Most physicians no longer own the practices where they work. Now, a new bill in Congress is asking how much control should a corporation have over the medicine we practice?
The proposed Stop Corporate Takeovers of Physicians Act would establish a federal ban on the corporate practice of medicine. It would require medical practices to be majority-owned and controlled by physicians and other licensed clinicians who actually practice medicine. It would also restrict how management services organizations, or MSOs, influence staffing, compensation, branding, contracts, and even specific clinical decisions.
The bill is unlikely to pass in the current Congress. But I don’t think we should ignore it.
The legislation reflects a larger shift already underway at the state level. But, more importantly, it puts physician autonomy, corporate control, and the structure of medical practice into the same policy debate.
In this Practice Management article, I’ll explain what corporate practice of medicine laws are, what this bill would change, why it matters now, and how it could affect our day-to-day practice—for better and for worse.
What Is the Corporate Practice of Medicine?
Corporate practice of medicine laws are meant to prevent non-physicians from controlling medical decisions. Medicine should be practiced by clinicians whose primary duty is to patients, not by corporations whose leaders may be accountable to investors, quarterly targets, or other business priorities.
Historically, these laws have been handled by individual states. Some states have strict restrictions (like California or Oregon). Others have weaker rules or broad exceptions. Enforcement also varies.
That patchwork helped create the modern MSO–professional corporation structure.
In a common arrangement, physicians technically own the professional corporation that delivers care. A separate MSO—often backed by private equity, a health plan, or another company—owns the brand, technology, administrative infrastructure, and other nonclinical assets. The practice then pays the MSO for management services.
At their best: MSOs give physicians billing support, technology, staffing infrastructure, and negotiating scale while preserving clinical independence.
At their worst: physician ownership exists mostly on paper while the MSO controls the levers that shape how care is delivered.
That gap between legal ownership and practical control is what this bill targets.
What the Proposed Federal CPOM Ban Would Do
The Stop Corporate Takeovers of Physicians Act goes further than a traditional ownership restriction.
According to an analysis from Elevare Law, the bill would make it unlawful for an entity that is not majority-owned and controlled by licensed clinicians to own or control a medical practice, employ a clinician, or practice medicine. The proposal includes exceptions for organizations such as nonprofit and public providers, hospitals, hospital-affiliated clinics, critical access hospitals, and rural emergency hospitals.
1. It would restrict MSO control over practice operations
The bill identifies business decisions that can shape clinical care, including:
Hiring and firing
Work schedules
Physician compensation
Staffing levels
Revenue targets
Billing and coding
Clinical standards
Negotiating or terminating payer contracts
If a company controls how many patients we see, how much time we have, who supports us, and how our compensation is calculated, it can influence care without ever entering an order in the EHR.
Many MSO structures use agreements that allow the management company to control or restrict the transfer of ownership in the physician-owned practice.
These arrangements provide continuity if the nominal physician owner leaves, retires, or dies. They can also give the MSO meaningful control over who owns the practice.
The bill would prohibit an MSO from controlling the sale or transfer of a medical practice’s shares, interests, or assets. That would challenge one of the legal tools supporting the “friendly physician” model, or “Friendly P.C. Model.”
3. It would restrict MSO branding
Many national healthcare companies market care under one consumer-facing brand while services are technically delivered by separate physician-owned entities in each state.
The proposed law would generally prohibit an MSO from advertising a practice’s services under a name other than the medical practice’s own name. For a multistate platform, this could require a fundamental redesign of how patients find and interact with the organization.
4. It would void several physician contract restrictions
The bill would make non-compete, non-disclosure, and non-disparagement agreements unenforceable in many physician arrangements.
Importantly, this provision would reach beyond private equity or investor-backed MSOs. It could also affect contracts between a fully physician-owned group and its employed physicians.
That could make it easier for physicians to change jobs, speak openly about unsafe conditions, or start competing practices. It could also make it harder for small physician groups to protect business information or retain clinicians after investing in recruitment and practice development.
5. It would directly protect clinical judgment
The bill would prohibit employers and healthcare organizations from interfering with clinical judgment through discipline, threats, retaliation, coercion, or excessive pressure. It specifically addresses decisions such as:
How much time a clinician spends with a patient
Whether a patient is admitted, placed in observation, or referred to palliative care
How quickly treatment must begin
Where a patient is referred after discharge
Which diagnosis or diagnosis code appears in the medical record
Which clinical orders are available in the EHR
The bill would reportedly give the Federal Trade Commission enforcement authority. Potential consequences could include private lawsuits, triple damages, attorneys’ fees, actions by state attorneys general, and exclusion from federal healthcare programs. The proposed requirements would take effect one year after enactment, without broad grandfathering for existing arrangements.
