
238     in Section 4-41a-102.
239          (7) "Cannabis production establishment agent registration card" means the same as that
240     term is defined in Section 4-41a-102.
241          (8) "Community location" means a public or private elementary or secondary school, a
242     church, a public library, a public playground, or a public park.

243          (9) "Conditional medical cannabis card" means an electronic medical cannabis card
244     that the department issues in accordance with Subsection 26-61a-201(1)(b) to allow an
245     applicant for a medical cannabis card to access medical cannabis during the department's
246     review of the application.
247          [(9)] (10) "Department" means the Department of Health.
248          [(10)] (11) "Designated caregiver" means:
249          (a) an individual:
250          (i) whom an individual with a medical cannabis patient card or a medical cannabis
251     guardian card designates as the patient's caregiver; and
252          (ii) who registers with the department under Section 26-61a-202; or
253          (b) (i) a facility that an individual designates as a designated caregiver in accordance
254     with Subsection 26-61a-202(1)(b); or
255          (ii) an assigned employee of the facility described in Subsection 26-61a-202(1)(b)(ii).
256          [(11)] (12) "Directions of use" means recommended routes of administration for a
257     medical cannabis treatment and suggested usage guidelines.
258          [(12)] (13) "Dosing guidelines" means a quantity range and frequency of administration
259     for a recommended treatment of medical cannabis.
260          [(13)] (14) "Financial institution" means a bank, trust company, savings institution, or
261     credit union, chartered and supervised under state or federal law.
262          [(14)] (15) "Home delivery medical cannabis pharmacy" means a medical cannabis
263     pharmacy that the department authorizes, as part of the pharmacy's license, to deliver medical
264     cannabis shipments to a medical cannabis cardholder's home address to fulfill electronic orders
265     that the state central patient portal facilitates.
266          [(15)] (16) "Inventory control system" means the system described in Section
267     4-41a-103.
268          [(16)] (17) "Legal dosage limit" means an amount that:
269          (a) is sufficient to provide 30 days of treatment based on the dosing guidelines that the
270     relevant [qualified] recommending medical provider or the pharmacy medical provider, in
271     accordance with Subsection 26-61a-201(4) or (5), recommends; and
272          (b) may not exceed:
273          (i) for unprocessed cannabis in a medicinal dosage form, 113 grams by weight; and

274          (ii) for a cannabis product in a medicinal dosage form, a quantity that contains, in total,
275     greater than 20 grams of active tetrahydrocannabinol.
276          [(17)] (18) "Legal use termination date" means a date on the label of a container of
277     unprocessed cannabis flower:
278          (a) that is 60 days after the date of purchase of the cannabis; and
279          (b) after which, the cannabis is no longer in a medicinal dosage form outside of the
280     primary residence of the relevant medical cannabis patient cardholder.
281          (19) "Limited medical provider" means an individual who:
282          (a) meets the recommending qualifications; and
283          (b) has no more than 15 patients with a valid medical cannabis patient card or
284     provisional patient card as a result of the individual's recommendation, in accordance with
285     Subsection 26-61a-106(1)(b).
286          [(18)] (20) "Marijuana" means the same as that term is defined in Section 58-37-2.
287          [(19)] (21) "Medical cannabis" means cannabis in a medicinal dosage form or a
288     cannabis product in a medicinal dosage form.
289          [(20)] (22) "Medical cannabis card" means a medical cannabis patient card, a medical
290     cannabis guardian card, [or] a medical cannabis caregiver card, or a conditional medical
291     cannabis card.
292          [(21)] (23) "Medical cannabis cardholder" means:
293          (a) a holder of a medical cannabis card; or
294          (b) a facility or assigned employee, described in Subsection [(10)] (11)(b), only:
295          (i) within the scope of the facility's or assigned employee's performance of the role of a
296     medical cannabis patient cardholder's caregiver designation under Subsection
297     26-61a-202(1)(b); and
298          (ii) while in possession of documentation that establishes:
299          (A) a caregiver designation described in Subsection 26-61a-202(1)(b);
300          (B) the identity of the individual presenting the documentation; and
301          (C) the relation of the individual presenting the documentation to the caregiver
302     designation.
303          [(22)] (24) "Medical cannabis caregiver card" means an electronic document that a
304     cardholder may print or store on an electronic device or a physical card or document that:

305          (a) the department issues to an individual whom a medical cannabis patient cardholder
306     or a medical cannabis guardian cardholder designates as a designated caregiver; and
307          (b) is connected to the electronic verification system.
308          (25) "Medical cannabis courier agent" means an individual who:
309          (a) is an employee of a medical cannabis courier; and
310          (b) who holds a valid medical cannabis courier agent registration card.
311          [(23)] (26) "Medical cannabis courier" means a courier that:
312          (a) the department licenses in accordance with Section 26-61a-604; and
313          (b) contracts with a home delivery medical cannabis pharmacy to deliver medical
314     cannabis shipments to fulfill electronic orders that the state central patient portal facilitates.
315          [(24)] (27) (a) "Medical cannabis device" means a device that an individual uses to
316     ingest or inhale cannabis in a medicinal dosage form or a cannabis product in a medicinal
317     dosage form.
318          (b) "Medical cannabis device" does not include a device that:
319          (i) facilitates cannabis combustion; or
320          (ii) an individual uses to ingest substances other than cannabis.
321          [(25)] (28) "Medical cannabis guardian card" means an electronic document that a
322     cardholder may print or store on an electronic device or a physical card or document that:
323          (a) the department issues to the parent or legal guardian of a minor with a qualifying
324     condition; and
325          (b) is connected to the electronic verification system.
326          [(26)] (29) "Medical cannabis patient card" means an electronic document that a
327     cardholder may print or store on an electronic device or a physical card or document that:
328          (a) the department issues to an individual with a qualifying condition; and
329          (b) is connected to the electronic verification system.
330          [(27)] (30) "Medical cannabis pharmacy" means a person that:
331          (a) (i) acquires or intends to acquire:
332          (A) cannabis in a medicinal dosage form or a cannabis product in a medicinal dosage
333     form from a cannabis processing facility; or
334          (B) a medical cannabis device; or
335          (ii) possesses cannabis in a medicinal dosage form, a cannabis product in a medicinal

336     dosage form, or a medical cannabis device; and
337          (b) sells or intends to sell cannabis in a medicinal dosage form, a cannabis product in a
338     medicinal dosage form, or a medical cannabis device to a medical cannabis cardholder.
339          [(28)] (31) "Medical cannabis pharmacy agent" means an individual who:
340          (a) is an employee of a medical cannabis pharmacy; and
341          (b) who holds a valid medical cannabis pharmacy agent registration card.
342          [(29)] (32) "Medical cannabis pharmacy agent registration card" means a registration
343     card issued by the department that authorizes an individual to act as a medical cannabis
344     pharmacy agent.
345          [(30)] (33) "Medical cannabis shipment" means a shipment of medical cannabis or a
346     medical cannabis product that a home delivery medical cannabis pharmacy or a medical
347     cannabis courier delivers to a medical cannabis cardholder's home address to fulfill an
348     electronic medical cannabis order that the state central patient portal facilitates.
349          [(31)] (34) "Medical cannabis treatment" means cannabis in a medicinal dosage form, a
350     cannabis product in a medicinal dosage form, or a medical cannabis device.
351          [(32)] (35) (a) "Medicinal dosage form" means:
352          (i) for processed medical cannabis or a medical cannabis product, the following with a
353     specific and consistent cannabinoid content:
354          (A) a tablet;
355          (B) a capsule;
356          (C) a concentrated liquid or viscous oil;
357          (D) a liquid suspension;
358          (E) a topical preparation;
359          (F) a transdermal preparation;
360          (G) a sublingual preparation;
361          (H) a gelatinous cube, gelatinous rectangular cuboid, or lozenge in a cube or
362     rectangular cuboid shape; or
363          (I) a resin or wax;
364          (ii) for unprocessed cannabis flower, a container described in Section 4-41a-602 that:
365          (A) contains cannabis flowers in a quantity that varies by no more than 10% from the
366     stated weight at the time of packaging;

367          (B) at any time the medical cannabis cardholder transports or possesses the container in
368     public, is contained within an opaque, child-resistant bag that the medical cannabis pharmacy
369     provides; and
370          (C) is labeled with the container's content and weight, the date of purchase, the legal
371     use termination date, and after December 31, 2020, a barcode that provides information
372     connected to an inventory control system; and
373          (iii) a form measured in grams, milligrams, or milliliters.
374          (b) "Medicinal dosage form" includes a portion of unprocessed cannabis flower that:
375          (i) the medical cannabis cardholder has recently removed from the container described
376     in Subsection [(32)] (35)(a)(ii) for use; and
377          (ii) does not exceed the quantity described in Subsection [(32)] (35)(a)(ii).
378          (c) "Medicinal dosage form" does not include:
379          (i) any unprocessed cannabis flower outside of the container described in Subsection
380     [(32)] (35)(a)(ii), except as provided in Subsection [(32)] (35)(b);
381          (ii) any unprocessed cannabis flower in a container described in Subsection [(32)]
382     (35)(a)(ii) after the legal use termination date; or
383          (iii) a process of vaporizing and inhaling concentrated cannabis by placing the cannabis
384     on a nail or other metal object that is heated by a flame, including a blowtorch.
385          [(33)] (36) "Nonresident patient" means an individual who:
386          (a) is not a resident of Utah or has been a resident of Utah for less than 45 days;
387          (b) has a currently valid medical cannabis card or the equivalent of a medical cannabis
388     card under the laws of another state, district, territory, commonwealth, or insular possession of
389     the United States; and
390          (c) has been diagnosed with a qualifying condition as described in Section 26-61a-104.
391          [(34)] (37) "Payment provider" means an entity that contracts with a cannabis
392     production establishment or medical cannabis pharmacy to facilitate transfers of funds between
393     the establishment or pharmacy and other businesses or individuals.
394          [(35)] (38) "Pharmacy medical provider" means the medical provider required to be on
395     site at a medical cannabis pharmacy under Section 26-61a-403.
396          [(36)] (39) "Provisional patient card" means a card that:
397          (a) the department issues to a minor with a qualifying condition for whom:

398          (i) a [qualified] recommending medical provider has recommended a medical cannabis
399     treatment; and
400          (ii) the department issues a medical cannabis guardian card to the minor's parent or
401     legal guardian; and
402          (b) is connected to the electronic verification system.
403          [(37)] (40) "Qualified medical provider" means an individual [who is qualified]:
404          (a) who meets the recommending qualifications; and
405          (b) whom the department registers to recommend treatment with cannabis in a
406     medicinal dosage form under Section 26-61a-106.
407          [(38)] (41) "Qualified Patient Enterprise Fund" means the enterprise fund created in
408     Section 26-61a-109.
409          [(39)] (42) "Qualifying condition" means a condition described in Section 26-61a-104.
410          [(40)] (43) "Recommend" or "recommendation" means, for a [qualified]
411     recommending medical provider, the act of suggesting the use of medical cannabis treatment,
412     which:
413          (a) certifies the patient's eligibility for a medical cannabis card; and
414          (b) may include, at the [qualified] recommending medical provider's discretion,
415     directions of use, with or without dosing guidelines.
416          (44) "Recommending medical provider" means a qualified medical provider or a
417     limited medical provider.
418          (45) "Recommending qualifications" means that an individual:
419          (a) (i) has the authority to write a prescription;
420          (ii) is licensed to prescribe a controlled substance under Title 58, Chapter 37, Utah
421     Controlled Substances Act; and
422          (iii) possesses the authority, in accordance with the individual's scope of practice, to
423     prescribe a Schedule II controlled substance; and
424          (b) who is licensed as:
425          (i) a podiatrist under Title 58, Chapter 5a, Podiatric Physician Licensing Act;
426          (ii) an advanced practice registered nurse under Title 58, Chapter 31b, Nurse Practice
427     Act;
428          (iii) a physician under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58,

429     Chapter 68, Utah Osteopathic Medical Practice Act; or
430          (iv) a physician assistant under Title 58, Chapter 70a, Utah Physician Assistant Act Ĥ→ .
431     [
whose:
432          (A) declaration of services agreement, as that term is defined in Section 58-70a-102,
433     includes the recommending of medical cannabis; and
434          (B) supervising physician is a qualified medical provider.
] ←Ĥ

435          [(41)] (46) "State central patient portal" means the website the department creates, in
436     accordance with Section 26-61a-601, to facilitate patient safety, education, and an electronic
437     medical cannabis order.
438          [(42)] (47) "State central patient portal medical provider" means a physician or
439     pharmacist that the department employs in relation to the state central patient portal to consult
440     with medical cannabis cardholders in accordance with Section 26-61a-602.
441          [(43)] (48) "State electronic verification system" means the system described in Section
442     26-61a-103.
443          [(44)] (49) "Valid form of photo identification" means any of the following forms of
444     identification that is either current or has expired within the previous six months:
445          (a) a valid state-issued driver license or identification card;
446          (b) a valid United States [federal- or state-issued] federal-issued photo identification,
447     including:
448          [(a) a driver license;]
449          [(b)] (i) a United States passport;
450          [(c)] (ii) a United States passport card; [or]
451          [(d)] (iii) a United States military identification card[.]; or
452          (iv) a permanent resident card or alien registration receipt card; or
453          (c) a passport that another country issued.
454          Section 4. Section 26-61a-103 is amended to read:
455          26-61a-103. Electronic verification system.
456          (1) The Department of Agriculture and Food, the department, the Department of Public
457     Safety, and the Department of Technology Services shall:
458          (a) enter into a memorandum of understanding in order to determine the function and
459     operation of the state electronic verification system in accordance with Subsection (2);

460          (b) coordinate with the Division of Purchasing, under Title 63G, Chapter 6a, Utah
461     Procurement Code, to develop a request for proposals for a third-party provider to develop and
462     maintain the state electronic verification system in coordination with the Department of
463     Technology Services; and
464          (c) select a third-party provider who:
465          (i) meets the requirements contained in the request for proposals issued under
466     Subsection (1)(b); and
467          (ii) may not have any commercial or ownership interest in a cannabis production
468     establishment or a medical cannabis pharmacy.
469          (2) The Department of Agriculture and Food, the department, the Department of Public
470     Safety, and the Department of Technology Services shall ensure that, on or before March 1,
471     2020, the state electronic verification system described in Subsection (1):
472          (a) allows an individual to apply for a medical cannabis patient card or, if applicable, a
473     medical cannabis guardian card, provided that the card may not become active until:
474          (i) the relevant qualified medical provider completes the associated medical cannabis
475     recommendation; or
476          (ii) for medical cannabis card related to a limited medical provider's recommendation,
477     the medical cannabis pharmacy completes the recording described in Subsection (2)(d);
478          (b) allows an individual to apply to renew a medical cannabis patient card or a medical
479     cannabis guardian card in accordance with Section 26-61a-201;
480          (c) allows a qualified medical provider, or an employee described in Subsection (3)
481     acting on behalf of the qualified medical provider, to:
482          (i) access dispensing and card status information regarding a patient:
483          (A) with whom the qualified medical provider has a provider-patient relationship; and
484          (B) for whom the qualified medical provider has recommended or is considering
485     recommending a medical cannabis card;
486          (ii) electronically recommend, after an initial face-to-face visit with a patient described
487     in Subsection 26-61a-201(4)(b), treatment with cannabis in a medicinal dosage form or a
488     cannabis product in a medicinal dosage form and optionally recommend dosing guidelines;
489          (iii) electronically renew a recommendation to a medical cannabis patient cardholder or
490     medical cannabis guardian cardholder:

