Alabama enforces the corporate practice of medicine, so the medicine sits with a physician-owned entity and everything else sits with the MSO. We connect you with a physician licensed in Alabama, execute the agreement, write protocols to state requirements, and keep the file current as they change.
Treatment sits with a physician-owned entity; the MSO does the rest.
Typical Timeline
~0 weeks
From application to a signed director and protocols in place. Some states — New York among them — take longer due to state-specific operational requirements.
Metros Covered
0 metros
Birmingham, Huntsville — remote coverage elsewhere in state.
What We Do in Alabama
Everything Between a Lease and a Legal Clinic
Membership is not a directory listing or a referral. We place the physician, paper the relationship to Alabama requirements, write the protocols your staff run on, and stay in the file as the rules move.
Physician Connection
A physician licensed in Alabama with real aesthetic or wellness experience, matched to what your clinic offers. We execute the agreement.
Entity & Agreements
The professional entity in the form this state expects, the management services agreement, delegation documents and standing orders — drafted, executed and filed.
Protocols & Consents
Treatment protocols per service line with intake, dosing, contraindications and consent language written to Alabama rules, signed by your director.
Clearance Screening Workflow
Who may perform the initial exam here, whether telehealth counts, and the clearance workflow your front desk actually runs.
Back Office
Insurance bound to the right entity, payroll and classification, credentialing paperwork and vendor onboarding — handled by people rather than a help article.
Supply at Member Pricing
The MedGrid catalog with member pricing on every eligible line item, one-click protocol reorders and one order history to reconcile.
Chart Review Cadence
A real, scheduled chart-review cadence in Alabama — signatures applied on a calendar, not backfilled in arrears when someone asks.
Growth & Marketing Review
Offers, campaigns and patient-facing copy reviewed against your state advertising rules before they run — not pulled down after a complaint.
How Oversight Works in AlabamaModerate CPOM State
How Corporate Practice of Medicine Works in Alabama
Alabama recognizes CPOM but its statutory exceptions and enforcement pattern are lighter than the country's strictest boards. The Alabama Board of Medical Examiners focuses less on chasing ownership structures and more on whether a licensed physician is genuinely directing care — collaborative practice agreements with nurse practitioners here are formal and specific, not a rubber stamp, and the board expects the same rigor from a med spa's delegation paperwork. A PC-MSO structure is still the safest way to organize a wellness business in Alabama, but the real exposure tends to sit in loose or outdated collaborative agreements rather than in who technically owns the company. Birmingham and Huntsville's aesthetics markets are growing quickly enough that clinics built without a real physician relationship stand out to a board that already spends most of its time reviewing exactly this kind of paperwork.
Alabama Board of Medical Examiners reviews collaborative agreements closely, not just ownership
NP/PA collaborative agreements must be specific and current, not boilerplate
PC-MSO structure recommended even where enforcement is lighter than Texas or NC
Birmingham and Huntsville's growing markets draw more board attention each year
The Structure
The Friendly-PC Model, Built for Alabama
Alabama enforces the corporate practice of medicine, which means the entity delivering care must be owned and controlled by a licensed physician. The answer is not to work around that — it is to split the business in two, in writing, the way the doctrine expects.
A physician-owned professional entity employs the clinical team and holds the medical decisions. Your MSO holds the brand, the lease, the staff, the systems and the supply, and a fair-market management fee moves between them. Done properly, nobody outside your accountant notices it exists.
The PC
What the Physician Entity Holds
Clinical decisions and treatment authority
Employment or engagement of the clinical team
Standing orders, protocols and chart review
The medical record and clinical documentation
The MSO
What Your Company Holds
Brand, marketing, lease and equipment
Non-clinical staff, payroll and scheduling
Systems, supply, purchasing and vendor accounts
Billing operations and back-office administration
Operating Structure
The Management Agreement and the Flow of Funds
The PC and the MSO are connected by a Management Services Agreement (MSA), the contract that defines what each side owes the other and how money actually moves between them in Alabama.
