US Hemp Ban Threatens Medicare CBD Reimbursement Pilot Program

The Centers for Medicare and Medicaid Services recently launched a pilot program to reimburse patients for hemp-derived products such as CBD, but a hemp ban passed by Congress in November could derail the initiative.

The program makes certain Medicare and Medicaid recipients eligible for reimbursement of up to $500 per year for hemp products, aiming to evaluate whether these products can reduce other health-related costs.

The program’s definition of hemp relies on the 2018 Farm Bill, which created the loophole allowing many cannabis products to bypass state dispensaries. Under that law, hemp includes any cannabis product with less than 0.3% delta-9 THC. If the hemp ban attached to last year’s spending bill takes effect on Nov. 12 — one year after passage — all products containing more than 0.4 milligrams of any type of THC would become federally illegal.

This would criminalize “the vast, vast majority of hemp products, including most non-intoxicating CBD products,” said Jonathan Miller of the U.S. Hemp Roundtable.

Inesa Ponomariovaite, owner of Nesa’s Hemp, which specializes in CBDA hemp extract, met with members of Congress this week to advocate for laws that would keep her products legal.

“Congress is trying to pass laws on something that they’re not even fully understanding, and that’s really going to affect us,” Ponomariovaite said, noting that during her meetings she had to explain the endocannabinoid system to senators who had not heard of it before.

The endocannabinoid system is a network of receptors in the brain and other organs that interacts with cannabinoids — compounds found in cannabis that also occur naturally in the human body. It helps regulate pain, memory, cognitive processing and energy, explaining why cannabis products affect users as they do.

Ponomariovaite said products containing a wide array of cannabinoids have stronger therapeutic effects than isolated CBD, which might be the only type of CBD available if the ban goes through.

Lawmakers have been trying to delay the hemp ban or replace it with regulation since it passed, Miller said. In December, Oregon Sen. Ron Wyden reintroduced the Cannabinoid Safety and Regulation Act, which would replace the ban with rules ensuring hemp products are safe and free of contaminants. Indiana Rep. Jim Baird introduced a bill in January to postpone the ban for two years.

Miller attributed the lack of progress to political gridlock: “Congress isn’t passing anything these days, it’s so polarized and so partisan that it’s hard for them to pass even the most obvious bills, and so we’re kind of caught up in that.”

While the White House has not proposed specific countermeasures to the hemp ban, President Trump posted on Truth Social, calling for Congress “to update the Law to ensure that Americans can continue to access the full-spectrum CBD products they have come to rely on.”

The Trump administration has taken steps to reschedule cannabis to acknowledge its medical potential, but has faced political resistance to its pro-cannabis policies, including the Medicare-linked hemp pilot. A group of advocates — including the Drug Free America Foundation and Cannabis Industry Victims Educating Litigators — sued Health Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz, accusing them of promoting substances that may soon become federally illegal without following proper administrative procedure. A court denied the lawsuit’s attempt to block the program.

Ponomariovaite said lawmakers are focusing on the wrong issue by dissecting the cannabis plant and legalizing some parts while banning others. The priority, she argued, should be contamination.

“Hemp itself is like a natural soil cleaner. It actually grabs all the micro toxins, the mildew, bacteria, metals, and absorbs them within the hemp plant. So if you extract that plant for medicinal properties, that plant is going to be loaded with toxins,” she said.

A Forbes Health investigation recently found that some popular CBD products contain mold, yeast and fungicide. While some hemp companies, like Ponomariovaite’s, verify safety through lab testing, and some states require it, quality controls are not universal. The Cannabinoid Safety and Regulation Act would allow the FDA to regulate hemp products.

Miller said he is “cautiously optimistic” that Congress will block the ban before it takes effect in November.

Ponomariovaite said if the ban goes through, she will continue making hemp products, but they will be less effective. To ensure they contain only legal cannabinoids, she said she will “basically have to do plant surgery. I am not a big fan of that. I want to keep all the chemistry in one bottle.”