491          (A) using telehealth services, for the qualified medical provider who originally
492     recommended a medical cannabis treatment during a face-to-face visit with the patient; or
493          (B) during a face-to-face visit with the patient, for a qualified medical provider who
494     did not originally recommend the medical cannabis treatment during a face-to-face visit; and
495          (iv) notate a determination of physical difficulty or undue hardship, described in
496     Subsection 26-61a-202(1), to qualify a patient to designate a caregiver;
497          (d) beginning on the earlier of September 1, 2021, or the date on which the electronic
498     verification system is functionally capable of facility medical cannabis pharmacy recording,
499     allows a medical cannabis pharmacy medical provider or medical cannabis pharmacy agent, in
500     accordance with Subsection 26-61a-501(11)(a), to record:
501          (i) a patient's recommendation from a limited medical provider, including any
502     directions of use, dosing guidelines, or caregiver indications from the limited medical provider;
503     and
504          (ii) a limited medical provider's renewal of the provider's previous recommendation;
505          [(d)] (e) connects with:
506          (i) an inventory control system that a medical cannabis pharmacy uses to track in real
507     time and archive purchases of any cannabis in a medicinal dosage form, cannabis product in a
508     medicinal dosage form, or a medical cannabis device, including:
509          (A) the time and date of each purchase;
510          (B) the quantity and type of cannabis, cannabis product, or medical cannabis device
511     purchased;
512          (C) any cannabis production establishment, any medical cannabis pharmacy, or any
513     medical cannabis courier associated with the cannabis, cannabis product, or medical cannabis
514     device; and
515          (D) the personally identifiable information of the medical cannabis cardholder who
516     made the purchase; and
517          (ii) any commercially available inventory control system that a cannabis production
518     establishment utilizes in accordance with Section 4-41a-103 to use data that the Department of
519     Agriculture and Food requires by rule, in accordance with Title 63G, Chapter 3, Utah
520     Administrative Rulemaking Act, from the inventory tracking system that a licensee uses to
521     track and confirm compliance;

522          [(e)] (f) provides access to:
523          (i) the department to the extent necessary to carry out the department's functions and
524     responsibilities under this chapter;
525          (ii) the Department of Agriculture and Food to the extent necessary to carry out the
526     functions and responsibilities of the Department of Agriculture and Food under Title 4, Chapter
527     41a, Cannabis Production Establishments; and
528          (iii) the Division of Occupational and Professional Licensing to the extent necessary to
529     carry out the functions and responsibilities related to the participation of the following in the
530     recommendation and dispensing of medical cannabis:
531          (A) a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act;
532          [(A)] (B) a pharmacist licensed under Title 58, Chapter 17b, Pharmacy Practice Act;
533          [(B)] (C) an advanced practice registered nurse licensed under Title 58, Chapter 31b,
534     Nurse Practice Act;
535          [(C)] (D) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act,
536     or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
537          [(D)] (E) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
538     Assistant Act;
539          [(f)] (g) provides access to and interaction with the state central patient portal;
540          [(g)] (h) provides access to state or local law enforcement:
541          (i) during a law enforcement encounter, without a warrant, using the individual's driver
542     license or state ID, only for the purpose of determining if the individual subject to the law
543     enforcement encounter has a valid medical cannabis card; or
544          (ii) after obtaining a warrant; and
545          [(h)] (i) creates a record each time a person accesses the database that identifies the
546     person who accesses the database and the individual whose records the person accesses.
547          (3) (a) Beginning on the earlier of January 1, 2021, or the date on which the electronic
548     verification system is functionally capable of allowing employee access under this Subsection
549     (3), an employee of a qualified medical provider may access the electronic verification system
550     for a purpose described in Subsection (2)(c) on behalf of the qualified medical provider if:
551          (i) the qualified medical provider has designated the employee as an individual
552     authorized to access the electronic verification system on behalf of the qualified medical

553     provider;
554          (ii) the qualified medical provider provides written notice to the department of the
555     employee's identity and the designation described in Subsection (3)(a)(i); and
556          (iii) the department grants to the employee access to the electronic verification system.
557          (b) An employee of a business that employs a qualified medical provider may access
558     the electronic verification system for a purpose described in Subsection (2)(c) on behalf of the
559     qualified medical provider if:
560          (i) the qualified medical provider has designated the employee as an individual
561     authorized to access the electronic verification system on behalf of the qualified medical
562     provider;
563          (ii) the qualified medical provider and the employing business jointly provide written
564     notice to the department of the employee's identity and the designation described in Subsection
565     (3)(b)(i); and
566          (iii) the department grants to the employee access to the electronic verification system.
567          (4) (a) As used in this Subsection (4), "prescribing provider" means:
568          (i) a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act;
569          [(i)] (ii) an advanced practice registered nurse licensed under Title 58, Chapter 31b,
570     Nurse Practice Act;
571          [(ii)] (iii) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act,
572     or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
573          [(iii)] (iv) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
574     Assistant Act.
575          (b) Beginning on the earlier of January 1, 2021, or the date on which the electronic
576     verification system is functionally capable of allowing provider access under this Subsection
577     (4), a prescribing provider may access information in the electronic verification system
578     regarding a patient the prescribing provider treats.
579          (5) The department may release limited data that the system collects for the purpose of:
580          (a) conducting medical and other department approved research;
581          (b) providing the report required by Section 26-61a-703; and
582          (c) other official department purposes.
583          (6) The department shall make rules, in accordance with Title 63G, Chapter 3, Utah

584     Administrative Rulemaking Act, to establish:
585          (a) the limitations on access to the data in the state electronic verification system as
586     described in this section; and
587          (b) standards and procedures to ensure accurate identification of an individual
588     requesting information or receiving information in this section.
589          (7) (a) Any person who knowingly and intentionally releases any information in the
590     state electronic verification system in violation of this section is guilty of a third degree felony.
591          (b) Any person who negligently or recklessly releases any information in the state
592     electronic verification system in violation of this section is guilty of a class C misdemeanor.
593          (8) (a) Any person who obtains or attempts to obtain information from the state
594     electronic verification system by misrepresentation or fraud is guilty of a third degree felony.
595          (b) Any person who obtains or attempts to obtain information from the state electronic
596     verification system for a purpose other than a purpose this chapter authorizes is guilty of a third
597     degree felony.
598          (9) (a) Except as provided in Subsection (9)(e), a person may not knowingly and
599     intentionally use, release, publish, or otherwise make available to any other person information
600     obtained from the state electronic verification system for any purpose other than a purpose
601     specified in this section.
602          (b) Each separate violation of this Subsection (9) is:
603          (i) a third degree felony; and
604          (ii) subject to a civil penalty not to exceed $5,000.
605          (c) The department shall determine a civil violation of this Subsection (9) in
606     accordance with Title 63G, Chapter 4, Administrative Procedures Act.
607          (d) Civil penalties assessed under this Subsection (9) shall be deposited into the
608     General Fund.
609          (e) This Subsection (9) does not prohibit a person who obtains information from the
610     state electronic verification system under Subsection (2)(a), (c), or (f) from:
611          (i) including the information in the person's medical chart or file for access by a person
612     authorized to review the medical chart or file;
613          (ii) providing the information to a person in accordance with the requirements of the
614     Health Insurance Portability and Accountability Act of 1996; or

615          (iii) discussing or sharing that information about the patient with the patient.
616          Section 5. Section 26-61a-106 is amended to read:
617          26-61a-106. Qualified medical provider registration -- Continuing education --
618     Treatment recommendation -- Limited medical provider.
619          (1) (a) (i) Except as provided in Subsection (1)(b), an individual may not recommend a
620     medical cannabis treatment unless the department registers the individual as a qualified
621     medical provider in accordance with this section.
622          (ii) Notwithstanding Subsection (1)(a)(i), a qualified medical provider who is podiatrist
623     licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act, may not recommend a
624     medical cannabis treatment except within the course and scope of a practice of podiatry, as that
625     term is defined in Section 58-5a-102.
626          (b) [An] Beginning on the earlier of September 1, 2021, or the date on which the
627     department gives notice of that the electronic verification system is functionally capable as
628     described in Subsection 26-61a-103(2)(d), an individual who meets the recommending
629     qualifications [in Subsections 26-61a-106(2)(a)(iii) and (iv)] may recommend a medical
630     cannabis treatment as a limited medical provider without registering under Subsection (1)(a)
631     [until January 1, 2021.] if:
632          (i) the individual recommends the use of medical cannabis to the patient through an
633     order described in Subsection (1)(c) after:
634          (A) a face-to-face visit for an initial recommendation or the renewal of a
635     recommendation for a patient for whom the limited medical provider did not make the patient's
636     original recommendation; or
637          (B) a visit using telehealth services for a renewal of a recommendation for a patient for
638     whom the limited medical provider made the patient's original recommendation; and
639          (ii) the individual's recommendation or renewal would not cause the total number of
640     the individual's patients who have a valid medical cannabis patient card or provisional patient
641     card resulting from the individual's recommendation to exceed 15.
642          (c) The individual described in Subsection (1)(b) shall communicate the individual's
643     recommendation through an order for the medical cannabis pharmacy to record the individual's
644     recommendation or renewal in the state electronic verification system under the individual's
645     recommendation that:

646          (i) (A) that the individual or the individual's employee sends electronically to a medical
647     cannabis pharmacy; or
648          (B) that the individual gives to the patient in writing for the patient to deliver to a
649     medical cannabis pharmacy; and
650          (ii) may include:
651          (A) directions of use or dosing guidelines; and
652          (B) an indication of a need for a caregiver in accordance with Subsection
653     26-61a-201(3)(c).
654          (d) If the limited medical provider gives the patient a written recommendation to
655     deliver to a medical cannabis pharmacy under Subsection (1)(c)(i)(B), the limited medical
656     provider shall ensure that the document includes all of the information that is included on a
657     prescription the provider would issue for a controlled substance, including:
658          (i) the date of issuance;
659          (ii) the provider's name, address and contact information, controlled substance license
660     information, and signature; and
661          (iii) the patient's name, address and contact information, age, and diagnosed qualifying
662     condition.
663          (e) In considering making a recommendation as a limited medical provider, an
664     individual may consult information that the department makes available on the department's
665     website for recommending providers.
666          (2) (a) The department shall, within 15 days after the day on which the department
667     receives an application from an individual, register and issue a qualified medical provider
668     registration card to the individual if the individual:
669          (i) provides to the department the individual's name and address;
670          (ii) provides to the department a report detailing the individual's completion of the
671     applicable continuing education requirement described in Subsection (3);
672          (iii) provides to the department evidence that the individual[:] meets the
673     recommending qualifications;
674          [(A) has the authority to write a prescription;]
675          [(B) is licensed to prescribe a controlled substance under Title 58, Chapter 37, Utah
676     Controlled Substances Act; and]

677          [(C) possesses the authority, in accordance with the individual's scope of practice, to
678     prescribe a Schedule II controlled substance;]
679          [(iv) provides to the department evidence that the individual is:]
680          [(A) an advanced practice registered nurse licensed under Title 58, Chapter 31b, Nurse
681     Practice Act;]
682          [(B) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or
683     Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or]
684          [(C) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
685     Assistant Act, whose declaration of services agreement, as that term is defined in Section
686     58-70a-102, includes the recommending of medical cannabis, and whose supervising physician
687     is a qualified medical provider; and]
688          (iv) for an applicant on or after November 1, 2021, provides to the department the
689     information described in Subsection (10)(a); and
690          (v) pays the department a fee in an amount that:
691          (A) the department sets, in accordance with Section 63J-1-504; and
692          (B) does not exceed $300 for an initial registration.
693          (b) The department may not register an individual as a qualified medical provider if the
694     individual is:
695          (i) a pharmacy medical provider; or
696          (ii) an owner, officer, director, board member, employee, or agent of a cannabis
697     production establishment, a medical cannabis pharmacy, or a medical cannabis courier.
698          (3) (a) An individual shall complete the continuing education described in this
699     Subsection (3) in the following amounts:
700          (i) for an individual as a condition precedent to registration, four hours; and
701          (ii) for a qualified medical provider as a condition precedent to renewal, four hours
702     every two years.
703          (b) In accordance with Subsection (3)(a), a qualified medical provider shall:
704          (i) complete continuing education:
705          (A) regarding the topics described in Subsection (3)(d); and
706          (B) offered by the department under Subsection (3)(c) or an accredited or approved
707     continuing education provider that the department recognizes as offering continuing education

708     appropriate for the recommendation of cannabis to patients; and
709          (ii) make a continuing education report to the department in accordance with a process
710     that the department establishes by rule, in accordance with Title 63G, Chapter 3, Utah
711     Administrative Rulemaking Act, and in collaboration with the Division of Occupational and
712     Professional Licensing and:
713          (A) for a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing
714     Act, the Podiatric Physician Board;
715          [(A)] (B) for an advanced practice registered nurse licensed under Title 58, Chapter
716     31b, Nurse Practice Act, the Board of Nursing;
717          [(B)] (C) for a qualified medical provider licensed under Title 58, Chapter 67, Utah
718     Medical Practice Act, the Physicians Licensing Board;
719          [(C)] (D) for a qualified medical provider licensed under Title 58, Chapter 68, Utah
720     Osteopathic Medical Practice Act, the Osteopathic Physician and Surgeon's Licensing Board;
721     and
722          [(D)] (E) for a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
723     Assistant Act, the Physician Assistant Licensing Board.
724          (c) The department may, in consultation with the Division of Occupational and
725     Professional Licensing, develop the continuing education described in this Subsection (3).
726          (d) The continuing education described in this Subsection (3) may discuss:
727          (i) the provisions of this chapter;
728          (ii) general information about medical cannabis under federal and state law;
729          (iii) the latest scientific research on the endocannabinoid system and medical cannabis,
730     including risks and benefits;
731          (iv) recommendations for medical cannabis as it relates to the continuing care of a
732     patient in pain management, risk management, potential addiction, or palliative care; and
733          (v) best practices for recommending the form and dosage of medical cannabis products
734     based on the qualifying condition underlying a medical cannabis recommendation.
735          (4) (a) Except as provided in Subsection (4)(b), a qualified medical provider may not
736     recommend a medical cannabis treatment to more than 275 of the qualified medical provider's
737     patients at the same time, as determined by the number of medical cannabis cards under the
738     qualified medical provider's name in the state electronic verification system.

739          (b) A qualified medical provider may recommend a medical cannabis treatment to up to
740     600 of the qualified medical provider's patients at any given time, as determined by the number
741     of medical cannabis cards under the qualified medical provider's name in the state electronic
742     verification system, if:
743          (i) the appropriate American medical board has certified the qualified medical provider
744     in the specialty of anesthesiology, gastroenterology, neurology, oncology, pain, hospice and
745     palliative medicine, physical medicine and rehabilitation, rheumatology, endocrinology, or
746     psychiatry; or
747          (ii) a licensed business employs or contracts with the qualified medical provider for the
748     specific purpose of providing hospice and palliative care.
749          (5) A [qualified] recommending medical provider may recommend medical cannabis to
750     an individual under this chapter only in the course of a [qualified medical] provider-patient
751     relationship after the [qualifying] recommending medical provider has completed and
752     documented in the patient's medical record a thorough assessment of the patient's condition and
753     medical history based on the appropriate standard of care for the patient's condition.
754          (6) (a) Except as provided in Subsection (6)(b), an individual may not advertise that the
755     individual recommends medical cannabis treatment in accordance with this chapter.
756          (b) For purposes of Subsection (6)(a), the communication of the following, through a
757     website, by [an individual described in Subsection (6)(c)] a qualified medical provider, does
758     not constitute advertising:
759          (i) a green cross;
760          (ii) a qualifying condition that the qualified medical provider treats; or
761          (iii) a scientific study regarding medical cannabis use.
762          [(c) The following are subject to Subsection (6)(b):]
763          [(i) before the department begins registering qualified medical providers:]
764          [(A) an advanced practice registered nurse described in Subsection (2)(a)(iv)(A);]
765          [(B) a physician described in Subsection (2)(a)(iv)(B); or]
766          [(C) a physician assistant described in Subsection (2)(a)(iv)(C); and]
767          [(ii) after the department begins registering qualified medical providers, a qualified
768     medical provider.]
769          (7) (a) A qualified medical provider registration card expires two years after the day on

