Med Spas Face Major Changes After IV Therapy Death Sparks “Jenifer’s Law” in Texas

Texas nurses working in medical spas face significant practice changes following the Texas Senate's passage of House Bill 3749, known as "Jenifer's Law." The bill, now awaiting Governor Abbott's signature, would establish strict regulations on who can administer intravenous (IV) treatments in medical spa settings across the state.

The legislation emerged from tragedy. Jenifer Cleveland died after receiving an IV treatment containing Total Parenteral Nutrition (TPN), a hospital-grade nutritional infusion, at Wortham Med Spa in San Antonio. Critically, this treatment was administered by an unlicensed individual without proper medical training or supervision.

Key provisions of HB 3749 include:

• Requiring a licensed physician to serve as the medical director of every medspa.
• Mandating that a physician perform an initial assessment and prepare a written treatment plan for each patient receiving cosmetic procedures or elective IV therapy.
• Limiting the delegation of IV therapy: Only physicians, physician assistants, advanced practice registered nurses (APRNs), or registered nurses (RNs) may administer elective IV therapy, and only under physician supervision.
• Notably, the bill would prohibit paramedics and EMTs from administering elective IV therapy in these settings.
• Increasing requirements for on-site physician presence and supervision during procedures.
• Reclassifying medspas as medical practice settings, subjecting them to the same regulatory standards as traditional medical practices.

Impact on nurses:

• Nurses (RNs and APRNs) would still be allowed to administer IV therapy, but only under stricter physician oversight and delegation.
• The bill would significantly change operational protocols for medspas, increasing compliance costs and limiting the autonomy of non-physician providers.
• For nurses practicing in aesthetic medicine, this legislation creates clear professional boundaries. 
• Under the proposed law, physicians may only supervise and delegate elective IV therapy duties to qualified medical professionals—specifically registered nurses, advanced practice registered nurses, or physician assistants. 
• This represents a significant shift in the regulatory landscape for medical spas, which have operated with varying levels of oversight across Texas.

The bill passed unanimously in the Texas House of Representatives on May 15, 2025, demonstrating rare bipartisan agreement on the need for increased patient protections in this growing industry. Representative Angelia Orr filed the legislation, which focuses specifically on the administration of elective IV therapies—treatments that have become increasingly popular in med spas for purposes ranging from hydration to vitamin infusions.

For registered nurses working in aesthetic medicine, this legislation validates their specialized training and scope of practice. It also establishes clear expectations for employers and physicians regarding appropriate delegation of IV therapy procedures. Advanced practice nurses may find new opportunities in medical spa settings as the industry adjusts to these requirements.

If signed by Governor Abbott, Jenifer's Law would take effect on September 1, 2025. Medical spas would then have to ensure compliance by employing appropriately licensed professionals for all IV therapies. For facilities currently using unlicensed staff for these procedures, this will necessitate significant operational changes.

Nurses practicing in or considering employment at medical spas should verify that their potential employers understand and comply with these new requirements. The legislation represents an important step toward ensuring that patients receiving elective IV treatments benefit from the same safety standards and professional oversight they would expect in traditional healthcare settings.

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