West Virginia Practice Structure Guide: The Medical Corporation Certificate, the Board Position Statement and the 2026 IV Opinion

Entity and Ownership

West Virginia Code section 30-3-15 provides that a corporation may not practice or offer to practice medicine, surgery or podiatric medicine without a certificate of authorization from the Board of Medicine. Applicants must show each shareholder is a licensed physician, with osteopathic licensees allowed. An authorized corporation may practice only through licensed physicians, podiatrists or physician assistants, who may be employees and not shareholders. The certificate renews every two years, the corporation must cease practice if a shareholder loses licensure or shares pass to a non-licensee, and violations are a misdemeanor with a fine up to $1,000 per violation for officers, shareholders or employees. A licensed hospital needs no certificate so long as it does not exercise control of physicians' independent medical judgment. The Board's process is to apply, receive a letter of authorization, file with the Secretary of State, and then receive a numbered certificate valid two years. We did not verify the corporation's name rules or fees.

The Corporate Practice Position

The Board's position statement, adopted in 2014 and re-adopted in 2018, says the Medical Practice Act incorporates explicit prohibitions on corporate practice intended to ensure physician autonomy, that courts have recognized certain exceptions such as a nonprofit hospital contracting with physicians, that all shareholders of medical corporations must be licensed physicians or podiatrists and that nominee shareholder structures are scrutinized, so authorization is precluded if a beneficial shareholder is a non-physician unless it is a nonprofit already found not to violate the doctrine. We did not locate the court cases the Board refers to and found no disciplinary matter, Attorney General opinion or Supreme Court decision on lay ownership or MSOs. Aiding or assisting an unauthorized person to practice is a discipline ground, and practicing without an active license is unlawful, including telemedicine to patients located in West Virginia. Vendor claims of a broader bar on employment are not supported by the statute, which says physicians may be employees of a medical corporation.

The Management Agreement and Fees

We found no West Virginia MSO-specific statute, rule or Board statement. The discipline statute covers requesting, receiving or paying a payment, rebate, refund, commission or other valuable consideration for referral of patients, and false or deceptive advertising. We found no statute or rule that bars percentage-of-revenue management fees as such, and the risk comes from the Board's position on lay control and the aiding-unauthorized-practice ground.

The Physicians Freedom of Practice Act limits a physician non-compete to one year and thirty road miles from the primary place of practice with the employer and makes it void on termination by the employer. It preserves patient list and records protections, repayment clauses, non-disclosure and non-solicitation of patients and employees, and exempts sale-of-business and owner-to-owner contracts for contracts since July 2017. We found no transaction notice law.

Med Spa and IV Rules

West Virginia has no med spa statute or Board statement that we found. The Board's 2010 public policy statement treats laser, pulsed light and radiofrequency work as surgery and the practice of medicine and follows College of Surgeons guidance, allowing ablative treatments to appropriately trained nurse practitioners and physician assistants with written protocols and direct supervision, and non-ablative treatments to nurses, cosmetologists, aestheticians and medical assistants under direct physician supervision, with the physician doing the initial review and authorizing the plan. We did not check whether it has been superseded.

A joint advisory opinion of the medical, osteopathic and pharmacy boards, listed in July 2026, says IV therapy is the practice of medicine requiring a patient relationship and record, a provider must personally evaluate, diagnose and recommend, standing orders are not allowed, nurses may administer under an individualized order, and adding to a bag is compounding. Item 21 says retail IV clinics not owned by providers with prescriptive authority shall not exercise influence or control over the provider's independent medical judgment. That is an advisory opinion and sits beside the statutory bar on lay-owned medical corporations, so we do not rely on it to approve lay ownership. Two 2026 bills, one to let physician assistants own businesses and an omnibus Board bill, passed the Senate and did not pass the House.

How We Structure It

As a rule we set up a medical 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 West Virginia the corporation holds the Board certificate, every shareholder is a licensed physician and the MSO is a vendor with no say over medical judgment.

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.