770     which the department issues the card.
771          (b) The department shall renew a qualified medical provider's registration card if the
772     provider:
773          (i) applies for renewal;
774          (ii) is eligible for a qualified medical provider registration card under this section,
775     including maintaining an unrestricted license [as described in Subsection (2)(a)(iii)] under the
776     recommending qualifications;
777          (iii) certifies to the department in a renewal application that the information in
778     Subsection (2)(a) is accurate or updates the information;
779          (iv) submits a report detailing the completion of the continuing education requirement
780     described in Subsection (3); and
781          (v) pays the department a fee in an amount that:
782          (A) the department sets, in accordance with Section 63J-1-504; and
783          (B) does not exceed $50 for a registration renewal.
784          (8) The department may revoke the registration of a qualified medical provider who
785     fails to maintain compliance with the requirements of this section.
786          (9) A [qualified] recommending medical provider may not receive any compensation
787     or benefit for the qualified medical provider's medical cannabis treatment recommendation
788     from:
789          (a) a cannabis production establishment or an owner, officer, director, board member,
790     employee, or agent of a cannabis production establishment;
791          (b) a medical cannabis pharmacy or an owner, officer, director, board member,
792     employee, or agent of a medical cannabis pharmacy; or
793          (c) a [qualified] recommending medical provider or pharmacy medical provider.
794          (10) (a) On or before November 1, 2021, a qualified medical provider shall report to
795     the department, in a manner designated by the department:
796          (i) if applicable, that the qualified medical provider or the entity that employs the
797     qualified medical provider represents online or on printed material that the qualified medical
798     provider is a qualified medical provider or offers medical cannabis recommendations to
799     patients; and
800          (ii) the fee amount that the qualified medical provider or the entity that employs the

801     qualified medical provider charges a patient for a medical cannabis recommendation, either as
802     an actual cash rate or, if the provider or entity bills insurance, an average cash rate.
803          (b) The department shall:
804          (i) ensure that the following information related to qualified medical providers and
805     entities described in Subsection (10)(a)(i) is available on the department's website or on the
806     health care price transparency tool under Subsection (b)(ii):
807          (A) the name of the qualified medical provider and, if applicable, the name of the
808     entity that employs the qualified medical provider;
809          (B) the address of the qualified medical provider's office or, if applicable, the entity
810     that employs the qualified medical provider; and
811          (C) the fee amount described in Subsection (10(a)(ii); and
812          (ii) share data collected under this Subsection (10) with the state auditor for use in the
813     health care price transparency tool described in Section 67-3-11.
814          Section 6. Section 26-61a-107 is amended to read:
815          26-61a-107. Standard of care -- Physicians and pharmacists not liable -- No
816     private right of action.
817          (1) An individual described in Subsection (2) is not subject to the following solely for
818     violating a federal law or regulation that would otherwise prohibit recommending, prescribing,
819     or dispensing medical cannabis, a medical cannabis product, or a cannabis-based drug that the
820     United States Food and Drug Administration has not approved:
821          (a) civil or criminal liability; or
822          (b) licensure sanctions under Title 58, Chapter 17b, Pharmacy Practice Act, Title 58,
823     Chapter 31b, Nurse Practice Act, Title 58, Chapter 67, Utah Medical Practice Act, Title 58,
824     Chapter 68, Utah Osteopathic Medical Practice Act, or Title 58, Chapter 70a, Utah Physician
825     Assistant Act.
826          (2) The limitations of liability described in Subsection (1) apply to:
827          (a) a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act,
828     an advanced practice registered nurse licensed under Title 58, Chapter 31b, Nurse Practice Act,
829     a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58,
830     Chapter 68, Utah Osteopathic Medical Practice Act, or a physician assistant licensed under
831     Title 58, Chapter 70a, Utah Physician Assistant Act:

832          (i) (A) whom the department has registered as a qualified medical provider; [and] or
833          (B) who makes a recommendation as a limited medical provider; and
834          [(B)] (ii) who recommends treatment with cannabis in a medicinal dosage form or a
835     cannabis product in a medicinal dosage form to a patient in accordance with this chapter; [or]
836     and
837          [(ii) before January 1, 2021, who:]
838          [(A) has the authority to write a prescription; and]
839          [(B) recommends a medical cannabis treatment to a patient who has a qualifying
840     condition; and]
841          (b) a pharmacist licensed under Title 58, Chapter 17b, Pharmacy Practice Act:
842          (i) whom the department has registered as a pharmacy medical provider; and
843          (ii) who dispenses, in a medical cannabis pharmacy, treatment with cannabis in a
844     medicinal dosage form or a cannabis product in a medicinal dosage form to a medical cannabis
845     cardholder in accordance with this chapter.
846          (3) Nothing in this section or chapter reduces or in any way negates the duty of an
847     individual described in Subsection (2) to use reasonable and ordinary care in the treatment of a
848     patient:
849          (a) who may have a qualifying condition; and
850          (b) (i) for whom the individual described in Subsection (2)(a)(i) or (ii) has
851     recommended or might consider recommending a treatment with cannabis or a cannabis
852     product; or
853          (ii) with whom the pharmacist described in Subsection (2)(b) has interacted in the
854     dosing or dispensing of cannabis or a cannabis product.
855          (4) (a) As used in this Subsection (4), "healthcare facility" means the same as that term
856     is defined in Section 26-21-2.
857          (b) A healthcare facility may adopt restrictions on the possession, use, and storage of
858     medical cannabis on the premises of the healthcare facility by a medical cannabis cardholder
859     who resides at or is actively receiving treatment or care at the healthcare facility.
860          (c) An employee or agent of a healthcare facility described in this Subsection (4) is not
861     subject to civil or criminal liability for carrying out employment duties, including:
862          (i) providing or supervising care to a medical cannabis cardholder; or

863          (ii) in accordance with a caregiver designation under Section [26-61a-201] 26-61a-202
864     for a medical cannabis cardholder residing at the healthcare facility, purchasing, transporting,
865     or possessing medical cannabis for the relevant patient and in accordance with the designation.
866          (d) Nothing in this section requires a healthcare facility to adopt a restriction under
867     Subsection (4)(b).
868          Section 7. Section 26-61a-201 is amended to read:
869          26-61a-201. Medical cannabis patient card -- Medical cannabis guardian card --
870     Conditional medical cannabis card -- Application -- Fees -- Studies.
871          (1) (a) [On or before March 1, 2020, the] The department shall, within 15 days after the
872     day on which an individual who satisfies the eligibility criteria in this section or Section
873     26-61a-202 submits an application in accordance with this section or Section 26-61a-202:
874          [(a)] (i) issue a medical cannabis patient card to an individual described in Subsection
875     (2)(a);
876          [(b)] (ii) issue a medical cannabis guardian card to an individual described in
877     Subsection (2)(b);
878          [(c)] (iii) issue a provisional patient card to a minor described in Subsection (2)(c); and
879          [(d)] (iv) issue a medical cannabis caregiver card to an individual described in
880     Subsection 26-61a-202(4).
881          (b) (i) Beginning on the earlier of September 1, 2021, or the date on which the
882     electronic verification system is functionally capable of facilitating a conditional medical
883     cannabis card under this Subsection (1)(b), upon the entry of a recommending medical
884     provider's medical cannabis recommendation for a patient in the state electronic verification
885     system, either by the provider or the provider's employee or by a medical cannabis pharmacy
886     medical provider or medical cannabis pharmacy in accordance with Subsection
887     26-61a-501(11)(a), the department shall issue to the patient an electronic conditional medical
888     cannabis card, in accordance with this Subsection (1)(b).
889          (ii) A conditional medical cannabis card is valid for the lesser of:
890          (A) 60 days; or
891          (B) the day on which the department completes the department's review and issues a
892     medical cannabis card under Subsection (1)(a), denies the patient's medical cannabis card
893     application, or revokes the conditional medical cannabis card under Subsection (8).

894          (iii) The department may issue a conditional medical cannabis card to an individual
895     applying for a medical cannabis patient card for which approval of the Compassionate Use
896     Board is not required.
897          (iv) An individual described in Subsection (1)(b)(iii) has the rights, restrictions, and
898     obligations under law applicable to a holder of the medical cannabis card for which the
899     individual applies and for which the department issues the conditional medical cannabis card.
900          (2) (a) An individual is eligible for a medical cannabis patient card if:
901          (i) (A) the individual is at least 21 years old; or
902          (B) the individual is 18, 19, or 20 years old, the individual petitions the Compassionate
903     Use Board under Section 26-61a-105, and the Compassionate Use Board recommends
904     department approval of the petition;
905          (ii) the individual is a Utah resident;
906          (iii) the individual's [qualified] recommending medical provider recommends treatment
907     with medical cannabis in accordance with Subsection (4);
908          (iv) the individual signs an acknowledgment stating that the individual received the
909     information described in Subsection (8); and
910          (v) the individual pays to the department a fee in an amount that, subject to Subsection
911     26-61a-109(5), the department sets in accordance with Section 63J-1-504.
912          (b) (i) An individual is eligible for a medical cannabis guardian card if the individual:
913          (A) is at least 18 years old;
914          (B) is a Utah resident;
915          (C) is the parent or legal guardian of a minor for whom the minor's qualified medical
916     provider recommends a medical cannabis treatment, the individual petitions the Compassionate
917     Use Board under Section 26-61a-105, and the Compassionate Use Board recommends
918     department approval of the petition;
919          (D) the individual signs an acknowledgment stating that the individual received the
920     information described in Subsection [(8)] (9);
921          (E) pays to the department a fee in an amount that, subject to Subsection
922     26-61a-109(5), the department sets in accordance with Section 63J-1-504, plus the cost of the
923     criminal background check described in Section 26-61a-203; and
924          (F) the individual has not been convicted of a misdemeanor or felony drug distribution

925     offense under either state or federal law, unless the individual completed any imposed sentence
926     six months or more before the day on which the individual applies for a medical cannabis
927     guardian card.
928          (ii) The department shall notify the Department of Public Safety of each individual that
929     the department registers for a medical cannabis guardian card.
930          (c) (i) A minor is eligible for a provisional patient card if:
931          (A) the minor has a qualifying condition;
932          (B) the minor's qualified medical provider recommends a medical cannabis treatment
933     to address the minor's qualifying condition;
934          (C) the minor's parent or legal guardian petitions the Compassionate Use Board under
935     Section 26-61a-105, and the Compassionate Use Board recommends department approval of
936     the petition; and
937          (D) the minor's parent or legal guardian is eligible for a medical cannabis guardian card
938     under Subsection (2)(b) or designates a caregiver under Subsection (2)(d) who is eligible for a
939     medical cannabis caregiver card under Section 26-61a-202.
940          (ii) The department shall automatically issue a provisional patient card to the minor
941     described in Subsection (2)(c)(i) at the same time the department issues a medical cannabis
942     guardian card to the minor's parent or legal guardian.
943          (d) Beginning on the earlier of January 1, 2021, or the date on which the electronic
944     verification system is functionally capable of servicing the designation, if the parent or legal
945     guardian of a minor described in Subsections (2)(c)(i)(A) through (C) does not qualify for a
946     medical cannabis guardian card under Subsection (2)(b), the parent or legal guardian may
947     designate up to two caregivers in accordance with Subsection 26-61a-202(1)(c) to ensure that
948     the minor has adequate and safe access to the recommended medical cannabis treatment.
949          (3) (a) An individual who is eligible for a medical cannabis card described in
950     Subsection (2)(a) or (b) shall submit an application for a medical cannabis card to the
951     department:
952          (i) through an electronic application connected to the state electronic verification
953     system;
954          (ii) with the recommending [qualified] medical provider; and
955          (iii) with information including:

956          (A) the applicant's name, gender, age, and address;
957          (B) the number of the applicant's valid form of photo identification;
958          (C) for a medical cannabis guardian card, the name, gender, and age of the minor
959     receiving a medical cannabis treatment under the cardholder's medical cannabis guardian card;
960     and
961          (D) for a provisional patient card, the name of the minor's parent or legal guardian who
962     holds the associated medical cannabis guardian card.
963          (b) The department shall ensure that a medical cannabis card the department issues
964     under this section contains the information described in Subsection (3)(a)(iii).
965          (c) (i) If a [qualified] recommending medical provider determines that, because of age,
966     illness, or disability, a medical cannabis patient cardholder requires assistance in administering
967     the medical cannabis treatment that the [qualified] recommending medical provider
968     recommends, the [qualified] recommending medical provider may indicate the cardholder's
969     need in the state electronic verification system, either directly or, for a limited medical
970     provider, through the order described in Subsections 26-61a-106(1)(c) and (d).
971          (ii) If a [qualified] recommending medical provider makes the indication described in
972     Subsection (3)(c)(i):
973          (A) the department shall add a label to the relevant medical cannabis patient card
974     indicating the cardholder's need for assistance; and
975          (B) any adult who is 18 years old or older and who is physically present with the
976     cardholder at the time the cardholder needs to use the recommended medical cannabis
977     treatment may handle the medical cannabis treatment and any associated medical cannabis
978     device as needed to assist the cardholder in administering the recommended medical cannabis
979     treatment; and
980          (C) an individual of any age who is physically present with the cardholder in the event
981     of an emergency medical condition, as that term is defined in Section 31A-22-627, may handle
982     the medical cannabis treatment and any associated medical cannabis device as needed to assist
983     the cardholder in administering the recommended medical cannabis treatment.
984          (iii) A non-cardholding individual acting under Subsection (3)(c)(ii)(B) or (C) may not:
985          (A) ingest or inhale medical cannabis;
986          (B) possess, transport, or handle medical cannabis or a medical cannabis device outside

987     of the immediate area where the cardholder is present or with an intent other than to provide
988     assistance to the cardholder; or
989          (C) possess, transport, or handle medical cannabis or a medical cannabis device when
990     the cardholder is not in the process of being dosed with medical cannabis.
991          (4) To recommend a medical cannabis treatment to a patient or to renew a
992     recommendation, a [qualified] recommending medical provider shall:
993          (a) before recommending cannabis in a medicinal dosage form or a cannabis product in
994     a medicinal dosage form:
995          (i) verify the patient's and, for a minor patient, the minor patient's parent or legal
996     guardian's valid form of identification described in Subsection (3)(a);
997          (ii) review any record related to the patient and, for a minor patient, the patient's parent
998     or legal guardian in:
999          (A) for a qualified medical provider, the state electronic verification system; and
1000          (B) the controlled substance database created in Section 58-37f-201; and
1001          (iii) consider the recommendation in light of the patient's qualifying condition and
1002     history of medical cannabis and controlled substance use during an initial face-to-face visit
1003     with the patient; and
1004          (b) state in the [qualified] recommending medical provider's recommendation that the
1005     patient:
1006          (i) suffers from a qualifying condition, including the type of qualifying condition; and
1007          (ii) may benefit from treatment with cannabis in a medicinal dosage form or a cannabis
1008     product in a medicinal dosage form.
1009          (5) (a) Except as provided in Subsection (5)(b), a medical cannabis card that the
1010     department issues under this section is valid for the lesser of:
1011          (i) an amount of time that the [qualified] recommending medical provider determines;
1012     or
1013          (ii) (A) six months for the first issuance, [90 days; (B)] and, except as provided in
1014     Subsection (5)(a)(ii)[(C)](B), for a renewal[, six months]; or
1015          [(C)] (B) for a renewal, one year if, after at least one year following the issuance of the
1016     original medical cannabis card, the [qualified] recommending medical provider determines that
1017     the patient has been stabilized on the medical cannabis treatment and a one-year renewal period

1018     is justified.
1019          (b) (i) A medical cannabis card that the department issues in relation to a terminal
1020     illness described in Section 26-61a-104 does not expire.
1021          (ii) The recommending [qualified] medical provider may revoke a recommendation
1022     that the provider made in relation to a terminal illness described in Section 26-61a-104 if the
1023     medical cannabis cardholder no longer has the terminal illness.
1024          (6) (a) A medical cannabis patient card or a medical cannabis guardian card is
1025     renewable if:
1026          (i) at the time of renewal, the cardholder meets the requirements of Subsection (2)(a) or
1027     (b); or
1028          (ii) the cardholder received the medical cannabis card through the recommendation of
1029     the Compassionate Use Board under Section 26-61a-105.
1030          (b) A cardholder described in Subsection (6)(a) may renew the cardholder's card:
1031          (i) using the application process described in Subsection (3); or
1032          (ii) through phone or video conference with the [qualified] recommending medical
1033     provider who made the recommendation underlying the card, at the qualifying medical
1034     provider's discretion.
1035          (c) A cardholder under Subsection (2)(a) or (b) who renews the cardholder's card shall
1036     pay to the department a renewal fee in an amount that:
1037          (i) subject to Subsection 26-61a-109(5), the department sets in accordance with Section
1038     63J-1-504; and
1039          (ii) may not exceed the cost of the relatively lower administrative burden of renewal in
1040     comparison to the original application process.
1041          (d) If a minor meets the requirements of Subsection (2)(c), the minor's provisional
1042     patient card renews automatically at the time the minor's parent or legal guardian renews the
1043     parent or legal guardian's associated medical cannabis guardian card.
1044          (e) The department may revoke a medical cannabis guardian card if the cardholder
1045     under Subsection (2)(b) is convicted of a misdemeanor or felony drug distribution offense
1046     under either state or federal law.
1047          (7) (a) A cardholder under this section shall carry the cardholder's valid medical
1048     cannabis card with the patient's name.