Step 1
Patients
Cash pay at the point of care. No insurance claims.
All clinical revenue
Step 2
The PC
Physician-owned. Receives the revenue, pays clinicians, malpractice and clinical supplies first.
Fixed monthly transfer under the MSA
Step 3
The Management Company (LLC)
The MSO. Holds the administrative infrastructure for everything non-clinical.
Fixed monthly retainer, invoiced
Step 4
MedGrid
Consulting agency to the LLC. Non-clinical services only.
The medical director: in a corporate-practice state the PC pays the director as its own clinician, before any transfer to the LLC. In a state without a corporate-practice bar, the director may instead invoice MedGrid for non-clinical advisory time. Clinical work is always paid by the PC.
01
Patient Revenue
All clinical revenue is cash pay, earned and received by the PC in its own account, never by the MSO. The PC covers clinician compensation, malpractice and clinical supplies first. Separate accounts, books and payroll keep the physician’s license and your investment protected if either side is ever questioned.
02
The Management Transfer
On the schedule set in the management services agreement, normally monthly, the PC transfers a fixed, fair-market amount to the management company (the LLC) for the non-clinical services it provides, never a percentage of medical revenue. That percentage is what turns a fee into fee-splitting.
03
The MedGrid Retainer
The LLC pays MedGrid a fixed monthly retainer, invoiced against a written scope of consulting, accounting, marketing, membership and certification work. MedGrid charges for no medical service and never touches a patient payment.
04
Who Signs What
The physician signs medical decisions, you sign business decisions, and the MSA keeps that line clean. The medical director is paid by the PC for clinical work, or by invoice to MedGrid for non-clinical advisory time in states where the law allows it.
Inside the Agreement
What a Management Agreement That Holds Up Contains
Scope
What the MSO Provides
A written list of the non-clinical services the MSO delivers: brand and marketing, lease and equipment, non-clinical staff and payroll, systems, purchasing and vendor accounts, billing operations and back-office administration.
The Fee
Flat and Fair-Market
One fixed monthly amount from the PC to the management company, set to fair market value for the services actually provided, followed by a fixed monthly retainer from the LLC to MedGrid. Neither is ever a percentage of medical revenue or a payment per patient or per referral, which is what keeps it from becoming fee-splitting.
Clinical Authority
Reserved to the PC
Diagnosis, treatment, protocols, prescribing, clinical hiring and discipline stay with the physician-owned entity, in writing. The MSO runs the business around the medicine and does not direct it.
Term
Term, Renewal and Exit
A defined term, renewal terms and termination rights for both sides, plus what happens to records, staff, equipment and patient continuity if the relationship ends, so neither side is trapped and patients are never stranded.
Records
Records, Privacy and the BAA
The medical record belongs to the PC. The MSO touches patient information only as a business associate under a HIPAA business associate agreement, with access limited to what its functions need.
Oversight
Built to Be Audited
Both sides agree to cooperate with board inquiries, insurer audits and buyer diligence, and the compliance file that supports the arrangement is kept current by the MSO and reviewed by the physician.
Common Ways This Goes Wrong
Four Mistakes We Rebuild Most Often
Most clinics arrive with a version of one of these. They are fixable without closing the doors, and they are the first things a board, insurer or buyer notices.
A Fee That Is a Revenue ShareA percentage of collections turns a service fee into fee-splitting in most corporate-practice states.
A Director With No Delegation on PaperA name on a form with no written protocols, delegation or chart review does not show clinical control.
The MSO Making Clinical CallsHiring or firing clinicians over clinical judgment, or setting treatment, is the control boards read most broadly.
One Account for EverythingCommingled funds erase the separation between the practice of medicine and the business around it.
General structure, not a legal opinion for your clinic. Your director and counsel confirm the specifics for Alabama before you treat.
Legal Compliance in Alabama
The Legal Structure Alabama Expects, Built Properly
Alabama enforces the corporate practice of medicine, so how the professional entity is formed, owned and paid decides whether the clinic holds up. This is the structure we put in place, and why.
