Qualifying Debilitating Medical Conditions

The Oversight Committee webpage has details on how to request the addition of a new medical condition to the qualifying list.

Adult Patient Qualifying Conditions

• Terminal illness
• Cancer
• Positive status for Human Immunodeficiency Virus (HIV Positive)
• Acquired Immune Deficiency Syndrome (AIDS)
• Decompensated cirrhosis
• Amyotrophic Lateral Sclerosis (ALS / Lou Gehrig’s Disease)
• Agitation of Alzheimer’s disease
• Post-traumatic Stress Disorder (PTSD) *Note: MUST be a licensed psychiatrist to certify this condition.
• Intractable epilepsy
• Autism with self-injurious or aggressive behavior
• A chronic or debilitating disease or medical condition or its treatment that produces one or more of the following
  • Cachexia or wasting syndrome
  • Severe, debilitating pain that has not responded to previously prescribed medication or surgical measure for more than three months, or for which other treatment options produced serious side effects.
  • Intractable nausea
  • Seizures
  • Severe and persistent muscle spasms, including but not limited to those characteristic of Multiple Sclerosis

Pediatric Patient Qualifying Conditions

If the qualifying patient is younger than 18 years of age, the physician must be a pediatric neurologist, pediatric gastroenterologist, pediatric oncologist or pediatric palliative care specialist.

• Intractable epilepsy
• A chronic or debilitating disease or medical condition where they have failed treatment involving one or more of the following symptoms
  • Cachexia or wasting syndrome
  • Intractable nausea
  • Severe, painful and persistent muscle spasms