The Medicare CBD Pilot Program: What It Is and How It Works

The Medicare CBD pilot program is officially called the Substance Access Benefit Enhancement Initiative (BEI). It's run by the CMS Innovation Center as part of the ACO REACH model. Through this pilot, participating ACOs can provide qualifying hemp-derived CBD products to eligible Medicare patients at no cost. Patients can receive up to $500 per year in qualifying products, delivered through their healthcare team rather than a pharmacy.

For a broader overview of how Medicare and CBD work together, start with our Medicare CBD guide.

Quick Facts

The pilot is called the Substance Access Benefit Enhancement Initiative (BEI)
It's administered by the CMS Innovation Center under the ACO REACH model
Participating ACOs can offer up to $500 per patient per year in qualifying CBD
Products must be hemp-derived, accurately labeled, and third-party tested
Patients receive products at no cost through their ACO, not through a pharmacy

What Is the CMS Innovation Center?

The CMS Innovation Center (CMMI) is a part of CMS that tests new payment and delivery models to improve care quality and reduce costs. It runs pilots, some of which become permanent programs if they prove effective.

The BEI is one such pilot. CMS created it to explore whether giving Medicare patients access to hemp-based wellness products through their ACO would improve outcomes in areas like pain management, sleep quality, and inflammation without requiring new prescriptions or costly treatments.

What Is an ACO REACH Model?

ACO REACH stands for Accountable Care Organization Realizing Equity, Access, and Community Health. It's a version of the ACO model that puts more emphasis on equity and whole-person care. ACOs in this model take on financial accountability for their patients' total health outcomes. They can earn shared savings if they improve quality and reduce unnecessary costs.

Participating in the BEI is something ACOs in this model can choose to do. It fits the whole-person care philosophy because it addresses non-pharmaceutical wellness needs directly.

How Does the Pilot Actually Work?

Here's what happens at each level:

At the CMS Level

CMS sets the rules: which products qualify, what the $500 cap is, what standards ACOs must follow, and how outcomes will be tracked. CMS funds the benefit as part of the broader ACO REACH shared savings framework.

At the ACO Level

ACOs that enroll in the BEI select qualifying CBD products from vendors who meet CMS standards. They enroll eligible patients, manage fulfillment, and report outcomes to CMS. Each ACO makes its own decisions about which products to carry and which patients to prioritize within the $500 cap.

At the Patient Level

Eligible patients talk to their doctor or care coordinator, get enrolled in the BEI benefit, and receive qualifying CBD products at no cost. They don't file any claims or deal with insurance billing. The ACO handles everything on the backend.

What Products Are Allowed Under the Pilot?

The BEI allows hemp-derived CBD products that meet these criteria:

Derived from industrial hemp with less than 0.3% Delta-9 THC
Third-party tested by an accredited laboratory
Accurately labeled (label claims match lab results)
No prohibited additives or synthetic ingredients
Produced by a company with documented quality controls

Edify's products are built to these standards. Our hemp is grown on our USDA organic Kentucky farm, processed in-house, and tested by independent labs. Every batch has a publicly accessible Certificate of Analysis. Learn more on our Medicare CBD approved products page.

Is the Pilot Available Nationwide?

ACO REACH operates in many regions across the U.S., but not every ACO in every area has enrolled in the BEI specifically. Coverage depends on whether your doctor's ACO has opted into the pilot. Participation is voluntary for ACOs.

To find out if you're in a covered area, the fastest path is asking your primary care doctor if their ACO participates in the Substance Access BEI.

How Long Will the Pilot Run?

Pilots at the CMS Innovation Center typically run for several years before being evaluated. The BEI is ongoing. CMS will assess whether it achieves its goals: improving patient outcomes in areas like pain, sleep, and overall wellness while not increasing total healthcare costs. If it succeeds, it could become a permanent feature of the ACO framework.

What Does "Outcome Tracking" Mean for Patients?

Your ACO may ask you to answer some questions about your health before and after you start using the CBD benefit. This helps them report outcome data to CMS. The questions might cover pain levels, sleep quality, medication use, or general wellbeing. Participating in this feedback is usually simple and may be done through a short survey or at your regular appointment.

How Do I Access the Pilot?

Through your doctor. Ask if their ACO participates in the Substance Access BEI. If yes, they'll walk you through enrollment. If no, you have other options, including other ways to access free CBD through Medicare or purchasing direct from Edify.

See the detailed steps on our how to get CBD from your doctor through Medicare page.

Why Edify's Products Are a Good Fit for This Pilot

The BEI requires transparency, quality, and consistency. That describes Edify exactly. Our Seed-to-Self model means we control every step: planting, growing, harvesting, extracting, formulating, and testing. Our nano-enhanced formulas absorb more efficiently, which means patients get more value out of each dose.

Our CBD Gummies for Sleep and CBD Gummies for Pain are popular options for managing common wellness concerns. Our Full Spectrum CBD Oil with CBG is ideal for patients who prefer an oil with no sweeteners or gummy texture.

Verify everything on our Seed-to-Self page and lab results page.

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Written by the Edify Wellness Team