Enrolled Copy H.B. 365
1 COSMETIC PROCEDURE AMENDMENTS
2024 GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Jeffrey D. Stenquist Senate Sponsor: Curtis S. Bramble
2
3 LONG TITLE
4 General Description:
5 This bill modifies provisions relating to cosmetic procedures.
6 Highlighted Provisions:
7 This bill:
8 ▸ defines terms;
9 ▸ allows a telemedicine service to be used for an initial consult before the initiation of a
10 treatment protocol or series of treatments; and
11 ▸ makes technical changes.
12 Money Appropriated in this Bill:
13 None
14 Other Special Clauses:
15 None
16 Utah Code Sections Affected:
17 AMENDS:
18 58-1-102, as last amended by Laws of Utah 2022, Chapter 415
19 58-1-302.1, as enacted by Laws of Utah 2023, Chapter 278
20 58-1-506, as last amended by Laws of Utah 2023, Chapter 223
21 58-67-102, as last amended by Laws of Utah 2023, Chapter 2
22
23 Be it enacted by the Legislature of the state of Utah:
24 Section 1. Section 58-1-102 is amended to read:
25 58-1-102 . Definitions.
26 [For purposes of] As used in this title:
27 (1) "Ablative procedure" [is as defined in] means the same as that term is defined in Section
28 58-67-102.
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29 (2) "Cosmetic medical procedure":
30 (a) [is as defined in] means the same as that term is defined in Section 58-67-102; and
31 (b) except for Chapter 67, Utah Medical Practice Act, and Chapter 68, Utah Osteopathic
32 Medical Practice Act, does not apply to the scope of practice of an individual
33 licensed under this title if the individual's scope of practice includes the authority to
34 operate or perform surgical procedures.
35 (3) "Cryolipolysis" means a nonablative fat reduction procedure that uses cold temperature
36 to reduce fat deposits in certain areas of the body.
37 [(3)] (4) "Department" means the Department of Commerce.
38 [(4)] (5) "Director" means the director of the Division of Professional Licensing.
39 [(5)] (6) "Division" means the Division of Professional Licensing created in Section
40 58-1-103.
41 [(6)] (7) "Executive director" means the executive director of the Department of Commerce.
42 [(7)] (8) "Licensee" includes any holder of a license, certificate, registration, permit, student
43 card, or apprentice card authorized under this title.
44 [(8)] (9) (a) (i) "Nonablative procedure" means a procedure that is expected or
45 intended to alter living tissue, but not intended or expected to excise, vaporize,
46 disintegrate, or remove living tissue.
47 (ii) Notwithstanding Subsection (8)(a)(i), nonablative procedure includes hair removal
48 and cryolipolysis.
49 (b) "Nonablative procedure" does not include:
50 (i) a superficial procedure;
51 (ii) the application of permanent make-up; or
52 (iii) the use of photo therapy and lasers for neuromusculoskeletal treatments that are
53 performed by an individual licensed under this title who is acting within their
54 scope of practice.
55 [(9)] (10) "Pain clinic" means:
56 (a) a clinic that advertises its primary purpose is the treatment of chronic pain; or
57 (b) a clinic in which greater than 50% of the clinic's annual patient population receive
58 treatment primarily for non-terminal chronic pain using Schedule II-III controlled
59 substances.
60 [(10)] (11) "Superficial procedure" means a procedure that is expected or intended to
61 temporarily alter living skin tissue and may excise or remove stratum corneum but have
62 no appreciable risk of damage to any tissue below the stratum corneum.
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63 (12) "Telemedicine service" means the same as that term is defined in Section 26B-4-704.
64 [(11)] (13) "Unlawful conduct" [has the meaning given in] means the same as that term is
65 defined in Subsection 58-1-501(1).
66 [(12)] (14) "Unprofessional conduct" [has the meaning given in] means the same as that term
67 is defined in Subsection 58-1-501(2).
68 Section 2. Section 58-1-302.1 is amended to read:
69 58-1-302.1 . Temporary license for telemedicine.
70 (1) As used in this section:
71 (a) "Nonresident health care license" means a health care license issued by another state,
72 district, or territory of the United States.
73 (b) "Telemedicine service" means the same as that term is defined in Section [26-60-102]
74 26B-4-704.
75 (2) An individual with a temporary license issued under this section is authorized to provide
76 a telemedicine service if:
77 (a) the telemedicine service is a service the individual is licensed to perform under the
78 nonresident health care license of the state, district, or territory that issued the
79 nonresident health care license;
80 (b) at the time the telemedicine service is performed, the patient is located in Utah; and
81 (c) performing the telemedicine service would not otherwise violate state law.
