What a reputation contract may not buy, under the consumer reviews rule

Is it legal to hire a company to manage your practice reviews?

Yes, up to the point where the vendor starts producing the reviews. Monitoring listings, asking real patients to post what they think, replying to what appears, correcting a wrong address in a directory: none of that is what the Federal Trade Commission's Rule on the Use of Consumer Reviews and Testimonials reaches. The rule took effect on October 21, 2024, and it bans a specific list of things a vendor might otherwise offer to do 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it..

That list is codified at 16 CFR Part 465, and the currently in force text sits in the eCFR under Title 16 2Ref 2Federal Trade Commission (codified via the Office of the Federal Register) (2026).Part 465—Rule on the Use of Consumer Reviews and Testimonials.Citing Part 465 as presently in force codified law under Title 16 rather than as the 2024 Federal Register notice.. Six sections, six different things a service package can contain, and the practice sits inside the rule alongside the company it hired. What decides a contract is whether the reviews it produces come from real patients describing their own experience, with any tie to the practice disclosed.

Whether a named patient's testimonial raises separate privacy duties is a different question, and this page does not answer it.

What Part 465 forbids

Six prohibitions, each in its own section, and a full service package can cross several of them at once. The rule bars fabricated reviews and testimonials, compensation conditioned on a review being positive or negative, undisclosed reviews from people inside the business, company-controlled sites presenting themselves as independent, review suppression by threat, and trading in fake indicators of social media influence 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it..

Several of those clauses turn on what the business knew or should have known. Buying a review, or spreading a testimonial, that the business knew or should have known was false is the fake-review clause's own trigger; the fake-influence clause asks the same of bought followers, likes and views, and also whether they were used to misrepresent influence for a commercial purpose 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it.. That makes the sourcing question, where do these reviews come from, one the practice needs answered in its own file.

Screening which patients get asked, a practice sometimes called review gating, is a different question from paying for sentiment, and it has a page of its own.

Hiring a vendor does not move your exposure

Both sides are inside the rule, and the contract does not decide which one the government reaches. The FTC's Endorsement Guides state that an advertiser may be liable for a deceptive endorsement even where the endorser is not, and that advertisers are expected to guide and monitor the people endorsing them 3Ref 3Federal Trade Commission (2023).Guides Concerning the Use of Endorsements and Testimonials in Advertising.An advertiser's liability for a deceptive endorsement even where the endorser is not liable, the advertiser's duty to guide and monitor endorsers, and the named liability of advertising agencies, public relations firms, review brokers and reputation management companies for their role in creating or spreading a deceptive endorsement.. The reviews rule's own preamble folds reputation management companies into the definition of a covered business 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it..

The Guides name the category outright: advertising agencies, public relations firms, review brokers, reputation management companies and other similar intermediaries can be liable for their role in creating or spreading endorsements they know or should know are deceptive 3Ref 3Federal Trade Commission (2023).Guides Concerning the Use of Endorsements and Testimonials in Advertising.An advertiser's liability for a deceptive endorsement even where the endorser is not liable, the advertiser's duty to guide and monitor endorsers, and the named liability of advertising agencies, public relations firms, review brokers and reputation management companies for their role in creating or spreading a deceptive endorsement.. So both parties can be reached, and the practice's share does not shrink because somebody else was paid to do the work.

That is why the scope-of-work clause deserves the attention you would give reading a payer contract. It is the paragraph that says what the practice has agreed to be responsible for.

Monitoring, the duty the Guides put on the advertiser, means asking the vendor in writing and on a schedule which patients it solicited, when, and with what message.

The staff review problem

Reviews from people inside the practice are their own category, and a solo owner is in it already. Section 465.5 treats an insider review, one written by an officer or manager, an employee or agent, or an immediate relative of any of them, as a disclosure problem rather than a ban, and the practice's exposure runs through who asked for the review and what they said about disclosing 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it..

An officer or manager who solicits or demands a review from an immediate relative, an employee or an agent, or who tells employees to seek reviews from their own relatives, violates the rule when the review appears without a clear and conspicuous disclosure of the relationship and the officer or manager encouraged that silence, never instructed disclosure, or knew or should have known the review was up undisclosed and took no remedial step 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it.. A generalized request to purchasers at large to post about their experience is carved out.

