South Carolina CPOM Rules 2026: Who Can Own a Practice

Yes, South Carolina enforces a corporate practice of medicine (CPOM) rule, but not through a statute. It comes from the state Supreme Court, which calls it a common law prohibition, and from a Board of Medical Examiners advisory opinion. We classify South Carolina as Moderate: the case law is old but alive, and the Board has put its expectations in writing.

For a non-physician founder: do not employ physicians in a general business corporation. Use a physician-owned professional corporation (PC) and a management services organization (MSO). For an NP or PA founder: South Carolina restricts NP practice, so a physician relationship is part of your structure either way.

This is general information, not legal advice. Confirm the current rules with a healthcare attorney licensed in South Carolina.

Last reviewed October 2026. State rules change often; statute and case references are summaries, not quotations.

Key takeaways

South Carolina's CPOM doctrine is judge-made: the Supreme Court traced it to Ezell v. Ritholz (1938) and restated it in Baird v. Charleston County (1999).
The Board of Medical Examiners' advisory opinion on corporate practice, as summarized, says the Board does not license corporations but expects licensees to keep independent medical judgment in any business arrangement.
South Carolina professional corporations generally may issue shares only to people licensed to render the professional service named in the articles, and at least half the directors generally must be qualified persons.
Out-of-state physicians treating South Carolina patients by telemedicine generally need a South Carolina license under S.C. Code 40-47-37, subject to what appears to be a narrow continuity-of-care exception.

Does South Carolina have a corporate practice of medicine doctrine?

Yes. South Carolina is a case-law state. In Baird v. Charleston County, 333 S.C. 519, 511 S.E.2d 69 (1999), physicians challenged county hospital bonds tied to a corporate venture. The court described a common law prohibition against the corporate practice of medicine and traced it to Ezell v. Ritholz, 188 S.C. 39 (1938), which allowed a licensed professional to sue to stop unlawful practice of the profession, including by a corporation.

The doctors in Baird still lost: the court said the proper remedy was an injunction against the corporation, not a challenge to the county's bonds. The doctrine exists, but private enforcement has a high bar.

The more practical signal is the Board. Its advisory opinion on the corporate practice of medicine, as summarized here, states that the Board does not license or regulate corporations. It then says the Board has well-established expectations about the economic relationships its licensees practice within. Licensees remain subject to the Medical Practice Act whatever the business form, must keep their clinical judgment independent, and may not let unlicensed persons practice medicine. In short: the Board will not chase your corporation, it will chase your physicians. Read the full opinion before relying on it, including for anything it says about management fees or ownership.

Who can own a medical practice in South Carolina?

Physicians, through a professional corporation. South Carolina's Professional Corporation Supplement, Title 33, Chapter 19 lets a PC issue shares only to individuals authorized by law in South Carolina or another state to render the professional service described in its articles, plus certain qualifying professional entities. Three details matter for founders:

Governance. Chapter 19 generally requires at least one-half of the directors, and most officers, to be qualified persons.
Disqualification. If a shareholder dies or becomes disqualified, the PC generally must acquire the shares, with a limited exception for short disqualifications. Plan the buy-sell terms of your physician-owner agreement around this.
Name. The name generally must include "professional corporation," "professional association," "P.C.," "P.A." or a similar designation.

Confirm these rules against the current code before relying on them.

Whatever room the courts may give hospitals and other licensed facilities, a venture-backed telehealth company is not one of them. Do not model your structure on hospital employment.

Can nurse practitioners and physician assistants own a practice in South Carolina?

South Carolina is a restricted NP practice state on AANP's map. In practice that generally means an NP works under a written practice agreement with a physician; confirm the current requirements. Owning the business does not remove that requirement, so an NP-founded brand still needs a physician in the clinical structure.

PAs also generally practice in a defined relationship with physicians; confirm the current supervision rules. Whether an NP or PA can hold shares in an entity that employs physicians is a technical Chapter 19 question, so get a South Carolina opinion first. The clean alternative: the NP or PA founder owns the MSO and contracts with a physician-owned PC. Our collaborating physician guide covers how those relationships are typically set up.

