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PENNSYLVANIA MEDICAL SPA REGULATIONS AND GUIDELINES

The following information is not meant to provide any legal advise and it is recommended you check with your your respective state boards, attorney, or malpractice carrier to ensure you are practicing within the letter of the law.  Regulations regarding aesthetic treatments and medical spas vary from state to state and can also change .

Which procedures at medical spas constitute medical treatment?

Pennsylvania  defines a cosmetic medical procedure as any procedure performed on a person that is directed at improving the person’s appearance and that does not meaningfully promote the proper function of the body or prevent or treat illness or disease.   The following procedures are including in a cosmetic medical procedure:  hair transplants, cosmetic injections (botulinum toxins and soft tissue fillers) dermaplaning, dermastamping, dermarolling, dermabrasion that removes cells beyond the stratum corneum, chemical peels using modification solutions that exceed 30% concentration with a pH value of lower than 3.0, laser hair removal, laser skin resurfacing, laser treatment of leg veins, sclerotherapy and other laser procedures, IPL and the use of class II medical devices designed to induce deep skin tissue alteration.

Who can own a medical spa?

A medical spa is considered a medical practice.  Therefore, every medical spa must be owned by a physician or a physician group.

Pennsylvania has a corporate practice of medicine doctrine meaning that physicians cannot be employed by non-physicians, and an entity that practices medicine may only be owned by licensed physicians. 

What type of training is needed?

 

Pennsylvania requires that any physician, physician assistant, advanced practice nurse or registered nurse who performs cosmetic medical procedures must a) be actively practicing in the state; and b) have received education or training from an institution of higher education or professional organization to perform cosmetic medical procedures and have experience performing such procedures.

Who can perform the procedures?

Only a physician, physician assistant, advanced practice registered nurse or registered nurse may perform the cosmetic medical procedures identified above.

Is a good faith examination needed?

Yes.  A physician, physician assistant or advanced practice registered nurse must perform an initial physical assessment.

If I’m not a doctor, can I employ a “medical director” to provide medical services for my medical spa?

 

No.  For the reasons stated above, having just a “medical director” on staff will not satisfy the regulatory requirements.

For a more complete list of questions and answers (see below) regarding regulations for the med spa, click https://facemedstore.com/products/state-by-state-rules-regulations-for-aesthetic-medicine-and-medical-spas. In addition, you will get a referral to an attorney specializing in medical spas and aesthetic practices.

If I’m not a doctor, can I share in the profits of a medical spa?

Can a nurse, physician assistant or nurse practitioner take a commission for administering laser treatments or injectables like Botox?

Can a physician assistant practice independently

How many physician assistants can a physician supervise?

Can a certified registered nurse practitioner (“CRNP”) practice independently? 

Do I have to be a doctor to own medical spa equipment, like lasers, or real estate?

Do I need to charge sales tax on procedures like Botox?

Who can legally fire a laser under Pennsylvania law?  

Does a physician need to be on site during laser and intense pulse light (IPL) devices?

Can an Aesthetician perform laser procedures? 

What kind of physician supervision is needed for a registered nurse (RN) in a medical spa? 

Is Informed Consent required?  

Does a medical spa need to obtain a license to operate? 

Must I follow OSHA regulations? 

What type of records are medical spas required to keep of their patients? 

How long do I have to keep the patient’s records?  

Can a med spa text or email patients to convey confidential medical information? 

Are Botox parties legal?   

What type of insurance does a medical spa need?  

What type of information must a medical spa post?   

Guidelines for Medical Spas in New Jersey

These are merely guidelines and represent a legal opinion. It is advisable to consult with an attorney as well as your malpractice carrier to ensure you are compliant with all the regulations. Nothing in this blog is meant to constitute legal advise.

Given the rapid growth of the medical spa industry, there is tremendous variation from state to state about the requirements for a medical spa in terms of ownership as well as who can perform the procedures.  In addition, different boards within the same state may have conflicting or differing guidelines.  For example a board of nursing may allow a nurse to perform a procedure under the supervision of a physician however the board of medicine may not allow a physician to delegate certain procedures.  If there is a poor outcome, then the supervising physician will be held to the more stringent guidelines of his/her own board even if the nurse performed the procedure.

In New Jersey, only a physician or physician group can own a medical spa.  There may be certain work arounds to this such as a MSO or medical service organization which can only help with operations and administration and should have no bearing on the medical treatment.

The most important aspect is who can performed procedures in a medical spa. In New Jersey, In terms of laser based services, a physician can delegate certain procedures like laser hair removal, infrared devices ( this can include YAG and non ablative erbium devices) and IPL to a physician assistant or a nurse.

A physician cannot delegate the use of radiofrequency to anyone.  This applies to all radiofrequency devices including RF microneedling. 

In terms of ablative treatments, such as a CO2 laser or ablative erbium laser, only a physician should be performing these treatments. 

The NJ BOME proposed regulations prohibit a physician from delegating the performance of fillers or neuromuscular blockers to anyone. Proposed regulation N.J.A.C. 13:35-6.14B. This certainly is not followed in New Jersey where may of these procedures are performed by physicians assistants and nurses (nurse practitioners)

The physician can only delegate the task to a PA or RN after the physician has personally examined the patient. Thereafter, the physician does not have to be physically on site during the procedure, but will have to be in communication via phone or email. Coolsculpting would be included in this category.

For a more complete list of answers to commonly asked questions, you can purchase documents for each state here. 

https://facemedstore.com/products/state-by-state-rules-regulations-for-aesthetic-medicine-and-medical-spas

 

Which procedures at medical spas constitute medical treatment? 

Can an aesthetician perform laser procedures? 

Who can own a medical spa? 

What type of training is needed? 

Who can perform the procedures? 

Is a good faith examination needed? 

If I’m not a doctor, can I employ a “medical director” to provide medical services for my medical spa? 

If I’m not a doctor, can I share in the profits of a medical spa? 

Can a nurse, physician assistant or nurse practitioner take a commission for administering laser treatments or injectables like Botox?

Can a physician assistant practice independently

How many physician assistants can a physician supervise? 

Can an advanced practice registered nurse practice independently? 

Do I have to be a doctor to own medical spa equipment, like lasers, or real estate?

Do I need to charge sales tax on procedures like Botox?

Who can legally fire a laser under New Jersey law? 

Does a physician need to be on site during laser and intense pulse light (IPL) devices? 

Can a dentist inject Botox? 

Is Informed Consent required? 

Does a medical spa need to obtain a license to operate? 

Must I follow OSHA regulations? 

What type of records are medical spas required to keep of their patients? 

How long do I have to keep the patient’s records?  

Can a med spa text or email patients to convey confidential medical information? 

Are Botox parties legal?

What type of insurance does a medical spa need? 

What type of information must a medical spa post? 

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