R66. Agriculture and Food, Specialized Products.

R66-5. Medical Cannabis Pharmacy.

R66-5-1. Authority and Purpose.

(1) Title 4, Chapter 41a, Cannabis Production Establishments and Pharmacies and Subsection 4-2-103(1)(i) authorize this rule.

(2) This rule establishes operating and licensing standards and requirements to be followed by medical cannabis pharmacies and their employees.

R66-5-2. Definitions.

(1) "Cannabis waste" means cannabis product that is damaged, deteriorated, mislabeled, expired, returned, subject to a recall, or enclosed within a container or package that has been opened or breached.

(2) "Card" means any type of medical cannabis card or registration card, whichever applies, authorized under Title 26B, Chapter 4, Part 2 Cannabinoid Research and Medical Cannabis.

(3) "Cardholder area" means the area of a medical cannabis pharmacy where a product is purchased that is restricted to a medical cannabis cardholder, a medical cannabis pharmacy employee, or another individual authorized by the medical cannabis pharmacy to enter the cardholder area.

(4) "DHHS" means The Utah Department of Health and Human Services.

(5) "Limited access area" means an area of a medical cannabis pharmacy where medical cannabis and medical cannabis devices shall be stored that is:

(a) a lockable cabinet in a medical cannabis pharmacy facility to which only a pharmacy agent or PMP has access; or

(b) an indoor area or room of a medical cannabis pharmacy facility that is separated from the cardholder and the public areas of the medical cannabis pharmacy by a physical barrier with suitable locks and an electronic barrier to detect entry doors.

(6) "PIC" means a pharmacist-in-charge who oversees the operation and generally supervises a medical cannabis pharmacy.

(7) "PMP" means a medical cannabis pharmacy medical provider that meets the criteria defined in Subsection 4-41a-1101(12).

(8) "Public waiting area" means an area of the medical cannabis pharmacy where the public waits for cardholders and cardholders wait for authorization to enter the cardholder area.

(9) "Recreational disposition" means:

(a) slang words or phrasing associated with the recreational use of cannabis;

(b) an image of a celebrity or other person whose target audience is children or minors;

(c) content that encourages, promotes, or otherwise creates an impression that the recreational use of cannabis is legal or acceptable, or that the recreational use of cannabis has potential health or therapeutic benefits;

(d) content that promotes excessive consumption;

(e) content that is obscene or indecent; and

(f) content that a reasonable person knows or should know appeals to children.

R66-5-3. Medical Cannabis Pharmacy License.

(1) A medical cannabis pharmacy license allows the licensee to receive cannabis from a licensed cannabis processor or medical cannabis pharmacy.

(2) A medical cannabis pharmacy license allows the licensee to sell medical cannabis or medical cannabis devices to medical cannabis patients.

(3) Each medical cannabis pharmacy license shall expire one calendar year from the date of licensure.

R66-5-4. Medical Cannabis Pharmacy Requirements.

(1) A medical cannabis pharmacy operating plan shall meet the requirements described in Section 4-41a-204 and contain a blueprint of the facility containing the following information:

(a) limited access areas;

(b) public waiting area;

(c) patient counseling area;

(d) where cannabis products and cannabis devices are stored;

(e) location of returned cannabis and cannabis waste awaiting destruction;

(f) the location of toilet facilities and hand washing facilities;

(g)(i) the location of a break room and the location of personal belonging lockers; and

(i) the location of the areas to be used for loading and unloading of cannabis and cannabis products.

(2) A medical cannabis pharmacy shall have a counseling area to allow for confidential patient counseling.

(3) A medical cannabis pharmacy shall protect confidential cardholder data and information stored in the Electronic Verification System to ensure that access to and use of the data and information is limited to those individuals and purposes authorized under Title 26B, Chapter 4, Part 2, Cannabinoid Research and Medical Cannabis, and this rule.

(4) A medical cannabis pharmacy shall set hours open for business to give patients the greatest access to medical cannabis possible.

