Regulatory Intelligence • Arizona OD Ownership Framework

Arizona Optometry Ownership Laws
& the HB 2026 Framework

Arizona's corporate practice of medicine doctrine and its interaction with evolving ownership legislation determines the structural architecture of every optometry practice transaction in the state. A Lumina capital engagement ensures your transaction structure is compliant from the first term sheet.

Legal Disclaimer: This report constitutes capital advisory intelligence — not legal advice. Arizona optometry ownership and corporate practice regulations are subject to legislative revision, regulatory interpretation, and case-specific application. All transaction structures deployed by Lumina Medical Capital clients are reviewed by Arizona-licensed healthcare legal counsel prior to execution. Engage qualified legal advisors before making ownership or transaction decisions.

Intelligence Report — Node 26

Arizona Optometry Ownership: The Regulatory Architecture That Governs Every Transaction

Lumina Medical Capital operates exclusively within the Arizona healthcare practice capital market. Understanding the regulatory framework that governs optometry practice ownership is not optional intelligence — it is the foundation upon which every transaction structure in our portfolio is built.

Arizona applies the corporate practice of medicine (CPOM) doctrine to healthcare professions including optometry. In practical terms, this doctrine restricts the ownership of optometry practices to licensed optometrists or to specific corporate entities authorized under Arizona Revised Statutes — and it directly affects how DSO platforms, private equity buyers, and multi-specialty groups may legally structure their Arizona acquisitions.

The emergence of HB 2026 — Arizona's healthcare ownership modernization legislation — introduced structural flexibility for certain transactions while simultaneously clarifying enforcement parameters that had previously been applied inconsistently. For the OD practice owner considering a sale, recapitalization, or DSO integration, the provisions of this framework determine which transaction structures are immediately executable and which require careful legal architecture before capital deployment can occur.

Regulatory Architecture

The Arizona Optometry Ownership Framework: Four Governing Pillars

Four distinct bodies of Arizona law intersect in any optometry practice transaction. Lumina's capital structures are engineered to comply with all four simultaneously.

Pillar I

Arizona Optometry Act (ARS Title 32, Chapter 16)

The primary governance statute for optometric practice in Arizona. Establishes licensure requirements, scope of practice definitions, and the foundational authority of the Arizona State Board of Optometry to regulate clinical and commercial aspects of optometric practice. Practice sales, corporate employment arrangements, and fee-splitting prohibitions are all addressed within or adjacent to this statute.

Pillar II

Corporate Practice of Medicine Doctrine

Arizona applies CPOM principles that restrict unlicensed entities — including non-physician-owned corporations — from owning or controlling the clinical operations of a healthcare practice. For optometry, this doctrine creates structural constraints on DSO and PE acquisition models that attempt to exercise direct clinical control. Properly structured management services agreements (MSAs) are the operative instrument for CPOM-compliant institutional acquisitions.

Pillar III

HB 2026: Ownership Modernization Provisions

Arizona's healthcare ownership modernization legislation introduced provisions that clarify the permitted scope of non-physician ownership interests in certain healthcare entities, establish safe harbor parameters for MSA arrangements, and create regulatory clarity for multi-specialty group practice structures. The legislation's implications for optometry transactions are significant — expanding some structural possibilities while codifying compliance requirements for DSO integration models.

Pillar IV

ARS § 10-2221 Professional Corporation Requirements

Arizona professional corporation statutes govern the entity structure of healthcare practices, establishing shareholder eligibility requirements, ownership transfer restrictions, and the conditions under which equity interests in optometry practices may be held by licensed versus unlicensed individuals. All equity transfer transactions — including partner buyouts, DSO integrations, and associate buy-ins — must navigate these provisions.

DSO Transaction Architecture

How DSO Acquisitions Are Structured for Arizona Compliance

The most common question Lumina receives from ODs approached by DSO platforms is: "How can a corporation own my practice if Arizona law requires licensed OD ownership?" The answer lies in the Management Services Agreement — the architectural instrument that separates clinical control (which must remain with a licensed entity) from administrative and commercial management (which may be contracted to a DSO entity).

A CPOM-compliant Arizona DSO acquisition typically involves four interdependent entities and agreements:

I
Licensed Professional Entity (PC or PLLC)

Owned 100% by a licensed Arizona OD. Holds the optometry license, employs clinical staff, and controls all clinical decision-making. This entity remains Arizona-compliant and provides the legal clinical authority for the practice's operations.

