Maine Management Services Agreement Guide: Non-Competes, Private Equity Definitions and Chapter 15 Duties

How to Price the Management Fee

We found no general Maine physician fee-splitting ground, only a laboratory rebate ban, and no authority on percentage fees. We use a fixed monthly fee for defined services and nothing tied to patient volume.

What the Practice Must Keep

The practice keeps examination, diagnosis, prescribing and delegation. Chapter 15 says only a physician, physician assistant or APRN may evaluate, diagnose and prescribe, a static online questionnaire is not an acceptable clinical interview, standing orders for individualized assessment are unprofessional conduct and IV mixing must be done by a licensed physician and not from a menu.

Terms to Avoid

Avoid delegating any of those functions to unlicensed personnel, and avoid bringing in private equity or hedge fund owners of the MSO, since the transaction law reaches an MSO owned or controlled by one. The private equity definition is broad enough that an MSO funded by outside investors could arguably be captured, which is our inference.

Term, Records and Departing Clinicians

A non-owner physician employed by the practice or an MSO cannot be required to sign a non-compete, the practitioner's right to choose must be recognized in any enforceable covenant and the general waiting-period carve-out is removed, and we did not confirm the effective date.

Filings, Notices and Watch Items

The 2026 transaction law requires 180 days' notice to the Department of Health and Human Services for a material change transaction, with a $10,000 a day penalty, and a physician-owned MSO with no private equity or hedge fund owner is outside its MSO definition. A separate ownership reporting duty is due by July 1, 2027 with an exemption for an independent provider organization with six or fewer providers and no ownership or control entities, and whether a practice served by an MSO counts is unclear. A petition on Chapter 15 was reported in August 2026.

Drafting Checklist

• Fee: fixed for defined services.
• Delegation: no examination, diagnosis or prescribing to unlicensed staff.
• Standing orders: not used.
• MSO ownership: physician-owned, with no private equity or hedge fund owner.
• Non-competes: none for non-owner clinicians.
• Reporting: check the July 1, 2027 duty.

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.