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Tag: medical practice ownership

Legal Controls for a Group Medical Practice in California (Part I)

The California Hospital Association defines a group practice as a “medical practice comprised of two or more physicians organized to provide patient care services.” All group medical practices need a strong, well-developed legal structure plan. Understanding the role/responsibilities of the different players in the business is essential. In part one of this series, our Bay Area medical practice law attorney discusses legal controls for group medical practices in terms of shareholders, partners, the board of directors, and managing partners. 


In California, a medical practice will generally be formed as a Professional Corporation (PC) under the state’s Moscone-Knox Professional Corporation Act. As a rule, a person must be licensed in the practice of medicine to be eligible to be a shareholder for a group medical practice.

Shareholders in a medical practice are typically the owners of the company. They have invested capital into the practice and, as a result, hold a vested interest in its success. Shareholders often have the power to vote on major decisions affecting the practice.

The rights and responsibilities of a shareholder in a group medical practice will depend, in part, on the structure of the business, including their stake in the company. A majority shareholder will have far more influence than a shareholder who owns a small stake.

The Board of Directors

The Board of Directors is responsible for the strategic direction and oversight of the medical practice. Members are often elected by the shareholders—and, in many cases—are shareholders themselves. Key responsibilities of the Board of Directors typically include establishing governance policies, ensuring the practice adheres to legal standards, financial oversight for the business, and strategy planning.

Managing Partner

The managing partner of a group medical practice is a person in a key leadership role. Most often, the managing partner is a senior physician who owns a significant stake in the business. The role of managing partner typically blends clinical medical expertise with strong business skills. Business leadership is important to ensure effective management of the medical practice’s operations.

  • The managing partner of a medical practice who is often the individual responsible for overseeing day-to-day operations and ensuring that the practice runs smoothly

Not just anyone can serve as the managing partner for a group medical practice In California. The role is highly regulated due to our state’s strict adherence to the Corporate Practice of Medicine (CPOM) doctrine. A medical practice must be owned and managed by licensed physicians—as such, the managing partner must be a licensed doctor.

Contact Our Bay Area Business Law Attorney for Group Medical Practices Attorney

Lynnette Ariathurai is a top-tier, solutions-driven advocate for clients. With extensive experience representing group medical practices, we have professional knowledge that you can rely on for questions about legal controls. Contact us today to set up your confidential consultation. From our Fremont law office, we work with group medical practices through the Bay Area.

California medical practice legal counsel, medical practice legal controls, medical practice legal structure, medical practice ownership

Compensation Structures in Medical Practices

Three are approximately 120,000 licensed physicians who are actively practicing in the state of California. Health care is a highly regulated, ultra-competitive industry. A medical practice needs the right foundation to succeed—and that includes a well-considered compensation structure for physicians. Here, our Bay Area medical practice lawyer provides an overview of the most common compensation structures for medical practices and discusses some issues to consider.

Understanding Compensation Structures for Medical Practices in California

Whether you are building a medical practice from the ground up or adding a new physician to an existing group practice, it is imperative that you have a comprehensive structure in place for compensation. In California, compensation structures for doctors often fit into one of the following three broad categories:

●  Physicians paid based on their own collections: In California, a common compensation structure for medical practice is paying physicians based on their own collections. A pro is that this model incentivizes individual performance—as a physician’s pay is directly tied to the revenue they generate through patient services. However, a con is that it can sometimes create vast disparities among physicians in a group practice.

●  Physicians paid a percentage of group collections: Alternatively, some practices adopt a model where physicians are paid a percentage of the group’s total collections. An advantage is that this approach fosters a more collaborative environment, as all practitioners contribute to and benefit from the group’s overall success. A potential downside is that this type of compensation model might diminish the motivation for high performance.

●  A hybrid model of physician pay: A hybrid model combines individual and group performance metrics to determine compensation. The structure aims to balance personal initiative with team collaboration. Physicians are rewarded for their individual contributions as well as their participation in the collective success of the practice. However, this type of model can be complex to administer.

What to Know About Federal and State Regulations for Physician Profit Sharing

A physician in California can be compensated, fully or partially, based on profits ensured by a group medical practice. That being said, any profit-sharing arrangement used to compensate a licensed doctor must comply with all applicable state and federal regulations, including the Stark Law and the federal anti-kick back statutes. Here is a basic overview of these regulations:

  • Stark Law: Named after Congressman Pete Stark, this is a federal law that prohibits physician self-referral. Specifically, it forbids doctors from referring Medicare or Medicaid patients to entities with which they or their immediate family members have a financial relationship—unless one of the narrow legal exceptions applies. This law aims to prevent conflicts of interest in physician referrals and ensure that medical decisions are based on patient need rather than potential financial benefits for the referring physician. Notably, California has a state-level version of the Stark Law, known as the “California Physician Self-Referral Law.” The law extends the principles of the federal Stark Law to services payable by any source, not just Medicare or Medicaid.
  • Federal Anti-kickback Statutes: The federal anti-kickback statute is a U.S. law that prohibits the exchange of anything of value in an effort to induce or reward the referral of federal healthcare program business—including Medicare and Medicaid. It aims to prevent healthcare providers from making medical decisions based on personal financial gain. Violations of this law are considered felonies and can result in significant penalties, including fines and imprisonment, as well as exclusion from participating in federal healthcare programs.