82 (3) The division shall issue a temporary license described in Subsection (2) to an individual
83 who has a nonresident health care license in good standing if:
84 (a) the individual has completed an application for a license by endorsement in
85 accordance with Section 58-1-302; and
86 (b) the division determines that they will not be able to process the application within 15
87 days from the day on which the application is submitted.
88 (4) The division may not charge a fee for a temporary license issued under this section
89 beyond the fee required for a license issued under Section 58-1-302.
90 Section 3. Section 58-1-506 is amended to read:
91 58-1-506 . Supervision of cosmetic medical procedures.
92 (1) For purposes of this section:
93 (a) "Delegation group A" means the following who are licensed under this title, acting
94 within their respective scopes of practice, and qualified under Subsections (2)(f)(i)
95 and (iii):
96 (i) a physician assistant, if acting in accordance with Chapter 70a, Utah Physician
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97 Assistant Act;
98 (ii) a registered nurse;
99 (iii) a master esthetician; and
100 (iv) an electrologist, if evaluating for or performing laser hair removal.
101 (b) "Delegation group B" means:
102 (i) a practical nurse or an esthetician who is licensed under this title, acting within
103 their respective scopes of practice, and qualified under Subsections (2)(f)(i) and
104 (iii); and
105 (ii) a medical assistant who is qualified under Subsections (2)(f)(i) and (iii).
106 (c) "Direct cosmetic medical procedure supervision" means the supervisor:
107 (i) has authorized the procedure to be done on the patient by the supervisee; and
108 (ii) is present and available for a face-to-face communication with the supervisee
109 when and where a cosmetic medical procedure is performed.
110 (d) "General cosmetic medical procedure supervision" means the supervisor:
111 (i) has authorized the procedure to be done on the patient by the supervisee;
112 (ii) is available in a timely and appropriate manner in person to evaluate and initiate
113 care for a patient with a suspected adverse reaction or complication; and
114 (iii) is located within 60 minutes or 60 miles of the cosmetic medical facility.
115 (e) "Hair removal review" means:
116 (i) conducting an in-person, face-to-face interview of a patient based on the responses
117 provided by the patient to a detailed medical history assessment that was prepared
118 by the supervisor;
119 (ii) evaluating for contraindications and conditions that are part of the treatment plan;
120 and
121 (iii) if the patient history or patient presentation deviates in any way from the
122 treatment plan, referring the patient to the supervisor and receiving clearance from
123 the supervisor before starting the treatment.
124 (f) "Indirect cosmetic medical procedure supervision" means the supervisor:
125 (i) has authorized the procedure to be done on the patient by the supervisee;
126 (ii) has given written instructions to the person being supervised;
127 (iii) is present within the cosmetic medical facility in which the person being
128 supervised is providing services; and
129 (iv) is available to:
130 (A) provide immediate face-to-face communication with the person being
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131 supervised; and
132 (B) evaluate the patient, as necessary.
133 (2) A supervisor supervising a nonablative cosmetic medical procedure for hair removal
134 shall:
135 (a) have an unrestricted license to practice medicine or advanced practice registered
136 nursing in the state;
137 (b) develop the medical treatment plan for the procedure;
138 (c) conduct a hair removal review, or delegate the hair removal review to a member of
139 delegation group A, of the patient prior to initiating treatment or a series of
140 treatments;
141 (d) personally perform the nonablative cosmetic medical procedure for hair removal, or
142 authorize and delegate the procedure to a member of delegation group A or B;
143 (e) during the nonablative cosmetic medical procedure for hair removal provide general
144 cosmetic medical procedure supervision to individuals in delegation group A
145 performing the procedure, except physician assistants, who shall act in accordance
146 with Chapter 70a, Utah Physician Assistant Act, and indirect cosmetic medical
147 procedure supervision to individuals in delegation group B performing the procedure;
148 and
149 (f) verify that a person to whom the supervisor delegates an evaluation under Subsection
150 (2)(c) or delegates a procedure under Subsection (2)(d) or (3)(c)(ii):
151 (i) has received appropriate training regarding the medical procedures developed
152 under Subsection (2)(b);
153 (ii) has an unrestricted license under this title or is performing under the license of the
154 supervising physician and surgeon; and
155 (iii) has maintained competence to perform the nonablative cosmetic medical
156 procedure through documented education and experience of at least 80 hours, as
157 further defined by rule, regarding:
158 (A) the appropriate standard of care for performing nonablative cosmetic medical
159 procedures;
160 (B) physiology of the skin;
161 (C) skin typing and analysis;
162 (D) skin conditions, disorders, and diseases;
163 (E) pre- and post-procedure care;
164 (F) infection control;
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165 (G) laser and light physics training;
166 (H) laser technologies and applications;
167 (I) safety and maintenance of lasers;
168 (J) cosmetic medical procedures an individual is permitted to perform under this
169 title;
170 (K) recognition and appropriate management of complications from a procedure;
171 and
172 (L) cardiopulmonary resuscitation (CPR).
