South Carolina Management Services Agreement Guide: The Board's Opinion on Clinical Judgment and Aiding and Abetting
South Carolina's Board says the licensee must control the exercise of clinical judgment at all times and that it is unlawful to let an unlicensed person direct, participate in or interfere with a licensee's practice.
Key Highlights
- The Board's 2022 advisory opinion says the licensee must control clinical judgment at all times and an arrangement that complies and is otherwise authorized by law is authorized.
- The medical practice act applies to a person or entity aiding and abetting unlicensed practice, with a misdemeanor of up to one year and $50,000.
- We found no South Carolina statute regulating MSOs or fee splitting in the chapter we searched.
- The Board's 2023 retail IV opinion says a medical director who does not personally evaluate patients is insufficient.
How to Price the Management Fee
We found no South Carolina fee-splitting statute in the chapter we searched and did not verify the Board's ethics rules on fee division. We use a fixed fee for defined services and nothing tied to referrals.
What the Practice Must Keep
The licensee controls the exercise of clinical judgment at all times, and the supervising physician personally evaluates patients, since the Board's 2023 joint opinion says a medical director who does not personally evaluate patients is insufficient and a physician issuing standing orders for RN-only models is aiding and abetting. The Board's 2024 laser guidance requires an exam of each patient before initial treatment or before authorizing a non-physician.
Terms to Avoid
Avoid any term allowing an unlicensed person to direct, participate in or interfere with the licensee's practice, standing-order RN-only IV models and a medical director in title only. The statute reaches a person or entity aiding and abetting.
Term, Records and Departing Clinicians
South Carolina has no non-compete statute, so common law governs, and a pending 2025 bill would void contract provisions that enable corporate practice or interfere with the physician-patient relationship and ban most physician non-competes. We could not confirm its fate. We do not use non-competes for employed clinicians.
Filings, Notices and Watch Items
We found no South Carolina transaction notice law. Registered nurses may perform cosmetic injections only with on-site supervision by a physician or APRN under the joint neuromodulator opinion.
Drafting Checklist
- Fee: fixed for defined services.
- Judgment: controlled by the licensee at all times.
- Supervisor: personally evaluates patients.
- Standing orders: not used for RN-only IV.
- 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.