The owner writing in their own voice is covered separately. An officer or manager who posts a review or testimonial about the business has to give a clear and conspicuous disclosure of that relationship, with a narrow exception for a testimonial where the relationship is already obvious to the audience 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it..

The first hire widens the clause without creating it. The rule's definitions count owners among a business's officers 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it., so the clause is live before anyone is on payroll; what a hire adds is a second household of immediate relatives and one more person who may want to help.

Write the instruction down before a vendor asks for staff participation. One page telling staff, and their households, that any review of the practice must state the relationship, kept with the vendor file, is the record that shows the instruction was given.

The clause an angry owner trips

Review suppression is banned by method rather than by outcome, and the listed methods are ones a frustrated owner might reach for. Section 465.7 covers stopping a review from being posted, or getting one taken down, through an unfounded or groundless legal threat, a physical threat, intimidation, or a public accusation the practice knew or recklessly disregarded to be false 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it..

What remains available is narrower than a vendor's takedown promise implies. A platform's own reporting process still exists for content that breaks its terms. Replying in public is its own decision, and for a clinician it runs into confidentiality questions this page does not take up.

The demand letter is the instrument the clause describes when the claim behind it is groundless. Whether a particular claim is founded is the assessment to run with counsel before the letter goes out.

What an enforcement case costs

Money, and the amount is a court's decision rather than the rule's. The preamble, published in August 2024, gives the maximum civil penalty then in force as $51,744 per violation, and notes in the same passage that courts weigh statutory factors and may impose much lower per-violation amounts, and that how violations are counted in a given case is also for the court 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it..

But the Commission is bringing these matters now. In April 2026 it published a proposed consent order against a company and its two principals, alleging that reviews and testimonials for their programs were falsely represented as the actual, genuine experiences and opinions of ordinary and impartial purchasers, with $1.5 million in monetary relief and disclosure obligations going forward 4Ref 4Federal Trade Commission (2026).Publishing.com, LLC, Christian Mikkelsen, and Rasmus Mikkelsen; Analysis of Proposed Consent Order To Aid Public Comment.A concrete, non-healthcare enforcement example: the April 2026 proposed consent order, the $1.5 million monetary-relief figure, the forward-looking disclosure obligations, and the misrepresentation charged (reviews and testimonials falsely presented as genuine, impartial purchaser experiences)..

That matter is not a healthcare case. No published FTC action against a medical or dental practice, or against a reputation vendor serving one, sits in the record behind this page. The rule's text carries no healthcare exception either, so what a clinician has here is a rule of general application, read across to a setting no case in these sources has tested.

Before you sign the scope of work

Read the scope of work for three things: where the reviews come from, who writes them, and what the vendor will do about a review the practice dislikes. Get each answer into the contract itself, because the contract is the document that still exists a year later, when the question is what the business knew or should have known 1Ref 1Federal Trade Commission (2024).Trade Regulation Rule on the Use of Consumer Reviews and Testimonials.The October 21, 2024 effective date of 16 CFR Part 465; the six prohibited practices and their section numbers; the definition of officers as including owners; the disclosure-based trigger of the insider solicitation clause and its carve-out for generalized solicitations; the knew-or-should-have-known standard in the fake-review and fake-influence clauses; the officer and manager disclosure requirement; the listed methods that make review suppression unlawful; the preamble's inclusion of reputation management companies within the definition of a covered business; and the maximum civil penalty figure as of the preamble's 2024 publication, with its own hedges about how courts set and count it..

Three clauses do most of the work:

• A statement that no review or testimonial will be authored, edited, or paid for by the vendor, its contractors, or anyone the practice employs.
• A sourcing record the vendor hands over on request, listing who was solicited and when. The Guides put a duty to guide and monitor on the advertiser 3Ref 3Federal Trade Commission (2023).Guides Concerning the Use of Endorsements and Testimonials in Advertising.An advertiser's liability for a deceptive endorsement even where the endorser is not liable, the advertiser's duty to guide and monitor endorsers, and the named liability of advertising agencies, public relations firms, review brokers and reputation management companies for their role in creating or spreading a deceptive endorsement., and a record is what monitoring looks like on paper.
• A named process for reviews the practice believes are false, ending at counsel rather than at a takedown promise.

A reputation contract is a purchase like any other, and where it belongs when you buy the stack in order is a separate question from whether its terms are lawful. Keep the signed scope of work, the vendor's sourcing records and the staff policy in one place. They are what a practice would produce if anyone asked how a given review got there.