Accountable Produce is Medicine Act of 2026
- Sponsor
- Rep. Smucker, Lloyd [R-PA-11]
- Committees
- Ways and Means Committee (primary)
- Last action
- Apr 16, 2026
Bottom line
The "Accountable Produce is Medicine Act of 2026" seeks to leverage federal health programs to integrate "food is medicine" interventions, specifically produce and nutrition support, to combat chronic diseases and reduce healthcare costs.
What it actually does
This bill mandates the Center for Medicare and Medicaid Innovation (CMMI) to establish and test an "Accountable Produce is Medicine Bundled Payment Model." This model would provide bundled payments to selected programs for furnishing comprehensive "Accountable Produce is Medicine services" (APIM services) to eligible Medicare, Medicaid, and CHIP beneficiaries with diet-related chronic diseases in underserved areas. The services include personalized health assessments, care coordination, telehealth, remote monitoring, lifestyle modification programs, and healthy, nutrient-dense foods, without cost-sharing for beneficiaries.
Proponents argue
Supporters argue that diet-related chronic diseases are a major driver of healthcare costs and that evidence-based "food is medicine" interventions, like produce prescriptions and nutrition counseling, can significantly improve health outcomes and reduce expenditures. They contend that this model will enhance the quality of care, promote disease prevention and management, and ultimately lead to long-term savings by addressing the root causes of chronic conditions.
Opponents contend
Critics might raise concerns about the administrative complexity and potential costs of establishing and overseeing a new bundled payment model, especially one involving food provision. They may question the scalability of such programs, the effectiveness of mandating specific dietary interventions, and the potential for fraud or waste in food procurement and distribution. Some might also argue that this initiative oversteps the traditional scope of federal healthcare programs.
The bill is concise and clearly structured, making it accessible for an informed reader to understand its core provisions within a short timeframe.
Section 3(1), amending Section 1115A(b)(2)(A) of the Social Security Act.
Required Establishment of Accountable Produce is Medicine Bundled Payment Model
This provision amends existing law to explicitly require the Center for Medicare and Medicaid Innovation (CMMI) to establish and test the "Accountable Produce is Medicine Bundled Payment Model." This model must be implemented no later than 180 days after the bill's enactment, making it a mandatory initiative rather than a discretionary one for CMMI.
Supporters argue
Supporters argue that mandating this model ensures CMMI prioritizes innovative approaches to diet-related diseases, which are a major public health and cost burden. They believe it guarantees action on a proven intervention.
Critics contend
Some might argue that mandating specific models limits CMMI's flexibility to respond to emerging evidence or to design models that best fit diverse healthcare landscapes, potentially leading to less efficient or effective programs.
Tradeoffs
The tension lies between ensuring action on a perceived high-impact intervention and maintaining CMMI's discretion to innovate and adapt its portfolio of models.
Section 3(2), adding new subsection (h) to Section 1115A of the Social Security Act.
Establishment and Core Components of the APIM Bundled Payment Model
This section outlines the core structure of the new model. It specifies that bundled payments will be made under Medicare, Medicaid, or CHIP to selected programs that provide "Accountable Produce is Medicine services" (APIM services) to eligible individuals. The Secretary must select at least five eligible programs, each participating for a minimum of two years, with a preference for programs providing specific types of healthy foods.
Section 3(2), adding new subsection (h)(3) to Section 1115A of the Social Security Act.
Comprehensive Accountable Produce is Medicine (APIM) Service Package
This provision details the mandatory services that selected programs must offer. These include screening for eligibility, providing a one-year package of APIM services (personalized health risk assessment, care coordination, telehealth, remote patient monitoring, lifestyle modification programs including nutrition counseling, and healthy nutrient-dense foods), quarterly health data collection, and re-evaluation for reenrollment. It also includes a disenrollment mechanism for non-engagement.
Section 3(2), adding new subsection (h)(4) to Section 1115A of the Social Security Act.
Bundled Payment and Zero Cost-Sharing for APIM Services
This provision grants the Secretary authority to determine the form, manner, and amount of bundled payments to selected programs. Crucially, it allows the Secretary to require programs to assume financial risk for performance starting in the third year. It also mandates that APIM services be provided to eligible individuals without any deductibles, copayments, coinsurance, or other cost-sharing under Medicare, Medicaid, or CHIP.
Section 3(2), adding new subsection (h)(6)(A) to Section 1115A of the Social Security Act.
Criteria for Patient Eligibility in the APIM Model
This provision precisely defines who qualifies as an "eligible individual" for the APIM model. Criteria include being a beneficiary of Medicare, Medicaid, or CHIP, residing in a medically underserved, rural, or health professional shortage area, having specific chronic conditions (diabetes, obesity, cardiovascular disease, hypertension, malnutrition, or others determined by the Secretary), being clinically judged to benefit, being prepared to participate, and not already receiving duplicative services.
When providing healthy, nutrient-dense foods, selected programs are given preference for produce grown within 250 miles or through the use of "regenerative agriculture." The bill also defines "regenerative agriculture" as a conservation management approach emphasizing natural resources through improved soil health, water management, and natural vitality.
Section 3(2), adding new subsection (h)(3)(B)(vi) and (h)(6)(C) to Section 1115A of the Social Security Act.
Why it matters:This is standard legislative practice for defining specific operational preferences within a broader program. It's not necessarily evasive but requires careful reading of the details.
Case for: Proponents argue that this preference supports local economies, reduces the carbon footprint associated with food transportation, and promotes sustainable agricultural practices that benefit environmental health, aligning health outcomes with broader ecological goals.
Case against: Critics might argue that such preferences could increase the cost of food procurement for programs, limit the availability of certain produce types, or create administrative hurdles in verifying sourcing, potentially making it harder for programs to participate or deliver cost-effective services.
Estimated impact: Potentially significant impact on local food systems and agricultural practices in areas where programs are selected, shifting demand towards local and regeneratively farmed produce.