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


"The issue is, if the physician said they did not see the patient, that is clearly a denial. If it is unclear whether or not they saw the patient or not, it's a rejection. We are being very careful about not trying to penalize patients in any way."

How does this interpretation not punish patients?

"I understand what your question is leading to," he responds. "I think the medical marijuana rules are written very clearly. I think you know what they are. They have to have a treatment relationship that includes a personal physical examination and they have to consult with a physician. In this case, the constitution regarding medical marijuana and the law is more specific than other debilitating conditions.... I understand where you're saying. I do."

He might. But denying patients medicine for six months when they thought they were doing the right thing shows little understanding from the CDPHE. To me, it also says that the CDPHE doesn't take marijuana as seriously as other medicine, as I doubt such a policy would be used for any other legal substance -- especially if the patient was acting in good faith when they trusted their healthcare provider. However, Urbina, an active physician himself, denied my assertion.

dnacateractkush.jpg
Medicine.
"All medications and medical marijuana are under tight scrutiny. As a physician, I managed lots of patients with chronic, debilitating conditions and I had to follow the law and I had to develop a very close working relationship with patients. I think the same conditions exist for medical marijuana. The rules are very similar in terms of the physician-patient relationship, so we are taking this very seriously."

One thing that the CDPHE release didn't mention was that patients have the right to appeal the denial. Appeals and requests for hearings have to be filed in writing within thirty days of the denial with the CDPHE. That said, if the board you are up against interprets the law the same way that Urbina has, it seems there's little chance of having the decision reversed right now.

As for patients just applying, Urbina has the following bit of advice:

"Going forward, as we continue to investigate these cases, we urge patients to seek confirmation from the health care providers and physicians that the provider is indeed a physician with no impediments to their ability to recommend medical marijuana. We don't want anyone else to be caught in this situation going forward.... They want to check to make sure that they are following the law."

I can understand that going forward. The department has made its stance clear. But for the 4,200 sitting in limbo now, denying them outright seems more like a political jab at medical marijuana while completely ignoring people in pain. I think Colorado voters expected more than that when we voted for Amendment 20 over a decade ago as a way to provide compassionate care.

William Breathes is the pot pen name for our medical marijuana dispensary critic. His dispensary reviews run weekly in our marijuana blog Mile Highs and Lows. Keep up with all your marijuana news, entertainment and occasional opinions like this at The Latest Word.


My Voice Nation Help
27 comments
Sort: Newest | Oldest
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? 

guy in pain
guy in pain

they know they can fuck us,and they did

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.

Bwebb30
Bwebb30

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

Jen
Jen

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

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.

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? 

William Breathes
William Breathes

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

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. 

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. 

Guest
Guest

yeah thats what i meant recommended .

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!

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.

Guest
Guest

lol this dude Monkey is my dude

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...

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!!!

Nate505
Nate505

Wow, and that idiot is a doctor.  Amazing.

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.

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.

From the Vault

 

©2013 Denver Westword, LLC, All rights reserved.
Browse Voice Nation
  • Voice Places Denver / Boulder

    Voice Places

    Find everything you're looking for in your city

  • Happy Hour App

    Happy Hour App

    Find the best happy hour deals in your city

  • Daily Deals

    Daily Deals

    Get today's exclusive deals at savings of anywhere from 50-90%

  • Best Of

    Best Of...

    Check out the hottest list of places and things to do around your city