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A Quick Look at AmSpa's 2019 L.A. Boot Camp

Posted By Administration, Thursday, April 11, 2019

boot camp

Attendees at the AmSpa Social and Lasky Aesthetics Tour on Friday, April 5, including Terri Ross, aesthetic practice consultant for Terri Ross Consulting; the AmSpa team; and Instagram influencers Chris Jilly (@PlasticSurgery), Dr. Erin (@DrErin.tv) and Emerald Gutierrez (@GlamRN_beverlyhills_).  

boot camp

Platinum vendor Environ Skincare shares the benefits of vitamin A products with attendees.

boot camp

Michael Byrd of ByrdAdatto and Alex Thiersch of AmSpa and ByrdAdatto discuss legal issues on Day 1 of the AmSpa Boot Camp.

boot camp

Instagram influencer Emerald Gutierrez (@GlamRN_beverlyhills_) hosts a lunch on Day 2 of the AmSpa Boot Camp to teach boot camp attendees the basic of opening an IG account.

boot camp

Dr. Christine Petti demos the Vivace RF microneedling, sponsored by Cartessa, at the L.A. Boot Camp event during cocktail hour.

Tags:  AmSpa's Med Spa & Aesthetic Boot Camps  Business and Financials  Med Spa Law  Med Spa Trends 

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Understanding the Legal Issues in Med Spa Advertising

Posted By Administration, Wednesday, April 10, 2019

advertising marketing

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

Medical spas are medical practices, so they are bound by the laws governing medical advertising. As soon as you are involved in any kind of medical treatment, you are subject to very strict requirements when it comes to advertising your practice.

Digital Age

According to the 2017 Medical Spa State of the Industry Report, digital marketing practices—specifically websites, email and organic social media—are the three most common marketing techniques for medical spas. Businesses cannot simply rely on word of mouth or good reviews attract customers—they must create effective promotional campaigns because there is so much competition and because the industry is cash-based, rather than insurance-based. Therefore, it is easy for medical spa owners and operators to slip into the retail mindset that they are going to do whatever they need to do to get people to come in. And while we do, in fact, encourage people to run their medical spas in such a manner, it is important to keep in mind that these practices are, above all, medical practices, so they are subject to the same rules and regulations that govern more traditional medical institutions.

Telling the Truth

All state medical boards have certain requirements for medical advertising. Most are relatively similar, but practitioners need to look at and understand their state laws regarding advertising. These regulations are typically fairly easy to find, and most are generally similar in that they require absolute, verifiable honesty.

Unlike, say, a car dealership or a furniture outlet, a medical outlet makes must be able to prove the claims it makes are true. For example, if you say, “Our nurses are the best injectors in the country,” that is likely to attract some unwanted attention—a medical board or nursing board is going to see such a claim and ask what it’s based on. It’ll ask where the proof of this is, and unless you’re prepared to submit something to that effect—which, obviously, is not possible—your practice could be in some trouble.

In the past, if you read the in-flight magazines from the major airlines, you may have seen lists of “best doctors in America.” If you’ve looked at these publications in recent years, however, you may have noticed that these lists have been changed to say “among the best doctors in America,” because that is at least somewhat truthful, and the doctors mentioned in these pieces are concerned about compliance too.

Troublesome Titles

Whether it’s in marketing collateral, on social media, or in influencer marketing, everything that’s said about your medical spa must be objectively verifiable. You can achieve this by citing your credentials and your certifications. We previously wrote about misleading titles that are used by some medical spa employees, and those merit mention here too—if you refer to an employee as a “medical aesthetician” or a “certified laser technician” in your advertising materials, you’re asking for trouble—you have to prove your employees are what you say they are, and in cases such as these, it simply can’t be done.

Under the Influence

Speaking of influencers, there also are a number of issues regarding social media in general and influencer marketing specifically. First and foremost, the FTC recently introduced a list of guidelines regarding proper disclosures that must be in place for compliant social media influencer marketing.

