As a business owner in the Texas med spa industry, I, along with my employees and clients, am facing an imminent threat to our businesses and livelihoods due to House Bill 3749. If passed in its current form, this bill will severely restrict how medical professionals operate within med spas, making it nearly impossible for nurse practitioners (NPs) and physician assistants (PAs) to perform essential services. This unnecessary restriction could force nearly 90% of Texas med spas to shut down, putting thousands of hardworking Texans out of work and drastically limiting patient access to safe, affordable aesthetic care.

HB 3749, while well-intentioned, is not making the industry any safer. We believe it will eliminate competition, drive up prices, create undue hardship for hundreds of small business owners. We urge Texas lawmakers to reconsider the parameters of this bill and work with industry professionals to create fair, effective regulations that protect both patients and businesses. Join us in opposing HB 3749 to preserve patient choice, professional autonomy, and the thousands of jobs at stake in the Texas med spa industry. 

Please sign this petition to make your voice heard and join the fight for what's right.

---- Letter to the Public Health Committee Chair ----

Mr. Crownover,

Three bills have recently been referred to your committee that could seriously disrupt, if not entirely shut down, many med spas throughout the state if passed in their current form.

As of 2023, there were approximately 2,000 med spas operating in Texas. We estimate these bills would shut down about 90% of those med spas, many of which are Texas small businesses, and put their employees out of work.

All three bills would also take a great leap backward in established medical practice by severely restricting the ability of physicians to delegate to physician assistants (“PAs”) and nurse practitioners (“NPs”). These bills threaten patient access, thousands of businesses, and professional autonomy. 

Each of these bills propose severe restrictions on how med spas operate. If passed in their current form:

HB 3749 Specifically targets med spas by prohibiting physicians from delegating good faith exams, diagnosis, and treatment plans to PAs and NPs. This means good faith exams and initial patient visits could only be done by a physician. It would also require physicians to be able to be immediately present on-site.

HB 3890  Prevents physicians from delegating prescriptive authority to NPs or PAs if outside the scope of the physician's residency training or primary medical practice, unless the physician has not less than five years of previous practice experience in that specialty While this bill could impact other specialties, it would drastically limit who can work in a med spa setting and would likely have the effect of making it so that essentially only dermatologists and plastic surgeons could operate a med spa, which has long been a goal of many dermatologists and plastic surgeons in Texas. (HB 3890 is a refile of HB 3229 from last session, which did not receive a hearing in House Public Health. Last session’s companion, SB 1959, did not receive a hearing in Senate Health and Human Services and was not refiled).

HB 3889 Requires a physician to establish a direct patient-physician relationship before an NP or PA can prescribe any controlled substance, further delaying and complicating care. While the implications of this bill go well beyond the med spa industry, this bill is also of great concern to med spas, as it severely limits access to care. (HB 3889 is a refile of HB 3230 from last session, which did not receive a hearing in House Public Health).

HB 3749 is widely reported as having been born of a tragedy – the senseless and terrible death of a mother of four who died receiving an IV infusion in Texas in 2023.  The bill contains many laudable elements, elements that we wholeheartedly support. For example, most provisions in the bill are equivalent or nearly equivalent to existing Texas Medical Board rules that are already the law in Texas. 

However, there are some provisions in HB 3749 that, if passed, would put the vast majority of Texas med spas out of business. HB 3749 would also severely limit competition, drastically drive up prices for consumers, and make Texas one of the most heavily regulated states when it comes to med spa procedures.

What happened to Jenifer Cleveland was unconscionable. It was also illegal. While, as mentioned before, many elements in HB 3749 are not objectionable and are, in fact, already the law, the provisions cited above will not advance patient safety. Rather they will shut down almost all med spas in Texas and put thousands out of work, while consolidating the ability to run a med spa into the hands of a select few.

Summary

We look forward to working with the authors of these bills to share these concerns, some of which they might not be aware of, and recommend modifications, where possible.

However, as filed, the three bills threaten the livelihoods of thousands of Texans.