The survival of self-funding in the face of PPACA, stricter stop-loss regulation, and the exchanges, is reliant upon doing more for less. Plan administrators are now thinking outside the box, developing payment methodologies that draw upon both old and new practices. Change, however, invites upheaval; in a world dominated by PPO networks and provider agreements, anyone who strays from the norm has a fight on their hands. Join The Phia Group’s CEO, Adam V. Russo, and Sr. Vice President, Ron E. Peck, as they dissect these new concepts, consider the pros and cons, and share their experiences as advocates of these new theories.
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In May of 2012, the California Workers’ Compensation Appeals Board (“WCAB”) adopted amendments, which impact the ability of lien claimants to obtain recovery.
• To secure reimbursement when filing a “green-lien,” lien claimants must pay a fee of $150.00.
• To secure reimbursement when filing a “green-lien,” “…lien claimants must appear at a lien conference and/or trial …”
We have already developed a strategy to ensure a smooth progression in light of these rules, and have the legal expertise in place to secure recovery. Please note, however, that the filing fee and appearance by local counsel will result in additional expense to the Plan. In an effort to maximize recoveries for our clients while minimizing costs, The Phia Group and its clients will have to conduct a cost-benefit analysis when deciding whether to pursue reimbursement, on a case by case basis.
PLEASE MARK YOUR CALENDAR! The Phia Group will be hosting a webinar specifically regarding these issues on January 23, 2013 at 4 PM EST / 1 PM PST. We have limited invitations to you and entities like you, directly impacted by these new rules. We will be discussing the new rules in greater detail, will field your questions, and will discuss the many issues benefit plans should keep in mind when assessing their options. It is important to us that you attend.
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The Phia Group’s CEO (Adam V. Russo), Sr. VP and General Counsel (Ron E. Peck), and resident subrogation litigation expert (Christopher Aguiar) will delve into current events, litigation, and changes in law (official and otherwise), as they share the current state of affairs for anyone and everyone interested in subrogation. You may think your time-tested methods for cost containment via claims recovery are safe and sound… and you’d be wrong. This is a discussion you will not want to miss.
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Happy Holidays to all of you! As we enter 2013, I just wanted to say thank you for the opportunity to serve you and the entire industry over the past 12 years and I look forward to doing so in 2013.
If you thought 2012 was a wild ride, wait until you see 2013. Obamacare is the law of the land, and it’s here to stay. The entities empowered by PPACA to issue mandates are prepared to unleash a tidal wave of regulations in 2013. Subrogation and coordination of benefits once again appear before the Supreme Court. The very definition of self-funding, rights under ERISA, and access to stop-loss have come under attack. Join The Phia Group’s CEO, Adam V. Russo, Sr. V.P. and General Counsel, Ron E. Peck, and V.P. of Consulting Services, Jennifer McCormick, as they discuss what we can expect to see in 2013, and how best to prepare for what’s coming.
The elections are over and regardless of who you voted for, the fact remains that PPACA is here to stay. While many of you have been utilizing our firm to assist in your compliance needs, we have never publicly announced that our team of experts can assist your organization with Regulatory Compliance issues until now.
Mitt Romney has been distancing himself from the healthcare reform he signed into law whilst governing Massachusetts. His team has responded to comparisons between “Romneycare” and “Obamacare,” stating that the two laws are vastly different, and vary based on scope of coverage, communities they apply to, and terms themselves. That being said, we can still draw many parallels between the two. Those of us who fail to look at the Bay State as a prototype for post-PPACA America are missing an opportunity to gaze into the future. From early successes, to a gradual bloating of the program… from red-tape, to recent moves to address the actual cost of care… the Commonwealth of Massachusetts is certainly a crystal ball. Join us as we dissect The Phia Group’s home state, and attempt to predict the nation’s future.