173 (3) For a nonablative cosmetic medical procedure for tattoo removal:
174 (a) a supervisor supervising a nonablative cosmetic medical procedure for tattoo
175 removal shall:
176 (i) have an unrestricted license to practice medicine or advanced practice registered
177 nursing in the state; and
178 (ii) develop the medical treatment plan for the procedure; and
179 (b) a nurse practitioner or physician assistant:
180 (i) shall conduct an in-person face-to-face evaluation of a patient before initiating a
181 treatment protocol or series of treatments for removing a tattoo;
182 (ii) shall inspect the patient's skin for any discoloration unrelated to the tattoo and any
183 other indication of cancer or other condition that should be treated or further
184 evaluated before the tattoo is removed;
185 (iii) shall refer a patient with a condition described in Subsection (3)(b)(ii) to a
186 physician for treatment or further evaluation; and
187 (iv) may not perform a nonablative cosmetic medical procedure to remove a tattoo on
188 a patient unless the patient is approved for the tattoo removal by a physician after
189 the physician evaluates the patient.
190 (4) For a nonablative cosmetic medical procedure other than hair removal under Subsection
191 (2) or tattoo removal under Subsection (3):
192 (a) a physician who has an unrestricted license to practice medicine, a nurse practitioner
193 who has an unrestricted license for advanced practice registered nursing, or a
194 physician assistant acting in accordance with Chapter 70a, Utah Physician Assistant
195 Act, who has an unrestricted license to practice as a physician assistant, shall:
196 (i) develop a treatment plan for the nonablative cosmetic medical procedure; and
197 (ii) conduct an [in-person face-to-face ]evaluation of the patient [prior to] either
198 in-person or utilizing a live telemedicine visit before the initiation of a treatment
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199 protocol or series of treatments; and
200 [(b) a nurse practitioner or physician assistant conducting an in-person face-to-face
201 evaluation of a patient under Subsection (3)(a)(ii) prior to removing a tattoo shall:]
202 [(i) inspect the patient's skin for any discoloration unrelated to the tattoo and any other
203 indication of cancer or other condition that should be treated or further evaluated
204 before the tattoo is removed;]
205 [(ii) refer a patient with any such condition to a physician for treatment or further
206 evaluation; and]
207 [(iii) shall not supervise a nonablative cosmetic medical procedure to remove a tattoo
208 on the patient until the patient has been approved for the tattoo removal by a
209 physician who has evaluated the patient; and]
210 [(c)] (b) the supervisor supervising the procedure shall:
211 (i) have an unrestricted license to practice medicine or advanced practice registered
212 nursing;
213 (ii) personally perform the nonablative cosmetic medical procedure or:
214 (A) authorize and provide general cosmetic medical procedure supervision for the
215 nonablative cosmetic medical procedure that is performed by a registered nurse
216 or a master esthetician;
217 (B) authorize and provide supervision as provided in Chapter 70a, Utah Physician
218 Assistant Act, for the nonablative cosmetic medical procedure that is
219 performed by a physician assistant; or
220 (C) authorize and provide direct cosmetic medical procedure supervision for the
221 nonablative cosmetic medical procedure that is performed by an esthetician;
222 and
223 (iii) verify that a person to whom the supervisor delegates a procedure under
224 Subsection (3)(c):
225 (A) has received appropriate training regarding the medical procedures to be
226 performed;
227 (B) has an unrestricted license and is acting within the person's scope of practice
228 under this title; and
229 (C) is qualified under Subsection (2)(f)(iii).
230 [(4)] (5) A supervisor performing or supervising a cosmetic medical procedure under
231 Subsection (2) or (3) or (4) shall ensure that:
232 (a) the supervisor's name is prominently posted at the cosmetic medical facility
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233 identifying the supervisor;
234 (b) a copy of the supervisor's lice