If you’re not sure your advertising is compliant, you can always ask your lawyer to evaluate it before it’s posted. Some state boards will even permit you to submit ads to them for review to make sure they’re compliant, although this process tends to take quite a while. Regardless, it’s very important that your practice does what it can to maintain compliant advertising, because the penalties for violations can be severe.

For more information on medical spa laws in your state, check your medical aesthetic legal summary. To learn more about legal and business best practices, attend one of AmSpa’s Medical Spa & Aesthetic Boot Camps and start on your road to becoming the next medical spa success story.

Tags:  AmSpa's 2017 Med Spa Statistical Survey  AmSpa's Med Spa & Aesthetic Boot Camps  Business and Financials  Med Spa Employee Types  Med Spa Law  Med Spa Trends 

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Knowing How Is Only Half the Battle

Posted By Administration, Tuesday, April 9, 2019

laser tattoo removal

By Patrick O’Brien, JD, legal coordinator for the American Med Spa Association

Training and education are valuable tools that can help you grow and develop your practice. However, before you spend a fortune on training, make sure you legally are able to perform the procedures. Education, skill and competency—these or similar terms are found throughout rules and regulations that govern medical and nursing practices, and they communicate the uncontroversial idea that a person should have some skill to safely perform a medical procedure on another person. But training and education alone won’t empower you to perform procedures—only a professional license or certification can do that.

This is the case with all professional licensure, from barbers to lawyers to nurses and doctors: Completing courses will give you the important skills you will need in your future profession. But it is the state-granted license that legally authorizes you to offer those professional services to others. You can quit reading this blog right now (please don’t) and go attend a barbering program to learn how to give the smoothest shaves known to man, but you will be breaking the law if you start practicing before getting a barber’s license from your state’s barbering board.

Laser or injection training can be invaluable, but it is useless to a medical assistant (MA) or nurse in a state that prohibits a physician from delegating injections to nurses or unlicensed individuals. As is often the case, “who can do what” varies significantly from state to state. (AmSpa Members can click here to check their state legal summary.) For example, in Texas, an MA with proper training and supervision is able to perform Botox injections. However, in California, MAs may not perform injections, nor may license vocational nurses (LVN)—only registered nurses (RN) and higher may perform those procedures there. In Florida, the nursing board has consistently denied RNs from including Botox injections in their scope of practice. Similarly, the Rhode Island Board of Nurse Registration and Nursing Education holds the stance that RNs and LVNs are not able to inject Botox or other fillers. AmSpa advises that as a best practice, medical aesthetic practices should only utilize RNs and higher for cosmetic injections, even if your state permits others to perform the procedures. But whatever you choose to do, it isn’t a good idea to spend time and money training up an employee who legally can’t use the training.

Now, the professional license that grants this authority doesn’t necessarily need to be your own. Many states allow appropriately trained people to perform procedures under the delegation and supervision of a licensed professional. In these cases, showing documentation of the appropriate training and skill is critical for compliant delegation of the procedure.

Laser hair removal and tattoo removal technician “certifications” are other common areas where this crops up. Most states do not recognize such certifications and restrict the use of lasers only to individuals with medical or nursing licenses. Even in states with laser technician licenses, the person must complete a particular state-approved education course and then apply for licensure with the state; simply taking any training course won’t do. So before signing up for training, find out how your state treats laser technicians and if that course meets state requirements.

Investing in training, education and skill development is crucial to having a successful medical aesthetic practice. But because states have different rules on professional scopes of practice, supervision and delegation, it is important to make sure your money is wisely spent. You must be sure that your state’s licensing boards include the new procedure in your scope of practice.

