Delaware Management Services Agreement Guide: Pricing Services and Keeping a Physician Genuinely on Site
Delaware has no fee-splitting ground or percentage-fee authority that we found, and the Board's supervision rule makes a physician's genuine presence a core drafting point.
Key Highlights
- The discipline statute has no fee-splitting, rebate or kickback ground, and we found no authority on percentage fees.
- Board rule 1700-11.0 says a delegating physician cannot be involved in patient care in name only and requires direct supervision when a diagnosis is rendered or a prescription plan is started.
- The discipline statute bars practice under a false or assumed name, so branding under the MSO's name should be reviewed.
- A statute voids non-competes in agreements between or among physicians.
How to Price the Management Fee
The discipline statute has no fee-splitting ground, and we found no authority on percentage fees. We use a fixed monthly fee for defined services and nothing tied to patient volume or referrals.
What the Practice Must Keep
The practice keeps clinical decisions, delegation and supervision. Board rule 1700-11.0 says standing orders must not be used to make a medical diagnosis or prescribe medication, direct supervision with the physician on premises is required when a diagnosis is rendered or a prescription treatment plan starts, and indirect supervision requires the physician to be reachable and able to be on site within 30 minutes.
Terms to Avoid
Avoid ghost-director or remote-only models for prescription-based services, standing-order models for diagnosis, and branding that presents the MSO as the practice, which should be reviewed against the assumed-name ground.
Term, Records and Departing Clinicians
A statute voids covenants not to compete in employment, partnership or corporate agreements between or among physicians while preserving damages reasonably related to the injury from termination, and we found no ruling on whether it reaches a non-physician employer or MSO. We do not use non-competes for employed clinicians.
Filings, Notices and Watch Items
We found no Delaware physician-practice or MSO transaction notice law, which should be confirmed. The name must contain chartered, professional association or P.A.
Drafting Checklist
- Fee: fixed for defined services.
- Supervision: direct when a diagnosis or prescription plan starts.
- Standing orders: not used for diagnosis or prescribing.
- Branding: reviewed against the assumed-name ground.
- Non-competes: none for employed clinicians.
How We Draft It
Patients pay the physician-owned practice, the practice pays the management company a fixed monthly fee under the agreement, and the management company pays MedGrid a fixed monthly retainer for consulting. The management company never practices medicine, and the agreement never moves a clinical decision to it. Our template follows the same flat-fee design in every state, with the state-specific limits below layered on top.
Disclaimer
This article is general educational information, not legal advice. Management agreement rules change and differ by state, and this summary draws on our published state guide, parts of which rest on secondary sources, so have health care counsel in the state review any agreement before you sign.
MedGrid MSO provides management services to independently owned practices; it does not practise medicine and does not direct clinical decisions. Requirements vary by state and by service, and change over time — nothing on this page is legal or medical advice. Talk to us or your own counsel before making a structural decision for your clinic.