1049          (b) (i) A medical cannabis patient cardholder or a provisional patient cardholder may
1050     purchase, in accordance with this chapter and the recommendation underlying the card,
1051     cannabis in a medicinal dosage form, a cannabis product in a medicinal dosage form, or a
1052     medical cannabis device.
1053          (ii) A cardholder under this section may possess or transport, in accordance with this
1054     chapter and the recommendation underlying the card, cannabis in a medicinal dosage form, a
1055     cannabis product in a medicinal dosage form, or a medical cannabis device.
1056          (iii) To address the qualifying condition underlying the medical cannabis treatment
1057     recommendation:
1058          (A) a medical cannabis patient cardholder or a provisional patient cardholder may use
1059     cannabis in a medicinal dosage form, a medical cannabis product in a medicinal dosage form,
1060     or a medical cannabis device; and
1061          (B) a medical cannabis guardian cardholder may assist the associated provisional
1062     patient cardholder with the use of cannabis in a medicinal dosage form, a medical cannabis
1063     product in a medicinal dosage form, or a medical cannabis device.
1064          (c) If a licensed medical cannabis pharmacy is not operating within the state after
1065     January 1, 2021, a cardholder under this section:
1066          (i) may possess:
1067          (A) up to the legal dosage limit of unprocessed cannabis in a medicinal dosage form;
1068          (B) up to the legal dosage limit of a cannabis product in a medicinal dosage form; and
1069          (C) marijuana drug paraphernalia; and
1070          (ii) is not subject to prosecution for the possession described in Subsection (7)(c)(i).
1071          (8) The department may revoke a medical cannabis card that the department issues
1072     under this section if the cardholder:
1073          (a) violates this chapter; or
1074          (b) is convicted under state or federal law of:
1075          (i) a felony; or
1076          (ii) after the effective date of this bill, a misdemeanor for drug distribution.
1077          [(8)] (9) The department shall establish by rule, in accordance with Title 63G, Chapter
1078     3, Utah Administrative Rulemaking Act, a process to provide information regarding the
1079     following to an individual receiving a medical cannabis card:

1080          (a) risks associated with medical cannabis treatment;
1081          (b) the fact that a condition's listing as a qualifying condition does not suggest that
1082     medical cannabis treatment is an effective treatment or cure for that condition, as described in
1083     Subsection 26-61a-104(1); and
1084          (c) other relevant warnings and safety information that the department determines.
1085          [(9)] (10) The department may establish procedures by rule, in accordance with Title
1086     63G, Chapter 3, Utah Administrative Rulemaking Act, to implement the application and
1087     issuance provisions of this section.
1088          [(10)] (11) (a) On or before January 1, 2021, the department shall establish by rule, in
1089     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, a process to allow
1090     an individual from another state to register with the Department of Health in order to purchase
1091     medical cannabis or a medical cannabis device from a medical cannabis pharmacy while the
1092     individual is visiting the state.
1093          (b) The department may only provide the registration process described in Subsection
1094     [(10)] (11)(a):
1095          (i) to a nonresident patient; and
1096          (ii) for no more than two visitation periods per calendar year of up to 21 calendar days
1097     per visitation period.
1098          [(11)] (12) (a) A person may submit to the department a request to conduct a research
1099     study using medical cannabis cardholder data that the state electronic verification system
1100     contains.
1101          (b) The department shall review a request described in Subsection [(11)] (12)(a) to
1102     determine whether an institutional review board, as that term is defined in Section 26-61-102,
1103     could approve the research study.
1104          (c) At the time an individual applies for a medical cannabis card, the department shall
1105     notify the individual:
1106          (i) of how the individual's information will be used as a cardholder;
1107          (ii) that by applying for a medical cannabis card, unless the individual withdraws
1108     consent under Subsection [(11)] (12)(d), the individual consents to the use of the individual's
1109     information for external research; and
1110          (iii) that the individual may withdraw consent for the use of the individual's

1111     information for external research at any time, including at the time of application.
1112          (d) An applicant may, through the medical cannabis card application, and a medical
1113     cannabis cardholder may, through the state central patient portal, withdraw the applicant's or
1114     cardholder's consent to participate in external research at any time.
1115          (e) The department may release, for the purposes of a study described in this
1116     Subsection [(11)] (12), information about a cardholder under this section who consents to
1117     participate under Subsection [(11)] (12)(c).
1118          (f) If an individual withdraws consent under Subsection [(11)] (12)(d), the withdrawal
1119     of consent:
1120          (i) applies to external research that is initiated after the withdrawal of consent; and
1121          (ii) does not apply to research that was initiated before the withdrawal of consent.
1122          (g) The department may establish standards for a medical research study's validity, by
1123     rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
1124          Section 8. Section 26-61a-202 is amended to read:
1125          26-61a-202. Medical cannabis caregiver card -- Registration -- Renewal --
1126     Revocation.
1127          (1) (a) (i) A cardholder described in Section 26-61a-201 may designate, through the
1128     state central patient portal, up to two individuals, or an individual and a facility in accordance
1129     with Subsection (1)(b), to serve as a designated caregiver for the cardholder [if a qualified
1130     medical provider notates in].
1131          (ii) The designation described in Subsection (1)(a)(i) takes effect if the state electronic
1132     verification system reflects a recommending medical provider's indication that the provider
1133     determines that, due to physical difficulty or undue hardship, including concerns of distance to
1134     a medical cannabis pharmacy, the cardholder needs assistance to obtain the medical cannabis
1135     treatment that the [qualified] recommending medical provider recommends.
1136          (b) (i) Beginning on the earlier of January 1, 2021, or the date on which the electronic
1137     verification system is functionally capable of servicing the designation, a cardholder described
1138     in Section 26-61a-201 who is a patient in one of the following types of facilities may designate
1139     the facility as one of the caregivers described in Subsection (1)(a):
1140          (A) an assisted living facility, as that term is defined in Section 26-21-2;
1141          (B) a nursing care facility, as that term is defined in Section 26-21-2; or

1142          (C) a general acute hospital, as that term is defined in Section 26-21-2.
1143          (ii) A facility may assign one or more employees to assist patients with medical
1144     cannabis treatment under the caregiver designation described in this Subsection (1)(b).
1145          (iii) The department shall make rules to regulate the practice of facilities and facility
1146     employees serving as designated caregivers under this Subsection (1)(b).
1147          (c) A parent or legal guardian described in Subsection 26-61a-201(2)(d), in
1148     consultation with the minor and the minor's qualified medical provider, may designate, through
1149     the state central patient portal, up to two individuals to serve as a designated caregiver for the
1150     minor, if the department determines that the parent or legal guardian is not eligible for a
1151     medical cannabis guardian card under Section 26-61a-201.
1152          (2) An individual that the department registers as a designated caregiver under this
1153     section and a facility described in Subsection (1)(b):
1154          (a) for an individual designated caregiver, may carry a valid medical cannabis caregiver
1155     card;
1156          (b) in accordance with this chapter, may purchase, possess, transport, or assist the
1157     patient in the use of cannabis in a medicinal dosage form, a cannabis product in a medicinal
1158     dosage form, or a medical cannabis device on behalf of the designating medical cannabis
1159     cardholder;
1160          (c) may not charge a fee to an individual to act as the individual's designated caregiver
1161     or for a service that the designated caregiver provides in relation to the role as a designated
1162     caregiver;
1163          (d) may accept reimbursement from the designating medical cannabis cardholder for
1164     direct costs the designated caregiver incurs for assisting with the designating cardholder's
1165     medicinal use of cannabis; and
1166          (e) if a licensed medical cannabis pharmacy is not operating within the state after
1167     January 1, 2021:
1168          (i) may possess up to the legal dosage limit of:
1169          (A) unprocessed medical cannabis in a medicinal dosage form; and
1170          (B) a cannabis product in a medicinal dosage form; [and]
1171          (ii) may possess marijuana drug paraphernalia; and
1172          (iii) is not subject to prosecution for the possession described in Subsection (2)(e)(i).

1173          (3) (a) The department shall:
1174          (i) within 15 days after the day on which an individual submits an application in
1175     compliance with this section, issue a medical cannabis card to the applicant if the applicant:
1176          (A) is designated as a caregiver under Subsection (1);
1177          (B) is eligible for a medical cannabis caregiver card under Subsection (4); and
1178          (C) complies with this section; and
1179          (ii) notify the Department of Public Safety of each individual that the department
1180     registers as a designated caregiver.
1181          (b) The department shall ensure that a medical cannabis caregiver card contains the
1182     information described in Subsection (5)(b).
1183          (4) An individual is eligible for a medical cannabis caregiver card if the individual:
1184          (a) is at least 21 years old;
1185          (b) is a Utah resident;
1186          (c) pays to the department a fee in an amount that, subject to Subsection
1187     26-61a-109(5), the department sets in accordance with Section 63J-1-504, plus the cost of the
1188     criminal background check described in Section 26-61a-203;
1189          (d) signs an acknowledgment stating that the applicant received the information
1190     described in Subsection 26-61a-201[(8)](9); and
1191          (e) has not been convicted of a misdemeanor or felony drug distribution offense that is
1192     a felony under either state or federal law, unless the individual completes any imposed sentence
1193     two or more years before the day on which the individual submits the application.
1194          (5) An eligible applicant for a medical cannabis caregiver card shall:
1195          (a) submit an application for a medical cannabis caregiver card to the department
1196     through an electronic application connected to the state electronic verification system; and
1197          (b) submit the following information in the application described in Subsection (5)(a):
1198          (i) the applicant's name, gender, age, and address;
1199          (ii) the name, gender, age, and address of the cardholder described in Section
1200     26-61a-201 who designated the applicant; and
1201          (iii) if a medical cannabis guardian cardholder designated the caregiver, the name,
1202     gender, and age of the minor receiving a medical cannabis treatment in relation to the medical
1203     cannabis guardian cardholder.

1204          (6) Except as provided in Subsection (6)(b), a medical cannabis caregiver card that the
1205     department issues under this section is valid for the lesser of:
1206          (a) an amount of time that the cardholder described in Section 26-61a-201 who
1207     designated the caregiver determines; or
1208          (b) the amount of time remaining before the card of the cardholder described in Section
1209     26-61a-201 expires.
1210          (7) (a) If a designated caregiver meets the requirements of Subsection (4), the
1211     designated caregiver's medical cannabis caregiver card renews automatically at the time the
1212     cardholder described in Section 26-61a-201 who designated the caregiver:
1213          (i) renews the cardholder's card; and
1214          (ii) renews the caregiver's designation, in accordance with Subsection (7)(b).
1215          (b) The department shall provide a method in the card renewal process to allow a
1216     cardholder described in Section 26-61a-201 who has designated a caregiver to:
1217          (i) signify that the cardholder renews the caregiver's designation;
1218          (ii) remove a caregiver's designation; or
1219          (iii) designate a new caregiver.
1220          (8) The department may revoke a medical cannabis caregiver card if the designated
1221     caregiver:
1222          (a) violates this chapter; or
1223          (b) is convicted under state or federal law of:
1224          (i) a felony; or
1225          (ii) after December 3, 2018, a misdemeanor for drug distribution.
1226          Section 9. Section 26-61a-401 is amended to read:
1227          26-61a-401. Medical cannabis pharmacy agent -- Registration.
1228          (1) An individual may not serve as a medical cannabis pharmacy agent of a medical
1229     cannabis pharmacy unless the department registers the individual as a medical cannabis
1230     pharmacy agent.
1231          (2) [Except as provided in Section 26-61a-403, a qualified] A recommending medical
1232     provider may not act as a medical cannabis pharmacy agent, have a financial or voting interest
1233     of 2% or greater in a medical cannabis pharmacy, or have the power to direct or cause the
1234     management or control of a medical cannabis pharmacy.

1235          (3) (a) The department shall, within 15 days after the day on which the department
1236     receives a complete application from a medical cannabis pharmacy on behalf of a prospective
1237     medical cannabis pharmacy agent, register and issue a medical cannabis pharmacy agent
1238     registration card to the prospective agent if the medical cannabis pharmacy:
1239          (i) provides to the department:
1240          (A) the prospective agent's name and address;
1241          (B) the name and location of the licensed medical cannabis pharmacy where the
1242     prospective agent seeks to act as the medical cannabis pharmacy agent; and
1243          (C) the submission required under Subsection (3)(b); and
1244          (ii) pays a fee to the department in an amount that, subject to Subsection
1245     26-61a-109(5), the department sets in accordance with Section 63J-1-504.
1246          (b) Except for an applicant reapplying for a medical cannabis pharmacy agent
1247     registration card within less than one year after the expiration of the applicant's previous
1248     medical cannabis pharmacy agent registration card, each prospective agent described in
1249     Subsection (3)(a) shall:
1250          (i) submit to the department:
1251          (A) a fingerprint card in a form acceptable to the Department of Public Safety; and
1252          (B) a signed waiver in accordance with Subsection 53-10-108(4) acknowledging the
1253     registration of the prospective agent's fingerprints in the Federal Bureau of Investigation Next
1254     Generation Identification System's Rap Back Service; and
1255          (ii) consent to a fingerprint background check by:
1256          (A) the Bureau of Criminal Identification; and
1257          (B) the Federal Bureau of Investigation.
1258          (c) The Bureau of Criminal Identification shall:
1259          (i) check the fingerprints the prospective agent submits under Subsection (3)(b) against
1260     the applicable state, regional, and national criminal records databases, including the Federal
1261     Bureau of Investigation Next Generation Identification System;
1262          (ii) report the results of the background check to the department;
1263          (iii) maintain a separate file of fingerprints that prospective agents submit under
1264     Subsection (3)(b) for search by future submissions to the local and regional criminal records
1265     databases, including latent prints;

1266          (iv) request that the fingerprints be retained in the Federal Bureau of Investigation Next
1267     Generation Identification System's Rap Back Service for search by future submissions to
1268     national criminal records databases, including the Next Generation Identification System and
1269     latent prints; and
1270          (v) establish a privacy risk mitigation strategy to ensure that the department only
1271     receives notifications for an individual with whom the department maintains an authorizing
1272     relationship.
1273          (d) The department shall:
1274          (i) assess an individual who submits fingerprints under Subsection (3)(b) a fee in an
1275     amount that the department sets in accordance with Section 63J-1-504 for the services that the
1276     Bureau of Criminal Identification or another authorized agency provides under this section; and
1277          (ii) remit the fee described in Subsection (3)(d)(i) to the Bureau of Criminal
1278     Identification.
1279          (4) The department shall designate, on an individual's medical cannabis pharmacy
1280     agent registration card the name of the medical cannabis pharmacy where the individual is
1281     registered as an agent.
1282          (5) A medical cannabis pharmacy agent shall comply with a certification standard that
1283     the department develops in collaboration with the Division of Occupational and Professional
1284     Licensing and the Board of Pharmacy, or a third-party certification standard that the department
1285     designates by rule, in collaboration with the Division of Occupational and Professional
1286     Licensing and the Board of Pharmacy and in accordance with Title 63G, Chapter 3, Utah
1287     Administrative Rulemaking Act.
1288          (6) The department shall ensure that the certification standard described in Subsection
1289     (5) includes training in:
1290          (a) Utah medical cannabis law; and
1291          (b) medical cannabis pharmacy best practices.
1292          (7) The department may revoke the medical cannabis pharmacy agent registration card
1293     of, or refuse to issue a medical cannabis pharmacy agent registration card to, an individual
1294     who:
1295          (a) violates the requirements of this chapter; or
1296          (b) is convicted under state or federal law of:

