What Business Owners Need to Know
The medical spa industry continues to grow rapidly across New York. Regulatory scrutiny is growing even faster.
In 2026, New York regulators have made one thing unmistakably clear: New York medical spas are now a priority enforcement target. Over the past year, state agencies have increased inspections, launched coordinated investigations, issued new public guidance, and expanded the work of a dedicated medical spa enforcement task force focused on unlicensed practice, improper supervision, deceptive advertising, and unsafe treatments.
If you own or plan to open a med spa in New York, compliance is no longer theoretical. It is an active and ongoing business risk. Remember that whether you call yourself a med spa or not does not matter.
This guide explains what med spa owners actually need to know to operate legally in New York and why enforcement activity has escalated so dramatically.
1. Spa vs. Med Spa. A Legal Distinction That Matters
One of the most common and costly mistakes we see is assuming that all services offered under the “med spa” label are treated the same under the law. They are not.
New York law draws a clear line between:
Appearance Enhancement Services
Non-medical services such as:
- Facials
- Waxing
- Eyelash extensions
- Non-invasive cosmetic treatments
These services may be performed by licensed cosmetologists, estheticians, or other appearance enhancement professionals regulated by the New York State Department of State.
Medical Services
Invasive or higher-risk procedures that constitute the practice of medicine, including:
- Botox and dermal fillers
- Laser and energy-based devices beyond basic hair removal
- Microneedling in many contexts
- CoolSculpting and cryotherapy
- GLP-1 weight loss injections such as Ozempic and Wegovy
- Hormone therapy and IV infusions
These services require medical licensure and medical oversight under New York law and fall under the authority of the New York State Education Department and, in some cases, the Department of Health.
Calling something “non-medical” does not make it non-medical. Regulators look at what you do, not what you call it.
2. Licensing and Supervision. Where Most Med Spas Get It Wrong
New York requires that medical procedures be performed by or under the supervision of appropriately licensed medical professionals, typically physicians.
That supervision must be real, not nominal.
Regulators are increasingly focused on:
- Paper medical directors who are not meaningfully involved
- Physicians who lend their licenses without actual oversight
- Practices where estheticians or cosmetologists perform medical procedures
Supervision is procedure-specific and may require (at a minimum):
- Physician availability and, sometimes, physical presence
- Physician-approved protocols
- Clear delegation and documentation
The idea that Botox, lasers, or injectables are “routine” or “non-invasive” does not remove them from medical regulation in New York.
3. Business Structure and the Corporate Practice of Medicine
New York strictly enforces the Corporate Practice of Medicine doctrine.
In most cases:
- Non-physicians cannot own or control medical practices
- Medical services must be provided through a physician-owned Professional Corporation or PLLC
- The entity must hold a Certificate of Authorization from the New York State Education Department
Most compliant med spas operate using:
- A physician-owned medical entity for clinical services
- A separate non-medical management company under a carefully drafted Management Services Agreement
If these arrangements are improperly structured, regulators may allege:
- Unauthorized practice of medicine
- Fee-splitting
- Fraud or deceptive business practices
We are seeing enforcement actions specifically targeting bad MSO structures, not just individual providers.
4. Who Regulates Med Spas in New York?
There is no single “med spa license” in New York.
Instead, med spas may be regulated simultaneously by:
- The New York State Department of State, which oversees appearance enhancement businesses and consumer protection
- The New York State Education Department, which licenses professionals and authorizes medical entities
- The New York State Department of Health, which regulates medical practice and facilities when applicable
This multi-agency framework is a major reason enforcement has increased. Agencies are now coordinating.
If your med spa blurs the line between beauty services and medical treatments, you may trigger oversight from multiple regulators at once.
5. Advertising, Pricing, and Consumer Protection
Beyond licensing, regulators are aggressively policing:
- Misleading or exaggerated advertising
- Overstated results or improper FDA claims
- Lack of price transparency
- Inadequate informed consent
Medical spas must:
- Clearly disclose who performs procedures
- Avoid deceptive marketing claims
- Provide accurate pricing information
- Maintain HIPAA-compliant records and consent forms
Consumer protection enforcement is often faster and more punitive than licensing discipline and easier for regulators to prove.
6. Increased Enforcement and the Med Spa Task Force
New York has publicly acknowledged a surge in unsafe and unlawful med spa practices.
Recent investigations have uncovered:
- Unlicensed injectors
- Expired or counterfeit injectables
- Physicians with no meaningful oversight role
- Improper use of compounded drugs
In response, the state has formed a medical spa enforcement task force and increased inspections, subpoenas, and coordinated actions across agencies.
Consequences we are seeing include:
- Civil fines
- License suspensions or revocations
- Forced closures
- Consent orders with strict ongoing monitoring
This is not a theoretical risk. It is active enforcement.
7. Insurance, Liability, and Adverse Events
Med spas offering medical services must carry appropriate professional malpractice coverage that aligns with the services actually provided.
General business liability insurance alone is not sufficient.
Practices should also have:
- Adverse event protocols
- Clear escalation pathways
- Documentation and reporting procedures
When something goes wrong, regulators often scrutinize everything, including licensing, structure, supervision, and advertising.
Best Practices for New York Med Spa Owners
If you operate or plan to operate a med spa in New York:
- Audit your services and confirm which are medical versus non-medical
- Verify licenses for every provider
- Ensure your business structure complies with CPOM rules
- Confirm physician oversight is real, documented, and defensible
- Review advertising, pricing, and consent materials
- Stay current on regulatory guidance and enforcement trends
Bottom Line: 2026 Is a Turning Point for New York Med Spas.
New York is taking med spa regulation seriously, and in 2026 enforcement is no longer reactive. It is proactive.
Whether you are launching a new med spa or operating an established one, compliance is not a box-checking exercise. It is foundational to protecting your business, your licenses, your reputation, and your patients.
At Lengea Law, we work exclusively with medical aesthetics and healthcare businesses nationwide, including New York med spas facing heightened scrutiny from multiple regulators. We help owners structure their businesses correctly from day one and fix compliance gaps before they become enforcement actions.
Do not wait for an investigation to reveal where you are exposed.
Contact us to schedule a compliance review or strategic consultation.