Retail Health Clinics: State Legislation and Laws


November 2011; material added 8/1/2017

Retail health clinics have grown in number from the first few that opened in early 2000, to more than 1,100 clinics in 2009. As of 2015 there were over 2,000 such clinics in operation in 41 states and Washington, D.C. According to their trade association,CCA, the clinics have served more than 35 million patients. These clinics are generally open seven days a week, with extended weekday hours; no appointments are necessary and visits generally take 15 to 20 minutes due to the limited scope of services offered. The large majority are co-located within a larger retail store, ranging from supermarkets and "big-box" discount super-stores to drug stores.

According to the Convenient Care Association, a trade association for retail clinics, the top medical conditions treated at these clinics include: sore throat, common colds, flu symptoms, cough, and sinus infection.  Visits to these clinics generally cost consumers between $45 and $75.  In some retail clinics, such as MinuteClinics in Minnesota, prices for various medical services are posted on an electronic sign.  Many health insurance companies will cover and reimburse clinic visits and some have waived co-pay fees at these clinics.  A recent study discovered that 67 percent of retail clinic visits were paid for by insurance (Medicare, Medicaid, private insurance, or workers' compensation). In contrast, about 90 percent of visits to primary care physicians are paid by insurance. Most clinics can refer patients to local doctors or emergency rooms and the availability of these clinics can help people avoid emergency rooms.  

2016-2017 Reports

  • What's Next for Retail Healthcare? The Trend That Disrupted Healthcare Consumerism a Decade Ago Continues to Evolve.
         In the early-to-mid 2000s, when the first retail clinics emerged and quickly proliferated, traditional healthcare providers raised concerns about quality as well as protecting their market share. In the meantime, the ability to get affordable treatment on the fly for minor illnesses such as coughs and sore throats became a hit with patients. The majority (91%) of patients who recently used a retail clinic reported that they were "satisfied" or "very satisfied" with their visit, according to an April 17, 2017, retail clinic survey from healthcare market researcher Kalorama Information. … Altogether, there are more than 2,500 convenient care clinics in operation in 43 states and Washington, D.C., according to the CCA association.” [ Read the full article] Published by Health Leaders Media, Sept. 29, 2017

  • Use Of Retail Clinics For Low-Acuity Conditions.  [Read extract] Health Aff May 2016.
    Use Of Retail Clinics: The Authors Reply. [Read extract] - Health Aff May 2016.

  • Retail Clinics on Stateline January 2016 health article by Pew's Stateline summarized it this way: "Retail and urgent care clinics by definition receive walk-in business. No weeks of waiting for appointments. And typically, they stay open weekends and evenings, when private practices are often closed. Many are located in areas with few doctors’ offices nearby."

Some indepedent studies have found the clinics deliver good or efficient care. {Added Jan. 2016}
> In Minnesota, for instance, the MN Community Measurement, a nonprofit health research firm, ranked clinics highly in primary care in 2013.  (MN Health Quality Reprt, PDF)
According to a Robert Wood Johnson Foundation report patient visits to retail clinics grew nationally from 1.5 million in 2006 to 10.5 million in 2014,  As much as 2 percent of primary care visits are to commercial clinics rather than doctors’ offices.
A 2010 survey found most respondents cited convenience as the main reason for using retail clinics: 59 percent said their major reason was the convenience of the hours, 56 percent said it was that no appointments were required, and 48 percent said it was the location. (in Health System Change brief, published Nov. 2013)

State legislation that specifically addresses these retail clinics has been relatively limited.  Over a five-year period, at least 16 states have considered legislation while two bills, in Florida and New Hampshire, were signed into law.  One additional state, Massachusetts, created regulation governing retail clinics through executive action.  State legislators have heard recommendations from interests representing multiple sides of the issue.  Some suggest that such clinics are a positive innovation and should be encouraged by state and local governments.  These and other advocates promote the clinics as a convenient and affordable alternative for people with relatively minor health care needs.  Others suggest caution and may seek to regulate the structure or qualifications of the personnel providing the medical services.  For example, some physician groups have raised concerns about the clinics and whether they will disrupt continuity of care.  Yet others call for a more in-depth study of the issue rather than immediately creating new statutes.

Looking at the business side of retail clinics and worried about conflict of interest, in 2007, New York state regulators investigated business relationships between drugstore companies and retail clinics to examine if patients treated in a retail clinic were being improperly steered to the affliated, onsite pharmacy locations to fill their prescriptions.  In a related issue, New York, Illinois, Rhode Island, and Tennessee recently also considered legislation to limit locations with retail clinics from selling tobacco products.  There has been no federal regulation of retail clinics as of 2010.

