https://www.mdside.com/blog/ State-by-state analysis of medical direction, good faith exams, PC-MSO structure and the rules for med spas, IV clinics and telehealth brands, written against primary sources. en-us Mon, 05 Oct 2026 19:35:25 +0000 https://www.mdside.com/rule-watch-2026-10-02/ https://www.mdside.com/rule-watch-2026-10-02/ Mon, 05 Oct 2026 19:19:02 +0000 Victor D. Cruz, MD Rule Watch A compounded glutathione recall, an FDA letter on online Botox sales, counterfeit Ozempic charges and a DEA pharmacy revocation. https://www.mdside.com/can-a-nurse-practitioner-own-a-med-spa/ https://www.mdside.com/can-a-nurse-practitioner-own-a-med-spa/ Mon, 05 Oct 2026 01:30:22 +0000 Victor D. Cruz, MD Legal & Structure Can a nurse practitioner own a med spa? It depends on two state rules: entity ownership and NP practice authority. CA, FL, TX, GA, NJ, PA, TN, NY table. https://www.mdside.com/how-to-open-a-med-spa-as-a-nurse/ https://www.mdside.com/how-to-open-a-med-spa-as-a-nurse/ Mon, 05 Oct 2026 01:29:23 +0000 Victor D. Cruz, MD Operations How to open a med spa as a nurse, in order: state structure, physician, entity, facility license, sourcing, insurance, scope, marketing, then opening. https://www.mdside.com/how-to-start-an-iv-hydration-business/ https://www.mdside.com/how-to-start-an-iv-hydration-business/ Mon, 05 Oct 2026 01:28:24 +0000 Victor D. Cruz, MD Operations How to start an IV hydration business: who may own it, who orders and starts each IV, Texas Jenifer's Law, Florida AHCA, 503A vs 503B bags. https://www.mdside.com/does-a-med-spa-need-a-medical-director/ https://www.mdside.com/does-a-med-spa-need-a-medical-director/ Mon, 05 Oct 2026 01:27:24 +0000 Victor D. Cruz, MD Compliance Does a med spa need a medical director? If your menu includes any prescription treatment, you need a physician involved. State rules and a menu table inside. https://www.mdside.com/how-to-start-a-glp-1-telehealth-business/ https://www.mdside.com/how-to-start-a-glp-1-telehealth-business/ Mon, 05 Oct 2026 01:26:24 +0000 Victor D. Cruz, MD Operations How to start a GLP-1 telehealth business: what your brand owns, what licensed physicians must own, and the order to build licensure, structure and sourcing. https://www.mdside.com/collaborating-physician-liability/ https://www.mdside.com/collaborating-physician-liability/ Mon, 05 Oct 2026 01:25:25 +0000 Victor D. Cruz, MD Compliance Is a collaborating physician liable for a nurse practitioner's error? Board exposure is statutory and personal. Presence rules by state inside. https://www.mdside.com/what-can-an-esthetician-do/ https://www.mdside.com/what-can-an-esthetician-do/ Mon, 05 Oct 2026 01:24:25 +0000 Victor D. Cruz, MD Compliance Can estheticians do Botox? No state we checked allows it under the license. Microneedling and laser hair removal rules for CA, FL, TX, NY and OH inside. https://www.mdside.com/med-spa-medical-director-agreement/ https://www.mdside.com/med-spa-medical-director-agreement/ Mon, 05 Oct 2026 01:23:26 +0000 Victor D. Cruz, MD Legal & Structure What a medical director agreement for a med spa must say: fixed fair-market fee, named duties, stop authority, delegation documents, and a real exit plan. https://www.mdside.com/can-a-dentist-be-a-medical-director/ https://www.mdside.com/can-a-dentist-be-a-medical-director/ Mon, 05 Oct 2026 01:22:27 +0000 Victor D. Cruz, MD Legal & Structure Can a dentist be a medical director? For a med spa, usually not. Tennessee requires an MD or DO; Florida's clinic statute omits dentists. Table inside. https://www.mdside.com/diagnosis-code-for-good-faith-exam/ https://www.mdside.com/diagnosis-code-for-good-faith-exam/ Mon, 05 Oct 2026 00:12:09 +0000 Victor D. Cruz, MD Compliance There is no diagnosis code for a good faith exam. The code reflects what the exam found: Z41.1, E66 with Z68, or a medical condition. Table inside. https://www.mdside.com/can-a-registered-nurse-open-a-med-spa/ https://www.mdside.com/can-a-registered-nurse-open-a-med-spa/ Sun, 04 Oct 2026 23:46:49 +0000 Victor D. Cruz, MD Legal & Structure Can an RN open a med spa? In many states an RN can own the business, but every treatment still needs a physician's exam and