Nevada Practice Structure Guide: Chapter 89, the Anti-Interference Statute and What It Means for an MSO

Entity and Ownership

Chapter 89 of the Nevada Revised Statutes governs professional entities, which are professional corporations or professional LLCs organized under the general chapters. The articles must name the profession and the owners and include a certificate from the profession's regulating board confirming that each natural-person director, stockholder, manager or member is licensed. A professional corporation's name must include a designator such as P.C. or Chartered plus the last name of a current or former stockholder, unless a fictitious name is registered. One entity may combine medicine, osteopathy, chiropractic and certain other fields. Services must be rendered only through licensed officers, managers and employees, and the section was amended in 2025 in ways we could not identify.

Only licensed natural persons in the same profession may hold ownership, transfers to unlicensed persons are barred, and acts in violation are void except as to innocent third parties. We found no general lay minority ownership exception. Disqualified owners must be separated within a reasonable time. A Nevada professional association under the same chapter is a different thing from an Arizona P.A., so we use the professional corporation.

The Anti-Interference Statute

NRS 89.055, added in 2017 and amended in 2019 and 2023, applies to entities that practice medicine and related fields. It bars owners from restricting good-faith patient and licensee communication, from influencing or interfering with a licensee's professional judgment on patient care, medical-records custody, hiring or firing, and coding and billing, from ending a contract because a licensee advocates for a patient or reports a violation, from imposing patient-volume or hours quotas, and from requiring third-party approval of licensee contracts. It binds owners, meaning the physician stockholders, and not the management company directly, but it defines what the physician owners cannot hand to an MSO. Our agreement keeps those functions with the practice.

The Corporate Practice Position

Nevada's position rests on attorney general opinions and the Chapter 89 scheme and not on case law or an express statute. A 1977 opinion, as described by secondary sources, treated practice by a general business corporation as unlawful and routed physicians to the professional entity chapter, and a 2010 opinion cited in a bill digest said no law prohibits a hospital from employing a physician. We did not retrieve the full 1977 or 2002 opinions. The Legislature passed AB 11 in 2023 to bar hospital employment of physicians, and the governor vetoed it. We found no Board of Medical Examiners or Attorney General corporate practice enforcement action.

The Management Agreement and Fees

The medical practice act makes it grounds for discipline to share fees with another licensee unless the patient is told and each share matches the work done and responsibility assumed, 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.

Physician groups may owe notice of certain transactions under a health care transaction statute if they hold at least 20% of a specialty in a service area, which a start-up clinic generally will not. Non-competes are void unless supported by 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.

Med Spa and Aesthetic Rules

Nevada has no med spa statute or license. Dermal filler injections are limited by statute to listed practitioners and must occur in a medical facility or the office of an authorized practitioner. A draft package from the Board of Medical Examiners would adopt a model Medical Spa Safety Act and a registry with a $500 annual fee, effective January 1, 2028, with an on-site supervising physician and written protocols. It is a draft and not law.

How We Structure It

As a rule we set up a professional corporation owned by the licensed physician, with no exceptions for what looks like a more flexible state. Patients pay the physician-owned practice. The practice pays the management company a fixed monthly fee under a written management services agreement. The management company pays MedGrid a fixed monthly retainer for consulting. The MSO never practices medicine, and the physician makes every clinical decision. In Nevada the agreement is drafted so the MSO has no role in records custody, hiring and firing of clinicians, or coding and billing decisions.

Disclaimer

This article is general educational information, not legal advice. Entity and corporate practice rules change, and parts of this summary rest on secondary sources, so have health care counsel in the state confirm the structure before you form or sign anything.