New York: Ownership and Oversight
Strict CPOM (century-old case law + licensing statutes). Single-profession entities, felony exposure for aiding unlicensed practice, a fee-splitting rule that shapes every MSO fee, and a two-agency formation process. NP oversight is experience-tiered; PA oversight is ratio-capped.
Who the statute actually covers
- "Profession": licensure runs through the State Education Department. Medicine is Education Law Article 131, PAs Article 131-B, nursing Article 139. A professional entity practices one profession, and shares may be issued or transferred only to New York licensees of that same profession (BCL §§ 1503, 1507; LLC Law § 1207).
- "Written practice agreement" governs NPs under 3,600 practice hours; since the 2022 NPMA update, 3,600+ hour NPs need neither an agreement nor a collaborative relationship. Extended on May 28, 2026 through July 1, 2030.
- Fee-splitting (Ed. Law § 6509-a): professional fees may not be shared with unlicensed persons — MSO compensation must be fixed and FMV.
1. Who can own what
| Entity / Path | Who may own | Key limits |
|---|---|---|
| Medical PC / PLLC | 100% owned by NY-licensed physicians. Shares/membership transferable only to same-profession licensees (BCL §§ 1503, 1507; LLCL § 1207). | Two-agency formation: Education Department consent first, then Department of State filing. |
| NP ownership | NPs may own nursing PC/PLLCs rendering NP services; they may not own or hold shares in a medical PC/PLLC. | An NP-owned practice renders nursing/NP services; the 3,600-hour framework governs how independently it operates. |
| PA ownership | No recognized lane. NY does not authorize PA-owned professional entities to render medical services. | A PA equity pitch in New York is a red flag until counsel confirms otherwise. |
| Lay / MSO | No unlicensed ownership. Aiding unlicensed practice is a Class E felony (Ed. Law § 6512). | General business corporations may employ physicians only in licensed-facility settings with an on-premises medical director. MSO fees must be flat/FMV, never a percentage of professional revenue. |
2. Collaborative and supervisory oversight
| Role | Agreement required | Oversight mechanics | Path to independence |
|---|---|---|---|
| PA | Supervision by a NY-licensed physician; scope defined by the supervising relationship (Ed. Law Art. 131-B). | Ratio caps: up to 4 PAs in private practice and up to 6 in a hospital setting. Supervision continuous but not on-site. | None. |
| NP | Under 3,600 hours: written practice agreement + written practice protocols (8 NYCRR § 64.5). Over 3,600 hours: no written agreement or mandated collaborative relationship. | For sub-3,600 NPs: collaborating physician must review patient records at least every 3 months. A physician may have written practice agreements with no more than 4 off-site NPs. | Yes: 3,600 qualifying hours ends the requirement. Sunsets July 1, 2030 unless made permanent; monitor S2360/A1220. |
3. Primary authorities
- N.Y. Bus. Corp. Law Art. 15; N.Y. LLC Law § 1207; Ed. Law Arts. 131, 131-B, 139.
- Ed. Law § 6512; § 6509-a.
- Ed. Law § 6902(3) and 8 NYCRR § 64.5.
- NP Modernization Act (2014, updated 2022); 2026 extension through July 1, 2030.
- People v. Woodbury Dermatological Institute, 192 N.Y. 454 (1908).
Practical read: New York layers three separate traps — entity, money, and criminal. Aiding unlicensed practice is a felony, not just discipline. And check the calendar on NP independence: it now runs to July 1, 2030, but it is still a sunset.
General education, not legal advice.