Tags:  Med Spa Employee Types  Med Spa Law  Med Spa Trends 

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Legislative Update: PAs & APRNs Gain Ground in First Quarter of 2019

Posted By Administration, Friday, April 5, 2019

legislature

By Patrick O’Brien, JD, legal coordinator for the American Med Spa Association

As the first quarter of 2019 draw to a close, so does a flurry of new bills being filed in legislative bodies across the country, and a good number of these bills may affect how medical spas operate. Additional bills will continue to trickle in, but in many states, congressional and senate sessions adjourn in late spring or early summer, so this is by far the busiest season of the year for new legislation. Tens of thousands of bills have been filed, and some have the potential to affect the medical aesthetic industry. If you are an AmSpa Plus Member, you may have received updates about legislation of interest in your state. Here is a short recap of the bills we’ve seen so far and some possible trends that may be emerging.

A move towards independent or less restrictive practice for advance practice registered nurses (APRNs) and physician assistants (PAs) is by far the most prominent development we have observed. These bills run the gamut from allowing physicians to oversee more PAs and APRNs to allowing PAs and APRNs to practice without any formal agreement or supervisory relationship at all. If these bills pass, they will change the landscape of medical practice. Once health professionals are able to practice on their own, it will lead to an explosion of independent practices and clinics, and that almost certainly will include practices that focus on aesthetic procedures. We’ll provide a deeper dive into these bills in a future article.

Next, we have not so much a trend, but rather a class of bills that would regulate aspects of medical practice or procedures at medical spas. For example, AB 821 and SB 2834 in New York would provide a regulation and licensing regime for the practice of laser hair removal, a practice that currently is unregulated in the state. Both Colorado and Oregon have introduced bills to regulate smoke that results from laser procedures; these laws currently would only affect hospitals and ambulatory surgical centers, but could easily be expanded to include all laser procedure practices. In Kansas, SB 120 would allow corporations to practice medicine. In Arizona, SB 1287 would allow laser technicians to perform procedures without medical supervision—instead, they only would be overseen by a laser safety officer. And in Florida, SB 732 originally would have brought significantly more regulations to medical spas but has since been amended to be less onerous. Most recently, in Texas, SB 2366—which we have covered in previous articles and a webinar—would greatly restrict who could perform procedures in a medical spa.

Overall, a mix of beneficial, neutral and restrictive bills has been introduced this year. However, the restrictive bills would prove far more damaging than the “good” bills are beneficial if they pass. All new laws will result in a period of compliance and adaptation. Good bills may let medical aesthetic professionals do things they couldn’t do before or streamline processes. Restrictive bills, on the other hand, may impose entirely new requirements or make some of current practices illegal or uneconomical. It could only take a single bill passing to disrupt the whole industry—successful bills often spread to other states, as legislators look to other states for inspiration for their efforts, so a successful push for a restrictive law in the name of “public safety” may continue in other states. That is why it is critical, now more than ever, to come together as an industry to help determine the rules and regulations that affect this industry. The aesthetic medical field is growing larger every year, and every year will bring more notice from lawmakers.

To receive updates whenever new laws are introduced in your state, become an AmSpa Member—click here to learn more. There is no better way to keep track of the legal matters that affect your medical aesthetic practice.

Tags:  Med Spa Employee Types  Med Spa Law  Med Spa Trends 

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Join AmSpa at the L.A. Medical Spa & Aesthetic Boot Camp

Posted By Administration, Wednesday, April 3, 2019

la boot camp

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

We are just a few days away from AmSpa’s Los Angeles Medical Spa & Aesthetic Boot Camp at the Sofitel Los Angeles at Beverly Hills, and we’re extremely excited for the opportunity to help medical aesthetic professionals develop their practices. There's still time to register for the event—just click here to sign up. Here’s a quick overview of the program:

Friday, April 5

Prior to the Boot Camp, AmSpa will present a special after-hours tour of the Lasky Aesthetics & Laser Center, one of the most successful medical spas in the United States. This event, which is sponsored by BTL Aesthetics, takes place from 5:30 – 7:30 p.m. PST and will show attendees how this well-appointed practice makes its clients comfortable while providing a high standard of service. Space for this exciting event is limited, so click here to register.

