Ohio Management Services Agreement Guide: Referral-Based Fee Rules and Strict Clinical and Pharmacy Terms

How to Price the Management Fee

Ohio's discipline statute makes the division of fees for referral of patients, or receiving a thing of value for a specific referral, a ground for discipline. That rule is referral-based and narrower than Illinois's, so a percentage-of-revenue management fee is not expressly prohibited. Law-firm and vendor guidance nonetheless flags percentage fees as a risk and recommends fair-market fees, so we use a fixed fee for defined services and nothing tied to referrals.

What the Practice Must Keep

The Board statement says no matter the business entity, a physician must exercise professional judgment in the patient's best interest, and the 2025 IV statement says licensees must not aid or abet the unlicensed practice of others, that standing orders do not replace a prescriber-patient encounter and that a medical director who is merely available does not create a valid relationship. The agreement keeps diagnosis, prescribing and delegation decisions with the physician.

Terms to Avoid

Avoid any payment tied to referrals, MSO authority over clinical judgment, standing-order IV models, a management company that adds to IV bags without a terminal distributor license, and any arrangement in which a medical director is only nominally involved. The Board of Pharmacy suspended licenses of several clinics and med spas in 2025, according to news reports we did not verify against its own records.

Term, Records and Departing Clinicians

No non-compete ban is enacted, with two bills pending as of May 2026. We found no Ohio-specific records rule for management agreements, and the practice keeps records and patient communications. A professional association under Chapter 1785 files a biennial statement with the Secretary of State.

Filings, Notices and Watch Items

We found no Ohio transaction notice law. A 2026 act revises hair removal delegation, and sources disagree on its effective date, so agreements that cite delegation limits should be checked against the current statute and rules.

Drafting Checklist

• Fee: fixed for defined services, nothing tied to referrals.
• Clinical judgment: stays with the physician.
• IV therapy: individual prescriber encounter, no standing orders, compounding licensed.
• Medical director: actively involved, not merely available.
• Delegation: checked against current hair removal and device rules.
• 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.