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In a move sure to motivate injured employees to get up off the
couch and go back to work, the 89th Legislature passed Texas House
Bill 46 on June 20, 2025, set to take effect on September 1, 2025. The bill
expands the conditions for which certain medical providers in the state can
prescribe “low-level” tetrahydrocannabinols (THC) cannabis under the Texas
Compassionate Use Program (TCUP).
Additionally, the level of permissible THC will increase, from the current
limit of 1% THC by weight to up to 10 milligrams per dose, not to exceed 1 gram
of THC per package.
Previously, medical marijuana under the Compassionate Use Program was limited
to diagnoses rarely encountered in workers’ compensation claims, such as
spasticity, Amyotrophic Lateral Sclerosis (ALS, or Lou Gehrig’s Disease),
autism, terminal cancer, or incurable neurodegenerative diseases.
However, HB46 adds to that list some conditions that are often part of workers’
compensation claims: traumatic brain injuries and chronic pain.
Anyone familiar with current trends in Texas comp will recognize the seismic
shift this expansion is sure to have on treatment and billing for work
injuries. “Traumatic brain injury” is an unfortunately vague term often
used to diagnose mild and temporary cranial trauma without any lasting effects,
such as a simple head contusion. “Chronic pain,” meanwhile, is a favorite
post-injury diagnosis used by some healthcare providers to prolong and inflate
treatment—and the billing that goes along with it. Circa September 2025,
Insurance carriers can therefore expect to see more frequent billing for
medical marijuana as part of injured workers’ treatment regimens for traumatic
brain injuries and chronic pain.
In fact, already we have heard of one enterprising physician hoping to
capitalize on the new legislation:
Copyright 2025, Stone Loughlin & Swanson, LLP