(5) A medical cannabis pharmacy may not dispense expired, damaged, deteriorated, misbranded, adulterated, or opened medical cannabis products or medical cannabis devices.

(6) A medical cannabis pharmacy shall have a written plan to handle potential recall and destruction of cannabis due to contamination.

(7) A medical cannabis pharmacy operating plan shall include a waste disposal plan that complies with Section 4-41a-1101.

(8) Pursuant to Section 4-41a-109, a medical cannabis pharmacy may use signage on the property that includes a logo, as long as the logo does not include a recreational disposition.

(9) A medical cannabis pharmacy shall provide a copy of a certificate of analysis for a medical cannabis product to a medical cannabis cardholder or a recommending medical provider if:

(a) it is requested in writing; and

(b) the medical cannabis pharmacy redacts the location of the medical cannabis processor.

(10) A medical cannabis pharmacy shall immediately report any actual or suspected criminal activity to:

(a) the department; and

(b) law enforcement with jurisdiction where the criminal acts occurred.

R66-5-5. Security Standards.

(1) A medical cannabis pharmacy shall comply with security standards established in Section 4-41a-1101.

(2) A medical cannabis pharmacy shall have a complete video surveillance system that:

(a) has a minimum camera resolution of 640 x 470 pixels or pixel equivalent for analog;

(b) allows for the clear and certain identification of any person or activities; and

(c) sets the date and time stamp embedded on video camera recordings correctly.

(3) Visitors to a medical cannabis pharmacy shall be required to have a properly displayed identification badge issued by the facility while on the premises of the facility.

(4) A Pharmacy Agent or PMP shall escort any medical cannabis pharmacy visitors while in the facility.

(5) A medical cannabis pharmacy shall keep and maintain a visitor log for each visitor that enters the facility showing:

(a) full name and age;

(b) badge number issued;

(c) time of arrival;

(d) time of departure; and

(e) purpose of the visit.

(6) The medical cannabis pharmacy shall maintain the visitor log for a minimum of one year.

(7) The medical cannabis pharmacy shall make the visitor log available to the department upon request.

R66-5-6. Inventory Control.

(1) All cannabis products and cannabis waste shall be entered into the inventory control system. Recorded information shall include:

(a) unique identification number;

(b) batch or lot number;

(c) name of product;

(d) storage location; and

(e) date entered in the inventory control system.

(2) Returned product shall be reactivated and placed into the inventory control system.

(3) Each cannabis product or cannabis waste shall be identified by a physical tag, label, or other suitable means containing information listed in Subsections R66-5-6(1)(a), (b), and (c).

(4) A receiving medical cannabis pharmacy shall;

(a) document in the inventory control system any material containing cannabis received, and any difference between the quantity specified in the transport manifest and the quantity received; and

(b) within one working day, notify the department if the quantity of cannabis received is greater than 10% of the amount recorded on the manifest.

R66-5-7. Minimum Requirements for the Storage and Handling of Cannabis.

(1) Storage areas shall provide adequate lighting, sanitation, temperature, humidity, space, equipment, and security conditions for the storage of cannabis.

(2) Stored cannabis shall be at least six inches off the ground.

(3) Cannabis shall be stored away from potential contaminants.

(4) Cannabis that is outdated, damaged, deteriorated, misbranded, or adulterated shall be stored separately by a physical barrier until it is destroyed.

R66-5-8. Product Recall.

(1) A recall may be initiated by a cannabis production establishment, a medical cannabis pharmacy, or the department.

(2) A medical cannabis pharmacy shall maintain a recall plan that includes, at a minimum:

(a) a designation of at least one employee who shall serve as the recall coordinator;

(b) if the recall is initiated by a medical cannabis pharmacy, a requirement that the pharmacy will immediately notify the department and the cannabis production establishment from which it obtained the cannabis product in question;

(c) a requirement that notification occur within 24 hours of the pharmacy becoming aware of a complaint about the medical cannabis product or medical cannabis device;

(d) a procedure to identify and isolate recalled products to prevent or minimize distribution to patients;

(e) a procedure to retrieve and destroy recalled product; and

(f) a communication plan to notify those affected by the recall.