Saturday, April 6

The Boot Camp begins at 8 a.m. with a breakfast, followed at 8:30 a.m. with my opening keynote. From there, we will move into the main program:

  • 9 – 10:30 a.m.: The Plan, presented by Bryan Durocher (Durocher Enterprises)—What are the most effective ways to develop a business plan for your medical spa? Medical Spa Consultant Bryan Durocher discusses the ins and outs of the planning process and helps determine how long it realistically takes to open a practice.
  • 11 a.m. – 12 p.m.: The Marketing Plan and Social Media, presented by Brandon and Jenny Robinson (Skin Body Soul MedSpa)—This session will help you determine how to most effectively market your medical aesthetic practice using both traditional methods and cutting-edge techniques.
  • 1 – 1:30 p.m.: Medical Aesthetic Hot Topics Panel, featuring Toni Lee Roldan-Ortiz (Environ Skincare) and Tim Sawyer (Crystal Clear Digital Marketing)—This panel, moderated by yours truly, will feature a spirited discussion of the current issues and events that concern medical spa owners and operators.
  • 1:30 – 3:30 p.m.: The Law, presented by Alex Thiersch (AmSpa) and Michael Byrd (ByrdAdatto)—In this presentation, we’ll discuss the long-standing and emerging legal issues that every medical spa owner needs to know about. As you can imagine, there is a lot to cover here, since new concerns seem to be arising daily lately.
  • 4:15 – 5 p.m.: The Treatments, presented by Terri Ross (Lasky Aesthetics)—Learn about the most profitable and popular treatments available to your practice, and find out how to best determine which treatments are right for you based on the state of your practice.
  • 5 – 6 p.m.: The Digital Marketing Ecosystem, presented by Tim Sawyer (Crystal Clear Digital Marketing)—Find out how to effectively spread the word about your medical aesthetic practice and how best to determine what’s working and what’s not. Your practice’s digital presence is more important than ever before, and curating it should be a top priority.

Saturday will wrap up with a cocktail reception from 6 – 7:30 p.m.

Sunday, April 7

Once again, the Boot Camp begins at 8 a.m. with a breakfast.

  • 8:30 – 9 a.m.: Anatomy of a $5-Million Med Spa, presented by Alex Thiersch (AmSpa)—Have you ever wondered what the difference is between your medical spa and one that’s mega-successful? It might be less significant than you think. This presentation will show what a $5-million med spa is doing right—and what you might be doing wrong.
  • 9 – 10 a.m.: The Financials, presented by Bryan Durocher (Durocher Enterprises)—At the end of the day, the money you’re bringing in is the most important measure of your practice’s success. This presentation will, among other things, demonstrate how to properly develop a budget and use metrics to determine your med spa’s strengths and weaknesses.
  • 10:30 – 11:30 a.m.: The Long-term Revenue, presented by Brandon and Jenny Robinson (Skin Body Soul MedSpa)—Simply being successful isn’t enough for a medical aesthetic practice; you have to know how to maintain and grow your success. In this session, the Robinsons will show you how to build patient loyalty and move your business forward.
  • 11:30 a.m. – 12:15 p.m.: The Consultation, presented by Terri Ross (Lasky Aesthetics)—As the old saying goes, you never get a second chance to make a first impression. Learn how to put your best foot forward with effective patient consultations—and how to turn them into consistent business.
  • 1 – 2 p.m.: The Lessons, presented by Louis Frisina—Every medical spa is different, but the successful ones share several common traits. In this session, Business Strategy Consultant Louis Frisina discusses the qualities that are typically found in practices that bring in a significant amount of revenue.
  • 2 – 3 p.m.: The Team, presented by Bryan Durocher (Durocher Enterprises)—A medical spa is only as good as its personnel, so it’s important to make sure that you hire a staff that can do everything you want it to—and more. In this session, you’ll learn about recruiting, hiring and retaining employees who can make your medical spa dreams come true.

