California
CANP: Restricted
One of the strongest CPOM bans, actively enforced. Medicine must be delivered through a professional medical corporation under Moscone-Knox; physicians hold at least 51%.
Resource · CPOM by state2026 edition
Corporate Practice
of Medicine, by state.
A 50-state map of who can own a medical practice, the entity you must form, and how each state enforces the CPOM doctrine. Click a state for the posture, ownership rules, and nurse-practitioner authority.
Click a state for CPOM posture, ownership rules, and NP authority. Filter with the legend above.
Full reference
CPOM posture across all 50 states plus DC.
Each entry summarizes the state's CPOM doctrine and NP practice authority. This is educational reference, not legal advice — book a call to map your specific structure.
Strict CPOM enforced
(18)Colorado
CONP: Full
CPOM enforced; medical practices are physician-owned. NP full practice authority follows 750 hours in a mentored agreement.
Illinois
ILNP: Reduced
Strict CPOM. Only physicians may own the medical corporation. NP full authority requires certification plus 4,000 clinical hours and 250 CE hours.
Indiana
INNP: Reduced
CPOM enforced; 100% physician ownership required. Collaborating physician required for NP practice.
Kansas
KSNP: Full
CPOM enforced; physician must own 100%. A domestic professional corporation may be required.
Massachusetts
MANP: Full
CPOM enforced; medical corporation must be 100% physician-owned. Full authority after 2 years of supervised practice.
Michigan
MINP: Restricted
CPOM enforced; 100% physician ownership. Practices operate as PLLCs or PCs. NP requires collaborative agreement for certain acts.
Minnesota
MNNP: Full
A non-medical corporation that employs a physician for its benefit can be treated as unlawfully practicing medicine.
Mississippi
MSNP: Reduced
CPOM enforced; all shareholders of a medical group must be physicians. Collaborating physician reviews charts monthly.
New Jersey
NJNP: Reduced
Strict CPOM rooted in case law and AG guidance. No PLLC; professionals form a PC, or an LLC only if wholly owned by licensed professionals.
New York
NYNP: Full
Strict CPOM. Only physicians may own the professional entity, and an in-state PC or PLLC is required; foreign PCs are not accepted.
Oregon
ORNP: Full
CPOM enforced through case law with strict new rules in 2025. 100% physician ownership. Full practice authority for NPs.
Pennsylvania
PANP: Reduced
CPOM enforced; 100% physician ownership. NPs need a prescriptive-authority collaborative agreement with at least 2 physicians.
South Carolina
SCNP: Restricted
CPOM enforced; 100% physician ownership. Supervising physician must reside in-state and may oversee up to 6 NPs.
South Dakota
SDNP: Full
PC must be physician-owned. NP independent after 1,040 collaborative hours.
Tennessee
TNNP: Restricted
CPOM enforced; physician must own 100% of shares. Both PC and PLLC structures are allowed. Collaborative oversight required.
Wisconsin
WINP: Reduced
Corporations that cannot meet medical licensing criteria may not practice medicine, so physician ownership is the norm.
Wyoming
WYNP: Full
Professional corporations must be owned by individuals licensed in the profession. NP independent practice authority.
Limited exceptions
(12)Arkansas
ARNP: Reduced
CPOM recognized via statute and AG opinion; corporations may not intrude on independent medical judgment. NP prescribing requires collaboration.
Connecticut
CTNP: Full
CPOM applies with limited exceptions. Full practice authority follows at least 3 years and 2,000 hours of collaboration.
Georgia
GANP: Restricted
Non-physician ownership is not outright forbidden, but the structure must keep clinical control with a physician and avoid fee-splitting.
Maine
MENP: Full
Full authority after 24 months supervised practice or employment at a facility with a physician medical director.
Maryland
MDNP: Full
CPOM applies with limited exceptions; agreements must state that independent clinical decision-making rests with the physician.
North Carolina
NCNP: Restricted
A physician or PA may form a PC/PLLC. Practices owned solely by PAs may not hire physicians. Board approval required for ownership changes.
Ohio
OHNP: Reduced
Ownership is possible so long as a physician controls clinical judgment; statutes bar corporate influence over professional clinical judgment.
Rhode Island
RINP: Full
CPOM applies, but rules allow licensed providers trained in the service to own clinics.
Texas
TXNP: Restricted
CPOM with limited exceptions. A physician must own majority shares (51%); joint ventures allowed with certain professionals.
Utah
UTNP: Full
Professional Corporation Act lets physicians, dentists, osteopaths, and chiropractors form PCs. NPs have full practice authority.
Washington D.C.
DCNP: Full
Ownership is possible so long as physicians maintain independent judgment. Full practice authority for NPs.
West Virginia
WVNP: Reduced
Ownership for non-physicians is unsettled and needs further research. NPs need a collaborative agreement to prescribe for 3 years.
