Title 23
Health and Safety

CHAPTER 105
Medical Spas Safety Act

§ 23-105-1. Definitions.

For purposes of this chapter:

(1) “Ablative lasers” or “ablative energy devices” means lasers intended to excise or vaporize the outer layer of skin.

(2) “Advanced practice registered nurse” or “APRN” means a registered nurse who has an active, unrestricted advanced practice registered nurse license granted under the authority of chapter 34 of title 5.

(3) “Certified nurse practitioner” means a certified nurse practitioner as defined in § 5-34-3.

(4) “Cosmetic medical procedure” means any procedure that does not require sedation that is performed on a person and is directed at improving the person’s appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease. Cosmetic medical procedures may include, but are not limited to, microneedling, hair transplants, cosmetic injections, cosmetic soft tissue fillers, dermaplaning, dermastamping, dermarolling, microdermabrasion, chemical peels, laser resurfacing, laser treatment of veins, sclerotherapy, other laser procedures, intense pulsed light, ablative laser, permanent fat removal, radio frequency microneedling, platelet-rich plasma, platelet-rich fibrin, and the use of class II medical devices designed to induce deep skin tissue alteration. A cosmetic medical service shall be performed by a delegate only if the services are within the scope of the delegate and have been delegated by a medical director, supervising physician, supervising PA, or supervising CNP who is responsible for supervision of the services performed.

(5) “Delegate” means a licensed non-physician tasked with performing a cosmetic medical procedure as defined in this section by a physician, PA, or CNP.

(6) “Department” means the Rhode Island department of health.

(7) “Medical director” means a physician or certified nurse practitioner who assumes the role of, or holds oneself out as, medical director. The medical director shall be:

(i) Trained in the indications for, and performance of, cosmetic medical procedures, including all medical devices or instruments that can alter or cause biological change or damage the skin and subcutaneous tissue. Training programs provided by a manufacturer or vendor of a medical device or supplies shall not be a medical director’s, supervising physician’s, PA’s, or CNP’s only education in the cosmetic medical service or the operation of medical devices to be used;

(ii) Responsible for implementing policies and procedures to ensure quality patient care;

(iii) Responsible for the delegation and supervision of cosmetic procedures;

(iv) Responsible for the oversight of all cosmetic medical procedures performed by physicians, PAs, CNPs, and non-physicians; and

(v) Responsible for ensuring that all supervising physicians, supervising PAs, and supervising CNPs, any physicians, PAs, and APRNs performing cosmetic medical procedures, and any non-physicians, non-PAs, and non-APRNs delegated to perform cosmetic medical procedures, are properly trained in the safe and effective performance of all cosmetic medical procedures that they perform at the medical spa.

(8) “Medical spa” means a licensed establishment in which cosmetic medical procedures are performed.

(9) “Physician” means an allopath or osteopath who has an active, unrestricted medical license granted under the provisions of chapter 37 of title 5.

(10) “Physician assistant” or “PA” means a person who is licensed and qualified by academic and practical training to provide medical and surgical services in collaboration with physicians.

(11) “Supervision” means an arrangement when a qualified supervising physician, a physician assistant in collaboration with a physician, or a CNP is either:

(i) On site and able to directly observe the treatment being performed, though not necessarily in the same room (i.e., direct supervision); or

(ii) Is off site, but is in the state and immediately available if needed, either in person or by telecommunication (i.e., indirect supervision).