Also, you’ll have the chance to visit with a number of exceptional vendors throughout this event. Attend the L.A. Medical Spa Boot Camp to check out the latest and greatest from the following companies:

We hope you can join us in Los Angeles this weekend. This AmSpa Boot Camp is a tremendous opportunity to get your medical aesthetic business headed in the right direction and learn some tips and tricks that can take it to the next level. Click here to register!

Tags:  AmSpa's Med Spa & Aesthetic Boot Camps  Business and Financials  Med Spa Law  Med Spa Ownership  Med Spa Trends 

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What Texas Senate Bill 2366 Means for the Med Spa Industry

Posted By Administration, Tuesday, April 2, 2019

texas state house

By Courtney P. Cowan, JD, associate attorney, ByrdAdatto

As many in the med spa industry are aware, Texas Senate Bill 2366 (SB 2366) was introduced earlier this month in the current legislative session. Almost instantaneously, it sent shockwaves through the medical community when it was filed by Senator Brian Hughes of District 1 on March 8th.

For context, the 86th Texas legislative session began on January 8, 2019, with almost 9,000 bills being introduced this session. March 8 was the last day to file a bill for the current session, which is notable since that was also the same day SB 2366 was filed. The regular session ends on May 27, 2019.

As the second step in a long legislative process, SB 2366 has been assigned to the Senate Business & Commerce Committee. This Committee will look over SB 2366, deliberate it, recommend it for amendment, and hold public hearing on it. At the end of its review of the bill, the Committee will give a report back to the Senate at large, which will then decide whether SB 2366 should be approved or disapproved. If it is approved, then SB 2366 will go to the Texas House of Representatives for review, repeating the entire process described above again before going to the Governor to be approved as law.

ByrdAdatto and American Med Spa Association (AmSpa) have been in contact with Senator Hughes’s office to gather more insight into the introduction of SB 2366. After speaking with a representative for Senator Hughes, his office commented that SB 2366 as it was introduced was not the intended language of the Senator. Moreover, the representative also stated that the response from the industry and stakeholders had been significantly more than they anticipated.

With all of that being said, it would take a lot of moving pieces, proposing and passing of more bills, as well as various legislative amendments for this bill to ever really take effect against delegated providers in the industry. Another point worth highlighting is that the first iteration of a bill, such as this one, will typically go through many revisions and amendments before ever getting passed (if ever). So even if SB 2366 goes into effect, it likely will look vastly different than the current proposed language.

Due to SB 2366 being such a hot topic within the industry, Patrick O’Brien of AmSpa and Samuel Pondrom of ByrdAdatto gave an in-depth webinar presentation for AmSpa regarding SB 2366. You can listen to Patrick and Sam’s discussion here.

ByrdAdatto understands that SB 2366 could impact Texas and its med spa industry in a big way, and we will continue to monitor the bill as it makes its way through the legislature. While it is uncertain whether SB 2366 will become law, it should be recognized that as the med spa industry continues to expand and grow, there will continue to be legislation implemented to regulate it.

As the daughter of a periodontist, Courtney P. Cowan has been fascinated by the health care field since childhood. Courtney often accompanied her father to his office where she developed an appreciation for physicians and their respective practices. Having absolutely no dexterity that is required to be a surgeon, however, Courtney instead decided to pursue a degree in business while attending Baylor University. It wasn’t until she was required to take a business law course that Courtney discovered her passion for the law. After graduating from SMU Dedman School of Law, Courtney serendipitously connected with ByrdAdatto and now assists our clients by combining her business background with her enthusiasm for health care and the law.

Tags:  Business and Financials  Med Spa Employee Types  Med Spa Law 

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How Do You Open a Med Spa?