Case-law enforced
(4)Arizona
AZNP: Full
CPOM exists through case law (Funk, Sears). PC statutes let non-licensed persons hold up to 49% of shares if they do not interfere with clinical judgment.
Idaho
IDNP: Full
No formal CPOM statute but enforced in practice. Physicians generally cannot be employed by a non-physician entity though they may contract with one.
Louisiana
LANP: Reduced
No explicit statutory CPOM ban, but the board can intervene if arrangements compromise the physician's independent judgment.
Washington
WANP: Full
CPOM exists but is not heavily enforced for PLLC or PC structures. Full practice authority for NPs.
Permissive / no doctrine
(11)Alabama
ALNP: Restricted
No statutory CPOM ban. A 1992 declaratory ruling lets a business employ physicians so long as physicians make independent clinical decisions.
Alaska
AKNP: Full
Full practice authority and no CPOM ban. An NP may own and operate a practice; confirm entity form with the Division of Corporations.
Delaware
DENP: Full
No outright CPOM ban, but all shareholders must be licensed in the services provided, so an NP or PA owner is possible in theory.
Florida
FLNP: Restricted
No formal CPOM doctrine, but a Health Care Clinic License is required for many non-physician-owned clinics, and fee-splitting rules apply.
Hawaii
HINP: Full
No CPOM ban and full practice authority; no collaborator required.
Iowa
IANP: Full
No formal CPOM ban; a range of entity types may operate. Full practice authority.
Kentucky
KYNP: Reduced
CPOM not strongly enforced so long as clinicians retain independent decision-making. NPs need a collaborative agreement to prescribe.
Missouri
MONP: Restricted
No CPOM doctrine enforced. Physician and NP must practice together for the first 30 days unless dual-trained.
Oklahoma
OKNP: Restricted
Permissive: non-physicians may own and manage medical facilities. NP prescriptive authority requires a written supervision statement.
Vermont
VTNP: Full
No CPOM ban. NPs with under 24 months and 2,400 hours need a collaborating agreement; otherwise independent.
Virginia
VANP: Restricted
Virginia does not bar corporate entities from employing licensed individuals. PC statute lists NPs and clinical nurse specialists.
Research pending
(6)Montana
MTNP: Full
Full practice authority per AANP. CPOM posture and ownership rules not yet verified in this dataset.
Nebraska
NENP: Full
Full practice authority per AANP. CPOM posture and ownership rules not yet verified in this dataset.
Nevada
NVNP: Full
Full practice authority per AANP. CPOM posture and ownership rules not yet verified in this dataset.
New Hampshire
NHNP: Full
Full practice authority per AANP. CPOM posture and ownership rules not yet verified in this dataset.
New Mexico
NMNP: Full
Full practice authority per AANP. CPOM posture and ownership rules not yet verified in this dataset.
North Dakota
NDNP: Full
Full practice authority per AANP. CPOM posture and ownership rules not yet verified in this dataset.
FAQ
Questions we get every week.
What is the Corporate Practice of Medicine (CPOM) doctrine?
+
CPOM is a body of state law that generally prohibits corporations, non-physicians, or lay entities from owning medical practices or employing physicians to practice medicine. It's designed to protect physicians' independent clinical judgment from commercial influence. Each state defines and enforces CPOM differently — through statute, case law, AG opinion, or a mix.
Which states enforce CPOM most strictly?
+
California, New York, Texas (with exceptions), Illinois, New Jersey, Massachusetts, Michigan, Colorado, Oregon, Pennsylvania, Tennessee, and several others enforce CPOM strictly. In these states, medicine must be delivered through a physician-owned professional entity (PC or PLLC), typically requiring at least 51% physician ownership.
Which states are permissive or have no CPOM doctrine?
+
Alaska, Alabama, Delaware, Florida, Hawaii, Iowa, Kentucky, Missouri, Oklahoma, Vermont, Virginia, and a handful of others do not enforce a strict CPOM ban. Non-physician entities can often own or contract with physicians, though other rules (fee-splitting, clinic licensing, medical director requirements) still apply.
What is a PC/MSO structure and why do I need one?
+
A PC/MSO (Professional Corporation / Management Services Organization) is the standard compliant structure for delivering medicine in CPOM states when the operating company is non-physician owned. The physician-owned PC holds all clinical activity and licenses; the MSO provides non-clinical services (billing, tech, marketing, admin) under an MSA. Getting this right is what unlocks legal multi-state operation for digital health, telemedicine, and franchise operators.
Can a nurse practitioner (NP) own a medical practice?
+
It depends on the state. In full-practice-authority states (AK, AZ, CO, HI, IA, ME, MD, MA, MT, NE, NV, NH, NM, ND, OR, RI, SD, UT, VT, WA, WY, DC), NPs can generally own and operate independently. In restricted or reduced states, NPs need a collaborating or supervising physician and typically cannot own a medical corporation outright.
Structure it right the first time.
Book a call. We'll map your PC/MSO, the states you're entering, and the compliant path to get there.