Cannabis Telehealth in Hawai‘i is Changing — Here’s How

30 July 2025

A month ago Governor Josh Green signed HB 302 into law (effective on 1 July 2025), a major overhaul of Hawai‘i’s medical cannabis program. Now enacted as Act 241, the law is reshaping how patients access medical cannabis certifications — especially through telehealth services, an area where there has been a lot of confusion.

Here’s what you need to know about how cannabis telehealth certifications rules are changing, what’s new, and when it all takes effect.

Key Telehealth changes are in Sections: 5, 6.

The Old Rules – What HI Cannabis Telehealth Looked Like Before

Until now, Hawai‘i law made telehealth for medical cannabis conditional:

• Patients seeking a medical cannabis card had to meet a doctor or APRN in person for their first certification visit.
• Only after that in-person consultation could they use telehealth for renewals or follow-up appointments.
• This caused access problems, particularly for patients on neighbor islands or those with limited mobility.

The New Rules - What Act 241 Changes

As of 1 July 2025, Act 241 removes the in-person requirement, allowing first-time certifications to happen via telehealth.

PATIENT-PROVIDER RELATIONSHIP:

A bona fide patient-provider relationship can now be established entirely online, with no prior face-to-face visit required.

This means patients can now:

• Book a first-time evaluation entirely online.
• Avoid unnecessary travel or long wait times for in-person visits.

QUALIFYING CONDITIONS:

Licensed Hawai‘i physicians and APRNs can certify patients for any condition they deem appropriate, not just a fixed list of illnesses.

This means patients can now get medical cannabis help with a broader scope of illnesses.

FEE CAPS

The law also caps fees providers can charge for certifications (no more than 3× the state registry fee). That means that no appointment should be more than $115 per visit.

What this means for the industry:

• With more telehealth platforms entering the market at lower costs, traditional in-person clinics may face pressure to reduce their prices. This increased competition is expected to significantly lower costs for patients, improving affordability and access across Hawai‘i.

Timeline of Key Events for HB 302

• April 30, 2025: HB 302 passes final readings in Legislature.
• June 27, 2025: Governor Green signs HB 302, enacting it as Act 241 despite privacy concerns over other parts of the law.
• July 1, 2025: Telehealth provisions officially take effect — no in-person requirement for first-time cannabis patients.
• January 1, 2028: A separate part of the law (Part IV) takes effect, banning unlicensed cannabis cultivation statewide.

Other Key Changes in Act 241

• New Criminal Penalties: Class C felony for unlicensed dispensary operations; misdemeanor for illegal online cannabis ads.
• Medical Records Inspection: DOH may review patient records from certifying providers to ensure compliance.
• Expanded Conditions: Providers can recommend cannabis for any medical condition they deem appropriate.
• Hemp Product Sales: Dispensaries may sell hemp products and accessories (not in waiting areas).
• Dispensary Transfers: Licensed dispensaries can purchase cannabis or products from other dispensaries under regulated limits.
• Cultivation Licenses (2028): All cannabis cultivation will require a DOH-issued license starting January 1, 2028.
• Nuisance Abatement Funding: State funds allocated to crack down on illegal cannabis activities and related nuisances.

Bottom Line

Cannabis telehealth in Hawai‘i has fundamentally changed:

• Before: Patients were required to see a doctor in person first.
• Now: Patients can be certified for medical cannabis fully online, starting July 1, 2025.