California Healthcare & Telehealth Compliance Guide
California has one of the strongest prohibitions on the Corporate Practice of Medicine (CPOM). Corporations may not practice medicine or employ physicians. The law extends to other licensed clinical professions. Exceptions exist for professional medical corporations (PCs), partnerships, HMOs, and nonprofit organizations.
- Corporate Practice of Medicine (CPOM): Strict
- Telehealth prescribing permitted: Yes
- In-person exam required first: No
- Audio-only visits allowed: Yes
- Nurse practitioner authority: Full
- Collaborative practice agreement required: No
- Good Faith Exam required: Yes
Telehealth prescribing in California
An appropriate prior examination is generally required before prescribing dangerous drugs or devices. A patient-provider relationship can be established via telehealth, but not via audio-only for new patients unless for sensitive services. A Good Faith Exam (GFE) is required before prescribing and can be performed via telehealth.
Controlled substances in California
The DEA has extended telehealth flexibilities for prescribing controlled substances (Schedule II-V) through December 31, 2026, allowing for prescription without a prior in-person exam, provided a legitimate medical purpose and evaluation is conducted via audio-visual telehealth.
Medical director requirements in California
While there isn't a specific "medical director" requirement for all telehealth operations, a collaborating physician is generally required for nurse practitioners who do not have independent practice authority. This physician provides oversight and is responsible for the overall care provided.
Nurse practitioner scope and collaborative practice in California
For nurse practitioners not practicing independently under AB 890, a collaborative practice agreement with a physician is required, outlining standardized procedures.
Key operating notes for California
Verbal or written informed consent for telehealth is required. Providers must be licensed in California. California has payment parity laws for telehealth.
Recent regulatory changes in California
Assembly Bill 890, effective in 2023, allows nurse practitioners to practice independently without physician supervision in specified settings after a transition period. Senate Bill 351, signed in 2025, codified existing Corporate Practice of Medicine guidance.
Frequently asked questions
How does California's strict CPOM doctrine affect my healthcare business?
California enforces strict Corporate Practice of Medicine laws, meaning non-physician entities cannot directly employ physicians or control clinical decisions. You'll need a properly structured PC-MSO arrangement to operate compliantly. TrueEval can guide you through the entity formation and management services agreements required.
Do I need a medical director for my medspa or IV therapy clinic in California?
Yes — California requires physician oversight for medical procedures performed in medspas, IV therapy clinics, and similar brick-and-mortar healthcare establishments. A medical director develops protocols, provides clinical oversight, and ensures regulatory compliance. TrueEval places board-certified medical directors licensed in California who understand both telehealth and in-person practice requirements.
Can nurse practitioners practice independently in California?
California grants full practice authority to nurse practitioners, allowing them to practice and prescribe independently without a collaborative practice agreement. TrueEval helps you navigate California's specific NP scope of practice regulations for both telehealth and brick-and-mortar operations.
What are the Good Faith Exam requirements for prescribing in California?
California requires a Good Faith Exam before prescribing medications via telehealth. The GFE can be conducted via telehealth — no in-person visit is required first. Audio-only telehealth is permitted. TrueEval's physician network conducts compliant GFEs for California patients.
What compliance requirements apply to cash-pay healthcare businesses in California?
Cash-pay healthcare operations in California — including telehealth, medspas, IV therapy, and wellness clinics — must still comply with all state medical practice acts, CPOM laws, prescribing regulations, and scope of practice requirements. The main difference is you won't deal with insurance billing compliance, but you must still maintain proper corporate structure, physician oversight, and clinical documentation. TrueEval specializes in cash-pay compliance frameworks for California.