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Paying for medical marijuana: A cloudy issue for comp insurers

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The six states where courts or legislatures have said insurers must reimburse for medical marijuana for injured workers have yet to provide guidance on how to do so, putting payers in the position of not being able to use the federal banking system to cover costs for a federally illegal substance.

“Among the first questions I get are, ‘How? I have no idea how we're going to pay for this,’” said Julie Schum, Chicago-based partner at Quintairos, Prieto, Wood & Boyer P.A., who covered legal issues surrounding medical marijuana in a session Tuesday at Riskworld, the Risk & Insurance Management Society Inc.’s annual conference in Atlanta.

“There are some clever ways of making payments on this, but you have to be very careful because you also don't want to look like you're giving cash for the commission of a federal crime,” Ms. Schum said.

She said that anecdotally she’s heard of insurers issuing prepaid cards to give to injured workers to cover their costs — without explicitly saying medical marijuana. The proposed Safe Banking Act, which would clear red tape for reimbursement, has stalled in Washington, she said.

Adequate dosing is another conundrum.

“Unfortunately, the states that have mandated it have not actually given us any guidance as to what they are mandating other than the issuance of medical cannabis,” Ms. Schum said. “They're allowing it to be entirely in the hands of the doctors.”

Marijuana prescriptions, too, are typically vague, adding to an insurer’s overall liability in claims management, she said.

“Most of the time it does not give you a lot of guidance as to what you should be buying in the dispensary,” she said. “They basically just say you should be getting enough cannabis to have X doses per week, and off you go. The dispensary is a Candyland of options for you to choose from.”