|(a) An incurable neurodegenerative disease is a condition,
injury, or illness:
(1) that occurs when nerve cells in the brain or peripheral
nervous system lose function over time; and
(2) for which there is no known cure.
(b) A qualifying physician under Texas Occupations
Code, Chapter 169, may prescribe low-THC cannabis to a patient with
a documented diagnosis of one or more of the following incurable neurodegenerative
(1) Incurable Neurodegenerative Diseases with Adult
(A) Motor Neuron Disease:
(i) Amyotrophic lateral sclerosis;
(ii) Spinal-bulbar muscular atrophy; and
(iii) Spinal Muscular Atrophy.
(B) Muscular Dystrophies:
(i) Duchenne Muscular Dystrophy;
(ii) Central Core; and
(iii) Facioscapulohumeral Muscular Dystrophy.
(C) Freidreich's Ataxia.
(D) Vascular dementia.
(E) Charcot Marie Tooth and related hereditary neuropathies.
(F) Spinocerebellar ataxia.
(G) Familial Spastic Paraplegia.
(H) Progressive dystonias DYT genes 1 through 20.
(I) Progressive Choreas: Huntington's Disease.
(i) Alzheimer's Disease;
(ii) Prion Diseases:
(I) Creutzfeldt-Jakob Disease;
(II) Gerstmann-Straussler-Scheinker Disease;
(III) Familial or Sporadic Fatal Insomnia; and
(i) Chronic Traumatic Encephalopathy:
(ii) Pick Disease;
(iii) Globular Glial Tauopathy;
(iv) Corticobasal Degeneration;
(v) Progressive Supranuclear Palsy;
(vi) Argyrophilic Grain Disease;
(vii) Neurofibrillary Tangle dementia, also known as
Primary Age-related Tauopathy; and
(viii) Frontotemporal dementia and parkinsonism linked
to chromosome 17 caused by mutations in MAPT gene.
(i) Lewy Body Disorders:
(I) Dementia with Lewy Bodies; and
(II) Parkinson's Disease; and
(ii) Multiple System Atrophy.
(M) Transactive response DNA-binding protein-43 (TDP-43)
(i) Frontotemporal Lobar Degeneration;
(ii) Primary Lateral Sclerosis; and
(iii) Progressive Muscular Atrophy.
(2) Incurable Neurodegenerative Diseases with Pediatric
(A) Mitochondrial Conditions:
(i) Kearn Sayers Syndrome;
(ii) Mitochondrial Encephalopathy Ragged Red Fiber;
(iii) Mitochondrial Encephalopathy Lactic Acidosis
(iv) Neuropathy, Ataxia, and Retinitis Pigmentosa;
(v) Mitochondrial neurogastrointestinal encephalopathy;
(vi) Polymerase G Related Disorders:
(I) Alpers-Huttenlocher syndrome;
(II) Childhood Myocerebrohepatopathy spectrum;
(III) Myoclonic epilepsy myopathy sensory ataxia; and
(IV) Ataxia neuropathy spectrum;
(vii) Subacute necrotizing encephalopathy, also known
as Leigh syndrome;
(viii) Respiratory chain disorders complex 1 through
4 defects: Co Q biosynthesis defects;
(ix) Thymidine Kinase;
(x) Mitochondrial Depletion syndromes types 1 through
(I) Deoxyguanisine kinase deficiency;
(II) SUCLG1-related mitochondrial DNA depletion syndrome,
encephalomyopathic form with methylmalonic aciduria; and
(III) RRM2B-related mitochondrial disease.
(B) Creatine Disorders:
(i) Guanidinoacetate methytransferase deficiency;
(ii) L-Arginine/glycine amidinotransferase deficiency;
(iii) Creatine Transporter Defect, also known as SLC
(C) Neurotransmitter defects:
(i) Segawa Diease, also known as Dopamine Responsive
(ii) Guanosine triphosphate cyclohydrolase deficiency;
(iii) Aromatic L-amino acid decarboxylase deficiency;
(iv) Monoamine oxidase deficiency;
(v) Biopterin Defects:
(I) Pyruvoyl-tetahydropterin synthase;
(II) Sepiapterin reductase;
(III) Dihydropteridine reductase; and
(IV) Pterin-4-carbinolamine dehydratase.
