State medical marijuana programs received poor grades for meeting patient needs, according to a report published by the advocacy group Americans for Safe Access.
Medical marijuana is legal in 23 states and the District of Columbia, but laws vary widely from state to state.
The report, "Medical Marijuana Access in the US: A Patient-Focused Analysis of the Patchwork of State Laws," ranks each state program based on patients' rights and protection from discrimination, access to medicine, ease of navigation, functionality and product safety protocols.
It is also the first to focus on whether states have adopted what the report summary calls recognized industry standards for cultivation, manufacturing and distribution, and laboratory testing for product identity and purity.
Maryland, New Hampshire, New Mexico and Washington have adopted best practices as well as recommendations and standards from the American Herbal Product Association, according to an announcement.
Overall, states scored highest for ease of navigation (C) and lowest in access to medicine and product safety (F), according to the summary.
The highest scoring states, with a B-plus, were California, Illinois and New Mexico.
States earning a B were Colorado, Hawaii, Maryland, Massachusetts, Nevada, Oregon and Washington. The report awarded B-minus scores to Arizona and Maine.
Delaware, Minnesota, New Hampshire, New Jersey, New York and the District of Columbia received Cs, Connecticut received a C-plus and Rhode Island was given a C-minus.
While no states received an overall F, Alaska, Michigan, Montana and Vermont received Ds or D-minuses.
Because marijuana is still illegal under federal law, hospitals risk losing their license and federal funding if they allow medical marijuana use in their facilities, FierceHealthcare previously reported. Medical marijuana isn't approved by the Food and Drug Administration, either, so it can't be provided in a hospital.