West Virginia 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 West Virginia, execute the agreement, write protocols to state requirements, and keep the file current as they change.
CPOM enforced
Treatment sits with a physician-owned entity; the MSO does the rest.
~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.
0 metro
Charleston — remote coverage elsewhere in state.
Membership is not a directory listing or a referral. We place the physician, paper the relationship to West Virginia requirements, write the protocols your staff run on, and stay in the file as the rules move.
A physician licensed in West Virginia with real aesthetic or wellness experience, matched to what your clinic offers. We execute the agreement.
The professional entity in the form this state expects, the management services agreement, delegation documents and standing orders — drafted, executed and filed.
Treatment protocols per service line with intake, dosing, contraindications and consent language written to West Virginia rules, signed by your director.
Who may perform the initial exam here, whether telehealth counts, and the clearance workflow your front desk actually runs.
Insurance bound to the right entity, payroll and classification, credentialing paperwork and vendor onboarding — handled by people rather than a help article.
The MedGrid catalog with member pricing on every eligible line item, one-click protocol reorders and one order history to reconcile.
A real, scheduled chart-review cadence in West Virginia — signatures applied on a calendar, not backfilled in arrears when someone asks.
Offers, campaigns and patient-facing copy reviewed against your state advertising rules before they run — not pulled down after a complaint.
West Virginia recognizes the Corporate Practice of Medicine doctrine with more statutory exceptions than the strictest states, and one detail trips up more clinics here than anywhere else: West Virginia licenses and regulates MDs and DOs through two entirely separate boards, the West Virginia Board of Medicine and the West Virginia Board of Osteopathic Medicine, and your medical director's paperwork has to be filed with the correct one. Charleston's market is small compared to the region's larger cities, which means fewer clinics have tested exactly how the state's CPOM exceptions apply in practice — a reason to build the structure carefully rather than assume it works the way it does in a neighboring, better-documented state. Delegation and supervision rules apply in full regardless of which board licenses your physician. A PC-MSO structure is the standard recommendation in West Virginia, built around whichever board actually governs your director's license.
West Virginia 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 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 West Virginia.
Cash pay at the point of care. No insurance claims.
Physician-owned. Receives the revenue, pays clinicians, malpractice and clinical supplies first.
The MSO. Holds the administrative infrastructure for everything non-clinical.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
General structure, not a legal opinion for your clinic. Your director and counsel confirm the specifics for West Virginia before you treat.
West Virginia 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.
The entity that delivers care in West Virginia 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.
All shares of the professional entity are held by a physician licensed in West Virginia. 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 PC and your MSO are connected by a written management services agreement (MSA) built for West Virginia. 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 rules in West Virginia 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.
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.
Articles, bylaws, shareholder agreements, meeting minutes, EIN, assumed-name filings and any West Virginia professional-entity registrations are filed correctly the first time and kept current, not reconstructed when a lender, insurer or acquirer asks for them.
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.
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 West Virginia 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 West Virginia before you treat.
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.
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 West Virginia, your accountant spends less time untangling who owns what.
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 West Virginia claims history.
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.
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.
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, 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 West Virginia 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.
Twenty minutes on what you treat, where you operate and what already exists. We tell you what West Virginia requires and what it will cost.
A licensed physician matched to what your clinic offers, plus verification of NPI and licensure against the categories on your menu.
Name clearance and Secretary of State filing, articles of incorporation, federal EIN — the professional entity formed where your structure requires one.
Management services agreement, delegation terms and standing orders drafted, executed and filed between your company and the PC.
Malpractice and liability coverage placed, banking opened in a CPOM-appropriate structure, payroll pointed at the right entity.
Protocol packs loaded, consents attached, EHR and vendor or pharmacy accounts configured.
Staff invited and credentialed, clearance screening workflow trained, patient-facing copy checked against your state's advertising rules.
Member pricing on, chart review on the calendar, and revisions pushed to you when West Virginia rules move.
Already operating in West Virginia? 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.
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 West Virginia.
Direction has to come from a physician holding an active West Virginia license — filed with the West Virginia Board of Medicine for an MD or the West Virginia Board of Osteopathic Medicine for a DO.
West Virginia's delegation and supervision rules apply in full regardless of which board licenses your director — standing orders need to be specific either way.
West Virginia sets who may perform the initial clearance exam and whether telehealth counts; a smaller market means fewer clinics have tested this in practice, so it's worth getting right the first time.
West Virginia's CPOM enforcement allows more flexibility than Texas or North Carolina, but a PC-MSO structure remains the standard way to organize a wellness business here.
General structure, not a legal opinion for your clinic. Your director and counsel confirm the specifics before you treat.
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.
Direction must come from a physician holding an active West Virginia 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.
Written, physician-signed protocols for each service on your menu, drafted to West Virginia rules: indications, contraindications, dosing ranges, escalation paths and who may perform what. They are revised when the rules move, not when someone complains.
No prescription and no injectable before a documented clearance by someone West Virginia 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.
Who may inject, prescribe or operate a device in West Virginia (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.
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.
Testosterone, ketamine and other scheduled drugs need the right federal and West Virginia 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.
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.
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.
Offers, before-and-after photos, credentials claims ("board certified", "MD-led"), discounts and drug-related claims are reviewed against West Virginia advertising rules and your director's scope before anything runs.
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 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.
How LegitScript Certification WorksWe connect you with a West Virginia-licensed physician — MD or DO — with real aesthetics experience, matched to what your clinic offers, and we file the agreement with the correct board and draft standing orders and protocols around your menu. Most clinics are live within about three weeks.
Yes, under a licensed West Virginia physician's direction and protocols for each service line, regardless of whether your director is an MD or a DO.
If your patients are located in West Virginia, the prescribing physician generally needs a West Virginia license through the appropriate board. Multi-state operators cover West Virginia through Group membership.
A monthly stipend plus membership, scoped to your service menu — a flat monthly rate, never billed by the hour or tied to patient volume. We give you the range on the first call.
Twenty minutes tells you what direction costs here, who is available, and how fast you can treat.
Nearby states