Lawyer for creation of private or public health establishment

Are you a specialist doctor and considering opening a medical practice? Whether it is a clinic, hospital, center, or any other structure in the health field, your project requires legal support to ensure its legal compliance and operational success. Our lawyers specialized in the creation and restructuring of private or public health establishments are available to support you at every stage.

As experts in health law, we provide you with personalized advice and solutions to formalize your medical structure. With several years of experience in File preparation, our team regularly collaborates with the competent authorities to guarantee tailor-made services.

Public or private healthcare establishment: understanding the distinction between a clinic and a hospital

A clinic is a private healthcare establishment offering medical care and services to patients, but is distinguished by its for-profit purpose. Unlike a hospital, the clinic is generally owned by a private-law structure, such as a commercial company, and practitioners primarily practice there on a self-employed basis.

The majority of medical practices adopt the status of a partnership or a corporation, depending on their organizational structure and the objectives of their partners. In a partnership, the partners maintain a close and personal link with the structure, their commitment being based on mutual trust.

In contrast, in a capital company, the firm is primarily based on the financial contributions made by the members, who become the central pillar of the structure. As for hospitals, they are local structures dedicated to care, prevention, and diagnosis. These public healthcare establishments provide primary care services and, in some cases, secondary care services, without accommodation, whether within the center or at home.

In addition to care and diagnostics, these establishments can also:

• carry out public health actions, such as therapeutic patient education and social actions to improve access to care for vulnerable populations;
• contribute to the continuity of outpatient care in addition to local health systems;
• serve as training venues for medical and paramedical professionals, including in the university context.

Hospitals follow a strict pricing model. In accordance with the Public Health Code (CSP), they primarily provide services reimbursed by the Health Insurance and apply third-party payment. No billing may exceed regulated rates.

The creation and management of a public health establishment are reserved for specific entities, such as:

• departments, municipalities or their groupings;
• public health establishments;
• managers of private establishments, whether for-profit or non-profit;
• collective interest cooperative societies.

Creating a healthcare facility is an ambitious and strategic project for any medical practitioner wishing to practice independently. To carry out this project successfully, it is essential to comply with the many legal and administrative procedures required, while meeting regulatory requirements.

Opening a medical facility, whether a clinic or a hospital, involves several key steps:

• conduct a territorial diagnosis;
• draft a shared health project and the constitutive acts;
• draw up a business plan;
• seek funding for the creation and development of the structure;
• find suitable premises;
• recruit medical and administrative staff;
• carry out the necessary incorporation formalities, etc.

Our lawyers specialized in the creation of private or public health establishments intervene in all legal aspects related to these medical structures.

Lawyer specialized in the creation and restructuring of private or public healthcare facilities to conduct a market study

The opening of a medical practice requires following essential preliminary steps, starting with a market study. This approach allows evaluating several essential elements of local competition and population demographics. Our lawyers specialized in the creation and restructuring of clinics and hospitals are able to identify the number of doctors already present in the area where you wish to establish yourself.

We can also analyze the characteristics of the residents, who will potentially become your patient base. The market study can also reveal your eligibility for certain state aid. These funds are mainly aimed at encouraging the establishment of healthcare facilities in areas classified as medical deserts. They may include additional remuneration, tax exemptions or other financial benefits.

A rigorous financing plan is essential to anticipate the expenses related to opening your clinic. Costs include medical equipment (instruments specific to the medical activity) and fittings (waiting room, furniture, computer equipment, letterhead, stamps, etc.). This step is also the opportunity to set your fees.

These must comply with the Social Security convention:

• sector 1 contracted doctors charge fixed fees without extra charges;
• sector 2 doctors may apply reasonable extra fees;
• sector 3 doctors have free fees but are not approved by the Social Security system.

Taking these parameters into account, the market study and the financing plan provide a solid basis for a successful installation.

Specialized lawyer in clinic creation and restructuring to help you choose the appropriate legal form

When creating a private healthcare establishment, the choice of legal form is a step that influences the management of the activity, the responsibilities of the practitioners, and the distribution of costs. Opting for an individual practice allows you to create a sole proprietorship, subject to the income tax regime in the category of Non-Commercial Profits (BNC). The advantage is total freedom in the organization of work and hours.

However, the doctor alone bears the costs related to the activity, which can limit the ability to invest in expensive or high-tech equipment.

Working together offers an interesting alternative for sharing:

• the premises, computer equipment and furnishings;
• human resources, such as administrative staff;
• possibly, the patient base and fees, according to the agreed terms.

To frame common services, a practice or collaboration contract is often necessary. This allows for precisely defining the commitments and responsibilities of each liberal health professional. Creating a company is also a suitable solution when several practitioners wish to structure their collaboration.

Different options are available to them:

• Civil Company of Means (SCM) or Economic Interest Grouping (EIG) to pool material resources and costs;
• Professional civil company (SCP) to bring together health professionals in a shared entity;
• Liberal exercise company (SEL) such as SELARL or SELAS.

Each choice has specific advantages and obligations. Our lawyers specialized in the creation and restructuring of private healthcare structures guide you in choosing the legal form best suited to your needs and professional goals.

We also intervene in legal transformations (e.g., converting an SARL into an SELARL, or an SCM into an SCP) and updating articles of association to meet new legal obligations. Our team of experts in corporate and business law can help you set up groups to pool resources.

Lawyer specialized in the creation and restructuring of clinics to carry out administrative formalities

Creating a healthcare structure involves completing several essential administrative formalities. First, the doctor(s) must register with the Order of Physicians, a crucial step to practice legally. Then, the activity must be declared to the Health Insurance and registered with the URSSAF.

Registration with the Autonomous Pension Fund for French Doctors (CARMF) is also required, as is notification to the Family Allowance Fund (CAF) regarding the place of practice. It is also mandatory to take out Professional Civil Liability insurance, which protects the practitioner against risks related to their activity.

The patient file must also be declared to the National Commission for Information Technology and Civil Liberties (CNIL) in order to comply with personal data protection. In addition, other steps must be taken, such as opening a professional bank account and setting up a dedicated telephone line.

In the daily management of healthcare facilities, contracts are essential tools. Our lawyers specialized in the creation or restructuring of clinics and hospitals assist you in the drafting of collaboration and/or employment contracts for doctors and staff. Our team is also competent in formalizing service contracts between facilities and self-employed professionals.