Field Notes from the Practice.
Compliance, infrastructure, and operating wisdom for medical wellness businesses — from the physicians and operators who do this every day.
California Telehealth & Meaningful Encounters
California is tightening telehealth standards for med spas and aesthetic clinics. For GLP-1s, IV therapy, peptides, and injectables, 2026 enforcement expects meaningful clinical encounters — not thin, automated touchpoints.
Mandatory Signage: The Disclosure Checklist
Colorado HB 25-1024 is already in effect. Med spas using unlicensed staff for delegated services must comply with three mandatory disclosure methods: on-site signage, website/advertising disclosures, and informed consent.
Colorado's Ownership Revolution: PAs & NPs
Colorado HB 26-1249 could reshape med spa ownership — allowing PAs, APRNs, RNs, estheticians, and cosmetologists to hold majority interest in a medical-aesthetics professional corporation. Still pending as of March 2026.
The 5-Day Adverse Event Reporting Rule
Indiana SB 282 requires med spas to report serious adverse events to the Medical Licensing Board within five days. Part of a broader 2026 reform package on registration, responsible practitioners, and compounded drugs.
The Florida Pharmacy Board Mandate
Florida SB 1728 / HB 1429 would require many med spas that purchase, store, compound, or administer prescription drugs to obtain a Board of Pharmacy license and designate a Responsible Person. Still pending as of March 2026.
Level I, II, or III? The MA Licensing Tier Guide
Massachusetts H 5087 would sort med spas into three licensing tiers based on procedure risk — with different director and physical-presence requirements at each level. Still pending in the Joint Committee on Public Health.