Committee hears DHHS‑requested fixes to therapeutic cannabis law, including ethics and provider oversight changes

Senate Bill 264, introduced in the Senate Judiciary Committee at the request of the New Hampshire Department of Health and Human Services (DHHS), would amend the therapeutic cannabis statute (RSA 126‑X) to resolve inconsistencies left after two bills passed last year.

Sen. Cassandra Prentice said the bill responds to two earlier pieces of legislation: House Bill 1222 (which modified physician‑assistant collaboration/scope provisions) and SB 357 (which expanded the list of provider types authorized to certify patients for therapeutic cannabis). SB 264 would:

- Clarify that physician assistants (PAs) who certify patients for therapeutic cannabis must have a collaborative agreement only when their scope of practice still requires one (a change tied to HB 1222 and a two‑year waiver process for some PAs). - Extend DHHS’s existing authority to refer concerns about certifying providers’ conduct to the appropriate professional licensing board to the newly authorized provider types (podiatrists, dentists, naturopathic doctors, optometrists, and other providers added by the 2024 expansion). - Close a conflict‑of‑interest loophole by extending existing prohibitions on financial relationships between certifying providers and in‑state Alternative Treatment Centers (ATCs) to analogous relationships with out‑of‑state cannabis dispensaries or entities.

Michael Holt, administrator of DHHS’s therapeutic cannabis program, described the drafting problems SB 264 would fix and said the bill is “largely remedial legislation” to align overlapping statutes. Jerry Kurnerck (retired surgeon and chair of the Therapeutic Cannabis Medical Oversight Board) said the oversight board unanimously supported the bill and described the ethics rationale: department referrals help regulatory boards investigate provider misconduct, and financial conflicts tied to out‑of‑state dispensaries can create incentives that compromise clinical judgment or patient safety.

Committee members asked practical questions about the proposed out‑of‑state prohibition. Holt and Kurnerck said the department has observed New Hampshire certifying providers advertising or otherwise promoting out‑of‑state dispensaries (notably in Maine) and that state regulation of those dispensaries differs: Maine’s medical marijuana dispensaries, they said, do not meet the same testing or labeling standards and therefore raise patient‑safety concerns. The proposed change would not bar a provider from certifying patients in New Hampshire so long as the provider did not maintain the prohibited financial/advertising relationships; it would give DHHS the authority to enforce the in‑state conflict‑of‑interest rule against out‑of‑state links.

Sen. Prentice and representatives of the oversight board and DHHS said the bill does not expand who may certify — that expansion was last year’s legislation — but creates necessary enforcement and alignment mechanisms to support the expanded program.

Representatives from the House members who shepherded the prior bills (including Rep. Wendy Thomas) and the Oversight Board reaffirmed support; committee members asked clarifying questions but did not take a vote that day.