Posted By Mike Meyer, Monday, April 1, 2019
Updated: Tuesday, April 2, 2019

open for business

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

Opening any business involves numerous complications that are difficult to predict and prepare for, but opening a medical spa is significantly more complicated than creating most other types of businesses. After all, a medical spa requires high-level business acumen, a thorough understanding of local medical rules and regulations, and dedicated, properly trained employees in order to succeed.

That’s a tall order when you’re just starting out, but help is available. If you find yourself overwhelmed by the obstacles in your way, you may want to attend one of AmSpa’s Medical Aesthetic Boot Camps. Early-bird registration for the Chicago Boot Camp—which takes place at the Chicago Marriott Southwest at Burr Ridge on May 4 – 5—ends at 11:59 p.m. EST on April 4, so if you’re near the Windy City and want to learn more about how to make your medical spa a success from day one, you can do so at a discounted rate until then.

Develop a Business Plan

Creating a detailed business plan is a vital step for any prospective business, and a medical aesthetics practice needs to address an unusual number of issues. Where will the business be located? How will it be designed? What will set it apart from its competition? How will you go about recruiting talented employees? What will you do to attract patients? What types of patients do you wish to attract? All these questions and many more will need to be addressed at the earliest stages of your business’ development.

Learn About Compliance

New medical spa owners might not know much about the rules and regulations they’ll be expected to follow when they enter the medical aesthetic industry, but it is important that they learn as quickly as possible. The “medical” part of the equation makes operating a medical spa much more complex than it would be if it was simply offering aesthetic services such as facials and manicures. The practice’s ownership structure must be developed in accordance with state laws, and that’s just the start—all medical treatments must be performed with proper supervision, and all marketing must be conducted with special attention paid to patient privacy and other factors. Regulations vary from state to state, so there is no one way to approach this, but it is extremely important that you develop an understanding of what is expected of a compliant practice.

Plan for the Future

The medical aesthetic industry is constantly changing, and understanding the metrics that provide the best insight into medical spa success can help keep you ahead of the curve. It is also important to learn how to efficiently operate and maintain the value of your practice. Your practice is about to become your life, so you need to know what you can do to make it as healthy as possible for as long as possible. And while you probably won’t want to think too much about your exit strategy while you’re opening your practice, it’s probably worth having that conversation with your partners, financial consultants and attorneys, as well.

These topics and many more are addressed at AmSpa’s Medical Aesthetics Boot Camps. If you are preparing to open a practice, it’s certainly worth your while to attend one near you. Early-bird pricing for the Chicago Boot Camp can be secured until 11:59 p.m. on April 4, so if you want to attend, click here to register. If you can’t attend the Chicago Boot Camp, keep in mind that subsequent 2019 Boot Camp events are scheduled for Atlanta, Seattle, Dallas, New York and Orlando; early-bird pricing is available for all of these events right now, so sign up today.

Tags:  AmSpa's Med Spa & Aesthetic Boot Camps  Business and Financials  Med Spa Law  Med Spa Ownership 

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Aesthetic Manufacturers Beware: Offering “Marketing Support” and “Practice Management Support” to Practices May Be Illegal

Posted By Administration, Friday, March 29, 2019

justice department

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa), & Patrick O’Brien, JD, legal coordinator for the American Med Spa Association

The U.S. Department of Justice (DOJ) issued a press release that may have a profound impact on the aesthetics industry as we know it. In settling an anti-kickback and False Claims Act claim against medical device manufacturer Covidien, the feds stated that device manufacturers who provide complimentary marketing support, product marketing plans and advertising support as incentives to purchase their products are engaging in an illegal kickback scheme. Even providing complimentary “lunch and learns” to customers may violate anti-kickback laws.

The DOJ enforcing the Anti-Kickback Statute and the False Claims Act is not unusual, and those of you familiar with AmSpa know we often warn practices of federal and state anti-kickback laws. What is unusual about this case, however, is the form the alleged kickbacks took—instead of money, the company offered free or reduced-cost marketing and advertising support, something that occurs all the time in the aesthetics industry.

