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Not legal advice, and CPOM is enforced through a patchwork of statutes, board opinions, and case law that changes. Use this table to calibrate, then verify your state with a healthcare attorney before structuring anything.
More than 30 states restrict non-physician ownership of medical entities (source: BMD). Enforcement intensity is what actually varies. A practical grouping, following healthcare counsel surveys (GuardianMD, ByrdAdatto): Three cautions when using the tiers. Permissive does not mean unregulated: fee-splitting and kickback statutes still apply everywhere (Florida is the canonical example). The doctrine is specialty-specific: dental has its own ownership statutes in most states, and they’re often stricter than medical. And tier boundaries move: several states have proposed tightening MSO oversight in recent legislative sessions, so re-verify before each new state.

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How to use this

Starting a practice as a clinician: your state’s tier mostly affects which entity you form. Building as a non-physician or expanding multi-state: the tier determines how much structure you need, the MSO/PC playbook, and the strictest state in your footprint sets your compliance bar (expansion). State-by-state statute detail lives at the companion MSO-PC Wiki.