Texas 2025 - 89th Regular

Texas House Bill HB3749 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R15680 BEE-F
2	2	By: Orr H.B. No. 3749
3	3
4	4
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the regulation of the practice of medicine, including
10	10	the performance of cosmetic medical procedures and the provision of
11	11	elective intravenous therapy.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Subtitle B, Title 3, Occupations Code, is
14	14	amended by adding Chapters 172 and 173 to read as follows:
15	15	CHAPTER 172. MEDICAL SPAS
16	16	SUBCHAPTER A. GENERAL PROVISIONS
17	17	Sec. 172.001. DEFINITIONS. In this chapter:
18	18	(1) "Cosmetic medical procedure" means a medical
19	19	procedure or medical treatment that is performed to alter or
20	20	reshape normal structures of the human body or to ablate or remove
21	21	living tissue solely to improve physical appearance. The term
22	22	includes the administration of a neuromodulator or dermal filler,
23	23	an ablative or non-ablative laser procedure, and a procedure using
24	24	an energy-emitting device.
25	25	(2) "Medical spa" means a facility outside a
26	26	physician's primary office location where cosmetic medical
27	27	procedures are performed.
28	28	(3) "Medical spa director" means a physician who
29	29	assumes the role of or represents that the person is the medical
30	30	director of a medical spa.
31	31	Sec. 172.002. STATUS OF MEDICAL SPA. A medical spa is a
32	32	medical practice setting.
33	33	Sec. 172.003. NOTICE REQUIRED IF PHYSICIAN NOT PRESENT. A
34	34	medical spa must post a notice stating that a physician is not
35	35	present at the location at any time when a physician is not present
36	36	at the medical spa.
37	37	SUBCHAPTER B. MEDICAL SPA DIRECTOR
38	38	Sec. 171.051. MEDICAL SPA DIRECTOR REQUIRED. A cosmetic
39	39	medical procedure may not be performed at a medical spa unless the
40	40	medical spa has a medical director.
41	41	Sec. 172.052. MEDICAL SPA DIRECTOR ELIGIBILITY. A person
42	42	may not act as a medical spa director unless the person is a
43	43	physician trained in:
44	44	(1) the indications for and performance of cosmetic
45	45	medical procedures; and
46	46	(2) the use of medical devices or instruments capable
47	47	of altering, causing biologic change to, or penetrating skin and
48	48	subcutaneous tissue.
49	49	Sec. 172.053. MEDICAL SPA DIRECTOR DUTIES. A medical spa
50	50	director shall:
51	51	(1) implement policies and procedures to:
52	52	(A) promote quality patient care; and
53	53	(B) provide for physician delegation and
54	54	supervision of the performance of cosmetic medical procedures;
55	55	(2) provide overall supervision for cosmetic medical
56	56	procedures performed at the medical spa, whether by a physician or a
57	57	non-physician provider; and
58	58	(3) oversee the training of physician and
59	59	non-physician providers to safely and effectively perform each
60	60	cosmetic medical procedure performed at the medical spa.
61	61	SUBCHAPTER C. PHYSICIAN PERFORMANCE, DELEGATION, OR SUPERVISION OF
62	62	COSMETIC MEDICAL PROCEDURE
63	63	Sec. 172.101. PHYSICIAN TRAINING REQUIREMENTS REGARDING
64	64	COSMETIC MEDICAL PROCEDURE. (a) A physician may not perform a
65	65	cosmetic medical procedure or supervise the performance of a
66	66	cosmetic medical procedure by a non-physician provider unless the
67	67	physician has completed training in the indications for and
68	68	performance of the cosmetic medical procedure and is able to
69	69	perform the procedure according to the standard of care.
70	70	(b) For purposes of Subsection (a), training provided by the
71	71	vendor or manufacturer of an injectable or medical device used to
72	72	perform a cosmetic medical procedure does not satisfy the training
73	73	requirements of that subsection.
74	74	Sec. 172.102. PHYSICIAN DELEGATION OR SUPERVISION OF
75	75	COSMETIC MEDICAL PROCEDURES. (a) A physician's authority to
76	76	delegate the prescribing or ordering of a drug or device relating to
77	77	cosmetic medical procedures is subject to Subchapter B, Chapter
78	78	157.
79	79	(b) A prescriptive authority agreement relating to cosmetic
80	80	medical procedures is included in the number of prescriptive
81	81	authority agreements authorized under Section 157.0512(c). The
82	82	exception provided in Section 157.0512(d) does not apply to a
83	83	prescriptive authority agreement relating to cosmetic medical
84	84	procedures.
85	85	(c) A physician who delegates or supervises the performance
86	86	of a cosmetic medical procedure shall:
87	87	(1) for each cosmetic medical procedure performed
88	88	under the physician's delegation and supervision:
89	89	(A) develop and maintain a written protocol; or
90	90	(B) review and approve in writing a written
91	91	protocol developed and maintained by another physician at the
92	92	medical spa;
93	93	(2) perform an initial assessment of the patient on
94	94	whom a cosmetic medical procedure will be performed;
95	95	(3) prepare a written treatment plan for each patient
96	96	on whom a cosmetic medical procedure will be performed, including
97	97	diagnosis, course of treatment, and specifications for any device
98	98	being used;
99	99	(4) if a cosmetic medical procedure is being performed
100	100	by a non-physician provider:
101	101	(A) obtain the patient's consent to the procedure
102	102	to be performed by the non-physician provider; and
103	103	(B) identify the name and credentials of the
104	104	non-physician provider who will perform the procedure; and
105	105	(5) create and maintain medical records in a manner
106	106	consistent with accepted medical practice and in compliance with
107	107	board rules.
