The Corporate Practice of Medicine (CPOM) doctrine is an essential regulatory framework in the healthcare sector, ensuring that medical decisions are made by licensed physicians and not influenced by non-medical business interests. In Arkansas, CPOM laws govern the relationships between healthcare providers, their business structures, and the way clinical practices are managed. Understanding and adhering to these regulations is crucial for healthcare businesses in the state to avoid legal pitfalls and continue providing high-quality care.

This blog provides a comprehensive compliance roadmap for healthcare providers in Arkansas, focusing on the essential elements of the CPOM law, the steps necessary to ensure compliance, and the best practices for structuring a compliant medical practice. Whether you are a physician opening a new practice, a healthcare business owner, or a telemedicine provider, this guide will help you navigate the regulatory environment for the year 2025 and beyond.

This is where Access Plus Health comes in. Our comprehensive CPOM guide for Arkansas serves as your roadmap to compliance in 2025. Access Plus Health breaks down the complexities of CPOM regulations, offering practical advice and solutions tailored to your practice. Partner with us to ensure your healthcare business stays compliant and focused on delivering exceptional patient care."

What is Corporate Practice of Medicine (CPOM) in Arkansas?

In Arkansas, the Corporate Practice of Medicine (CPOM) doctrine prohibits non-physician entities from owning or controlling medical practices or making medical decisions. The core purpose of CPOM laws is to preserve the autonomy of licensed healthcare professionals, ensuring that clinical decisions are made based on patient welfare and not on financial interests.

Key elements of Arkansas CPOM laws include:

1. Physician Autonomy: Only licensed physicians can make clinical decisions. Non-physician business owners are not allowed to interfere with the practice of medicine or direct the medical staff’s clinical decisions.
2. Separation of Business and Clinical Operations: While a business entity may own a medical practice, it cannot influence medical decisions. There must be a clear separation between business operations and clinical functions.
3. Control over Employment Practices: Physicians must retain control over hiring, firing, and supervising medical staff. Non-physician owners may only be involved in financial or business management roles, not clinical decisions.

CPOM laws are designed to prevent situations where business interests may conflict with the medical judgment necessary to provide the best patient care.

Key Considerations for Healthcare Providers in Arkansas

As a healthcare provider in Arkansas, ensuring compliance with CPOM regulations requires understanding the legal landscape, the restrictions placed on ownership and management, and the operational requirements for maintaining a compliant medical practice. Here are the key considerations for healthcare providers to be mindful of:

1. Structuring Your Medical Practice

One of the most important aspects of CPOM compliance is the legal structure of the healthcare practice. Arkansas law requires that the ownership and control of medical practices remain with licensed physicians. This means that healthcare providers must establish a professional corporation (PC) or a professional limited liability company (PLLC) in which physicians hold ownership.

• Physician Ownership: Physicians must be the primary owners of the practice. This ensures that control over clinical decisions remains in the hands of licensed professionals.
• Non-Physician Participation: Non-physician business investors may financially participate in the practice, but they cannot have a controlling interest or influence clinical decisions.
• Clear Ownership Agreements: The ownership structure must be clearly defined in the practice’s corporate documents. These documents should specify the roles and responsibilities of both physician and non-physician owners to avoid any confusion about the separation of clinical and business functions.

2. Employment and Supervision Contracts

CPOM regulations also impact employment and supervision practices. Healthcare providers must ensure that employment contracts, especially for non-physician practitioners such as nurse practitioners (NPs) or physician assistants (PAs), comply with CPOM laws.

• Physician Supervision: Physicians are responsible for supervising non-physician healthcare providers. This supervisory relationship should be clearly outlined in contracts, detailing the scope of practice and supervision responsibilities.
• Non-Physician Providers: While non-physicians can work in a medical practice, they must be properly supervised by a licensed physician. This means that the physician is accountable for the decisions made by these providers in the course of patient care.
• Independent Contractor Agreements: If non-physician providers are contracted rather than employed, the same principles apply. The contracts should specify that the physician has ultimate control over medical decisions.

