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We have recommended that they wait until further guidance is provided by the state and our physician-led Quality Committee has completed its review and outlined a formal policy and process that will be needed to appropriately address the new law and support our patients. Mercy has not prohibited its physicians from signing the cards. Karen Vander Sanden, public relations specialist for Mercy Cedar Rapids, told Bleeding Heartland on February 7, Yet when this patient asked to be referred to another doctor who would sign the paperwork, he 'was told no one in the Mercy network would do it.' Incomplete forms lacking a physician's signature 'will not be accepted.'

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Providers are simply confirming they have a professional relationship with the applicant and have been involved in diagnosing and treating that patient's debilitating medical condition. Indeed, the IDPH application makes clear that the health care provider is not writing a prescription for cannibidiol (see page 4). They are not being asked to prescribe medical cannabis.' This source, who preferred not to be identified by name, was frustrated, since 'All that my doctor had to do was sign a form stating I have a qualifying diagnosis. When one lifelong Mercy Cedar Rapids patient in his 30s took the IDPH form to his primary care provider, he 'was flatly told no Mercy physician in Cedar Rapids would sign off on it,' he told me. 'FLATLY TOLD NO MERCY PHYSICIAN IN CEDAR RAPIDS WOULD SIGN OFF'

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untreatable pain, defined as 'any pain whose cause cannot be removed and, according to generally accepted medical practice, the full range of pain management modalities appropriate for the patient has been used without adequate result or with intolerable side effects'.any terminal illness with a probable life expectancy of under one year, if the illness or its treatment produces one or more of the following: severe or chronic pain, nausea or severe vomiting cachexia or severe wasting.Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease.seizures, including those characteristic of epilepsy.multiple sclerosis with severe and persistent muscle spasms.Cancer (if the treatment or underlying condition produces severe or chronic pain, nausea or severe vomiting, cachexia or severe wasting).Whereas the previous law applied only to certain seizure disorders, House File 524, passed during the final hours of the legislature's 2017 session, allows Iowans to obtain cannabidiol if they suffer from any of the following 'debilitating medical conditions':

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The state's public health department has approved at least 283 Medical Cannabidiol Registration Cards for patients or their caregivers since a new law went into effect last May. The Iowa Clinic averages 450,000 visits annually, serving about 148,000 unique patients across its central Iowa locations. Mercy Cedar Rapids handled 451,400 outpatient visits last year at offices around Iowa's second largest metro area. The number of patients affected by their health care group's policies is unknown but potentially large. Without cooperation from a primary care provider, Iowans cannot start the process of receiving authorization to use cannabidiol legally. Most if not all of the 250-plus health care providers at The Iowa Clinic, a doctor-owned group in the Des Moines area, are also refusing to sign medical cannabis card applications. Mercy Cedar Rapids appears to have instructed its 503 physicians not to sign the IDPH paperwork, according to two sources with qualifying conditions, who receive health care at different facilities in that network. Iowa law requires applicants to obtain their doctor's signature attesting that the patient has a 'qualifying debilitating medical condition.' But the law stipulates that health care practitioners have 'no duty to provide' written confirmation of the patient's diagnosis.

Doctors affiliated with Mercy Cedar Rapids and The Iowa Clinic are refusing to sign paperwork their patients need to register for the Iowa Department of Public Health's medical cannabis program.

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