Prior misconduct rarely an obstacle for doctors in Pennsylvania’s medical marijuana program

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HARRISBURG — Matthew Roman used to be Pennsylvania’s top doctor for getting a medical marijuana card.

In 2018, the year dispensaries began selling cannabis in the state, Roman was the only doctor to issue more than 3,000 medical marijuana certifications in Pennsylvania, according to health department records obtained by Spotlight PA through a Commonwealth Court decision.

Back then, Roman was more than just a prolific certifier.

He sued federal officials in 2018, claiming they unconstitutionally blocked people enrolled in state medical cannabis programs from buying a gun.

On social media, he showed off his medical marijuana card and offered the chance to win free card consultations. In a late 2017 video viewed by Spotlight PA, he appeared to roll and smoke marijuana while in Delaware.

Underneath all the attention, Roman had a drug problem, he later said. And soon it all came crashing down. A state medical board disciplined him in 2019. The consent agreement he entered into said he displayed a problematic pattern of cannabis use “leading to clinically significant impairment” and met the criteria for cannabis use disorder. He lost his ability to certify patients for the state’s medical marijuana program.

Roman, by his own account, worked hard to get back on track. In a letter to the health department last year, he described the effort he put into addressing his cannabis use disorder diagnosis, including inpatient rehab, group therapy, individual therapy, as well as drug testing. He wrote that “after over four years of sobriety from marijuana and alcohol,” his views on medical marijuana have changed, saying that “it should be a last resort.”

But after Roman’s medical license was reinstated in 2023 and his probation was lifted, the health department denied his application to return to the medical marijuana program.

Officials with the agency have since fought to keep him from returning.

The health department has rarely blocked practitioners from joining Pennsylvania’s medical program based on past discipline, records obtained by Spotlight PA show. And while Roman was denied, several other physicians who are active in the program — some of whom have been among the top doctors for issuing certifications — also have past disciplinary history. That includes a doctor who received a federal prison sentence in the early 2000s after pleading guilty to charges related to drug distribution.

Roman’s case highlights an under-the-radar debate over who gets to certify patients to use medical marijuana and whether past misbehavior should bar people from the program indefinitely.

» READ MORE: While Pennsylvania struggles to legalize, Delaware opens applications for marijuana licenses

The case, and a review of certification records, also shows how the program has changed in recent years.

State regulators have expanded who is eligible as a patient, including adding anxiety as a qualifying condition in 2019. In 2020, they temporarily eliminated the requirement for patients to meet with a doctor in person for a certification — a change lawmakers made permanent in 2021. More doctors now issue thousands of certifications a year.

While Roman was the only doctor in Pennsylvania’s medical marijuana program to issue more than 3,000 certifications in 2018, 30 physicians reached that number four years later.

Roman continued his push to return to the program. From the start of 2017 to at least mid-May, he was the only denied doctor whose appeal reached a hearing, records released by the department show.

After his November hearing, a state examiner agreed with him, recommending he be allowed back in. But an attorney for the health department objected, warning that the hearing examiner’s rationale could give any doctor who’s ever been disciplined standing to force their way back into the program once their license is restored.

As of July, Roman was still waiting for a decision from the health secretary.

“At some point, doesn’t a human being have a right to restore credibility through hard work?” Roman told Spotlight PA. “I feel like I’ve reached that point.”

In Pennsylvania, patients need a physician’s approval to legally purchase cannabis from dispensaries.

The health department isn’t the state agency that decides whether doctors have a medical license, but it does have the power to determine who enters the medical marijuana practitioner registry.

Back in 2016, when the legislature and then-Gov. Tom Wolf, a Democrat, legalized medical marijuana, they created a set of rules for those doctors. In the years that followed, the Department of Health expanded some requirements through regulations.

The law requires medical marijuana physicians to complete a four-hour training course, and says the Department of Health “must determine that the physician is, by training or experience, qualified to treat a serious medical condition.”

Under the law, the health department must also review records from the Pennsylvania Department of State showing “whether the physician has a valid, unexpired, unrevoked, unsuspended Pennsylvania license to practice medicine and whether the physician has been subject to discipline.”

» READ MORE: My dog ate marijuana while out on a walk. Turns out, lots of dogs mistakenly ingest weed.

The law does not specifically ban physicians who are on probation from being part of the registry, but department regulations go further and prohibit doctors whose license is “limited or otherwise restricted by the applicable medical board.”

Department regulations also allow it to deny physicians who have been the subject of disciplinary action. But those rules don’t differentiate between different types of violations or the length of time since the infractions.

To better understand the department’s practices, Spotlight PA reviewed disciplinary records for the 100 doctors who issued the most certifications in 2022. Of those, at least four had prior discipline on their medical license.

Unlike Roman, none of them had to file an appeal to be admitted into the program, records released by the department show.

The types of sanctions and alleged offenses varied.

The list includes Marcellus Boggs, who health department records say issued more than 9,000 medical marijuana certifications in 2022. He ranked fourth in the state among medical marijuana doctors that year.