When a group medical practice in the Bay Area sets up a compensation system for its physicians, it is imperative that they do so in a manner that does not run afoul of the Stark Law, the California physician self-referral law, or federal anti-kickback statutes. A business lawyer with experience working with group medical practices can help your company put the right structure in place.

Allocation of Expenses is an Important Issue and May be Challenging to Calculate

As part of the process for developing a compensation model for a group medical practice in California, it is important to consider the allocation of expenses. Expenses matter to a business as much as revenue generated. Some key factors that must be evaluated include:

●  Overhead: Understanding and allocating overhead costs is crucial in any compensation model. These expenses include rent, utilities, insurance, and equipment. Properly attributing these costs ensures financial fairness and transparency within the practice.

●  Staffing/managers: Staffing costs, including salaries for support staff and managers, represent a significant portion of practice expenses. Equitable allocation of these costs among physicians is essential for a fair compensation model.

●  Practice vs. personal: Finally, distinguishing between practice-related and personal expenses is vital. Personal expenses, such as individual professional development or specific equipment, should be clearly differentiated from general practice expenses.

Contact Our California Business Lawyer for Medical Practices Today

Lynnette Ariathurai is a business law attorney with extensive experience representing medical practices. If you have any questions or concerns about the right compensation structure for your medical practice, we are here to help. Contact us today for a strictly confidential, no obligation consultation. From our office in Fremont, we work with medical practices throughout the Bay Area.

medical practice compensation models, medical practice compensation structures, medical practice ownership

Buy-Sell Agreements for Medical Practices

We Help Medical Practices with Buy-Sell Agreements in the Bay Area

Do you own and operate a medical practice in California? If you share ownership rights with any other party, it is imperative that you have a well-drafted buy-sell agreement in place. It is important to hire a solutions-driven business lawyer with extensive experience advising medical practices. If you have any questions about buy-sell agreements, we can help. Contact us at our Fremont law office today to set up your confidential, no obligation initial consultation.

What is a Buy-Sell Agreement?

A buy-sell agreement (buyout agreement) can be a contract between co-owners of a business. Most often, the agreement lays out the procedure under which the shares of a departing owner will be distributed or sold if they decide to exit the business due to various reasons—such as death, disability, or retirement.

Why Buy-Sell Agreements Are So Important for Medical Practices in California

While many business owners can benefit from a buy-sell agreement, these types of contracts are especially vital for medical practices. California law mandates that a medical practice must be owned and operated by a licensed medical professional (Moscone-Knox Professional Corporation Act). If a physician partner suddenly departs, another licensed professional must own the business. The practice cannot be directly transferred to most other parties—such as a non-physician spouse. A well-drafted buy-sell agreement helps to ensure a proper transition plan is in place.

A Buy-Sell Agreement Should be Customized to Meet the Needs of a Medical Practice

Every medical practice has its unique dynamics, professional relationships, and future aspirations. As such, a generic, one-size-fits-all buy-sell agreement can lead to complications down the road. It is crucial that the agreement reflects the individual needs and circumstances of the medical practice.  Especially taking into consideration the assets and liabilities of the practice. You will want to make sure that you address any unique issues related to your practice.

Key Elements of a Well Drafted Buy-Sell Agreement

Although every buy-sell agreement should be customized to meet the needs of the medical practice, there are some key issues that should always be considered and addressed. Here are some of the most important elements that you will find in a typical buy-sell agreement:

  • Valuation: Parties should define how the practice will be valued—whether through a predetermined formula or by a specified third-party professional.
  • Trigger: The contract should clearly state the situations (death, disability, retirement, etc.) that will activate the buy-sell provisions.
  • Funding: A properly drafted agreement will explain how the buyout will be funded—whether through insurance, personal funds, or outside financing.

We Help Medical Practices Negotiate and Draft Buy-Sell Agreements

Buy-sell agreements for medical practices are complex contracts. It is imperative that you have the right agreement in place for your business. Our law firm negotiates, drafts, and reviews buy-sell contracts for medical practices in California. We will ensure that any contract that you sign properly protects your legal rights and financial interests.

Contact Our California Business Lawyer for Medical Practices

Lynnette Ariathurai is a business law attorney for medical practices who has extensive experience with buy-sell agreements. Contact us today for your confidential consultation. We help medical practices with the negotiation, drafting, and review of buy-sell agreements throughout the Bay Area.

buy-sell agreements, medical practice ownership, sell medical practice