Entity Form
We Set Up a PC, Never a PLLC
The entity that delivers care in Alabama is set up as a physician-owned professional corporation (PC), or the state's equivalent, never a PLLC. We do not set up PLLCs in any state. A PC is the form professional-practice law is written around: shareholders must be licensed, shares cannot pass to a non-licensee, and officers and directors mirror the clinical control the board expects.
One structure in every state, so one compliance playbook and nothing to re-paper when a state tightens
Articles, bylaws and shareholder documents drafted for the professional entity from the start
Ownership
A Licensed Physician Owns the PC
All shares of the professional entity are held by a physician licensed in Alabama. MedGrid takes no equity in your business, holds no option to buy the PC, and does not direct clinical care. The shareholder documents also address what happens to the shares if the physician leaves, retires or loses their license, so a transition never leaves the clinic without a lawful owner.
The Agreement
A Management Services Agreement That Holds Up
The PC and your MSO are connected by a written management services agreement (MSA) built for Alabama. It lists what the MSO provides, sets a flat, fair-market fee, reserves every clinical decision to the PC, and spells out term, termination and what happens to records. It is written to be read by a regulator, an insurer or a buyer, not just signed.
Fee-Splitting
A Flat Fee, Never a Cut of the Medicine
Fee-splitting rules in Alabama and federal anti-kickback principles are why the management fee is flat and tied to what the MSO actually provides, never a percentage of medical revenue and never a payment per patient or per referral. The fee is documented as fair market value so the arrangement can be explained line by line.
Control
Business Control Without Clinical Overreach
Boards read control broadly. The MSO runs the brand, lease, staff, systems and supply; it does not hire or fire clinicians over clinical judgment, set treatment plans, write protocols, or reach into charts beyond what a business function needs. Who signs what is written down, so the line is visible on paper and in practice.
Records
Corporate Records Kept Current
Articles, bylaws, shareholder agreements, meeting minutes, EIN, assumed-name filings and any Alabama professional-entity registrations are filed correctly the first time and kept current, not reconstructed when a lender, insurer or acquirer asks for them.
Money & Insurance
Separate Accounts, Right-Entity Coverage
Patient revenue lands in the PC's own account, and the PC transfers a fixed management amount to the MSO, which in turn pays MedGrid a fixed monthly retainer. Malpractice coverage is bound to the PC and its providers, and general liability, cyber and employment practices coverage sit with the entity they protect, so a claim against one side does not become a claim against everything.
Records & Privacy
Medical Records Belong to the PC
The medical record is the professional entity's. The MSO touches patient information only as a business associate under a HIPAA business associate agreement, with access limited to what its functions need, and Alabama privacy and retention rules built into the policies.
General structure, not a legal opinion for your clinic. Your director and counsel confirm the specifics for Alabama before you treat.
Why We Form a PC
The Business Case for a PC in Alabama, Beyond What the Law Requires
Compliance is the reason most clinics hear about. The practical reasons show up in your accounting, your insurance, your director's fee, your processing and your next lender or buyer.
Tax and Accounting
Cleaner Books, Faster Closes
A professional corporation is an entity type accountants know well. Physician compensation, retirement plans and S-corp elections where they benefit you follow established patterns, and keeping the PC's books separate from the MSO's makes month-end faster and returns cleaner. In Alabama, your accountant spends less time untangling who owns what.
Insurance
Coverage That Is Easier to Place, Often for Less
Underwriters understand a physician-owned practice entity as a standard medical risk. In our experience malpractice and professional liability coverage is easier to bind and is typically priced lower than for an ownership structure a carrier has to ask questions about. Rates still depend on the carrier, your menu and Alabama claims history.
Medical Director
Typically Lower Medical Director Fees
When the clinical entity is a properly formed PC with documented delegation and protocols, the director is in a standard professional relationship instead of lending a license to a structure that is hard to defend. In our experience that keeps director fees typically lower and the arrangement easier to renew.
