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HB486 • 2026

Medical care facilities; expanded access to medical cannabis for terminally ill patients.

<p class=ldtitle>A BILL to amend the Code of Virginia by adding a section numbered 32.1-127.4, relating to medical care facilities; expanded access to medical cannabis for terminally ill patients.</p>

Healthcare
Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Shin
Last action
2026-02-12
Official status
Incorporated
Effective date
Not listed

Plain English Breakdown

The effective date of this bill is contingent on federal rescheduling, which introduces uncertainty regarding when the provisions will become enforceable.

Medical Care Facilities; Expanded Access to Medical Cannabis for Terminally Ill Patients

This bill allows medical care facilities in Virginia to permit terminally ill patients to use medical cannabis during their stay, with certain conditions and restrictions.

What This Bill Does

  • Defines 'eligible patient' as someone who is at least 18 years old, a resident of Virginia, diagnosed with a terminal illness, and has a second opinion from another healthcare provider following an in-person examination and review of medical records.
  • Requires medical care facilities to create policies that allow eligible patients to use medical cannabis during their stay, following specific guidelines.
  • Prohibits smoking or vaping as methods for using medical cannabis in these facilities.
  • Specifies that the rules do not apply when emergency medical services are being provided.
  • Allows medical care facilities to stop allowing medical cannabis if there is federal enforcement action against them.

Who It Names or Affects

  • Medical care facilities
  • Terminally ill patients who meet specific criteria

Terms To Know

Eligible patient
A person over 18 years old, a Virginia resident, diagnosed with a terminal illness, and confirmed by another healthcare provider following an in-person examination and review of medical records.
Medical Cannabis Program
The state's legal framework for the use of medical marijuana.

Limits and Unknowns

  • This bill will only take effect after federal law changes to reschedule marijuana from Schedule I to Schedule III.
  • It does not require facilities to provide patients with written certification or include cannabis in discharge plans.

Bill History

  1. 2026-02-12 Health and Human Services

    Incorporated by Health and Human Services (HB75-Keys-Gamarra) (Voice Vote)

  2. 2026-02-10 Health

    Subcommittee recommends incorporating (Voice Vote)

  3. 2026-02-10 Health

    House subcommittee offered

  4. 2026-01-30 House

    Fiscal Impact Statement from Department of Planning and Budget (HB486)

  5. 2026-01-21 Health

    Assigned sub: Health

  6. 2026-01-12 House

    Prefiled and ordered printed; Offered 01-14-2026 26104839D

  7. 2026-01-12 Health and Human Services

    Referred to Committee on Health and Human Services

Official Summary Text

Medical care facilities; expanded access to medical cannabis for terminally ill patients.
Requires medical care facilities to permit terminally ill patients, as defined in the bill, to use medical cannabis. The bill requires medical care facilities to adopt policies facilitating the use of medical cannabis. The provisions of the bill do not apply to the provision of emergency medical services, including in emergency departments of hospitals. The bill requires compliance with applicable drug and medication requirements, specifies that compliance with its provisions shall not be a condition of obtaining, retaining, or renewing a license as a medical care facility, and establishes a protocol for noncompliance in the event of intervention by the federal government. The bill has a delayed effective date contingent on the federal rescheduling of marijuana from a Schedule I to a Schedule III drug. This bill was incorporated into HB 75.

Current Bill Text

Read the full stored bill text
HOUSE BILL NO. 486

AMENDMENT IN THE NATURE OF A SUBSTITUTE

(Proposed by the House Committee on Health and Human Services

on ________________)

(Patron Prior to Substitute--Delegate Shin)

A BILL to amend the Code of Virginia by adding a section numbered
32.1-127.4
, relating to medical care facilities; expanded access to medical cannabis for eligible patients.

Be it enacted by the General Assembly of Virginia:

1. That the Code of Virginia is amended by adding a section numbered
32.1-127.4
as follows:

§
32.1-127.4
.
Expanded
access to medical cannabis.

A
. For the purpose of this section
,
"
eligible p
atient" means
a person

(i) who is 18 years of age or older and a resident of the Commonwealth, (ii) who has been diagnosed as having a terminal disease, and (iii) whose diagnosis as having a terminal disease has been confirmed by a consulting health care provider following an in-person examination and review of his medical records.

B. A medical care facility shall
establish a policy to address circumstances under which

a
n eligible
patient
would be permitted
to use medical cannabis in accordance with the requirements of the Medical Cannabis Program (§
4.1-1600
et seq.)
during an inpatient stay
.
Such policy
shall:

1. Prohibit smoking or vaping as methods to use
medical
cannabis
;

2.
Include the use of
medical
cannabis within the
eligible
patient
'
s medical records
;

3.
Require a
n eligible
patient to provide a copy of the
eligible
patient
'
s
w
ritten certification
as described in
§
4.1-1601
;

4.
Reasonably restrict the manner in which a
n

eligible
patient stores and uses
medical
cannabis, including requiring the
medical
cannabis to be stored in a locked container, to ensure the safety of other patients, guests,
and
employees of the
medical
care facility, compliance with other state laws, and the safe operation of the
medical
care facility
;
and

5.
Develop and disseminate written guidelines for the use of
medical
cannabis within the
medical
care facility pursuant to this chapter.

C.
This section does not apply to a
n eligible
patient receiving emergency
medical
services, as defined in
§
32.1-111.1
, or to the emergency department of a
hospit
al
while the
eligible
patient is receiving emergency
medical
services.

D.
Medical care facilities permitting
eligible
patient use of medical
cannabis
shall comply with applicable drug and medication requirements.

This
sub
section
does not require a
medical
care facility to provide a
n eligible
patient with a
written certification
to use
medical
cannabis in compliance with
§
4.1-1601
or include
medical
cannabis in a
n eligible
patient
'
s discharge plan.

E
.
If a federal regulatory agency, the United States Department of Justice (U
.
S
.
DOJ), or the federal Centers for Medicare and Medicaid Services (CMS) takes one of the following actions, a
medical
care facility may suspend compliance with
this section
until the
federal
regulatory agency, U
.
S
.
DOJ, or CMS notifies the
medical
care facility that it may resume permitting the use of
medical
cannabis within the facility:

1.
A federal regulatory agency or the U
.
S
.
DOJ initiates enforcement action against a
medical
care facility related to the facility
'
s compliance with a state-regulated medical
cannabis
program
; or

2.
A federal regulatory agency, the U
.
S
.
DOJ, or CMS issues a rule or otherwise provides notification to the
medical
care facility that expressly prohibits the use of medical
cannabis
in
medical
care facilities or otherwise prohibits compliance with a state-regulated medical
cannabis
program.

This
sub
section does not permit a
medical
care facility to prohibit
eligible
patient use of
medical
cannabis due solely to the fact that cannabis is a Schedule I
II
drug pursuant to the federal Controlled Substances Act or other federal constraints on the use of
medical
cannabis that were in existence prior to the enactment of this
section
.

F.
Refusal to permit the use of medical cannabis pursuant to this section shall not constitute a basis to deny issuance or renewal of or to revoke or suspend
a license as a medical care facility.

2. That the provisions of this act shall become effective upon the date that cannabis is federally rescheduled from Schedule I to Schedule III under the federal Controlled Substances Act.