Texas Medical Spa Lawyers

Open a Med Spa in Compliance with Texas Laws with Experienced Legal Counsel

Medical spas are growing in popularity and profitability, which is attracting new providers and investors to the market. Medical spa services, however, are closely regulated by the Texas Medical Board, the Texas Department of License and Regulation, and the Texas Department of State Health Services, along with federal regulatory agencies. These regulators have been quick to crack down on med spas that do not follow the rules.

To avoid government scrutiny, medical spa owners and affiliates must comply with all relevant regulations, including Texas’ Corporate Practice of Medicine (CPOM) doctrine, Stark Law, and the Anti-Kickback Statute (AKS).

At Hendershot Cowart P.C., we help physicians, health care entrepreneurs, registered nurses (RNs), licensed vocational nurses (LVNs), and physician assistants (PAs) participate in the booming medical spa market using compliant business models and structures. We have over 100 years of collective experience in health and medical law, helping healthcare clients set up enterprises that flourish under a compliant model.

Call us at (713) 783-3110 to discuss your goals for a medical spa practice in Texas.

What Is a Medical Spa?

A medical spa or med spa is a traditional day spa combined with a medical clinic that offers non-invasive medical cosmetic procedures. While licensed estheticians can provide facials, massages, and other non-medical skin care, all medical procedures must be performed under the supervision of a licensed physician.

Because of this, medical spas are considered a medical practice and regulated by the CPOM doctrine and other healthcare-specific rules and regulations.

Our Texas med spa attorneys can help you keep your practice compliant.

Which Med Spa Treatments Are Considered the Practice of Medicine in Texas?

Several med spa procedures cross the line into the practice of medicine. The Texas Administrative Code describes these as “nonsurgical medical cosmetic procedures” and requires that a physician, or properly supervised midlevel practitioner (such as a PA or APRN), perform an appropriate patient examination and issue an order for the recommended treatment.

Nonsurgical medical cosmetic procedures include but are not limited to “the injection of medication or substances for cosmetic purposes” and “the use of a prescription medical device for cosmetic purposes.”

Common medical spa treatments that fall into this category include:

• Dermal fillers (Botox, Dysport)
• Coolsculpting
• Hormone replacement therapy
• Microdermabrasion and dermaplaning
• Microneedling and microblading
• Laser hair removal and intense pulse light therapy (photofacials)
• Platelet-Rich Plasma injections (O-shot)

In Texas, only licensed physicians can order these medical procedures without supervision.

Who Can Open a Med Spa?

Texas’ Corporate Practice of Medicine doctrine prohibits non-physicians from owning a medical practice or employing physicians. The intent of the law is to prevent undue control or influence over a licensed physician’s professional medical judgment, ethics, and patient care. As a result, only licensed physicians can own a medical practice, including med spas. Physician assistants can own shares of med spas, or be minority partners, but at least one physician must be the majority owner.

This does not mean that non-physicians cannot participate in the day-to-day operations of a med spa. In many cases, a physician can own the medical practice while an affiliated management services organization (MSO) manages the non-medical aspects of the practice.

To learn more about owning a med spa, please read our blog, “Can a Non-Physician Own a Med Spa?”

Call us at (713) 783-3110 to discuss your goals for a medical spa practice in Texas.

Are There any Other Laws or Regulations to Be Aware of?

There are several other regulations that may apply to services offered by a med spa. The Texas Medical Board only regulates the practice of medicine. Whereas, some popular procedures offered by med spas, including laser hair removal and microblading, are regulated by other state agencies. Our attorneys can help you navigate the multitude of regulations that apply to your med spa treatment offerings.

MSOs Help Non-Physicians Participate in Med Spa Operations

Management services organizations are stand-alone entities set up to handle the administrative operations of a medical practice through a management services agreement. 

These operational duties may range from:

• Procurement of office space and medical equipment
• Management of finances
• HR and payroll
• Staff training
• Coding, billing, and collections
• Oversight of regulatory compliance
• Electronic medical record services
• Marketing and branding
• And more

Entrepreneurs and providers beware, however: Merely structuring a management services agreement and launching an MSO does not mean that your practice will comply with the state and federal laws that regulate med spas. To structure a compliant MSO, a management services agreement will have to meet a number of specific elements, including requirements that the agreement:

• Be in writing;
• Persist for a period of one year;
• Identify all of the services that are being rendered; and
• Ensure cumulative compensation to be paid on an annual basis is set in advance at a fair market value (FMV) that does not take into account the value or volume of any referrals or other businesses generated between the parties

Hendershot Cowart P.C. Can Help You Structure a Compliant Medical Spa in Texas

Often med spa owners and investors think they are safe simply because they have never been the subject of an investigation or complaint. We urge you to double-check your compliance before a problem arises. Contact Hendershot Cowart P.C. today to review your existing med spa’s arrangements or advise you on the best structure for a new med spa business.

If you are opening a med spa in Texas or simply want to evaluate your practice for compliance, please call us at (713) 783-3110 or send us a message online. We hope to be your attorneys for the life of your healthcare business.