Management Services Agreement

Between TeleEMC d/b/a First Visit MD (Luxe Inventions LLC) and Partner Practice

Florida CPOM Compliant AKS Safe Harbor Structured Legal Review Recommended
⚠️ This document is a template for legal review. Both parties should obtain independent Florida healthcare counsel before execution. This document does not constitute legal advice.
Template Version 1.0 · 2026 · Florida Operations

Table of Contents

  1. Parties and Recitals
  2. Definitions
  3. Management Services
  4. Clinical Independence
  5. Compensation
  6. Brand License
  7. HIPAA and Patient Data
  8. Compliance Obligations
  9. Term and Termination
  10. Representations and Warranties
  11. Indemnification
  12. Limitation of Liability
  13. General Provisions
  14. Signatures

1. Parties and Recitals

This Management Services Agreement (this "Agreement") is entered into as of _______________, 2026 (the "Effective Date") by and between:

TeleEMC d/b/a First Visit MD, a Florida limited liability company operating as a licensed health care clinic under the Agency for Health Care Administration (AHCA), with its principal place of business at 4800 N. Federal Hwy., Suite 105B, Boca Raton, FL 33431 (the "MSO" or "TeleEMC"); and

_________________________________, a _______________ entity licensed to practice chiropractic medicine in the State of Florida, with its principal place of business at _________________________________ (the "Practice").

TeleEMC and Practice are each a "Party" and collectively the "Parties."

1.1 Recitals

WHEREAS, TeleEMC is an AHCA-licensed health care clinic operating a telehealth peptide therapy program under the brand name MyTelePep, staffed by Florida-licensed physician assistants and advanced registered nurse practitioners under physician Medical Director supervision;

WHEREAS, Practice desires to offer a branded wellness program to its patients using TeleEMC's licensed clinical infrastructure, technology platform, pharmacy relationships, and compliance framework;

WHEREAS, the Parties wish to enter into a management services arrangement consistent with Florida's Corporate Practice of Medicine doctrine, the federal Anti-Kickback Statute Personal Services and Management Contracts Safe Harbor (42 C.F.R. §1001.952(d)), and all applicable Florida law;

WHEREAS, Practice acknowledges that it is not a licensed medical practice for purposes of the clinical services provided hereunder, and that all clinical decisions shall be made exclusively by TeleEMC's licensed providers;

NOW, THEREFORE, in consideration of the mutual covenants herein, the Parties agree as follows:

2. Definitions

"Clinical Services" means telehealth consultations, clinical assessments, prescribing decisions, protocol development, follow-up care, and all other activities constituting the practice of medicine or advanced practice nursing as defined under Florida law, performed exclusively by TeleEMC's licensed providers.

"Compounded Medications" means prescription medications prepared by TeleEMC's licensed 503A compounding pharmacy partner pursuant to valid prescriptions issued by TeleEMC's licensed providers.

"Enrolled Patient" means a patient who has completed TeleEMC's intake process, received a clinical evaluation from a TeleEMC-contracted licensed provider, and is actively enrolled in a wellness program during the applicable billing month.

"Infrastructure Fee" means the per-Enrolled-Patient monthly fee paid by Practice to TeleEMC for Management Services as defined in Section 3.

"Management Services" means the non-clinical administrative, operational, technological, and compliance services provided by TeleEMC to Practice as described in Section 3.

"Practice Brand" means the trade name, logo, and brand identity of Practice as used in connection with the Wellness Program.

"Protected Health Information" or "PHI" has the meaning ascribed to it under HIPAA (45 C.F.R. §160.103).

"Wellness Program" means the Practice-branded peptide wellness program operated by Practice using TeleEMC's Management Services infrastructure.

3. Management Services

3.1 Services Provided by TeleEMC

During the Term, TeleEMC shall provide the following Management Services to Practice:

