141 - The Legal Shortcuts DPC Physicians Need to Know Before Opening a Medical Practice

What if I told you there’s a legal way to skip the long process of getting a clinic license — and still open your doors legally?

In today’s episode, I’m sharing a lesser-known rule that Florida physicians can use to start a Direct Primary Care clinic fast — without jumping through the typical hoops. You’ll also learn about the federal changes coming in 2026 that will reshape how patients pay you.

• Discover why skipping the healthcare clinic license may be 100% legal — and smart
• Find out what Medicare rules really mean for your DPC model
• Get plugged into two proven resources that can guide your entire startup process

If you’re in Florida and dreaming of DPC freedom, this episode could save you months of frustration — hit play now.

Resources 

DPC Frontier  www.dpcfrontier.com

Freedom Healthworks  - https://freedomhealthworks.com/

Hint DPC Playbook - https://get.hint.com/dpc-playbook

Discover how medical graduates, junior doctors, and young physicians can navigate residency training programs, surgical residency, and locum tenens to increase income, enjoy independent practice, decrease stress, achieve financial freedom, and retire early, while maintaining patient satisfaction and exploring physician side gigs to tackle medical school loans.

Transcript

Coach JPMD (00:00.076)
In this episode, we're going to learn the legal hurdles and some tips and resources for direct primary care practices as we continue our series on direct primary care. Welcome back to another episode where I help younger physicians decrease stress and increase income by transitioning from corporate to independent practices, even without any business experience. So what you'll learn today are some key resources to help you start and grow your direct primary care practice, the Medicare rule and what it means.

to you and accepting patients. And lastly, I'm gonna share a little known secret in Florida that can and probably will change your thoughts on opening up a new healthcare clinic. So welcome to another episode of the Independent Physicians Blueprint with your host, Coach JPMD, that's me. And we continue the series on direct primary care. So I'm gonna give you a recap, episode 134.

we define what direct primary care was and it's a membership based model. It's like a low cost concierge practice where members or patients pay a monthly fee ranging from $50 to $150 to have access to your primary care doctor or their primary care doctor. In episode 136, we covered marketing and what you need to do in terms of marketing yourself, marketing your practice.

getting online and doing the things that you need to do to get exposed. And in episode 139 last week, we talked about the growth strategies that you can employ to quickly grow your direct primary care practice. So why are we doing this? We're doing this because we want to give our listeners the resources to understand how to get and remain independent in the practice of medicine.

And some people want to work for corporate America and want to work for large hospital corporations and that's fine. But we also want to give those physicians that want to do something different, that want to stay independent, that want to do things that might be able to help them pay their student loans off as quickly as possible. So in today's episode, we're going to kind of talk about the legal aspects and some of the legal hurdles that direct primary care

Coach JPMD (02:20.46)
providers might be going through and I'm not a I'm not a an attorney by any stretch of imagination but I do know and have done some research on some resources and one of the biggest resources that I have seen out there is the DPC frontier and I'll have the resources at the end and the show notes and DPC frontier I believe is DPC frontier.com

And I'll correct that if I, it's wrong, it was set up by Dr. Philip Eskew and he is a physician with an MBA as well as an attorney and has a lot of resources on his website. He goes through each state and shows, shows us where to

where things are going in terms of the legal aspects of direct primary care, what the pitfalls are, the Medicare laws that are associated with direct primary care.

So that is a tremendous resource that I would strongly suggest that you look into if you're interested in direct parent care practices. But also he has a directory that will list your practice as you grow your practice, as you market your practice. And they can, can list for free your practice on his website so that people who are looking for a direct parent care or hybrid models or membership based concierge practices.

All of them are there. So I definitely encourage you to check that website out. And in episode 84 with Christopher Habeig, we discussed his company, Freedom Health Works, that helps practices start up in their parent care practices around the country. And they know the legalities around certain aspects of starting practices. And they help you navigate through the

Coach JPMD (04:24.352)
starting up and maintaining your practice. So that is again a great resource. Another thing that you have to consider is dispensing medications in your office.

And in Florida, and I'm sure it's like that in other states, Florida allows physicians and providers to actually dispense medications in your office. So as you grow your DPC practice, that may be something that you might want to implement. Because if patient comes to you and they're sick and they need antibiotics, they need blood pressure medications, thyroid medications refilled, there are ways of dispensing medications legally in Florida.

