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Guide to Management Services Organizations in Texas for Non-Physicians.

A lot of doctors running medical practices today have a tough time dealing with the rules and regulations. Management Service Organizations, or MSOs, are here to help. They don’t just help doctors; they can also benefit other healthcare professionals who aren’t doctors.

MSOs provide a chance for non-doctor healthcare workers, like nurses and physician assistants, to get involved in healthcare businesses like med spas and IV clinics, which they usually can’t own due to Texas laws.

In this article, we’ll explain what MSOs are, talk about the rules in Texas, and show how non-doctor healthcare workers can work with MSOs in medical practices.

How MSOs Help Non-Doctor Healthcare Workers:

Nurses, physician assistants, and others see lots of opportunities in healthcare. People want new ways to improve their health. But in Texas, there’s a rule called the Corporate Practice of Medicine (CPOM) that stops many non-doctors from owning healthcare businesses like med spas.

Thankfully, MSOs offer a way for non-doctors to be part of medical practices by handling the non-medical stuff through a separate company that they can own.

Why Can’t a Nurse or Physician Assistant Own a Medical Practice?

Texas has a law called the Corporate Practice of Medicine (CPOM) to make sure that non-medical people don’t influence a doctor’s medical decisions. According to this law, companies and non-doctors can’t employ doctors to provide healthcare services in the state.

Physician assistants can own part of a medical practice if they own less than any individual doctor.

What Is an MSO?

Medical Management Services Organizations (MSOs) are companies that take care of the business side of healthcare. Unlike medical practices that must be owned by a licensed doctor in Texas, MSOs can be owned by anyone interested in investing in healthcare.

MSOs manage the administrative parts of a practice, such as:

  • Management, financial, and actuarial management
  • Employment of non-medical personnel
  • Providing and managing office space
  • Administrative and claims management
  • Billing, coding, and collections
  • HR, accounting, and payroll
  • Regulatory compliance
  • Administrative and risk management
  • Quality reporting and improvement
  • Data acquisitions, analytics, and care management workflow
  • Information systems support

MSOs are set up through management services agreements, which are like complicated contracts. If not done right, they can be risky. These agreements must clearly separate medical and non-medical stuff and follow state and federal laws.

Also, MSOs shouldn’t control a provider’s decisions, as this can lead to problems with the Corporate Practice of Medicine law.

Anti-Kickback Statute Considerations for MSOs:

Everyone involved in an MSO arrangement should know about the Anti-Kickback Statute (AKS). Breaking AKS can lead to criminal charges for getting paid for federally funded healthcare services.

To avoid problems, MSO agreements should follow AKS rules, including having clear agreements, lasting at least one year, and having fair prices that are written down beforehand.

It is essential to seek the advice of attorneys experienced in health and medical law. At Dike Law Group, our health care attorneys have extensive experience counseling both physicians and non-physicians on the proper execution of the MSO model, as well as a range of health care and regulatory compliance matters. Contact one of our attorneys at Dike Law Group and schedule a meeting so we can discuss at

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