On August 21, the Health and Human Services Commission Executive Council met to discuss and approve proposed TCUP rules, which are now up for public comment. Click here to watch the meeting, including public comment from Nico Richardson from Texas Original.
Richardson brought up an excellent point and recommendation. He proposed that the rule be revised to place the responsibility with businesses, not physicians, to submit proposals for approved vape devices. This will ensure that TCUP dispensaries are able to fulfill orders efficiently.
See proposed rules below and submit public comment if you’d like to see the rules amended.
August 21, 2025 Meeting Info and Proposed Rules
SUMMARY
Texas Occupations Code Chapter 169 allows qualified doctors to prescribe low-THC cannabis to patients diagnosed with a medical condition listed in Section 169.003 and who meet other requirements of the Texas Compassionate Use Program. The proposed rules explain how physicians can request to add medical conditions to the list, set standards for pulmonary inhalation medical devices prescribed under the program, and establish a timeline for reviewing and approving such devices.
The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes an amendment to §1.61, concerning Incurable Neurodegenerative Diseases, and new §1.63, concerning Pulmonary Inhalation Devices for Low-THC Cannabis.
BACKGROUND AND PURPOSE
The purpose of the proposal is to implement House Bill (H.B.) 46, by King et al, 89th Legislature, Regular Session, 2025, which amends Texas Occupations Code §169.003 to allow DSHS to receive physician requests to add medical conditions to the list of qualifying conditions for which physicians may prescribe low-THC cannabis under the Texas Compassionate Use Program at the Texas Department of Public Safety. H.B. 46 also amends Texas Occupations Code Chapter 169 to add §169.006 to allow physicians to prescribe medical devices for the pulmonary inhalation of an aerosol or vapor to administer low-THC cannabis and establish a timeline for reviewing and approving such devices. In accordance with H.B. 46, the rule must be effective not later than October 1, 2025.
New Proposed Rule: Physician Recommendations for Additional Qualifying Conditions
- If adopted this new rule would establish a process for physicians to request adding a condition to the list of medical conditions for which a physician may prescribe low-THC cannabis. DSHS will provide requests and any submitted peer reviewed evidence to the Department of Public Safety (DPS). DPS will then submit requests to the legislature for consideration.
- For recommendations that request the addition of neurodegenerative diseases to the list of medical conditions, DSHS will assess those requests for any neurodegenerative diseases not currently approved.
New Proposed Rule: Pulmonary Inhalation Devices for Low-THC Cannabis.
- A pulmonary inhalation device is a machine designed, marketed, and commercially sold to allow a user to inhale an aerosolized or vaporized substance.
- (A pulmonary inhalation device must not burn or ignite a substance for the purpose of inhaling smoke.
- A qualifying physician under Texas Occupations Code Chapter 169 may prescribe a pulmonary inhalation device for low-THC cannabis to a patient who is qualified to receive a low-THC cannabis prescription.
- A qualifying physician under Texas Occupations Code Chapter 169 may submit a form to DSHS to request adding a pulmonary inhalation device to the list from which a physician may choose when prescribing a pulmonary inhalation device for low-THC cannabis.
- A request under subsection (d) of this section must be submitted using the form, Request to Add Medical Conditions for Which a Physician May Prescribe LowTHC Cannabis or Add Pulmonary Inhalation Devices for Low-THC Cannabis, located on the DSHS website.
- The Texas Department of State Health Services must review pulmonary inhalation devices every six months with stakeholders to determine potential changes to this section.
PUBLIC COMMENT
Written comments on the proposal may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4601 West Guadalupe Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.
To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be:
- postmarked or shipped before the last day of the comment period;
- hand-delivered before 5:00 p.m. on the last working day of the comment period; or
- emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate “Comments on Proposed Rule 25R037” in the subject line.