Regulatory Exposure
Fewer Reasons for a Regulator to Write to You
Warning letters from the FDA and letters from state boards tend to follow unsupported claims, unlicensed prescribing, unclear clinical control or questionable sourcing. A PC with a physician who truly directs care, protocols on file and advertising reviewed before it runs removes the avoidable triggers. It does not make a clinic immune from oversight, and nobody can promise that.
Payments
Better Payment Processing Options
Processors and acquirers underwrite medical merchants more readily when the merchant is a physician-owned professional entity with a clear structure behind it. That often means more processor choices, fewer holds and better terms, including for card-not-present payments, though each processor decides for itself.
Banks, Payers and Buyers
Easier Banking, Contracting and Diligence
Banks, payers, landlords, lenders and acquirers all ask the same question: who owns and controls the practice? A PC answers it in the corporate record. That makes opening accounts, signing payer and vendor contracts and getting through a buyer's diligence list in Alabama a document request, not an argument.
Typical outcomes, not guarantees. Results vary by carrier, processor, accountant and state, and this is general information, not tax, insurance or legal advice.
Onboarding in Alabama
From First Call to First Compliant Treatment
01Day 1
The Call
Twenty minutes on what you treat, where you operate and what already exists. We tell you what Alabama requires and what it will cost.
02Week 1
Connect & Credentials
A licensed physician matched to what your clinic offers, plus verification of NPI and licensure against the categories on your menu.
03Week 1
The Entity
Name clearance and Secretary of State filing, articles of incorporation, federal EIN — the professional entity formed where your structure requires one.
04Week 1–2
The Agreements
Management services agreement, delegation terms and standing orders drafted, executed and filed between your company and the PC.
05Week 2
Insurance & Payroll
Malpractice and liability coverage placed, banking opened in a CPOM-appropriate structure, payroll pointed at the right entity.
06Week 2
Protocols & Systems
Protocol packs loaded, consents attached, EHR and vendor or pharmacy accounts configured.
07Week 2–3
Staff & Launch Readiness
Staff invited and credentialed, clearance screening workflow trained, patient-facing copy checked against your state's advertising rules.
08Ongoing
Live & Maintained
Member pricing on, chart review on the calendar, and revisions pushed to you when Alabama rules move.
Already operating in Alabama? Most clinics come to us with some of this half-built — an entity in the wrong form, a director on a handshake, insurance bound to the wrong name. We rebuild underneath a working business without closing your doors, and we tell you on the first call which items you can skip.
Supported Modalities
How to Find a Medical Director in Alabama for Your Service Menu
Aesthetics and med spas in full, and the wellness side with them — IV drips, GLP-1 weight loss, peptide therapy, HRT and TRT, and more, in clinic or via telehealth. Direction and protocols are built around the modalities you actually offer in Alabama.
Medical direction has to come from a physician holding an active Alabama license — the Alabama Board of Medical Examiners does not recognize direction from a physician licensed only in another state.
Collaborative Agreements and Standing Orders
Alabama expects a real, specific collaborative practice agreement for every nurse practitioner or PA on staff, spelling out exactly which services they may deliver and under what conditions.
Clearance Screening
Alabama sets who can perform the initial medical clearance and how telehealth factors in — your intake workflow has to be built to that answer, not a generic template.
Ownership Structure
Alabama's CPOM enforcement is real but comes with more exceptions than the strictest states, so most wellness businesses here use a PC-MSO model without the heavier apparatus Texas or North Carolina require.
General structure, not a legal opinion for your clinic. Your director and counsel confirm the specifics before you treat.
Metros We Cover
BirminghamHuntsville
Clinical Compliance in Alabama
What Safe, Defensible Care Looks Like Here
Clinical compliance is what a patient, a board or an insurer actually sees. It is built from written protocols, real oversight and a chart that tells the story.
Medical Director
A Director Licensed in Alabama Who Actually Directs
Direction must come from a physician holding an active Alabama license, with a documented cadence of availability, protocol review and chart review. A name on a form does not satisfy a board inquiry; the record of oversight does.
