In 2009, an investigation by then-New York State Attorney General Andrew Cuomo uncovered conflicts of interest in one system that health insurers used to calculate reimbursement for patients who received care from providers outside their plan’s network. As a result of this investigation, FAIR Health
-- an independent, not-for-profit corporation -- was created to establish and maintain a new database that could be used to help insurers determine their reimbursement rates for out-of-network charges, and provide patients with a clear, unbiased explanation of the reimbursement process.
As part of the collective settlement the Attorney General’s office reached with the insurers, FAIR Health received millions of de-identified healthcare claims that many had used to help them determine their rates. This data continues to be analyzed and processed with the goal of increasing its completeness, accuracy, and neutrality, as it will form the basis of our licensed products. The data is also the basis of educational products and tools for consumers made available on this website.