108	108	Sec. 172.103. AVAILABILITY OF MEDICAL SPA SUPERVISING
109	109	PHYSICIAN. A physician supervising the performance of a cosmetic
110	110	medical procedure at a medical spa must be immediately able to be
111	111	present on site and respond in person, if needed.
112	112	SUBCHAPTER D. NON-PHYSICIAN PROVIDER PERFORMANCE OF COSMETIC
113	113	MEDICAL PROCEDURES
114	114	Sec. 172.151. NON-PHYSICIAN PROVIDER REQUIREMENTS FOR
115	115	COSMETIC MEDICAL PROCEDURES. (a) A non-physician provider may
116	116	perform cosmetic medical procedures only if the provider has been
117	117	properly trained, the procedure has been delegated to the provider
118	118	by a supervising physician, and the provider is acting under
119	119	physician supervision.
120	120	(b) Training provided by a vendor or manufacturer of an
121	121	injectable or medical device used to perform a cosmetic medical
122	122	procedure does not qualify the individual to perform a cosmetic
123	123	medical procedure.
124	124	(c) A non-physician provider shall:
125	125	(1) wear identification that clearly indicates any
126	126	license the person holds and states that the person is not a
127	127	physician;
128	128	(2) review and follow written protocols for each
129	129	delegated cosmetic medical procedure;
130	130	(3) verify that the supervising physician has assessed
131	131	the patient and given written treatment instructions for each
132	132	procedure to be performed;
133	133	(4) review with each patient the cosmetic medical
134	134	procedure to be performed;
135	135	(5) notify the medical spa director and supervising
136	136	physician of any adverse events or complications before the patient
137	137	leaves the medical spa or, if the patient has already left the
138	138	medical spa, immediately on becoming aware of the adverse event or
139	139	complication;
140	140	(6) communicate post-procedure instructions to each
141	141	patient;
142	142	(7) document all relevant details of the cosmetic
143	143	medical procedure in the patient's medical record; and
144	144	(8) satisfy any requirement of the non-physician
145	145	provider's licensing board.
146	146	(d) A cosmetic medical procedure may not be performed at a
147	147	medical spa unless:
148	148	(1) a physician is physically present at the medical
149	149	spa; or
150	150	(2) at least one non-physician provider trained in
151	151	basic life support is physically present at the medical spa.
152	152	CHAPTER 173. PROVISION OF ELECTIVE INTRAVENOUS THERAPY
153	153	SUBCHAPTER A. GENERAL PROVISIONS
154	154	Sec. 173.001. DEFINITIONS. In this chapter:
155	155	(1) "Elective intravenous therapy" means a procedure:
156	156	(A) to administer fluids, nutrients,
157	157	medications, or blood directly into a patient's bloodstream through
158	158	a vein;
159	159	(B) that is sought by the patient to alleviate
160	160	symptoms of temporary discomfort or improve temporary wellness; and
161	161	(C) that is not administered in:
162	162	(i) a physician's office;
163	163	(ii) a health facility licensed under
164	164	Subtitle B, Title 4, Health and Safety Code;
165	165	(iii) a mental hospital licensed under
166	166	Chapter 577, Health and Safety Code; or
167	167	(iv) a hospital maintained or operated by
168	168	this state.
169	169	(2) "Registered nurse" means a person licensed by the
170	170	Texas Board of Nursing to practice professional nursing.
171	171	SUBCHAPTER B. ELECTIVE INTRAVENOUS THERAPY
172	172	Sec. 173.051. DELEGATION OF PRESCRIBING OR ORDERING
173	173	ELECTIVE INTRAVENOUS THERAPY. (a) A physician may delegate the act
174	174	of prescribing or ordering elective intravenous therapy to:
175	175	(1) a physician assistant acting under adequate
176	176	physician supervision; or
177	177	(2) a registered nurse acting under adequate physician
178	178	supervision.
179	179	(b) A physician's authority to delegate the act of
180	180	prescribing or ordering elective intravenous therapy is subject to
181	181	Subchapter B, Chapter 157.
182	182	(c) A prescriptive authority agreement relating to elective
183	183	intravenous therapy is included in the maximum number of
184	184	prescriptive authority agreements authorized under Section
185	185	157.0512(c). The exception provided in Section 157.0512(d) does
186	186	not apply to a prescriptive authority agreement relating to
187	187	elective intravenous therapy.
188	188	SECTION 2. The changes in law made by this Act apply to the
189	189	performance of a medical act on or after the effective date of this
190	190	Act under a physician's delegation, including the act of
191	191	prescribing, ordering, or administering a controlled substance,
192	192	dangerous drug, or device, regardless of:
193	193	(1) the manner in which the delegation is made; and
194	194	(2) whether the delegation is made before, on, or
195	195	after the effective date of this Act.
196	196	SECTION 3. This Act takes effect September 1, 2025.