And so that is something that you want to consider. And the big one, of course, is the HSA, FSA benefits that we discussed with Lee Gross and the HR1 law that was recently passed, that's going to take into effect in 2026, January 2026. And in that law, it allows patients to use their health savings accounts or their FSA accounts.

pre-tax to cover the membership for direct primary care practices. So that is a legal hurdle that was passed and that is something that is going to benefit the direct primary care space. you know, then of course, as you set up your business, as in any business, you have to have business licenses.

malpractice insurance, liability insurance, and I strongly recommend that you seek legal advice with a healthcare attorney before you set up things so that you know exactly what thing needs to be set up. There are some resources that I've recently seen and I'll share that in the show notes as well where there are checklists that you can have that can help you through this whole process.

Coach JPMD (06:27.498)
So that is the episode on legal help for physicians setting up direct primary care practices who want to and are looking to become independent of corporate controls. But as I said, I wanted to share one last thing, and that is actually two things, because we didn't really talk about the Medicare rule. But the Medicare rule is really important. That's an important rule. So before we get to the last thing, the Medicare rule states that

In order for, actually, if you are looking to take care of patients in a membership model, you must opt out of Medicare. And I shouldn't say must, but it is strongly encouraged that you opt out of Medicare because if you see a patient in and as a member in your direct primary care model, and they pay you a membership fee, and they have Medicare,

then you are obligated as a Medicare provider to bill Medicare for those services. You can be in big legal trouble if you don't do that. So.

It is recommended that and from everywhere I've read online, including Dr. Hescu, who details that in a blog post that he had and several articles that he's had on his website, where it's important to opt out of Medicare and sometimes can take up to 90 days to do that. So not only should you opt out of Medicare, but opt out of all insurances because if that patient that you're seeing has Blue Cross Blue Shield or Aetna or Humana and you are contracted with those insurances, then per your contract, and of course you have

to read your contract, you may be obligated to see that patient and bill Medicare for those services. So if you're accepting third party insurances, that requires you to bill them. And that kind of leads into the last thing I wanted to talk about. that was, and that is the secret that I read about recently that involves

Coach JPMD (08:34.496)
When you are setting up a healthcare clinic in Florida, if you are accepting insurance, whether it'd been Medicare, Medicaid, book off the shield, any third party payer, you are required to have a healthcare clinic license as a, as a provider of services in that clinic.

What that means is that you have to apply to the Florida Department of Health and they have to inspect your clinic and you cannot really operate in a clinic setting unless you have a healthcare clinic license if you're accepting insurance. If you are not accepting insurance, as per the Florida Department of Health, you do not need to have a healthcare clinic license. You're exempt because you're not billing third party.

insurances. So that again is something that is a huge, huge win for physicians who are looking to set up a clinic and

don't want to wait, don't want to wait for a healthcare clinic license, which can be very costly. A lot of people have to, a lot of people will actually employ or hire an attorney to help, and that can be very costly. So if you're not accepting third party insurance, then you are not required to have a healthcare clinic license. And this allows you to be able to set up a clinic tomorrow, as long as you have the space.

doesn't mean that you don't have to have a business license, a practice, and all the other things that you have to have, but the healthcare clinic license is definitely a barrier that is lowered when you're not accepting insurance. So that's the episode on the legal help with Derek Primary Care or for Derek Primary Care physicians looking to start practices or maintain their practice in the space. So,

Coach JPMD (10:33.966)
Like I said, the DPC frontier is a great resource. The Medicare rule, you now know that you probably should opt out of Medicare and other insurances. And you don't need a healthcare clinic license to start up a clinic accepting a membership model. So I'm gonna reiterate that I am not an attorney. And if you have any questions or if there's anything that doesn't make sense.

Definitely seek counsel, seek wise counsel from an attorney, preferably a healthcare attorney that can help you navigate through these waters. And we'll see you next week for another episode. And I think next week we're ending or we're finishing up the series on direct primary care. And we're going to end with employers and how direct primary care practices can help employers save costs. See you next week. Thank you so much for listening to the podcast.

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