The Phia Group Blog Posts

The Phia Group and Healthcare Recovery Solutions (HRS) Join Forces to Empower Healthcare Payers in Recovering Lost Dollars from PFAS, PFOA and PFOS Payouts

On June 29, 2023
The Phia Group, a distinguished leader in healthcare cost containment, and Healthcare Recovery Solutions (HRS), a prominent healthcare mass tort subrogation expert, announce their most recent and pressing initiative. In response to an environmental crisis in the US, our team is launching a robust initiative to provide unparalleled recovery solutions for healthcare payer clients. Through the integration of our unique and exclusive capabilities, including patented, state-of-the-art mass tort data analytics and subrogation recovery specialists, we will offer an extraordinary opportunity for clients to identify and recover medical costs associated with toxic chemicals known as PFAS, PFOA and PFOS.

Empowering Plans: P165 – Artificial Intelligence Meets Subrogation

On June 26, 2023
We are halfway through 2023, and Artificial Intelligence (AI) remains one of the year’s hottest topics, particularly in the worlds of business and healthcare. In the latest edition of The Phia Group’s Empowering Plans podcast, Attorneys Jon Jablon and Cindy Merrell zero in on how AI could have a monumental impact on the field of subrogation within the larger context of healthcare law.

Merck vs. Biden

On June 23, 2023
The globally recognized, multi-billion-dollar pharmaceutical company Merck & Co. sued the U.S. government on June 6th in an effort to halt the Medicare drug price negotiation program contained in the Inflation Reduction Act. The drug negotiation program aims to form agreements with drugmakers to lower costs on their most expensive drugs, which will save billions of dollars for Americans, particularly those on Medicare, while sapping Big Pharma of billions in potential revenue. In the first attempt by a drugmaker to challenge the law, Merck is pushing to be declared exempt from the drug price negotiation program, which they claim would lower their drug prices by 25 to 60 percent below market value.

What Happens When Auto and Health Insurance Collide?

On June 20, 2023
I remember when I graduated college, I was in the early stages of adulthood and my parents told me that I needed to get my own car insurance. Beyond knowing that my monthly bills were going up, I had little understanding about car insurance other than it was required and it provided protection in the event of an accident. After over a decade of practicing, law I have found that most adults (not just recent college graduates) do not actually know or understand their own auto coverage. Even fewer adults know how auto insurance and health benefits may intersect in the event of an auto collision.

Empowering Plans: P164 – The Key to a Successful Self-funding Experience: Knowledge!

On June 9, 2023
With many self-funded employers entering the field from a world where their benefits are “set it and forget it,” educating plan sponsors about their obligations, relationships, opportunities, and risks is often the difference between retaining and losing a client. Attorneys Andrew Silverio and Christopher Aguiar muse about the challenges arising when self-funded plans aren’t educated about their benefit offerings, the risk mitigation mechanisms, and the cost containment tools being utilized to ensure the plan’s viability.

A Weight Off My Chest

On June 6, 2023
Insurance is supposed to be something you purchase to protect yourself against unforeseen – but costly – losses. You don’t “expect” to be involved in a motor-vehicle accident, but you purchase automobile insurance to protect yourself against the costs incurred in an accident. You don’t expect your home to flood or burn down, but you purchase homeowner’s insurance to protect yourself against the costs incurred in such incidents. Automobile insurance does not pay to fill your car’s gas tank or change the oil. These are foreseen, planned costs of automobile ownership and maintenance. Homeowner’s insurance does not pay to replace the filters in your HVAC or power wash mold from the siding. These are foreseen, planned costs of home ownership and maintenance. Why, then, does health insurance pay for foreseen, planned costs of your body’s maintenance? More importantly, how have recent trends taken advantage of our addiction to health insurance, and the expectation that it will pay for everything?

Empowering Plans: P163 – ChatGPT: Disrupting the Healthcare Industry

On May 19, 2023
In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Brian O'Hara provide an overview of ChatGPT, the artificial intelligence chatbot developed by OpenAI, and describe how it is disrupting the healthcare industry. In particular, they focus on one emerging use for the technology - acting as a virtual assistant for patient care. What are the advantages of using AI in this manner? What are the concerns? Tune in for what will be a topic that we revisit in the coming weeks and months!

The Business of Benefits

On May 18, 2023
Those who service health benefit plans are usually focused on delivering the most robust coverage for the least cost. Yet, all too often we forget that our industry, like any other, only thrives when our own businesses prosper. From adjustments to a post-pandemic environment (and employee populations working remotely from numerous locations), to conflict resolution between entities (such as disputes between plans, stop-loss, and TPAs over reimbursement of fees for savings and management of the NSA), join The Phia Group as we discuss the current events and case studies that will impact whether your own organization sinks or swims.

Empowering Plans: P162 – Mind the Gap 2.0: Don’t be Afraid to Ask for a Handbook

On May 12, 2023
In this episode of Empowering Plans, Kelly Dempsey and Kevin Brady outline the relevant details provided within our Handbook Gap Free Reviews. They provide a description of the service, the case studies which gave rise to this service and describe why a review of the Handbook is more important now than ever before!

Empowering Plans: P161 – New Challenges to Old Favorites - NSA, ACA, and more (Acronyms)!

On April 28, 2023
In their latest podcast, Attorneys Nick Bonds and Corey Crigger are back to discuss the No Surprises Act (NSA) and the Affordable Care Act (ACA). Join them as they provide an overview of each of these laws and the recent legal challenges out of Nick’s home state of Texas. Will payment determinations resume? Has the ACA finally been struck down? Tune in to find out!

Before and After – Examples of Mistakes that Were Addressed and How to Avoid Them

On April 20, 2023
Accidents happen, but they aren’t all inevitable. Often, errors that lead to conflicts and costly outcomes could be avoided. Join The Phia Group’s team as they dig into real case studies, and share examples where The Phia Group was called upon to address some avoidable losses, as well as compare them to scenarios where the proper preemptive steps were taken. This April, remember what Benjamin Disraeli said: "The fool wonders; the wise man asks." Register today for this free and informative webinar!

Empowering Plans: P160 – How the Ending of COVID-era National Emergency Impacts Your Health Plan

On April 18, 2023
On April 10, President Joe Biden signed a bipartisan congressional resolution to terminate the U.S. national emergency in response to the COVID-19 pandemic—weeks before the development was supposed to occur in conjunction with a separate public health emergency expiring on May 11. Unsurprisingly, in the wake of such a stunning announcement, group health plans from coast to coast are scrambling to decide whether they must adjust their processes. In the latest Empowering Plan Podcast, Attorney Jennifer McCormick, Senior Vice President, Consulting, and Joanie Verinder, Director, Service Strategist, discuss the sudden end to the National Emergency, the many ways in which health benefit plans are affected, particularly in regards to timelines, and the information their respective participants need to be aware of.

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