Date: March 16, 2026

Dear Joint Committee on Public Health,

On behalf of the Aesthetic Medical Providers of Massachusetts (AMP-MA), a statewide coalition of Nurse Practitioners, Physicians, Physician Associates, Nurses, and other licensed medical professionals, as well as practice leaders and stakeholders dedicated to promoting patient safety, ethical practice, and evidence-based standards in medical aesthetics, we will be participating in the March 23rd virtual hearing regarding H. 5087.

We are requesting that H. 5087 move no further, and that the committee allow us to work collaboratively with lawmakers for any future proposed legislation regarding our industry. Together, we can ensure additional safety measures for patients as needed that are better aligned with industry standards and existing Massachusetts state law.

H. 5087, as written, resembles other proposals that have been circulated nationwide by the American Dermatologist Association for several years, been defeated and or adjusted by every single state that has considered this type of legislation. Funded by outside private equity firms who wish to buy up Aesthetic Medical practices, install physician medical directors, and create “chains” in this industry, this and other national trade groups seek to reclaim Medical Aesthetic treatments now that health insurance reimbursements have become less reliable, and payors are squeezing medical practices out of their normal levels of profit. Legislation impacting patient safety and outcomes should be determined with the patients best interest in mind, and not simply to support special interest groups.

We are also reaching out to Members of the Joint Committee on Health Care, and matching them with their constituents, so that we can educate the committee and engage in policy decisions moving forward. We hope that all Members will tour our facilities and understand the cutting-edge technologies and treatments, approved by all governing bodies at the state and federal level, compliant with national standards, and serving patients daily. As the growing body of practitioners, from all types of levels of service in this industry – aestheticians to doctors – that represents providers in the state, we should be

consulted regarding regulation and legislation to ensure patient safety and the highest medical standards.

Most our businesses are small, woman-owned businesses – both in Massachusetts and nationwide – creating jobs, stimulating the economy, and improving healthcare outcomes for all Americans – regardless of their race, gender, or financial status. As written, H. 5087 is redundant in some places, and contradictory in others - regarding state laws, as well as state registration and licensure requirements in accordance with the Massachusetts Division of Occupational Licensure (DOL).

AMP-MA appreciates the Legislature’s efforts to establish a clear regulatory framework for medical spas in Massachusetts. As an organization representing front-line clinicians who deliver these services daily, we strongly support thoughtful regulations that protect patients while preserving access to safe, high-quality care.

As technology and treatments in our industry continue to advance, the purpose of our organization is to support legislators and regulators as they develop standards. We intend to be proactive – providing solutions to decision makers that may not be familiar with the nuances of our industry.

 

Support for Key Safety Provisions 

AMP-MA members include Nurse Practitioners who own and operate medical aesthetic practices, as well as Physicians and Physician Associates who work collaboratively within the industry, providing safe, evidence-based care to patients throughout the Commonwealth.

Although AMP-MA was not consulted in the creation of this legislation, we support several elements of H.5087 that align with best practices in healthcare oversight, including:

• Clear definitions distinguishing medical from non-medical aesthetic procedures
• Requirements for emergency preparedness and safety protocols
• Enforcement of current credentialing and competency standards for providers – the intent of this bill can be achieved by enforcing what is already established by DOL
• Measures to address unlicensed or unsafe operators

These provisions would reduce regulatory ambiguity and elevate safety standards.

 

Areas of Concern 

As currently written, several provisions may unintentionally restrict access to care, conflict with existing Massachusetts practice laws, and impose operational burdens without demonstrable improvements in patient safety. Moreover, these provisions are not aligned with other standards in the region and could inadvertently impact patient outcomes.

1. Recognition of Independent Practice Authority 

Massachusetts law, via Chapter 112, grants Nurse Practitioners independent practice authority following required experience and certification. Provisions that require physician oversight or medical directorship for services within an NP’s lawful scope could conflict with established state law and limit access to qualified providers.

This or any related future legislation must ensure that nurse practitioners are exempt from DPH licensure and able to own their own practice. AMP-MA recommends explicit statutory language affirming that nothing in this legislation shall restrict the lawful independent practice of Nurse Practitioners or Physician Associates, as authorized under Massachusetts law, Chapter 112.

AMP-MA recommends explicit statutory language affirming that nothing in this legislation shall restrict the lawful independent practice of Nurse Practitioners or Physician Associates as authorized under Massachusetts law Chapter 112. It is not clear if this legislation is trying to amend Chapter 112 on this matter, is contradicting, or what the intent is. However, what it achieves is changing a vital aspect of Massachusetts medical care statewide that could have repercussions on the rest of the industry – especially during another pandemic, when safe, reliable, licensed clinics must be in abundance.

AMP-MA recommends that:

• This portion is removed from the bill and the Committee and interested legislators learn more about provider licensure and board certification before restricting Nurse Practitioners and Physician Associates.
• Medical Aesthetic provider facilities are treated no differently than other medical clinics.

 

2. Physical Presence Requirements 

Mandating a fixed on-site presence of a clinical or medical director for a percentage of operating hours does not reflect modern healthcare delivery models for other divisions of the medical industry, which commonly rely on telecommunication, on-call availability, and structured protocols to ensure patient safety. For example, hospitals in Massachusetts do not even require a doctor to always be present, per 105 CMR Standards for Hospitals that Provide a Medical Control Center. 

Rigid presence requirements may disproportionately impact multi-location practices, rural access, and small businesses, without clear evidence of improved clinical outcomes, and are already imposed on practices that are properly staffed with certified medical professionals in accordance with Massachusetts state law.

