The Centers for Medicare & Medicaid Services (CMS) has finalized a rule, due in the Federal Register on Monday, permitting Medicare Advantage (MA) plans to cover selected hemp products as Special Supplemental Benefits for the Chronically Ill (SSBCI).
A CMS update from April 2025 had excluded all cannabis products from SSBCI coverage. The revised rule limits that ban to products illegal under applicable state or federal law, allowing MA organizations to offer hulled hemp seed, hemp seed protein powder, and hemp seed oil—contingent on FDA's determination that they are generally recognized as safe (GRAS) and that they meet the SSBCI standard requiring "a reasonable expectation of improving or maintaining the health or overall function" of enrollees. CMS noted evidence that hemp seed protein powder may offer nutritional benefits.
This action is separate from a different CMS initiative launched this week under which Medicare can cover hemp-derived CBD and THC products meeting specific requirements.
The 2018 Farm Bill—signed by President Donald Trump in his first term—legalized hemp with less than 0.3 percent delta-9 THC on a dry weight basis. A subsequent regulatory change effective November 12, 2026 will recriminalize products containing more than 0.4 milligrams of total THC per container, at which point any non-compliant product becomes a Schedule I controlled substance ineligible for SSBCI coverage.
The rule, first proposed in November, also bars MA organizations from covering hemp products illegal under state law within their service area, regardless of federal status. If future legal changes permit additional cannabis products, MA plans may expand their SSBCI offerings in a subsequent plan year without new CMS rulemaking, CMS noted.
CMS addressed public comments on marijuana rescheduling—a process Trump directed to be completed "in the most expeditious manner" in December—stating that rescheduling to Schedule III would not automatically make cannabis products allowable as SSBCI without also satisfying the Federal Food, Drug, and Cosmetic Act.
The separate hemp-derived CBD and THC Medicare program is being challenged in a lawsuit by a coalition of anti-marijuana organizations. A federal judge denied their motion for a temporary restraining order but scheduled a hearing for April 20 on a preliminary injunction request. The White House Office of Management and Budget is conducting meetings this week and next on FDA CBD enforcement policy, and FDA issued guidance stating it will not interfere with the Medicare hemp coverage plan's implementation.