(D) Congenital Disorders of Glycosylation.
(E) Lysosomal Storage Diseases:
(I) Mucopolysaccharidosis Type I, also known as Hurler
Syndrome or Scheie Syndrome;
(II) Mucopolysaccharidosis Type II, also known as Hunter
(III) Mucopolysaccharidosis Type III, also known as
Sanfilippo A and B;
(IV) Mucopolysaccharidosis Type IV, also known as Maroteaux-Lamy;
(V) Mucopolysaccharidosis Type VII, also known as Sly.
(V) Schindler; and
(I) Mucolipidoses Type II, also known as Inclusion
Cell disease; and
(II) Mucolipidoses Type III, also known as pseudo-Hurler
(I) Gaucher Type 2 and Type 3;
(II) Neimann Pick Type A and B;
(III) Neimann Pick Type C;
(V) GM1 gangliosidosis;
(VI) GM2 gangliosidosis also known as Tay-sachs and
(VII) Metachromatic leukodystrophy;
(VIII) Neuronal ceroid lipofuscinosis types 1-10 including
Batten Disease; and
(IX) Farber Disease; and
(v) Glycogen Storage-Lysosomal: Pompe Disease.
(F) Peroxisomal Disorders:
(i) X-linked adrenoleukodystrophy;
(ii) Peroxisomal biosynthesis defects:
(I) Zellweger syndrome:
(II) Neonatal Adrenoleukodystrophy; and
(iii) D Bidirectional enzyme deficiency.
(i) Canavan disease;
(ii) Pelizaeus-Merzbacher disease;
(iii) Alexander disease;
(iv) Multiple Sulfatase deficiency;
(v) Polyol disorders;
(vi) Glycine encephalopathy, also known as non-ketotic
(vii) Maple Syrup Urine Disease;
(viii) Homocysteine re-methylation defects;
(ix) Methylenetetrahydrofolate reductase deficiency
(x) L-2-hydroxyglutaric aciduria;
(xi) Glutaric acidemia type 1;
(xii) 3-hydroxy-3-methylglutaryl-CoA lyase deficiency;
(xiv) Manosidosis alpha and beta;
(xvi) Peripheral neuropathy types 1 through 4;
(xvii) Pyruvate Dehydrogenase Deficiency;
(xviii) Pyruvate Carboxylase Deficiency;
(xix) Refsum Disease; and
(xx) Cerebral Autosomal Dominant Arteriopathy with
Sub-cortical Infarcts and Leukoencephalopathy.
(H) Fatty Acid Oxidation:
(i) Trifunctional protein deficiency; and
(ii) Long-chain L-3 hydroxyacyl-CoA dehydrogenase deficiency.
(I) Metal Metabolism:
(i) Wilson Disease;
(ii) Pantothenate Kinase Associated Neurodegeneration;
(iii) Neurodegeneration with brain iron accumulation.
(J) Purine and Pyrimidine Defects:
(i) Adenylosuccinate synthase Deficiency;
(ii) 5-aminoimidazole-4-carboxamide ribonucleotide
(iii) Hypoxanthine-guanine phosophoribosyltransferase
Deficiency also known as Lesch-Nyhan disease;
(iv) Dihydropyrimidine dehydrogenase Deficiency; and
(v) Dihydropirimidinase Deficiency.
(c) A treating physician of a patient suffering from
an incurable neurodegenerative disease not listed in subsection (b)
of this section may submit a request to the department to have a disease
(d) A request under subsection (c) of this section
shall be submitted to the department on a form prescribed by the department,
which can be found on the department's website at https://www.dshs.texas.gov/chronic/default.shtm.
(e) After review of the submitted documentation, the
department may request additional information or make a determination.