Federal CBD Health Insurance Plan Will Reportedly Allow THC Amount Far Exceeding Hemp Limit Signed By Trump

The Centers for Medicare & Medicaid Services (CMS) will soon be launching a
pilot program that would cover the costs of CBD products for eligible
patients under certain federal health insurance plans. But newly reported
details about the effort signal that it policy could conflict with a
separate law redefining hemp in a way that severely restricts allowable THC
content.

CMS Administrator Mehmet Oz has previously described the CBD coverage plan
that’s being implemented in response to an executive order President Donald
Trump signed in December that also directs the finalization of a federal
marijuana rescheduling rule, saying the CBD components of the plan could be
rolled out as early as April.

But as the agency has prepared to provide cannabidiol coverage under the
pilot program, it has set an initial limit of 3 milligrams of total THC
(including delta-8, delta-9 and delta-10 THC, for example) per serving—as
Cannabis Wire first reported—which is more than seven times the THC limit
for hemp-derived cannabinoid products as defined under a spending bill
Trump signed last year.

The cannabis section of that agriculture-focused spending legislation
restricts total THC content to .4 milligrams per container. And that law,
which industry stakeholders say will effectively eliminate the consumable
cannabinoid market, takes effect in November.

A CMS spokesperson told Cannabis Wire that agency “will adjust its
definition in accordance with the law,” without clarifying how it arrived
at the 3 milligram total THC limit in the first place.

Bipartisan lawmakers and hemp industry advocates have pushed to delay the
enactment of the new hemp THC restrictions signed by Trump, but those
efforts have not gained traction. An amendment on the issue was not adopted
at a recent House committee markup of a new Farm Bill.

Marijuana Moment reached out to CMS further inquiring about the apparent
THC policy conflict, but a representative was not immediately available.

The planned pilot program “expressly excludes inhalable products,” the
spokesperson also said. And the “orally administered” CBD products that are
made available would be subject to “state and local law,” though that
raises other questions given the complex patchwork of state-level hemp and
cannabinoid policies.

In any case, the newly reported details about the yet-unpublished rules for
the pilot program comes weeks after an executive at a hemp company that’s
been collaborating with CMS said that the agency had already finalized its
plans for federal health insurance coverage of cannabidiol.

“This pilot will help the [Food and Drug Administration, or FDA] move from
uncertainty into a practical framework with clear dosing, risk mitigation
and clear manufacturing label expectations that end up rewarding the
responsible companies and, in the end, protect and serve the consumer,”
Jared Stanley, co-founder of the cannabis company Charlotte’s Web, said.

“As far as the population, it was important to note that it was stated in
the briefing that this is starting in a pilot, but expecting to expand
beyond just the pilot,” he said. “So that’s multiple indications that we
expect to see. And we’re very excited. It has amazing potential.”

Relatedly, the CMS spokesperson told Cannabis Wire that while it couldn’t
provide specific numbers around patients expected to participate in the
pilot program, those details will come out when they’re available, and the
agency would generally provide updates on the rollout “in the coming weeks.”

Asked about the status of the CBD rulemaking last month, CMS directed
Marijuana Moment to a webpage with an FAQ that describes the integration of
hemp into a Beneficiary Engagement Incentive (BEI) program under the
agency’s Long-term Enhanced ACO Design (LEAD) Model.

“The Substance Access BEI gives model participants the option of consulting
with their patients about the possible use of eligible hemp products,” the
CMS page says. “The implementation of this BEI and any related dispensing
would be funded entirely at the participant’s expense; CMS would not cover
the cost of such products. Further, CMS will have strict program integrity
safeguards to ensure that these incentives do not result in program or
patient abuse.”

“The Substance Access BEI is only available to participants in states where
the eligible hemp products are considered legal,” it says.

While the broader rules on the CBD Medicare pilot program haven’t been
publicized yet, CMS’s website briefly details how it’s navigating
hemp-related issues as part of regulatory models under LEAD, the Accountable
Care Organization (ACO) and the Enhancing Oncology Model (EOM).

Oz, the CMS administrator, explained in December that the policy change
will “allow millions of Americans on Medicare to become eligible to receive
CBD as early as April of next year—and at no charge if their doctors
recommend them.”