 Massachusetts: An Example of Retail Clinic Regulation

In 2008 Massachusetts created regulations for the operation of retail health clinics, terming them "Limited Services Clinics."  These included a specific list of services that these clinics are limited to providing.  The list below includes services as provided by the Limited Services Clinic Coordinator in the Health Care Safety and Quality Bureau of the Massachusetts Department of Public Health.

  • Allergies (ages 6+)
  • Bronchitis (ages 10 -65)
  • Ear Infections
  • Pink Eye and Styes
  • Sinus Infection
  • Strep Throat
  • Swimmer's Ear
  • Upper Respiratory Infections
  • Ear Wax Removal
  • Flu Diagnosis (Ages 10-65)
  • Mononucleosis
  • Suture Removal
  • TB Testing
  • Vaccines and Immunizations
  • NO childhood immunizations other than Flu vaccine.
  • NO limited services clinic may provide treatment to children younger than 18 months.
  • Athlete's Foot
  • Cold Sores
  • Deer Tick Bites (ages 12+)
  • Impetigo
  • Minor Burns
  • Minor Skin Infections and Rashes
  • Minor Sunburn
  • Poison Ivy (ages 3+)
  • Ringworm
  • Shingles Treatment
  • Wart Removal

Scope of Practice Laws for Non-Physician Medical Practitioners

Retail clinics are staffed primarily by non-physician medical practitioners such as nurse practitioners (NPs), advanced nurse practitioners (ANPs), and physician assistants (PAs). State practices and laws vary regarding the flexibility of these non-physician medical practitioners to prescribe drugs and practice medicine. NCSL tracks Scope of Practice information through a legislative tracking database. To view legislation, please visit Scope of Practice Legislation Tracking Database.

Retail Clinics & Urgent Care Clinics by the Numbers - 2014

Merchant Medicine's industry Newsletter (c), published the following snapshots, dated November 1, 2014

Retail Clinics

|  Urgent Care Clinics

Retail Clinics on November 1, 2014:  1,805

Retail Clinics on October 1, 2014:  1,790

Net One-Month Change:  +15
Retail Clinics on January 1, 2014:  1,607
Net YTD Change:  198

Top-5 Retail Clinic Operators on November 1, 2014

Retail Clinic Operator


MinuteClinic 901
Walgreens Healthcare Clinic 437
The Little Clinic 140
Target Clinic 80
RediClinic 30

Pace Slows

The number of openings in October 2014 compared to the same month last year was significantly lower. MinuteClinic added seven new locations, which is still more than all other operators combined.  But in October 2013 MinuteClinic added 46 new sites.


Top-20 Urgent Care Operators Combined Clinics on November 1, 2014:  1,370
Top-20 Urgent Care Operators Combined Clinics on October 1, 2014:  1,354

Net One-Month Change: +16

| Top-5 Urgent Care Operators on November 1, 2014

Urgent Care Operator


Concentra 290
Dignity/U.S. Healthworks 158
MedExpress 138
American Family Care/DRX 133
NextCare 112

Active Urgent Care Market

The urgent care market was active, both with clinic openings and transactions.  The news that Humana is seeking to sell Concentra for $1 billion and that HCA is buying CareNow in Dallas, has the industry watching for a new burst of transactions

State-by-State Map - 2009

Retail clinics have grown not only in their numbers, but also in their overall distribution across the states.  By retail clinics have spread out to a total of 37 states as of February 2009.  The following map represents the distribution of these clinics across the different states.



Source: Merchant Medicine, LLC.

Additional Resources

Health Groups' Statements on Retail Health Clinics:

  • American Academy of Pediatrics Statement in Opposition to Retail Health Clinics.                                                       
  • American Academy of Family Physicians Statement of Non-Endorsement of Retail Health Clinics.                                      
  • Convenient Care Association, which is a trade association of retail clinics, released this report titled, "Convenient Care Clinics: The Future of Accessible Health Care"

NCSL Resources:

Additional Research and Opinions on Retail Clinics:


ARCHIVE of Retail Clinic Legislation

The following chart lists filed and enacted legislation targeting retail clinics in the states in the period of rapid growth, 2006-2011.

State/ Legislation or Regulation Details

2010 SB 10-170- Sets forth policies and procedures; referrals; restricts scope; vaccine reporting obligations; medical record obligations.


2007 Title XXXII, Chap. 456.041- Prohibits primary care physicians from supervising more than one office facility.  Also limits the number of health care professionals (nurse practitioners and physician assistants) a primary care physician is able to supervise to four. (HB 699- Passed and signed into law by governor on 6/20/06.)


