Bringing a diagnosing psychologist or physician in-house forces licensee ownership. Flip: separate licensee-owned diagnostic entity plus a management company.
Who may give the diagnosis in District of Columbia
The medical-necessity diagnosis is made by a licensed physician or a licensed psychologist. A BCBA may not diagnose ASD, so the diagnostician you would bring in-house is a psychologist or a physician, and both are professions the state may treat differently from behavior analysis.
How District of Columbia treats psychology and medicine ownership
The District requires that a professional corporation have as shareholders only individuals licensed to render the same professional service, and a professional service is one that may lawfully be rendered only pursuant to a license. Both psychology and medicine channel into licensee-owned entities.
What bringing the diagnostician in-house does
Bringing a diagnosing psychologist or physician in-house forces licensee ownership. Flip: separate licensee-owned diagnostic entity plus a management company.
How to structure it in District of Columbia
Keep the ABA entity ABA-only and non-licensee owned, and put the diagnosis in a separate licensee-owned entity connected through a management company on fair-market-value, not volume-based, terms so the referral survives the federal Anti-Kickback Statute; or rely on an outside referral with no remuneration flowing for the referral. If the diagnostician is a physician and the payer is Medicaid, the federal physician self-referral rules add a layer that a psychologist does not trigger. The full three-entity structure is set out in the diagnostician question hub.
The corporate-practice, professional-entity, and anti-kickback rules summarized here are amended and reinterpreted, and verbatim text is a starting point rather than a conclusion. The official District of Columbia code, the applicable federal safe harbor, and qualified healthcare-regulatory and tax counsel are the authoritative sources.