NEW YORK, June 18, 2020 /PRNewswire/ -- FAIR Health's support for state workers' compensation programs has earned praise from officials in Oklahoma and South Carolina for assisting their efforts to update their workers' compensation fee schedules. In addition to updates for Oklahoma and South Carolina, FAIR Health also recently completed work on the Commonwealth of Kentucky's fee schedule—the fourth update since revising that jurisdiction's 2013 workers' compensation fee schedule.
FAIR Health assisted Oklahoma with the first update to its fee schedule since 2012; going forward, the schedule will be updated biannually. Working with the Workers' Compensation Commission (WCC), FAIR Health obtained feedback from numerous stakeholders about the current fee schedule. To assist the WCC in making informed decisions, FAIR Health analyzed multiple sources of data, including data from the WCC, private payors and the Centers for Medicare & Medicaid Services (CMS), as well as workers' compensation fee schedules from other states. In the new fee schedule, FAIR Health benchmark data are used as a basis for dental fees and to develop rates for medical procedure codes that are not valued by CMS. The new schedule was approved by the state legislature in May and will go into effect on July 1, 2020.
Mark Liotta, Chairman of the Oklahoma WCC, praised FAIR Health's contribution, saying, "We made the right choice in selecting FAIR Health through the competitive bidding process to assist us with our first fee schedule update since 2012. Their analyses were detailed and thorough, which helped us make important decisions for the benefit of injured workers in Oklahoma." WCC Commissioner Jordan Russell noted, "We had an aggressive time frame in which to research and draft a fee schedule and FAIR Health came through for us. They solicited feedback from our stakeholders and provided data analyses that were invaluable in helping us make decisions."
This year also marks the first time FAIR Health has worked with the South Carolina WCC to update its fee schedule, which became effective on April 1. FAIR Health analyzed South Carolina's workers' compensation data, studied the impact of different conversion factors on projected expenses under the program and presented the proposed changes at a public meeting. As in Oklahoma, FAIR Health data are used to fill gaps in the schedule where CMS does not provide a value.
Scott Beck, Chairman of the South Carolina WCC, commended FAIR Health's contribution to the fee schedule update, saying, "FAIR Health brought additional layers of analysis to our fee schedule, which provided a new perspective that added to our insights." Gary Cannon, Executive Director, added, "FAIR Health exceeded expectations not only by meeting deadlines but also by providing additional data points to consider. This assisted in our decision making."
FAIR Health just completed working with Kentucky to update its 2020 workers' compensation fee schedule. This is the fourth fee schedule that FAIR Health has developed with the Kentucky Department of Workers' Claims, having previously supported the Department with the 2013, 2016 and 2018 fee schedules. FAIR Health joined Commissioner Robert Swisher in presenting the changes to the schedule at on-site stakeholder meetings in Kentucky. The fee schedule, which is based on FAIR Health data, will become effective on July 1, 2020.
FAIR Health President Robin Gelburd stated, "We are very gratified to assist Oklahoma, South Carolina and Kentucky with their workers' compensation fee schedules through review of data trends, Medicare rates and various methodologies." In addition, FAIR Health currently is involved with a number of other states—for example, Colorado, Georgia, Louisiana and Mississippi—to develop and support their workers' compensation fee schedules.
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About FAIR Health
FAIR Health, a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the tax code, is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of private healthcare claims data, which includes over 31 billion claim records contributed by payors and administrators who insure or process claims for private insurance plans covering more than 150 million individuals. FAIR Health licenses its privately billed data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health's systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers' compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish and an English/Spanish mobile app, which enable consumers to estimate and plan for their healthcare expenditures and offer a rich educational platform on health insurance. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. FAIR Health also is named a top resource for patients in Dr. Marty Makary's book The Price We Pay: What Broke American Health Care—and How to Fix It and Elisabeth Rosenthal's book An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. For more information on FAIR Health, visit fairhealth.org.
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