FAIR Health Certified as Qualified Entity by the Centers for Medicare & Medicaid Services

NEW YORK, June 7, 2016 /PRNewswire-USNewswire/ -- FAIR Health, a leading national, independent, nonprofit organization that advances system-wide healthcare cost transparency through consumer resources, data products and health services research support, announced today that it has been certified as a Qualified Entity (QE) by the Centers for Medicare & Medicaid Services (CMS) under the Qualified Entity Certification Program. FAIR Health is one of only four organizations in the country currently certified by CMS to receive Medicare claims data for all 50 states and the District of Columbia.  

As a QE, FAIR Health will be responsible for supporting objectives included in the Affordable Care Act (ACA) to promote transparency and performance improvements in the provision of healthcare services. QE certification enables qualified organizations to receive Medicare Part A, Part B and Part D claims data. As part of its participation in the program, FAIR Health looks forward to developing public reports based on its database of private insurance claims in combination with Medicare information to further promote transparency and benefit all participants in the US healthcare sector.

The Medicare data received through the program will supplement FAIR Health's data repository of private insurance claims—currently more than 20 billion medical and dental procedures billed through private health insurance claims dating back to 2002. FAIR Health adds approximately 1.7 billion records each year to its private claims database. These records are contributed by approximately 60 companies, including many of the country's largest commercial insurers and third-party administrators. The database contains claims from organizations that insure or process claims for approximately 150 million covered lives from all 50 states, the District of Columbia, Puerto Rico and the US Virgin Islands.

FAIR Health's repository offers a conflict-free, trusted and transparent source of healthcare data. The vast database supports the organization in fulfilling its cost transparency mission by powering an award-winning, free consumer website available in English (www.fairhealthconsumer.org) and Spanish (www.consumidor.fairhealth.org), which enables consumers to estimate and plan their medical and dental expenditures, and offers educational resources to support health literacy. The database also is used to support research into such topics as cost and utilization trends, the effects of public policy and regional variations in healthcare treatment and protocols. Likewise, the database serves as the foundation for standard data products and customized datasets used by insurers, providers, policy makers, academicians and others to support research, government programs and a range of strategic and operational needs in both the business and public sectors.

FAIR Health President Robin Gelburd noted, "Our QE certification by CMS speaks to the special trust the healthcare sector places in FAIR Health and our processes, IT infrastructure and mission-driven activities. We look forward to using Medicare data to expand the scope and reach of our efforts to advance the nationwide movement to increase publicly available and actionable healthcare information."

About FAIR Health

FAIR Health is a national, independent, nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information through comprehensive data products, consumer resources and health systems research support. FAIR Health uses its database of billions of privately billed medical and dental healthcare claims to power an award-winning, free consumer website available in English and Spanish and to create data products serving all healthcare stakeholders, including government officials, insurers, researchers, consumers, employers, brokers, hospitals, medical facilities, doctors and TPAs. For more information, visit www.fairhealth.org.

Contact:
Dean Sicoli
FAIR Health
Executive Director Communications and PR
646 664-1645
[email protected]

SOURCE FAIR Health