Crohn's and IBD joined the Texas list. Most patients haven't heard
Texans with Crohn's spent years watching other states list IBD while Texas didn't.
HB 46 ended that in September 2025: Crohn's disease and other inflammatory bowel
disease (ulcerative colitis included) now qualify. The GI community has been slow to
mention it, so consider this the memo.
Reading the statute's wording
The bill's language is "Crohn's disease or other inflammatory bowel disease," which is
broader than most coverage suggested. Ulcerative colitis qualifies. Indeterminate
colitis qualifies. What the wording doesn't reach is IBS (a distinct diagnosis that
isn't an IBD), but HB 46's other addition covers a lot of that ground:
abdominal pain persisting more than 90 days can be
documented as chronic pain regardless of which GI label it carries.
What an IBD evaluation looks like
Same shape as every TCUP evaluation: video visit with a CURT-registered physician,
fifteen minutes, $45–$199 depending on the service. With an established diagnosis the
documentation is quick: diagnosis year, treatment history, current state. Most
telehealth clinics ask for no records up front; the physician documents the condition
during the visit. The prescription enters the registry, often same day, and licensed
dispensaries deliver statewide or hand orders over at pickup locations, verified by
name and date of birth.
A detail specific to GI patients
Texas prescriptions specify the route of administration, and for IBD that's worth thirty
seconds of thought before the visit. Oral products depend on the gut you're medicating;
sublinguals and lozenges don't, and vape products (legal since HB 46 when the
pulmonary inhalation route is written into the CURT entry) bypass it entirely. Ask the
physician to write the routes you'll actually use, because dispensaries fill what the
prescription says. It's the kind of program fine print that saves a second visit.
Flares don't wait for a delivery window
The access problem specific to IBD is unpredictability. A flare arrives on its own
schedule, and the week you most need medicine on hand is the week you are least able to
drive to a counter or wait several business days for a route. That argues for holding
supply rather than ordering to demand: Texas permits a 90-day refill against your
prescription, and keeping a buffer is the whole point of that allowance.
Both. HB 46 added Crohn’s disease and other inflammatory bowel disease as qualifying conditions, which covers ulcerative colitis and indeterminate colitis. IBS is a different diagnosis and isn’t on the list by name, though IBS pain that has persisted more than 90 days can be evaluated under the chronic pain condition.
I’m on a biologic. Does that matter?
Tell the evaluating physician. That’s what the visit is for. TCUP prescribing decisions are made with your full medication list, and your gastroenterologist should know as well. There’s no rule against qualifying while on any particular therapy.
Do I need my colonoscopy records or GI notes?
Most telehealth clinics don’t require records before the visit. The physician can document the condition from the clinical interview. An established IBD diagnosis with a treatment history makes that conversation short. If your diagnosis is recent or complicated, uploading your GI’s notes saves the visit for your actual questions.
What product forms make sense with a GI condition?
Product selection is the physician’s call, written into the prescription with dose and route. Worth knowing going in: Texas dispensaries carry non-oral routes: sublingual tinctures and lozenges absorbed before the gut, topicals, and since HB 46, vape products via the pulmonary inhalation route. If absorption during flares is a concern, raise it in the evaluation so the route fits.
Does Crohn’s have to last 90 days, like chronic pain?
No. The 90-day requirement belongs to the chronic pain condition. Crohn’s disease and other inflammatory bowel disease are qualifying conditions in their own right, so the diagnosis is what qualifies, including a recent one. If you are still waiting on a diagnosis and have had abdominal pain for more than 90 days, the chronic pain condition may cover you in the meantime.
I have an ostomy or a J-pouch. Do I still qualify?
Surgery doesn’t erase the diagnosis the statute names. Patients living with IBD after a resection, colectomy, or ostomy are evaluated on their history and what they are dealing with now, and the physician documents whichever condition fits. Mention any surgery that changes how you absorb oral medication, because that shapes the route written into the prescription.
Will my health insurance see this?
Not through a claim, because there isn’t one. Insurance pays for neither the evaluation nor the product, so nothing is billed to your plan from the program. CURT itself is a closed registry that registered physicians, licensed dispensaries, and DPS can access. What goes into your gastroenterologist’s chart is up to you, and telling them is still the right call.
How do I keep from running out during a flare?
Order on a margin, not at empty. Delivery runs on route cycles, and a flare is exactly when a missed window hurts most. Keep a buffer of a couple of weeks, know how many refills remain on your prescription, and open an account with a second operator before you need it, so an out-of-stock product at one doesn’t become a gap in supply.
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