Phia Group

Not Surprised – First NSA Analysis Shows That You’re Paying Too Much…And Phia Can Help!

On April 25, 2024
On Dec. 27, 2020, the No Surprises Act (NSA) was signed into law, with an eye towards protecting patients against so-called “surprise” balance bills. The law leaned heavily on “good faith” negotiations between payers and providers, as well as “objective” decision making via independent dispute resolution. Three years later, The Brookings Institution reported that you are paying nearly four-times what Medicare pays (an average of 390%) and are spending at least 50% MORE than an average PPO network. The bottom line? Providers are winning and you are paying MORE now than you did before the NSA’s passage.

The Phia Group’s CEO, Adam V. Russo, Named Recipient of the Free Market Medical Association 2024 Be A Beacon Award

On April 24, 2024
Canton, MA – April 24, 2024 – The Phia Group’s CEO, Adam V. Russo, was presented with the Be A Beacon Award at the Free Market Medical Association (FMMA) Annual Conference in recognition of his outstanding leadership and achievements in transforming healthcare.

The Phia Group's 2nd Quarter 2024 Newsletter

On April 17, 2024
The Phia Group is off to a great start in the second quarter of 2024! Check out our newsletter to get acquainted with some of the latest happenings in our neck of the woods.

Empowering Plans: P187 – Decoding ACA FAQ #66: Essential Health Benefits Unpacked

On April 11, 2024
Listen in as Kelly Dempsey and Brian O'Hara hit it out of the park in this Empowering Plans episode about Essential Health Benefits (EHBs)! The regulating bodies are at it again and issued ACA FAQ #66 on April 2, 2024! Listen in for a quick refresher on EHBs - how they started, where they are now, and where we’re going - and Phia’s interpretation and analysis of FAQ #66.

Understanding IDR | Key Insights on the No Surprises Act

On April 8, 2024
Explore the complexities of the IDR process under the No Surprises Act, including when it applies and how to navigate it effectively for better outcomes.

The Phia Group Is Named Winner of the 2024 Top Workplaces USA Award

On April 3, 2024
Canton, MA – The Phia Group, a leading provider of health care cost containment solutions, proudly announced today that it has been honored with the 2024 Top Workplaces USA award. This prestigious recognition, presented by Energage, underscores The Phia Group's commitment to fostering an exceptional workplace environment for its employees by providing such outstanding benefits as ongoing education, philanthropic events, and zero-cost health coverage for employees that have been with the company for five or more years.

Medicaid Estate Recovery | Understanding the Implications

On April 3, 2024
Explore the implications of Medicaid estate recovery on families, including the emotional & financial burdens, & the proposed Stop Unfair Recoveries Act.

Lenmeldy | Exploring the Price of the New Gene Therapy

On April 1, 2024
Discover the implications of Lenmeldy, the world’s most expensive drug, and how its high cost affects access to treatment for patients with rare diseases.

The Phia Group Announces the Addition of the Renowned John Blaney as Their Chief Innovation Officer

On March 28, 2024
Canton, MA – Rarely can an organization with decades of industry leading ascendency truly claim to make a change that will both revolutionize its fundamental essence to the core, as well as deliver to its clients monumental improvements on top of what is already the industry’s best results. In other words, when does the best get even better? This is one such moment. March 30, 2024 will be remembered as the day that The Phia Group publicly announced the addition of the renown John Blaney as their Chief Innovation Officer.

Empowering Plans: P186 – Xenotransplantation: A Potential Game Changer for Self-Funded Plans

On March 28, 2024
Ham it up with attorneys Nick Bonds and Jen McCormick from the Phia Group as they dive into the groundbreaking world's first successful genetically engineered pig kidney transplant at MGH in Boston. Explore the details of this medical breakthrough, its implications for the healthcare industry, and the considerations for the future of dialysis, plan language, and stop loss provisions. Tune in to gain invaluable insights into the intersection of law, healthcare, and cutting-edge medical advancements.

Wegovy: Not Just a Weight Loss Drug

On March 20, 2024
Earlier this month, the wildly popular weight loss medication was approved in the US to help prevent life-jeopardizing cardiovascular events in people who are overweight, obese, and/or have a history of cardiovascular disease. The FDA’s stamp of approval for drugmaker Novo Nordisk to include cardiovascular benefits to Wegovy’s label meant it was the first weight loss drug to market itself in this manner. Now the million-dollar question (no pun, intended) becomes, will this label expansion make insurers feel more inclined to provide coverage? For good measure, will Medicare, currently barred by law from covering drugs for weight loss alone, be compelled to include Wegovy under its umbrella?

Empowering Plans: P185 – Weighing the Options

On March 14, 2024
Over the last twelve months we have seen major interest in GLP-1s (Semaglutide- Ozempic / Wegovy and Tirzepatide – Mounjaro / Zepbound). Although GLP-1s have been around for years as a treatment for diabetes, the recent popularity is due to their use as a weight loss drug. Join Ron Peck and Corey Crigger as they discuss the impact this surge in demand has had on health plans and consumers. Are health plans and consumers informed about the benefits and drawbacks of this drug? Are consumers too focused on the benefits? Are health plans too focused on cost? Find out as Ron and Corey discuss one of the hottest topics in the industry.

Significant Effects of a Recent Healthcare Cyberattack

On March 11, 2024
Explore the significant impact of a recent massive healthcare breach on benefit plans, including challenges in claims processing & potential regulatory relief.

Empowering Plans: P184 – State of the Union, 2024

On March 8, 2024
In his third State of the Union address, President Biden touted his administration’s record and outlined the issues he and his team will likely be campaigning on heavily as the 2024 presidential race kicks off in earnest. Sprinkled throughout were a number of policy wish list items, including some key healthcare initiatives that we’ll be keeping a close eye on in the coming months. Attorneys Brady Bizarro and Nick Bonds bring you some of the highlights in this episode of the Empowering Plans podcast.

How a Major Cyberattack Affects Healthcare Benefit Plans

On March 7, 2024
Learn about the indirect effects of a recent healthcare breach on benefit plans, including challenges with claims & potential future regulatory relief.