Texas House Bill 3749 (HB 3749), known as “Jenifer’s Law,” was signed into law on June 20, 2025, and will take effect on September 1, 2025. Initially feared to impose strict new regulations on IV hydration clinics and med spas across Texas, the final version of the bill may actually reduce some compliance burdens for clinic owners and supervising physicians.
The bill was introduced in response to the tragic death of Jenifer Cleveland in July 2023. Jenifer received an IV infusion at an unregulated Texas med spa in Wortham. An investigation by the Texas Medical Board (TMB) revealed major lapses in medical oversight—no on-site physician, a medical director located 100 miles away, no clinical protocols, and unlicensed staff administering treatment.
Early Draft Would Have Overhauled Medical Spa Supervision
The original version of HB 3749 raised significant concerns for Texas IV therapy providers and medical spas. Proposed changes included:
- Requiring supervising physicians to be physically present and immediately available.
- Establishing new eligibility standards and duties for medical directors.
- Reclassifying med spas as medical facilities requiring additional licensure.
- Prohibiting physicians from delegating treatments unless they were fully trained in the procedure.
- Mandating that patients receive a written treatment plan and in-person assessment by a physician before delegation.
- Increasing training requirements for personnel administering treatments.
- Requiring clinics to post signs when a physician is not on-site.
However, these provisions were stripped from the final bill. As passed, HB 3749 reflects a far more provider-friendly approach—offering clarity on certain regulatory issues while avoiding overreach into the day-to-day operations of IV therapy businesses.
The “Physician’s Office” Conundrum
HB 3749 applies only to IV therapy provided outside of a physician’s office, licensed healthcare facility, mental hospital, or state-operated hospital. But what exactly counts as a “physician’s office”?
Texas healthcare laws—including TMB regulations—use the term frequently but never define it. While rules governing delegation, supervision, and office-based surgery reference physician offices, there is no formal definition under Texas law. Informally, it seems to mean a location where a physician primarily works, maintains patient records, and exercises control, more than just a pop-up or rented exam room.
The lack of clarity creates a regulatory gray area for healthcare providers operating mobile IV hydration services or shared medical spaces. And unfortunately, HB 3749 does nothing to resolve that ambiguity. As with many regulatory questions in Texas healthcare law, interpretation will depend on how the Texas Medical Board applies the rule to real-world scenarios.
Reframing IV Therapy as “Elective” Treatment
One of the most impactful elements of HB 3749 is its characterization of IV hydration therapy as “elective” treatment. This distinction may reduce the burden of proving strict medical necessity for each infusion.
Historically, Texas physicians have faced scrutiny and even disciplinary action for prescribing medically unnecessary medications or therapies. That standard has required a full patient evaluation, lab testing, diagnosis, and treatment planning.
Under the new law, however, IV therapy is framed more like elective wellness care. This shift could allow physicians and advanced practice providers to offer IV infusions based on patient preference, so long as a physical exam and basic safety screening are performed. The focus moves away from treating specific conditions and toward wellness, preventive care, and patient autonomy.
For IV therapy clinic owners and medical spa operators, this could be a game-changer, allowing for simplified intake procedures and expanded services that align with patient demand.
No Change to Delegation Rules (Despite Misreporting)
Some early reporting on HB 3749 incorrectly claimed the law restricted IV administration only to physician assistants (PAs), nurse practitioners (APRNs), or registered nurses (RNs). That’s not accurate.
The final statute says that physicians may delegate to those professionals—but this merely restates the existing delegation framework under Chapter 157 of the Texas Occupations Code. It does not eliminate the ability to delegate to others, nor does it impose new credentialing requirements.
Instead, the legal standard remains: delegation is appropriate when supervision is adequate. What counts as “adequate” depends on what a reasonable and prudent physician would consider acceptable, given the training and experience of the provider performing the treatment.
Best Practices for Texas IV Hydration Clinics
In light of HB 3749, Texas IV therapy providers and wellness clinic operators should consider the following best practices:
- Ensure that elective IV therapy is ordered or prescribed by a physician, PA, or APRN under a valid prescriptive authority agreement.
- Treatments should be administered only by licensed providers (physicians, PAs, APRNs, or RNs), and always under adequate physician supervision.
- Supervising physicians remain legally responsible for verifying provider qualifications, establishing protocols, and maintaining oversight.
What Comes Next?
We won’t know the full impact of HB 3749 until it is interpreted and enforced by the Texas Medical Board. Providers should stay informed as TMB issues guidance or disciplinary rulings that clarify how this law will be applied in practice.
Clinic owners should also review their intake procedures—shifting the focus from medical necessity to comprehensive safety screening, informed consent, and patient education. Legal compliance will depend not just on who provides treatment, but how well those processes are documented and supervised.
Final Thoughts
Texas HB 3749 represents a notable shift in how the law approaches elective IV hydration therapy. While born out of tragedy, the final version of the bill strikes a more balanced tone—aimed at patient safety without stifling innovation. For physicians, midlevel providers, and IV hydration clinic owners, this is a pivotal moment to reevaluate compliance procedures and seize new opportunities in the growing wellness market.
Need help navigating the new law? Our healthcare attorneys work with IV therapy providers, med spas, and supervising physicians across Texas. Contact us today to ensure your clinic is fully compliant with the latest regulations.
Joshua Massingill
Joshua Massingill is an attorney practicing in Austin, Texas. He serves on the Texas State Bar’s Law Practice Management Committee, the Leander Educational Excellence Foundation (LEEF) Board of Directors, and the Success-Werx Board of Advisors. He mentors young entrepreneurs in Leander ISD’s INCubatorEDU program and is active in his church.
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