Healthcare Law Blog

Medical Cannabis in Kentucky: What Practitioners Need to Know

As of January 1, 2025, medical cannabis is legal in Kentucky. Physicians and nurse practitioners who want to create access for their patients to this important treatment must become authorized to certify patients for medical cannabis and should be extremely careful to comply with confusing and complex regulatory requirements.

The Basics

The Office of Medical Cannabis in the Cabinet for Health and Family Services is charged with administering Kentucky’s medical cannabis program. Allowable medical cannabis products include edibles, oils, tinctures, vapes, and raw plant material, and only registered cardholders over the age of 21 may purchase vapes. Individuals certified for medical cannabis use are prohibited from consuming raw plant materials by smoking and all raw plant materials packaged in the Commonwealth must be labeled as “not intended for consumption by smoking.” Patients are certified to purchase medical cannabis products at licensed retailers.

Qualifying As a Practitioner

Under Kentucky’s program, no practitioner actually prescribes medical cannabis. Rather, physicians and nurse practitioners must register with their licensing boards to become a “Medical Cannabis Practitioner.” Only physicians and nurse practitioners may register, as physician assistants are excluded. Once registered with the proper licensing board, they must then also register with the Cabinet’s Medical Cannabis Practitioner Registry by accessing www.kymedcan.ky.gov. Both registration with the licensing board and the Cabinet are subject to renewal timelines as well.

Registered Medical Cannabis Practitioners evaluate patients to determine if they are qualified to be certified to receive a medical cannabis card. To qualify for certification, the patient must experience a qualifying medical condition. Once certified, a patient may register for a medical cannabis card, which gives the patient the ability to purchase cannabis products at licensed medical cannabis retailers.

To evaluate a patient, a practitioner must establish a bona fide practitioner-patient relationship and evaluate the patient in-person. Thereafter, as an established patient, the practitioner may see the patient via telehealth. KRS 216B.010(1) defines a bona fide practitioner-patient relationship as a treating or consulting relationship where the medical cannabis practitioner has: examined the patient’s past medical and psychiatric history, history of substance use, and conducted a thorough examination; discussed risks, benefits, limitations, and alternatives to medical cannabis; discussed potential drug interactions; obtained written patient consent; and established with the patient the expectation that the practitioner will provide follow-up care. Finally, before signing off on a medical cannabis application for the patient, the practitioner must review and analyze the patient’s KASPER data.

Generally, when a patient is evaluated by a provider in any setting, even if the purpose of the evaluation is to determine whether the patient can be certified for a medical cannabis card, if the practitioner conducts an evaluation, identifies a chief complaint, and determines services are medically necessary, then the visit should be covered by insurance. Medicare does not generally cover medical cannabis, and coverage of medical cannabis will vary by commercial insurance carrier. A practitioner should be able to bill for the patient encounter as long as he or she complies with standard billing guidelines. While a practitioner does not have to issue an Advance Beneficiary Notice (ABN) to a medical cannabis patient, it would be prudent to inform patients that Medicare does not cover medical cannabis.

Under state law, a medical cannabis practitioner may not have any ownership interest or investment in or a compensation agreement with a licensed cannabis retail or production business. Practitioners must adhere to their respective licensing board’s laws and regulations. Both the KBML and KBN have promulgated extensive regulations regarding professional standards for medical cannabis practitioners (201 KAR 9:067 and 201 KAR 20:067, respectively).

Physician Authorization

Physicians may apply to become authorized medical cannabis practitioners through the Kentucky Board of Medical Licensure’s (KBML) website. Applying physicians must submit an application to the KBML along with a $100 non-refundable fee. There are also Continuing Medical Education (CME) requirements that must be met and proof tendered. If approved, a physician will receive written or electronic notification from the KBML.

A physician must be in good standing with the KBML. For a complete list of requirements, please see 201 KAR 9:067.

APRN Authorization

APRNs may become authorized medical cannabis practitioners through the Kentucky Board of Nursing (KBN) portal. To apply, APRNs must submit an application along with a $100 non-refundable fee. APRNs must also submit, along with their initial application, their DEA registration certificate, PDMP (KASPER) registration certificate, and submit proof of their completion of continuing education course requirements.

An APRN must be in good standing with the KBN. For a complete list of requirements, please see 201 KAR 9:067.

Patient Qualifications

To receive a medical cannabis card, an individual must be a resident of Kentucky and at least 18 years of age or have an assigned caregiver, must not been convicted of a disqualifying felony offense, and have a written certification from a medical practitioner indicating a diagnosis of a qualifying condition that would benefit from the treatment of medical cannabis.

Registered patients will be issued an electronic medical card and can possess a 30-day supply of medical cannabis (some patients may qualify for a larger supply based on medical necessity as documented by their certifying physician or APRN). Designated caregivers that have a current medical card can purchase a 30-day supply for each assigned patient. Visiting qualified patients from other states with a current medical card can purchase a 10-day supply.

To be eligible for a medical cannabis card, patients must have at least one of the following diagnoses:

• Any type or form of cancer, regardless of stage.
• Chronic or debilitating pain, epilepsy or any other seizure disorder.
• Multiple sclerosis, muscle spasms, or spasticity.
• Chronic nausea or cyclical vomiting syndrome that has been proven resistant to other conventional medical treatments.
• Post-traumatic stress disorder (PTSD).
• Any other medical condition or disease that the Kentucky Center for Cannabis determines. To date, no new conditions have been added.

An initial written certification for medical cannabis will be valid for 60 days. The issuing medical cannabis practitioner may renew an initial written certification up to three additional 60-day periods. After issuing up to three initial written medical cannabis certifications for a patient, a practitioner may not issue another initial written certification to the patient until conducting an examination with the patient either in-person or via telehealth. Thereafter, a subsequent written certification issued to renew a registry identification card is valid for 90 days.

The Uncertain Future

While the use of medical cannabis has been authorized by many states, its use is new in Kentucky. Because of the complexity of the requirements for both practitioners and patients, proper medical cannabis use presents many issues. For more information about medical cannabis for practitioners, contact your McBrayer attorney today.

Lisa English Hinkle is a Member of McBrayer law. Ms. Hinkle chairs the healthcare law practice and is located in the firm’s Lexington office. Contact Ms. Hinkle at lhinkle@mcbrayerfirm.com or (859) 231-8780, ext. 1256

Valerie Michael is an Associate at McBrayer's Lexington office. Ms. Michael focuses her area of practice on healthcare law, handling a wide variety of matters, such as healthcare professional licensure defense, compliance, and regulatory issues. Ms. Michael can be reached at vmichael@mcbrayerfirm.com or (859) 231-8780, ext. 1266.

Services may be performed by others. This article does not constitute legal advice.