2005-2006 SB 603- Bans NPs from practicing in retail locations that also house pharmacies.


2007 HB 1885 by Rep. McAuliffe- Would require a permit for the operation of such a retail health clinic, issued by the Department of Public Health, and sets forth requirements for obtaining a permit.  Requires clinics to pay $2,500 per location for permits from state health dept., clinics must notify patients' physicians about visit details, have 1 physician supervisor per 2 nurse practitioners NPs, allow patients to fill prescriptions at pharmacy of choice. (Held in committee; did not pass House as of 10/30/08.)

2008 HB 5372- Sets forth regulations for patient safety and follow-up care; tobacco and alcohol sale ban on premises. 


2009 SB 216- Accreditation; facilities; policies and protocols; referrals; patient notifications; compliance with state and federal laws; medical record obligations; state department enforcement and inspection.

2009 SB 216.1-  An amendment was proposed to change the bill to require the state department of health to conduct a study to determine: (1) the number of health clinics in the state; (2) the number of health clinics that are regulated by the state; (3) the adequacy of the state regulations for health clinics; and (4) whether any additional standards are necessary. (Proposed amendment #1 SB 216-1— Filed 02/11/2009.)


KRS 216B.024- Legislation authorizing licensure and regulation of health clinics and services.

902 KAR 20:400 (Regulations)- License; restricted scope; patient notification; administration and operation; facilities; non-promotion of host.


Executive Branch Regulation - The Massachusetts Public Health Council, which sets policy for the Department of Public Health, created regulations for the operation of retail health clinics in Massachusetts.  These regulations stipulate what medical conditions can be treated, what age groups can be treated, medical record keeping procedures, medical referral procedures, treatment of repeat patients, and regulate the sale of tobacco products if the retail clinic is located in a retail location that sells such products. [See description below]
(Passed/signed by governor in 1/08.)


2006 SB 1124- Limited the number of physician assistants that a physician could supervise to three.

New Hampshire

2008 HB 1484 by Rep. Emerton (Chapter 227)- Establishes a commission to study and develop legislation to regulate the operation of retail health clinics and limited service clinics, also known as "mini clinics". (Signed into law by governor on 6/16/08.)

2009 HB 422- Limits the scope of services to preventative and wellness promotion, and routine treatment of simple well-defined medical credentials; the employment of credentialed professional and medical staff; mandatory postings of services, hours and after-hour care sources. 

He-P 806- Licensing requirements for all non-emergency walk-in care centers (NEWCC) pursuant to RSA 151:2

New York

2011 NY S 3673- Relates to the establishment of convenient care clinics; authorizes the public health council to adopt/amend rules and regulations relating thereto.

2011 NY A 81- Relates to the establishment of convenient care clinics within a retail business operation or space used by an employer to provide health care services to its employees.

North Carolina

2007 SB 1256 by Sen. Rand- Would provide for a study by the Legislative Research Commission on Store-Based Retail Health Clinics. (Carried over to 2008 Session; did not pass by the end of session, 7/25/2008.)


2008 SB 1523 by Sen. Leftwich- Would specify certain scope of practice requirements; would require certain supervision of retail health clinics; would direct the State Board of Health to promulgate rules. (Did not pass by the end of session.)

2008 SB 1638 by Sen. Paddack- Would provide for supervision of non-physician practitioner in certain circumstances.(Did not pass by the end of session.)


2008 HB 2788- Applicant for retail license cannot offer clinical health care services.

Rhode Island

2008 HB 7676- Prohibits health clinic on same premises as a pharmacy licensed to compound and dispense prescriptions.


2008 HB 3502- Bans sale of cigarettes at any place of business where medical services are offered.



2007 HB 1096 by Sen. Patrick- Would relate to the delegation of certain medical acts by a physician to an advanced practice nurse or physician assistant. (Did not pass by the end of session.)

2009 SB 532- Expands the practice authority for nurse practitioners and physician assistants, reduces the burden on collaborating physicians, and significantly increases access to health care.

2009 HB 2257- Prohibits retail establishments from selling tobacco products where the establishment has a health care clinic on the premises.

ARCHIVE: Older Reports and Opinions

FTC Opinions:

Related Media Articles:

Disclaimer: NCSL is not responsible for information or opinions contained in internet links to web sites outside this organization.  The opinions and/or policies expressed in non-NCSL materials are those of the authors, sponsors or sponsoring organization, and not NCSL.

Authors: Richard Cauchi, Health Program Director compiled an original memorandum on retail clinic state actions. Andrew Thangasamy of Denver expanded and updated the material in 2009. Katherine Mason provided additional updates in 2011.