II
Management Services Organization (MSO)

Owned by the DSO or PE platform. Provides non-clinical management services to the PC — billing, marketing, administrative staff, equipment ownership, lease management, and technology infrastructure. Compensated via a management services fee.

III
Management Services Agreement (MSA)

The operative contract between the PC and MSO. Defines services scope, fee structure, term, renewal rights, and — critically — the boundaries of MSO influence over clinical operations to maintain CPOM compliance. The MSA is the document Arizona regulators scrutinize most intensively.

IV
Equity Option Agreement / Call Option

Gives the MSO (or its affiliate) the right to purchase the PC's equity in the future — typically upon a regulatory change or the OD's decision to exit entirely. This structure allows the DSO to effectively control the economic value of the practice while maintaining legal compliance with Arizona ownership requirements.

Transaction Compliance Checklist

Key compliance requirements for optometry practice transactions in Arizona. All Lumina-structured transactions are validated against these criteria.

Licensed OD holds controlling clinical entity
PC or PLLC owned by Arizona-licensed OD throughout transaction
MSA does not cede clinical autonomy to non-licensed entity
Fee structures, prescribing authority, and patient decisions remain with the PC
Fee-splitting prohibition compliance
MSA management fees structured as fixed or percentage-of-collections — not referral-based
Arizona Board of Optometry notification (where required)
Certain ownership changes require Board disclosure or approval
Non-compete enforceability under ARS § 23-1501
Arizona is a restrictive covenant-enforceable state with specific scope and duration requirements
Medicaid / AHCCCS participation transfer compliance
Provider number reassignment or new enrollment required upon ownership change
Advisory Note

Lumina Medical Capital works in coordination with a vetted network of Arizona healthcare transactional attorneys whose practices focus exclusively on physician practice M&A, CPOM compliance, and DSO structure design. Capital and legal advisory are engaged simultaneously on all Lumina transactions.

Legislative Intelligence

HB 2026: What Changed and What It Means for OD Practice Transactions

Arizona House Bill 2026 advanced healthcare ownership modernization by introducing several provisions that materially affect how optometry practices may be structured for institutional ownership, multi-specialty integration, and DSO acquisition. Key provisions relevant to OD practice transactions include:

§ 2026.01
Expanded Non-Physician Ownership Safe Harbors

HB 2026 clarified the conditions under which non-physician entities may hold economic interests in healthcare entities without triggering CPOM violations — specifically through properly structured MSA arrangements that maintain licensed professional control of clinical operations. This provision provides statutory footing for DSO MSO structures that previously operated under more ambiguous regulatory guidance.

§ 2026.02
Multi-Specialty Group Practice Structure Clarity

Provisions addressing the structure of multi-specialty practices that integrate optometry with ophthalmology, primary care, or other licensed professions. Previously, cross-specialty ownership arrangements in Arizona existed in a regulatory gray zone. HB 2026 codified permissible structures and ownership boundaries, which directly affects integrated clinical platform acquisitions.

§ 2026.03
Telehealth and Remote Clinical Supervision Parameters

Provisions relevant to multi-location practices operating under a single licensed optometrist's supervisory authority. For DSO platforms and multi-site OD practices in Maricopa County, this provision affects how clinical coverage obligations are structured when the founding OD is not physically present.

§ 2026.04
Non-Compete Provisions in Healthcare Transactions

Arizona has historically enforced reasonable non-compete covenants in healthcare practice sales. HB 2026 interacts with ARS § 23-1501 to provide additional enforcement clarity for restrictive covenants attached to optometry practice acquisition transactions — a provision of particular relevance to DSO platforms acquiring practices where departing OD non-competes are integral to goodwill value preservation.

Related Intelligence
Arizona Optometry Compliance & Regulatory Briefing
Access Report
Regulatory-Compliant Capital Structure

Every Lumina Transaction
Is Built to Survive Scrutiny.

Arizona's optometry ownership landscape is not a compliance obstacle — it is a structural design challenge that Lumina solves on every engagement. We coordinate capital advisory with Arizona healthcare legal counsel to deliver transaction structures that are regulatory-defensible from the first term sheet to the funded close.

Initialize Practice Equity Assessment

Confidential intake. Institutional NDA. Legal coordination included.