What Kind of [Month] Has it Been?

On December 2, 2021
As we approach the new year, let’s take a moment to pause and reflect on the whirlwind of policies, proposals, and issues swirling in the end-of-2021 zeitgeist as we brace for 2022. So, where to begin…

Empowering Plans: P123 – Supreme Court Takes Major Dialysis Case

On November 23, 2021
In this episode of the Empowering Plans podcast, join attorneys Brady Bizarro and Andrew Silverio as they discuss important developments in dialysis case law. Earlier in November, the Supreme Court agreed to hear arguments in a case which could settle an important question about the Medicare Secondary Payer Act and have important ramifications for plan language and payment methodologies. Brady and Andrew trace the history of the case and the differences in legal interpretation by the lower courts. Finally, they offer some predictions about how the Court may rule and the impact it could have on the industry.

Act Now, Plan Ahead – The 2021 Endgame and 2022 Outlook

On November 16, 2021
Renewal season is in full swing, and 2022 will be here before you know it. Are you confident that you have done everything you need to do to close 2021 on a high, and enter 2022 on the right foot? Join The Phia Group as they discuss what must be done now to finish 2021 strong, as well as forecast what to expect in 2022. The Phia Group’s unrivaled access to data, industry developments, and ongoing analysis has allowed us to identify what to expect and how to prepare. From the No Surprises Act and transparency, to COVID fallout and threats posed by prescription drug costs and rehab facilities, both the constant stream of regulatory changes and provider efforts to squeeze payers, hurdles and opportunities of today will dictate the outlook for 2022.

Empowering Plans: P122 – COVID-19 Vaccine Mandate Update

On November 12, 2021
This week on Empowering Plans, Kelly Dempsey and Kevin Brady discuss the controversial OSHA vaccine mandate rules – where they started, where they stand now, and the many legal challenges that have arisen. This won’t be the last you hear of this topic and despite the legal challenges, employers should not delay in getting their action plan and policies in place.

The Phia Group is Proud to Announce that Scott Bennett has Joined their Team

On November 12, 2021
The Phia Group is proud to announce that Scott Bennett has joined their already robust team of health benefit professionals, as its Vice President of Provider Relations.

Empowering Plans: P121 – Transplants: The Future is Now!

On October 29, 2021
This week on Empowering Plans, Nick Bonds and Jon Jablon discuss a highly nuanced topic that has been the bane of many health plans: organ transplants. From interspecies organ transplantation to COVID’s effect on the global organ trade, it’s an evolving topic with serious implications on healthcare.

The NBA Health Care Scandal

On October 28, 2021
One person submitted paperwork for $48,000 worth of root canals and crowns on eight teeth at a Beverly Hills dental office--while he was living in Taiwan. Another individual filed a $19,000 claim for chiropractic services that he (allegedly) never received. And then there were suspicious invoices, filled in with (again, allegedly) fraudulent dates and account numbers, one of which was filed for services in a "wellness office" that specialized in "sexual health, anti-aging, and general well-being."

The Phia Group's 4th Quarter 2021 Newsletter

On October 27, 2021
It’s renewal season, and everyone is scrambling to retain current business as well as attract some new lives for 2022. Check out the full report here!

The Stacks – 4th Quarter 2021

On October 27, 2021
The Consolidated Appropriations Act (“CAA”) did many things and has created obligations, questions, and confusion for many stakeholders. Find out more here!

The Needle of Damocles: OSHA’s Anticipated Vaccine Rules

On October 27, 2021
President Biden’s Department of Labor (DOL) is tasked with developing requirements employers with 100 or more employees to follow. Click to read more!

A Spooky Surprise: NSA Regulations on IDR Released

On October 19, 2021
On September 30th, the federal government released an interim final rule to enact additional components of the No Surprises Act. See what it entails.

A Teaser! A Rose by Any Other Name…

On October 15, 2021
If a plan beneficiary felt their claim was underpaid it was due for an appeal. With the ACA's introduction, the volume of appeals increased. Read more today!

Empowering Plans: P120 – To Appeal, or not to Appeal

On October 15, 2021
Join The Phia Group’s CLO and SVP of Consulting as they dissect the No Surprises Act and reveal how and confusion regarding what constitutes a basis for appeal.

Empowering Plans: P119 - Workers' Compensation & COVID-19 Claims

On September 30, 2021
Join Rebekah McGuire-Dye and Cindy Merrell to discuss current Workers’ Compensation regulations impact health plans, responsibility for Covid-19 related claims.

Dialysis Carve-Outs and Network Contracts: Like Oil and Water

On September 30, 2021
Many plans choose to "carve out" dialysis claims, or pay them at a different rate than other claims but it can become a problem depending. Find out how.