Corporate Practice of Medicine, by state.

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.

In this dataset the strict-CPOM jurisdictions are California, Illinois, Indiana, Kansas, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Jersey, New York, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Wisconsin, Wyoming. In these states medicine generally has to be delivered through a licensee-owned professional entity (PC or PLLC), with the non-clinical business sitting in a separate management company.

Alabama, Alaska, Delaware, Florida, Hawaii, Iowa, Kentucky, Missouri, New Hampshire, New Mexico, Oklahoma, Vermont, Virginia do not enforce a general corporate practice ban. A non-physician entity can often own or contract with clinicians there, though fee-splitting rules, clinic or facility licensure, and medical director requirements still apply. A separate group — Arizona, Idaho, Louisiana, Montana, Washington — has no clean statute but is enforced through case law, board policy, or AG opinion, and Arkansas, Colorado, Connecticut, District of Columbia, Georgia, Maine, Maryland, Nebraska, North Carolina, North Dakota, Ohio, Rhode Island, Texas, Utah, West Virginia allow a defined carve-out.

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.

Ownership and supervision are two different questions. NPs can hold equity in the entity that delivers care in Alabama, Alaska, Arizona, Arkansas, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming. Elsewhere it is minority-only, limited to a non-medical entity type, or there is no ownership lane at all — and even where an NP can own, a physician collaboration or supervision requirement may still apply, permanently in some states.

PAs can hold equity in the care-delivering entity in Alabama, Alaska, Arizona, Florida, Idaho, Iowa, Maine, Montana, New Hampshire, New Mexico, North Carolina, North Dakota, Utah, Washington, Wyoming. A handful of states allow a minority stake or a PA-only professional entity, and several give PAs no ownership lane into a medical entity at all. PA supervision or collaboration agreements are permanent in many states even where ownership is allowed.