The Phia Group Blog
Welcome to The Phia Group Blog, your source for cutting-edge insights into health plans, cost containment, and industry regulations updates. We break down top stories and trends, share actionable strategies, and provide expert perspectives to help you stay ahead.
The “Teeth” of a Refund Request: Cross-Patient Offsetting
By: Jon Jablon, Esq. Overpayment recovery can be messy even on a good day. As we all know all too well, without a contract, there’s no meaningful cap on what a provider can charge for its services; the provider’s legal…
Methods for Medicare Part D Creditable Coverage Determinations
By: Kendall Jackson, Esq. Each year, self-funded health plans must adhere to an array of disclosure, notice, and filing requirements, and compliance with these requirements already carries a degree of stress. While compliance with annual requirements would in theory be…
By: David Ostrowsky For many Americans—millions, in fact—October projects as being a no-pun-intended rather frightening month. As you’re reading this blog at the onset of fall foliage season, enrollees in the Affordable Care Act (ACA) marketplace across America are opening…
TrumpRx: A New Prescription for America’s Drug Costs? What Employers and TPAs Should Watch
Brady Bizarro, Esq. When President Donald Trump announced TrumpRx, his new prescription drug pricing initiative, it sounded part marketplace, part policy shake-up, and part political theater. But beneath the headlines, TrumpRx reflects a real shift in how Washington – and…
Wearables, Health Apps, and Cybersecurity Risks for Self-Funded Health Plans
By: Bryan M. Dunton, Esq. Wearables and health apps are no longer niche wellness perks but instead have become a cornerstone of modern wellness initiatives. Fitbit, Apple Watch, Garmin, glucose monitors, and app-based coaching programs promise to improve engagement, encourage…
Don’t Pay For Your Fun in the Sun This Summer
By: Kate MacDonald As Summer 2025 comes to a close, it’s always good to take stock of your favorite memories before moving on to a new season. This might mean doing a commemorative social media post, making a scrap book…
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