KMBL Medical Cannabis- What to know

 

October 16, 2024

By: Jonas Bastien (Jonas.Bastien@emwnlaw.com)

 

Navigating Kentucky’s Medical Cannabis Industry: A Guide for Doctors and APRNs Seeking to Prescribe Medicinal Cannabis.

  1. Kentucky’s Medical Cannabis Industry 

In Kentucky, the regulation and structure of the medical cannabis industry fall under multiple government entities. Primarily, the Medical Cannabis Division within the Kentucky Cabinet for Health and Family Services (the “Cabinet” or “CHFS”) oversees the implementation and regulation of the state’s medical cannabis program. The Medical Cannabis Division  operates within the framework of Senate Bill 47, which legalized medical cannabis. The Cabinet is responsible for issuing patient identification cards, maintaining patient registries, and ensuring compliance with state laws and regulations.

The Kentucky Board of Medical Licensure (“KBML”), on the other hand, regulates the certification of physicians who are then permitted to provide medical cannabis recommendations. The KBML ensures that only qualified medical professionals who meet specific licensure, continuing education, and compliance requirements can certify patients for medical cannabis use. 

Similarly, the Kentucky Board of Nursing (“KBN”) regulates the certification of APRNs seeking authorization to write written certifications for the use of medical cannabis. The KBN has opened their application for APRNs seeking authorization to certify patients for medical cannabis use. 

The Department for Public Health within CHFS is tasked with ensuring that health and safety standards are followed within dispensaries and cultivation facilities. This includes setting rules for the production, labeling, and sale of medicinal cannabis products, as well as monitoring patient access and the distribution of products.

Each of these entities works collaboratively to ensure that medical cannabis is available to qualifying patients while upholding strict regulatory standards to prevent misuse and ensure public safety.

  1. Medical Cannabis in Kentucky: Recent Developments 

In Kentucky, the Cabinet’s Office of Medical Cannabis is currently reviewing nearly 5,000 business license applications following the state’s legalization of medical cannabis and initial licensure cycle. These applications seek licensure for cultivation, processing, and dispensary facilities. A breakdown of cannabis business applicants is shown below: 

Total: ​4,998

Cultivator Tier I: 239

Cultivator Tier II: 190

Cultivator Tier III: 155

Processor: 334

Dispensary: 4,075

Safety Compliance Facility: 5

 After submission, applicants undergo a review process that includes compliance checks, security plan evaluations, and financial assessments.  A brief overview of the lottery process is outlined below: 

Governor Andy Beshear recently announced that the lottery for cultivator licenses will be held on October 28, 2024 with pertinent applicants being notified of their participation in the lottery one week prior, on October 21, 2024.  

  1. Considerations for Medical Cannabis Patients in Kentucky 

The Medical Cannabis Division within the Cabinet oversees the implementation and regulation of the state’s medical cannabis program. This division ensures that the program operates within the framework of Senate Bill 47, which legalized medical cannabis, and is responsible for issuing patient identification cards, maintaining registries, and ensuring compliance with state laws.

In Kentucky, under Senate Bill 47, specific medical conditions qualify a patient for medical cannabis use. These include:

  • Cancer
  • Chronic pain unresponsive to other treatments
  • Epilepsy or seizure disorders
  • Multiple sclerosis
  • Post-Traumatic Stress Disorder (PTSD)
  • Sickle cell anemia
  • HIV/AIDS
  • Glaucoma
  • Muscular dystrophy
  • Crohn’s disease
  • Neuropathies

The list of qualifying conditions for medical cannabis use in Kentucky under Senate Bill 47 can be expanded in the future. The Cabinet has the authority to add new medical conditions to the list based on scientific evidence and public health considerations. This can happen through regulatory updates or legislative action if new research or patient needs demonstrate that additional conditions should qualify for medical cannabis treatment.

The Office of Medical Cannabis will soon be hosting a series of webinars for licensed Kentucky physicians and APRNs on how to become authorized and registered to provide qualified patients with written certifications for medical cannabis. You can see the details h​ere. 

  1. Legal Support for Physicians and Advanced Practice Registered Nurses Licensed in Kentucky Seeking Authorization as a “Medical Cannabis Practioner.” 

In Kentucky, only physicians and advanced practice registered nurses duly authorized by their respective state licensing board to provide written certifications pursuant to KRS 218B.050, and who are also registered as a medical cannabis practitioner with the Cabinet’s Office of Medical Cannabis may provide written certifications for the use of medical cannabis. 

A medical cannabis practitioner, as defined by in KRS 218B.010, “means a physician or an advanced practice registered nurse who is authorized to prescribe controlled substances under KRS 314.042, who is authorized by his or her state licensing board to provide written certifications pursuant to KRS 218B.050.”​

​Physicians and advanced practice registered nurses (“APRNs”) must be authorized through their respective licensing board in order to register with the Kentucky Office of Medical Cannabis as a medical cannabis practitioner. You can register as a medical cannabis practitioner through the Practitioner Authorization Registration Portal linked here​. 

The Kentucky Board of Medical Licensure (“KBML”) has promulgated its regulation regarding how physicians may become authorized to write written certifications for the use of medical cannabis. You can read their regulation here​. 

The KBML has opened their application for physicians seeking authorization. You can find the application, along with more information, here​. ​​

The KBML may suspend or revoke a medical cannabis practitioner’s authorization to provide written certifications for the use of medical cannabis and practice license for multiple violations or a serious violation of KRS 218B or administrative regulations promulgated by the Kentucky Office of Medical Cannabis. 

Similarly, the Kentucky Board of Nursing (“KBN”) has promulgated its regulation regarding how APRNs may become authorized to write written certifications for the use of medical cannabis. You can read their regulation here​. 

