Idaho Management Services Agreement Guide: Supervision Duties That Cannot Move to the MSO
Idaho's Board of Medicine disavowed the corporate practice doctrine in 2016, but a rule says a supervising physician's duties cannot be transferred to a business entity, which bars handing supervision to an MSO.
Key Highlights
- Section 54-1814 makes dividing fees in exchange for referral a discipline ground, and a pure percentage fee for management services is not squarely within the text.
- IDAPA 24.33.01.200.04 says a supervising physician's duties of medical personnel may not be transferred to a business entity, professional corporation or partnership.
- Cosmetic treatments may be performed only by a physician or supervised medical personnel using non-incisive, non-ablative devices, with the physician on site or immediately available.
- Idaho's key-employee statute presumes a covenant of 18 months or less reasonable, and courts weigh patient choice for physicians.
How to Price the Management Fee
The fee-splitting ground covers dividing fees or gifts for professional services with any person, institution or corporation in exchange for referral, and it is referral-linked. A pure percentage fee for management services is not squarely within the text, and we found no Idaho authority on percentage fees, so we use a fixed fee for defined services.
What the Practice Must Keep
The supervising physician keeps the duties the rule assigns: accepting full responsibility, documenting an evaluation, assessment and plan before the first treatment, and being on site or immediately available, with no more than three medical personnel supervised at once. Those duties cannot be transferred to a business entity, professional corporation or partnership or assigned to another physician or person.
Terms to Avoid
Avoid transferring supervision to the MSO, delegating beyond non-incisive, non-ablative devices and products, and any referral-linked pay. The Board's 2016 disavowal is a non-enforcement position and not a repeal, and other grounds still bar aiding unlicensed practice.
Term, Records and Departing Clinicians
Courts weigh patient choice and continuity of care for physician covenants, and we found no 2025 or 2026 amendment and no physician-specific ban. We do not use non-competes for employed clinicians. Records safeguarding failures are a discipline ground.
Filings, Notices and Watch Items
We found no Idaho transaction notice law for physician practices or MSOs. A supervising physician registration form is kept at each practice location.
Drafting Checklist
- Fee: fixed for defined services.
- Supervision: stays with a named physician, never transferred to the MSO.
- Treatments: non-incisive, non-ablative only for medical personnel.
- Ratio: no more than three medical personnel at once.
- Registration: supervising physician form at each location.
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.