I received this frantic email from " Sandy Elliott, CISR, Medspa Insurance Specialist". Evidently Sandy is concerned that her medspa insurance company may not be as relevant if California bans non-physicians from operating, owning or overseeing the operations of medical spas.

"There has been much press lately about California Assembly Bill 2398 & I feel this is such an important matter, that I am emailing information regarding this bill to medspas in all states. If this bill (sponsored by the American Society for Dermatologic Surgery) passes, it could be devastating to California medspas & since California is a bellwether state, it could very well set a precedent for other states to follow suit. Following is pertinent, current information from www.aestheticmedicinenews.com, from an article dated April 16, 2008:

“ The Business & Professions Committee of the State Assembly held a bill hearing on April 9, 2008 at which time the proposed AB 2398 (Amended April 1, 2008) was presented to the Committee. Unfortunately, following a brief discussion and only a few minor changes made, the bill was approved by the Committee.

An amended draft of the bill was drafted on 4-10-08 and was approved by the Assembly Judiciary Committee on April 15th. The bill will now go to the full Assembly where it must be approved prior to May 31, 2008 in order to be sent to the Senate or it will die. Refer to the current attached draft.

This legislation is sponsored by the American Society for Dermatologic Surgery, and if passed will have a monumental impact on physicians, nurses, NPs , PAs and management companies involved in the aesthetic field. Physicians who are involved in aesthetic practices on a part-time basis must be on-site, providing direct supervision of delegated procedures, and must personally provide good faith exams on all patients prior to delegation. RNs will not be allowed to perform any procedures without the physician on-site unless the treatment is performed in a physician owned office with certain restrictions.

Of great note included in this bill is the severe scrutiny of lay (non-physician), corporate owned entities, or management companies, that manage “medspas”, which would deemed to be the “owners / operators” of the practice in violation of the “corporate practice of medicine prohibition.” Entities in violation would be subjected to extreme penalties and even prison time. Physicians supervising aesthetic practices conducted in these entities would also risk penalties and loss of licenses.

Due to the nature of the enforcement of this legislation the Medical Board must opine on its position regarding passage. An important Board Meeting of the Medical Board will be held on April 25, 2008 from 9:00am to 1:00pm to review this amended bill. This meeting is open to the public and opposition will be heard; the location will be the Convention Center 1400 J. Street, Sacramento. Attendance at this meeting and opposition voiced by those concerned is vital, especially nurses and physicians who realize the real patient safety issues involved.

Companies and individuals involved in aesthetic practice operation and/or management must assume an immediate and aggressive opposition to this bill; the consequences of passage, even with significant modification would be disastrous. Letters of opposition, especially sent from your physician and nurses on office letterhead, should be faxed and mailed immediately to the below contacts:

Assembly Members

Assembly B &P Committee

P.O Box 942849

Sacramento, CA 9429-0049

Karen Bass, Majority Leader (916) 319-2147

Mike Eng, Chair (916) 319-2149

Ross Warren, Consultant (916) 319-2149

Alan Nakanishi (916) 319-2110

Judiciary Committee

David Jones (916) 319-2188

Medical Board

2005 Evergreen St. (1200)

Sacramento, CA 95815

Chief of Legislation Linda Whitney (916) 263-2387

You can follow the status of this bill on the legislative website (www.leginfo.ca.gov)

This is an extremely time sensitive matter and your personal involvement is important.”

I encourage all of you to send letters of opposition as soon as possible. I would also like to suggest contacting your own Assemblyman & voice your opposition to the bill. To assist you, I have attached a list of all CA Assembly Members, their District Numbers, addresses & phone numbers. You can also go to http://www.assembly.ca.gov/ to email them (click on Assembly Roster).

Thank you.
Sandy"

Of course, I'm not in California, nor are the majority of medical spa owners who probably received this email. Utah, (my state) already operates under direct physician oversight so I'm well acquainted it. Surface was built physician services and treatments as a foundation rather than as something to be skirted. What will happen I wonder?