Exceeding your “fair market value”

[wrsthofthekitty]

I am sure there are many employed physicians here and I am curious if anyone has ever exceeded their “fair market value.“ I am employed and receive reimbursement based on a “draw“ where they reimburse me at a steady rate and adjust that rate based on what my production values looks like throughout the year. This often results in my employer owing me a significant amount of money at the end of the year, but this is “attempted to be minimized.” They then “true up” what they owe you in the first quarter of the next year with what the like to call a bonus, Which is really just money that you earn from the year before.There is a clause in my contract that says they will not pay me more than my fair market value, but this is notably difficult to discern and not Specifically spelled out.

For last year they have decided not to pay me the amount that they owe me, because I exceeded my fair market value in my specialty. This means that they just keep tens of thousands of dollars that I earned from the prior year. Do I have any recourse here? I like to be busy, but I suppose if I knew what exactly my fair market value was I could have been taking more vacation throughout the year avoid this situation, but it is all so nebulous that it is seemingly impossible to predict. Should I be seeking legal counsel? Is there a way to avoid this in the future by changing the draw so I owe them money?

any advice is appreciated!

Contract detail:

[FIREshrink]

I am sure there are many employed physicians here and I am curious if anyone has ever exceeded their “fair market value.“ I am employed and receive reimbursement based on a “draw“ where they reimburse me at a steady rate and adjust that rate based on what my production values looks like throughout the year. This often results in my employer owing me a significant amount of money at the end of the year, but this is “attempted to be minimized.” They then “true up” what they owe you in the first quarter of the next year with what the like to call a bonus, Which is really just money that you earn from the year before.There is a clause in my contract that says they will not pay me more than my fair market value, but this is notably difficult to discern and not Specifically spelled out.

For last year they have decided not to pay me the amount that they owe me, because I exceeded my fair market value in my specialty. This means that they just keep tens of thousands of dollars that I earned from the prior year. Do I have any recourse here? I like to be busy, but I suppose if I knew what exactly my fair market value was I could have been taking more vacation throughout the year avoid this situation, but it is all so nebulous that it is seemingly impossible to predict. Should I be seeking legal counsel? Is there a way to avoid this in the future by changing the draw so I owe them money?

any advice is appreciated!

My system has the same structure but to my knowledge FMV is defined as 90%ile, which almost no one has ever reached. I have worked with many docs and I do not personally know of a single case where the true up was withheld.

[Hank]

Goodness, how well has the hospital performed financially these past few years?

It seems far more likely that the administrators and C-suite are being paid in excess of their "fair market value" than that a highly productive doctor is paid too much relatively to productivity.

[HikingDO]

Time for a new job

[Hank]

I feel like there might be a Rihanna song that addresses this sort of situation...

[abds]

What does your contract say? Seems like that’s really all that matters.

[AR]

What does your contract say? Seems like that’s really all that matters.

He seems to be telling us that it says "Fair Market Value" without actually defining how it is determined.

[gap55u]

We used to have contracts that specified no one would make in excess of 90% of mgma for our specialty - like someone else said, I wonder if that is their definition. the big issue is that your contract, and the system, should definite how they determine FMV. If you aren’t getting a monthly report on wrvu per month and YTD/fYTD also require that.

[abds]

He seems to be telling us that it says "Fair Market Value" without actually defining how it is determined.

Don’t know how I missed that important sentence when I read the first post. I guess OP needs to find a new job or work less.

[Hank]

Welp, I hit 90% of MGMA already. See you guys in a month and a half when 2023 starts.

[White.Beard.Doc]

There are laws stating that the hospital cannot pay you more than fair market value or they can be considered in violation of the stark laws for paying you an illegal kickback.

However, if there is a going rate of pay for RVU based compensation, and you are generating a very high number of RVUs, then they can justify the high pay on that basis and say that is fair market value based on RVUs of productivity and the going rate of compensation per RVU. This is a gray area of the law and different health care attorney's interpret it differently.

Another option for you would be to demand the numbers in advance, and then to track your RVUs on an ongoing basis every month, and then to take extra time off or shorten your days at work once you reach the RVUs that will get you to your 90% maximum compensation.

[Savedfpdoc]

This is ridiculous, you produced more than your anticipated salary and they won’t give you what you’ve earned
Your contract says they won’t pay you over market value but do they say they can actually keep money you earned that was over that value? Those things have to spelled out clearly .
however it probably will be more of a headache to get them to pay you. I’d just cut my losses and leave ASAP. Can you terminate the contract early? What’s the penalty?

. I’m rvu based and if I produce more than what’s anticipated per quarter I get 50% of that when quarter ends , the other 50% stays in a pot and my under/over is calculated at end of yr . If I’m under then the money in the pot is “used up”. If I’m over then I get all the money in the pot in a lump sum at the end of the yr. I can ask them to increase my base pay throughout the year so the pot at the end doesn’t get so big, I don’t like lending them money without interest!!

[AR]

I am sure there are many employed physicians here and I am curious if anyone has ever exceeded their “fair market value.“ I am employed and receive reimbursement based on a “draw“ where they reimburse me at a steady rate and adjust that rate based on what my production values looks like throughout the year. This often results in my employer owing me a significant amount of money at the end of the year, but this is “attempted to be minimized.” They then “true up” what they owe you in the first quarter of the next year with what the like to call a bonus, Which is really just money that you earn from the year before.There is a clause in my contract that says they will not pay me more than my fair market value, but this is notably difficult to discern and not Specifically spelled out.

For last year they have decided not to pay me the amount that they owe me, because I exceeded my fair market value in my specialty. This means that they just keep tens of thousands of dollars that I earned from the prior year. Do I have any recourse here? I like to be busy, but I suppose if I knew what exactly my fair market value was I could have been taking more vacation throughout the year avoid this situation, but it is all so nebulous that it is seemingly impossible to predict. Should I be seeking legal counsel? Is there a way to avoid this in the future by changing the draw so I owe them money?

any advice is appreciated!

Over what period are they deciding that you can't be paid over market value? Presumably it's an annual salary. If that is the case just tell them to give you the whole bonus and they can just reduce your future draw the minimum amount to keep you under the annual fair market value limit. Then make sure you work a lot less the rest of the year.

This way you get less money, but at least they're not getting free work out of you. But it's all hypothetical really. They're going to say no anyway.

[Golfing Doc]

I am an employed physician and our rvu’s routinely get flagged for being over fmv and get audited by a consultant. If the consultant says we haven’t violated fmv, then we get paid for our rvu’s. If we don’t get ok’d by the consulting firm, then we don’t get paid.

[HikingDO]

More stupidity in medicine. Administrators can make as much as they want, there’s no cap, but we’re limited to “fair market value”, no matter how much more we work.