1297          (i) a felony; or
1298          (ii) after December 3, 2018, a misdemeanor for drug distribution.
1299          (8) (a) A medical cannabis pharmacy agent registration card expires two years after the
1300     day on which the department issues or renews the card.
1301          (b) A medical cannabis pharmacy agent may renew the agent's registration card if the
1302     agent:
1303          (i) is eligible for a medical cannabis pharmacy agent registration card under this
1304     section;
1305          (ii) certifies to the department in a renewal application that the information in
1306     Subsection (3)(a) is accurate or updates the information; and
1307          (iii) pays to the department a renewal fee in an amount that:
1308          (A) subject to Subsection 26-61a-109(5), the department sets in accordance with
1309     Section 63J-1-504; and
1310          (B) may not exceed the cost of the relatively lower administrative burden of renewal in
1311     comparison to the original application process.
1312          Section 10. Section 26-61a-403 is amended to read:
1313          26-61a-403. Pharmacy medical providers -- Registration -- Continuing education.
1314          (1) (a) A medical cannabis pharmacy:
1315          (i) shall employ a pharmacist who is licensed under Title 58, Chapter 17b, Pharmacy
1316     Practice Act, as a pharmacy medical provider;
1317          (ii) may employ a physician who has the authority to write a prescription and is
1318     licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah
1319     Osteopathic Medical Practice Act, as a pharmacy medical provider;
1320          (iii) shall ensure that a pharmacy medical provider described in Subsection (1)(a)(i)
1321     works onsite during all business hours; and
1322          (iv) shall designate one pharmacy medical provider described in Subsection (1)(a)(i) as
1323     the pharmacist-in-charge to oversee the operation of and generally supervise the medical
1324     cannabis pharmacy.
1325          (b) An individual may not serve as a pharmacy medical provider unless the department
1326     registers the individual as a pharmacy medical provider in accordance with Subsection (2).
1327          (2) (a) The department shall, within 15 days after the day on which the department

1328     receives an application from a medical cannabis pharmacy on behalf of a prospective pharmacy
1329     medical provider, register and issue a pharmacy medical provider registration card to the
1330     prospective pharmacy medical provider if the medical cannabis pharmacy:
1331          (i) provides to the department:
1332          (A) the prospective pharmacy medical provider's name and address;
1333          (B) the name and location of the licensed medical cannabis pharmacy where the
1334     prospective pharmacy medical provider seeks to act as a pharmacy medical provider;
1335          (C) a report detailing the completion of the continuing education requirement described
1336     in Subsection (3); and
1337          (D) evidence that the prospective pharmacy medical provider is a pharmacist who is
1338     licensed under Title 58, Chapter 17b, Pharmacy Practice Act, or a physician who has the
1339     authority to write a prescription and is licensed under Title 58, Chapter 67, Utah Medical
1340     Practice Act, or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; and
1341          (ii) pays a fee to the department in an amount that, subject to Subsection
1342     26-61a-109(5), the department sets in accordance with Section 63J-1-504.
1343          (b) The department may not register a [qualified] recommending medical provider or a
1344     state central patient portal medical provider as a pharmacy medical provider.
1345          (3) (a) A pharmacy medical provider shall complete the continuing education described
1346     in this Subsection (3) in the following amounts:
1347          (i) as a condition precedent to registration, four hours; and
1348          (ii) as a condition precedent to renewal of the registration, four hours every two years.
1349          (b) In accordance with Subsection (3)(a), the pharmacy medical provider shall:
1350          (i) complete continuing education:
1351          (A) regarding the topics described in Subsection (3)(d); and
1352          (B) offered by the department under Subsection (3)(c) or an accredited or approved
1353     continuing education provider that the department recognizes as offering continuing education
1354     appropriate for the medical cannabis pharmacy practice; and
1355          (ii) make a continuing education report to the department in accordance with a process
1356     that the department establishes by rule, in accordance with Title 63G, Chapter 3, Utah
1357     Administrative Rulemaking Act, and in collaboration with the Division of Occupational and
1358     Professional Licensing and:

1359          (A) for a pharmacy medical provider who is licensed under Title 58, Chapter 17b,
1360     Pharmacy Practice Act, the Board of Pharmacy;
1361          (B) for a pharmacy medical provider licensed under Title 58, Chapter 67, Utah Medical
1362     Practice Act, the Physicians Licensing Board; and
1363          (C) for a pharmacy medical provider licensed under Title 58, Chapter 68, Utah
1364     Osteopathic Medical Practice Act, the Osteopathic Physician and Surgeon's Licensing Board.
1365          (c) The department may, in consultation with the Division of Occupational and
1366     Professional Licensing, develop the continuing education described in this Subsection (3).
1367          (d) The continuing education described in this Subsection (3) may discuss:
1368          (i) the provisions of this chapter;
1369          (ii) general information about medical cannabis under federal and state law;
1370          (iii) the latest scientific research on the endocannabinoid system and medical cannabis,
1371     including risks and benefits;
1372          (iv) recommendations for medical cannabis as it relates to the continuing care of a
1373     patient in pain management, risk management, potential addiction, and palliative care; or
1374          (v) best practices for recommending the form and dosage of a medical cannabis
1375     product based on the qualifying condition underlying a medical cannabis recommendation.
1376          (4) (a) A pharmacy medical provider registration card expires two years after the day
1377     on which the department issues or renews the card.
1378          (b) A pharmacy medical provider may renew the provider's registration card if the
1379     provider:
1380          (i) is eligible for a pharmacy medical provider registration card under this section;
1381          (ii) certifies to the department in a renewal application that the information in
1382     Subsection (2)(a) is accurate or updates the information;
1383          (iii) submits a report detailing the completion of the continuing education requirement
1384     described in Subsection (3); and
1385          (iv) pays to the department a renewal fee in an amount that:
1386          (A) subject to Subsection 26-61a-109(5), the department sets in accordance with
1387     Section 63J-1-504; and
1388          (B) may not exceed the cost of the relatively lower administrative burden of renewal in
1389     comparison to the original application process.

1390          Section 11. Section 26-61a-501 is amended to read:
1391          26-61a-501. Operating requirements -- General.
1392          (1) (a) A medical cannabis pharmacy shall operate:
1393          (i) at the physical address provided to the department under Section 26-61a-301; and
1394          (ii) in accordance with the operating plan provided to the department under Section
1395     26-61a-301 and, if applicable, 26-61a-304.
1396          (b) A medical cannabis pharmacy shall notify the department before a change in the
1397     medical cannabis pharmacy's physical address or operating plan.
1398          (2) An individual may not enter a medical cannabis pharmacy unless the individual:
1399          (a) is at least 18 years old; and
1400          (b) except as provided in Subsection (5), possesses a valid:
1401          (i) medical cannabis pharmacy agent registration card;
1402          (ii) pharmacy medical provider registration card; or
1403          (iii) medical cannabis card.
1404          (3) A medical cannabis pharmacy may not employ an individual who is younger than
1405     21 years old.
1406          (4) A medical cannabis pharmacy may not employ an individual who has been
1407     convicted of a felony under state or federal law.
1408          (5) Notwithstanding Subsection (2), a medical cannabis pharmacy may authorize an
1409     individual who is not a medical cannabis pharmacy agent or pharmacy medical provider to
1410     access the medical cannabis pharmacy if the medical cannabis pharmacy tracks and monitors
1411     the individual at all times while the individual is at the medical cannabis pharmacy and
1412     maintains a record of the individual's access.
1413          (6) A medical cannabis pharmacy shall operate in a facility that has:
1414          (a) a single, secure public entrance;
1415          (b) a security system with a backup power source that:
1416          (i) detects and records entry into the medical cannabis pharmacy; and
1417          (ii) provides notice of an unauthorized entry to law enforcement when the medical
1418     cannabis pharmacy is closed; and
1419          (c) a lock on each area where the medical cannabis pharmacy stores cannabis or a
1420     cannabis product.

1421          (7) A medical cannabis pharmacy shall post, both clearly and conspicuously in the
1422     medical cannabis pharmacy, the limit on the purchase of cannabis described in Subsection
1423     26-61a-502(2).
1424          (8) A medical cannabis pharmacy may not allow any individual to consume cannabis
1425     on the property or premises of the medical cannabis pharmacy.
1426          (9) A medical cannabis pharmacy may not sell cannabis or a cannabis product without
1427     first indicating on the cannabis or cannabis product label the name of the medical cannabis
1428     pharmacy.
1429          (10) (a) Each medical cannabis pharmacy shall retain in the pharmacy's records the
1430     following information regarding each recommendation underlying a transaction:
1431          (i) the [qualified] recommending medical provider's name, address, and telephone
1432     number;
1433          (ii) the patient's name and address;
1434          (iii) the date of issuance;
1435          (iv) directions of use and dosing guidelines or an indication that the [qualified]
1436     recommending medical provider did not recommend specific directions of use or dosing
1437     guidelines; and
1438          (v) if the patient did not complete the transaction, the name of the medical cannabis
1439     cardholder who completed the transaction.
1440          (b) (i) Except as provided in Subsection (10)(b)(ii), a medical cannabis pharmacy may
1441     not sell medical cannabis unless the medical cannabis has a label securely affixed to the
1442     container indicating the following minimum information:
1443          (A) the name, address, and telephone number of the medical cannabis pharmacy;
1444          (B) the unique identification number that the medical cannabis pharmacy assigns;
1445          (C) the date of the sale;
1446          (D) the name of the patient;
1447          (E) the name of the [qualified] recommending medical provider who recommended the
1448     medical cannabis treatment;
1449          (F) directions for use and cautionary statements, if any;
1450          (G) the amount dispensed and the cannabinoid content;
1451          (H) the suggested use date;

1452          (I) for unprocessed cannabis flower, the legal use termination date; and
1453          (J) any other requirements that the department determines, in consultation with the
1454     Division of Occupational and Professional Licensing and the Board of Pharmacy.
1455          (ii) A medical cannabis pharmacy may sell medical cannabis to another medical
1456     cannabis pharmacy without a label described in Subsection (10)(b)(i).
1457          (11) A pharmacy medical provider or medical cannabis pharmacy agent shall:
1458          (a) upon receipt of an order from a limited medical provider in accordance with
1459     Subsections 26-61a-106(1)(b) and (c):
1460          (i) for a written order, contact the limited medical provider or the limited medical
1461     provider's office to verify the validity of the recommendation; and
1462          (ii) for a written order that the pharmacy medical provider or medical cannabis
1463     pharmacy agent verifies under Subsection (11)(a)(i) or an electronic order, enter the limited
1464     medical provider's recommendation or renewal, including any associated directions of use,
1465     dosing guidelines, or caregiver indication, in the state electronic verification system;
1466          (b) in processing an order for a holder of a conditional medical cannabis card described
1467     in Subsection 26-61a-201(1)(b) that appears irregular or suspicious in the judgment of the
1468     pharmacy medical provider or medical cannabis pharmacy agent, contact the recommending
1469     medical provider or the recommending medical provider's office to verify the validity of the
1470     recommendation before processing the cardholder's order;
1471          [(a)] (c) unless the medical cannabis cardholder has had a consultation under
1472     Subsection 26-61a-502(4) or (5), verbally offer to a medical cannabis cardholder at the time of
1473     a purchase of cannabis, a cannabis product, or a medical cannabis device, personal counseling
1474     with the pharmacy medical provider; and
1475          [(b)] (d) provide a telephone number or website by which the cardholder may contact a
1476     pharmacy medical provider for counseling.
1477          (12) (a) A medical cannabis pharmacy may create a medical cannabis disposal program
1478     that allows an individual to deposit unused or excess medical cannabis, cannabis residue from a
1479     medical cannabis device, or medical cannabis product in a locked box or other secure
1480     receptacle within the medical cannabis pharmacy.
1481          (b) A medical cannabis pharmacy with a disposal program described in Subsection
1482     (12)(a) shall ensure that only a medical cannabis pharmacy agent or pharmacy medical provider

1483     can access deposited medical cannabis or medical cannabis products.
1484          (c) A medical cannabis pharmacy shall dispose of any deposited medical cannabis or
1485     medical cannabis products by:
1486          (i) rendering the deposited medical cannabis or medical cannabis products unusable
1487     and unrecognizable before transporting deposited medical cannabis or medical cannabis
1488     products from the medical cannabis pharmacy; and
1489          (ii) disposing of the deposited medical cannabis or medical cannabis products in
1490     accordance with:
1491          (A) federal and state law, rules, and regulations related to hazardous waste;
1492          (B) the Resource Conservation and Recovery Act, 42 U.S.C. Sec. 6991 et seq.;
1493          (C) Title 19, Chapter 6, Part 5, Solid Waste Management Act; and
1494          (D) other regulations that the department makes in accordance with Title 63G, Chapter
1495     3, Utah Administrative Rulemaking Act.
1496          (13) The department shall establish by rule, in accordance with Title 63G, Chapter 3,
1497     Utah Administrative Rulemaking Act, protocols for a recall of cannabis and cannabis products
1498     by a medical cannabis pharmacy.
1499          Section 12. Section 26-61a-502 is amended to read:
1500          26-61a-502. Dispensing -- Amount a medical cannabis pharmacy may dispense --
1501     Reporting -- Form of cannabis or cannabis product.
1502          (1) (a) A medical cannabis pharmacy may not sell a product other than, subject to this
1503     chapter:
1504          (i) cannabis in a medicinal dosage form that the medical cannabis pharmacy acquired
1505     from a cannabis processing facility that is licensed under Section 4-41a-201;
1506          (ii) a cannabis product in a medicinal dosage form that the medical cannabis pharmacy
1507     acquired from a cannabis processing facility that is licensed under Section 4-41a-201;
1508          (iii) a medical cannabis device; or
1509          (iv) educational material related to the medical use of cannabis.
1510          (b) A medical cannabis pharmacy may only sell an item listed in Subsection (1)(a) to
1511     an individual with:
1512          (i) (A) a medical cannabis card;
1513          (B) a department registration described in [Subsection 26-61a-202(10)] Section

1514     26-61a-201; or
1515          (C) until December 31, 2020, a letter from a medical provider in accordance with
1516     Subsection (10); and
1517          (ii) a corresponding valid form of photo identification.
1518          (c) Notwithstanding Subsection (1)(a), a medical cannabis pharmacy may not sell a
1519     cannabis-based drug that the United States Food and Drug Administration has approved.
1520          (d) Notwithstanding Subsection (1)(b), a medical cannabis pharmacy may not sell a
1521     medical cannabis device to an individual described in Subsection 26-61a-201(2)(a)(i)(B) or to a
1522     minor described in Subsection 26-61a-201(2)(c) unless the individual or minor has the
1523     approval of the Compassionate Use Board in accordance with Subsection 26-61a-105(5).
1524          (2) A medical cannabis pharmacy:
1525          (a) may dispense to a medical cannabis cardholder or to an individual described in
1526     Subsection (10)(b), in any one 28-day period, up to the legal dosage limit of:
1527          (i) unprocessed cannabis that:
1528          (A) is in a medicinal dosage form; and
1529          (B) carries a label clearly displaying the amount of tetrahydrocannabinol and
1530     cannabidiol in the cannabis; and
1531          (ii) a cannabis product that is in a medicinal dosage form; and
1532          (b) may not dispense:
1533          (i) more medical cannabis than described in Subsection (2)(a); or
1534          (ii) to an individual whose [qualified] recommending medical provider[, or for an
1535     individual described in Subsection (10)(a), the medical professional described in Subsection
1536     (10)(a)(i),] did not recommend directions of use and dosing guidelines, until the individual
1537     consults with the pharmacy medical provider in accordance with Subsection (4), any medical
1538     cannabis.
1539          (3) An individual with a medical cannabis card [or an individual described in
1540     Subsection (10)(a)]:
1541          (a) may purchase, in any one 28-day period, up to the legal dosage limit of:
1542          (i) unprocessed cannabis in a medicinal dosage form; and
1543          (ii) a cannabis product in a medicinal dosage form;
1544          (b) may not purchase:

