A new study published in JAMA Internal Medicine and reported by NBC News has brought renewed attention to the IV hydration spa industry, raising concerns about inconsistent oversight.

National Analysis Highlights Regulatory Gaps

A mixed-methods study led by Anishaa Sivakumar, MD, and published October 6 in JAMA Internal Medicine, examined how IV hydration spas are regulated across the U.S. The researchers reviewed state laws, policies, and statements; analyzed 255 facility websites; and conducted secret shopper calls with clinics in every state and D.C. The aim: to assess oversight and spa practices in four critical areas: governance, prescriber credentials, dispensing practices, and compounding.

As of June 2024, 32 states had issued policies or statements about IV clinics, and only four of these—Alabama, North Carolina, South Carolina, and Vermont—addressed all four key areas. Most spa websites made broad claims about boosting immunity or providing wellness benefits, yet just two cited sources. During secret shopper calls, only a quarter of facilities disclosed risks of receiving IV therapy and just 27% required a consultation with a licensed health professional, both of which are key patient safety protections necessary when receiving medical treatment. The study authors recommend more stringent requirements around facility registration, clear disclosure of product information and risks, and robust reporting for both benefits and adverse outcomes.

The American Med Spa Association (AmSpa), which represents medical spas nationwide, has long advocated for clearer standards and greater accountability in the delivery of IV therapies and other medical aesthetic services. AmSpa CEO Alex Thiersch emphasized that many providers may not fully understand the medical nature of IV therapy. “If you’re putting a needle in someone’s vein, that’s 100% medical practice,” Thiersch told NBC News.

Explore the Medical Aesthetic IV Therapy Resource Center for more on running a legally compliant IV therapy program.

Raising the Bar for IV Therapy Oversight

In 2025, AmSpa gave testimony during the passage of Texas House Bill 3749, Jenifer's Law, which established new requirements for IV therapy in outpatient settings. Under the law, which took effect September 1, elective IV treatments must be administered by licensed registered nurses or advanced practitioners following a prescription and under the supervision of a physician, physician assistant, or APRN. This legislation represents a significant step toward ensuring that IV therapy is delivered safely and responsibly.

AmSpa continues to promote best practices for safe and compliant med spas, placing public safety at the forefront. Through advocacy, education, and industry collaboration, the association works to elevate standards, support transparency in patient care, and foster a culture rooted in professionalism and ethical practice.

As public interest in wellness services grows, AmSpa encourages providers to prioritize informed consent, evidence-based practice and continuous education. Thiersch urges practitioners to lead by example: “To hold yourself, your colleagues and your peers to a higher standard. To speak up when something isn’t right. To say enough when shortcuts or recklessness put patients at risk.”

AmSpa offers a range of resources to help providers stay informed about regulatory requirements. Members can explore guidance on who can administer IV therapy in their state and schedule their complimentary annual consultation with national health care law firm ByrdAdatto.