Phia Group

The Phia Group Announces the Hiring of Justin Forton as a Client Success Account Executive

On September 19, 2024
CANTON, MA – September 19, 2024 – In its continued dedication to bolstering the health benefits industry, The Phia Group has hired Justin Forton as a Client Success Account Executive. Justin will channel his data analytics experience and industry-focused customer service expertise to support and collaborate with The Phia Group’s clientele.

Medicare's First Ten Negotiated Drug Prices Announced

On September 16, 2024
Discover Medicare's first list of negotiated drug prices, featuring ten high-cost medications. Learn how these changes will impact seniors & healthcare costs.

Empowering Plans: P201 – Diving Into the Parity Pool: MHPAEA’s Latest Updates

On September 12, 2024
Regulators finally announced the long-awaited MHPAEA Final Rules on September 9, 2024. Many of these changes will directly affect group health plan design and modify the NQTL comparative analysis testing requirements - many of which will be significant for plans as they prepare for 2025. Join attorneys Jennifer McCormick and Bryan Dunton for their discussion on several critical considerations for plans as renewal season approaches.

The Phia Group Announces Enhancement to Ecosystem of Services: Care Empowered Pricing

On September 11, 2024
The Phia Group’s industry-leading ecosystem of cost containment services, including ICE, Subrogation & Recovery, PACE, and Phia Unwrapped, has been bolstered with Care Empowered Pricing, a cutting-edge Reference-Based Pricing (RBP) model providing quality care and fair pricing tailored to your needs.

Empowering Plans: P200 – Recognizing Our Blind Spots

On September 5, 2024
Dr. Marty Makary is a New York Times bestselling author, renowned Johns Hopkins surgeon, and globally recognized expert on medical research. In its most recent edition of the Empowering Plans podcast series (“Recognizing Our Blind Spots”), Dr. Makary was a special guest as he engaged in conversation with CEO Adam V. Russo about his new book, Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health, https://geni.us/blindspots. This is an episode jampacked with enlightening and engaging anecdotes that will leave you with new insight into commonly held assumptions about healthcare. After all, in order to fix the healthcare industry, people need to have access to correct information about modern medicine.

Section 1557 Final Rule | Current Status and Implications

On August 30, 2024
Explore the status of the Section 1557 Final Rule, including its implications for gender identity protections and the challenges posed by recent court rulings.

Empowering Plans: P199 – Summer Regulation Rundown

On August 29, 2024
The regulators rush to finalize a suite of marquee regulations as the clock gradually runs out on the Biden administration. Even when finalized, these regulations may be vulnerable in the post-Chevron landscape. Attorneys Kelly Dempsey and Nick Bonds pick apart some of the big rules we’re looking forward to and the challenges they may face.

Healthcare in Rural America | Overcoming Access Barriers

On August 19, 2024
Explore the significant barriers to healthcare access in rural America, including resource scarcity, long distances to facilities, & low health literacy rates.

Don't Be Surprised - Phia's Keys to Success with The No Surprises Act and Appeals Management

On August 19, 2024
As the dog days of summer drag on, the No Surprises Act and its benefactors are feeling the heat. Case volume is overloading the IDR process. Courts are split over whether and how parties can enforce arbitration awards. Payers, including group health plans, are paying nearly four times as much for services as CMS. Combined, this all threatens to undermine the original intent of the law and drive up costs for all. Now, more than ever, it is paramount to understand how these developments impact you and to enact a process to triage billing disputes - separating NSA claims from appeals. Phia is the option for success in this arena. Join our legal team on Tuesday, August 20th, at 1:00 P.M. ET, as we discuss our unique, battle tested processes for handling NSA claims and appeals. From utilizing intelligent out-of-network pricing methodologies and benchmarking to deploying cutting edge appeal review software, we cover all the bases and reveal the best practices for success.

Empowering Plans: P198 – Healthcare on the Ballot

On August 15, 2024
Nick Bonds and Corey Crigger are hosting this political edition of the Empowering Plans Podcast series. With an election looming in November, Nick and Corey take a look at the policies and agendas from the Harris/Walz and Trump/Vance tickets. They discuss the impact that each administration could have on the self-funded industry and the country, in the most civil political discourse you can find. Tune in to hear what each nominee has to say about: Medical Debt, the Opioid Crisis, Public Healthcare options, and more!

Health Over Wealth Act | Protecting Patients from PE Firms

On August 5, 2024
Learn about the Health Over Wealth Act, designed to hold private equity firms accountable in healthcare, ensuring patient welfare is prioritized over profits.

Empowering Plans: P197 – The Concerns About PBMs and the Demand for Reform

On August 1, 2024
In this episode of the Empowering Plans podcast, attorneys Jon Jablon and Kendall Jackson break down the consequences of PBM steerage. Join us in the discussion of the Federal Trade Commission’s inquiry into PBM practices and the push for legislation to increase transparency in the market and hold PBMs accountable.

The Phia Group's 3rd Quarter 2024 Newsletter

On July 30, 2024
The Phia Group is off to a great start in the third quarter of 2024! Check out our newsletter to get acquainted with some of the latest happenings in our neck of the woods.

What the Overturning of Chevron Means for Healthcare

On July 19, 2024
For the past forty years, federal agencies have had considerable latitude to interpret and enforce regulations and subsequently advance regulatory initiatives. Per the precedent established in the Supreme Court’s 1984 decision in Chevron U.S.A., Inc. v. Natural Resources Defense Council, courts have had to defer to federal agencies regarding legal challenges over ambiguously written laws passed by Congress. The rationale was as follows: The public servants employed by the federal agencies, whether they be scientists, engineers, law enforcement officials, economists, or experts in another field, have more specialized expertise in the given matter – even more so than Supreme Court justices -- and should thus be accountable for implementing the law. But effective late last month, the High Court, believing that unelected government officials should not wield such tremendous influence, overturned that precedent, thus yielding unprecedented power to the courts to use their own discretion in interpreting laws – many of which pertain to the country’s healthcare ecosystem.

Empowering Plans: P196 – Exploring Claims Processing Models

On July 18, 2024
On this episode of the Empowering Plans Podcast, attorneys Andrew Silverio and Cindy Merrell delve into the pros and cons of the pay and chase versus pend and pay models of claims processing. They provide an in-depth discussion on the coordination of benefits and the timing of claims processing when another party may be responsible for payment.