Do you need an MSO for your ABA practice in Oregon?

The headline: a permissive baseline and a new strict law

Oregon is a split picture, and getting it right means holding two facts at once. The baseline, for a pure behavior-analysis practice, is permissive: Oregon's corporate-practice rules for professional corporations are written for the practice of medicine by physicians, not for behavior analysts, and Oregon historically allowed non-licensees to hold a minority interest in a clinical practice. On that baseline, an MSO is often optional for an ABA group. The complication is that in 2025 Oregon passed SB 951 and HB 3410, described by many as the strictest corporate-practice and management-company law in the country, and although that law is aimed at medical entities, it is new enough that anyone structuring an Oregon healthcare business should read it before relying on the permissive baseline.

Why Oregon's traditional doctrine does not reach pure ABA

Oregon has recognized a corporate-practice-of-medicine doctrine since a 1947 Oregon Supreme Court decision, and its professional-corporation statute requires medical PCs to be majority-owned and directed by licensed physicians (ORS 58.375). But that statute is, by its terms, about the practice of medicine: it applies to a professional corporation organized to practice medicine, and Oregon's own legislative analysis has noted that it does not apply to other independently practicing health care providers. Behavior analysis is licensed separately, through the Behavior Analysis Regulatory Board, not the Medical Practice Act. So the physician-majority ownership rule does not, on its own, force a behavior-analysis practice into a licensee-only structure, and Oregon historically permitted non-licensee minority ownership of clinical practices generally.

The 2025 change: SB 951 and HB 3410

SB 951 and HB 3410 were designed to stop business entities from doing an end-run around Oregon's corporate-practice doctrine through complex ownership and contracting. Among other things, the law prohibits a management-services organization and the people affiliated with it from owning or controlling a majority of a professional medical entity it manages, and it restricts an MSO from hiring or firing medical licensees, setting their schedules or compensation, setting clinical staffing levels, setting prices, or negotiating payor contracts. It also voids many noncompetition, nondisclosure, and nondisparagement agreements with medical licensees.

The reach of the law turns on two defined terms. A professional medical entity is an entity authorized to provide medical services, and a medical licensee is defined as a physician, nurse practitioner, physician associate, or naturopathic physician. Behavior analysts are not within that definition, so a practice that delivers only behavior analysis through licensed behavior analysts appears to fall outside the law's core prohibitions. The caution is twofold: the law is new and its edges are untested, and the moment a medical licensee is part of your clinical model, you are squarely inside it. Treat Oregon as a state where the answer for pure ABA is probably permissive but must be confirmed against the current state of this law.

Two further points sharpen the picture. First, the exemptions cut in ABA's favor: alongside carve-outs for hospitals and certain telemedicine arrangements, the law is understood to except certain behavioral-health entities, which reinforces the reading that a pure behavior-analysis practice sits outside its core prohibitions. Second, understand the teeth before you rely on any of this. A violation is treated as an unlawful trade practice, which means the Oregon Attorney General may seek civil penalties and injunctive relief, and private plaintiffs may pursue damages. That is a materially different enforcement posture from a licensing-board referral: it invites the counterparties with money at stake, rather than a regulator, to test your structure. The practical read for an ABA operator is that Oregon is permissive today and hostile in direction, so build the structure you would be comfortable defending if the definition of a covered entity were widened.

ABA is licensed through the Behavior Analysis Regulatory Board

Oregon licenses behavior analysts and assistant behavior analysts and registers behavior analysis interventionists through the Behavior Analysis Regulatory Board, which sits under the Oregon Health Authority's Health Licensing Office (ORS 676.802 to 676.830; licensure under ORS 676.810, registration under ORS 676.815, and the title protections at ORS 676.820). BACB certification is the qualifying credential. Because behavior analysis is licensed under this chapter rather than the Medical Practice Act, it is the medicine-specific rules, not the behavior-analysis ones, that drive the permissive baseline described above.

