Page 16 - OctSam2019

CORPORATE
MEDICINE

The State of the

CPOM and

the Law in

TEXAS

By Jeff Wurzburg, Esq.

he Corporate Practice of Medicine practice of medicine, combined with the fied in the Texas Medical Practice Act,
(CPOM) doctrine faces renewed constraint of medical school debt, have which is part of the Texas Occupations
pressures in an era of delivery sys- made employment an attractive option. Code (TOC). In Texas, CPOM generally
tem reform and payors shifting reimburse- However, this shift likely doesn’t spell the prohibits corporations, entities or individu-
ment to value. In Texas and other states, end to the principle underlying CPOM laws als that are not physicians from the practice
legislative changes have loosened the pro- – that a physician’s medical judgment must of medicine.
hibitions on corporate practice to align with remain free from corporate and financial
current public policy goals of integration pressures – just a realignment in philoso- Section 155.001
and collaboration. phy. The dual trends of physician/hospital Requires an individual to have a license
In 2012, hospitals or health systems em- alignment and reimbursement based on issued by the TMb to practice medicine.
ployed around 25% of U.S. physicians and value and clinical integration have put pres-
by 2018 the percentage increased to 44%. sure on certain aspects of CPOM restric- Section 155.003
between July 2016 and January 2018, hos- tions. However, Texas still maintains a Requires an individual to satisfy certain el-
pitals acquired 8,000 medical practices and robust CPOM law in comparison to many igibility standards that a corporate entity
14,000 physicians left private practice and other states. would not be able to fulfill in order to receive
entered into employment arrangements a medical license, including with regard to
with hospitals. In 2018, close to 70% of Texas Restrictions on CPOM age, professional character and education.
physicians below 40 were employees. For Originally, the notion of corporate prac-
many younger physicians, the promise of a tice was defined and developed through Section 157.001
set salary and the ability to focus on the case law. The prohibitions were later codi- Permits a physician to delegate certain

16 San Antonio Medicine • October 2019