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Upstate News

Upstate named to research network to create database on healthcare reimbursement

SYRACUSE, N.Y.— Upstate Medical University is one of four upstate New York academic institutions named as part of a research network that will create and develop a new healthcare database for consumer reimbursement and a new Web site where consumers can compare prices before they choose doctors.

Leading the work of the research network will by FAIR Health Inc., a new not for profit company that will be headquartered at Syracuse University. In addition to Upstate, other members of the research network are SUNY Buffalo, Cornell University, University of Rochester.

“FAIR Health and the upstate research network headquartered at Syracuse University will bring much-needed transparency, accountability and fairness to a broken consumer reimbursement system we have called Code Blue,” said Attorney General Andrew M. Cuomo. “By transforming this system for consumers nationwide, New York proves its reputation as a reform leader for the nation. By spending almost $100 million in settlement proceeds from health insurers, this initiative will also create new jobs and contribute to the development of the upstate economy that is vital to New York. Today is a win for consumers, New York and the nation.”

Upstate Medical University President David R. Smith, M.D., said, “We are pleased to participate in this collaborative research project. The accurate processing and analysis of health claims data is extremely important within the healthcare industry.”

The announcement, made Oct. 27, arises from a wide-ranging investigation by Cuomo’s office into how the health insurance industry reimburses consumers for out-of-network health care charges. The investigation uncovered a fraudulent and conflict-of-interest ridden reimbursement system affecting millions of patients and their families and costing Americans hundreds of millions of dollars in unexpected and unjust medical costs.

In addition to creating and managing the new database, FAIR Health and the upstate research network will design a new consumer Web site where, for the first time, patients around the country can find out in advance how much they are likely to be reimbursed for out-of-network health care services in their area. Information in the new database will be made available for academic research, and the database itself, in non-industry hands for the first time, is expected to make FAIR Health a significant driver in health care reform efforts.