Let me know if this sounds familiar: As part of its sales strategy, Covidien—which produces and sells a radiofrequency ablation catheter device called “ClosureFast”—would provide free marketing and practice support to physicians who purchased the devices to help them establish and grow their ClosureFast practices. This included providing the physicians with customized marketing plans and hosting “lunch and learn” meetings to educate area physicians about the purchaser’s ClosureFast vein practice in the hope of generating referrals.

Well, guess what? This non-monetary support constitutes an illegal kickback, alleges the DOJ, and can expose offenders to fines and even criminal liability.

The DOJ makes clear in its press release that these types of remuneration are treated the same as monetary kickbacks and will be actively pursued. Although the DOJ’s press release describes the marketing and sales support as being very tailored and specific to the individual practices, it does not indicate that this was a deciding factor in its pursuit of this case. Based on the press release’s rationale, many other types of non-monetary support also could be seen as kickbacks; this may include common industry practices such as providing advertising and marketing materials or services to new device purchasers. As is often the case with high-profile enforcement actions, this may mark the beginning of additional enforcement—not only at the federal level, but also for states acting under their own anti-kickback statutes.

While most medical spas are not directly affected by this new enforcement angle because they don’t bill to Medicare or Medicaid, it is conceivable that state enforcement agencies may take a closer look at these practices in light of the broad language contained in state anti-referral and anti-patient solicitation statutes. These state rules often apply to medical practices regardless of whether they bill to insurance.

This is potentially huge news for manufacturers in the industry. Stay tuned—AmSpa’s lawyers are dissecting the decision to determine its impact on the industry.

Tags:  Business and Financials  Med Spa Law 

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Who Can Perform Microneedling?

Posted By Administration, Wednesday, March 27, 2019

microneedling

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

Microneedling is a popular procedure in med spas, but many owners and practitioners do not know if aestheticians can legally perform the treatment. As is the case with many regulatory issues in the medical spa industry, the answer can vary depending on what state you practice in. In much of the United States, however, the answer likely is no.

Also known as collagen induction therapy, microneedling is a minimally invasive treatment that is designed to rejuvenate the skin. A device with fine needles creates tiny punctures in the top layer of the skin, which triggers the body to create new collagen and elastin.

Is It Medicine?

An aesthetician’s license does not permit him or her to perform medical treatments; rather, aestheticians may only perform procedures for the purpose of beautification. Many med spas look at these standards and assume that aestheticians can perform microneedling; however, many state regulatory boards specifically are classifying microneedling as medical treatment, no matter whether the needles actually penetrate the outer layer of the skin.

Illinois and California, for example, specifically listed microneedling as medical treatment in 2016 because they classified the device as medical equipment. At an American Med Spa Association Medical Spa Boot Camp in San Jose, Calif., Kristy Underwood, executive director of the California Board of Barbering and Cosmetology, gave additional details as part of a 30-minute Q&A session.

“This isn’t new—aestheticians cannot penetrate the skin,” Underwood said. “They also can’t use any metal needles, period. [California] aestheticians are prohibited from using metal needles.” She added that they cannot use anything that might be disapproved by the FDA.

For more business and legal med spa best practices, attend an AmSpa Medical Spa & Aesthetic Boot Camp near you.

Supervision & Delegation

In some states, however, people holding aesthetician licenses can perform certain medical procedures. These states differentiate between an aesthetician and a person who is performing medical procedures under the supervision and delegation of a physician.

This means that if the patient is first examined by a physician or a mid-level practitioner—a nurse practitioner or a physician assistant—an individual working in a medical spa may perform microneedling. However, it is very important to note that if aestheticians are going to perform this procedure under this caveat, they cannot represent themselves as aestheticians while doing so. This means aestheticians must flip over their aesthetician name tags and take down any certification they might have hanging on the wall.

The state may allow an aesthetician as a person to perform this procedure under proper medical supervision; however, the regulatory board does not cover this under an aesthetician license.

