CMS Unveils Hemp-Derived Product Incentive for Patient Care

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS), through the CMS Innovation Center, announced that organizations participating in certain Innovation Center models may begin offering a new Substance Access Beneficiary Engagement Incentive (BEI) starting April 1, 2026. Through this optional incentive, eligible hemp-derived products can be incorporated into patient care plans under clinician guidance, consistent with model requirements and applicable law.

“CMS is committed to innovation that meets patients where they are while maintaining strong safeguards and clinical oversight,” said CMS Administrator Dr. Mehmet Oz. “Under the president’s leadership, we’re expanding the tools available to improve patients’ health while generating important insights into how providers can use these tools safely and effectively in real-world care settings.”

The Substance Access BEI is a provider-led, model-specific tool within Innovation Center models and is not available to all Medicare beneficiaries. It is available to participants in the ACO REACH Model and the Enhancing Oncology Model (EOM), and will be available to participants in the Long-Term Enhanced ACO Design (LEAD) Model beginning in 2027. For the current performance period, five Accountable Care Organizations (ACOs) in the ACO REACH Model have submitted implementation plans that CMS will review. CMS anticipates initial approved participants to begin offering the incentive starting April 1, with additional organizations able to participate over time.

“This new CMS initiative gives providers in certain models another tool—with necessary safeguards—to support their patients’ needs through consultation about whether possible use of hemp products could help improve symptoms,” CMS Innovation Center Director Abe Sutton said.

Under the Substance Access BEI, participating organizations that elect and receive CMS approval may furnish eligible hemp-derived products for up to $500 per year per eligible beneficiary, subject to model requirements and safeguards, as well as clinical determination. Federally legal hemp-derived products eligible in the model contain no more than 0.3% delta-9 THC and exclude the following: inhalable products, any products containing more than 3 mg per serving of tetrohydrocannabinols in an orally administered form, and any products containing cannabinoids not naturally produced or capable of being produced by or in the cannabis plant during its cultivation. This definition operates within the 2018 Agriculture Improvement Act’s hemp provisions and does not override the Controlled Substances Act or authorize Schedule I substances. Products must comply with applicable federal, state and local laws and meet quality and safety standards, including third-party testing for potency and contaminants.

The incentive is delivered within a clinician-led care plan based on shared decision-making between the clinician and patient. A physician or other qualified clinician must determine that the approach is safe and appropriate and conduct shared decision-making, including a discussion of potential risks and benefits, review of current medications, and follow-up planning. Participating organizations are responsible for procurement and must comply with program integrity safeguards, including restrictions on marketing to induce beneficiary selection and requirements governing financial arrangements.

CMS said this is not a Medicare coverage change, and CMS will not pay for or reimburse providers for these products under the Substance Access BEI. The incentive includes strong safeguards to protect patients and ensure appropriate use, including physician oversight, strict product standards and program integrity requirements. The Substance Access BEI is made available consistent with federal law, including the 2018 Agriculture Improvement Act, and is being implemented through existing Innovation Center model authorities. CMS will monitor implementation and evaluate outcomes as part of its ongoing work to test new approaches to appropriate and cost-effective care delivery and payment. CMS said it does not make claims regarding the therapeutic value of these products.

More information about the Substance Access Beneficiary Engagement Incentive, including eligibility criteria and program requirements, is available at cms.gov/priorities/innovation/substance-access-beneficiary-engagement-incentive.