  1. Clinical Provider Services. TeleEMC shall provide access to Florida-licensed PAs and APRNs contracted as independent providers to conduct telehealth consultations with Enrolled Patients, make prescribing decisions, and provide follow-up clinical care. All providers operate under TeleEMC's Medical Director supervision. TeleEMC's providers exercise independent clinical judgment and are not subject to direction by Practice.
  2. Pharmacy Coordination. TeleEMC shall coordinate with its licensed 503A compounding pharmacy partner to fill prescriptions issued by TeleEMC's providers, arrange private-label packaging of Compounded Medications under the Practice Brand, and arrange shipping of medications directly to Enrolled Patients' addresses.
  3. Technology Platform. TeleEMC shall provide access to its HIPAA-compliant EHR system (eClinicalWorks), telehealth video platform, secure patient messaging, and online intake portal, configured with Practice Brand elements.
  4. White-Label Patient Portal. TeleEMC shall configure a patient intake portal branded with Practice's name, logo, and color scheme. Practice's patients interact with Practice's brand throughout the patient experience.
  5. Compliance Infrastructure. TeleEMC shall maintain its HIPAA compliance program, informed consent documentation, telehealth consent forms compliant with F.S. §456.47, Medical Director oversight documentation, and regulatory monitoring.
  6. Clinical Protocols. TeleEMC shall develop and maintain evidence-informed prescribing protocols for all available compounds under Medical Director supervision, updated as FDA compounding regulations evolve.
  7. Patient Education Materials. TeleEMC shall provide co-branded patient education materials, co-branded marketing templates, and intake support materials for use by Practice.
  8. Monthly Reporting. TeleEMC shall provide Practice with a monthly dashboard report showing active Enrolled Patients, protocol distribution, renewal rates, and program metrics.
  9. Account Management. TeleEMC shall provide a dedicated account manager and staff training support during onboarding and throughout the Term.

3.2 Services Provided by Practice

Practice shall provide the following non-clinical services in connection with the Wellness Program:

  1. Marketing and promotion of the Wellness Program to Practice's existing patient base and prospective patients, using TeleEMC-approved materials and messaging;
  2. Patient intake support including directing patients to the white-label intake portal and answering non-clinical administrative questions;
  3. Billing and collection of program fees from Enrolled Patients;
  4. Patient relationship management for non-clinical matters including scheduling, billing questions, and general program inquiries;
  5. Compliance with all obligations of Practice under this Agreement.
Critical Limitation: Practice shall not provide any Clinical Services, make any clinical recommendations regarding specific compounds or protocols, direct TeleEMC's providers in their clinical decisions, or represent to patients that Practice employs the providers delivering clinical care. All clinical matters shall be referred immediately to TeleEMC's clinical team.

4. Clinical Independence

4.1 Provider Independence

TeleEMC's licensed providers shall at all times exercise independent clinical judgment in their care of Enrolled Patients. Practice shall not interfere with, direct, or influence any provider's clinical decisions, prescribing practices, or patient care recommendations. This independence is not merely contractual — it is a legal requirement under Florida law and a condition of every provider's licensure.

4.2 No Employment of Providers by Practice

For purposes of Clinical Services delivered through the Wellness Program, TeleEMC's contracted providers are not employees, agents, or contractors of Practice. Practice has no supervisory authority over providers with respect to clinical matters. If Practice employs a licensed healthcare provider for separate chiropractic-adjacent services, that employment relationship is entirely separate from this Agreement and does not extend to Clinical Services under the Wellness Program.

4.3 Medical Director Oversight

TeleEMC's Florida-licensed Medical Director maintains statutory oversight responsibility for all clinical protocols, provider performance, and quality of care delivered through the Wellness Program. Practice shall not interfere with Medical Director oversight functions.

4.4 Patient Safety Obligations

If Practice becomes aware of any patient safety concern related to the Wellness Program, Practice shall immediately notify TeleEMC's clinical team at the emergency contact provided during onboarding. Practice shall not attempt to manage clinical patient safety issues independently.

5. Compensation

5.1 Infrastructure Fee

In consideration for Management Services provided under this Agreement, Practice shall pay TeleEMC the Infrastructure Fee for each Enrolled Patient per month as follows:

  1. Starter Tier (1–25 Enrolled Patients): $165.00 per Enrolled Patient per month;
  2. Growth Tier (26–75 Enrolled Patients): $150.00 per Enrolled Patient per month;
  3. Scale Tier (76–150 Enrolled Patients): $135.00 per Enrolled Patient per month;
  4. Enterprise Tier (150+ Enrolled Patients): As agreed in writing by the Parties.

5.2 Fee Characteristics

The Infrastructure Fee is: (a) set in advance and not determined by the volume or value of any specific prescription; (b) consistent with fair market value for the services provided; (c) not conditioned on the referral of patients to TeleEMC or any affiliated entity; and (d) the same regardless of which compound or protocol is prescribed for an individual patient. These characteristics are intentional and essential to the legal compliance of this arrangement.

