State accepting applications for medical-cannabis licensing lottery and prescribing authority; patient cards not available until Jan. 1

Rep. Jason Nemes, R-Middletown, and Sen. Stephen West, R-Paris,
discussed medical cannabis legislation before a committee in March.
(Photo by Legislative Research Commission Public Information)

By Sarah Ladd
Kentucky Lantern

Kentuckians can now begin applying for a cannabis business license, and medical providers can apply to the state Board of Medical Licensure and Board of Nursing for authority to write cannabis prescriptions.

This is thanks to a bipartisan House Bill 829 that became law during this year’s legislative session and moved up the medical cannabis timeline from January 2025 to July 1. In 2023, the legislature legalized medical marijuana for Kentuckians suffering from specified chronic illnesses.

Patients who qualify — with a history of post traumatic stress disorder (PTSD), cancer or other approved medical conditions — still won’t be able to apply for cannabis cards until Jan. 1.

Applications for dispensers and cultivators will remain open until Aug. 31. A limited number of licenses will be awarded, and winners will be chosen in a regional lottery system. The state will award 48 licenses to dispensaries in 11 regions, 10 to processors and 16 to cultivators.

Lottery winners are expected to be announced in October, Gov. Andy Beshear has said. Filling the applications via lottery, Beshear said in April, is a way to keep the process more equitable.

“It creates a more fair process,” he said. “Not one where people bid against each other and only then the big companies can be a part of it.”

Applicants will be required to pay an application fee and provide documentation including business history, operating plans and financial information.

“The program is focused on ensuring cannabis business licensing is fair, transparent and customer-service oriented,” Sam Flynn, executive director of the Kentucky Office of Medical Cannabis, said in a statement.

Rep. Jason Nemes, R-Middletown, the primary sponsor of HB 829, said the new timeline is “the culmination of a long effort to provide for the safe use of medical marijuana to provide relief to Kentuckians suffering from pain and disease.”

“We’re taking the regulatory process seriously,” Nemes said, “and looking forward to seeing it move forward.”

For more information on applying, visit this website.

Services Monday for Dr. Russell Travis, health-care leader, 87

Russell Travis, M.D.

Funeral services will be held Monday in Lexington for Dr. Russell Travis, a retired surgeon who was a longtime leader in Kentucky's health-care community. He died Oct. 29 at the age of 87.

Travis served as chair of the state Board of Medical Licensure and the state Workers' Compensation Board and held various positions with the American Academy of Occupational Medicine. He was president of the American Association of Neurological Surgeons and a longtime member of the Joint Washington Committee of Neurosurgery, which helped set national policy for neurological medicine. 

He was a visiting professor at medical schools in Kentucky, South Carolina, Michigan, Mississippi and Virginia. His many awards included the Lifetime Achievement Award from the International Academy of Independent Medical Evaluators and the Service to Mankind Award from the Kentucky Medical Association.

Travis grew up in Glasgow but was born in Jenkins, on the Virginia border, and he "would often speak fondly of his years in the mountains," his obituary said. "He gave back to the Appalachian community for over 30 years, by providing on-site neurosurgical care to those residents who lacked access."

He is survived by his wife, Jill Travis, four children, a brother and six grandchildren. Visitation will be held from 4 to 8 p.m. Sunday, Nov. 6, and 9:30 to 10:30 a.m. Nov. 7, with funeral services following immediately, at Kerr Brothers Funeral Home on Harrodsburg Road. In lieu of flowers, the family suggests donations to Kentucky Easter Seals or the Lexington Humane Society.

In wake of pill-mill regulation fight, Beshear has chance to craft a medical licensing board more to his liking

Gov. Steve Beshear

Gov. Steve Beshear is in a position to reshape a state medical board that has played a central and controversial role in recent efforts to crack down on prescription drug abuse. Mike Wynn of The Courier-Journal  reports that the terms of three members of the Kentucky Medical Licensure Board expired Aug. 31, and two other members’ terms await action after ending last year.

The licensure board drew criticism in 2011 "for not taking more aggressive action against so-called pill mills and corrupt doctors who supply Kentucky’s drug epidemic," Wynn writes. "The medical industry also has criticized the board in recent months for writing what doctors view as overly complex and excessive prescription regulations under HB 1, a landmark bill from the 2012 General Assembly that takes aim at abuse of drugs."

Beshear spokeswoman Kerri Richardson said the appointments are under review but did not indicate how the governor might proceed other than noting that he will consider qualifications and recommendations. Current board members serve until Beshear makes any new appointments. (Read more)

State medical board is soft on physicians, compared to other states and professions, and seems to be getting more lax

Though the state has a serious problem with abuse of prescription drugs, the Kentucky Board of Medical Licensure has a history of being soft on physicians with problematic prescription pill-writing practices, reinstating licenses after doctors have been convicted of felonies within Kentucky and granting licenses to doctors who have had them taken away in other states. So reports R.G. Dunlop of The Courier-Journal, whose three-day package that began yesterday highlights many instances of doctors whose medical privileges have been restored after serious run-ins with the law.

He starts with Tufan Senler, who ran a weight-loss clinic in Jefferson County and pleaded guilty to felony drug trafficking and money-laundering charges. "But in March 2010, after Senlar had been sentenced to two years' probation, the Kentucky Board of Medical Licensure restored his medical privileges — even though he still had more than six months of court-imposed home incarceration to serve," Dunlop reports.