In 2001, Boggs faced discipline based on allegations that he violated requirements related to prescribing the drug methadone for a patient known as AP who was addicted to heroin. A consent agreement said Boggs maintained the patient on methadone in excess of 14 days and “did not complete or maintain patient medical records for Patient AP recording the prescribing, administering or dispensing of the drug methadone for the period from October 1998 until March 2000.”

As part of the agreement, he was ordered to pay a $1,500 civil penalty and his medical license was suspended for three years — all but six months of that suspension was stayed in favor of probation. The State Board of Medicine reinstated his license to an unrestricted, non-probationary status in November 2004.

Ron Boyles, CEO of Green Bridge Society, a medical marijuana certification business based in Blair County, responded to a letter sent to Boggs by Spotlight PA. In a statement, Boyles called Boggs “an esteemed employee of Green Bridge Society.”

He referred to the situation that led to Boggs’ discipline as “a singular act of compassion that was resolved by the medical board, after which he continued his career as an emergency room doctor for many years.” Boggs told Spotlight PA the discipline was based on him trying to help someone. He also referenced the lack of any other discipline on his record, and said it was appropriate for state regulators to approve him as a practitioner for the medical marijuana program.

“I’m about trying to help patients become healthy,” Boggs said.

In an interview, Boyles said Boggs and all the other doctors on his staff are paid based on an hourly rate, not on the number certifications they issue. The company also helps patients navigate the health department’s system, has a pharmacist follow up with them, and offers comprehensive care, he said.

“We are the real deal. … I’m very passionate about the education,” Boyles said.

The company is popular, he said.

“As far as Dr. Boggs doing a lot of patients,” Boyles added, “he does a lot, because I give him a lot. I mean, he’s a full-time physician for me, works seven days a week here. We rarely take a break.”

One of the other top doctors in the program with prior discipline on their medical license is Roxanne Rick, who department records show was the only doctor to issue more than 9,000 certifications in 2020.

Her medical license was suspended in 2003, after she pleaded guilty to two counts related to illegal drug distribution and one conspiracy count, according to an order from the State Board of Medicine and federal court records. She was sentenced to 57 months imprisonment, which was later reduced following sentencing guideline changes, according to a legal filing entered on her behalf.

The State Board of Medicine reinstated her medical license to a probationary status in December 2013. The board concluded that she “satisfied her burden of establishing that she has made significant progress in personal rehabilitation since her conviction” and “satisfied her burden of establishing that she is unlikely to reoffend criminally.”

A little over five years later, in January 2019, the board reinstated her medical license to unrestricted, non-probationary status. Rick sought to join the medical marijuana program afterward, records show, and issued more than 3,100 medical marijuana certifications that year.

Bob Scherer, a business owner who helps patients obtain medical marijuana certifications, responded to letters and messages sent to Rick from Spotlight PA, saying that she is contracted to work with him.

“Dr. Rick has at all times accepted responsibility for any prior disciplinary history, and understands reentry programs for physicians are specific to each case,” Scherer said in a statement. “The medical marijuana program is unique in that physicians cannot advertise, and only make recommendations, and do not dispense or prescribe.”

He said, “Rick dedicates most of her practice to the medical marijuana program.” After the Pennsylvania Department of Health approved anxiety as a qualifying condition in 2019, and then in 2020 made telehealth appointments available in response to the coronavirus pandemic, “patients seeking treatment for anxiety soared, and Dr. Rick became one of the top doctors” for “approving patients for medical marijuana,” Scherer said.

Under the Wolf administration, state regulators sent denial letters to four doctors, according to records provided in response to Right-to-Know requests covering the start of the medical marijuana program to mid-May of this year.

The cases followed a similar pattern: The department denied the doctor, saying it was because their license was suspended or on probation; the license restrictions were later lifted; and the doctor ultimately joined the program. None of those four doctors ranked high for approving medical marijuana cards in 2022. The number of certifications they issued that year ranged from about a dozen to under 260.

The Wolf administration didn’t deny any doctors based on prior discipline, according to the letters released by the department.

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But the administration of Democratic Gov. Josh Shapiro, by contrast, cited prior discipline when it denied Roman and another doctor last year. Both had unrestricted medical licenses at the time of the denials. The other doctor also appealed, but withdrew before his hearing, records show. A third denial letter from January 2024 cited a doctor’s prior discipline and his failure to submit documentation to allow the department to complete its review.

The department denied changing its processes for reviewing which doctors to admit into the program and said it continues to follow the state’s medical marijuana law and regulations.

The agency declined to comment on decisions about specific doctors, citing confidentiality practices. The Bureau of Medical Marijuana may ask physicians with prior disciplinary actions to provide additional information before making a decision, said department spokesperson Mark O’Neill.

Patrick Nightingale is a criminal defense attorney, Pennsylvania medical marijuana patient and advocate, and supporter of legalizing cannabis for all adults 21 and over.

He said he wants as many physicians as possible participating in the program, so that patients have options. But he also thinks it’s appropriate for state regulators to use discretion when choosing which formerly disciplined doctors can join the program.

