CPOM Compliance Documentation — MyTelePep / TeleEMC Florida Operations

Effective: January 1, 2026 · Florida Operations Only

1. Overview — What Is CPOM and Why Does It Matter

The Corporate Practice of Medicine (CPOM) doctrine is a legal principle that prohibits non-physician business entities from owning, controlling, or profiting from the practice of medicine. The doctrine's purpose is to ensure that medical decisions are made by licensed professionals exercising independent clinical judgment — not by business owners whose financial interests might compromise patient care.

In Florida, the CPOM doctrine derives from multiple statutory and regulatory sources including F.S. §458.331 (allopathic medicine), F.S. §460.413 (chiropractic), F.S. §400.9935 (health care clinic licensing), and judicial interpretations of what constitutes "control" over medical practice. Florida also prohibits fee-splitting between healthcare providers and third parties under F.S. §456.054 and §460.413(1)(i).

The core rule: A chiropractic practice entity cannot employ a PA or NP to prescribe medications and then take a share of the revenue generated by those prescriptions. Doing so constitutes both unlicensed practice of medicine and illegal fee-splitting under Florida law, regardless of how the arrangement is papered.

2. How the TeleEMC MSO Structure Achieves Compliance

The MyTelePep white-label partner program uses a Management Services Organization (MSO) model specifically designed to comply with Florida's CPOM doctrine. The structure separates clinical functions (performed by TeleEMC's licensed entity) from non-clinical management functions (performed by the partner practice) and ensures that the partner practice earns a business margin on non-clinical services — not a share of medical revenue.

The Four-Element Compliance Test

For a Florida MSO arrangement to be CPOM-compliant, it must satisfy four elements: (1) the licensed medical entity maintains full clinical independence; (2) the management entity provides genuine, defined non-clinical services; (3) the management fee reflects fair market value for those services and is not tied to referral volume or prescription value; and (4) the arrangement does not constitute unlicensed practice of medicine by the management entity. The TeleEMC MSO structure is designed to satisfy all four elements.

2.1 Clinical Entity: TeleEMC (AHCA-Licensed)

TeleEMC d/b/a First Visit MD is the AHCA-licensed health care clinic that performs all Clinical Services. TeleEMC:

Holds an active AHCA health care clinic license under F.S. Chapter 400
Employs and supervises all licensed PAs and APRNs who conduct patient consultations
Maintains a Florida-licensed Medical Director with statutory oversight responsibility
Issues all prescriptions through its licensed providers
Maintains all clinical records in its HIPAA-compliant EHR
Holds all clinical and regulatory liability for patient care
Receives the Infrastructure Fee from partner practices as compensation for Management Services

2.2 Management Entity: Partner Practice

The partner chiropractic practice is the non-clinical management entity. The partner practice:

Markets and promotes the branded wellness program to its patients
Collects program fees from enrolled patients
Provides non-clinical patient support and program coordination
Pays TeleEMC a fixed per-patient Infrastructure Fee for defined Management Services
Earns a legitimate business margin on the non-clinical wellness program services it delivers
Has zero involvement in clinical decisions, prescribing, or patient care management
Does not employ TeleEMC's providers for purposes of the clinical program

2.3 Why the Partner's Margin Is Not Fee-Splitting

Fee-splitting under F.S. §460.413(1)(i) occurs when a licensee divides a professional fee with any person or entity in exchange for a referral or for any other reason. The partner practice's margin in the TeleEMC arrangement is not a division of a professional fee because:

The partner practice collects its own program price from its own patients — it is not sharing in a fee charged by TeleEMC;
The partner practice pays TeleEMC for defined management services — TeleEMC is not paying the partner a portion of its clinical revenue;
The partner's margin is the difference between what it charges its patients and what it pays for services — this is a standard business margin, not a professional fee division;
The Infrastructure Fee is fixed and not conditioned on the volume or value of any prescription, consistent with AKS Safe Harbor requirements.

What this arrangement is NOT: TeleEMC does not pay the partner practice a percentage of prescription revenue. TeleEMC does not pay the partner a per-referral fee. The partner practice does not receive compensation tied to how many patients enroll or what compounds they receive. Any arrangement structured in those ways would be non-compliant and is explicitly prohibited in the Management Services Agreement.

3. Applicable Florida Statutes and Regulatory Framework

F.S. §400.9935 — Health Care Clinic Requirements

Requires that any clinic where healthcare services are provided for compensation obtain an AHCA health care clinic license. TeleEMC holds this license. Partner practices are not providing healthcare services — they are providing wellness program management services — and therefore do not independently trigger this requirement. However, partner practices should confirm this analysis with their own counsel based on their specific activities.

F.S. §460.413(1)(i) — Chiropractic Fee-Splitting Prohibition

Prohibits a chiropractic licensee from sharing a professional fee with any person or entity. As analyzed in Section 2.3, the partner's margin in the TeleEMC arrangement is not a shared professional fee. The partner charges its own program price and pays for services — it does not receive a portion of TeleEMC's professional fees.

F.S. §456.054 — Patient Self-Referral Act

Prohibits a healthcare provider from referring a patient to an entity in which the provider has a financial interest, with limited exceptions. Partner practices must ensure they do not have a disqualifying financial interest in TeleEMC. The MSO arrangement creates a vendor-client relationship, not an ownership interest. Partner practices should confirm with counsel that their specific arrangement does not trigger self-referral concerns.

