ARIZONA Bill Seeks to Regulate and License Medical Spas

Posted By American Med Spa Association, Tuesday, February 8, 2022

Bill Name: Senate Bill 1367 (SB 1367) 

Primary Sponsor: Senator Nancy Barto

Status: FAILED 1/26/2022 Introduced and referred to Senate Committee on Rules and Committee on Health and Human Services

AmSpa’s Take: Reducing practice oversight requirements and allowing independence for physician assistants (PAs) is a growing national trend. Many states have already done this for nurse practitioners with positive results. Arizona is often an early adopter of these types of rules and may provide their PAs with a way to own their own practice.

Outlook: This bill is in the first steps of the process and, based on the sponsor’s past records and party, it is more likely to pass. The bill is currently only sponsored by the one senator, who is also the chair of the Committee on Health and Human Services, so this could indicate strong support, at least through the first committee stage.

Analysis: Currently, Arizona medical spas are regulated the same as other medical offices or physician’s practices. There isn’t a separate set of regulations that apply only for medical spa facilities. The newly introduced House Bill 340 (SB 1367), if passed, would create ownership and practice requirements for medical spas.   

Currently, physician assistants (PAs) must practice under the supervision of a physician. Their scope of practice and prescriptive authority are defined by this supervisory relationship. SB 1367 would change this relationship to one of collaboration between physicians and PAs. This relationship is initially defined by a collaboration agreement between the physician and PA. The agreement describes the PA’s scope of practice and the ability to prescribe Schedule II-V controlled substances. Within the framework of the collaborative relationship, PAs have a broad scope of practice in a number of settings limited by their experience and competence. The duties of the collaborating physician remain largely similar to their current responsibilities. Physicians are still limited to collaborating with a maximum of six PAs, and they still need to evaluate and monitor the PAs’ training and practice.   

The major change that SB 1367 would provide is a possible path to practice independence for PAs. PAs with fewer than 4,000 hours of clinical practice would practice under the written collaboration agreements as above. However, once a PA has more than 4,000 hours of clinical practice, they are no longer required to have a written agreement and, instead, practice in collaboration with other health care professionals as appropriate for the patient’s condition and the PA’s experience. The PA’s scope and the level of this collaboration would then be set at the practice level by the practice or employer and could still involve a written collaboration agreement.   

SB 1367 does not explicitly state that PAs with more than 4,000 hours can practice independently, but it does strongly imply that by listing “private practice” as one of the “employers” who can set the collaboration level. If so, this would put Arizona among the first few states to allow PAs to practice on their own without physician oversight. This has been a long-running trend in practice requirements for advanced practitioners, such as PAs and advanced practice registered nurses (APRNs). The majority of states have already provided APRNs with the ability to practice independently and, slowly, states are heading in that same direction for PAs. If you would like additional information, to read the bill or to contact the sponsors, you can find the necessary information through this link