Creating and applying standard operating procedures for fee-for-service HCP compensation is critical in driving compliant remuneration practices.  At the same time, unique situations arise with regularity, leaving compliance leaders to navigate grey areas while still needing to adhere to sound policies.  When handled well, compliance teams manage risk and reduce the potential for non-compliant HCP engagements, including the matter of compensation.

One of these unique challenges involves physicians with multiple board certifications.  HCPs certified in more than one medical specialty can create uncertainty in the application of fair market value (FMV) principles.  Their additional expertise may make them appealing candidates for collaboration — but it isn’t always clear where to set compensation levels for their services.

Step one in determining most engagement fees is selecting a defensible hourly rate for the specialist in question.  Established rate cards usually make that a straightforward exercise. When multiple specialties apply to the same HCP, however, different rates and considerations enter the picture.

In these cases, basic FMV rate-setting principles still apply.  Because those principles focus on specialty as a primary differentiating factor, it remains advisable to choose a primary specialty for the HCP, then apply it consistently.

When companies make this determination, they consider how they’ll be engaging the HCP, specifically as it relates to their portfolios and the therapeutic areas in question.  Is the physician clearly being contracted for their expertise in Specialty A?  Or is it Specialty B?  The answers naturally direct teams toward the specialty that bears the most relevance.  Often, the company’s focus on one therapeutic area over the other — Specialty A over B —means that the HCP’s rate will be set at Specialty A’s level for all engagements.  Consistency and applicability rule the day.

This is not to say that additional certifications are a nonfactor; far from it.  In some cases, the HCPs’ additional expertise may bear direct relevance on the services they provide.  When this happens, dual expertise may warrant adjustments to compensation.

In these cases, there are several paths justifying a higher rate, with the main ones being tiering (i.e., parameters are designed to accommodate such cases) and the application of exceptions .  In the same vein, FMV frameworks that include acceptable ranges of hourly rates allow teams to select different amounts.  A dual-certified HCP may command rates at the higher end of the appropriate specialty range.

Such approaches remain unique to each company.  Ideally, an organization will have recognized that use-cases may arise in which additional certifications come into play, and they will have accounted for it in their SOPs.  Because there is no industry-standard approach for managing compensation in these situations, such SOPs create clarity when teams encounter dual-certified HCPs.

In the end, as always, clear documentation and consistently applied principles provide the most defensible path forward.  Once teams determine their approach, best practice is to record it as policy for future use.  They thus carry forward guidance on this one grey area — and clear the way to tackle the next unique HCP engagement challenge that arises.