Advancing Research and Patient Access in a Changing Landscape

Realm of Caring is a leading voice in cannabinoid research and patient education, helping bridge the gap between science, policy, and real-world outcomes.

With so much change at the federal level around CBD and broader cannabis reform, we sat down with Executive Director Sasha Kalcheff-Korn to discuss what it all means for patients, providers, and the future of cannabinoid-based care.

How will the CMS CBD Pilot Program change access to cannabinoid therapies for Medicare patients, and what limitations still remain?

The CMS CBD Pilot Program is an important first step toward bringing cannabinoid therapies into a more structured healthcare setting for Medicare patients. For the first time, certain providers participating in models like ACO REACH, the Enhancing Oncology Model, and eventually the LEAD Model may be able to recommend eligible hemp-derived CBD products to Medicare beneficiaries as part of a physician-guided care plan. Just as importantly, the program is designed to generate outcomes data, which could help inform future coverage decisions and give healthcare systems a better understanding of how these therapies are being used in real-world care.

That said, the pilot is still quite limited. It is not a blanket Medicare benefit, and CMS will not directly cover the cost of the products. Access is restricted to patients aligned with participating organizations, and only certain orally administered, hemp-derived products that meet strict THC and ingredient thresholds are eligible. Large groups of patients will still be left out, including many Medicaid beneficiaries, pediatric patients, adults who do not qualify for Medicare, and people in hospice, assisted living, or long-term care settings. While this is meaningful, it is still a narrow pilot rather than broad access.

How could federal cannabis rescheduling impact research, clinical data generation, and the ability to integrate cannabinoid therapies into healthcare?

Federal cannabis rescheduling has the potential to lower some of the longstanding barriers that have made cannabinoid research unnecessarily difficult. For years, researchers, clinicians, and institutions have faced major obstacles in studying cannabis and cannabinoid therapies in rigorous, real-world settings. Rescheduling could make it easier to expand clinical research, support more standardized data collection, and build a stronger evidence base around safety, efficacy, dosing, and long-term outcomes. That kind of data is essential if cannabinoid therapies are going to be taken seriously within mainstream healthcare.

It could also help bridge the gap between what patients are already doing and what healthcare systems are currently equipped to support. Patients are already using cannabinoid products for conditions like chronic pain and cancer-related symptoms, often without clinical oversight. A more research-friendly federal framework would improve the ability to generate clinical and observational data, support provider education, and create clearer pathways for integrating cannabinoid therapies into care plans in a responsible, evidence-based way. Rescheduling could be a critical catalyst for broader medical legitimacy and healthcare integration.

What needs to happen next for cannabinoid therapies to achieve broader Medicare coverage and long-term adoption?

For cannabinoid therapies to achieve broader Medicare coverage, pilot programs like this one need to show that they improve patient outcomes while maintaining or reducing overall healthcare costs. That means robust participation from patients, providers, accountable care organizations, and researchers. If these demonstration models produce strong data, they could support future expansion under value-based care frameworks and help build the case for broader reimbursement.

Beyond data, broader adoption will also require policy alignment and infrastructure. Providers need clearer guidance, compliant product options, and systems for shared decision-making, follow-up, and monitoring. Manufacturers need to meet high standards for quality, consistency, testing, and traceability. And policymakers need to protect access to safe, regulated cannabinoid products so that research and care models reflect how patients are actually using these therapies in everyday life. Long term, broader Medicare coverage will depend on a combination of credible research, thoughtful federal policy, provider engagement, and sustained advocacy to ensure patients are not left behind as the system evolves.