Pennsylvania state laws and regulations that affect your medical practice

1. Under what business structures are physicians permitted to practice?

Physicians may practice in the following manner:

A. Solo

B. Partnership, Professional Association or Limited Liability Company

A physician may practice in a partnership, professional association or professional limited liability company, but such entity must be composed solely of licensed health care professionals who render the same professional services. A physician who is a member of a limited liability company remains personally responsible for his or her own negligence, wrongful acts, etc., and that of any person under his or her direct supervision and control.

(15 Pa. C.S.A 2903; 15 Pa. C.S.A. 8921)

C. Associational Relationship with Other Physician or Professional Entity.

A physician may form partnerships or professional corporations, for the practice of medicine, with other licensed physicians, allopathic or osteopathic, optometrists, dentists, psychologists, podiatrists and chiropractors.

(49 PA ADC § 25.214)

D. Managed Health Care Plans

A physician may participate in organized managed health care plans including, but not limited to, those involving wholly or partially pre-paid medical services. This includes health maintenance organizations, preferred provider organizations, competitive medical plans, individual practice associations, or other similar designations. A physician may participate in any such plan which complies with the following requirements:

i. The physician retains authority at all times to exercise professional judgment within accepted standards of practice regarding care, skill and diligence in examinations, diagnosis and treatment of each patient.

ii. The physician retains authority at all times to inform the patient of appropriate referrals to any other health care providers - whether or not those persons are provider-members of the plan and whether or not the plan covers the cost of service by such non-member providers to the patient.

iii. In the case of managed care plans or health maintenance organizations, the physician enters into a written agreement with the plan containing a provision that the plan members are not liable to the provider for any services for which the plan is liable.

(31 Pa Code § 152.6)

2. What requirements must be met for a practitioner to engage in professional practice in Pennsylvania?

A practitioner may engage in professional practice only when in possession of a current biennial registration issued by the Board.

(49 PA ADC § 16.25)

Copyright Kern Augustine Conroy and Schoppmann, P.C. Used with permission.

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