Texas: what Jenifer's Law (HB 3749) means for med spas

Key facts:

• Texas HB 3749 (Jenifer's Law) took effect September 1, 2025.
• It regulates elective IV therapy provided outside a hospital or doctor's office.
• A physician, NP, or PA must evaluate the patient before an elective IV, which is a Good Faith Exam (GFE).
• Only a physician, NP, PA, or RN can start and administer the IV.
• It adds no new state requirements for injectables, laser, or other cosmetic procedures.

What is Jenifer's Law (HB 3749)?

HB 3749 is a Texas law named for Jenifer Cleveland, who died in 2023 after an IV infusion at a med spa in Wortham, Texas. Governor Greg Abbott signed it into law on June 20, 2025, and it took effect September 1, 2025. You can read the enrolled bill text on the Texas Legislature site.

The first draft was sweeping. It would have regulated cosmetic procedures across the board, required a physician to perform every initial exam, and mandated a physician on site. After industry input, the version that passed is far narrower and focuses on elective IV therapy.

What counts as elective IV therapy?

Elective IV therapy is the non-emergency administration of fluids, vitamins, or medications into the bloodstream for hydration, wellness, or temporary symptom relief, delivered outside a hospital or doctor's office. Think vitamin drips, hydration infusions, and mobile IV services. IV care given in a hospital or licensed clinic is regulated separately and isn't covered here.

Who can administer IV therapy in Texas now?

Before an elective IV is administered, a physician, nurse practitioner, or physician assistant must evaluate the patient, which in practice is a Good Faith Exam (GFE). Only a physician, NP, PA, or registered nurse can start and administer the IV. Medical assistants, licensed vocational nurses, paramedics, and unlicensed technicians can no longer perform that step. A physician can still delegate ordering and administration to qualified providers under adequate supervision.

Does Jenifer's Law affect injectables or laser treatments?

No. If your med spa offers injectables, laser, or other cosmetic treatments and not IV drips, HB 3749 adds no new state requirements to those services. The rumored on-site physician mandate did not make the final law. Existing Texas Medical Board rules still apply: a physician, PA, or NP must establish the patient relationship through a Good Faith Exam, which can be done via telehealth, before any aesthetic procedure, and at least one person trained in basic life support should be on site during procedures.

What should Texas med spas do about it?

If you offer IV therapy, check who starts your IVs and confirm every patient is evaluated first. If you don't, treat this as a prompt to confirm your GFE process, documentation, and supervision agreements are solid. Regulators are paying closer attention to the med spa industry, and the practices that stay ahead of it are the ones already running by the book.

FAQs

When did Jenifer's Law take effect?

September 1, 2025.

Does the law require a physician on site at all times?

No. It requires adequate physician supervision and delegation, not a full-time on-site physician. Existing Texas Medical Board rules govern supervision and emergency readiness.

Can a nurse practitioner or physician assistant perform the Good Faith Exam?

Yes. A physician, NP, or PA can evaluate the patient before an elective IV.

Who can legally start an elective IV in Texas?

A physician, NP, PA, or registered nurse. Medical assistants, LVNs, paramedics, and unlicensed technicians cannot.

Fresh Clinics helps med spa owners put this infrastructure in place, from telehealth Good Faith Exams to medical oversight and documentation. Learn more about Fresh Clinics membership.