Page 13 - Katten Kattwalk and Kattison Avenue - Winter 2026 - Issue 5
P. 13
cannot control clinical decisions. In others, nurse Recent Business and Legal Developments to Watch
practitioners or physician assistants may own
or co-own; in further others, lay ownership is With the increasing popularity of med spas, state
legislatures and medical boards are recalibrating med
permissible but does not excuse compliance with
medical practice rules. Where CPOM applies, the spa rules. Several 2024-2025 developments illustrate
the trajectory:
MSO PC model is common, where a physician-
owned professional entity retains clinical control; • States are formalizing licensing and facility
a separate management services organization standards. Rhode Island enacted legislation to
provides non-clinical support for fair market value regulate and license medical spas, reflecting a
fees that comply with fee splitting restrictions. broader move toward clearer facility oversight.
Other states are considering or adopting
2. Scope of practice, delegation and supervision. requirements for posted physician oversight,
States define who may perform injectables, written protocols and emergency preparedness.
laser/energy procedures and invasive skincare,
and what supervision is required. Many require • Supervision and delegation are tightening. Texas
a physician, nurse practitioner or physician advanced measures classifying med spas and IV
assistant to conduct a “good faith” evaluation clinics as regulated medical practice settings and
before treatment; some prohibit delegation of requiring policies on delegation, supervision and
specific laser uses, and most strictly limit what training; proposals would require initial clinical
estheticians may perform without medical assessments and posted notices when a physician
licensure. Violations (e.g., unlicensed practice, is not on site. Courts and boards continue to
inadequate supervision or “rent a medical hold medical directors liable for inadequate
director” arrangements) are leading enforcement supervision, even when they did not personally
targets. perform procedures.
3. Advertising and endorsements. The FTC polices • Scrutiny of ownership and management services
deceptive or unsubstantiated claims, guarantees organizations (MSO) is rising. Regulators have
and undisclosed paid endorsements; state questioned “straw” physician ownership and man-
boards often regulate use of titles, testimonials agement contracts that encroach on clinical con-
and before and after depictions. Claims must be trol. Both Oregon and California moved to restrict
evidence-based, risks must be disclosed, photos certain MSO practices, and boards in other states
should be representative and non misleading, have issued guidance warning against arrange-
and influencer posts must be properly labeled. In ments that mask lay control over medicine.
fashion collaborations, both the brand and the • Scope of practice adjustments continue. States
provider can be accountable for noncompliant are updating who may do what and under whose
messaging.
supervision. Notable actions include licensing
4. Privacy, safety and product integrity. With the frameworks for advanced estheticians and
rise of “medical influencers” on social media, modifications to master the esthetician scope;
patient images and encounters are increasingly some states limit the delegation of lasers to
shared online, sometimes in real time. As specific license types.
health care providers, med spas must protect • Enforcement is active and multifront. Boards and
patient information under HIPAA and state attorneys general have pursued cases involving
privacy laws, especially when using imagery or unlicensed practice, misleading advertising,
engaging in digital marketing. US Food and Drug improper use of medical titles, and counterfeit
Administration (FDA) oversight touches devices or unapproved drugs. FDA and pharmacy boards
and drugs; recent warnings emphasize counterfeit have focused on compounding and sourcing
or unapproved injectables and compounding for injectables; Occupational Safety and Health
limits for popular weight loss medications.
Administration (OSHA) and HIPAA enforcement
remain evergreen risk areas.
13
