Michigan: Ownership and Oversight
Strict CPOM (learned professions doctrine). Michigan's doctrine turns on a single definitional hinge: medicine is a "learned profession" that must live in a PC or PLLC with licensed owners, while nursing is not — which sends APRN-owned practices through ordinary LLCs. Oversight was rebuilt in 2016 with no ratios and a practice-agreement model for PAs.
Who the statute actually covers
- Learned professions doctrine: MBCA § 251(1) bars ordinary corporations from practicing learned professions (medicine, osteopathy, dentistry); AG Opinions 6592 (1989) and 6770 (1993) extend the bar to employing licensed professionals. Medical practices must be PCs or PLLCs, with every shareholder/member/manager licensed in the profession.
- The nursing hinge: RNs and APRNs are not "learned professionals" under Michigan law, so an APRN-owned practice cannot use a PLLC; it operates through an ordinary LLC rendering nursing services.
- PA PLLC limitation: a PA cannot organize a PLLC whose only members are PAs; PA equity exists only alongside physician members.
- "Practice agreement" / "participating physician" (MCL 333.17047; PA 379 of 2016): PAs practice medicine with a participating physician under a written practice agreement; PAs are independent "prescribers" holding their own Michigan controlled substance licenses.
1. Who can own what
| Entity / Path | Who may own | Key limits |
|---|---|---|
| Medical PC / PLLC | Physicians only as shareholders/members/managers. | Foreign-licensed professionals may hold membership roles but cannot render Michigan services. |
| PA equity | Only as a member of a PLLC that also has physician members; a PA-only PLLC is prohibited. | |
| APRN-owned practice | Through an ordinary LLC rendering nursing services. | The constraint is scope, not entity: services beyond APRN independent scope require physician delegation. |
| Lay / MSO | Not permitted for medical entities; employing physicians through ordinary corporations violates the doctrine. | Fee-splitting separately prohibited; keep MSO fees flat and FMV. |
2. Collaborative and supervisory oversight
| Role | Agreement required | Oversight mechanics | Path to independence |
|---|---|---|---|
| PA | Written practice agreement with a participating physician (MCL 333.17047; PA 379 of 2016). Facility- and group-designated participating physicians expressly allowed. | No ratios — Michigan eliminated numeric PA-per-physician limits. No countersignature requirement. PAs prescribe (Schedules 2–5) under the practice agreement without separate physician delegation, holding their own CS and DEA registrations. | None. |
| NP / APRN | No collaborative agreement required for nursing-scope practice (PA 499 of 2016). But acts beyond that scope, and all controlled-substance prescribing (Schedules 2–5), require written physician delegation; Medicaid billing requires a written collaborative practice agreement on the state form. | No ratios, no chart-review percentages, no countersignature requirement in the Public Health Code. APRNs may prescribe noncontrolled drugs independently. | None as such: no FPA statute; delegation for controlled substances is permanent. |
3. Primary authorities
- MBCA § 251(1); Professional Service Corporation Act; Michigan LLC Act.
- Mich. AG Op. Nos. 6592 (1989), 6770 (1993).
- MCL 333.17047-17048; PA 379 of 2016.
- PA 499 of 2016; MCL 333.17201 et seq., 333.16215.
Practical read: Michigan's whole analysis hangs on the learned-professions definition, and it cuts both ways. The recurring Michigan deal error is treating an APRN's ordinary LLC as if it could absorb medical services — the entity is fine, the scope is not. On the oversight side, Michigan is quietly one of the most flexible restricted states: no ratios, no chart percentages.
General education, not legal advice.