Medical marijuana: CDPHE's Dr. Chris Urbina on physician assistants, patient denials

medical marijuana doctor holding bottle with green cross cropped.JPG
By mid-January, as many as 4,200 potential medical marijuana patients will be told they are as much to blame for a "fraudulent" MMJ application as the doctor who signed off on a physician assistant's evaluation of that patient. The punishment? Waiting six months before they can apply again for the medication they needed a few months ago when they actually started the process.

In a press release on Friday, the Colorado Department of Public Health and Environment finally addressed growing concern among patients about medical marijuana applications being denied because of issues with physician assistants allegedly performing evaluations.

According to the CDPHE, a denial letter will be sent out to those patients who visited with physician assistants and not doctors, according to the department's interpretation of state law that says patients must have a working relationship with an actual physician.

Keep in mind that while this law currently prevents physician assistants from doing medical marijuana evaluations now, they still can do everything from sewing up a wound to prescribing Oxycontin. As a constant emergency room patient myself, I've been attended to more by PAs than actual doctors. I can completely understand why patients who have spent any time dealing with the health-care system for their debilitating condition wouldn't think twice about seeing a PA for an MMJ evaluation. But apparently the CDPHE doesn't and essentially is saying patients who trusted their doctor and health-care provider to do the right thing should be punished by not getting the meds they need.

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Dr. Chris Urbina
I spoke with CDPHE director Dr. Chris Urbina yesterday. He explained the department's reasoning:

"We took this seriously," he says. "We contacted the physicians to find out, first of all, if they had actually seen the patients. That was the important piece, because by constitution, by law, the physician has to have a working relationship with the patient to make a determination of 1) Do they have a debilitating condition that they can apply for a medical marijuana card, and 2) Does the physician then have a long term relationship so that he or she can monitor the patient to make sure their condition is either not getting better, etc. just like a physician-patient relationship you would expect. And finally, do they have some documentation of that. So, in those cases we are reviewing this with the physicians. And those cases where they didn't have a relationship, those cases will be denied."

Again, that sounds like punishing patients for someone else's mistake -- especially considering the CDPHE has the ability to simply reject the applications and allow patients to visit another doctor immediately. As the CDPHE also mentioned in the press release: "Denied applicants must wait six months from the date of denial before reapplying for the registry. Rejected applicants can resubmit a new application without delay and without the additional application processing fee."

But not Urbina, who says the CDPHE is merely following the letter of the law outlined by the constitution and recent legislation.

Page down for more of our interview with Dr. Ubrina.


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27 comments
Concerned Patient
Concerned Patient

I was under the impression if a recommendation wasn't denied within 35 days it was considered automatically APPROVED. What about that in the law?

MMJ Timmy Top
MMJ Timmy Top

I know people affected by this "doctor." They said they thought it weird that they didn't even go through examination to get their MMJ card. They said they didn't know, but they got their medicine, which truly helps them, so they didn't think twice... Till now. They agree, it is a good thing to crack down on these fake, greedy doctors, but feel like they should be refunded, so they can go get examined at a legitimate practice, and be recommended for their MMJ card. 

Being that they can still legally be a patient just as long as they see a legitimate doctor, who abides by the MMJ laws, they are unsure of whether they will reapply without a refund.

Caregivers can still legitimately help MMJ patients who have been recommended by a doctor who follows laws. Therefore, anyone out their who needs their medicine, don't let this stop you for these six months.

guy in pain
guy in pain

i applied in october and saw a pa , i asked if that was ok and was reassured it was,she could give me oxie if i needed it, i guess the gov would prefer i take that, they are owned by big pharm aint they, they dont care about the patients just their payoffs, nice smile in the pic asshole

0josh0
0josh0

This robbery will backfire. I hope they are prepared for a war. $90 x 4k = $360,000 and no more apps to deal with for 6 months. I hope they are ready for litigation and thousands of appeals. Do they really think that the denied will forget that the CDPHE ripped them off? 

Bwebb30
Bwebb30

Question.... What do y'all who live in areas where there are no doctors do? Areas where the office may be "remote" and covered by a Physician Assistant to Nurse Practitioner?

Bwebb30
Bwebb30

I have been a PA for 30 years. I do not work nor am I licensed in Colorado. That said, after reading ths and other articles, it is clear to me Dr. Urbina does not nderstand the MD/PA relationship. PAs, working under the supervision of a licensed medical doctor, within at doctor's scoe of practice, and who accepts responsibility for the actions of the PA, provide medical services to that doctor's patients. We do not and can not practice "Independantly". So, essentially, once a person is seen by a PA, a clinical/professional relationship exists between the patient, MD an PA. Single.

Jen
Jen

Sounds like CDPHE is enforcing the law as written.  That's their job.  Shouldn't the real issue be with the law?

Bob Smith
Bob Smith

CDPHE is a government agency, in a state that is predominately conservative with pockets of liberalism, being asked to license use of an drug that's padded cop department pocketbooks for decades because of its federal illegality. Of course those in charge of it are going to use every possible way, no matter how obscure or convoluted, to deny licenses. We're fools to think otherwise.

