CPOM Compliance for South Carolina Healthcare Startups
South Carolina is more flexible than California on classic CPOM, but S.C. Code § 40-47-30 still requires authorization before anyone practices medicine, and Title 33 Chapter 19 still restricts who may own the professional corporation.
Get a Free CPOM AssessmentThe law in South Carolina
Key authorities (official text)
SCLLR · Board of Medical Examiners · S.C. Code Title 40 Chapter 47 · Title 33 Chapter 19South Carolina Board of Medical Examiners · S.C. Code Title 40 Chapter 47 · Title 33 Chapter 19 (Professional Corporation Supplement).
South Carolina CPOM is Moderate. The state does not copy California Business & Professions Code § 2400. Official text of S.C. Code § 40-47-30(A): a person may not practice medicine in this State unless the person is twenty-one years of age and has been authorized to do so pursuant to Article 1. § 40-47-20(36) defines “Practice of Medicine,” including holding out as authorized to practice, prescribing, diagnosing or treating, surgery, a documented medical opinion or treatment for a patient in the State by a physician located outside the State after transmission of patient data from within a state, and a determination of medical necessity affecting diagnosis or treatment. Charleston, Greenville, and Columbia digital-health diligence still wants a physician-owned PC plus a fair-market-value MSA.
Do not treat the absence of a B&P § 2400 analogue as permission for a lay operating company to practice medicine. Chapter 47 licenses people. A medical-director title on a Delaware company does not satisfy § 40-47-30. The Board of Medical Examiners sits under § 40-47-10 and disciplines licensees for misconduct under § 40-47-110, including obtaining fees under dishonorable, false, or fraudulent circumstances and violating the code of medical ethics adopted by the board. Professional corporations sit in the South Carolina Professional Corporation Supplement. § 33-19-109 is how a person elects professional-corporation status. § 33-19-130(a) says a domestic or foreign corporation may render professional services in this State only through individuals licensed or otherwise authorized in this State to render the services. § 33-19-200(a) limits issuance of shares to individuals authorized to render the professional service, to certain general partnerships of qualified persons, and to professional corporations authorized to render that service. § 33-19-300 requires that not less than one-half of the directors, and all officers except the secretary and treasurer, be qualified persons. Collaboration and supervision under § 40-47-195 are a different job from owning the Professional Corporation. See collaborating physician vs physician PC owner.
Typical PC / MSO structure in South Carolina
Form a South Carolina professional corporation under Chapter 19 owned by a South Carolina-licensed MD or DO. The MSO, often the Delaware operating company, provides non-clinical services under a written MSA at fair market value. Clinical revenue lands in the PC. Foundry forms that structure ($15,000) and matches a friendly PC owner ($3,000/mo). Not a rented Super PC. Not a reading of § 40-47-195 supervision as a substitute for Chapter 19 ownership.
If you also treat North Carolina or Georgia patients, South Carolina’s Moderate label does not control those states. Start with the CPOM 50-state guide and form for the footprint you actually have. Neighboring North Carolina and Georgia have their own statutes.
When you still need a PC vs only an MSO
Use the table as an operator rule, not a filing opinion. Confirm with counsel.
| South Carolina fact pattern | Typical entity | Why |
|---|---|---|
| South Carolina-only, cash-pay, physician already owns the practice | May stay on the existing professional corporation | Still document clinical control and FMV admin if an MSO is in the picture |
| Venture-backed or multi-state telehealth that includes Charleston / Greenville / Columbia | South Carolina professional corporation + FMV MSA | Buyers and payers test CPOM compliance the same way they do in strict states. § 40-47-20(36)(e) treats inbound telemedicine as practice of medicine |
| NP/PA practice with a supervising physician | Still a physician-owned PC plus a § 40-47-195 supervision file | Supervision is not PC ownership. See collaborating physician |
| South Carolina plus North Carolina or Georgia | Form for the neighboring states you treat, then qualify South Carolina | South Carolina’s Moderate label does not soften NCGS 90 or Georgia board rules |
Fee-splitting and funds-flow risk
S.C. Code § 40-47-110 is the Board of Medical Examiners misconduct overlay. A percentage-of-collections management fee is the pattern that looks most like a split of professional fees and like de facto control. Prefer a fixed or FMV-supported admin fee. Pair South Carolina CPOM with the fee-risk table on CPOM compliance.
