By: Caitlin A. Koppenhaver
On June 20, 2025, Governor Abbott signed House Bill 3749, known as Jenifer’s Law, into law. Effective September 1, 2025, this legislation amends the Texas Occupations Code to regulate, for the first time, elective intravenous (IV) therapy performed outside of hospitals and physician offices (Full text here: 89(R) HB 3749 – Enrolled version – Bill Text).
The bill was passed unanimously following the tragic 2023 death of Jenifer Cleveland, who received an IV infusion at a med spa administered by an unlicensed individual without adequate physician oversight. Her case exposed the lack of clear regulatory safeguards in rapidly expanding wellness sectors such as elective IV therapy.
The statute provides a clear definition of “elective intravenous therapy” as a procedure in which fluids, nutrients, medications, or blood are administered directly into a patient’s vein. It applies when a patient seeks treatment to relieve temporary discomfort or to promote temporary wellness, rather than to treat a specific illness or injury. The statute further clarifies that elective IV therapy does not include treatments administered in a physician’s office, a licensed hospital, a licensed mental health facility, or a Texas state-operated hospital. This language is significant because it squarely situates elective IV therapy within the wellness and medspa context.
HB 3749 also establishes who may prescribe or order elective IV therapy. A physician may delegate this authority to a physician assistant (PA) or an advanced practice registered nurse (APRN), provided the delegation occurs under a prescriptive authority agreement or facility-based protocol authorized by Chapter 157 of the Occupations Code. Further, this delegation remains subject to the statutory cap on prescriptive authority, which limits physicians to supervising the equivalent of seven full-time delegates. Nothing in the new law diminishes the physician’s ongoing supervisory responsibility.
The law is equally clear on administration. Elective IV therapy may be administered only by a physician, PA, APRN, or registered nurse (RN), and always under “adequate physician supervision.” The Act does not define ‘adequate supervision,’ leaving the term subject to interpretation by the Texas Medical Board. In practice, providers should anticipate that the Board may look to its existing delegation rules which emphasize physician accessibility, written protocols, good faith exams, emergency procedures, and chart review as the baseline for compliance.
Because Jenifer’s Law integrates elective IV therapy into Texas’s broader prescriptive authority structure, compliance requires careful attention to delegation agreements and supervisory practices. Physicians must make sure that delegation is properly documented in writing, that prescriptive authority agreements are registered with the Texas Medical Board, and that chart review and supervision requirements are satisfied. Providers should also update screening, consent, and emergency protocols to reflect the elective nature of these services and the supervisory standard imposed by the statute.
Jenifer’s Law defines physician responsibility and delegation under Texas law and provides that elective IV therapy is to be regulated within a medical oversight framework. For an industry that has expanded rapidly in recent years, this is a legislative reset that establishes patient safety as the cornerstone of continued growth.
