By Alex R. Thiersch, JD, Founder/Director, The American Med Spa Association (AmSpa)

The question of who can own a med spa is always one of the most common with medical aesthetic practices, and in Massachusetts it can be a tricky one because of the nature of the laws in the state. Massachusetts is one of a few states that has a clinic licensure statute—a comprehensive regulation that outlines a process by which a person or organization other than a physician or a physician-owned company can own a health care facility, such as a medical spa.

In the past, we at AmSpa and ByrdAdatto have worked with companies in the commonwealth to obtain clinical status for their businesses. However, approximately a year ago, we were informed that in some cases, this process may not be necessary.

"We reached out [to the Massachusetts Department of Public Health] because this potential client had said that according to their conversations with the department of health, as a nurse practitioner (NP) licensed in Massachusetts, they do not have to get a license to own a clinic," said Renee E. Coover, JD, associate at ByrdAdatto. "That was flying in the face of everything that we had been told by the department of health—they said if you're a non-physician, you must have clinic licensure in order to operate as a medical spa."

When ByrdAdatto reached out to the Department of Public Health, it was told that in the opinion of the department's legal counsel, an NP does not need to obtain a clinic license to own a medical spa. However, since this was merely the opinion of one person, the firm felt uncomfortable telling clients that such a course of action was legally sound.

"If they went to the department of health and they got the same answer, we would be fine, but if they happened to talk to someone else who said, 'No, that is not the case,' we were fearful we were going to give out incorrect information," Coover says. "We're going to reach back out to the department of health, because at this point, I don't feel as confident giving information one or way or the other as to really what the law says when it comes to clinic licensure."

As it stands, though, this issue may be moot, because Massachusetts law states that NPs require physician supervision in order to have a prescriptive practice.

"In light of that requirement, it would be difficult at this point to say an NP could own their own practice, because if they're going to be prescribing anything—Botox, fillers, etc.—all of those types of treatments are going to need a prescription," Coover explains. "They're still going to require physician supervision. Without that prescriptive authority, I don't know really how they would be able to independently have this medical spa."

However, Massachusetts Senate Bill S.1257, which is currently in committee, would, if passed, remove the requirement for physician supervision for an NP prescriptive practice. If this bill passes, NPs could theoretically operate a practice completely independently of a physician. This, in turn, raises some questions about how an NP who owns a practice would be able to market it—is it really "medical" if there's no physician involved?—but these are issues that will need to be addressed when and if the bill passes.

See the process for clinic licensure in Massachusetts in the video below:

For more information on medical spa law attend AmSpa's Medical Spa & Aesthetic Boot Camp in Boston September 15–16 where you'll learn the keys to build and run a legally compliant and profitable medical spa practice. See the full 2018 Boot Camp schedule to find a Boot Camp near you and be the next med spa success story.