(3) The medical cannabis pharmacy shall track the total amount of affected medical cannabis product and the amount of medical cannabis product returned to the medical cannabis pharmacy as part of the recall.

(4) The medical cannabis pharmacy shall coordinate the destruction of the medical cannabis product with the department and allow the department to oversee the destruction.

(5) A medical cannabis pharmacy shall notify the department before initiating a voluntary recall.

R66-5-9. Abandoning or Relinquishing a License.

(1) When a medical cannabis pharmacy determines to cease operations, the licensee shall:

(a) send notice to the department with the date of closure of the medical cannabis pharmacy;

(b) provide a written plan to the department for approval, detailing:

(i) when the department may conduct a comprehensive inventory;

(ii) the expected disposition of any medical cannabis product and medical cannabis devices; and

(iii) the name of the medical cannabis pharmacy to which the orders, including any refill information and patient records, will be transferred; and

(c) post a closing notice in a conspicuous place at the public entrance doors to the medical cannabis pharmacy that includes the closing date.

(2) On the date of the closing, the licensee shall remove medical cannabis product and medical cannabis devices from the medical cannabis pharmacy according to the department approved plan.

(3) The licensee shall remove signs and notify the landlord of the property that it is unlawful to use the word "medical cannabis pharmacy," or any other words of the same or similar meaning or any graphic representation that would mislead the public that a medical cannabis pharmacy is located at the address.

R66-5-10. Walk- up, Drive-Through, and Curbside Service.

(1) A medical cannabis cardholder may make an order for medical cannabis by phone or online and receive the product using a medical cannabis pharmacy's walk-up, drive-through, or curbside service.

(2)(a) Medical cannabis products and medical cannabis devices, including those that are awaiting pick-up, shall be securely stored in the medical cannabis pharmacy facility until a medical cannabis cardholder arrives for pick-up.

(b) A medical cannabis product or medical cannabis device may not be stored outside of a medical cannabis pharmacy facility before a customer arrives to pick-up the product.

(3)(a) A medical cannabis pharmacy's video surveillance shall enable the video recording of each medical cannabis cardholder transaction that includes:

(i) video surveillance of a cardholder, cardholder vehicle, medical cannabis pharmacy employee verifying the cardholder's valid form of government issued identification; and

(ii) the transfer and dispensing of an item bought by a cardholder.

(b) Video cameras shall record points of entry and exit of a parking lot and shall be angled to ensure the capture of clear and certain identification of a cardholder and their vehicle's license plate.

(4)(a) The individual receiving the delivery of a product from the medical cannabis pharmacy employee via walk-up, drive-through, or curbside pick-up shall be a cardholder.

(b) When drive-through service is used, the medical cannabis cardholder verifying their ID to the medical cannabis pharmacy shall be visible to cameras and to the medical cannabis pharmacy employee who is helping them.

(5)(a) When a PMP's consultation with a medical cannabis cardholder is required, the consultation may be provided in-person, over the phone, or with another real-time communications device.

(b) It is the responsibility of the medical cannabis pharmacy to ensure the privacy of these consultations, regardless of where or how the consultations happen.

R66-5-11. Targeted Marketing.

(1) A medical cannabis pharmacy may engage in targeted marketing pursuant to Subsection 4-41a-1104(2)(f).

(2) Targeted marketing may not:

(a) include deceptive, false, or misleading statements;

(b) contain any health-related statement that is untrue or tends to create a misleading impression as to the effects on health of cannabis consumption;

(c) promote excessive consumption;

(d) contain a statement, design, illustration, picture, or representation that:

(i) encourages or represents the recreational use of cannabis;

(ii) displays the use of cannabis, including the consumption, smoking, or vaping of cannabis;

(iii) encourages or promotes cannabis for use as an intoxicant; or

(iv) is obscene or indecent;

(e) include any image designed or likely to appeal to children, such as:

(i) cartoons;

(ii) toys;

(iii) animals;

(iv) children; or

(v) any other likeness to images, characters, or phrases that are popularly used to advertise to children;

(f) contain any language or imagery that is likely to mislead patients to believe that the medical cannabis product has been endorsed, made, or used by the state or any of its representatives, except where specifically authorized; or

(g) display medical cannabis products or images of products where the advertisement is visible to members of the public.