5.3 Payment Terms

TeleEMC shall invoice Practice on the first business day of each calendar month for all Enrolled Patients active during the prior month. Payment is due within fifteen (15) days of invoice. Late payments accrue interest at 1.5% per month. TeleEMC may suspend Management Services for accounts more than thirty (30) days past due.

5.4 No Referral Compensation

Neither Party shall pay or receive any compensation, fee, or thing of value that is tied to the volume or value of referrals of patients, prescription orders, or any other item or service reimbursable by a federal or state healthcare program. The Infrastructure Fee is compensation for defined Management Services only.

5.5 Retail Pricing Independence

Practice independently determines the program price charged to Enrolled Patients. TeleEMC has no role in setting Practice's retail pricing. Practice's margin is a legitimate business margin earned on wellness program services Practice delivers to its patients, separate from the clinical services provided by TeleEMC.

6. Brand License

6.1 Grant of License

Practice grants TeleEMC a limited, non-exclusive, royalty-free license to use Practice's name, logo, and brand elements solely for the purpose of configuring the white-label patient portal, co-branded materials, and private-label medication packaging under this Agreement.

6.2 TeleEMC Brand Restrictions

Practice shall not use the MyTelePep or TeleEMC brand names, logos, or trademarks in any patient-facing materials without TeleEMC's prior written consent. The patient-facing Wellness Program experience shall be presented under Practice's brand.

6.3 Required Disclosures

Notwithstanding Section 6.2, TeleEMC's licensed providers shall identify themselves as practicing through a licensed Florida telehealth clinic at the start of every patient consultation, consistent with F.S. §456.47. This disclosure is a legal requirement and may not be suppressed by Practice.

7. HIPAA and Patient Data

7.1 Business Associate Agreement

The Parties acknowledge that Practice is a Covered Entity or Business Associate under HIPAA and that TeleEMC will access, use, and maintain PHI of Enrolled Patients. The Parties shall execute a Business Associate Agreement (BAA) substantially concurrently with this Agreement. In the event of any conflict between this Agreement and the BAA with respect to PHI, the BAA shall control.

7.2 Data Ownership

All medical records created through Clinical Services provided under this Agreement are owned by TeleEMC and maintained in TeleEMC's EHR. Patient demographic and intake data collected through Practice's portal is jointly accessible by both Parties subject to their respective roles and HIPAA obligations. Neither Party shall sell PHI for marketing purposes.

7.3 Breach Notification

Each Party shall notify the other within twenty-four (24) hours of becoming aware of any actual or suspected breach of PHI involving Enrolled Patients. The Parties shall cooperate in investigating and remediating any breach and in providing required notifications under HIPAA's Breach Notification Rule and Florida Statute §501.171.

8. Compliance Obligations

8.1 Practice Compliance Obligations

Practice shall: (a) not make clinical representations or recommendations regarding specific peptide compounds to patients; (b) direct all clinical patient questions to TeleEMC's clinical team; (c) use only TeleEMC-approved patient communication templates for clinical topics; (d) not represent that Practice is a licensed medical clinic or that Practice employs the providers delivering Clinical Services; (e) comply with all applicable Florida laws governing chiropractic practice and this Agreement; (f) not market the Wellness Program using claims that violate FDA promotional guidelines for compounded medications.

8.2 TeleEMC Compliance Obligations

TeleEMC shall: (a) maintain its AHCA health care clinic license in good standing; (b) maintain all provider licensure and credentialing; (c) maintain its HIPAA compliance program; (d) coordinate only with licensed 503A compounding pharmacies; (e) maintain Medical Director supervision consistent with Florida law; (f) update Clinical Protocols as required by regulatory changes.

8.3 Annual Compliance Review

The Parties shall conduct an annual compliance review of this Agreement and the Wellness Program structure with their respective healthcare counsel, no later than each anniversary of the Effective Date. Either Party may terminate this Agreement on 60 days' written notice if a compliance review identifies a material issue that the Parties cannot resolve.

9. Term and Termination

9.1 Initial Term

This Agreement shall commence on the Effective Date and continue for an initial term of one (1) year (the "Initial Term"), unless earlier terminated as provided herein. This one-year minimum term is intentional and is required for compliance with the AKS Personal Services Safe Harbor.

9.2 Renewal

Following the Initial Term, this Agreement shall automatically renew for successive one-year periods unless either Party provides written notice of non-renewal at least sixty (60) days prior to the end of the then-current term.