Who is allowed to own the practice

For a pure ABA practice, Oregon's baseline allows flexibility: the physician-ownership rule of ORS 58.375 does not apply to behavior analysis, and Oregon historically permitted non-licensee minority ownership, so a practice can often be owned with non-licensee participation, provided the licensed behavior analysts keep clinical control. Where your model includes a medical licensee, the analysis shifts to the medical PC rules and to SB 951's MSO restrictions, and a licensee-owned clinical entity paired with an MSO becomes the safe structure. The dividing line is whether a physician, nurse practitioner, physician associate, or naturopath is in your clinical chain.

What a management services organization actually is

An MSO is a separate company that provides the non-clinical side of a practice to a clinical entity. The clinical entity employs the licensed clinicians; the MSO employs everyone else and runs the business. A management services agreement ties them together, and the clinical entity pays the MSO a fee. For a pure ABA practice in Oregon you may not need the split, but the model has uses, and for any medically adjacent model it is now governed by SB 951.

When you would want an MSO, and the SB 951 caution

Three situations make an MSO worthwhile. First, a multidisciplinary or medically adjacent model: the moment a physician, nurse practitioner, physician associate, or naturopath is involved, SB 951 and the medical PC rules apply, and the structure must be built to comply with the new law rather than the permissive baseline. Second, multistate scale: a single management company across separate, locally compliant clinical entities. Third, private equity. The SB 951 caution runs through all three: in Oregon, an aggressive MSO that controls clinical or business decisions of a medical entity is now the precise target of the statute, with a private right of action, so the design has to be conservative. See the practice expansion and sale page for the transaction view.

How Oregon would evaluate your arrangement

The decisive questions are whether a medical licensee is in the chain and whether the 2025 law applies. These factors follow from that.

Fee design and fee-splitting

For a pure ABA practice, Oregon does not impose a percentage-fee ban, and fixed or cost-plus management fees set to fair market value are the safest because they trace to documented services. Where SB 951 applies, the MSO's economics and control are constrained by the statute, not just by general fee-splitting principles, so percentage and profit-based arrangements deserve particular scrutiny. For Oregon Health Plan and other Medicaid clients, the federal anti-kickback statute applies on top (42 U.S.C. § 1320a-7b(b)).

Keeping clinical judgment with the clinician

In every model, the clinician keeps authority over clinical decisions, assessment, treatment planning, and supervision. For pure ABA that is good practice. Where a medical licensee is involved, SB 951 makes clinical and key business control a hard statutory line, reserving specified decisions to the professional medical entity and away from the MSO. Write the operating and management documents so clinical judgment stays with the clinician and, where the new law applies, so the MSO stays within its limits.

How this connects to the rest of your compliance stack

Ownership is one layer. Three others interact with it directly:

• Payor and Medicaid disclosure. Your real ownership stack, including any MSO, is disclosed at enrollment and revalidation (42 C.F.R. Part 455). See Medicaid and insurance mandates.
• Facility licensure. A change in the ownership or service model can affect facility and records obligations. See facility licensure and HIPAA.
• Entity structure. The PC and PLLC options and the medicine-specific rules are their own analysis. See entity structures for ABA practices.

Setting it up in Oregon: the sequence

1. Map your clinical model. Decide whether any medical licensee (physician, NP, PA, naturopath) is in your clinical chain. That single fact decides whether the medicine-specific rules and SB 951 apply.
2. Confirm SB 951 applicability. With Oregon counsel, determine whether ORS 676.555 reaches your model before designing any MSO arrangement.
3. License the practitioners. Behavior analysts and assistant behavior analysts through the BARB (ORS 676.810).
4. Form the entity to match. Pure ABA has historical flexibility; a medically adjacent model uses a compliant clinical entity plus an MSO built to SB 951's limits.
5. Paper the management agreement conservatively. Keep clinical control with the clinician and, where SB 951 applies, keep the MSO out of the reserved decisions.
6. Confirm with Oregon healthcare counsel. This is the fastest-moving law in the guide; current advice is essential.

Oregon MSO variables at a glance

Frequently asked questions