Can Utah APRNs independently perform ablative cosmetic medical procedures? Anderson v. Dept. of Commerce Explained

The Utah Supreme Court’s decision in Anderson v. Department of Commerce provides crucial guidance on the scope of practice for advanced practice registered nurses (APRNs) regarding ablative cosmetic medical procedures. The case arose when the Utah Division of Professional Licensing charged Anderson, a licensed APRN, with unlawfully practicing medicine by performing tumescent liposuction and fat grafting procedures.

Background and Facts

Since 2012, Anderson had been licensed as an APRN. In 2019, she began providing body contouring services including tumescent liposuction and fat transfer procedures using the Vibrasat device with local anesthesia. DOPL filed a notice of agency action alleging Anderson engaged in unlicensed practice of medicine and exceeded her APRN scope of practice. The parties agreed these procedures constitute ablative cosmetic medical procedures under Utah law.

Key Legal Issues

The central question was whether APRNs have statutory authority to perform ablative cosmetic medical procedures. Under Utah Code § 58-67-102(19)(b)(ii), such procedures do not constitute unlawful practice of medicine if “the scope of practice for the person performing the ablative cosmetic medical procedure includes the authority to operate or perform a surgical procedure.” The court had to determine whether the broad language in the Nurse Practice Act provides this authorization.

Court’s Analysis and Holding

The court applied correctness review to this question of statutory interpretation. Examining the entire statutory scheme, the court noted that the legislature used specific language—”operate” or “perform a surgical procedure”—that mirrors express authorizations for other licensees like dentists and podiatrists. The NPA’s broad definition referencing “diagnosis, treatment, correction, consultation, and referral” does not constitute express authorization to operate or perform surgery. The court emphasized that the 2012 Cosmetic Medical Procedures bill created a comprehensive regulatory scheme that expressly allows APRNs to perform only two specific ablative procedures (erbium full ablation and CO2 fractionated resurfacing) and only under physician delegation and supervision.

Practice Implications

This decision clarifies that Utah’s professional licensing statutes require express statutory authorization for healthcare professionals to perform procedures outside traditional scope boundaries. The ruling reinforces that comprehensive legislative schemes like the Cosmetic Medical Procedures Act must be read harmoniously, and specific delegation provisions would be rendered meaningless if broader interpretations were adopted. Healthcare professionals should ensure their scope of practice explicitly authorizes specific procedures rather than relying on broad definitional language.