CMS to Add COPD, Substance Use Care to ACCESS Model in 2027

CMS Will Add COPD and Substance Use Disorder to ACCESS Model in 2027

The Centers for Medicare & Medicaid Services (CMS), the federal agency that administers Medicare, plans to expand its ACCESS payment model to cover more chronic conditions starting in 2027. According to a September 16, 2026 report from Healthcare Dive, the Trump administration is adding chronic obstructive pulmonary disease (COPD), substance use disorder, and tobacco cessation to the model's list of covered conditions, describing ACCESS as a "technology-based payment experiment."

CMS payment models like ACCESS typically test new ways of paying doctors, hospitals, or other providers for managing specific health conditions, often built around data sharing, remote monitoring, or coordinated follow-up rather than the standard Medicare fee-for-service structure. This is one of several demonstration models CMS runs alongside traditional Medicare to test whether different payment approaches improve outcomes or lower costs. Because the source description does not detail which conditions ACCESS already covers, how many providers currently participate, or the exact effective date in 2027, those specifics remain unclear pending CMS's formal program announcement.

Why a Payment Model Expansion Matters to Medicare Beneficiaries

CMS payment models like ACCESS operate inside original Medicare and are built around participating providers, not something a beneficiary chooses directly the way they select a Medicare Advantage or Part D plan. Even so, an expansion like this can shape care on the ground: when CMS adds a condition such as COPD or substance use disorder to a payment model, it creates a financial incentive for participating doctors and health systems to invest in monitoring, coordination, and technology for patients with that diagnosis.

According to Healthcare Dive, the ACCESS model expansion adds COPD, substance use disorder, and tobacco cessation to its list of covered conditions starting in 2027. Beneficiaries managing any of these conditions may see their provider offer more structured follow-up, such as remote check-ins or care coordination, if that provider chooses to participate in the model, though CMS has not yet detailed the specific services or technology the expansion will fund.

The change is also a reminder that CMS regularly tests new delivery and payment approaches inside original Medicare, separate from the private Medicare Advantage and Part D plans most beneficiaries compare each fall. Medicare Advantage insurers sometimes build their own chronic-condition management programs into supplemental benefits, so this federal expansion is worth watching even for beneficiaries enrolled in a private plan rather than original Medicare.

What Medicare Beneficiaries Should Do Now

Because CMS has not released full program details for the 2027 expansion, there is no enrollment action required from beneficiaries at this time. A few steps can help readers stay ahead of the change:

• Ask your provider about ACCESS model participation. If you manage COPD, substance use disorder, or are trying to quit tobacco, ask your primary care doctor or specialist whether their practice takes part in CMS's ACCESS model and whether that could affect your care plan in 2027.
• Watch for updates during Medicare's fall enrollment period. The Medicare Annual Enrollment Period runs October 15 through December 7, 2026, the window when beneficiaries can compare and switch Medicare Advantage and Part D plans for coverage starting January 1, 2027. This CMS payment model does not require a plan change, but reviewing how any plan handles chronic disease management is worth doing regardless.
• Compare chronic care support across Medicare Advantage plans. Some Medicare Advantage plans already include disease management programs, care coordination, or tobacco cessation support as supplemental benefits. Readers managing COPD or substance use disorder should ask a licensed agent how a given plan's chronic care benefits compare before making a decision.
• Talk to a licensed Medicare agent for plan-specific questions. This is a policy and payment change, not medical or financial advice. A licensed agent can explain how, if at all, a specific Medicare Advantage or Part D plan's benefits interact with provider-level programs like ACCESS.

Medicare Plan Path will continue tracking CMS's ACCESS model rollout and update readers as the agency releases more details on the 2027 expansion, including which providers participate and what specific services the added conditions will cover. For the original report, see Healthcare Dive.