How does the friendly PC-MSO model work in South Carolina?

The MSO owns the brand, technology, staff, and marketing. A South Carolina-licensed physician owns the PC, which holds the patient relationships and the clinical decisions. A management services agreement connects them.

With no detailed statute, the Board opinion is your drafting checklist. Draft the MSA so that:

The MSO has no say over diagnosis, treatment, prescribing, or clinical protocols.
The physician owner has real authority over clinical policy and can hire and fire clinical staff.
The management fee reflects the fair value of services. South Carolina has no widely cited statute that sets a percentage cap, but percentage-of-revenue fees invite questions about fee-splitting and lay profit from medicine.

For the full mechanics, see our friendly PC-MSO model explainer.

What does this mean for a telehealth brand serving South Carolina patients?

CPOM and licensure follow the patient. If the patient is in South Carolina, South Carolina law applies, wherever your company is incorporated.

Licensure is the first gate. Under S.C. Code 40-47-37, a physician practicing via telemedicine must hold a South Carolina license, though residency in the state is not required. The statute also restricts telemedicine prescribing of certain controlled substances absent Board authorization; confirm the current scope. The statute reportedly includes a narrow exception for continuing care of a patient seen in person, so we rate South Carolina's out-of-state access as Limited; confirm the exception's scope before relying on it. A recent bill, S. 377, would have created an out-of-state telehealth registration; check whether it was enacted.

The working structure: a physician-owned PC with South Carolina-licensed clinicians, managed by your MSO. See telehealth licensing by state guide and the 50-state CPOM guide. If you also serve the Carolinas together, compare our North Carolina guide.

South Carolina CPOM at a glance

Topic	South Carolina (as of October 2026)
CPOM enforcement	Moderate: common law doctrine plus a Board advisory opinion
Primary legal basis	Ezell v. Ritholz (1938); Baird v. Charleston County (1999); Board of Medical Examiners advisory opinion
Professional entity options	Professional corporation under Title 33, Chapter 19 owned by licensed professionals
Fee-splitting rule	No specific percentage cap confirmed; fees should be fair-market-value and free of lay control
NP practice authority	Restricted (generally a practice agreement with a physician)
Out-of-state telehealth licensing	Limited: South Carolina license generally required (S.C. Code 40-47-37)
Typical structure for non-physician founders	Physician-owned PC plus MSO under a management services agreement

Frequently asked questions

Is the corporate practice of medicine illegal in South Carolina?

South Carolina's Supreme Court recognized a common law prohibition on the corporate practice of medicine in Baird v. Charleston County (1999). No single statute spells it out. The Board of Medical Examiners enforces the policy through its licensees.

Can a non-physician own a medical practice in South Carolina?

Not directly. South Carolina professional corporations generally may issue shares only to people licensed to render the professional service the corporation provides. A non-physician can own an MSO that provides non-clinical services to a physician-owned PC under a management services agreement.

Do out-of-state telehealth physicians need a South Carolina license?

Generally yes. S.C. Code 40-47-37 requires a physician practicing telemedicine with South Carolina patients to hold a South Carolina license, subject to what appears to be a narrow exception for continuing care after an in-person relationship. A proposed out-of-state registration bill would have changed this; check whether it was enacted.

Can a nurse practitioner open a practice in South Carolina?

An NP can own a business, but South Carolina is a restricted practice state, so the NP generally needs a written practice agreement with a physician; confirm the current requirements. Owning an entity that employs physicians raises separate professional corporation questions.

What does the South Carolina Board of Medical Examiners say about corporate practice?

Its advisory opinion on corporate practice, as summarized, says the Board does not regulate corporations. It also says licensees must keep independent medical judgment, remain subject to the Medical Practice Act in any business form, and must not let unlicensed persons practice medicine.

Sources

Launch in South Carolina on a structure that is already built

MyOrbitHealth can form a PC-MSO structure for your brand, supply a physician PC owner or collaborating physician, or let you launch on its existing MSO / friendly-PC structure with 2,400+ licensed providers. Licensed providers make every clinical decision, and MyOrbitHealth does not practice medicine. See PC-MSO formation, physician PC owner services, or book a call.