3. Compliance with Telemedicine Regulations

The rise of telemedicine has brought new challenges to CPOM compliance. As healthcare providers in Arkansas increasingly offer virtual consultations, understanding how CPOM laws apply to telemedicine is critical. Telemedicine provides unique opportunities for extending patient care, but it also requires adherence to CPOM regulations.

• Supervision in Telemedicine: Even in virtual consultations, the physician must supervise non-physician providers. The supervisory relationship should extend to telehealth services to ensure that clinical decisions are still made by licensed physicians.
• Licensing Across State Lines: Arkansas-based telemedicine providers must be licensed to practice in Arkansas, but they should also be aware of any additional licensing requirements in other states where they might provide care.

Steps to Ensure Compliance with CPOM Laws in Arkansas

Healthcare providers in Arkansas must take several steps to ensure they remain compliant with CPOM laws and avoid potential legal issues. These steps include establishing the right corporate structure, maintaining proper documentation, and ensuring appropriate supervision and management.

1. Work with Legal Professionals

Given the complexity of CPOM regulations, it is essential for healthcare providers to work with legal experts who specialize in healthcare law. These professionals can help structure the practice in a way that ensures compliance, review contracts for non-physician providers, and provide guidance on navigating the complexities of CPOM laws.

• Healthcare Lawyers: Healthcare-specific attorneys will understand the nuances of Arkansas CPOM laws and can help healthcare providers draft documents that ensure compliance.
• Ongoing Legal Support: Regular consultations with legal professionals can help healthcare providers stay updated on any changes to state regulations and ensure that the practice remains in compliance over time.

2. Form a Professional Corporation or PLLC

As previously mentioned, Arkansas law mandates that healthcare practices be structured as professional corporations (PCs) or professional limited liability companies (PLLCs). These entities allow physicians to retain ownership and control over medical decisions while providing flexibility for business operations.

• Professional Corporation (PC): A professional corporation is a business entity that is typically formed by licensed professionals (e.g., physicians, dentists). This structure is commonly used for medical practices and ensures that only licensed individuals are responsible for medical decisions.
• Professional Limited Liability Company (PLLC): A PLLC is a hybrid business structure that combines the benefits of a limited liability company (LLC) with the requirement that only licensed professionals can own and operate the medical practice.

3. Create Clear Employment and Supervision Agreements

Healthcare providers should ensure that all employment contracts, particularly those involving non-physician providers, include clear clauses that outline supervision responsibilities. These agreements should specify the physician's role in overseeing the medical decisions of non-physicians and ensure compliance with CPOM laws.

• Clear Scope of Practice: Clearly define the scope of practice for non-physician providers, including the limits of their decision-making authority.
• Supervision Requirements: Outline the supervisory requirements for physicians, ensuring that they retain ultimate control over clinical decisions.

4. Monitor Regulatory Changes

CPOM laws may evolve over time, so healthcare providers must remain informed about any changes in Arkansas state law. Regularly monitoring regulations ensures that healthcare businesses stay compliant with the latest requirements.

• State Healthcare Regulations: Healthcare providers should monitor updates from the Arkansas Medical Board, the Arkansas State Board of Pharmacy, and other regulatory bodies for changes in CPOM and related healthcare laws.
• Professional Associations: Joining professional associations, such as the Arkansas Medical Society or the Arkansas Telemedicine Association, can provide access to regulatory updates, legal guidance, and networking opportunities.

Ensuring compliance with Arkansas' Corporate Practice of Medicine (CPOM) regulations is crucial for healthcare providers in the state. By following the CPOM compliance roadmap outlined in this blog, healthcare providers can avoid legal challenges, maintain physician autonomy, and continue to deliver high-quality patient care.

Key steps for compliance include forming the right corporate structure, ensuring proper supervision of non-physician providers, regularly reviewing contracts, and staying updated with regulatory changes. Working with legal professionals and maintaining clear documentation will help Arkansas healthcare providers navigate the complexities of CPOM regulations in 2025 and beyond. By doing so, they will continue to operate within the bounds of the law and provide the best possible care to their patients.