In October, the C-J submitted questions to the board, asking it to provide information about 30 disciplinary cases, as well as its policies. "The board's written responses, received a month later, did not address most of the questions about specific cases, and ignored cases entirely," Dunlop reports.

Legislators have expressed their disapproval, with House Speaker Greg Stumbo and Attorney General Jack Conway both asking the board to make use of the state's prescription drug-monitoring system known as KASPER. Until last week, the board was against requiring doctors to use KASPER, though on Thursday agreed to support mandatory registration.

Not only has the board has been lax in tracking doctors, it has allowed physicians to practice in Kentucky when they've ran into trouble in other states. Again, Dunlop lists several examples, one of which involves Ali Sawaf. His medical privileges had been taken away at a Michigan hospital and he was convicted of tax evasion and domestic violence. In 1998, the Kentucky board granted him a license, and three years later, he was "facing a multitude of federal and state criminal charges, including the illegal prescribing of controlled substances," Dunlop reports. He was given a 20-year prison term.

Frank Rapier, who recently retired as the head of Appalachian High Intensity Drug Trafficking Areas program, said it was "ridiculous" that the board would allow doctors who were convicted or disciplined in other states to practice in Kentucky. "Why would we allow that?" he said. "An arsonist gets kicked out of one state, and you're gonna let him in yours?" In Florida, the state medical board often tells doctors who have been asked to surrender their licenses to "never" reapply. In Virginia and Ohio, a doctor can have his or her license permanently revoked. In Kentucky, they can reapply after two years in most cases.

And though Kentucky's board is lax compared to other states, it seems to be getting more lenient. "According to data compiled by a federation of licensure boards nationwide, the Kentucky board's total 'prejudicial actions,' which include the most serious sanctions it imposed, dropped from 95 in 2009 to 52 last year," Dunlop reports. "That was the fewest such actions by the board since at least 1999."

For more than 10 years, Kentucky's board has consistently been ranked by Public Citizen, a national nonprofit consumer-advocacy organization, as one of the country's best. But in 2010, it dropped to 12 place, down from third the year before. Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, called the drop "very worrisome."

Kentucky's licensing board is also more lax than other professional boards in the state. After a felony conviction, Kentucky lawyers and pharmacists can lose their licenses permanently. The pharmacy board "can also revoke a license for five years and a day, which requires the pharmacist to seek reinstatement and, at least in some instances, to retake required tests," Dunlop reports. Attorney Kent Westberry, a former federal prosecutor and president of the Kentucky Bar Association in 2004-05, said he could only remember one instance of an attorney who had been disbarred for a felony conviction getting his license reinstated.

Gov. Steve Beshear said the board has pledged "to take swifter, more decisive action against these drug-dealing doctors who are no longer practicing medicines but who are instead enabling devastating additions." Conway said he is "hopeful" the board will become part of a solution in combatting prescription drug abuse. Stumbo said he plans to propose legislation that will improve the use of KASPER and make the board take "prompt action to curtail the prescribing privileges of anyone convicted of inappropriate prescribing."

Board attorney Lloyd Vest said changes must come from the legislative level, saying that the options of permanent license revocation and longer periods before reinstatement is considered would have to be made law and "the board would certainly respond to those legislative statements." (Read more)

Federal agency is pressured to re-post online database of doctors' malpractice and disciplinary cases

U.S. Sen. Charles Grassley has joined journalists, academic researchers and consumer groups in calling on the Health Resources and Services Administration to put back online the National Practitioner Data Bank, a database of malpractice and disciplinary cases against doctors.

"In a strongly worded letter, the Iowa Republican, who has led investigations of fraud and waste in government health programs, said the now-removed file 'serves as the backbone in providing transparency for bad-acting health care professionals'," Duff Wilson of The New York Times reports. Grassley gave HRSA, part of the the Department of Health and Human Services, until Oct. 21 to hand over documents and answer a series of questions, ending with "What is your timeline for getting the database up and running again?"

For a PDF of Grassley's letter, click here. Under pressure, the agency has scheduled a conference call on the issue for Thursday, Oct. 13, from 1 to 2 p.m. Eastern Time.

The database "was created in 1986 for hospitals, medical boards, insurers and others to share information so that bad doctors do not slip through cracks in reporting," Wilson writes. The law makes doctors' names confidential, but the database has a Public Use File for researchers and journalists, in which doctors are identified only by numbers.

Some journalists have been able to identify doctors using information from other sources, such as lawsuits. "After a complaint by one doctor identified by The Kansas City Star, the agency threatened the newspaper reporter with a fine, pulled the doctor’s file from its Web site on Sept. 1 and began a review of how to hide the identities better," Wilson reports. "Its actions provoked protests" from the Association of Health Care Journalists, the Society of Professional Journalists, the Reporters Committee for Freedom of the Press and other groups. In a letter, they told HRSA, "Nothing in the Public Use File can be used to identify individuals if reporters or researchers don’t already know for whom they are searching."

Grassley wrote, "It seems disturbing and bizarre that HRSA would attempt to chill a reporter’s First Amendment activity with threats of fines for merely 'republishing' public information from one source and connecting it with public information from another. A journalist’s shoe-leather reporting is no justification for such threats or for HRSA to shut down public access to information that Congress intended to be public."

The Public Use File can be downloaded from the website of Investigative Reporters and Editors, one of the groups, protesting its removal from the HRSA site, but "that file will be more and more out-of-date as the dispute goes on," Wilson notes. She also reports that Robert E. Oshel, associate director for research and disputes in the Division of Practitioner Data Banks, says the agency is misinterpreting the law. (Read more)