He added that Medicare Advantage insurers CMS has contacted are “also
agreeing to consider CBD to be used for the 34 million Americans that they
cover.”

One outstanding question concerns coverage eligibility. As described by the
administrator in December, it would affect those 65 and older who qualify
for Medicare, but the specific qualifying conditions weren’t detailed.
There were repeated mentions of chronic pain, specifically related to
cancer, but it’s possible the CBD eligibility criteria includes additional
conditions.

At the signing ceremony, Oz also gave kudos to Howard Kessler, founder of
The Commonwealth Project, which produced a video about the benefits of
cannabidiol for seniors that Trump shared on Truth Social last year and who
apparently has pressed the president to enact reform to expand cannabis
access.

While CMS implemented an earlier final rule last April specifically
stipulating that marijuana, as well as CBD that can be derived from
federally legal hemp, are ineligible for coverage under its Medicare
Advantage program and other services, the agency is now revising that
policy.

CMS had already announced certain changes as part of a rulemaking process
that was unveiled late last year, affecting “marketing and communications,
drug coverage, enrollment processes, special needs plans, and other
programmatic areas” for insurance programs it oversees. One of those
changes dealt with cannabidiol coverage.

The rule as proposed would amend regulations, which currently state that
any “cannabis products” cannot be covered. The policy would prevent
coverage for only “cannabis products that are illegal under applicable
state or federal law, including the Federal Food, Drug, and Cosmetic Act.”
Since hemp and its derivatives like CBD are federally legal, the change
suggests patients in states where such products are legal could make valid
insurance claims to pay for the alternative treatment option, as long as
the product is also federally legal.

Meanwhile, following the White House announcement in December, Oz spoke
with NewsNation about the policy change, responding to a question about how
the broader marijuana rescheduling decision squares with the Trump
administration’s aggressive efforts to stymie the flow of other illicit
drugs, particularly fentanyl.

“We think they fit hand in hand,” he said. “This is really about
researching—specifically CBD, which is hemp-derived endocannabinoids
[sic]—are actually worthy of Americans using them,” he said. “It’s hard to
do some of this work, especially with medical marijuana. And this is not
about legalization of marijuana.”

“There is no legalization language at all,” he added. “It’s about
rescheduling this class of product so that it can be researched more
readily.”

The idea that marijuana has no medical value, as its currently defined as a
Schedule I drug, is “just patently wrong for marijuana,” he said, noting
that the Food and Drug Administration (FDA) has approved certain
cannabis-based drugs for conditions such as epilepsy “that work quite
nicely.”

“That belief that it should be Schedule I is just an incorrect place to put
it,” he said. “Schedule III seemed to make sense to the president. He
argued that it allows us to do the research more readily.”

“We’re finding a way to allow Medicare beneficiaries to get access to some
of these products. And so, within Medicare, we have the ability, for the
first time ever—and we delivered on this promise to the president today—to
allow doctors to recommend hemp-derived CBD for patients who have cancer,
for example, and have a lot of pain from that.”

The administrator said surveys show a majority of seniors who take CBD for
pain management find it beneficial, and the White House wants to “make it
easier for patients to access this” and allow them to access the
cannabinoid at “no charge” through the federal health insurance program.

Meanwhile, Oz took a different tone last month when he warned that “there
are going to be consequences” as more Americans choose marijuana over
alcohol—including problems caused by “high-dose hemp and CBD.”

In the background, the U.S. Department of Health and Human Services (HHS)
and FDA recently submitted proposed regulations concerning CBD enforcement
and compliance with the White House Office of Management and Budget’s (OMB)
Office of Information and Regulatory Affairs (OIRA). There’s been
speculation that the rule could be related to the CMS pilot program, but
that hasn’t been confirmed. And it’s also possible the proposal is linked
to an unrelated FDA mandate from Congress to produce a list of known
cannabinoids ahead of the federal hemp redefinition.

*Photo courtesy of Kimzy Nanney.*

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Far Exceeding Hemp Limit Signed By Trump appeared first on Marijuana Moment.