Texas House Bill 3749 (H.B. 3749), also known as Jenifer’s Law, was enacted in response to concerns highlighted by the death of a patient during an IV infusion at a Texas medical spa. The legislation introduces regulations specific to intravenous (IV) therapy provided outside of traditional healthcare settings, such as medical spas and IV hydration clinics. The law will go into effect on September 1, 2025.
While an earlier version of H.B. 3749 proposed broader general oversight of medical spas and included changes to rules regarding cosmetic procedures, the final version signed into law in June by Governor Greg Abbott applies to elective IV therapy only. Elective IV therapy is defined as “the administration of fluids, nutrients, medications, or blood directly into a patient’s bloodstream to alleviate temporary discomfort or improve wellness, when not provided in a physician’s office, licensed healthcare facility, mental hospital, or state-operated hospital.”
This law will affect all Texas medical spas that provide elective IV therapy, and failure to comply could result in regulatory enforcement under Texas Medical Board rules. Providers of elective IV therapy should review their current business practices to ensure they comply with the new delegation and supervision standards.
Key Compliance Takeaways
H.B. 3749 emphasizes delegation, supervision, and operational impacts for medical spas offering elective IV therapy. These provisions will apply to IV therapy performed on or after September 1, 2025.
- Patient Assessment and Prescribing/Ordering: A licensed physician must oversee the patient assessment, prescribing/ordering process. Physicians may delegate the prescribing or ordering of elective IV therapy only to a physician assistant (PA) or advanced practice registered nurse (APRN) acting under adequate physician supervision.
- Administration of IV Therapy: Administration of elective IV therapy may be delegated by a physician only to a PA, APRN, or registered nurse (RN) under adequate supervision by a physician. Licensed vocational nurses (LVNs), paramedics, medical assistants, aestheticians, or other unlicensed personnel are prohibited from administering elective IV therapy. This may require medical spas to adjust staffing, consider hiring additional RNs or other providers, or ensuring existing staff meet these qualifications.
- Supervision Requirements: While delegations to RNs, PAs, or APRNs must occur under “adequate physician supervision,” the law does not require on-site physician presence. Physicians only need to be available for emergency consultations consistent with current Texas Medical Board regulations. Medical spas should include supervision protocols in any relevant medical director or delegation agreements.
- Documentation and Contracts: Patient consent forms should be updated to disclose the elective nature of IV therapy, the risks inherent to elective IV therapy, and disclosure that only qualified providers may administer it. Medical director, delegation, employment, and vendor agreements should be revised to include delegation protocols and training requirements. Medical aesthetic businesses should also emphasize safety screenings during the intake processes, as the law reduces the need for documenting medical necessity, while prioritizing contraindication checks.
- Scope and Exclusions: The regulations apply only to elective IV therapy in non-traditional settings. Services in physician offices or licensed facilities are exempt. Medical spas offering “menu based” IV options should also take steps to ensure patient selections align with safety protocols.
- Monitoring and Guidance: The Texas Medical Board may issue further interpretations or rules on implementation. Medical spas should monitor for updates and consider consulting legal counsel to review operations before the effective date.
Conclusion
Texas medical spas and aesthetic businesses that provide elective IV therapy should audit their patient screening, delegation, staffing, and documentation practices to ensure they are aligned with new requirements set forth in H.B. 3749. Training staff in these new requirements and updating policies to reflect the elective classification of these services will help further mitigate risks.
If you have questions or need assistance reviewing your Texas medical spa’s compliance with H.B. 3749, contact Frier Levitt’s Healthcare team today.
