Nevada Management Services Agreement Guide: Records, Hiring, Billing and the Anti-Interference Statute
Nevada's anti-interference statute bars physician owners from influencing records custody, hiring and firing, coding and billing and clinical judgment, which defines what the owners cannot hand to an MSO.
Key Highlights
- NRS 89.055 bars owners from interfering with licensee judgment on patient care, medical-records custody, hiring or firing and coding and billing, and from imposing patient-volume or hours quotas.
- The statute binds the physician owners and not the MSO directly, but it defines what the agreement must not give the MSO.
- The practice act bars fee sharing with a licensee unless the patient is told and shares match work done, and we found no Board opinion on percentage MSO fees.
- Physician groups may owe transaction notice if they hold at least 20% of a specialty in a service area.
How to Price the Management Fee
The practice act makes it grounds for discipline to share fees with another licensee unless the patient is told and each share matches work personally done, to receive payments that tend to affect objective evaluation or treatment, and to aid an unlicensed person to practice. A fixed or fair-market fee to an unlicensed management company is not squarely addressed, and we found no Board opinion on percentage fees, so we use a fixed fee.
What the Practice Must Keep
The practice keeps medical-records custody, hiring and firing of licensees, coding and billing decisions and clinical judgment, plus any patient-licensee communication, and the agreement imposes no patient-volume or hours quotas or third-party approval of licensee contracts.
Terms to Avoid
Avoid giving the MSO any role in those functions, any quota on patient volume or hours, ending a licensee's contract because they advocate for a patient or report a violation, and pay that tends to affect objective evaluation or treatment.
Term, Records and Departing Clinicians
Non-competes are void unless supported by valuable consideration, no greater than necessary and not an undue hardship, and are barred for hourly employees. A 2025 bill to ban provider non-competes failed, and we do not use them for employed clinicians.
Filings, Notices and Watch Items
Physician groups may owe notice of certain transactions if they hold at least 20% of a specialty in a service area, which a start-up clinic generally will not. A Board of Medical Examiners draft would create a med spa registry from 2028 if the Legislature acts in 2027.
Drafting Checklist
- Fee: fixed for defined services.
- Records: custody with the practice.
- Hiring: by the practice.
- Billing and coding: by the practice.
- Quotas: none on volume or hours.
- Retaliation: none for patient advocacy or reports.
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.