1545          (i) more medical cannabis than described in Subsection (3)(a); or
1546          (ii) if the relevant [qualified] recommending medical provider did not recommend
1547     directions of use and dosing guidelines, until the individual consults with the pharmacy
1548     medical provider in accordance with Subsection (4), any medical cannabis; and
1549          (c) may not use a route of administration that the relevant [qualified] recommending
1550     medical provider or the pharmacy medical provider, in accordance with Subsection (4) or (5),
1551     has not recommended.
1552          (4) If a [qualified] recommending medical provider recommends treatment with
1553     medical cannabis but does not provide directions of use and dosing guidelines:
1554          (a) the qualified medical provider or the medical cannabis pharmacy recording a
1555     recommendation under the order of a limited medical provider, shall document in the
1556     recommendation:
1557          (i) an evaluation of the qualifying condition underlying the recommendation;
1558          (ii) prior treatment attempts with medical cannabis; and
1559          (iii) the patient's current medication list; and
1560          (b) before the relevant medical cannabis cardholder may obtain medical cannabis, the
1561     pharmacy medical provider shall:
1562          (i) review pertinent medical records, including the [qualified] recommending medical
1563     provider documentation described in Subsection (4)(a); and
1564          (ii) unless the pertinent medical records show directions of use and dosing guidelines
1565     from a state central patient portal medical provider in accordance with Subsection (5), after
1566     completing the review described in Subsection (4)(b)(i) and consulting with the recommending
1567     [qualified] medical provider as needed, determine the best course of treatment through
1568     consultation with the cardholder regarding:
1569          (A) the patient's qualifying condition underlying the recommendation from the
1570     [qualified] recommending medical provider;
1571          (B) indications for available treatments;
1572          (C) directions of use and dosing guidelines; and
1573          (D) potential adverse reactions.
1574          (5) (a) A state central patient portal medical provider may provide the consultation and
1575     make the determination described in Subsection (4)(b) for a medical cannabis patient

1576     cardholder regarding an electronic order that the state central patient portal facilitates.
1577          (b) The state central patient portal medical provider described in Subsection (5)(a)
1578     shall document the directions of use and dosing guidelines, determined under Subsection (5)(a)
1579     in the pertinent medical records.
1580          (6) A medical cannabis pharmacy shall:
1581          (a) (i) access the state electronic verification system before dispensing cannabis or a
1582     cannabis product to a medical cannabis cardholder in order to determine if the cardholder or,
1583     where applicable, the associated patient has met the maximum amount of medical cannabis
1584     described in Subsection (2); and
1585          (ii) if the verification in Subsection (6)(a)(i) indicates that the individual has met the
1586     maximum amount described in Subsection (2):
1587          (A) decline the sale; and
1588          (B) notify the [qualified] recommending medical provider who made the underlying
1589     recommendation;
1590          (b) submit a record to the state electronic verification system each time the medical
1591     cannabis pharmacy dispenses medical cannabis to a medical cannabis cardholder;
1592          (c) package any medical cannabis that is in a container that:
1593          (i) complies with Subsection 4-41a-602(2) or, if applicable, [26-61a-102(32)(a)(ii)]
1594     provisions related to a container for unprocessed cannabis flower in the definition of
1595     "medicinal dosage form" in Section 26-61a-102;
1596          (ii) is tamper-resistant and tamper-evident; and
1597          (iii) opaque; and
1598          (d) for a product that is a cube that is designed for ingestion through chewing or
1599     holding in the mouth for slow dissolution, include a separate, off-label warning about the risks
1600     of over-consumption.
1601          (7) (a) Except as provided in Subsection (7)(b), a medical cannabis pharmacy may not
1602     sell medical cannabis in the form of a cigarette or a medical cannabis device that is
1603     intentionally designed or constructed to resemble a cigarette.
1604          (b) A medical cannabis pharmacy may sell a medical cannabis device that warms
1605     cannabis material into a vapor without the use of a flame and that delivers cannabis to an
1606     individual's respiratory system.

1607          (8) A medical cannabis pharmacy may not give, at no cost, a product that the medical
1608     cannabis pharmacy is allowed to sell under Subsection (1).
1609          (9) The department may impose a uniform fee on each medical cannabis transaction in
1610     a medical cannabis pharmacy in an amount that, subject to Subsection 26-61a-109(5), the
1611     department sets in accordance with Section 63J-1-504.
1612          [(10) (a) Except as provided in Subsection (10)(b), until December 31, 2020, an
1613     individual may purchase up to the legal dosage limit of an item listed in Subsection (1)(a) from
1614     a licensed medical cannabis pharmacy if:]
1615          [(i) the individual presents to the medical cannabis pharmacy a letter from the medical
1616     professional described in Subsection 58-37-3.7(2)(a)(i)(B) that indicates the medical
1617     professional's medical cannabis recommendation for the individual;]
1618          [(ii) the medical cannabis pharmacy receives independent confirmation from the
1619     medical professional described in Subsection (10)(a)(i) or an employee of the medical
1620     professional that the letter is valid;]
1621          [(iii) the medical cannabis pharmacy:]
1622          [(A) scans or photocopies the individual's letter and the individual's valid form of
1623     photo identification;]
1624          [(B) creates a record of the transaction, including the documents described in
1625     Subsection (10)(a)(iii)(A), the date of purchase, and the type and quantity of medical cannabis
1626     the individual purchased; and]
1627          [(C) provides information to the individual about obtaining a medical cannabis card;
1628     and]
1629          [(iv) unless the medical professional recommends specific directions of using and
1630     dosing guidelines in the letter, the pharmacy medical provider determines the best course of
1631     treatment through consultation with the individual regarding:]
1632          [(A) the individual's qualifying condition underlying the recommendation from the
1633     medical professional;]
1634          [(B) indications for available treatments;]
1635          [(C) directions of use and dosing guidelines; and]
1636          [(D) potential adverse reactions.]
1637          [(b) (i) An individual who purchases medical cannabis from a medical cannabis

1638     pharmacy under Subsection (10)(a) may not purchase medical cannabis from a different
1639     medical cannabis pharmacy under Subsection (10)(a).]
1640          [(ii) If the department notifies a medical cannabis pharmacy, in accordance with
1641     Subsection (10)(c), of an individual purchasing medical cannabis under Subsection (10)(a)
1642     from more than one medical cannabis pharmacy, a medical cannabis pharmacy may not sell an
1643     item listed in Subsection (1)(a) to the individual under Subsection (10)(a).]
1644          [(iii) An individual may not purchase medical cannabis under Subsection (10)(a) if the
1645     individual is a medical cannabis cardholder.]
1646          [(c) (i) Until December 31, 2020, on or before the first day of each month, each
1647     medical cannabis pharmacy shall provide to the department, in a secure manner, information
1648     identifying each individual who has purchased medical cannabis from the medical cannabis
1649     pharmacy under Subsection (10)(a).]
1650          [(ii) The department shall review information the department receives under
1651     Subsection (10)(c)(i) to identify any individuals who:]
1652          [(A) have purchased medical cannabis under Subsection (10)(a) from more than one
1653     pharmacy; or]
1654          [(B) hold a medical cannabis card.]
1655          [(iii) If the department identifies an individual described in Subsection (10)(c)(ii), the
1656     department shall notify each medical cannabis pharmacy regarding:]
1657          [(A) the identification of the individual; and]
1658          [(B) the individual's ineligibility to purchase medical cannabis for a reason described in
1659     Subsection (10)(b).]
1660          [(11)] (10) A medical cannabis pharmacy may purchase and store medical cannabis
1661     devices regardless of whether the seller has a cannabis-related license under this title or Title 4,
1662     Chapter 41a, Cannabis Production Establishments.
1663          Section 13. Section 26-61a-503 is amended to read:
1664          26-61a-503. Partial filling.
1665          (1) As used in this section, "partially fill" means to provide less than the full amount of
1666     cannabis or cannabis product that the [qualified] recommending medical provider recommends,
1667     if the [qualified] recommending medical provider recommended specific dosing parameters.
1668          (2) A pharmacy medical provider may partially fill a recommendation for a medical

1669     cannabis treatment at the request of the [qualified] recommending medical provider who issued
1670     the medical cannabis treatment recommendation or the medical cannabis cardholder.
1671          (3) The department shall make rules, in collaboration with the Division of
1672     Occupational and Professional Licensing and the Board of Pharmacy and in accordance with
1673     Title 63G, Chapter 3, Utah Administrative Rulemaking Act, specifying how to record the date,
1674     quantity supplied, and quantity remaining of a partially filled medical cannabis treatment
1675     recommendation.
1676          (4) A pharmacy medical provider who is a pharmacist may, upon the request of a
1677     medical cannabis cardholder, determine different dosing parameters, subject to the dosing
1678     limits in Subsection 26-61a-502(2), to fill the quantity remaining of a partially filled medical
1679     cannabis treatment recommendation if:
1680          (a) the pharmacy medical provider determined dosing parameters for the partial fill
1681     under Subsection 26-61a-502(4) or (5); and
1682          (b) the medical cannabis cardholder reports that:
1683          (i) the partial fill did not substantially affect the qualifying condition underlying the
1684     medical cannabis recommendation; or
1685          (ii) the patient experienced an adverse reaction to the partial fill or was otherwise
1686     unable to successfully use the partial fill.
1687          Section 14. Section 26-61a-601 is amended to read:
1688          26-61a-601. State central patient portal -- Department duties.
1689          (1) On or before July 1, 2020, the department shall establish or contract to establish, in
1690     accordance with Title 63G, Chapter 6a, Utah Procurement Code, a state central patient portal as
1691     described in this section.
1692          (2) The state central patient portal shall:
1693          (a) authenticate each user to ensure the user is a valid medical cannabis patient
1694     cardholder;
1695          (b) allow a medical cannabis patient cardholder to:
1696          (i) obtain and download the cardholder's medical cannabis card;
1697          (ii) review the cardholder's medical cannabis purchase history; and
1698          (iii) manage the cardholder's personal information, including withdrawing consent for
1699     the use of the cardholder's information for a study described in Subsection

1700     26-61a-201[(11)](12);
1701          (c) if the cardholder's [qualified] recommending medical provider recommended the
1702     use of medical cannabis without providing directions of use and dosing guidelines and the
1703     cardholder has not yet received the counseling or consultation required in Subsection
1704     26-61a-502(4):
1705          (i) alert the cardholder of the outstanding need for consultation; and
1706          (ii) provide the cardholder with access to the contact information for each state central
1707     patient portal medical provider and each pharmacy medical provider;
1708          (d) except as provided in Subsection (2)(e), facilitate an electronic medical cannabis
1709     order:
1710          (i) to a home delivery medical cannabis pharmacy for a medical cannabis shipment; or
1711          (ii) to a medical cannabis pharmacy for a medical cannabis cardholder to obtain in
1712     person from the pharmacy;
1713          (e) prohibit a patient from completing an electronic medical cannabis order described
1714     in Subsection (2)(d) if the purchase would exceed the limitations described in Subsection
1715     26-61a-502(2)(a) or (b);
1716          (f) provide educational information to medical cannabis patient cardholders regarding
1717     the state's medical cannabis laws and regulatory programs and other relevant information
1718     regarding medical cannabis; and
1719          (g) allow the patient to designate up to two caregivers who may receive a medical
1720     cannabis caregiver card to purchase and transport medical cannabis on behalf of the patient in
1721     accordance with this chapter.
1722          (3) The department may make rules in accordance with Title 63G, Chapter 3, Utah
1723     Administrative Rulemaking Act, to implement the state central patient portal.
1724          Section 15. Section 58-5a-102 is amended to read:
1725          58-5a-102. Definitions.
1726          In addition to the definitions under Section 58-1-102, as used in this chapter:
1727          (1) "Board" means the Podiatric Physician Board created in Section 58-5a-201.
1728          (2) "Indirect supervision" means the same as that term is defined by the division by
1729     rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
1730          (3) "Medical assistant" means an unlicensed individual working under the indirect

1731     supervision of a licensed podiatric physician and engaging in specific tasks assigned by the
1732     licensed podiatric physician in accordance with the standards and ethics of the podiatry
1733     profession.
1734          (4) "Practice of podiatry" means the diagnosis and treatment of conditions affecting the
1735     human foot and ankle and their manifestations of systemic conditions by all appropriate and
1736     lawful means, subject to Section 58-5a-103.
1737          (5) "Unlawful conduct" includes:
1738          (a) the conduct that constitutes unlawful conduct under Section 58-1-501; and
1739          (b) for an individual who is not licensed under this chapter:
1740          (i) using the title or name podiatric physician, podiatrist, podiatric surgeon, foot doctor,
1741     foot specialist, or D.P.M.; or
1742          (ii) implying or representing that the individual is qualified to practice podiatry.
1743          (6) (a) "Unprofessional conduct" includes, for an individual licensed under this
1744     chapter:
1745          [(a)] (i) the conduct that constitutes unprofessional conduct under Section 58-1-501;
1746          [(b)] (ii) communicating to a third party, without the consent of the patient, information
1747     the individual acquires in treating the patient, except as necessary for professional consultation
1748     regarding treatment of the patient;
1749          [(c)] (iii) allowing the individual's name or license to be used by an individual who is
1750     not licensed to practice podiatry under this chapter;
1751          [(d)] (iv) except as described in Section 58-5a-306, employing, directly or indirectly,
1752     any unlicensed individual to practice podiatry;
1753          [(e)] (v) using alcohol or drugs, to the extent the individual's use of alcohol or drugs
1754     impairs the individual's ability to practice podiatry;
1755          [(f)] (vi) unlawfully prescribing, selling, or giving away any prescription drug,
1756     including controlled substances, as defined in Section 58-37-2;
1757          [(g)] (vii) gross incompetency in the practice of podiatry;
1758          [(h)] (viii) willfully and intentionally making a false statement or entry in hospital
1759     records, medical records, or reports;
1760          [(i)] (ix) willfully making a false statement in reports or claim forms to governmental
1761     agencies or insurance companies with the intent to secure payment not rightfully due;

1762          [(j)] (x) willfully using false or fraudulent advertising;
1763          [(k)] (xi) conduct the division defines as unprofessional conduct by rule made in
1764     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; or
1765          [(l)] (xii) falsely making an entry in, or altering, a medical record with the intent to
1766     conceal:
1767          [(i)] (A) a wrongful or negligent act or omission of an individual licensed under this
1768     chapter or an individual under the direction or control of an individual licensed under this
1769     chapter; or
1770          [(ii)] (B) conduct described in Subsections (6)(a)(i) through [(k)] (xi) or Subsection
1771     58-1-501(1).
1772          (b) "Unprofessional conduct" does not include, in accordance with Title 26, Chapter
1773     61a, Utah Medical Cannabis Act, when registered as a qualified medical provider or acting as a
1774     limited medical provider, as those terms are defined in Section 26-61a-102, recommending the
1775     use of medical cannabis within the scope of a practice of podiatry.
1776          Section 16. Section 58-31b-502 is amended to read:
1777          58-31b-502. Unprofessional conduct.
1778          (1) "Unprofessional conduct" includes:
1779          (a) failure to safeguard a patient's right to privacy as to the patient's person, condition,
1780     diagnosis, personal effects, or any other matter about which the licensee is privileged to know
1781     because of the licensee's or person with a certification's position or practice as a nurse or
1782     practice as a medication aide certified;
1783          (b) failure to provide nursing service or service as a medication aide certified in a
1784     manner that demonstrates respect for the patient's human dignity and unique personal character
1785     and needs without regard to the patient's race, religion, ethnic background, socioeconomic
1786     status, age, sex, or the nature of the patient's health problem;
1787          (c) engaging in sexual relations with a patient during any:
1788          (i) period when a generally recognized professional relationship exists between the
1789     person licensed or certified under this chapter and the patient; or
1790          (ii) extended period when a patient has reasonable cause to believe a professional
1791     relationship exists between the person licensed or certified under the provisions of this chapter
1792     and the patient;

