Rhode Island Management Services Agreement Guide: Keeping the Practice's Members Involved

How to Price the Management Fee

The discipline statute covers dividing fees or agreeing to split fees for bringing to or referring a patient, soliciting patronage through agents and deceptive advertising, and a separate statute covers laboratory referral payments. An MSO paid per patient it markets could be examined under the first, which is our inference, and we found no authority on percentage fees. We use a fixed fee for defined services.

What the Practice Must Keep

The practice's members stay actively involved in running the business, and neither the business nor its owner exercises any control over the manner in which the physician, physician assistant or nurse practitioner provides medical services. The practice keeps medical records for at least seven years.

Terms to Avoid

Avoid a management company that actively operates the business with significant influence and no active involvement of the practice's members, and avoid any term that would be barred by the pending bills: a practice owner also owning or controlling the MSO unless the practice owns a majority of it, stock-transfer restrictions, MSO non-disclosure clauses, advertising under the MSO's name and relinquishing control of hiring, compensation, revenue disbursement, pricing, billing or payer contracting.

Term, Records and Departing Clinicians

A statute voids any restriction on practicing medicine in a partnership, employment or other professional relationship with a physician, and any restriction on treating or soliciting current patients, with a sale-of-practice exception of up to five years. We do not use non-competes for employed clinicians.

Filings, Notices and Watch Items

The Attorney General's rule effective January 28, 2026 requires 60 days' notice for a merger or affiliation producing a group of eight or more physicians, physician assistants or nurse practitioners, a transaction involving a significant equity investor holding more than 10% of the group or its MSO, or forming an MSO to administer insurer contracts. A solo or small cash-pay practice with a physician-owned MSO and no outside investor appears to fall outside it. Senate Bill 2459 and House Bill 7721 were held for study.

Drafting Checklist

• Fee: fixed for defined services.
• Member involvement: the practice's members run the business.
• Control: none by the business or owner over how clinicians provide care.
• Records: kept seven years.
• Investors: none above 10% in the MSO.
• Watch: Senate Bill 2459 and House Bill 7721.

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.