FAIR Health Data Cleared for Use in Federal Dispute Resolution

The integration of FAIR Health’s benchmark data into the federal No Surprises Act (NSA) process offers a standardized, empirical framework for resolving payment disagreements. Because these benchmarks are derived from a massive collection of real-world claims—including self-funded plans across all 50 states and U.S. territories—they provide a more comprehensive picture of market rates than traditional fee schedules or transparency files. By utilizing the FH NSA Reference File and FH Allowed Benchmarks, stakeholders can ground their offers in objective, geography-specific data.

Independent dispute resolution entities serve as the primary arbiters in these proceedings, and they are now positioned to use these tools to assess the validity of party submissions. FAIR Health maintains that its reliance on actual, anonymized claim records ensures the data reflects genuine contracted amounts rather than theoretical pricing. While the organization provides various analytical tools, it explicitly notes that its FH Charge Benchmarks—based on provider-billed amounts—are excluded from use in the NSA process, requiring parties to select the specific reference files tailored for regulatory compliance.