Rock Solid Posted July 17, 2014 Share Posted July 17, 2014 I was presented an opportunity a few months ago to become essentially a leased employee from the PLLC that I formed here in Texas. I have several ortho, general surgery, urology, and renal transplant docs who utilize me only in the OR. With the lower reimbursement rates these days they do not want to employ their own PA, and certainly we all know too well that docs within the same group do not share PAs very well. I want to make sure that I can legally do this in Texas. I know any professional can start up a PLLC. I just want to make sure that what I have done in organizing and filing the PLLC, being credentialed through all of the private insurance plans in my area, submitting my docs to the state board as my supervising docs, and then using my own biller to have the money sent to me is appropriate, legal, and ethical. In Texas they just passed a law a year ago that allows PAs and physicians to be partners, however, only allowing the PA to be a minority partner. My understanding is that not all PAs that form PLLC have to have a physician partner but that if a PA and physician do decide to partner that the physician retains majority ownership. Medicare now is a different story. They do not recognize PAs to be sole proprietors. Failing to allow us to be sole proprietors requires us to partner with physicians in order to receive payment. NPs however can be sole proprietors and NPs can bill Medicare directly and get reimbursed directly from Medicare. Are there any other PAs out there, specifically in Texas, doing this type of work and have you run in to the Medicare road block? Like I said...the private carriers contract with me directly...no issue at all. Link to comment Share on other sites More sharing options...
Gordon, PA-C Posted July 20, 2014 Share Posted July 20, 2014 I suggest you retain the services of an excellent attorney in Texas who knows the law well. That being said, in my understanding a PA can form a PLLC by themselves. In fact, Texas is very lax w/ PLLC requirements, ANY professional with ANY license can form a PLLC. That includes people like barbers or cosmetologists. Furthermore, there's no requirement for an MD to be "part" or "majority partner" of the PLLC. That only applies if you actually own a medical practice, clinic, hospital, etc. Beware that the state of Texas charges a "franchise tax" on all PLLCs. If you want to buy a house in the future, I recommend setting up a PLLC and then changing IRS designation to tax it as an S-corp. S-corp allows the PLLC to pay you as an "employee" even though you are the owner of the PLLC. This way, you can get a W2 w/ verifiable income. If you leave it as a PLLC and just take your income as profit or "distributions" then practice lenders for mortgage lenders are going to scrutinize your LLC with a microscope and impose all kinds of arbitrary rules on you that slows down the mortgage process. IF you are sure you dont need any capital for business or a home mortgage then it doesnt matter, but if there's any chance you will want to do that in the future, taxing your LLC as an S-corp is very valuable. Link to comment Share on other sites More sharing options...
cinntsp Posted July 21, 2014 Share Posted July 21, 2014 Have you tried contacting TAPA? I'm sure someone there could help or at least point you in the right direction. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted July 21, 2014 Share Posted July 21, 2014 ^^^ Chirping crickets... Sent from my iPad using Tapatalk Link to comment Share on other sites More sharing options...
rlwpac Posted August 11, 2014 Share Posted August 11, 2014 To my knowledge, the partners of a PLLC must all have the same type of professional license. While MD and PA do not have the same type of license, they both practice medicine so I am no sure how this works. Why would you use this as opposed to an LLC, which does not have such a restriction? Just food for thought. Link to comment Share on other sites More sharing options...
FBIDoc Posted August 11, 2014 Share Posted August 11, 2014 Unless it has changed, the ownership issue lies with Medicare...you have to have a 1% non-PA ownership stake to bill Medicare via a PA-owned company...this can be a supervising doc, friend, etc...can even be a family member but that gets sticky and places you under more scrutiny... Link to comment Share on other sites More sharing options...
Moderator ventana Posted August 12, 2014 Moderator Share Posted August 12, 2014 Unless it has changed, the ownership issue lies with Medicare...you have to have a 1% non-PA ownership stake to bill Medicare via a PA-owned company...this can be a supervising doc, friend, etc...can even be a family member but that gets sticky and places you under more scrutiny... correct medicare requires 1% co-ownership does not specify who this co-owner can be BUT your state law likely does comment on this. Many states have laws on the books to prevent the corporate practice of medicine, which in effect says that you have to be professional corp (PC) in order to practice medicine. In order to be a PC all your owners have to be licensed providers - in my case a doc and a PA. Then I had to get both the Medical Board and PA board send in letters supporting that it was okay (as the first PA owned practice in the state that was co-owned with a doc this created a lot of problems with the state, and the lifesaving thing was finally getting a hold of a state attorney who I could talk to directly.) Then there are states like NY which specifically BAN a PA from in any way employing an SP......... Really need to read a lot (like everything you can get your hands on) and then talk to an attorney with an open mind. Mine was an attorney married to a Peds Doc.... Link to comment Share on other sites More sharing options...
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