| South Carolina pattern | Risk | Safer pattern |
|---|---|---|
| Lay LLC holds itself out as practicing medicine | High: § 40-47-30 / § 40-47-20(36) license overlay | Licensed-professional corporation under Chapter 19 |
| MSO paid % of professional collections | High: § 40-47-110(B)(11) and (13) + diligence overlay | Fixed FMV admin fee with a memo |
| Out-of-state physician treats SC patients without a SC license | High: § 40-47-20(36)(e) telemedicine overlay | South Carolina-licensed clinician; form for the footprint you treat |
| Lay equity in the professional corporation | High: § 33-19-200 / § 33-19-300 | Licensed-physician ownership of the PC |
| Physician PC + FMV MSA + separate books | Base case | Revisit FMV when volume changes |
Board of Medical Examiners vs buyer / payer checks
The Board of Medical Examiners disciplines licensees. Buyers and payers run a different file. Use both columns. License risk and diligence risk are not the same test. Full operating map: CPOM compliance.
| Who checks | What they sample | South Carolina fail signal |
|---|---|---|
| SCLLR / Board of Medical Examiners | Unlicensed practice (§ 40-47-30); misconduct (§ 40-47-110) | Figurehead PC owner; MSO writing protocols; inbound telemedicine without a SC license |
| Buyer diligence | Shareholder ledger vs Secretary of State; one claim from payer to PC bank to MSA invoice | MSO lockbox; percentage MSA; no South Carolina-licensed owner |
| Payer / credentialing | Claim TIN and group NPI on the physician-owned PC | Marketing MSO TIN on the claim |
What South Carolina founders need to know
- South Carolina is Moderate, not “no CPOM.” § 40-47-30 is a license rule; Chapter 19 is the ownership rule.
- § 40-47-20(36)(e) treats inbound telemedicine as the practice of medicine. An out-of-state medical-director title is not a South Carolina license.
- § 33-19-200 and § 33-19-300 restrict professional-corporation shares, directors, and officers.
- Charleston / Greenville / Columbia health-tech diligence still asks who owns the PC, who bills, and how the MSA is priced.
- Foundry does not drop clients into a plug-in 50-state PC. Multi-state needs a 50-state licensed physician.
Operational checklist: CPOM compliance. Setup path: MSO-PC formation ($15,000). Full map: CPOM 50-state guide. Book a call from the homepage.
South Carolina CPOM FAQ
Does South Carolina have strict CPOM?
South Carolina is Moderate / more flexible than California or New York. There is no B&P § 2400 analogue. S.C. Code § 40-47-30, Chapter 19, and § 40-47-110 still expect licensed control of medicine and clean fees. Foundry keeps South Carolina as Moderate on the CPOM 50-state guide.
Do I still need an MSO-PC in South Carolina?
Yes for most venture-backed and multi-state models. The professional entity holds clinical care; the MSO is paid fair market value for non-clinical services.
Is telemedicine into South Carolina the practice of medicine?
Yes on the statutory definition. § 40-47-20(36)(e) covers a documented medical opinion or treatment for a patient in the State by a physician located outside the State after transmission of patient data from within a state.
How does South Carolina treat fee-splitting?
§ 40-47-110 is the disciplinary overlay. A percentage-of-collections MSA is the high-risk pattern. Prefer a fixed FMV admin fee.
How does Foundry help with South Carolina CPOM?
MSO-PC formation is $15,000 one-time. A South Carolina-licensed physician PC owner is $3,000/mo. Foundry is not a law firm.