As regulatory oversight of medical spas continues to evolve in Texas, House Bill 3749 (HB 3749) has taken a notable turn. In a shift from the bill’s original intent to more thoroughly regulate med spas and cosmetic procedures, earlier this month, the Texas House Public Health Committee adopted a narrower version of HB 3749 that focuses exclusively on elective intravenous (IV) therapy administered outside traditional medical settings. For most med spa operators that do not offer IV therapy, the status quo remains unchanged, and HB 3749 no longer presents immediate challenges to ongoing operations, as long as such operations are compliant with existing laws and regulations.
As McGuireWoods previously covered, HB 3749, originally introduced in March 2025, sought to establish a restrictive regulatory framework for med spas. As originally proposed, the bill required additional physician supervision (including the requirement that physicians conduct initial patient assessments prior to med spa services being rendered), training and oversight requirements for Texas med spas. Operators and lobbyists challenged the bill as overly restrictive.
Revised Scope of HB 3749
The substitute version of HB 3749 eliminates all provisions related to med spas and cosmetic procedures. The revised bill solely regulates elective IV therapy provided outside of a physician office, licensed healthcare facility or hospital. Revised HB 3749 passed the House and is pending review by the Texas Senate Health &Human Services Committee. If enacted, the bill will take effect Sept. 1, 2025, formally codifying requirements around elective IV therapy services delivered outside of clinical environments.
Revised HB 3749 specifies the following.
- Elective IV therapy refers to the intravenous administration of fluids, nutrients, medications or blood into a patient’s vein for the purpose of temporary symptom relief or wellness enhancement and only applies when provided outside traditional medical settings, such as physician offices, licensed health facilities, mental hospitals and state-operated hospitals.
- Physicians may delegate prescriptive authority of elective IV therapy to physician assistants (PAs) and nurse practitioners (NPs), provided they are acting under a physician’s delegated prescriptive authority and supervision.
- Administration of IV therapy can be delegated to PAs, NPs or registered nurses acting under adequate physician supervision.
Considerations for Med Spas
Revised HB 3749 represents a departure from the original scope and no longer applies to traditional med spas that focus on aesthetic services, such as injectables and lasers. However, the initial push for expanded regulation, paired with the attention this bill garnered, signals a growing legislative interest in the wellness sector. Med spa operators, investors and providers who render aesthetic services in Texas should remain vigilant as additional efforts to regulate cosmetic procedures may reemerge in future sessions.
McGuireWoods and McGuireWoods Consulting continue to monitor progress of this bill. For questions about how HB 3749 may impact your business or to request a compliance review, contact one of the authors.
