Big news for Texas med spa owners, IV hydration businesses, nurse practitioners, and wellness professionals:
House Bill 3749 (HB 3749) is scheduled for a hearing in the Texas House Public Health Committee on April 28, 2025, and we now have word from trusted sources that the bill has been significantly revised. The public hearing will be at 8:00 am Central Time, broadcast live at this link https://house.texas.gov/videos.
Under the revised version, the bill no longer impacts cosmetic medical procedures such as Botox, fillers, or laser treatments. Instead, HB 3749 now focuses exclusively on elective IV therapy — a welcome development for most med spas, but still critical for businesses that offer hydration therapy.
At Lengea, we’ve helped hundreds of aesthetic and wellness businesses navigate Texas law, and we’re sounding the alarm: This bill could severely limit access to care, increase overhead costs, and sideline qualified providers like EMS or paramedics from providing IV therapy services.
What Does HB 3749 Propose?
The updated bill no longer applies to cosmetic procedures or med spas in general. Instead, it focuses exclusively on elective IV therapy.
Key concerns include:
- Limiting the pool of possible providers for IV Therapy businesses could lead to increased competition and higher labor costs.
- Discouraging entrepreneurship by preventing qualified providers like EMS or paramedics from opening and providing services at their own IV Therapy business.
- Reducing access to IV therapy in rural and underserved areas where there are a limited number of licensed RNs, PAs, APRNs, and physicians.
Key Provisions of SB 378
SB 378 proposes amendments to the Texas Occupations Code, specifically targeting the practices of barbers and cosmetologists:
- Prohibition of Certain Medical Procedures: Barbers and cosmetologists would be prohibited from:
- Making incisions into the dermis layer of the skin, including for the purpose of injecting medications or other substances.
- Using devices as defined by Section 551.003 of the Texas Occupations Code, which includes prescription medical devices.
- Licensing Requirements: Individuals holding a barbering or cosmetology license may perform the aforementioned procedures only if they are separately licensed or authorized by law to do so.
- Enforcement and Burden of Proof: In disciplinary actions related to violations of these provisions, the license holder bears the burden of proving they are authorized to perform the act in question.
- Clarification of Regulatory Authority: The bill does not affect the authority of other state agencies regulating medical professions to enforce relevant laws. Properly trained providers that lack a medical or nursing license may still be able to provide these services under the Medical Board’s rules with proper physician supervision and delegation protocols in place.
Why Med Spas Should Still Pay Attention:
Just because the scope has been limited does not mean med spas are in the clear. These restrictions would apply to every business providing elective IV therapy. Under the substitute language:
- Only physicians, NPs, PAs, RNs, and other persons licensed by the Texas Board of Nursing can administer elective IV therapy.
- Estheticians, EMTs, firefighters, and unlicensed medical assistants—even those operating under a physician’s oversight—would no longer be allowed to place IVs or administer IV drips.
- This will directly impact IV businesses and med spas with hybrid wellness offerings that rely on qualified staff who lack the necessary licenses.
Even with the narrowed scope, this bill could:
- Force staffing changes and increase costs for any med spa offering IV hydration services.
- Prevent the use of trained EMTs and other professionals who are currently providing safe, compliant care under current board-approved delegation and supervision models.
- Introduce new barriers to access for patients and business owners in rural and underserved areas.
If you are…
- An IV hydration provider or business owner in Texas
- Concerned about your practice model, ability to staff your business, or job security
- Frustrated by inconsistent enforcement across the industry
Now is the time to raise your voice.
How to Take Action
We encourage all Texas-based clients and colleagues to submit written testimony or contact your local representative before the hearing.
Key Resources:
- Find your representative: https://wrm.capitol.texas.gov/home
- Public Health Committee Members: https://house.texas.gov/committees/committee/?committee=C410
Sample Email You Can Send
Feel free to copy and paste this message, personalize it with your story, and email it to your representative and committee members:
Subject: Opposition to HB 3749– Impact on Patient Access & Med Spa Operations
Dear Representative [Last Name],
My name is [Your Name], and I am a [your title: nurse practitioner / nurse / PA / business owner / paramedic] in [Your City], Texas.
I am writing to express my strong opposition to HB 3749, which would require physicians to be physically present at med spas where aesthetic procedures are performed. While I fully support patient safety and appropriate oversight, this bill goes too far and will:
- undermine existing supervision protocols that already protect patients;
- disrupt collaborative care models that have safely served thousands of Texans; and
- create unnecessary barriers for aesthetic providers, especially in rural and underserved areas.
As a licensed and responsible provider, I urge you to reject this bill and, instead, support thoughtful, balanced regulation that reflects the realities of modern, team-based aesthetic care.
Please consider revisions that protect patient safety without removing highly trained providers from the care team.
Thank you for your time and service to our community.
Sincerely,
[Your Full Name]
[Credentials]
[Business Name, if applicable]
[Email & Phone Number]
What Happens Next If HB 3749 and SB 378 Pass the Committees?
If the Committee approves the bill, here’s what happens next:
- House Calendars Committee – Decides whether to schedule a full House vote.
- Texas House Vote – Full House debates and votes.
- Senate Review – Assigned to a Senate committee, then full Senate vote.
- Reconciliation – House and Senate must agree on the final version.
- Governor’s Desk – The Governor can sign, veto, or let it become law.
The Texas legislative session ends June 2, 2025—so the next few weeks are critical.
Let’s Protect the Future of Aesthetics in Texas
Lengea will continue to advocate for smart, balanced regulation in the med spa and wellness space. If you’d like to speak with an attorney about how HB 3749 and SB 378 could affect your business—or want help organizing your team to take action—we’re here to help.
Contact us: (646) 396-0804
Email: team@lengealaw.com
The hearings are on April 28th and 29th. Let your voice be heard before it’s too late.