FMV Profiling
Written by Michelle Henley
Updated at January 17th, 2024
Healthcare and life sciences companies rely on input from thought leaders (e.g., physicians or other healthcare professionals (HCPs) to provide advice on various topics such as product development or research, to serve as peer-to-peer educators, to oversee clinical trials, or to serve as a moderator or attendee at conferences or other events. Companies often provide payment, reimbursement of expenses, or other things of value to these individual(s).
To minimize scrutiny and to ensure the legitimacy of these transactions (and to technically fall under “safe harbor” provisions of the US Anti-Kickback statute), the individual must be paid what is referred to as a “Fair Market Value” (FMV) rate for these types of engagements. FMV can be challenging to determine, and many companies rely on external vendors or consultants to provide what are referred to as FMV “rate cards”, which provide a single rate or range of rates for HCPs based on geography, specialty, level of expertise and/or experience.
Lextegrity's FMV Profiling feature enables assignment of FMV rates to Health Care Professionals (HCPs) and Patients. Using this feature ensures that the value being provided to the individuals is consistent with your organization's predefined value that the individual would bring.
Key Features
- FMV Profiling is a privilege-based feature. The following privileges can be assigned to users as needed.
- Enables viewing of Individual profile data and also provides the ability for users to request profiling and reprofiling.
- Integrates with Consultant Engagement requests to show FMV rates during service fee support calculation.
- Approved FMV profiling requests are saved to Master Data for additional maintenance and visibility.
- Direct Access through the FMV Profiling link on the left navigation bar.
Configurations/Things to Know
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FMV profiling is done based on Country, Individual Specialty, and Tier of the individual.
- FMV profiling based on the Activity types is not supported. In such cases, flat FMV rates within the Engage a Consultant request can be used.
- We can import your organization's FMV rate table into the Integrity Gateway. Lextegrity provides a standard template that is used to ingest the FMV data into the application. Note: The HCP Tiering process itself is handled outside of the application.
- For suggested rates, the application can either show a single value or a range.
- FMV profiling involves a submitter requesting for an HCP to be profiled. This is done by submitting a request which is then routed to appropriate approvers. Once the request is fully approved, HCP’s profile in master data is updated with the approved rate.
- CVs uploaded in the FMV profiling request submitted by business users are not uploaded to the master data profile of the HCP, and, therefore, are not visible in the FMV profiling UI while looking at the profile of an HCP. These CVs are also not automatically uploaded to Engage a Consultant request when a profiled HCP is added to the request. CVs always remain inside the FMV Profiling request in which the HCP was requested to be profiled.
FAQ
We do profiling based on Activity type. How can this be supported in the Integrity Gateway? FMV profiling is done based on Country, Individual Specialty and Tier. FMV profiling based on the Activity types is not supported. In such cases, FMV Flat rate within the Engage a Consultant request can be used.
We provide Flat FMV Rates for certain Activity types. How can this be supported in the Integrity Gateway? We can import your organization's FMV rate table into the Integrity Gateway. Lextegrity provides a standard template that is used to ingest the FMV data into the application. Note: The HCP Tiering process itself is handled outside of the application.
We do an annual refresh of FMV rates for all HCPs. How can that information be updated in the application? In such cases, we can extract all the FMV rates from the system and provide a spreadsheet containing HCPs, Party ID, and current rates. The customer will be responsible for updating the spread and returning it back to Lextegrity. Our team will import the new rates back into the system.
Can I manage the FMV rates for an individual as a system administrator? If a change to an existing FMV rate, the HCP can be reprofiled, or the rate can be updated within master data. Note: Updating master data does not change existing requests. The change would only apply to new requests, or existing requests can be updated with the new rate and resubmitted for approval.
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