Texas Management Services Organization (MSO)

What Is a Management Services Organization (MSO)?

An MSO is a business entity that handles the administrative side of a healthcare practice. This includes billing, HR, office management, marketing, compliance, and more. By using an MSO, non-physicians can legally own and operate healthcare businesses without violating Texas’s Corporate Practice of Medicine (CPOM) laws. Physicians retain control over all clinical decisions, while non-physician owners manage the business operations.

Why MSOs Are Essential in Texas Healthcare

Texas has strict CPOM rules prohibiting non-doctors from owning or controlling medical practices. An MSO creates a compliant structure by separating the medical entity (owned by a physician) from the administrative entity (owned by a non-physician). This ensures your healthcare business is both legal and profitable.

Services We Support Through MSOs

Our team helps clients create MSOs that provide:

• Office space and equipment management
• Billing, coding, and collections support
• Scheduling and front-desk operations
• Payroll, HR, and staff training
• IT infrastructure and EHR management
• Financial reporting and analytics
• Regulatory compliance oversight
• Marketing, website development, and patient engagement

MSOs cannot make clinical decisions or employ physicians—those responsibilities remain with the licensed medical practice.

Legal Compliance for MSOs in Texas

• CPOM Compliance: Ensure all clinical decisions remain under physician control.
• Management Services Agreements (MSA): Draft contracts defining services, fees, and responsibilities while protecting clinical autonomy.
• Anti-Kickback Statute (AKS): Structure your MSO to avoid legal risk when federal insurance is involved, charging fair market value for services and avoiding improper referral arrangements.

Who Should Consider an MSO?

MSOs are ideal for:

• Non-physician investors and entrepreneurs
• Nurses, physician assistants, or estheticians launching med spas or wellness clinics
• Physicians seeking to offload administrative responsibilities
• Private equity or investment firms acquiring healthcare practices
• Founders of IV hydration, concierge care, or telehealth services

Partner with a Texas Healthcare Attorney to Launch Your MSO

Setting up an MSO in Texas is complex. Mistakes can result in regulatory violations, fines, or even criminal liability. At Dike Law Group, our experienced attorneys guide non-physicians and physicians through the legal requirements to structure compliant MSO models, draft Management Services Agreements, and navigate federal and state regulations.

Serving Texas Cities: Houston, San Antonio, Dallas, Fort Worth, Austin, El Paso, Arlington, Corpus Christi, Plano, Lubbock, Laredo, Irving, Garland, Frisco, McKinney, Denton, Midland, Abilene, Waco, Tyler, Beaumont, Odessa, Round Rock, Carrollton, Lewisville, McAllen, Wichita Falls, San Marcos, Galveston, Nacogdoches, Amarillo