Dec. 10: Massachusetts regulators plan first vote on dropping the medical marijuana residency requirement

Massachusetts cannabis regulators plan to take a first vote on Dec. 10 on proposed rules that would drop the state's residency requirement for medical marijuana patients, opening the program to people who live in other states, State House News Service reported on Oct. 26.

The proposal was introduced at the Cannabis Control Commission's Oct. 22 public meeting as part of its "Chapter 65 Fall Regulatory Round," the rulemaking that carries out the marijuana reform law Gov. Maura Healey signed in April. According to the Commission's meeting materials, the changes to the medical rules (935 CMR 501) would also create a new dispensing-only medical license and end mandatory vertical integration for medical operators.

What the residency change would do

Under the Commission's current medical regulations, effective Sept. 11, 2026, a qualifying patient must be a Massachusetts resident, unless the person is receiving end-of-life or palliative care or cancer treatment in Massachusetts, as determined by a certifying health care provider.

The Commission's Oct. 22 presentation, under the heading "Residency Requirement Eliminated," says qualifying patient registration would instead be "based solely on qualifying medical condition." The presentation says the change would allow participation by out-of-state residents, seasonal workers and transient individuals, and describes it as aligning the program "with patient-centric healthcare practices and equity goals."

State House News Service reported that under the proposal, people 18 and older, regardless of what state they live in, who are diagnosed with a "debilitating medical condition" by a certified health care provider in Massachusetts could register to buy medical marijuana. People under 18 would need a debilitating condition that is also considered a "life-limiting illness," certified by two health care providers.

"Simply put, it is a really effective way and a thoughtful way for us to give medical patients across the country more access to treatment for any of the reasons that they're using marijuana for medicinal purposes," Commissioner Xiomara DeLobato told the News Service.

Timeline

According to State House News Service, DeLobato said commissioners plan to:

• take an initial vote on the regulations on Dec. 10;
• take public comments from Jan. 1 to Feb. 2; and
• consider changes and then take a final vote.

The Commission's meeting materials list Nov. 12 as its next public meeting and Dec. 10 among its 2026 public meeting dates, noting the dates are tentative and subject to change. The rules are not final, and current residency rules stay in place until new regulations are adopted.

Other changes in the medical rules package

The Commission's Oct. 22 presentation lists several other proposed changes to the medical program:

• New Medical Marijuana Dispensary (MMD) license. The license would cover businesses that purchase, store, dispense and deliver medical marijuana, without cultivation or product manufacturing. MMDs could operate on their own or alongside adult-use businesses or fully integrated medical operators.
• End of mandatory vertical integration. Existing Medical Treatment Centers would be redesignated as Fully Integrated MTCs, which could choose which functions (cultivation, manufacturing, dispensing) to keep, with a 36-month pathway to convert to an MMD.
• Pediatric certification. Nurse practitioners and physician assistants could certify pediatric patients with life-limiting illnesses, while existing specialty requirements stay in place.
• Institutional care. Caregiving institutions such as long-term care facilities and hospices would get new authority to order medical marijuana, with standards for on-site administration, storage and handling, and three-year renewals.
• Provider registry. Certifying providers would move to a three-year renewal cycle, with automatic suspension if their underlying professional license lapses, and could opt into a public directory.
• Supply chain. Adult-use licensees could transfer product to medical establishments, and product manufacturers could produce above-cap quantities solely for medical distribution, which the presentation says would provide "stability for medical supply during adult-use market fluctuations."
• Overwater transport. A June 2024 administrative order on transporting marijuana by water to Dukes County and Nantucket would be written into the regulations.

The Marijuana Herald, which reported on the meeting materials on Oct. 22, noted that several implementation questions remain open. The presentation lists policy questions for commissioners, including whether fully integrated licensees must perform a minimum number of activities, whether security requirements and fees should depend on which activities a licensee performs, and what it would mean to "administer" medical marijuana at an MMD.

At the same meeting, the Commission released draft testing regulations (935 CMR 503) for discussion at its Nov. 12 meeting.

Why it matters for the medical market

Medical marijuana is not taxed in Massachusetts, while adult-use products face a 6.25% state sales tax, a 10.75% excise tax and a local option tax of up to 3%, State House News Service reported. Adult-use stores already sell to anyone 21 or older from any state.

Citing Commission data, the News Service reported that year-to-date medical marijuana sales to patients and caregivers fell from $17.9 million in September 2023 to $11.2 million in September 2026.

Jeremiah MacKinnon, president and executive director of the Massachusetts Patient Advocacy Alliance, told the News Service the proposal is "a step in the right direction to modernize our medical program." He said the change could let people who travel to Massachusetts for care keep accessing medical marijuana, and that expanding the patient pool would be "a positive thing for the health and long-term stability of the industry" after a few years in which, he said, the medical market has been struggling.

How Massachusetts compares

According to State House News Service, citing the National Conference of State Legislatures, 41 states and the District of Columbia allowed medical marijuana use as of June 2025. The News Service reported that New Hampshire, Rhode Island, Connecticut, New York and Maine are among the states that allow non-residents to get medical marijuana, and that Massachusetts and Vermont are the only New England states that don't.

The News Service also reported that the proposal is similar to a Senate-approved measure that would have recognized patient registrations from other states. That provision was dropped after talks with the House and was not in the bill (H 5350) lawmakers sent to Healey.

The Question 8 backdrop

The proposal comes days before voters decide Question 8 on Nov. 3. GBH News reported that the measure would reverse the state's 2016 legalization of adult-use cannabis: medical marijuana and possession of small amounts would remain legal, but the adult-use industry, including hundreds of stores and growing operations, would have to shut down. GBH, citing the Commission, reported that the industry had $1.65 billion in sales in 2025 and brought in $289 million in state sales taxes in fiscal year 2025.

Ryan Dominguez, executive director of the Massachusetts Cannabis Coalition, told State House News Service that the proposed regulations would give out-of-state patients a way to get products they may need in Massachusetts if voters approve Question 8. Patrick Nestor, a spokesperson for the campaign supporting the ballot question, declined to comment on the proposed regulations, the News Service reported.

What happens next

The Commission plans its initial vote on the medical rules on Dec. 10, followed by a public comment period from Jan. 1 to Feb. 2 and a final vote, according to State House News Service. Until new regulations are adopted, the current rules, including the residency requirement and its exceptions for end-of-life, palliative and cancer care, remain in effect.