In today’s video we talk about the MSO model (once again) for a large health and wellness or integrative care center.

Hi, I’m Michael H. Cohen, founding attorney of the Cohen Healthcare Law Group. Our attorneys help healthcare industry clients like you, navigate healthcare and FDA legal issues so you can launch, or grow and scale your healthcare business.

In advising over 1,000 clients, at this juncture, we’ve found that the MSO model largely works best for a large, multidisciplinary health and wellness center, whether it focuses on integrative medicine, functional medicine, behavioral health, or another approach to health.

In particular, the MSO helps in particular with twin legal risks: the prohibition against corporate practice of medicine (“CPM”), and the prohibition against fee-splitting and kickbacks.

The corporate practice of medicine rule (the prohibition) has to do with arrangements that regulators could regard as unlawful intrusions by administrative persons and entities into clinical practice of medicine, psychology, and certain other licensed healthcare professions.

A corporate practice of medicine violation can arise in the multidisciplinary health center because sometimes it’s unclear as to which healthcare professional is responsible for supervising others, if at all.  And healthcare providers other than MDs and DOs have a more limited, defined scope of practice.  If they offer services outside their defined scope of practice, they’re said to be practicing “medicine” unlawfully.

As an example, the California Medical Board has conducted enforcement activity even against licensed naturopathic doctors for intruding into the practice of “medicine.”

NDs must avoid activities or practices which may be construed as unlicensed or corporate practice of medicine.  And, the whole enterprise has to be structured correctly.

Some of the remedies here include deploying the MSO structure so as to separate the management and marketing from the clinical medical side and ensuring that NDs remain within their scope of practice, particularly when it comes to activities by nursing staff such as administering IV injections.  These must be supervised by an MD or DO.

As to the kickback and fee-splitting issue, while it’s common to have doctors share fees within a professional medical corporation, this gets trickier when trying to share professional fees between an MD and an ND.

Thanks for watching. Please contact us with your questions. We have helped so many healthcare industry clients build their dream.  We look forward to working with you on your journey to success!