order. State rules inside. https://www.mdside.com/colorado-med-spa-ownership-professional-service-corporation/ https://www.mdside.com/colorado-med-spa-ownership-professional-service-corporation/ Fri, 02 Oct 2026 17:08:42 +0000 Victor D. Cruz, MD State Guides Who can own a med spa in Colorado: C.R.S. 12-240-138 limits the medical entity to physician shareholders, with PAs in the minority. https://www.mdside.com/colorado-medical-director-supervision-rule-1-17/ https://www.mdside.com/colorado-medical-director-supervision-rule-1-17/ Fri, 02 Oct 2026 17:07:44 +0000 Victor D. Cruz, MD State Guides Colorado medical director supervision requirements under Board Rule 1.17: on-site visits every two weeks, 14-day chart review, written protocols. https://www.mdside.com/michigan-nurse-practitioner-medical-director/ https://www.mdside.com/michigan-nurse-practitioner-medical-director/ Fri, 02 Oct 2026 17:06:45 +0000 Victor D. Cruz, MD State Guides Can a nurse practitioner be a medical director in Michigan? What MCL 333.17211a lets an NP do alone, and the four med spa functions that need a physician. https://www.mdside.com/friendly-pc-model-california-carbon-health-art-center/ https://www.mdside.com/friendly-pc-model-california-carbon-health-art-center/ Fri, 02 Oct 2026 17:05:45 +0000 Victor D. Cruz, MD Legal & Structure The friendly PC model in California after the Carbon Health settlement and the Art Center Holdings brief: which MSO contract terms are now targets. https://www.mdside.com/compounded-semaglutide-b12-empower-warning-letter/ https://www.mdside.com/compounded-semaglutide-b12-empower-warning-letter/ Fri, 02 Oct 2026 17:04:46 +0000 Victor D. Cruz, MD Clinical Compounded semaglutide with B12 after FDA's Empower warning letter: why the add-on is not the test, and what a significant difference statement needs. https://www.mdside.com/alabama-weight-loss-prescribing-rules/ https://www.mdside.com/alabama-weight-loss-prescribing-rules/ Thu, 01 Oct 2026 06:39:41 +0000 Victor D. Cruz, MD State Guides Alabama weight-loss prescribing rules, Ala. Admin. Code ch. 540-X-17: who may prescribe phentermine, what a CRNP or PA may prescribe, refill limits. https://www.mdside.com/alabama-laser-delegation-levels/ https://www.mdside.com/alabama-laser-delegation-levels/ Thu, 01 Oct 2026 06:38:41 +0000 Victor D. Cruz, MD State Guides Who can operate a laser in Alabama: Level 1 and Level 2 delegates, case counts, supervision and registration under Ala. Admin. Code ch. 540-X-11. https://www.mdside.com/alabama-collaborating-physician-360-hour-cap/ https://www.mdside.com/alabama-collaborating-physician-360-hour-cap/ Thu, 01 Oct 2026 06:37:41 +0000 Victor D. Cruz, MD State Guides How many nurse practitioners can a physician supervise in Alabama: the 360-hour cap, quarterly QA and covering physician rules in ch. 540-X-8. https://www.mdside.com/colorado-nurse-practitioner-med-spa-without-physician/ https://www.mdside.com/colorado-nurse-practitioner-med-spa-without-physician/ Thu, 01 Oct 2026 06:36:41 +0000 Victor D. Cruz, MD State Guides Can a nurse practitioner open a med spa in Colorado without a physician? Prescriptive authority, the 750-hour mentorship, and the limits. https://www.mdside.com/michigan-laser-hair-removal-physician-supervision/ https://www.mdside.com/michigan-laser-hair-removal-physician-supervision/ Thu, 01 Oct 2026 06:35:41 +0000 Victor D. Cruz, MD State Guides Michigan laser hair removal rules: MCL 333.16276 requires physician supervision, patient consent to the operator, and limits what estheticians may do. https://www.mdside.com/michigan-telehealth-good-faith-exam/ https://www.mdside.com/michigan-telehealth-good-faith-exam/ Thu, 01 Oct 2026 06:34:42 +0000 Victor D. Cruz, MD State Guides Michigan telehealth good faith exam rules: consent, prescribing, referral and follow-up duties under MCL 333.16284 and 16285, plus the testosterone layer. https://www.mdside.com/ftc-hims-hers-lawsuit-telehealth-billing-privacy/ https://www.mdside.com/ftc-hims-hers-lawsuit-telehealth-billing-privacy/ Thu, 01 Oct 2026 06:33:42 +0000 Victor D. Cruz, MD Compliance The FTC Hims & Hers lawsuit, read for operators: the ROSCA billing counts, the