(3) Targeted marketing shall accurately and legibly identify:

(a) the medical cannabis pharmacy responsible for its content; and

(b) a statement that cannabis products are for use by patients only.

(4) Any targeted marketing for medical cannabis products that is related to the benefits, safety, or efficacy of the product, including therapeutic or medical claims, shall:

(a) be supported by substantial, current clinical evidence or data; and

(b) include information on side effects or risks associated with the use of cannabis.

(5) A medical cannabis pharmacy may have a link on its website to allow individuals to sign up to receive targeted marketing electronically.

R66-5-12. Change in Operating Plans.

(1) A medical cannabis pharmacy shall submit a notice, on a form provided by the department, before making any

changes to the pharmacy's operating plan, including:

(a) ownership or financial backing of the facility;

(b) the facility's name;

(c) any modification, remodeling, expansion, reduction, or physical, non-cosmetic alteration of a facility;

(d) change to the protected areas;

(e) change in regular hours of operation or hours open for business; and

(f) any other information requested by the department.

(2) Pursuant to Subsection 4-41a-201.1(7), a medical cannabis pharmacy may not implement changes to the initial approved operatiing plan without board approval.

(3) The department shall specify the reason for the denial of approval for a change to the operation plan.

R66-5-13. Pharmacy License and Renewal.

(1) A medical cannabis pharmacy shall submit a notice of intent to renew to the department within 30 days of license expiration.

(2) The licensee shall report the information required for renewal under Subsection 4-41a-201.1(10)(b)(iv) to the board.

(3) If the licensing fee and intent to renew are not submitted by the day of license expiration, the licensee may not continue to operate.

(4) The board may take into consideration significant violations issued in determining license renewals.

R66-5-14. Geographic Regions.

(1) Pursuant to Subsection 4-41a-1005(1), the department shall divide the state into geographic regions based on:

(a) overall population;

(b) patient population; and

(c) travel time.

(2) The department establishes the following geographic regions by county:

(a) Region 1- Northern Utah:

(i) Box Elder;

(ii) Cache; and

(iii) Rich.

(b) Region 2 - Weber Basin

(i) Davis;

(ii) Morgan; and

(iii) Weber;

(c) Region 3 - Salt Lake:

(i) Salt Lake;

(ii) Summit; and

(iii) Tooele;

(d) Region 4 - Uintah Basin:

(i) Daggett;

(ii) Duchesne; and

(iii) Uintah;

(e) Region 5 - West Central:

(i) Juab;

(ii) Sanpete;

(iii) Utah; and

(iv) Wasatch;

(f) Region 6- Central:

(i) Carbon;

(ii) Emery;

(iii) Millard;

(iv) Piute;

(v) Sevier; and

(vi) Wayne;

(g) Region 7 - Southwest:

(i) Beaver;

(ii) Garfield;

(iii) Iron;

(iv) Kane; and

(v) Washington; and

(h) Region 8 - Southeast:

(i) Grand; and

(ii) San Juan.

R66-5-15. Cannabis Pharmacy Agents.

(1) Medical cannabis pharmacy employees shall be registered as PMP or a medical cannabis pharmacy agent.

(2) A medical cannabis pharmacy is responsible for ensuring that each agent has received any task specific training as outlined in the operating plan submitted to the department.

(3) A medical cannabis pharmacy agent shall have a properly displayed identification badge which has been issued by the department at all times while on the facility premises or while engaged in the transportation of cannabis.

(4) Each medical cannabis pharmacy agent shall have their state issued identification card in their possession to certify that the information on their badge is correct.