Protocols
Standing Orders for Every Service Line
Written, physician-signed protocols for each service on your menu, drafted to Alabama rules: indications, contraindications, dosing ranges, escalation paths and who may perform what. They are revised when the rules move, not when someone complains.
Exam & Clearance
Good-Faith Exam Before First Treatment
No prescription and no injectable before a documented clearance by someone Alabama allows to perform it. Whether telehealth counts, and which clinician may do the initial exam, is set by the state; the screening workflow is built to the answer and every clearance is filed to the chart.
Scope & Delegation
Written Delegation, Competency on File
Who may inject, prescribe or operate a device in Alabama (physician, NP, PA, RN, aesthetician) depends on state scope and supervision rules. Delegation is written per provider and per procedure, with competency sign-off held on file.
Prescribing
Prescriptions, Pharmacies and Compounded Drugs
Prescriptions are written per patient and filled by licensed pharmacies, and compounded GLP-1s, peptides and hormones come only from compliant 503A or 503B sources. "Research use only" products are never used on patients, and brand-name claims are never made for a compounded drug.
Compounded and peptide categories follow current FDA positions, which we monitor and reflect in your protocols
Office-stock rules differ by state and drug category, so they are set in writing before ordering
Controlled Substances
DEA and State Registrations Verified
Testosterone, ketamine and other scheduled drugs need the right federal and Alabama registrations, and the right patient relationship, before anyone prescribes. On MedGrid, DEA-restricted categories stay hidden until the credential is verified, and telehealth controlled-substance rules are applied as they stand at the time of prescribing.
Consent & Charting
Consents, Charting and Adverse Events
Informed consent is attached to each service, chart notes follow a documented standard, and emergency protocols and adverse-event reporting are in place before the first patient. Complications are documented, escalated to the director and followed to closure.
Quality Review
Chart Review on a Calendar
Director chart review happens on a schedule, with signatures dated when the review happened rather than backfilled later. Findings feed back into protocols and staff training, which is the difference between a clinic that is compliant on paper and one that is compliant in practice.
Advertising and Platform Compliance
Advertising Rules
Alabama Advertising and Claims Review
Offers, before-and-after photos, credentials claims ("board certified", "MD-led"), discounts and drug-related claims are reviewed against Alabama advertising rules and your director's scope before anything runs.
Platform Policies
Google, Meta and Payments Have Their Own Rules
Ad platforms and payment processors apply healthcare policies that go beyond state law, and many gate prescription-drug, telehealth and compounded-medication advertising behind third-party certification. Content that is legal in the state can still be rejected, or an account suspended, if it breaks a platform policy.
LegitScript
LegitScript Certification, Where Your Menu Needs It
LegitScript reviews the same structure a board would: licensure, ownership, physician oversight and how you advertise. A documented PC and MSO structure makes certification a paperwork exercise instead of a scramble.
We connect you with a physician actively licensed in Alabama with real aesthetic or wellness experience, matched to what your clinic offers, and we draft the collaborative agreement and standing orders around your actual service menu. Most Alabama clinics are live within about three weeks of the first call.
Can an Alabama Med Spa Offer GLP-1s, Peptides, or HRT/TRT?
Yes, with a licensed Alabama physician directing the program and specific written protocols for each service. Alabama's collaborative practice rules mean the paperwork behind each category matters as much as the treatment itself.
Does a Telehealth Practice Prescribing Into Alabama Need an Alabama-Licensed Director?
If your patients are located in Alabama, the physician directing their care generally needs to hold an Alabama license. Multi-state operators get per-state coverage through Group membership rather than trying to stretch one director's license.
What Does Medical Direction Cost in Alabama?
A monthly stipend for the physician's time plus MedGrid membership — a flat monthly rate, never billed by the hour or tied to patient volume. We quote the range on the first call once we know your service menu, rather than after a long discovery process.
Opening or Fixing a Clinic in Alabama?
Twenty minutes tells you what direction costs here, who is available, and how fast you can treat.