cancellation count and the Meta customer-list allegations. https://www.mdside.com/arkansas-telehealth-testosterone/ https://www.mdside.com/arkansas-telehealth-testosterone/ Fri, 25 Sep 2026 15:52:23 +0000 Yared Vazquez, MD State Guides Arkansas telehealth testosterone: why 17 CAR § 140-3201 requires an in-person exam before a Schedule III prescription, the exceptions, and the path. https://www.mdside.com/connecticut-telehealth-testosterone/ https://www.mdside.com/connecticut-telehealth-testosterone/ Fri, 25 Sep 2026 15:51:24 +0000 Yared Vazquez, MD State Guides Connecticut telehealth testosterone: § 19a-906(c) bars Schedule III prescribing by telehealth. What video can still do, and the in-person path that works. https://www.mdside.com/missouri-telehealth-testosterone/ https://www.mdside.com/missouri-telehealth-testosterone/ Fri, 25 Sep 2026 15:50:24 +0000 Yared Vazquez, MD State Guides Missouri telehealth testosterone after H.B. 2372: what RSMo § 334.108.3 now bars, the competing § 191.1146 reading, and the in-person path that works. https://www.mdside.com/pennsylvania-telehealth-testosterone/ https://www.mdside.com/pennsylvania-telehealth-testosterone/ Fri, 25 Sep 2026 15:49:24 +0000 Yared Vazquez, MD State Guides Pennsylvania telehealth testosterone: why 49 Pa. Code § 16.92 requires a physical exam before a Schedule III prescription, and the 30-day path. https://www.mdside.com/nurse-practitioner-testosterone-telehealth/ https://www.mdside.com/nurse-practitioner-testosterone-telehealth/ Fri, 25 Sep 2026 15:48:25 +0000 Yared Vazquez, MD Compliance Can a nurse practitioner prescribe testosterone by telehealth? Yes in most states. The 8 where NP rules are stricter: supply caps, physician review, exams. https://www.mdside.com/testosterone-pdmp-check-by-state/ https://www.mdside.com/testosterone-pdmp-check-by-state/ Fri, 25 Sep 2026 15:47:25 +0000 Yared Vazquez, MD Compliance PDMP check for testosterone by state: the 13 states whose mandate reaches it, how often to query, and where only opioids and benzodiazepines trigger it. https://www.mdside.com/telehealth-trt-program-survives-dea-deadline/ https://www.mdside.com/telehealth-trt-program-survives-dea-deadline/ Fri, 25 Sep 2026 15:46:26 +0000 Yared Vazquez, MD Operations Telehealth TRT after the DEA deadline: how to build a testosterone program that keeps working if the flexibilities extend, get replaced, or lapse. https://www.mdside.com/rule-watch-2026-09-25/ https://www.mdside.com/rule-watch-2026-09-25/ Fri, 25 Sep 2026 04:09:15 +0000 Victor D. Cruz, MD Rule Watch FDA's Empower warning letter on compounded GLP-1s, new Kybella label warnings, a cord blood product letter and more, for clinic operators. https://www.mdside.com/alabama-telehealth-testosterone/ https://www.mdside.com/alabama-telehealth-testosterone/ Thu, 24 Sep 2026 23:28:40 +0000 Yared Vazquez, MD State Guides Alabama telehealth testosterone: the in-person encounter rule in Ala. Code § 34-24-704, the hybrid visit the Board accepts, and the ACSC requirement. https://www.mdside.com/louisiana-telehealth-testosterone/ https://www.mdside.com/louisiana-telehealth-testosterone/ Thu, 24 Sep 2026 23:27:40 +0000 Yared Vazquez, MD State Guides Louisiana telehealth testosterone: the in-person rule in R.S. 40:1223.4 and LSBME § 7513, the facility exception, and the annual visit video depends on. https://www.mdside.com/minnesota-telehealth-testosterone/ https://www.mdside.com/minnesota-telehealth-testosterone/ Thu, 24 Sep 2026 23:26:41 +0000 Yared Vazquez, MD State Guides Minnesota telehealth testosterone: Minn. Stat. § 151.37 requires an in-person exam first. The group-practice path, and why hCG is caught too. https://www.mdside.com/rhode-island-telehealth-testosterone/ https://www.mdside.com/rhode-island-telehealth-testosterone/ Thu, 24 Sep 2026 23:25:42 +0000 Yared Vazquez, MD State Guides Rhode Island telehealth testosterone: what 216-RICR-40-05-1 says, what the Board's guideline prohibits, and the in-person path that holds up. https://www.mdside.com/telehealth-testosterone-by-state/ https://www.mdside.com/telehealth-testosterone-by-state/ Thu, 24 Sep 2026 22:31:37 +0000 Yared Vazquez, MD Compliance Telehealth