BISMARCK — A man with terminal lung and bone cancer was denied a medical marijuana card due to an error in his application caused by an advanced nurse practitioner at a now-closed Bismarck clinic.
Another person was denied a medical marijuana card after paying up to $200 to the same clinic that advertised sale of the cards.
Last month, the North Dakota Attorney General's office initiated an investigation into the Green Health Docs clinic that led to the subsequent closure of the business.
The clinic's closure highlights the demand for medical marijuana in the state and the extent to which people will go to obtain a medical marijuana card.
With physicians expressing reluctance to certify patients for medical marijuana, patients may instead turn to private practices, said Dr. Chris Meeker, the chief medical officer at Sanford Health in Bismarck.
"I think ultimately that's what will happen, is somebody will open a legitimate private business for this," Meeker said.
Green Health Docs in Bismarck was found to have been illegitimate after patients visited the clinic in hopes of finding a provider to certify them and instead lost $170 to $200.
The attorney general's office initiated an investigation into the clinic last month after it received complaints from the state Department of Health and two consumers, according to Parrell Grossman, director of the Consumer Protection Division.
Grossman said the Department of Health found that the clinic's medical provider, an advanced nurse practitioner, did not establish a "bona fide provider-patient relationship" with those who visited the clinic.
A "bona fide provider-patient relationship" is a requirement under the state's medical marijuana law that ensures the provider is aware of the patient's medical history and current medical condition, and that the patient is under the provider's care for that condition.
The relationship cannot be "for the sole purpose of providing written certification for the medical use of marijuana," the law states.
Without a "bona fide provider-patient relationship," people who visited Green Health Docs were denied medical marijuana cards and lost their money.
Green Health Docs has medical marijuana evaluation clinics in Maryland, Ohio, Oklahoma and Missouri, according to its website. Dr. Anand Dugar, who started Green Health Docs, did not return a phone message seeking comment.
Grossman said Green Health Docs cooperated with his office's investigation and it was resolved "fairly quickly" with a legal settlement, which was finalized on April 30.
The settlement included that Green Health Docs pay $21,800 to 112 consumers, according to Grossman. A majority of consumers each paid the clinic $200, but about 20 of them paid $170.
"The attorney general's legal action is strictly consumer protection action," he said. "A business cannot offer and collect payment for services it cannot provide, and that occurred in this instance."
In addition to issuing refunds, the business was prohibited from advertising or engaging in services related to certifying patients for medical marijuana unless the Department of Health determined that Green Health Docs "is in full compliance with the law," according to Grossman.
Green Health Docs also had to pay the state $1,000.
It remains to be seen whether the demand for providers to certify patients for medical marijuana will increase after the state Legislature this year added 12 new medical conditions to the list of qualifying conditions.
CHI St. Alexius prohibits providers from recommending medical marijuana due to its federal Schedule I status. Sanford Health in Bismarck allows providers to at their discretion.
The state's law was also changed this year to remove language that says a provider must state "that in their professional opinion the patient is likely to receive therapeutic or palliative benefit from the medical use or marijuana."
Meeker testified in support of the bill after hearing from some physicians at Sanford that this would be a barrier if they ever considered certifying.
Despite the language removal, Meeker said he doesn't think many more physicians will jump on board to certify.
"We do have physicians who are willing to certify. I think their primary concern is not so much certifying marijuana as it is getting known as a medical marijuana-certifier. They just think that will change the nature of their practice," he said.
Meeker said North Dakota's medical marijuana law does a good job of protecting patients from illegitimate private practices advertising medical marijuana certification because of the "bona fide patient-provider relationship" requirement.
Grossman advises consumers to ensure that the services they are seeking are in compliance with the law, meaning they have an actual provider-patient relationship.
"That certainly can't happen when you walk through the doors of a brand new medical provider who has never treated you," he said.