Florida House leaders have rolled out a proposal that would allow patients to smoke medical marijuana, but only after going through what one critic called a “bureaucratic mess of red tape.”

The House proposal, released Tuesday afternoon, would require doctors get the approval of a “case review panel” before they could order smokable marijuana for patients.

Under a Senate plan approved by a key committee Monday, patients would have to see two doctors before being allowed to smoke, adding to out-of-pocket costs.

The House and Senate efforts come after Gov. Ron DeSantis gave lawmakers until March 15, 10 days after the annual legislative session begins, to address the smoking issue. If the Legislature does not act, the Republican governor threatened to drop the state's appeal of a court decision that said a Florida law banning patients from smoking medical marijuana is unconstitutional.

DeSantis, a Harvard Law School graduate who took office Jan. 8, agrees that the smoking ban runs afoul of a constitutional amendment, overwhelmingly approved by voters in 2016, that legalized medical marijuana for a broad swath of patients.

It's uncertain whether the House and Senate plans, as they now stand, would garner DeSantis' approval.

“Patients need more medicine, not more government,” Rep. Matt Gaetz, a top adviser to DeSantis on medical marijuana and other issues, said in a text when asked Wednesday about the proposals. Gaetz, a former Florida House member, was one of the architects of the state's medical cannabis laws.

DeSantis has also criticized delays in implementation of the constitutional amendment, saying the state should increase the number of medical marijuana operators to ensure that patients have access to cannabis treatment.

Courtney Coppola, interim director of the state Office of Medical Marijuana Use, addressed DeSantis' concerns after giving the House Health Quality Subcommittee an update Wednesday.

“We're always looking to improve efficiency and move as quickly as possible. You heard Gov. DeSantis say that he is interested in doing that as well, and we … are preparing everything we can to make sure that that's a reality,” Coppola, who was asked by DeSantis to stay on the job for another 90 days, told reporters.

While the smoking legislation is in the early stages, it is already clear that GOP House leaders, including House Speaker José Oliva, are balking at an outright repeal of the smoking ban. Supporters of banning or placing restrictions on smoking marijuana have pointed primarily to the health risks of smoking.

Also, Oliva has raised concerns that allowing smoking would amount to a de facto authorization of marijuana for recreational use.

“The House's position has generally been, and I believe still continues to be, recreational marijuana is not something anyone voted for,” Oliva told reporters last week.

Oliva said smoking was not on the ballot when voters passed the 2016 constitutional amendment.

“The discussion that is being had now is, basically, we want recreational marijuana. We want to call it medicine, because if you call it medicine we have some cover, so that's what we would like,” he said.

The House measure (PCB HHS-01) would require doctors to provide a laundry list of information before getting approval from the “case review panel,” which would be created by the Board of Medicine and the Board of Osteopathic Medicine.

The required documentation includes other routes of marijuana administration used by the patient; assessment of the effectiveness of the other treatment delivery methods; research documenting that smoking is an effective route of administration to treat the patient's condition; and documentation supporting the physician's opinion that the benefits of smoking would likely outweigh the potential health risks for the patient.

The bill would require the review panel to “give great weight to high quality medical research conducted according to commonly accepted” scientific standards and would give the panel 10 days to rule on the request for approval.

But Rep. Carlos Guillermo Smith, D-Orlando, blasted the proposal, which will get its first hearing in a House committee next week.

The measure “is a bureaucratic mess of red tape and additional boards that have to deliberate and approve whether a patient should be allowed to smoke medical cannabis after a doctor has already recommended it,” Smith said.

Meanwhile, at the behest Monday of Chairwoman Gayle Harrell, the Senate Health Policy Committee significantly altered what had been a simple proposal to strip the smoking ban out of state law.

The amended Senate measure (SB 182) would require patients who want to smoke medical marijuana to seek a second opinion, from doctors who are not certified by the state to order cannabis for patients. If a second doctor gives the nod, patients would then have to return to their original doctors to get the order.

Sen. Jeff Brandes, a St. Petersburg Republican who sponsored the measure, said he would not allow it to go to the Senate floor for a full vote as it stands after the changes.

Whether the House and Senate will reach consensus on a proposal that meets the governor's wishes by the March 15 deadline remains uncertain. The annual legislative session starts March 5.

Smith, who said he's skeptical about whether lawmakers will lift the ban “in a way that doesn't make it worse,” is developing legislation aimed at lowering patients' treatment costs.

Patients and caregivers must pay $75 each year for state-issued identification cards, up to $500 for initial consultations with doctors who've been approved to order the cannabis treatment and between $100 and $300 for follow-up visits. Under Florida law, patients must see their doctors at least every seven months.

Also, they spend hundreds of dollars per month for cannabis-based products.

Among Smith's ideas is extending the period of time identification cards would be valid.

“The license for a concealed-carry permit, you get that for six years before you have to renew it. Six years. Why not let the medical cannabis IDs, which is also a constitutional right, be aligned with concealed-carry licenses?” he told The News Service of Florida.

Dara Kam reports for the News Service of Florida.