It's government of a thousand cuts, bleeding you out, slowly. The chickenshit tactics they're using here mirror those used against Occupy, in a way. Death by bureaucrat.

Guest
Guest

Judging by that look on Dr. Urbina's face I am guessing he is the type of guy who would read the comment section of an article where he is interviewed.

I sure hope he understands how outrageous he is. A follow up may be in order, Westword? 

Guest
Guest

a truly unbelievable, inhumane take on fairness.

Guest
Guest

Very well written article William. Physicians Assistants should no doubt be allowed to write the prescriptions. 

Have to go Underground Again!
Have to go Underground Again!

So if I understand correctly, the six month punishment is added onto the two months my card has already been expired, plus any additional amount of time they delay the denials. And if they stretch it out another couple of months, they could end up denying these patients for a very, very long time. Since it is a renewal, I cannot use my three month old paperwork at a MMC. I have already been denied my meds for two months and haven't yet seen the denial. They have had my paperwork for three months already. Surely they could have sent the denial by now. Then, after six months punishment, I reapply, then have to wait an additional two months for the card. The six month punishment actually becomes a ONE YEAR punishment! Holy crap!

Colorado Mmj Patient
Colorado Mmj Patient

EVERY patient that is Denied MUST REQUEST A HEARING. We need all 4,200 to act on this. We have a form letter from Rev. Baker that you can send in once you get your denial. You can view it here.

http://www.coloradomedicalmari...

Where are the MMCs with helping fight this nonsense? RedCard holders are the only ones that can shop at the MMCs, so why aren't they up in arms about this? With the 40k patient dip, you would think they would be fighting for every patient. 

Patients don't know every little detail it takes to obtain a red card. That is what the doctor and his staff are for. Patients should be contacting their doctor about this too.

WB,

You should have asked Dr. Urbina if feels right keeping the $90 fee for these people. Ask him what will happen to the $378,000??? 

What a mess...

Nate505
Nate505

Wow, and that idiot is a doctor.  Amazing.

guy in pain
guy in pain

they know they can fuck us,and they did

Bwebb30
Bwebb30

Sorry, iPad touch pad issues.... The last sentence above should read MD and PA. Simple.

William Breathes
William Breathes

They are interpreting the law and enforcing it as they interpret it. Punish patients with their decision is their choice.

As I said above:

As a constant emergency room patient myself, I've been attended to more by PAs than actual doctors. I can completely understand why patients who have spent any time dealing with the health-care system for their debilitating condition wouldn't think twice about seeing a PA for an MMJ evaluation. But apparently the CDPHE doesn't and essentially is saying patients who trusted their doctor and health-care provider to do the right thing should be punished by not getting the meds they need.

William Breathes
William Breathes

We'll be following up on this story as we've been doing for a few weeks now. Thanks Guest.

mike
mike

Marijuana is illegal to be prescribed so it's "recommended." Something every physicians assistant can do. Let's stop the rhetoric now and believe that this is a political attempt to curb marijuana dispensaries. 

Monkey
Monkey

That makes me sick! Grow your own or find a caregiver with a new doctor signature. If that's not your cup of tea and you prefer the centers, I would totally understand if someone in your position got creative. All you really need is the CHPHE website, a printer and the same list of doctors that centers check to verify licenses. https://www.doradls.state.co.u...Sometimes if people are treated like criminals, they act like criminal.

Angela Foxhawk
Angela Foxhawk

In a time like this, let's ask that question again, "What happened to the filing fees of those patients denied?"  Is this just another case of people following the rules as they were aware of them and now being hit on the nose with a paper and being told they are bad boys and girls and must sit in the corner?!!!?  This whole process is ridiculous.  My mother has MS and has been rejected twice due to paperwork errors.  Right.  We should not be working this from two points of view.  It is either medicine and can be obtained anywhere medication can  be obtained and at anytime!!!  Or it is still the underground substance that this government made it long ago. I believe it is meant to heal and the only way it can do that is if it can be obtained!!!

guy in pain
guy in pain

like to wipe that smirk off his face,some doctor i guess he thinks oxy is safer then pot

Robert Chase
Robert Chase

He's more Hick's hatchet man than anything else.

Guest
Guest

yeah thats what i meant recommended .

Guest
Guest

lol this dude Monkey is my dude

Colorado Mmj Patient
Colorado Mmj Patient

What the hell kind of doctor is this guy ?  Maybe he writes prescriptions for insulin and pain killers for his own patients ... but the scrips are post-dated 9 months.What about "Do no harm".My doctor often leaves me with a PA or a nurse.  That doesn't mean the PA or nurse is going to go off the reservation on their own - they are going to finish up for the doctor is all.  I am STILL a little shocked every time I hear about some idiot like this conjuring up non-existant problems to deny people medication.  Ignorant and cruel.

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