1793          (d) (i) as a result of any circumstance under Subsection (1)(c), exploiting or using
1794     information about a patient or exploiting the licensee's or the person with a certification's
1795     professional relationship between the licensee or holder of a certification under this chapter and
1796     the patient; or
1797          (ii) exploiting the patient by use of the licensee's or person with a certification's
1798     knowledge of the patient obtained while acting as a nurse or a medication aide certified;
1799          (e) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
1800          (f) unauthorized taking or personal use of nursing supplies from an employer;
1801          (g) unauthorized taking or personal use of a patient's personal property;
1802          (h) unlawful or inappropriate delegation of nursing care;
1803          (i) failure to exercise appropriate supervision of persons providing patient care services
1804     under supervision of the licensed nurse;
1805          (j) employing or aiding and abetting the employment of an unqualified or unlicensed
1806     person to practice as a nurse;
1807          (k) failure to file or record any medical report as required by law, impeding or
1808     obstructing the filing or recording of such a report, or inducing another to fail to file or record
1809     such a report;
1810          (l) breach of a statutory, common law, regulatory, or ethical requirement of
1811     confidentiality with respect to a person who is a patient, unless ordered by a court;
1812          (m) failure to pay a penalty imposed by the division;
1813          (n) prescribing a Schedule II controlled substance without complying with the
1814     requirements in Section 58-31b-803, if applicable;
1815          (o) violating Section 58-31b-801;
1816          (p) violating the dispensing requirements of Section 58-17b-309 or Chapter 17b, Part
1817     8, Dispensing Medical Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if
1818     applicable;
1819          (q) establishing or operating a pain clinic without a consultation and referral plan for
1820     Schedule II or III controlled substances; or
1821          (r) falsely making an entry in, or altering, a medical record with the intent to conceal:
1822          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
1823     or an individual under the direction or control of an individual licensed under this chapter; or

1824          (ii) conduct described in Subsections (1)(a) through (q) or Subsection 58-1-501(1).
1825          (2) "Unprofessional conduct" does not include, in accordance with Title 26, Chapter
1826     61a, Utah Medical Cannabis Act, when registered as a qualified medical provider or acting as a
1827     limited medical provider, as [that term is] those terms are defined in Section 26-61a-102,
1828     recommending the use of medical cannabis.
1829          (3) Notwithstanding Subsection (2), the division, in consultation with the board and in
1830     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
1831     unprofessional conduct for an advanced practice registered nurse described in Subsection (2).
1832          Section 17. Section 58-37-3.7 is amended to read:
1833          58-37-3.7. Medical cannabis decriminalization.
1834          (1) As used in this section:
1835          (a) "Cannabis" means the same as that term is defined in Section 26-61a-102.
1836          (b) "Cannabis product" means the same as that term is defined in Section 26-61a-102.
1837          (c) "Legal dosage limit" means the same as that term is defined in Section 26-61a-102.
1838          (d) "Medical cannabis card" means the same as that term is defined in Section
1839     26-61a-102.
1840          (e) "Medical cannabis device" means the same as that term is defined in Section
1841     26-61a-102.
1842          (f) "Medicinal dosage form" means the same as that term is defined in Section
1843     26-61a-102.
1844          (g) "Nonresident patient" means the same as that term is defined in Section
1845     26-61a-102.
1846          (h) "Qualifying condition" means the same as that term is defined in Section
1847     26-61a-102.
1848          (i) "Tetrahydrocannabinol" means the same as that term is defined in Section
1849     58-37-3.9.
1850          (2) Before [January] July 1, 2021, including during the period between January 1,
1851     2021, and the effective date of this bill, an individual is not guilty under this chapter for the use
1852     or possession of marijuana, tetrahydrocannabinol, or marijuana drug paraphernalia if:
1853          (a) at the time of the arrest or citation, the individual:
1854          [(i) (A) had been diagnosed with a qualifying condition; and]

1855          [(B) had a pre-existing provider-patient relationship with an advanced practice
1856     registered nurse licensed under Title 58, Chapter 31b, Nurse Practice Act, a physician licensed
1857     under Title 58, Chapter 67, Utah Medical Practice Act, a physician licensed under Title 58,
1858     Chapter 68, Utah Osteopathic Medical Practice Act, or a physician assistant licensed under
1859     Title 58, Chapter 70a, Utah Physician Assistant Act, who believed that the individual's illness
1860     described in Subsection (2)(a)(i)(A) could benefit from the use in question;]
1861          [(ii) for possession, was:]
1862          [(A) the parent or legal guardian of an individual described in Subsection (2)(a)(i) who
1863     is a minor; or]
1864          [(B) the spouse of an individual described in Subsection (2)(a)(i); or]
1865          [(iii) (A)] (i) for possession, was a medical cannabis cardholder; or
1866          [(B)] (ii) for use, was a medical cannabis patient cardholder or a minor with a
1867     [qualifying condition] provisional patient card under the supervision of a medical cannabis
1868     guardian cardholder; and
1869          (b) (i) for use or possession of marijuana or tetrahydrocannabinol, the marijuana or
1870     tetrahydrocannabinol is one of the following in an amount that does not exceed the legal
1871     dosage limit:
1872          (A) unprocessed cannabis in a medicinal dosage form; or
1873          (B) a cannabis product in a medicinal dosage form; and
1874          (ii) for use or possession of marijuana drug paraphernalia, the paraphernalia is a
1875     medical cannabis device.
1876          (3) A nonresident patient is not guilty under this chapter for the use or possession of
1877     marijuana, tetrahydrocannabinol, or marijuana drug paraphernalia under this chapter if:
1878          (a) for use or possession of marijuana or tetrahydrocannabinol, the marijuana or
1879     tetrahydrocannabinol is one of the following in an amount that does not exceed the legal
1880     dosage limit:
1881          (i) unprocessed cannabis in a medicinal dosage form; or
1882          (ii) a cannabis product in a medicinal dosage form; and
1883          (b) for use or possession of marijuana drug paraphernalia, the paraphernalia is a
1884     medical cannabis device.
1885          (4) (a) There is a rebuttable presumption against an allegation of use or possession of

1886     marijuana or tetrahydrocannabinol if:
1887          (i) an individual fails a drug test based on the presence of [tetahyrdrocannabinol]
1888     tetrahydrocannabinol in the sample; and
1889          (ii) the individual provides evidence that the individual possessed or used cannabidiol
1890     or a cannabidiol product.
1891          (b) The presumption described in Subsection (4)(a) may be rebutted with evidence that
1892     the individual purchased or possessed marijuana or tetrahydrocannabinol that is not authorized
1893     under:
1894          (i) Section 4-41-402; or
1895          (ii) Title 26, Chapter 61a, Utah Medical Cannabis Act.
1896          Section 18. Section 58-37-6.5 is amended to read:
1897          58-37-6.5. Continuing education for controlled substance prescribers.
1898          (1) For the purposes of this section:
1899          (a) "Controlled substance prescriber" means an individual, other than a veterinarian,
1900     who:
1901          (i) is licensed to prescribe a controlled substance under Title 58, Chapter 37, Utah
1902     Controlled Substances Act; and
1903          (ii) possesses the authority, in accordance with the individual's scope of practice, to
1904     prescribe schedule II controlled substances and schedule III controlled substances that are
1905     applicable to opioid narcotics, hypnotic depressants, or psychostimulants.
1906          (b) "D.O." means an osteopathic physician and surgeon licensed under Title 58,
1907     Chapter 68, Utah Osteopathic Medical Practice Act.
1908          (c) "FDA" means the United States Food and Drug Administration.
1909          (d) "M.D." means a physician and surgeon licensed under Title 58, Chapter 67, Utah
1910     Medical Practice Act.
1911          (e) "SBIRT" means the Screening, Brief Intervention, and Referral to Treatment
1912     approach used by the federal Substance Abuse and Mental Health Services Administration or
1913     defined by the division, in consultation with the Division of Substance Abuse and Mental
1914     Health, by administrative rule, in accordance with Title 63G, Chapter 3, Utah Administrative
1915     Rulemaking Act.
1916          (2) (a) Beginning with the licensing period that begins after January 1, 2014, as a

1917     condition precedent for license renewal, each controlled substance prescriber shall complete at
1918     least 3.5 continuing education hours per licensing period that satisfy the requirements of
1919     Subsection (3).
1920          (b) (i) Beginning with the licensing period that begins after January 1, 2024, as a
1921     condition precedent for license renewal, each controlled substance prescriber shall complete at
1922     least 3.5 continuing education hours in an SBIRT-training class that satisfies the requirements
1923     of Subsection (4).
1924          (ii) Completion of the SBIRT-training class, in compliance with Subsection (2)(b)(i),
1925     fulfills the continuing education hours requirement in Subsection (3) for the licensing period in
1926     which the class was completed.
1927          (iii) A controlled substance prescriber:
1928          (A) need only take the SBIRT-training class once during the controlled substance
1929     prescriber's licensure in the state; and
1930          (B) shall provide a completion record of the SBIRT-training class in order to be
1931     reimbursed for SBIRT services to patients, in accordance with [Section] Sections 26-18-22 and
1932     [Section] 49-20-416.
1933          (3) A controlled substance prescriber shall complete at least 3.5 hours of continuing
1934     education in one or more controlled substance prescribing classes, except dentists who shall
1935     complete at least two hours, that satisfy the requirements of Subsections (4) and (6).
1936          (4) A controlled substance prescribing class shall:
1937          (a) satisfy the division's requirements for the continuing education required for the
1938     renewal of the controlled substance prescriber's respective license type;
1939          (b) be delivered by an accredited or approved continuing education provider
1940     recognized by the division as offering continuing education appropriate for the controlled
1941     substance prescriber's respective license type; and
1942          (c) include a postcourse knowledge assessment.
1943          (5) An M.D. or D.O. completing continuing professional education hours under
1944     Subsection (4) shall complete those hours in classes that qualify for the American Medical
1945     Association Physician's Recognition Award Category 1 Credit.
1946          (6) The 3.5 hours of the controlled substance prescribing classes under Subsection (4)
1947     shall include educational content covering the following:

1948          (a) the scope of the controlled substance abuse problem in Utah and the nation;
1949          (b) all elements of the FDA Blueprint for Prescriber Education under the FDA's
1950     Extended-Release and Long-Acting Opioid Analgesics Risk Evaluation and Mitigation
1951     Strategy, as published July 9, 2012, or as it may be subsequently revised;
1952          (c) the national and Utah-specific resources available to prescribers to assist in
1953     appropriate controlled substance and opioid prescribing;
1954          (d) patient record documentation for controlled substance and opioid prescribing; [and]
1955          (e) office policies, procedures, and implementation[.]; and
1956          (f) some training regarding medical cannabis, as that term is defined in Section
1957     26-61a-102.
1958          (7) (a) The division, in consultation with the Utah Medical Association Foundation,
1959     shall determine whether a particular controlled substance prescribing class satisfies the
1960     educational content requirements of Subsections (4) and (6) for an M.D. or D.O.
1961          (b) The division, in consultation with the applicable professional licensing boards,
1962     shall determine whether a particular controlled substance prescribing class satisfies the
1963     educational content requirements of Subsections (4) and (6) for a controlled substance
1964     prescriber other than an M.D. or D.O.
1965          (c) The division may by rule establish a committee that may audit compliance with the
1966     Utah Risk Evaluation and Mitigation Strategy (REMS) Educational Programming Project
1967     grant, that satisfies the educational content requirements of Subsections (4) and (6) for a
1968     controlled substance prescriber.
1969          (d) The division shall consult with the Department of Health regarding the medical
1970     cannabis training described in Subsection (6)(f).
1971          (8) A controlled substance prescribing class required under this section:
1972          (a) may be held:
1973          (i) in conjunction with other continuing professional education programs; and
1974          (ii) online; and
1975          (b) does not increase the total number of state-required continuing professional
1976     education hours required for prescriber licensing.
1977          (9) The division may establish rules, in accordance with Title 63G, Chapter 3, Utah
1978     Administrative Rulemaking Act, to implement this section.

1979          (10) A controlled substance prescriber who, on or after July 1, 2017, obtains a waiver
1980     to treat opioid dependency with narcotic medications, in accordance with the Drug Addiction
1981     Treatment Act of 2000, 21 U.S.C. Sec. 823 et seq., may use the waiver to satisfy the 3.5 hours
1982     of the continuing education requirement under Subsection (3) for two consecutive licensing
1983     periods.
1984          Section 19. Section 58-67-502 is amended to read:
1985          58-67-502. Unprofessional conduct.
1986          (1) "Unprofessional conduct" includes, in addition to the definition in Section
1987     58-1-501:
1988          (a) using or employing the services of any individual to assist a licensee in any manner
1989     not in accordance with the generally recognized practices, standards, or ethics of the
1990     profession, state law, or division rule;
1991          (b) making a material misrepresentation regarding the qualifications for licensure under
1992     Section 58-67-302.7 or Section 58-67-302.8;
1993          (c) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
1994     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
1995          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act; or
1996          (e) falsely making an entry in, or altering, a medical record with the intent to conceal:
1997          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
1998     or an individual under the direction or control of an individual licensed under this chapter; or
1999          (ii) conduct described in Subsections (1)(a) through (d) or Subsection 58-1-501(1).
2000          (2) "Unprofessional conduct" does not include:
2001          (a) in compliance with Section 58-85-103:
2002          (i) obtaining an investigational drug or investigational device;
2003          (ii) administering the investigational drug to an eligible patient; or
2004          (iii) treating an eligible patient with the investigational drug or investigational device;
2005     or
2006          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
2007          (i) when registered as a qualified medical provider or acting as a limited medical
2008     provider, as [that term is] those terms are defined in Section 26-61a-102, recommending the
2009     use of medical cannabis;

2010          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
2011     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
2012          (iii) when registered as a state central patient portal medical provider, as that term is
2013     defined in Section 26-61a-102, providing state central patient portal medical provider services.
2014          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
2015     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
2016     unprofessional conduct for a physician described in Subsection (2)(b).
2017          Section 20. Section 58-68-502 is amended to read:
2018          58-68-502. Unprofessional conduct.
2019          (1) "Unprofessional conduct" includes, in addition to the definition in Section
2020     58-1-501:
2021          (a) using or employing the services of any individual to assist a licensee in any manner
2022     not in accordance with the generally recognized practices, standards, or ethics of the
2023     profession, state law, or division rule;
2024          (b) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
2025     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
2026          (c) making a material misrepresentation regarding the qualifications for licensure under
2027     Section 58-68-302.5;
2028          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act; or
2029          (e) falsely making an entry in, or altering, a medical record with the intent to conceal:
2030          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
2031     or an individual under the direction or control of an individual licensed under this chapter; or
2032          (ii) conduct described in Subsections (1)(a) through (d) or Subsection 58-1-501(1).
2033          (2) "Unprofessional conduct" does not include:
2034          (a) in compliance with Section 58-85-103:
2035          (i) obtaining an investigational drug or investigational device;
2036          (ii) administering the investigational drug to an eligible patient; or
2037          (iii) treating an eligible patient with the investigational drug or investigational device;
2038     or
2039          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
2040          (i) when registered as a qualified medical provider or acting as a limited medical

2041     provider, as [that term is] those terms are defined in Section 26-61a-102, recommending the
2042     use of medical cannabis;
2043          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
2044     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
2045          (iii) when registered as a state central patient portal medical provider, as that term is
2046     defined in Section 26-61a-102, providing state central patient portal medical provider services.
2047          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
2048     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
2049     unprofessional conduct for a physician described in Subsection (2)(b).
2050          Section 21. Section 58-70a-503 is amended to read:
2051          58-70a-503. Unprofessional conduct.
2052          (1) "Unprofessional conduct" includes:
2053          (a) violation of a patient confidence to any person who does not have a legal right and a
2054     professional need to know the information concerning the patient;
2055          (b) knowingly prescribing, selling, giving away, or directly or indirectly administering,
2056     or offering to prescribe, sell, furnish, give away, or administer any prescription drug except for
2057     a legitimate medical purpose upon a proper diagnosis indicating use of that drug in the amounts
2058     prescribed or provided;
2059          (c) prescribing prescription drugs for oneself or administering prescription drugs to
2060     oneself, except those that have been legally prescribed for the physician assistant by a licensed
2061     practitioner and that are used in accordance with the prescription order for the condition
2062     diagnosed;
2063          (d) failure to maintain at the practice site a delegation of services agreement that
2064     accurately reflects current practices;
2065          (e) failure to make the delegation of services agreement available to the division for
2066     review upon request;
2067          (f) in a practice that has physician assistant ownership interests, failure to allow the
2068     supervising physician the independent final decision making authority on patient treatment
2069     decisions, as set forth in the delegation of services agreement or as defined by rule;
2070          (g) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
2071     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable; or