(5) A pharmacy agent may perform the following duties:

(a) assist a prospective cardholder with an application for a medical cannabis card;

(b) assist the cardholder with understanding available products, proper use of a medical device, medical cannabis strains, and methods of consumption or application within the dosing guidelines specified by an RMP or PMP;

(c) verify the status of an individual's medical cannabis card and dosing guidelines in a patient recommendation within the Electronic Verification System;

(d) enter and retrieve information from the Inventory Control System;

(e) authorize entry of a cardholder into the cardholder counseling area;

(f) take a refill order from an RMP;

(g) provide pricing and product information;

(h) process cardholder payment, including the issuance of receipt, refund, credit, and cash;

(i) prepare labeling for a product;

(j) retrieve medical cannabis and medical cannabis devices from inventory;

(k) accept a new order of medical cannabis or a medical cannabis device, orders left on voicemail for a PMP to review;

(l) verbally offer to a cardholder, the opportunity for counseling with a PMP regarding medical cannabis, or a medical cannabis device;

(m) assist with dispensing of product to a cardholder;

(n) screen calls for a PMP;

(o) prepare an inventory of medical cannabis and medical cannabis device;

(p) transport medical cannabis, or medical cannabis device; and

(q) assist with maintaining a safe, clean, and professional environment.

(6) A pharmacy agent may not perform the following duties:

(a) receive dosing guidelines for a patient's recommendation over the phone or in-person;

(b) determine or modify dosing guidelines in a patient's recommendation; or

(c) provide counseling or consultation regarding a patient's medical condition, or medical treatment.

R66-5-16. Violation Categories.

(1) Public Safety Violations: $3,000 - $5,000 per violation. This category is for violations that present a direct threat to public health or safety, including:

(a) cannabis sold to an unlicensed source;

(b) cannabis purchased from an unlicensed source;

(c) refusal to allow inspection;

(d) failure to comply with PIC requirements;

(e) failure to maintain required general operating standards;

(f) failure to comply with product recall requirements;

(g) unauthorized personnel on the premises;

(h) permitting criminal conduct on the premises; or

(i) engaging in or permitting a violation of the Title 4, Chapter 41a, Medical Cannabis Pharmacy Operation and Agents, which amounts to a public safety violation as described in this subsection.

(2) Regulatory Violations: $1,000 - $5,000 per violation. This category is for violations involving this rule and other applicable state rules:

(a) failure to maintain alarm and security systems;

(b) failure to keep and maintain records for at least five years;

(c) failure to maintain traceability;

(d) failure to follow transportation requirements;

(e) failure to follow the waste and disposal requirements;

(f) failure to follow the walk- up, drive-thru, delivery, and curbside service requirements;

(g) failure to follow targeted marketing requirements;

(h) failure to follow agent duties and responsibilities requirements; or

(i) engaging in or permitting a violation of Title 4, Chapter 41a, Medical Cannabis Pharmacy Operation and Agents or this rule which amounts to a regulatory violation as described in this subsection;

(3) Licensing Violations: $500- $5,000 per violation. This category is for violations involving licensing requirements, including:

(a) an unauthorized change to the operating plan;

(b) failure to notify the department of changes to the operating plan;

(c) failure to notify the department of changes to financial or voting interests of greater than 10%;

(d) failure to follow the operating plan as approved by the department;

(e) engaging in or permitting a violation of this rule or Title 4, Chapter 41a, Medical Cannabis Pharmacy License which amounts to a licensing violation as described in this subsection; or

(f) failure to respond to violations.

(4) The department shall calculate penalties based on the level of violation and the adverse effect or potential adverse effect at the time of the incidents giving rise to the violation.

(5) The department may enhance or reduce the penalty based on the seriousness of the violation.

KEY: medical cannabis, medical cannabis pharmacy, targeted marketing, geographic regions, pharmacy cannabinoids, cannabis products

Date of Last Change: January 7, 2026

Authorizing, and Implemented or Interpreted Law: 4-41a-1101(12), 4-41a-1104(4), 4-2-103(1)(i)