Missouri Corporate Practice of Medicine (CPOM) Overview
- Does Missouri have a Corporate Practice of Medicine (CPOM) Doctrine?: No.
- Summary of Current Law: Missouri was a pioneer in departing from the corporate practice of medicine (CPM) doctrine, a move that predated other states' adoption following the Painless Parker cases. The Missouri Court of Appeals, in the landmark case State ex rel. Sager v. Lewin (1907), interpreted its state medical practice act to allow corporations similar rights to individuals in contracting physicians for providing medical care. This interpretation found support in the established practice of hospitals incorporating to offer medical services via licensed physicians. Furthermore, a 1962 opinion by the Missouri Attorney General affirmed that corporations could contract with licensed medical practitioners without engaging in the practice of medicine. By 1967, only Missouri and Nebraska had accepted corporate practice, highlighting their progressive stance. However, by 1987, this perspective had significantly shifted, with most states aligning with Missouri's approach, as noted in others' legal analysis. This evolution marked a substantial change in the national outlook towards the corporate practice of medicine.
- Sources: State ex inf. McKittrick v. Gate City Optical Co., 97 S.W.2d 89 (Mo. 1936).
What are Corporate Practice of Medicine (CPOM) Laws?
CPOM laws are regulations that prohibit standard corporations (or other non-physician entities) from practicing medicine or employing practicing physicians. The primary goal of these laws is to ensure that medical decisions are made solely based on patient care and not influenced by corporate interests. These laws vary by state, but they generally aim to protect the physician-patient relationship from commercial influence.
While the focus is often on physicians and medical care, the CPOM family of laws typically apply to a wide range of licensed healthcare providers, including psychologists, speech therapists, physical therapists, occupational therapists, mid-level providers (nurse practitioners and physician assistants), dentists, dietitians, podiatrists, chiropractors, pharmacists, optometrists, and many others. The goal of CPOM laws is shared across these professions: ensure clinical decisions aren’t influenced by corporate pressures.
Who Do These CPOM Laws Apply To?
A state’s CPOM restrictions typically apply to any standard corporate entity that seeks to provide medical or licensed healthcare services. This includes corporations, limited liability companies (LLCs), and other business entities. For an entity to comply with CPOM laws and practice medicine, it typically must be:
- 100% owned by a physician (or physicians) licensed to practice medicine in that state, and
- Formed as a special type of physician-owned legal entity: a Professional Corporation (“PC” for short). In some states, a Professional Limited Liability Company (“PLLC”) is also permitted.
Most states with CPOM laws only permit the corporate practice of medicine through these physician-owned PCs or PLLCs.
Complying with Missouri CPOM laws
If you're looking to start a healthcare business in Missouri and need to comply with Missouri CPOM laws by setting up a MSO-friendly PC structure, Permit can help—affordably and fast. Feel free to reach out.