In other states, like Connecticut, where regulation changes from Covid-19 practices have inhibited nurses and nurse practitioners from owning Aesthetic Medical Spas and working remotely with physicians, private equity firms are rushing in to acquire these assets. As a result, nurses and nurse practitioners are losing their livelihood, patients are losing access to wellness treatments, and this multimillion-dollar job creating portion of the Connecticut economy is being destroyed. Simply put, mandating full-time physicians on-site will destroy treatments and jobs for the middle-class while billionaires line their pockets and destroy jobs for women and minorities.

AMP-MA recommends maintaining current state standards and focusing on enforcing them properly across all medical providers, rather than inventing new and unnecessary ones. All medical providers should be treated equally as nurses, nurse practitioners, doctors, and physician associates, whether they are providing medical aesthetic treatments, emergency room treatments, or surgery services, as long as they are achieved under proper licensure and in safe, medical setting.

Moreover, requirements for separate site directors at each facility location may duplicate existing medical leadership structures already established under current healthcare regulations, creating administrative burden without measurable safety benefit. If hospitals in Massachusetts are unable and not required to always have on site physicians, why would Aesthetic Medical spas be treated differently?

AMP-MA recommends that:

• This portion is removed from the bill and the Committee and interested legislators learn more about provider licensure and board certification before adding additional classifications.
• Medical Aesthetic provider facilities are treated no differently than other medical clinics.

 

3. Procedure Classification Concerns 

The bill’s tiered classification system is unnecessary and not aligned with standards in other states. Moreover, it is redundant, as the state of Massachusetts already has specific regulations and licensures for all types of medical and wellness providers, including but not limited to aestheticians, nurses, nurse practitioners, doctors, physical therapists, pharmacists, technicians, etc. The DOL does not have a tiered system for other medical providers, and it sets a dangerous president to impose this on our industry, as it will then need to be imposed on all medical practices. Medical providers must comply with the DOL, and existing laws should be enforced.

If classifications are overly restrictive or tied to provider type rather than procedure risk, they could unintentionally limit the ability of qualified licensed professionals to practice within their lawful scope. Moreover, there are multiple different providers that provide the services of aesthetic medical practices outside of Medical Aesthetic Spa settings, including gynecology, dermatology, dentistry, and even plastic surgery centers.

Moreover, the Food and Drug Administration and Federal statutes regulate every product that we use, the use thereof, and the treatments that we provide. Setting tiers for the system, which would be unique to the state of Massachusetts, would be very confusing regarding standard federal laws that have been adopted and imposed over decades.

AMP-MA recommends that:

• This portion is removed from the bill and the Committee and interested legislators learn more about provider licensure and board certification before adding additional classifications.
• Medical Aesthetic provider facilities are treated no differently than other medical clinics.

 

4. Remove Specific Licensure for Aesthetic Medical Spas 

Already in the state of Massachusetts, Physicians and Physicians Assistants are exempt from the Department of Public Health Licensure as long as the owner is a licensed to a medical provider who provides care more than 50% of the time. This is why most private practices are owned by medical providers. An additional licensure on Aesthetic Medical Spas is not aligned with the rest of the health care industry and puts an undue disadvantage on the industry. Already, these facilities are subject to compliance, investigation, and regulation by their boards, including but limited to medical, pharmaceutical, nursing, and aesthetics. If a facility has individuals that are practicing a procedure outside of their scope, there are already boards in place and measures to enforce repercussions. Imposing additional licensure is not going to entice bad actors to behave any differently, in fact, it will just drive bad actors to practice more “in the dark.”

Recommendations 

AMP-MA respectfully recommends that H.5087 be amended to:

• Explicitly recognize the independent practice authority of Nurse Practitioners and Physician Associates
• Remove additional licensure requirements for Medical Aesthetic Spas
• Allow qualified non-physician providers to serve in clinical leadership roles where appropriate
• Replace rigid physical presence requirements with medical industry availability standards
• Remove levels of certification in lieu of the roles of individual boards and licensures that make this redundant
• Include representation from practicing medical aesthetic providers on any advisory or rulemaking committee and consult the industry before making unilateral decisions
• Provide reasonable transition provisions for currently operating compliant practices

 

Conclusion 

Overly restrictive requirements may reduce patient access to safe, regulated aesthetic services and inadvertently drive patients to unregulated settings or out-of-state providers.

Regulatory frameworks should support patient safety while maintaining reasonable access to qualified providers. AMPMA does not want our industry to be overregulated to the point that it drives practitioners out of the state, patients out of the state, or causes the practice of medical aesthetics to be driven “underground.” As such, our goal is to engage with legislators to ensure that H. 5087 aligns with current Massachusetts laws and regulations, while enhancing patient safety.

AMP-MA supports a balanced regulatory framework that protects patients while recognizing the qualifications of licensed medical professionals – including Nurse Practitioners, Physicians, and Physician Associates – who safely deliver aesthetic and medical care through Massachusetts daily.

We stand ready to serve as a resource to policymakers and regulators to ensure that any final legislation promotes safety, preserves access to care, and reflects the expertise of those who provide these services daily.

We would recommend that the Committee on Public Health table this legislation until we can work together collaboratively with the legislature and state regulatory bodies to come up with a solution by “beginning with the end in mind.” The goal should be patient and provider safety and identifying and targeting bad actors. Together, we can identify constraints in the current industry and address them. Please include our industry.

Respectfully submitted, 

Aesthetic Medical Providers of Massachusetts (AMP-MA)