Montana Management Services Agreement Guide: The Independent-Judgment Agreement and the Non-Compete Statute
Montana's Board of Medical Examiners rule permits practice through a professional corporation or with a licensed facility under a written agreement preserving independent judgment, which is a useful template for any MSO agreement.
Key Highlights
- ARM 24.156.405(2)(m) does not prohibit a professional corporation or a relationship with a licensed facility if a written agreement says it may not affect independent judgment, judgment is in fact not affected and the licensee is not required to refer to a particular provider or supplier.
- We found no Montana fee-splitting provision in the physician statutes.
- A statute voids post-termination non-competes and patient non-solicits for covered providers, except for sale of a practice.
- Whether it reaches a covenant imposed on a practice in an MSO agreement is an open question.
How to Price the Management Fee
We searched the physician statutes and found no fee-splitting provision, and the Board's rule lists abusive billing practices without addressing fee division. The rule's no-required-referral language is the closest limit, so we use a fixed fee for defined services and nothing that requires referrals.
What the Practice Must Keep
The agreement includes a written statement that the relationship may not affect the licensee's independent judgment, the judgment is in fact not affected, and the licensee is not required to refer patients to a particular provider or supplier or to act against the patient's best interest. The practice keeps records, which must be secured, documented and transferred on request.
Terms to Avoid
Avoid making the MSO the employer, partner or joint venture party of the physician, avoid any required referral to a particular provider or supplier, and avoid cites to ARM 24.156.625 or MCA 37-3-322, which are repealed.
Term, Records and Departing Clinicians
MCA 28-2-724 voids any term of a partnership, employment or other professional relationship with a covered provider that restricts after termination practicing in any area for any period or treating or soliciting current patients, with exceptions for sale of a practice and declining repayment provisions. It was amended three times in 2025, which we did not reconcile, and we do not use covenants for employed clinicians.
Filings, Notices and Watch Items
We found no Montana transaction notice law. The Boards of Nursing and Barbers and Cosmetologists say a person not licensed by a board may own a medical spa, which does not address the Medical Board's rule.
Drafting Checklist
- Fee: fixed, with no required referrals.
- Independent judgment: written agreement included.
- MSO role: vendor, not employer or partner.
- Records: secured and transferable on request.
- 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.