testosterone by state: where a live video visit can start TRT for a new patient, the 8 states that need in-person first, and the conditions. https://www.mdside.com/how-to-get-legitscript-certified/ https://www.mdside.com/how-to-get-legitscript-certified/ Thu, 24 Sep 2026 12:10:00 +0000 Victor D. Cruz, MD Compliance How to get LegitScript certified: the documents you need, the order to do things in, how long review takes, and why clinic applications stall. https://www.mdside.com/legitscript-glp-1-weight-loss/ https://www.mdside.com/legitscript-glp-1-weight-loss/ Thu, 24 Sep 2026 12:09:00 +0000 Yared Vazquez, MD Compliance LegitScript for GLP-1 brands: how reviewers treat compounded semaglutide and tirzepatide, pharmacy and prescribing checks, and copy that fails review. https://www.mdside.com/legitscript-for-med-spas/ https://www.mdside.com/legitscript-for-med-spas/ Thu, 24 Sep 2026 12:08:00 +0000 Gavin W. Sigle, MD Compliance Does a med spa need LegitScript certification? When in-person care is out of scope, and when GLP-1s, hormones, telehealth or online sales bring you in. https://www.mdside.com/legitscript-trt-telehealth/ https://www.mdside.com/legitscript-trt-telehealth/ Thu, 24 Sep 2026 12:07:00 +0000 Yared Vazquez, MD Compliance LegitScript certification for TRT telehealth: Schedule III rules, DEA telemedicine flexibilities through 2026, labs, state licensure and ad copy. https://www.mdside.com/legitscript-peptides/ https://www.mdside.com/legitscript-peptides/ Thu, 24 Sep 2026 12:06:00 +0000 Gavin W. Sigle, MD Compliance LegitScript and peptides: what reviewers ask about BPC-157, research-use-only supply, FDA Category 2 changes and 503A compounding. https://www.mdside.com/legitscript-vs-nabp/ https://www.mdside.com/legitscript-vs-nabp/ Thu, 24 Sep 2026 12:05:00 +0000 Victor D. Cruz, MD Compliance LegitScript vs NABP compared: who each certification is for, .pharmacy domains, and what Google, Meta and the card networks accept. https://www.mdside.com/mobile-iv-therapy-structure/ https://www.mdside.com/mobile-iv-therapy-structure/ Sun, 20 Sep 2026 01:57:36 +0000 Yared Vazquez, MD Operations Mobile IV therapy structure: facility licensure, where controlled substances are registered, where stock sits, and who orders the treatment. https://www.mdside.com/concierge-event-iv-services/ https://www.mdside.com/concierge-event-iv-services/ Sun, 20 Sep 2026 01:56:36 +0000 Yared Vazquez, MD Operations Event and concierge IV services: why a standing order is not a substitute for the exam, and what off-site emergency readiness actually requires. https://www.mdside.com/florida-add-weight-management/ https://www.mdside.com/florida-add-weight-management/ Sun, 20 Sep 2026 01:55:36 +0000 Yared Vazquez, MD Growth Adding medical weight management in Florida: AHCA licensure or exemption, sourcing, advertising limits and what actually changes in your structure. https://www.mdside.com/adding-hormone-therapy-to-iv-clinic/ https://www.mdside.com/adding-hormone-therapy-to-iv-clinic/ Sun, 20 Sep 2026 01:54:37 +0000 Yared Vazquez, MD Growth Adding hormone therapy to an IV clinic: controlled substance registration, CLIA if you test on site, and the telehealth prescribing question. https://www.mdside.com/buyer-diligence-pc-mso/ https://www.mdside.com/buyer-diligence-pc-mso/ Sun, 20 Sep 2026 01:53:37 +0000 Victor D. Cruz, MD Legal & Structure The findings that recur in PC-MSO diligence: commingled banking, fees that do not match the MSA, undated protocols, missing BAAs and void proxies. https://www.mdside.com/mso-statutes-oregon-vermont-california/ https://www.mdside.com/mso-statutes-oregon-vermont-california/ Sun, 20 Sep 2026 01:52:38 +0000 Victor D. Cruz, MD Legal & Structure Oregon SB 951, Vermont H.583 and California SB 351 compared: what the three MSO statutes share, how they differ in kind, and what a national operator does. https://www.mdside.com/documents-to-open-a-med-spa/ https://www.mdside.com/documents-to-open-a-med-spa/ Sun, 20 Sep 2026 01:40:42 +0000 Victor D. Cruz, MD Operations The documents needed to open a med spa, grouped by what blocks what: entity, facility licensure, clinical governance, people, money and insurance.