F.S. §456.47 — Telehealth Standards

Establishes requirements for telehealth providers in Florida including provider identification rights, informed consent, HIPAA-compliant platform requirements, and standards of care. TeleEMC's clinical infrastructure is designed to comply with all §456.47 requirements. Provider identification at the start of each visit is mandatory and cannot be suppressed by partner branding arrangements.

42 U.S.C. §1320a-7b — Federal Anti-Kickback Statute

Prohibits offering, paying, soliciting, or receiving anything of value to induce or reward referrals of items or services covered by federal healthcare programs. The Infrastructure Fee is structured to satisfy the Personal Services and Management Contracts Safe Harbor at 42 C.F.R. §1001.952(d): the agreement is in writing, covers all services, is for at least one year, and the compensation is set in advance, consistent with fair market value, and not determined by the volume or value of referrals.

4. Permitted vs. Prohibited Activities — Quick Reference Matrix

Activity	Partner Practice	Notes
Market the wellness program to patients	PERMITTED	Using TeleEMC-approved materials and messaging
Collect program fees from patients	PERMITTED	Partner sets its own retail price
Provide non-clinical patient support	PERMITTED	Billing questions, scheduling, general program info
Display branded program materials in office	PERMITTED	Under the partner's brand, TeleEMC-compliant messaging
Earn margin between program price and infrastructure fee	PERMITTED	Legitimate business margin on non-clinical services
Direct clinical questions to TeleEMC providers	PERMITTED	Required — clinical matters must go to TeleEMC
Make clinical recommendations about specific compounds	PROHIBITED	Constitutes unauthorized practice of medicine
Tell patients which protocol they should receive	PROHIBITED	Clinical decision exclusive to TeleEMC providers
Employ TeleEMC's providers for this program	PROHIBITED	Providers are TeleEMC-contracted, not Practice employees
Receive compensation tied to prescription volume	PROHIBITED	Would constitute fee-splitting and AKS violation
Represent to patients that Practice provides clinical care	PROHIBITED	Misrepresentation of clinical responsibility
Suppress provider identity disclosure at visit start	PROHIBITED	Required by F.S. §456.47
Have NP on staff prescribe through this program	STRUCTURED	Only if NP contracts independently with TeleEMC — not as Practice employee for this purpose

5. The NP-on-Staff Question

A common question from partner practices that employ an NP or APRN is whether that provider can prescribe through the Wellness Program. The answer is yes — but only through a specific structure that maintains CPOM compliance.

5.1 The Compliant Structure for NP Participation

If a partner practice's NP holds an active, unencumbered Florida APRN license and meets TeleEMC's credentialing requirements, the NP may participate in the Wellness Program as follows:

The NP enters into a separate Independent Provider Agreement directly with TeleEMC;
The NP prescribes through the Wellness Program as a TeleEMC-contracted provider — not as an employee of the chiropractic entity for this purpose;
The NP's clinical compensation flows from TeleEMC to the NP directly at fair market rate;
The chiropractic entity does not receive any portion of the NP's clinical compensation for Wellness Program prescribing;
The NP's prescribing activity and the chiropractic entity's employment of the NP for other services are entirely separate arrangements with clear documentation.

5.2 What Cannot Happen

The chiropractic entity cannot: employ the NP to prescribe peptides and take a cut of the resulting program revenue; direct the NP's prescribing decisions in the Wellness Program; or use the NP's Wellness Program activity to satisfy the clinical component of any arrangement that results in the chiropractic entity profiting from medical services.

6. Annual Compliance Checklist for Partner Practices

Partner practices should review the following annually with their Florida healthcare counsel:

Management Services Agreement is current, signed, and reflects actual services being performed
Infrastructure Fee paid to TeleEMC reflects fair market value for services received
No compensation arrangement exists that ties partner earnings to referral volume or prescription value
Partner practice staff are not making clinical recommendations to patients about specific compounds
All clinical patient questions are being routed to TeleEMC's clinical team
Partner practice is not representing itself as a licensed medical practice for purposes of this program
TeleEMC providers are properly identifying themselves at the start of each patient consultation
HIPAA BAA with TeleEMC is current and covers all PHI flows
If an NP on staff is prescribing through the program, their separate Independent Provider Agreement with TeleEMC is current and compliant
Marketing materials reviewed by TeleEMC compliance team within the past 12 months
No Florida regulatory guidance has been issued that materially affects this arrangement
Partner practice has consulted with Florida healthcare counsel regarding any changes to practice structure or ownership

7. Important Limitations of This Documentation

This document does not constitute legal advice. CPOM analysis is highly fact-specific. The compliance framework described here is designed for Florida operations under the specific structure of the TeleEMC Management Services Agreement. It may not apply to: operations in other states (CPOM strictness varies dramatically by state); material changes to the MSO structure; practices with ownership structures involving physicians or other licensed providers; or future changes in Florida law or regulatory guidance. Every partner practice must obtain its own independent Florida healthcare counsel review before executing the Management Services Agreement. The existence of this document is not a substitute for that review.

8. Contact for Compliance Questions

For partner-specific compliance questions related to the TeleEMC MSO structure:

TeleEMC Compliance Team
Email: compliance@mytelepep.com
4800 N. Federal Hwy., Suite 105B, Boca Raton, FL 33431

For external Florida healthcare law resources, the Florida Healthcare Law Firm (floridahealthcarelawfirm.com) and Shumaker, Loop & Kendrick, LLP maintain current guidance on Florida CPOM and AHCA compliance matters.