The KBN has opened their application for APRNs seeking authorization. You can find information on how to apply, along with additional details, here​.

The KBN may suspend or revoke a medical cannabis practitioner’s authorization to provide written certifications for the use of medical cannabis and practice license for multiple violations or a serious violation of KRS 218B or administrative regulations promulgated by the Kentucky Office of Medical Cannabis. ​

 

The Kentucky Office of Medical Cannabis  has also provided an Authorized Practitioner Registration Guide to assist prospective and authorized medical cannabis practitioners. The guide provides an overview of the eligibility and application requirements to become authorized medical cannabis practitioners, including step-by-step guidance on the processes for becoming authorized and providing written certifications. It also includes additional resources and information for practitioners on the processes and requirements for qualified patients. 

Additional quick references can be found on the Medical Cannabis Practitioner resources page, which you can find here​.

Medical cannabis practitioners may begin entering written certifications into the practitioner registry on December 1, 2024. Patients will need their written certification, which is valid for 60 days, before applying for a medical cannabis card with the Program. The Kentucky Office of Medical Cannabis cannot accept applications for medical cannabis cards until January 1, 2025.

The Kentucky Office of Medical Cannabis is providing a webinar series on how physicians licensed through the KBML and practicing in the Commonwealth can register and become authorized and to provide qualified patients with written certifications for medical cannabis. Webinar details are included below:​

Webinar Series: How Licensed Kentucky Physicians Become Authorized Medical Cannabis Practitioners

Similarly, the Kentucky Office of Medical Cannabis is providing a webinar series on how APRNs licensed through the KBN and practicing in the Commonwealth can become authorized and register to provide qualified patients with written certifications for medical cannabis. Webinar details are included below:​

Webinar Series: How Licensed Kentucky APRNs Become Authorized Medical Cannabis Practitioners 

The Kentucky Office of Medical Cannabis has filed 5 regulations regarding patients and caregivers, including the written certification form that medical cannabis practitioners will use. You can find all of the patient and caregiver regulations here. For more information regarding patients and caregivers, please view the Kentucky Office of Medical Cannabis Patient and Caregiver webpage. 

Once medical cannabis practitioners are authorized and registered, the Kentucky Office of Medical Cannabis will provide a list of registered medical cannabis practitioners on their website. For more information about how to write written certifications, please click here​. 

As Kentucky continues to implement its medical cannabis program, physicians face complex regulatory requirements under 201 KAR 9:067, an administrative regulation promulgated by the Kentucky Board of Medical Licensure. For physicians looking to become certified medical cannabis practitioners, the path involves navigating stringent licensing, continuing education, and compliance standards. As a cannabis law and administrative law attorney, I’m here to help streamline the process, ensuring full compliance with KBML regulations and mitigating risks related to the practice of certifying patients for medical cannabis.

  1. Why Legal Guidance is Crucial for Physicians and APRNs

The Kentucky medical cannabis landscape is highly regulated, and even minor missteps during the application process or in ongoing compliance can result in significant legal and professional consequences. From the eligibility criteria to the post-certification responsibilities, the KBML and KBN require strict adherence to their respective rules, processes, and regulations, which can be overwhelming for healthcare providers unfamiliar with cannabis regulations.

As an experienced cannabis law attorney, I specialize in guiding healthcare providers through this detailed regulatory landscape. For physicians, this may include: 

  1. Application Preparation and Submission: The KBML’s “Application for Authorization to Provide Written Certifications for the Use of Medicinal Cannabis” involves several requirements, including documentation of licensure, DEA registration, KASPER compliance, and completion of continuing medical education (CME). Missing or incomplete information can result in delays or denial of certification. I assist physicians in compiling and submitting a complete and accurate application to ensure a smooth review process.
  2. Understanding 201 KAR 9:067: This regulation governs who can provide medical cannabis certifications in Kentucky, including rules regarding conflict of interest, record-keeping, and the requirement for six hours of CME focused on medical cannabis. I help physicians interpret these regulations and implement compliant practices in their offices, particularly concerning documentation and patient assessments.
  3. Mitigating Conflicts of Interest: Physicians are barred from having any financial interest in cannabis businesses. I work with healthcare professionals to ensure they are fully compliant with this rule, providing clarity on how to avoid potential conflicts that could jeopardize their certification or standing with the KBML.
  4. KASPER Compliance: Physicians must be registered with KASPER and report all patient certifications for medical cannabis. I provide legal counsel to ensure physicians properly integrate KASPER reporting into their practice without running afoul of patient privacy laws or reporting requirements.

APRNs face a similar process with the Kentucky Board of Nursing. 

  1. Dealing with KBML Investigations or Disciplinary Actions

Physicians and/or APRNs may encounter a KBML or KBN investigation, respectively, or potential disciplinary action related to their medical cannabis practice. Should that situation arise, physicians and APRNs must be cautious and mindful of their obligations under the law and potential options moving forward. The KBML has the authority to investigate physicians for non-compliance with 201 KAR 9:067 or improper patient evaluations. The KBN has similar authority over APRNs. 

  1. Conclusion: Why Legal Guidance Matters

Navigating Kentucky’s medical cannabis certification process requires attention to detail, comprehensive knowledge of the legal and regulatory landscape, and compliance with stringent standards. As Kentucky’s medical cannabis industry grows, physicians and APRNs must have the legal tools needed to confidently offer medical cannabis certifications to their patients, mitigate risks, and protect their professional standing, reputation, and license.

If you’re a physician or APRN interested in becoming a certified medical cannabis practitioner or need assistance navigating Kentucky’s medical cannabis industry, I’m here to guide you every step of the way. Together, we will ensure that your practice is fully prepared to meet Kentucky’s evolving regulatory requirements in its burgeoning medical cannabis industry.

For more information or to schedule a free consultation, feel free to contact me. 

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