Practice Management

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  • 1.  Practice Ownership by Individual Physician Entities

    Posted 03-23-2023 14:24

    Like many states that prohibit corporate practice of medicine, Kansas generally prohibits ownership of a physician practice by a non-physician.  I have some docs who are interested in owning their share of the practice in an entity such as an LLC for tax reasons.  That's fine in Kansas as long as the ownership doesn't pass to a non-physician.  The concern of the group is that we wouldn't have any way to prevent or necessarily even know about a change of ownership of a separate entity that owns the share of the practice, which could jeopardize the legal standing of the practice.

    Does anyone have a structure that allows ownership of the practice share by an entity in a state that prohibits non-physician ownership?  If so, what safeguards are in place to prevent ownership of the shareholding entity by a non-physician?

    Thanks

    Dave



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    David Smith FACMPE
    Executive Director
    United Imaging Consultants
    Mission KS
    (785) 393-8387
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  • 2.  RE: Practice Ownership by Individual Physician Entities

    Posted 03-23-2023 14:57

    David – That can be controlled in the Operating Agreement. What I have seen and set up is that the Member cannot transfer their Membership to any non-physician and that in the event of death the trust or estate must effect the dissolution of the Membership within some set time period. There are other terms and conditions that most attorneys can delineate. There is always the possibility of an "illegal" transfer of the Membership, but if that happens the Operating Agreement also usually contains language to address it such that the Membership must be relinquished within X time from realization of the illegal transfer or the value drops to $0. Again most attorneys know how to set that up.....   Let me know if you want a scrubbed piece of language. I can probably get one together for you.

     

    Keith E. Chew, MHA, CMPE, FRBMA

    Principal

    Consulting with Integrity

    18 Hawks Nest

    Chatham, IL     62629

    217-971-5293

     






  • 3.  RE: Practice Ownership by Individual Physician Entities

    Posted 03-23-2023 15:33

    Dave

     

    Keith couldn't have said it better.  Our Operating Agreement controls the transfer and price of member interests.  It also states that if a partner leaves the group they are forced to sell their shares back to the entity per the formula in Operating Agreement.

     

    Paul

     






  • 4.  RE: Practice Ownership by Individual Physician Entities

    Posted 03-23-2023 15:46

    Thanks, Paul and Keith

    The risk we are trying to figure out how to mitigate is the risk of a transfer contrary to the provisions of the relevant agreements.  What happens if a shareholder ignores their contractual obligation or the operating agreement and allows a non-physician to own a share of their entity, and the group is operating illegally as a result?  It's hard to see how the practice would have visibility on who owns the entity that owns the share of the practice.

    Dave



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    David Smith FACMPE
    Executive Director
    United Imaging Consultants
    Mission KS
    (785) 393-8387
    ------------------------------



  • 5.  RE: Practice Ownership by Individual Physician Entities

    Posted 03-23-2023 16:09
    David
    In addition to the clauses Paul and Keith referenced, I have also seen agreements that require approval of all other members to permit a transfer. One could also insert clause that requires sign off by a previously approved health care attorney. In any event, I strongly recommend use of a health care attorney knowledgeable in these type of transactions and restrictions to ensure the agreement is not subject to challenge
    Larry

    Larry Buchwalter
    Sent from my iPhone
    Please pardon any typos





  • 6.  RE: Practice Ownership by Individual Physician Entities

    Posted 03-23-2023 16:15

    Dave

     

    We only offer an ownership position in our Imaging facility LLC to current partners of The Group, provided that the supermajority of the partners agree.  We ask the new member to execute an agreement stating that they have read, understand and agree to comply with the Operating Agreement.  If they sell their shares to some other entity, they are in violation of the agreement. In the past 19 years we have never had an issue. Hopefully, your partners are more trustworthy that stooping so low with the potential of getting into legal trouble.

     

    Paul

     






  • 7.  RE: Practice Ownership by Individual Physician Entities

    Posted 03-23-2023 16:29

    David,

    Just thinking out loud here, but does Kansas require listing of owners when doing annual business filing with Secretary of State?  Can't think of any other potential option to verify.  If unable, possibly you could draft an acknowledgement that the physician would have to sign that there are no others owners of the LLC he/she is asking you to pay?  May not be perfect but I would think shield your group somewhat?



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    Joshua Dorsey
    Chief Executive Officer
    Radiology Associates of Northern Kentucky
    Crestview Hills KY
    614-284-1597
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  • 8.  RE: Practice Ownership by Individual Physician Entities

    Posted 03-23-2023 16:29

    David – A couple of groups have made an "illegal" transfer place the value of the Membership at$0 or 0%. That effectively makes the value "0" sop there is not issue with a non-physician owning any Membership value....

     

    Keith E. Chew, MHA, CMPE, FRBMA

    Principal

    Consulting with Integrity

    18 Hawks Nest

    Chatham, IL     62629

    217-971-5293