9.3 Termination for Cause

Either Party may terminate this Agreement immediately upon written notice if the other Party: (a) materially breaches this Agreement and fails to cure such breach within thirty (30) days of written notice; (b) loses any license, certification, or regulatory approval material to its performance under this Agreement; (c) is convicted of a healthcare fraud offense or excluded from participation in federal healthcare programs; or (d) engages in any conduct that in the terminating Party's reasonable judgment creates material legal, regulatory, or reputational risk.

9.4 Effect of Termination

Upon termination: (a) TeleEMC shall continue Clinical Services for Enrolled Patients for sixty (60) days to ensure continuity of care; (b) Practice shall cease using the white-label platform and TeleEMC materials; (c) TeleEMC shall transfer or make available patient medical records as required by applicable law; (d) all accrued but unpaid Infrastructure Fees shall become immediately due and payable.

10. Representations and Warranties

10.1 Practice Representations

Practice represents and warrants that: (a) it is duly licensed to practice chiropractic medicine in Florida; (b) it has full authority to enter into this Agreement; (c) it is not excluded from participation in any federal or state healthcare program; (d) it will not use the Wellness Program to generate referrals to any entity in which Practice has a financial interest in violation of the Florida Patient Self-Referral Act; (e) it has obtained or will obtain independent legal counsel regarding this Agreement before execution.

10.2 TeleEMC Representations

TeleEMC represents and warrants that: (a) it holds a valid AHCA health care clinic license; (b) all contracted providers hold current, unencumbered Florida licenses; (c) it maintains a Business Associate Agreement with its pharmacy partner; (d) its Medical Director holds a current, unencumbered Florida medical license; (e) it has full authority to enter into this Agreement.

11. Indemnification

Each Party ("Indemnifying Party") shall indemnify, defend, and hold harmless the other Party and its officers, directors, employees, and agents (collectively, "Indemnified Party") from and against any claims, damages, losses, costs, and expenses (including reasonable attorneys' fees) arising from: (a) the Indemnifying Party's breach of this Agreement; (b) the Indemnifying Party's negligence or willful misconduct; (c) the Indemnifying Party's violation of applicable law. TeleEMC shall indemnify Practice specifically for clinical malpractice claims arising from TeleEMC providers' clinical decisions. Practice shall indemnify TeleEMC specifically for claims arising from Practice's non-clinical wellness program activities and marketing.

12. Limitation of Liability

Neither Party shall be liable to the other for any indirect, incidental, consequential, special, or punitive damages arising under or related to this Agreement, regardless of the form of action. Each Party's total liability under this Agreement shall not exceed the total Infrastructure Fees paid in the twelve (12) months preceding the claim giving rise to liability, except that this limitation shall not apply to: (a) indemnification obligations under Section 11; (b) breaches of HIPAA obligations; or (c) fraud or willful misconduct.

13. General Provisions

13.1 Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of Florida. Any dispute shall be resolved in the state or federal courts of Palm Beach County, Florida.

13.2 Entire Agreement

This Agreement, together with the BAA executed concurrently herewith, constitutes the entire agreement between the Parties with respect to its subject matter and supersedes all prior agreements and understandings. No amendment shall be effective unless in writing signed by both Parties.

13.3 Severability

If any provision of this Agreement is found to be unenforceable, such provision shall be modified to the minimum extent necessary to make it enforceable, and the remaining provisions shall continue in full force and effect.

13.4 No Waiver

Failure by either Party to enforce any provision of this Agreement shall not constitute a waiver of the right to enforce that provision in the future.

13.5 Notices

All notices under this Agreement shall be in writing and delivered by email with delivery confirmation or certified mail to: TeleEMC: info@mytelepep.com, 4800 N. Federal Hwy., Suite 105B, Boca Raton, FL 33431; Practice: the address set forth on the signature page below.

13.6 Independent Contractors

The Parties are independent contractors. Nothing in this Agreement creates a partnership, joint venture, employment, or agency relationship between the Parties.

13.7 Regulatory Compliance

The Parties acknowledge that healthcare regulatory requirements may change during the Term. Each Party shall promptly notify the other of any regulatory change that may materially affect the compliance of this arrangement. The Parties shall cooperate in good faith to modify this Agreement as necessary to maintain compliance.

14. Signatures

IN WITNESS WHEREOF, the Parties have executed this Management Services Agreement as of the Effective Date first written above.

Execution

TeleEMC d/b/a First Visit MD (Luxe Inventions LLC)

Authorized Signature

Printed Name

Title

Date

Florida AHCA License Number

Practice (Partner)

Authorized Signature

Printed Name

Title

Date

Florida License Number

Practice Address

Notice Email Address