Intravenous (IV) hydration, once strictly provided as medication in a hospital, is now available in spa settings, at home, and it can even be ordered at some hotels like room service. Whether it’s a hangover treatment, anti-aging serum, or just a vitamin boost, IV hydration is being offered practically everywhere. Given the casual attitude around these kinds of treatments, it may seem like the legal framework is equally casual.


For med spas with robust menus that already operate in the surgical and prescriptive space, IV therapy fits right into the medical practice structure. But if a business exclusively offers IV therapy, does it constitute a medical practice on its own? If so, what rules apply? 


The Legal Practice of Medicine


In most states, although IV therapy may be referred to as a cosmetic treatment, it is still classified legally as practicing medicine because it is performed via injection. Accordingly, only trained and licensed medical professionals may perform the service. Some states may have supervision requirements and special IV training requirements; other states may have limitations on where IV therapy may be performed, such as in a clinic, a dedicated “IV Bar,” or in a patient’s home. Generally, though, IV hydration businesses do fall into the category of a full medical practice.


In most states, a business that practices medicine must be owned by medical professionals. This means that unless a business is owned by physicians, it is not allowed to hire medical professionals to practice medicine. New York is an example of a state with a strong stance on the Corporate Practice of Medicine. There, an IV hydration business must be owned by a physician or Nurse Practitioner with full practice authority. Florida is on the other end of the spectrum and does not have as many ownership restrictions, so hiring a medical director or physician by a non-medical corporation is permitted. 


Of course, even in the most restrictive states, there are legal workarounds. For example, an IV therapy business can be incorporated as a professional medical company owned by medical professionals but still be able to hire a Management Service Organization to take care of day-to-day business operations. (See this blog post for more information on these rules, known as the Corporate Practice of Medicine Doctrine and MSO Structure.) 



Performing IV Hydration


Once an IV hydration business is formed correctly, it is crucial to make sure that all the procedures are provided legally. Injecting any fluid intravenously is unambiguously defined as a medical service that may only be provided by licensed medical professionals following the applicable rules of medical care, such as secure record keeping and a good-faith examination to establish a relationship between a patient and a practitioner with prescriptive authority. 


Generally, physicians, nurse practitioners, physicians assistants, and registered nurses may perform IV services within their scope of practice. Many states also allow Licensed Practical Nurses (LPNs/LVNs) to provide IV services as long as they are supervised by a physician on-site or nearby in case of an emergency. Some states may allow medical assistants to initiate or assist with IV services under the direct presence of a physician or in an emergency. 


In many states, an IV therapy business may be required to be specially licensed, and as a general rule it’s always a good idea to have robust insurance for both the business and the practitioners. The equipment you are using must be certified and up to date while all sterile protocols must be strictly followed, including medical practice standards and federal workplace safety guidelines. This may seem like a lot to worry about, but with the proper staffing, training, and legal advice, any IV hydration business can be set up to operate in compliance with the law. 


Licensing and Mobile Services


Some states prohibit mobile, concierge, or at-home services entirely; other states, like Florida, permit outside-the-office services as long as practitioners obtain additional licensure for at-home infusion services. A few states have vague guidelines or no legislation, meaning that it’s possible to operate in the gray zone for now, but a new law might get written and put you out of business. 


To avoid any issues, it is critical to have a competent attorney who is knowledgeable about your state’s laws and regularly completes compliance reviews for your business. Whether you’re just starting an IV hydration business or want to grow your operation, the right attorney will give you an advantage over your competition and ensure a smooth ride across the ever-changing legal landscape of this growing and exciting industry. 


*This blog post is for informational purposes only and does not constitute legal or medical advice or the forging of an attorney-client relationship. Please retain the services of a licensed attorney to discuss the ways the law applies to your business.