2072          (h) falsely making an entry in, or altering, a medical record with the intent to conceal:
2073          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
2074     or an individual under the direction or control of an individual licensed under this chapter; or
2075          (ii) conduct described in Subsections (1)(a) through (g) or Subsection 58-1-501(1).
2076          (2) "Unprofessional conduct" does not include, in accordance with Title 26, Chapter
2077     61a, Utah Medical Cannabis Act, when registered as a qualified medical provider or acting as a
2078     limited medical provider, as [that term is] those terms are defined in Section 26-61a-102,
2079     recommending the use of medical cannabis.
2080          (3) Notwithstanding Subsection (2), the division, in consultation with the board and in
2081     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
2082     unprofessional conduct for a physician assistant described in Subsection (2).
2083          Section 22. Section 62A-4a-404 is amended to read:
2084          62A-4a-404. Fetal alcohol syndrome or spectrum disorder and drug dependency
2085     -- Reporting requirements.
2086          (1) As used in this section:
2087          (a) "Health care provider" means:
2088          (i) an individual licensed under:
2089          (A) Title 58, Chapter 31b, Nurse Practice Act;
2090          (B) Title 58, Chapter 44a, Nurse Midwife Practice Act;
2091          (C) Title 58, Chapter 67, Utah Medical Practice Act;
2092          (D) Title 58, Chapter 68, Utah Osteopathic Medical Practice Act;
2093          (E) Title 58, Chapter 70a, Utah Physician Assistant Act; or
2094          (F) Title 58, Chapter 77, Direct-Entry Midwife Act; or
2095          (ii) an unlicensed individual who practices midwifery.
2096          (b) "Newborn child" means a child who is 30 days of age or younger.
2097          (c) "[Qualified] Recommending medical provider" means the same as that term is
2098     defined in Section 26-61a-102.
2099          (d) (i) "Substance abuse" means the misuse or excessive use of alcohol or other drugs
2100     or substances.
2101          (ii) "Substance abuse" does not include use of drugs or other substances that are:
2102          (A) obtained by lawful prescription and used as prescribed; or

2103          (B) obtained in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act,
2104     and used as recommended by a [qualified] recommending medical provider.
2105          (2) A health care provider who attends the birth of a newborn child or cares for a
2106     newborn child and determines any of the following, shall report the determination to the
2107     division as soon as possible:
2108          (a) the newborn child:
2109          (i) is adversely affected by the child's mother's substance abuse during pregnancy;
2110          (ii) has fetal alcohol syndrome or fetal alcohol spectrum disorder; or
2111          (iii) demonstrates drug or alcohol withdrawal symptoms; or
2112          (b) the parent of the newborn child or a person responsible for the child's care
2113     demonstrates functional impairment or an inability to care for the child as a result of the
2114     parent's or person's substance abuse.
2115          Section 23. Section 67-3-11 is amended to read:
2116          67-3-11. Health care price transparency tool -- Transparency tool requirements.
2117          (1) The state auditor shall create a health care price transparency tool:
2118          (a) subject to appropriations from the Legislature and any available funding from
2119     third-party sources;
2120          (b) with technical support from the Public Employees' Benefit and Insurance Program
2121     created in Section 49-20-103, the Department of Health, and the Insurance Department; and
2122          (c) in accordance with the requirements in Subsection (2).
2123          (2) A health care price transparency tool created by the state auditor under this section
2124     shall:
2125          (a) present health care price information for consumers in a manner that is clear and
2126     accurate;
2127          (b) be available to the public in a user-friendly manner;
2128          (c) incorporate existing data collected under Section 26-33a-106.1;
2129          (d) incorporate data collected under Section 26-61a-106, regarding fees for qualified
2130     medical providers recommending medical cannabis, as those terms are defined in Section
2131     26-61a-102;
2132          [(d)] (e) group billing codes for common health care procedures;
2133          [(e)] (f) be updated on a regular basis; and

2134          [(f)] (g) be created and operated in accordance with all applicable state and federal
2135     laws.
2136          (3) The state auditor may make the health care pricing data from the health care price
2137     transparency tool available to the public through an application program interface format if the
2138     data meets state and federal data privacy requirements.
2139          (4) (a) Before making a health care price transparency tool available to the public, the
2140     state auditor shall:
2141          (i) seek input from the Health Data Committee created in Section 26-1-7 on the overall
2142     accuracy and effectiveness of the reports provided by the health care price transparency tool;
2143     and
2144          (ii) establish procedures to give data providers a 30-day period to review pricing
2145     information before the state auditor publishes the information on the health care price
2146     transparency tool.
2147          (b) If the state auditor complies with the requirements of Subsection (4)(a), the health
2148     care price transparency tool is not subject to the requirements of Section 26-33a-107.
2149          (5) Each year in which a health care price transparency tool is operational, the state
2150     auditor shall report to the Health and Human Services Interim Committee before November 1
2151     of that year:
2152          (a) the utilization of the health care price transparency tool; and
2153          (b) policy options for improving access to health care price transparency data.
2154          Section 24. Section 78A-2-231 is amended to read:
2155          78A-2-231. Consideration of lawful use or possession of medical cannabis.
2156          (1) As used in this section:
2157          (a) "Cannabis product" means the same as that term is defined in Section 26-61a-102.
2158          (b) "Directions of use" means the same as that term is defined in Section 26-61a-102.
2159          (c) "Dosing guidelines" means the same as that term is defined in Section 26-61a-102.
2160          (d) "Medical cannabis" means the same as that term is defined in Section 26-61a-102.
2161          (e) "Medical cannabis card" means the same as that term is defined in Section
2162     26-61a-102.
2163          (f) "Medical cannabis device" means the same as that term is defined in Section
2164     26-61a-102.

2165          (g) "[Qualified] Recommending medical provider" means the same as that term is
2166     defined in Section 26-61a-102.
2167          (2) In any judicial proceeding in which a judge, panel, jury, or court commissioner
2168     makes a finding, determination, or otherwise considers an individual's possession or use of
2169     medical cannabis, a cannabis product, or a medical cannabis device, the judge, panel, jury, or
2170     court commissioner may not consider or treat the individual's possession or use any differently
2171     than the lawful possession or use of any prescribed controlled substance if:
2172          (a) the individual's possession complies with Title 4, Chapter 41a, Cannabis Production
2173     Establishments;
2174          (b) the individual's possession or use complies with Subsection 58-37-3.7(2) or (3); or
2175          (c) (i) the individual's possession or use complies with Title 26, Chapter 61a, Utah
2176     Medical Cannabis Act; and
2177          (ii) the individual reasonably complies with the directions of use and dosing guidelines
2178     determined by the individual's [qualified] recommending medical provider or through a
2179     consultation described in Subsection 26-61a-502(4) or (5).
2180          (3) Notwithstanding Sections 77-18-1 and 77-2a-3, for probation, release, a plea in
2181     abeyance agreement, a diversion agreement, or a tendered admission under Utah Rules of
2182     Juvenile Procedure, Rule 25, a term or condition may not require that an individual abstain
2183     from the use or possession of medical cannabis, a cannabis product, or a medical cannabis
2184     device, either directly or through a general prohibition on violating federal law, without an
2185     exception related to medical cannabis use, if the individual's use or possession complies with:
2186          (a) Title 26, Chapter 61a, Utah Medical Cannabis Act; or
2187          (b) Subsection 58-37-3.7(2) or (3).
2188          Section 25. Section 78A-6-115 is amended to read:
2189          78A-6-115. Hearings -- Record -- County attorney or district attorney
2190     responsibilities -- Attorney general responsibilities -- Disclosure -- Admissibility of
2191     evidence -- Cannabis.
2192          (1) (a) A verbatim record of the proceedings shall be taken in all cases that might result
2193     in deprivation of custody as defined in this chapter. In all other cases a verbatim record shall
2194     also be made unless dispensed with by the court.
2195          (b) (i) For purposes of this Subsection (1)(b):

2196          (A) "Record of a proceeding" does not include documentary materials of any type
2197     submitted to the court as part of the proceeding, including items submitted under Subsection
2198     (4)(a).
2199          (B) "Subjects of the record" includes the child's guardian ad litem, the child's legal
2200     guardian, the Division of Child and Family Services, and any other party to the proceeding.
2201          (ii) Notwithstanding any other provision, including Title 63G, Chapter 2, Government
2202     Records Access and Management Act, the court shall release a record of a proceeding made
2203     under Subsection (1)(a) to any person upon a finding on the record for good cause.
2204          (iii) Following a petition for a record of a proceeding made under Subsection (1)(a),
2205     the court shall:
2206          (A) provide notice to all subjects of the record that a request for release of the record
2207     has been made; and
2208          (B) allow sufficient time for the subjects of the record to respond before making a
2209     finding on the petition.
2210          (iv) A record of a proceeding may not be released under this Subsection (1)(b) if the
2211     court's jurisdiction over the subjects of the proceeding ended more than 12 months before the
2212     day on which the request is made.
2213          (2) (a) Except as provided in Subsection (2)(b), the county attorney or, if within a
2214     prosecution district, the district attorney shall represent the state in any proceeding in a minor's
2215     case.
2216          (b) Subject to the attorney general's prosecutorial discretion in civil enforcement
2217     actions, the attorney general shall enforce all provisions of Title 62A, Chapter 4a, Child and
2218     Family Services, and this chapter, relating to:
2219          (i) protection or custody of an abused, neglected, or dependent child; and
2220          (ii) petitions for termination of parental rights.
2221          (3) The board may adopt special rules of procedure to govern proceedings involving
2222     violations of traffic laws or ordinances, wildlife laws, and boating laws. However, proceedings
2223     involving offenses under Section 78A-6-606 are governed by that section regarding suspension
2224     of driving privileges.
2225          (4) (a) For the purposes of determining proper disposition of the minor in dispositional
2226     hearings and establishing the fact of abuse, neglect, or dependency in adjudication hearings and

2227     in hearings upon petitions for termination of parental rights, written reports and other material
2228     relating to the minor's mental, physical, and social history and condition may be received in
2229     evidence and may be considered by the court along with other evidence. The court may require
2230     that the individual who wrote the report or prepared the material appear as a witness if the
2231     individual is reasonably available.
2232          (b) For the purpose of determining proper disposition of a minor alleged to be or
2233     adjudicated as abused, neglected, or dependent, dispositional reports prepared by the division
2234     under Section 78A-6-315 may be received in evidence and may be considered by the court
2235     along with other evidence. The court may require any individual who participated in preparing
2236     the dispositional report to appear as a witness, if the individual is reasonably available.
2237          (5) (a) Except as provided in Subsections (5)(c) through (e), in an abuse, neglect, or
2238     dependency proceeding occurring after the commencement of a shelter hearing under Section
2239     78A-6-306 or the filing of a petition under Section 78A-6-304, each party to the proceeding
2240     shall provide in writing to the other parties or their counsel any information which the party:
2241          (i) plans to report to the court at the proceeding; or
2242          (ii) could reasonably expect would be requested of the party by the court at the
2243     proceeding.
2244          (b) The disclosure required under Subsection (5)(a) shall be made:
2245          (i) for dispositional hearings under Sections 78A-6-311 and 78A-6-312, no less than
2246     five days before the day on which the proceeding is held;
2247          (ii) for proceedings under Chapter 6, Part 5, Termination of Parental Rights Act, in
2248     accordance with Utah Rules of Civil Procedure; and
2249          (iii) for all other proceedings, no less than five days before the day on which the
2250     proceeding is held.
2251          (c) The division is not required to provide a court report or a child and family plan to
2252     each party to the proceeding if:
2253          (i) the information is electronically filed with the court; and
2254          (ii) each party to the proceeding has access to the electronically filed information.
2255          (d) If a party to a proceeding obtains information after the deadline in Subsection
2256     (5)(b), the information is exempt from the disclosure required under Subsection (5)(a) if the
2257     party certifies to the court that the information was obtained after the deadline.

2258          (e) Subsection (5)(a) does not apply to:
2259          (i) pretrial hearings; and
2260          (ii) the frequent, periodic review hearings held in a dependency drug court case to
2261     assess and promote the parent's progress in substance use disorder treatment.
2262          (6) For the purpose of establishing the fact of abuse, neglect, or dependency, the court
2263     may, in the court's discretion, consider evidence of statements made by a child under eight
2264     years of age to an individual in a trust relationship.
2265          (7) (a) As used in this Subsection (7):
2266          (i) "Cannabis" means the same as that term is defined in Section 26-61a-102.
2267          (ii) "Cannabis product" means the same as that term is defined in Section 26-61a-102.
2268          (iii) (A) "Chronic" means repeated or patterned.
2269          (B) "Chronic" does not mean an isolated incident.
2270          (iv) "Directions of use" means the same as that term is defined in Section 26-61a-102.
2271          (v) "Dosing guidelines" means the same as that term is defined in Section 26-61a-102.
2272          (vi) "Medical cannabis" means the same as that term is defined in Section 26-61a-102.
2273          (vii) "Medical cannabis cardholder" means the same as that term is defined in Section
2274     26-61a-102.
2275          (viii) "[Qualified] Recommending medical provider" means the same as that term is
2276     defined in Section 26-61a-102.
2277          (b) In any child welfare proceeding in which the court makes a finding, determination,
2278     or otherwise considers an individual's possession or use of medical cannabis, a cannabis
2279     product, or a medical cannabis device, the court may not consider or treat the individual's
2280     possession or use any differently than the lawful possession or use of any prescribed controlled
2281     substance if:
2282          (i) the individual's possession or use complies with Title 4, Chapter 41a, Cannabis
2283     Production Establishments;
2284          (ii) the individual's possession or use complies with Subsection 58-37-3.7(2) or (3); or
2285          (iii) (A) the individual's possession or use complies with Title 26, Chapter 61a, Utah
2286     Medical Cannabis Act; and
2287          (B) the individual reasonably complies with the directions of use and dosing guidelines
2288     determined by the individual's [qualified] recommending medical provider or through a

2289     consultation described in Subsection 26-61a-502(4) or (5).
2290          (c) In a child welfare proceeding, a parent's or guardian's use of cannabis or a cannabis
2291     product is not abuse or neglect of a child under Section 78A-6-105 unless there is evidence
2292     showing that:
2293          (i) the child is harmed because of the child's inhalation or ingestion of cannabis, or
2294     because of cannabis being introduced to the child's body in another manner; or
2295          (ii) the child is at an unreasonable risk of harm because of chronic inhalation or
2296     ingestion of cannabis or chronic introduction of cannabis to the child's body in another manner.
2297          (d) Unless there is harm or an unreasonable risk of harm to the child as described in
2298     Subsection (7)(c), in a child welfare proceeding a parent's or guardian's use of medical cannabis
2299     or a cannabis product is not contrary to the best interests of a child if:
2300          (i) for a medical cannabis cardholder after January 1, 2021, the parent's or guardian's
2301     possession or use complies with Title 26, Chapter 61a, Utah Medical Cannabis Act, and there
2302     is no evidence that the parent's or guardian's use of medical cannabis unreasonably deviates
2303     from the directions of use and dosing guidelines determined by the parent's or guardian's
2304     [qualified] recommending medical provider or through a consultation described in Subsection
2305     26-61a-502(4) or (5); or
2306          (ii) before January 1, 2021, the parent's or guardian's possession or use complies with
2307     Subsection 58-37-3.7(2) or (3).
2308          (e) Subsection (7)(c) does not prohibit a finding of abuse or neglect of a child under
2309     Section 78A-6-105, and Subsection (7)(d) does not prohibit a finding that a parent's or
2310     guardian's use of medical cannabis or a cannabis product is contrary to the best interests of a
2311     child, if there is evidence showing a nexus between the parent's or guardian's use of cannabis or
2312     a cannabis product and behavior that would separately constitute abuse or neglect of the child.
2313          Section 26. Effective date.
2314          If approved by two-thirds of all the members elected to each house, this bill takes effect
2315     upon approval by the governor, or the day following the constitutional time limit of Utah
2316     Constitution, Article VII, Section 8, without the governor's signature, or in the case of a veto,
2317     the date of veto override.
2318          Section 27. Revisor instructions.
2319          The Legislature intends that the Office of Legislative Research and General Counsel, in

2320     preparing the Utah Code database for publication, replace the language "the effective date of
2321     this bill" in Subsections 26-61a-201(8)(b)(ii) and 58-37-3.7(2) to the bill's actual effective date.