PROVIDENCE, R.I. (AP) — The Rhode Island Medical Society has joined a lawsuit against the state health department over its decision to accept medical marijuana applications signed only by doctors, not nurse practitioners and physician assistants.

The state American Civil Liberties Union affiliate filed suit last week on behalf of the Rhode Island Patient Advocacy Coalition, Rhode Island Academy of Physician Assistants and a Bristol patient.

Rhode Island in August began requiring patients seeking medical marijuana to get a physician’s signature. Applications signed by nurse practitioners and physician’s assistants had previously been accepted.

The lawsuit says the change was made without public notice or legislative approval.