Proposed Texas legislation would destroy the medical aesthetics industry as we know it, and not for the safety reason it claims.

On March 4, 2025, Rep. Angelia Orr filed HB 3749 in the Texas Legislature. Dubbed “Jenifer’s Law” by some in the press, it was purportedly filed in response to the tragic death of Jenifer Cleveland following an IV infusion treatment at Luxe Medical Spa in July of 2023. The proposed law would ban advanced practice registered nurses (APRNs) (such as nurse practitioners (NPs)) and physician assistants (PAs) from performing initial assessments of patients at med spas, otherwise known as good faith exams (GFEs). The law would also, in effect, require a physician to be present at med spas full time.

Days later, Rep. Elizabeth Campos filed HB 3889 and HB 3890. These bills targeted APRNs and PAs directly. HB 3889 prohibits NPs or PAs from prescribing drugs to patients unless the patient has been seen and examined by the NP or PA’s overseeing physician. HB 3890 goes a step further, prohibiting any physician from supervising advanced practitioners (NPs and PAs) outside their original medical specialty without years of additional practice.

Each of these bills are extreme outliers that would make Texas the only state in the United States to curb NP and PA practice in this manner. No other state–Texas currently included–has banned NPs and PAs from performing patient assessments in any setting, let alone medical spas.  Together, these bills would devastate the medical spa industry in the biggest and fastest growing state in the space.

And despite indiscriminately hammering away at the medical aesthetics industry, the bills don’t even tackle the very problem they are supposedly designed to address:  The tragic death of a woman receiving an unlawful, unsupervised IV treatment.

This is a low moment for aesthetics. Each of these bills must be defeated, and AmSpa asks all of you to support it in shutting them down.

Sponsors and proponents of these bills will likely invoke issues of patient safety and public health. HB 3749 is, in fact, sourced directly to a tragedy that shook our industry to its core. But upon reading these bills, the real tragedy is that these bills were brought at all. They do not make med spas safer. They do not address any of the very real issues the industry grapples with: unlicensed and undertrained providers, lack of supervision, and the blatant flaunting of medical regulations that all safe, law-abiding medical spas must, and do, follow.

And none of these bills, including “Jenifer’s Law,” attempt to solve the actual problem that caused Ms. Cleveland’s tragic death last year.

That last sentence bears repeating. Despite purportedly being filed in response to the Jenifer Cleveland tragedy, HB 3749 does not improve current IV medication laws at all. It actually makes IV laws less restrictive in Texas. And HBs 3889 and 3890, without any apparent scientific basis and without data-supported research, eliminate a well-established and critical safety feature from medical aesthetics. All in the name of “safety?”

So, what’s going on here?

I have reviewed and analyzed these bills for several days now and it saddens me to say that I can come to only one conclusion: “Jenifer’s Law,” and the two bills that followed it, are not designed to help patients like Jenifer Cleveland at all. They’re not even about “safety.” In short, this is an effort to box out certain types of providers so they don’t have access to this fast-growing and rewarding industry.

I realize this sounds cynical. But don’t take my word for it, just read the bills; HB 3749 in particular. And keep in mind that this has been dubbed “Jenifer’s Law,” drafted in an effort to address an illegal, unsupervised IV treatment by an unlicensed provider at a medical spa run by a physician.

First, most of the bill, however erroneously, works to address establishing oversight and supervision standards for medical spas and medical aesthetic treatments, not IV treatments. And it does so by specifically disallowing NPs and PAs from performing initial assessments, delegating and supervising treatments, and managing complications. The bill further states that every med spa must have a physician, not an NP or PA, “immediately available … to be present” at the facility, if needed.

You don’t need to read between the lines here. If passed, NPs and PAs in Texas med spas would no longer be able to see new patients, perform good faith assessments, or treat patients independently, regardless of their training or whether they had a lawful and proper collaborating/supervisory agreement in place. And in order for a physician to be “immediately available” to be on-site, the physician would physically need to be on-site at the facility every day, a requirement that is not in place in other areas of medicine in Texas, let alone other states.

So, in short, HB 3749’s solution to a physician’s lack of oversight, failure to properly diagnose and assess a patient, and inability to treat an emergency complication, is to remove trained and qualified PAs and NPs from the system? How does that help?

Second, other than curtailing NP and PA authority, HB 3749 doesn’t meaningfully improve the current law in Texas at all. In fact, Texas’ current aesthetic regulatory framework, which was developed by the Texas Medical Board and is already one of the strictest in the country , is far more definitive, provides more specific guidance, and offers more patient protection than HB 3749. HB 3749 is a vague repetition of the current law, and its only material change removes safeguards that were in place beforehand: the involvement of NPs and PAs.

Finally, despite being termed “Jenifer’s Law,” and despite being filed in response to a death due to IV therapy, the bill’s IV provisions have none of the safety or supervision requirements that it proposes for medical spas: there is no physician assessment required for IV treatment, no on-site physician presence required for IV treatment and, incredibly, no requirement that anyone trained in basic life support be onsite. And the bill takes the unusual step to grant registered nurses the ability to prescribe IV treatments, something RNs cannot do in any other health care setting.

I’ve read these bills several times, and every time I go through them, I’m more confused, dismayed and, if I’m being honest, more than a little upset. We were all shocked by the death of Jenifer Cleveland at Luxe Med Spa in 2023, and we all want nothing more than to ensure that such a tragedy never happens again. But it is not at all helpful to file specious, transparent bills aimed at punishing specific providers WHO HAD NOTHING TO DO WITH THE TRAGEDY IN THE FIRST PLACE!

These bills are so cavalier in their treatment of the tragic death of Ms. Cleveland and so transparent in their attempt to block specific providers out of the industry, it’s impossible not to conclude that they are anything but a direct attempt to exclude NPs and PAs from medical aesthetics.

There are bad actors and bad situations in this industry that must be addressed, but NPs and PAs are not it. Neither are physicians, RNs, or 99% of the other medical providers who make up the medical aesthetic industry. The problems are caused by unlicensed, noncompliant, untrained providers doing treatments they shouldn’t be doing. In other words, unlawful practices blatantly operating contrary to well-established law and medical regulation. Can we please shut down those bad actors before we start banning provider groups that actually keep the industry safe?

It goes without saying that HB 3749, HB 3889, and HB 3890 must all be defeated. But this is just the beginning. These bills demonstrate without a shadow of doubt that forces are aligning against the med spa industry. They attack the med spa industry at its core, and they must all be soundly defeated.

What can you do? Click here to learn more.
AmSpa is leading the charge to block these bills and others like it nationwide, click here to join.