“I think that some additional scrutiny should be applied,” Nightingale told Spotlight PA. “ … But I would hate to say just across the board if you have any disciplinary actions whatsoever, you’re out.”

Karen O’Keefe, director of state policies for the Marijuana Policy Project, described recommending cannabis as “one of the more innocuous” and “low-risk” activities for a doctor. In terms of doctors with prior discipline, she doesn’t think certifying for cannabis should be treated more strictly than performing surgery or prescribing opioids.

“If they don’t think the doctor is safe to perform duties as a doctor, they shouldn’t do any of those duties,” said O’Keefe, whose group supports cannabis legalization for adults and patients.

Back in 2018, when Roman was Pennsylvania’s top doctor for a marijuana card, many things were different about the program.

There were fewer qualifying conditions that made patients eligible, doctors could not approve patients over the phone, and there were fewer doctors issuing certifications. Roman also said his use of social media at the time led many patients to him.

“That really created a snowball effect. So everybody was coming to see me at that time,” he said. “It wasn’t that I was over-certifying patients or anything like that. It was just that the program was so new.”

Following the disciplinary actions, the State Board of Medicine reinstated his medical license to an unrestricted, non-probationary status in April 2023. The order said that an attorney for the Pennsylvania Department of State did not oppose the reinstatement, and that records indicated Roman successfully completed all the requirements of a prior order for monitoring.

One of the central conflicts involved in Roman’s application to return to the medical marijuana program is how often he intends to issue certifications.

In a twist — given Roman’s very vocal support of cannabis in the past — the health department has spent a significant portion of its arguments raising concerns that he would deny certifications to patients who have a qualifying medical condition. That could lead to extra costs and delays in access to medication for patients, an attorney for the department said in a legal filing.

That part of the dispute is based on statements Roman made when he applied to return to the program. In a July 2023 letter, he suggested many patients today who have cards probably use marijuana for recreational reasons. He described how he would be happy to not certify patients again, and that it went “against my morals.”

But he said he still had “ownership over” a marijuana certification practice and wanted to be available to certify patients in case of an emergency. By the time of his hearing in November, he testified that he “disinvested myself and divorced myself from that business completely and had zero percent interest in it anymore.”

Still, he said he wanted to return to the program, and called the prior comments about not wanting to certify patients “brash” — he was attempting to address any concerns that he would too easily approve patients.

He later told Spotlight PA that he can have a better perspective on who’s at risk of cannabis use disorder.

“I’ve seen both sides of it,” he told Spotlight PA. “I’ve seen patients be helped by cannabis. But I’ve also seen patients, including myself, who have gotten hurt from cannabis.”

After a Spotlight PA reporter asked him about videos from 2017 and 2018, including one where he appeared to smoke marijuana, Roman said he appreciated that being brought to his attention and would get them removed; they were no longer available online later that same day.

The department has made multiple arguments against him returning to the program, including some that focused on the specifics of prior disciplinary actions and others challenging his credibility as a witness.

Joanna Waldron, an attorney representing the department in this case, wrote that when Roman applied to return to the program, he had little track record in practice and professional compliance without extensive monitoring and support. The attorney also said the legislature gave the Bureau of Medical Marijuana substantial discretion for how to run the program and cited its responsibility to determine if doctors are qualified.

Some of the department’s arguments speak to broader issues in the program, and address the department’s power to monitor doctors and whether it thinks patients have access to enough doctors currently.

Laura Mentch, director of the Bureau of Medical Marijuana, testified in November that she had not “received any complaints that there are not enough certifying practitioners” in the program, and said telehealth appointments have increased options for patients.

Waldron described limits on the department’s power, writing that the state’s medical marijuana law and regulations don’t give the bureau “the same investigation resources or authority to require extra requirements to prove compliance” that other agencies, including a licensing board, hold.

Despite the department’s concerns over Roman, hearing examiner Peter Kovach in April recommended he be allowed to return to the program. Kovach cited the State Board of Medicine’s order reinstating his license as evidence that the reasons for the disciplinary actions have been resolved.

Roman “credibly testified that he believes he is in a better position now to understand when patients are at risk of cannabis use disorders and that this additional knowledge and experience actually improves his ability to certify patients for cannabis cards,” the hearing examiner later added.

In May, Waldron urged the health secretary to reject the hearing examiner’s recommendation.

The attorney for the health department argued that under the hearing examiner’s approach, the Bureau of Medical Marijuana would have to approve every application from a physician who “had a valid, unexpired, unrevoked, unsuspended Pennsylvania license to practice medicine, regardless of any prior discipline by the State Board of Medicine.”

Roman now works as a family doctor in Delaware, he told Spotlight PA in July.

During the interview, he said that if he is ultimately allowed to join Pennsylvania’s medical marijuana program he might pull himself out of it.

Then he took the statement even further.

“Actually, that is what I plan to do,” Roman said. “I’m going to pull myself out of the program once I’m in it. But I want to do it on my own accord — not because I was kicked out of the program and prevented from getting back in.”

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