Support for State Laws and Initiatives
FAIR Health’s data serve as official reference points for state consumer protection laws, reimbursement for emergency services and state health programs—an endorsement of our effective stewardship of the FAIR Health data repository; our neutrality; and the reliability, security and breadth of our data.
- California set a specific FAIR Health benchmark as a ceiling on emergency department charges for low-income patients.
- Connecticut chose a specific FAIR Health benchmark as the standard for payment for out-of-network emergency services.
- New York State identified FAIR Health’s 80th percentile benchmark as a guideline for disclosing plan rules on reimbursements and as a factor for consideration in independent dispute resolution regarding out-of-network emergency services and surprise out-of-network services at in-network facilities.
FAIR Health has provided data and technical assistance to officials addressing balance billing issues in over 20 states. Several states and healthcare exchange plans provide direct links to FAIR Health’s consumer site for their constituents and beneficiaries.
FAIR Health has assisted a number of states to develop and update their workers’ compensation fee schedules, including Colorado, Georgia, Kentucky and Mississippi. Other states where FAIR Health data have been used for workers’ compensation programs include Alaska, North Dakota, Pennsylvania and Wisconsin.
Other state uses of FAIR Health data include:
- Out-of-network claims pricing under the state health insurance plan (Alaska);
- Supporting the reimbursement of dental claims for disabled pediatric patients (Arizona);
- Supporting a study on ground and air ambulance services (Florida);
- Providing an authorized personal injury protection (auto liability) reimbursement standard (New Jersey);
- Providing Medicaid program support and supporting a program establishing fair reimbursement for services rendered to neurologically impaired newborns (New York); and
- Supporting comparative analyses as well as advocacy, transparency and consumer education efforts (Texas) .
States turn to FAIR Health for a true representation of market-level healthcare costs
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