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Empowering Plans: P157 – New TPA Liabilities – Section 1557

On March 3, 2023
One of the healthcare trends we have been following so far in 2023 is expanded TPA liabilities. In this edition of the Empowering Plans podcast, attorneys Brady Bizarro and Andrew Silverio discuss a recent federal court case in which a TPA was found liable for violations of the ACA’s Section 1557. Despite numerous defenses raised by the TPA, many of which we see regularly used by TPAs, the court rejected them all, potentially expanding the scope of Section 1557. Tune in to hear more about this significant case and what it means for our industry.

Empowering Plans: P156 – Accommodating Reasonably: Navigating the ADA and PWFA in 2023

On February 16, 2023
On this episode of Empowering Plans, Kelly Dempsey and Kevin Brady provide some valuable insights into the reasonable accommodation process under the ADA and PWFA. The PWFA, which will be effective this June, expands the scope of existing federal law with respect to accommodating employees with known limitations related to pregnancy, childbirth, or related medical conditions. Tune in to learn why this is important for employers in 2023 and beyond!

Empowering Plans: P155 – The State of the Union 2023: Phia’s Take

On February 10, 2023
The State of the Union has always served as an important bellwether for our country, but also, for our industry, revealing what the current administration’s healthcare policies will be going forward, and in some cases, which ones enjoy bipartisan support. In this special edition podcast, join attorneys Ron Peck and Brady Bizarro as they break down the president’s speech, providing you with their reaction and analysis, and explain what you should be watching this year.

Empowering Plans: P154 – No Ordinary Time in Healthcare

On February 3, 2023
Corey Crigger and Nicholas Bonds cover a lot of ground in the newest installment of The Phia Group’s Empowering Plans podcast: Whether it’s the National and Public Health Emergencies starting to wind down or what state legislatures have in store for non-profit hospitals that overcharge or Amazon creeping into the healthcare space, Phia’s attorneys are here to keep you up to date on the ever-changing world of healthcare.

Empowering Plans: P153 – Living Up To Expectations

On January 20, 2023
Over the last decade, The Phia Group’s leaders have made quite a few predictions. There have been some hits and misses. Join attorneys Ron Peck and Jen McCormick as they discuss past predictions, their predictions for 2023, and what the best health plans need to do to stay ahead of the game this year!

Empowering Plans: P152 – The Contemporary Fiduciary: Emerging Law on an Old Topic

On January 5, 2023
In this installment of The Phia Group’s Empowering Plans podcast, join attorneys Katie MacLeod and Jon Jablon as they discuss fiduciary status, both traditionally and in the new age of self-funding. This industry is faced with changes all the time, even to some of its oldest rules; in the spirit of consumer protection, the legal and regulatory winds are once again changing to challenge certain long-held understandings about fiduciary duties. TPAs in particular should tune into this one!

Empowering Plans: P151 – The Who, What, and When of Offsetting Benefits

On December 20, 2022
In this installment of The Phia Group’s Empowering Plans podcast, attorneys Chris Aguiar and Cindy Merrell discuss offsetting benefits and when a Plan may want to consider it.

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.

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.

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!