Question 1

What is the Corporate Practice of Medicine (CPOM)?

Accepted Answer

Corporate practice of medicine (CPOM) laws prohibit corporations or non-licensed individuals from practicing medicine or employing physicians to provide medical services. This doctrine is designed to ensure that medical decisions are made by licensed healthcare professionals rather than influenced by business interests.

The intent is to protect patients from deceptive behavior that might come with the private ownership of medical corporations.

Question 2

Can nurses own a healthcare business?

Accepted Answer

In strict CPOM states, these regulations can make it very difficult for nurses and advanced providers, like NPs and PAs, to own and operate healthcare clinics, such as an IV hydration business or med spa.
Nurse entrepreneurs need to be aware of the specific CPOM regulations in their state and learn how to navigate the legal limitations. In some cases, nurses may need to collaborate with physician partners or find alternative business structures to comply with CPOM laws.

Question 3

Why do healthcare providers need to comply with CPOM laws?

Accepted Answer

CPOM laws protect patients by ensuring medical decisions stay under the supervision of licensed physicians. These laws prevent unlicensed individuals or businesses from influencing clinical judgment, prescribing, or treatment planning. For nurse-led or non-physician–owned practices, complying with CPOM is essential to avoid board investigations, legal penalties, and forced shutdowns. A compliant structure keeps clinical control with the physician while allowing the business side to operate efficiently and legally.

Question 4

How do MSOs help with CPOM compliance?

Accepted Answer

An MSO (Management Services Organization) separates clinical responsibilities from business operations. The MSO handles administrative, operational, and non-clinical functions, while a physician-owned PC manages all clinical care. This structure ensures clinical decisions remain physician-led—fulfilling CPOM requirements—while allowing nurses, entrepreneurs, and medical spas to own and operate the business side. MSOs provide a safe, scalable foundation for compliance and growth.

Question 5

Can MSOs operate across multiple states?

Accepted Answer

Yes. MSOs can operate nationally as long as the clinical entities in each state follow that state’s CPOM rules and physician-ownership requirements. GuardianMD builds multi-state structures that keep operations unified while ensuring each clinical practice is correctly formed, licensed, and compliant. This makes it easier for expanding clinics and franchises to scale safely.

Question 6

Are MSO and CPOM requirements the same in every state?

Accepted Answer

No. CPOM laws vary significantly between states. Some require physician ownership of the clinical entity; others allow broader NP autonomy but still mandate oversight or specific agreements. MSO requirements also differ depending on fee structures, delegation limits, and supervision standards. GuardianMD tailors every MSO to state-specific laws to ensure full compliance.

Question 7

What is required to create a compliant MSO structure?

Accepted Answer

A compliant MSO requires creating two entities—a physician-owned professional corporation (PC/PLLC) for clinical care and a non-clinical MSO for business operations. It also requires a legally sound Management Services Agreement (MSA), proper fee arrangements, documented oversight workflows, and clear separation of clinical vs. administrative duties. GuardianMD handles the full setup end-to-end.

Question 8

How long does it take to implement an MSO structure?

Accepted Answer

Most MSO structures can be set up within 2–4 weeks, depending on the state and the complexity of your services. This includes entity formation, agreement drafting, compliance review, and operational setup. GuardianMD streamlines the process so your practice can launch or transition quickly without sacrificing compliance.

Question 9

What is a Managed Services Agreement (MSA)?

Accepted Answer

An MSA defines the relationship between the physician-owned PC and the MSO. It outlines which services the MSO provides—such as staffing, marketing, billing, scheduling, or administrative support—and how the MSO is compensated. A properly drafted MSA is essential for CPOM compliance and ensures the clinic operates legally and efficiently.

Question 10

What’s the difference between a PLLC and an MSO?

Accepted Answer

A PLLC (or PC) is the clinical entity, owned by a licensed physician who maintains control over medical decision-making. An MSO is the business entity, owned by the nurse, entrepreneur, or clinic operator. The MSO handles non-clinical functions and contracts with the PLLC through an MSA. Together, they form a compliant CPOM-safe structure.

Question 11

What are the benefits of an MSO for doctors?

Accepted Answer

MSOs free physicians from administrative burdens by handling scheduling, operations, HR, marketing, billing, and more. This allows medical directors and supervising physicians to focus solely on clinical oversight. A well-structured MSO also protects physicians from CPOM violations and ensures they have proper documentation, protocols, and support.

Question 12

How is GuardianMD’s MSO model different from traditional management companies?

Accepted Answer

Traditional MSOs often use generic agreements or loosely compliant structures. GuardianMD builds state-specific, CPOM-safe MSOs backed by decades of regulatory experience. We support both the clinic and the physician, maintain audit-ready documentation, and update your structure as laws change. It’s not just management—it’s integrated compliance infrastructure.

Question 13

Does GuardianMD provide MSO services nationwide?

Accepted Answer

Yes. We build compliant MSO/PC structures in all 50 states and adjust each model to state-specific CPOM laws. Whether you operate one clinic or a multi-state organization, GuardianMD ensures your structure is fully aligned with each state’s regulatory requirements.

Question 14

What makes GuardianMD’s structure fully CPOM-compliant?

Accepted Answer

Our MSO model follows strict separation of clinical vs. non-clinical functions, compliant fee arrangements, state-specific ownership requirements, and clearly defined oversight workflows. We build the PC, MSO, and MSA in accordance with your state’s laws and continually maintain compliance through policy updates, documentation support, and physician guidance.

Question 15

Can GuardianMD help set up a new practice from scratch?

Accepted Answer

Yes. We can form your PC and MSO, draft compliant agreements, match you with a licensed physician, and create the operational framework needed to launch. From CPOM structuring to medical director placement and compliance workflows, GuardianMD provides a full turnkey setup.

Question 16

Who owns the MSO in GuardianMD’s model?

Accepted Answer

In our structure, the nurse practitioner, RN, or non-physician clinic owner retains 100% ownership of the MSO. The physician owns only the clinical PC, preserving CPOM compliance while allowing the nurse or entrepreneur full control over operations, brand, revenue, and growth strategy.

Question 17

Does GuardianMD track ongoing state regulatory changes for me?

Accepted Answer

Yes. Our compliance team monitors state board rules, CPOM updates, supervision standards, and regulatory shifts. We update your documentation and provide guidance anytime laws change, ensuring your clinic stays fully compliant without you having to track every regulation.

Question 18

Can I transition my existing practice into GuardianMD’s MSO model?

Accepted Answer

Absolutely. We can convert your current structure—whether it’s NP-owned, physician-owned, or an informal partnership—into a compliant MSO/PC model. We handle the restructuring, entity formation, agreements, physician matching, and operational transition while keeping your practice running smoothly.

Question 19

Can GuardianMD assist with other compliance areas, like HIPAA or billing?

Accepted Answer

Yes. While MSO formation is a core service, we also support HIPAA compliance, documentation standards, protocol development, Good Faith Exam workflows, medical director oversight, and operational compliance. GuardianMD offers a comprehensive suite of compliance solutions for nurse-led and multi-state healthcare practices.

Healthcare MSO and CPOM Compliance

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Clinics should be cautious of companies that charge no setup fee or require no upfront work.​

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