Summary: Texas has restructured its medical spa regulations under Title 22, Rule § 169 of the Texas Administrative Code (Rule § 169), focusing on clearer delegation, supervision, and written protocol requirements. Med Spa owners should update their practices to ensure compliance with these changes, including proper training, written orders, and necessary signage. This is a key opportunity to streamline operations and enhance patient safety.
Key Changes in the New Rules:
- Reorganization and Simplification:
- The provisions previously encompassed in Title 22, Rule § 193.17 of the Texas Administrative Code (“Rule § 193.17”) are now distributed among four distinct rules under Title 22, Subchapter E—Other Delegated Acts. This restructuring has resulted in a more concise set of regulations, eliminating approximately 50% of the requirements and text of former Rule § 193.17. .
- Clarification of Delegation Standards:
- Rule § 169.25 emphasizes that non-surgical medical cosmetic procedures constitute the practice of medicine and must be appropriately delegated and supervised.
- Rule § 169.26 outlines general standards for delegation, requiring physicians to ensure that delegatees possess proper training and that a signed written protocol is in place. Physicians must also be trained in the procedures they delegate. Prior to delegation, a physician, physician assistant (PA), or advanced practice registered nurse (APRN) must establish a practitioner-patient relationship, maintain medical records, disclose the credentials of the individual performing the procedure, and ensure the presence of at least one person with basic life-support training onsite. Additionally, supervision mandates that the physician, PA, or APRN be onsite or immediately available for emergency consultation.
- Written Orders and Protocols:
- Rule § 169.27 addresses the responsibilities of delegating physicians concerning written orders, which are akin to the “written protocols” in the former Rule § 193.17. Physicians must develop or review and approve these orders, which should include the identity of the delegating physician, criteria for patient selection, descriptions of appropriate care, and procedures for handling emergencies or complications.
- Notice and Identification Requirements:
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- Rule § 169.28 mandates that the names of delegating physicians and the required complaint notification per Title 22 Rule § 177.2 of the Texas Administrative Code be displayed in public areas and treatment rooms of the facility. Additionally, all individuals performing delegated medical acts must wear name tags that identify their name and license or credential.
Implications for Texas Medical Spa Practices:
For medical spa practices in Texas, this restructuring presents an opportune moment to review and update existing policies and procedures to ensure alignment with the new rules. Practices that were not fully compliant with the former Rule §193.17 should take this opportunity to establish a uniform compliance approach. Even for those previously in compliance, it is advisable to assess current practices to determine if any updates are necessary under the new regulations.
Recommended Actions:
- Review and Update Protocols: Examine current delegation protocols and written orders to ensure they meet the requirements outlined in Rules § 169.26 and § 169.27.
- Training and Supervision: Confirm that all personnel involved in performing delegated procedures have received appropriate training and that supervision protocols comply with the new standards.
- Compliance with Notice Requirements: Ensure that the names of delegating physicians and the required complaint notifications are prominently displayed in all public areas and treatment rooms, and that staff members wear appropriate identification badges as specified in Rule § 169.28.
By proactively addressing these changes, Texas medical spa practices can enhance compliance, improve patient safety, and streamline operations in accordance with the updated regulatory framework.