This sounds onerous, and it is certainly involves more effort than a facial or another aesthetician service, but this does not have to be a deal-breaker for offering microneedling services in your medical spa. The supervising physician does not need to be in the room watching the aesthetician perform the procedure and, in many states, does not need to see the patient before each treatment—just the first one.

The More You Know

Regulations can vary greatly depending on where a business operates, so it is very important to know the laws that govern medical aesthetic businesses in your state. When in doubt, consult an attorney in your state who is familiar with aesthetics.

AmSpa members have access to legal summaries of the laws regulating medical spas in their state, as well as an annual complimentary compliance consultation with the law firm of ByrdAdatto.

See AmSpa’s Treatment Directory for more information on microneedling.

Tags:  AmSpa's Med Spa & Aesthetic Boot Camps  Med Spa Law  Microneedling 

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Why a Risk Assessment Is Critical for Your Practice

Posted By Administration, Monday, March 25, 2019

checklist risk assessment

By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

For a medical aesthetics practice to best serve its patients and maintain a viable business, it needs to understand the ways in which it may be compromising patient safety or otherwise violating the law. Therefore, if your practice has not undergone a thorough risk assessment recently, it should do so as soon as possible.

“A risk assessment establishes the baseline of where a practice is from a compliance perspective and helps identify risk areas that need to be fixed,” said Michael Byrd, partner at ByrdAdatto, a Dallas-based law firm that specializes in business and health care law. “Let’s get a baseline of where you are so we can figure out what needs to happen.”

A properly conducted risk assessment will cover both business and medical concerns, and it will identify areas where the practice is compliant, areas where the practice needs to be mindful to remain in compliance, and areas where the practice is not compliant that need to be corrected.

“A risk assessment is essentially a blend of legal and clinical evaluation of compliance,” Byrd said. “From a legal perspective, we’re making sure that the ownership is set up in a compliant way, and then that the policies and procedures are set up in a compliant manner. Clinically, do they have appropriate policies and procedures as it relates to treatment, delegation and supervision, OSHA, telemedicine, HIPAA, etc.? A lot of times when we’re doing a risk assessment, we have a lawyer look at it, plus a clinical person, and sometimes even an IT person helping to evaluate if there’s a cyber-security risk from a HIPAA perspective.”

To begin the process of conducting a risk assessment, a practice should engage with a health care law firm that has a great deal of experience conducting such investigations. Additionally, stakeholders need to be prepared to be as open as possible so evaluators can get a clear idea of what is going on at the practice.

“We’ll identify the ownership documents to send us, and then if it’s a full risk assessment, we’ll involve a clinical consultant who’ll look at it from a clinical perspective, and then we’ll work together to make sure that the policies and procedures navigate that particular state’s laws,” Byrd said. “There’s a big element of knowing who’s doing the initial exams and who can be delegated to provide the treatment, and even by procedure, there are certain procedures that are only appropriate for certain providers. That’s a lot of the back and forth we’ll have with the consultant.”

If this sounds like a major undertaking, well… it is. However, it is assuredly better to know the areas in which your practice falls short of compliance and what can be done to correct that rather than remain ignorant and be surprised when an investigation uncovers violations.

“It can be overwhelming, but if it can be integrated as part of the culture of the business, our clients are very successful,” Byrd said. “A risk assessment is really just a starting point, but then you have a culture of following these procedures and evaluating as laws change, technology and procedures change, and your personnel changes, evolving your compliance plan with that. The clients that adopt that as part of the culture of their business have been really successful in minimizing that risk.”

Byrd says that after his firm conducts a risk assessment, it typically will check in with clients every three months to make sure that everything is on track. If a firm does not offer periodic check-ins, he recommends repeating the risk assessment process annually.

Tags:  Business and Financials  Compliance is Cool  Med Spa Law  Med Spa Ownership  Med Spa Trends 

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