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In-Network vs Out-of-Network Claims
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In-Network vs Out-of-Network Claims
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Phia Group
Phia Group Media
A Flip of the Calendar: Looking Ahead to Healthcare in 2023
On December 13, 2022
With a new year comes new developments in healthcare — and 2023 will be no exception. While ever-increasing healthcare costs remain at the forefront of our attention, landmark healthcare legislation — in particular, the No Surprises Act (“NSA”) — continues to cause unforeseen issues for health plans and stop-loss carriers. Additionally, evolving business trends involving mergers, acquisitions, and investments from non-traditional entities promise to impact the industry. Join The Phia Group’s panel of cost containment experts as they look ahead to the challenges and opportunities that await us next year.
Empowering Plans: P150 – Manufacturer Assistance Programs
On December 8, 2022
Attorneys Brady Bizarro and Andrew Silverio discuss manufacturer/copay assistance programs and outline some of the different approaches being utilized to manage specialty drug spending. Also on the agenda is a current lawsuit against one such program administrator, and how the landscape might be shaped in the coming months.
Empowering Plans: P149 – Another Ping-Ponging of IC/EE Rules?
On November 17, 2022
In recent history there have been several rules that have been amended and re-amended (or just overturned and new rules published). Join Kelly Dempsey and Kevin Brady as they explore the ever-changing world of employee classification rules. The 2021 rule is viewed as leaving workers vulnerable to misclassification and was inconsistent with existing federal court decisions, thus the current administration is seeking to make a change. Tune in to learn more and why this rule matters to self-funded health plans.
Down the Stretch: Wrapping up a Historical 2022
On November 15, 2022
We are entering the home stretch. With a couple months to go, we can confidently say that 2022 has been one of the most momentous years in the history of American healthcare. The Phia Group’s panel of experts will revisit what they feel were the ten most impactful healthcare developments of 2022, covering a broad swath of topics that includes price transparency (the Consolidated Appropriations Act and No Surprises Act), governance (state laws that preempt ERISA), and equitable benefit coverage (Mental Health Parity and Addiction Equity Act). Who knew one year could have such a profound impact on our industry? Join the fun and find out how impactful 2022 has been.
Empowering Plans: P148 – The Ever Changing Times of Healthcare
On November 3, 2022
“It’s an ever-changing time…” in the healthcare landscape. Corey Crigger and Nick Bonds are back on the podcast mics to discuss some of the more interesting developments they’ve seen in 2022. Tune in to be sure these developments aren't burdensome and rest assured that the dreams you believe in will still come true.
Empowering Plans: P147 – Transparency & More: Burning CAA/NSA FAQs
On October 27, 2022
In this installment of The Phia Group’s Empowering Plans podcast, attorneys Jen McCormick and Jon Jablon bring up some of the most common questions that The Phia Group’s consulting team has been asked to field over and over again. From the so-called broker compensation rules to a TPA’s obligations related to a group’s No Surprises Act compliance, Jen and Jon highlight some of the main points to keep in mind when making important decisions regarding your business.
Book of Russo: Chapter 5
On October 21, 2022
In the latest episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, and guest host, Mike Ferguson, President & CEO of the Self-Insurance Institute of America (SIIA), have to say about SIIA’s 2022 National Conference, the history of SIIA, and what to expect from SIIA in years to come.
The Witching Hour for Healthcare Plans
On October 20, 2022
Quite a few treats are in store for those tuning into The Phia Group’s next webinar, one that will cover some tricky topics. From breaking down regulatory changes impacting the healthcare industry (i.e., mental health parity, discretionary authority) to developments concerning plan drafting language, Phia’s roundtable of experts will keep you in the know. Oh, and did we mention that there’s also going to be a discussion of what to expect from a health policy standpoint in next month’s midterm elections?
The Phia Group's 4th Quarter 2022 Newsletter
On October 19, 2022
The Phia Group is off to a great start in the fourth quarter of 2022! Check out our newsletter to get acquainted with some of the latest happenings in our neck of the woods.
The Stacks – 4th Quarter 2022 Newsletter
On October 19, 2022
This is "The Stacks" from The Phia Group's 4th Quarter 2022 Newsletter
Empowering Plans: P146 - A Possible Threat to a Plan’s Discretionary Authority
On October 14, 2022
Currently before the Senate, a new bill has been announced that would ban all references to a plan administrator’s discretionary authority, as well as remove all deference courts give to their claims determinations. Regardless of whether this bill will be passed, what does this and similar rhetoric say about public and political attitudes towards self-funded health plans? Ron Peck, Chief Legal Officer, and attorney Kaitlyn MacLeod are here to talk about this and more. Enjoy!
Book of Russo: Chapter 4
On September 22, 2022
In the latest episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, and guest host, Dr. Jeffery Gold, have to say about Direct Primary Care and why Dr. Gold decided to open his own practice in Massachusetts.
Empowering Plans: P144 - The Latest Developments Involving Patient Assistance Programs
On September 16, 2022
In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Andrew Silverio discuss patient assistance programs. They explain what these programs are, how they have been utilized in the industry, and the latest regulations and litigation surrounding them. Tune in to find out what plan sponsors need to know!
A Prescription for Success? The Unknown Impact of Recent Legislation on Prescription Expenses
On September 15, 2022
The Inflation Reduction Act, signed into law by President Biden last month, includes provisions to lower prescription drug prices for Medicare recipients. But what about most Americans who are on employer-sponsored plans? Could they be adversely affected by pharma companies potentially elevating prices in response? In its next webinar, The Phia Group takes a deeper dive into the residual effects of this landmark act on your plan—as well as how the recent Johnson & Johnson lawsuit involving patient assistance programs may heighten the risk for companies using such PAPs. For good measure, Phia’s panel of experts will also provide an update on final rules just released regarding the No Surprises Act.
Empowering Plans: P143 - Is Wrongful Death the Death of a Subrogation Claim?
On September 2, 2022
In this installment of the Empowering Plans podcast, attorneys Chris Aguiar and Cindy Merrell discuss the murky waters of wrongful death and healthcare subrogation claims.
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