Policy Watch: 17 Regulatory Updates — March 17, 2026

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Policy Watch
March 17, 2026. 17 regulatory items above the clinical relevance threshold of 40. Sources include Federal Register, regulations.gov, and regulatory RSS feeds. Listed in descending order of relevance score.

Score 70Regulations.gov

Schedules of Controlled Substances: Placement of 2-Methyl AP-237 in Schedule I

The DEA placed 2-Methyl AP-237, a synthetic opioid, into Schedule I, establishing it as a controlled substance with no accepted medical use—a scheduling action unrelated to cannabis medical practice.

Score 70Regulations.gov

Schedules of Controlled Substances: Placement of 2,5-dimethoxy-4-iodoamphetamine and 2,5-dimethoxy-4-chloroamphetamine in Schedule I

Regulatory Summary

This action schedules synthetic amphetamines (DOI and DOC) as Schedule I controlled substances, with no direct relevance to cannabis medicine, clinicians, or patients.

Score 70Regulations.gov

Schedules of Controlled Substances: Temporary Placement of MDMB–4en–PINACA, 4F–MDMB–BUTICA, ADB–4en–PINACA, CUMYL–PEGACLONE, 5F–EDMB–PICA, and MMB–FUBICA into Schedule I

The DEA temporarily scheduled six synthetic cannabinoids as Schedule I controlled substances, restricting their availability and relevant to clinicians managing patients who may use these unregulated alternatives to cannabis.

Score 70Regulations.gov

Schedules of Controlled Substances: Placement of Ethylphenidate in Schedule I

Regulatory Summary

This DEA action schedules ethylphenidate as a controlled substance, which is relevant to cannabis clinicians as it establishes precedent for scheduling synthetic compounds and may inform discussions about drug interactions or co-prescribing considerations.

Score 70Regulations.gov

Schedules of Controlled Substances: Placement of Metonitazene in Schedule I

The DEA placed metonitazene, a synthetic opioid, in Schedule I, establishing stricter controls on this non-cannabis substance with minimal direct clinical impact on cannabis medicine practitioners or patients.

Score 70Regulations.gov

Schedules of Controlled Substances: Temporary Placement ofEtizolam, Flualprazolam, Clonazolam, Flubromazolam, and Diclazepam in Schedule I

Regulatory Summary

The DEA temporarily scheduled five benzodiazepine analogs as Schedule I controlled substances, relevant to cannabis clinicians managing anxiety or seizure patients who may have been using these unregulated alternatives.

Score 70Regulations.gov

Importer of Controlled Substances Application Biopharmaceutical Research Company – DEA1224

Regulatory Summary

A biopharmaceutical company’s DEA application to import controlled substances enables domestic cannabis medicine research and development, directly affecting clinician access to investigational cannabinoid therapies.

Score 55Regulations.gov

Importer of Controlled-Bright Green(2024-20083)DEA1426

Regulatory Summary

DEA registration 2024-20083 authorizes a controlled substance importer, potentially affecting cannabis clinicians’ and patients’ access to federally regulated cannabis products and research materials.

Score 55Regulations.gov

Importer of Controlled-Cambridge Isotope(2024-20082)DEA1429

Regulatory Summary

DEA approval for Cambridge Isotope to import controlled substances enables research isotope availability, supporting cannabis pharmacokinetics and cannabinoid metabolism studies relevant to clinical evidence development.

Score 55Regulations.gov

Medicare and Medicaid Programs: Calendar Year 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; etc.

CMS updates 2025 Medicare payment policies and Part B coverage, potentially affecting reimbursement for cannabis-related services and clinical consultations that eligible providers may bill to Medicare beneficiaries.

Score 55Regulations.gov

Medicare and Medicaid Programs; CY 2025 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program (CMS-1807-P)

CMS proposes 2025 Medicare Part B payment and coverage policies; cannabis remains federally non-covered, limiting Medicare reimbursement for cannabis-based treatments regardless of state legalization.

Score 55Regulations.gov

Bulk Manufacturer-Royal Emerald (2024-11786) DEA1368

Regulatory Summary

DEA approved Royal Emerald as a bulk manufacturer for controlled substances, enabling increased production capacity for cannabis-derived pharmaceutical products used in clinical settings.

Score 55Regulations.gov

Importer Controlled-VA Cooperative (2024-11795) DEA1374

Regulatory Summary

DEA Form 1374 establishes importer controlled substance cooperative procedures, enabling licensed cannabis clinicians to legally procure federally-regulated cannabis products for patient treatment under DEA oversight.

Score 55Regulations.gov

Importer Controlled- Quagen Pharma (2024-11892) DEA1381

Regulatory Summary

DEA Form 1381 import control action for Quagen Pharma restricts controlled substance importation, potentially affecting cannabis-derived pharmaceutical product availability and supply chains for clinical practitioners.

Score 55Regulations.gov

Exempt Chemical Preparations May 2024 (2024-10465) – DEA372

Regulatory Summary

The DEA’s May 2024 exemption list for chemical preparations clarifies which cannabis-derived or cannabis-related formulations may be exempt from Schedule I restrictions, directly affecting prescribing options and product availability for clinicians and patients.

Score 55Regulations.gov

Medicare and Medicaid Programs; CY 2024 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Continued Implementation of Requirements for Manufacturers of Certain Single-dose Container or Single-use Package Drugs to Provide Refunds with Respect to Discarded Amounts; Medicare Advantage (CMS-1784-F)

Regulatory Summary

This final rule establishes 2024 Medicare/Medicaid payment policies and coverage requirements that may affect cannabis medicine access and reimbursement for eligible patients under these federal programs.

Score 55Regulations.gov

This CMS rule establishes 2024 Medicare/Medicaid payment policies and coverage requirements; cannabis clinicians should note potential implications for reimbursement eligibility and documentation standards for cannabis-based treatments under federal insurance programs.

Digest-Level Clinical Commentary

Dr. Caplan’s Take
These regulatory filings suggest that the DEA continues to prioritize synthetic cannabinoid and novel psychoactive substance enforcement while the broader healthcare system, as evidenced by the extensive Medicare and Medicaid policy updates, remains focused on traditional pharmaceutical reimbursement structures that largely exclude cannabis-derived therapeutics. The proliferation of controlled substance scheduling actions coupled with standard pharmaceutical importer and manufacturer licensing indicates that cannabis medicine remains positioned outside mainstream clinical pathways, requiring practitioners like myself to navigate an increasingly bifurcated regulatory landscape where evidence-based cannabis applications are not yet integrated into federal payment or coverage determinations. For clinical practice, this signals continued reliance on state-level frameworks and patient self-pay models until federal rescheduling or explicit Medicare coverage decisions create structural pathways for cannabis to function within conventional medical practice and reimbursement systems.

Clinical Perspective

These regulatory actions reflect ongoing federal efforts to manage emerging synthetic drugs and novel psychoactive substances that continue to circumvent existing controlled substance laws, requiring periodic scheduling updates to address public health threats. The numerous importer and manufacturer applications alongside Medicare payment policy updates indicate the routine administrative work necessary to maintain pharmaceutical supply chains while ensuring appropriate oversight of controlled substances in clinical practice. Overall, the digest captures the balance regulators must maintain between preventing drug abuse and supporting legitimate pharmaceutical distribution and medical care delivery.

Controlled Substances SchedulingDrug Enforcement AdministrationPharmaceutical RegulationHealthcare Payment Policy

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