SIOUX FALLS (AP) – South Dakota's largest health care providers proposed Monday that lawmakers drop part of the requirement for people seeking medical marijuana identification cards to obtain a physician's recommendation to use the drug.

Under the proposal, physicians would still need to certify that patients have conditions such as severe pain, seizures or multiple sclerosis that would qualify them for a medical marijuana ID. But they would not need to specifically recommend that medical marijuana be used to treat the condition.

The proposal was welcomed by medical marijuana advocates, who have worried that patients will have a difficult time getting medical pot recommendations from physicians. Doctors have expressed hesitancy about recommending medical marijuana as the state prepares to legalize it.

Although a voter-passed law legalizing medical marijuana takes effect July 1, the full medical cannabis program is still in flux. The state has until November to start issuing ID cards, meaning people wouldn't be able to legally buy medical cannabis until then. In the meantime, state lawmakers are planning changes to the law.

Sarah Aker, the director of fiscal policy at the South Dakota Association of Healthcare Organizations, said there has been “a lot of concern from physicians" over the certifications for medical marijuana. She said doctors are hesitant to recommend pot because there is a lack of comprehensive research on its medical benefits, but they might be more comfortable writing certifications if they didn't specifically recommend using cannabis.

Jeremiah Murphy, a lobbyist for the Cannabis Industry Association of South Dakota, said medical marijuana advocates would support dropping that part of the recommendation requirement. But he opposed two other potential changes to the law that legislators discussed: restricting patients' ability to grow cannabis at home and allowing local governments to enter the medical marijuana business by obtaining retail licenses from the state.

Meanwhile, several Native American tribes in the state are planning to enter the cannabis industry, giving people an opportunity to purchase marijuana on tribal lands where it has been legalized. Ross Garelick Bell, a lobbyist for the Crow Creek Sioux, Oglala Lakota and Yankton Sioux, said tribal governments are hoping to make their own marijuana programs “cohesive” with South Dakota's regulations.

However, it remains unclear what South Dakota's final medical cannabis laws will be. Republican lawmakers oscillated between reminding themselves they had a duty to carry out the will of the voters and entertaining warnings that medical marijuana legalization will have severe repercussions. Lawmakers listened for over an hour as Dr. Kenneth Finn, a doctor from Colorado who has been an outspoken critic of marijuana legalization, warned of increases in pot use among children and a bump in emergency room visits for people who react poorly to the drug.

Although lawmakers have treaded lightly regarding the new law that passed with 70% of the vote, they have made it clear that they will make at least some changes to it.

Republican Rep. Fred Deutsch said, “Do we tweak the law or do we put up some major guardrails?”