Tennessee lawmakers on Wednesday began a detailed review of a 99-page proposal that would establish a tightly regulated medical marijuana program, allowing home delivery while prohibiting smokable flower and home cultivation.
The Senate Judiciary Committee held the first of two scheduled hearings on Senate Bill 459, sponsored by Senator Ferrell Haile, which was deferred to a summer study earlier this year. The committee is scheduled to continue its review Thursday, with the legislation expected to undergo further revisions before potentially returning during the 2027 legislative session.
The proposed framework would place the Tennessee Department of Health in charge of administering the program and establish licenses for three tiers of cultivators, processors, dispensaries and testing laboratories.
Patients would need a prescription from a physician authorized to prescribe controlled substances. Before issuing an initial prescription, the physician would be required to conduct an in-person examination, review the patient’s medical history and discuss the potential benefits, risks and side effects of marijuana.
Qualifying conditions would initially be limited to Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), certain cases of cancer, inflammatory bowel disease including Crohn’s disease and ulcerative colitis, epilepsy or seizures, multiple sclerosis, Parkinson’s disease, HIV/AIDS and sickle cell disease.
The Medical Cannabis Commission could later recommend that lawmakers add conditions when it determines sufficient scientific evidence supports their inclusion.
Under the proposal, patients could purchase tablets, capsules, tinctures, non-sugarcoated gelatinous products, gels, oils, creams, suppositories, transdermal patches, nebulizer products and liquids or oils administered through an inhaler.
Dispensaries would be prohibited from selling raw marijuana flower, and smoking marijuana would not qualify as an authorized medical use. Patients also would not be allowed to grow marijuana at home.
Products containing more than 90% delta-9 THC would be prohibited, and vaporized products could not be dispensed to patients younger than 21.
One of the most significant elements of the framework is its pharmacist requirement. Every licensed dispensary would be required to employ or contract with at least one Tennessee-licensed pharmacist and designate a pharmacist-in-charge.
Pharmacist consultation would have to be available whenever a dispensary is open. Every patient or caregiver visiting a dispensary for the first time would be required to consult with a pharmacist before receiving marijuana, with additional consultations required when there is a significant change in treatment or concerns about drug interactions, adverse effects or other safety issues.
Those consultations could occur in person or through real-time, HIPAA-compliant telehealth.
The proposal would also explicitly allow dispensaries to provide home delivery, with marijuana products delivered to the address registered to the patient.
During Wednesday’s hearing, Senator London Lamar raised questions about how extensively patients would be tracked by the state.
Matt Gibbs, an attorney for the Medical Cannabis Commission, acknowledged that purchases would be tracked, responding “100 percent. Absolutely” when Lamar questioned whether the state would track patients each time they obtained marijuana.
The actual proposal provides more detail on those safeguards. Rather than establishing a separate monitoring database, medical marijuana prescriptions and dispensary transactions would be entered into Tennessee’s existing Controlled Substance Database.
Before dispensing a product, businesses would be required to verify that the patient has an active certification, confirm the patient’s identity and check their dispensing history to make sure purchase limits are not exceeded.
Law enforcement could access the system to determine whether someone has an active certification and whether they are within their possession limit, but officers would be prohibited from accessing the patient’s specific medical condition, diagnosis codes or detailed medical history.
Medical marijuana information in the database would be confidential and exempt from public disclosure, with unauthorized access or disclosure punishable as a Class A misdemeanor and a fine of up to $5,000 per violation.
Patients would generally be allowed to possess a 30-day supply, with physicians authorized to approve as much as a 90-day supply for patients living in rural areas, those with mobility limitations or others with documented circumstances.
The legislation also contains employment protections. Employers could not discriminate against someone solely because they are a registered medical marijuana patient, although businesses could continue enforcing drug-free workplace policies and could prohibit possession, use or impairment while working.
A positive test for marijuana or THC alone could not serve as the sole basis for determining that an employee was impaired. The protections would not apply to safety-sensitive occupations.
The business licensing system would be geographically limited. The Medical Cannabis Commission would divide Tennessee into zones based on population, geography, access and other factors, and the Tennessee Education Lottery Corporation would conduct drawings to award licenses.
No more than two licenses of each type could initially be awarded in an individual geographic zone. Dispensary applicants would pay a $5,000 nonrefundable application fee and, once operating, a $30,000 annual renewal fee. Annual renewal fees for cultivators would range from $5,000 to $50,000 depending on cultivation tier.
Local governments would also retain substantial control over whether the industry operates within their borders.
In fact, the proposal states that marijuana businesses would not automatically be allowed anywhere in Tennessee. A municipality or county would first have to vote to approve marijuana business operations before any licensed business could open there. Residents could also petition to put the issue before voters.
Other provisions establish statewide seed-to-sale tracking, mandatory laboratory testing, child-resistant packaging and restrictions on advertising, including prohibitions on cannabis-leaf imagery, green crosses, flashing signs and advertising that suggests recreational use.
Despite Wednesday’s extensive discussion, the proposal has not been approved by the committee and would not itself legalize medical marijuana at this stage.
The Senate Judiciary Committee’s study continues Thursday, when lawmakers are expected to hear additional testimony and recommendations from interested parties. The current 99-page framework is expected to serve as the starting point for legislation that could return when lawmakers reconvene in 2027.
The proposal also contains an unusual federal trigger: the act specifies that it would take effect 30 days after federal action rescheduling marijuana from Schedule I to Schedule III, with the Department of Health beginning the process of implementing the program after that action.
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