Currently, Rhode Island medical spas are regulated by the same regulations as other medical offices or physicians’ practices. Recently, the licensing boards have issued informal guidance but there isn’t a separate set of regulations that apply only for medical spa facilities. The newly introduced House Bill 5351 (HB 5351), if passed, would create training, licensing and supervision requirements for medical spas. Rep. Baginski has introduced similar legislation in the last three legislative sessions.

As introduced, HB 5351 defines medical aesthetic practices as establishments that perform “cosmetic medical procedures.” They may be licensed health facilities, practitioner’s offices or operated by hospitals. Cosmetic medical procedures are broadly defined to include any procedure directed at improving appearance that does not meaningfully promote function or treat a disease and does not require sedation. The definition goes on to list a number of procedures that are included, such as hair transplants, cosmetic injections, dermabrasion beyond the stratum corneum, laser treatments, platelet-rich plasma (PRP), intravenous therapy, radio frequency and vitamin infusions. Under this bill, cosmetic medical procedures can only be provided by or under the supervision of a physician, physician assistant (PA) or advanced practice registered nurse (APRN). The bill includes a definition of supervision that has both on-site and off-site options. It requires every medical aesthetic practice to be owned by, employ, or contract with a physician, PA or APRN who actively practices in Rhode Island.

Prior to treatment, a supervising physician, PA or APRN must:

1. Perform an initial patient assessment;
2. Create a written treatment plan for each patient;
3. Obtain patient consent; and
4. Create medical records for the patients.

In order for non-physicians, non-PAs or non-APRNs to perform cosmetic medical procedures, they must have a minimum of 20 hours of training and an appropriate license or certification. When they are delegated treatments, they must:

1. Review the protocols;
2. Verify that the patient has been assessed by a physician, PA or APRN;
3. Review the procedure with the patient;
4. Notify the supervising person of any adverse events or complications;
5. Document all details in the medical records; and
6. Satisfy any requirements of their licensing board.

The bill gives the Rhode Island Department of Health (DoH) until January 1, 2026, to adopt regulations to implement this bill. And HB 55351 specifically allows for registered nurses (RN) to perform cosmetic medical procedures under the delegation and supervision of a physician, PA or APRN. The bill also allows licensed estheticians to perform chemical peels that do not exceed 30% concentration or have a pH lower then 3.0, radio frequency, intense pulse light and microneedling under their own license and not requiring supervision or delegation. Dentists are also specifically permitted to perform cosmetic injections without supervision or delegation, and electrologists can perform laser hair removal without supervision. The practice of licensed tattoo artists is also exempted from the bill.

Note that the committee has already recommended to hold this bill for study, so it is unclear if there will be chances of further advancement this year. We will be monitoring this bill as it works its way through the session. If you would like additional information, to read the bill or to contact the sponsors, you can find it through this link.