Why Now?
The short answer is that independent practice has become harder to sustain. By January 2026, 82% of practicing physicians were employed by a hospital or corporate entity. Only 18% practiced in physician-owned settings. Hospitals and corporations owned nearly 64% of physician practices.
Physician Employment Trends PAI-Avalere Health Report
Administrative burden, prior authorization, EHR costs, cybersecurity, staffing, compliance, and weak negotiating leverage have pushed many physicians toward employment. Hospitals, insurers, and investor-backed platforms can spread those costs across larger organizations.
Employment also offers real benefits such as predictable income, benefits, infrastructure, capital, and freedom from running the business. But we trade something for that support. The organization takes on the business risk, and it gains more control over schedules, workflows, staffing, compensation, and strategic decisions. That trade-off has become central to medicine. The proposed federal CPOM ban is one attempt to reset the balance.
This proposed legislation also follows a wave of state activity. Oregon, Massachusetts, New Mexico, Indiana, Washington, and California have all moved to strengthen oversight of healthcare transactions or corporate influence over medical practices. Even if this federal bill stalls, parts of it could become a template for state lawmakers.
How This Could Improve Our Day-to-Day Practice
For physicians, the most appealing part of the bill is the explicit protection of clinical judgment. In the ICU, operational pressure often arrives disguised as efficiency (throughput targets, admission status, discharge destination, length of stay, documentation, coding, and how quickly beds need to turn over). In the outpatient clinic, it can show up as shorter visits, overbooked schedules, limited staffing, productivity formulas, referral restrictions, or EHR defaults that steer decisions.
Most of these policies are not inherently malicious. Hospitals and practices need to manage capacity, staffing, and finances. But when the operational target becomes more important than the patient in front of us, physicians need meaningful protection to push back.
This bill could also improve physician mobility by limiting non-competes. A pulmonologist leaving an employed group might have more freedom to join another local practice or open an independent clinic without moving their family across the state.
Restrictions on non-disparagement and confidentiality clauses could make it easier for clinicians to raise concerns about unsafe staffing, unrealistic productivity expectations, or business practices that interfere with care.
At its best, the legislation would make physician ownership and clinical autonomy real rather than ceremonial.
How This Could Make Practice More Difficult
Modern practices need capital, technology, compliance support, billing expertise, contracting teams, and operational infrastructure. Most physicians do not want to personally manage all of that but many practices could not survive without outside support.
A broad restriction on MSO involvement could destabilize arrangements that are working well. Requiring separate practice brands could confuse patients and weaken the efficiencies of a national platform. Restrictions on ownership transfer could make succession planning and financing harder. Compliance costs would likely rise, especially for organizations operating across multiple states.
There is also a risk of pushing consolidation toward the entities exempted by the bill. If hospitals and hospital-affiliated clinics remain exempt while investor-backed MSOs face tighter restrictions, independent practices may find it easier to sell to a hospital than to pursue another partnership model. A law designed to protect physician independence could unintentionally strengthen hospital employment.
What Pulmonary and Critical Care Physicians Should Watch
For those of us in pulmonary and critical care, this debate touches several parts of practice:
ICU operations: Who has the final say over admission, observation, palliative care, transfer, and discharge decisions?
Productivity: Can an employer use compensation or scheduling pressure to influence time spent with a complex patient?
Documentation and coding: Where is the line between accurate documentation support and pressure to select financially favorable diagnoses?
Staffing: How much authority should a management company have over physician, APP, nursing, and respiratory therapy staffing?
Referral patterns: Can physicians refer patients to the most appropriate post-acute or specialty setting, even when it falls outside the organization?
Practice ownership: Will new rules create a realistic path to physician-owned pulmonary groups, or simply narrow the alternatives to hospital employment?
These questions will shape where we work, how we are paid, and how much control we retain at the bedside.
In summary, the proposed federal corporate practice of medicine ban could strengthen clinical autonomy and expose arrangements in which physician ownership is mostly nominal. It could also disrupt MSO models that provide practices with valuable infrastructure and unintentionally accelerate hospital employment. The central question is not whether business belongs in medicine. It is whether physicians retain enough authority to put the patient first when business and medicine disagree.
