By Heather Stauffer

Pennsylvania is gearing up for full implementation of its medical marijuana law early next year, but significant questions still remain about exactly what that will look like for patients and businesses.

Some of those questions have to do with the fact that medical marijuana is a new market here, and Pennsylvania’s law differs in varying degrees from those in other states.

Pennsylvania’s law allows some forms of medical marijuana, but not smoking, for patients with certain medical conditions.

Other questions revolve around the fact that federal law, which currently is not being enforced very strictly, says all forms of marijuana are illegal.

Here are some of the key issues facing patients and businesses.

Will insurance cover medical marijuana?

The law says it doesn’t have to, and observers say that probably means it won’t.

“If an insurance company is given an opportunity not to provide coverage, more often than not it’s going to go that route,” said attorney Bill Roark, co-chair of the Pennsylvania Bar Association’s medical marijuana and hemp law committee.

Dr. James Rochester of WorkNet Occupational Medicine in Lancaster agreed, but said that could change “if the economics of it make sense for insurers.”

Speaking at a Lancaster Chamber event in December, attorney Jonathan Spadea of The Chartwell Law Offices in Harrisburg said self-insured companies might consider covering medical marijuana for certain conditions if it could be significantly cheaper than very expensive prescription drugs their employees are currently using.

Charles R. Dielmann, a broker at Horst Insurance in Manheim Township, had a similar perspective, saying he thinks the federal approach will change and insurers will cover medical marijuana when it benefits them to do so — but that will take a while.

Citing the federal law, Highmark spokesman Leilyn Perri said in an email that medical marijuana “would not be federally recognized as a prescription drug, and would not be covered.”

How much will it cost?

That’s hard to predict, as Pennsylvania’s law doesn’t set prices — although that was initially considered, according to Roark.

But, he said, the law does have a provision that if the Department of Health decides the price of medical marijuana has become unreasonable, it can implement a price ceiling for six months.

Last March the New Jersey Department of Health reported that medical marijuana’s average price per ounce in that state, Arizona, Maine, New Mexico, Rhode Island and Vermont was $311, with the lowest in New Mexico at $284 and the highest in New Jersey at $489.

However, all those states’ laws are different than Pennsylvania’s — which notably doesn’t allow smoking of medical marijuana — and Roark said the costs “are ultimately going to be dictated by the market.”

He noted that he’ll be curious to see how the supply produced by the limited number of business permits Pennsylvania awards will align with demand.

A report called Cannabis Benchmarks, which has tracked averaged wholesale marijuana prices since 2015, shows they peaked at $1,953 per pound in the first quarter of 2016. For the first quarter of this year, they stood at $1,613.

Will I be able to get a prescription for it?

No, because of the federal law.

Instead, patients will have to register with the state Department of Health, obtain a physician’s certification that they suffer from one of the medical conditions Pennsylvania’s law covers, then apply for a ID card that will allow them to obtain medical marijuana from an approved dispensary in Pennsylvania.

Specifics of that process, including the ID card application fee, are still being finalized.

Will my regular doctor be able to certify me?

Possibly not, as only doctors who have completed a four-hour training course on medical marijuana — which is still being developed — will be able to certify patients.

Many doctors remain wary of medical marijuna, saying more research is needed. The Pennsylvania Medical Society, for instance, opposed the bill that authorized Pennsylvania’s law.

Not getting the training could be an easy way for doctors who have concerns to avoid having to deal with the issue directly.

How can I find a doctor who will certify me?

Regulators have proposed an online registry that would let patients seeking medical marijuana find doctors who can certify them to get it.

Are permits to grow, process and dispense medical marijuana get-rich-quick tickets for the lucky few companies that get them?

More than 500 companies paid nonrefundable fees of $10,000 and $5,000 to apply for the 27 dispensary and 12 grower-processor permits that Pennsylvania will issue in late June, so there’s obviously an expectation that it will be profitable.

However, Roark said, the big financial question is whether there will be any change to a federal law that keeps any business dealing in a prohibited controlled substance from taking any of the tax deductions or credits that businesses ordinarily do.

Under that law, he said, people in the medical marijuana business are paying tax rates “in excess of 50 percent.” And, he said, the federal stance is also making banks reluctant to get involved with marijuana ventures.

However, he said, one recent projection also showed the U.S. market for legalized marijuana, medical or otherwise, rising from $5.7 billion in 2015 to $21 billion by 2020.