Phia Group

A New Year Brings New (Higher) Prescription Drug Prices

On January 18, 2024
It must be January. W-2 forms are hitting the mail. Fitness centers are packed to the brim. The NFL playoffs are in full force.

Understanding Gender-Affirming Care Exclusions in Plans

On January 16, 2024
Explore the complexities of gender-affirming care exclusions in health plans, including legal considerations, compliance issues, and potential discrimination risks.

Navigating 2024: The Latest, Most Innovative Plan Design Features & Stop-Loss Policy Updates

On January 16, 2024
In this first webinar of 2024, our crew will provide a rundown of 2024’s biggest plan document and stop-loss updates, including matters about which our team has been asked the most. Stay ahead of the crowd, and join The Phia Group as we jump into the year with a head start. Together we will resolve lingering problems of the past and equip you with a list of changes to expect and topics you need to monitor in 2024 and beyond.

The Phia Group's 1st Quarter 2024 Newsletter

On January 11, 2024
The Phia Group is off to a great start in the first quarter of 2024! Check out our newsletter to get acquainted with some of the latest happenings in our neck of the woods.

Empowering Plans: P179 – Higher Healthcare Prices (Made From Concentrate)

On January 4, 2024
The trend of provider consolidation is primed to pick up pace in 2024, distilling some areas into even more highly concentrated healthcare markets. Ron Peck and Nick Bonds break down how this concentration impacts the costs of healthcare and can drive costs upward for employers and employees alike. With fewer provider options, higher prices, and patients caught in the middle, Ron and Nick outline just a few of their concerns and discuss some of the tools health plans have at their disposal.

Understanding Cross-Plan Offsetting & DOL's Recent Actions

On January 3, 2024
Explore the implications of cross-plan offsetting in healthcare, including the DOL's recent action against EmblemHealth for violating fiduciary duties.

Time’s Up! It’s Gag Clause Attestation Season

On December 26, 2023
As the year wraps up and plans and TPAs around the country are scrambling to handle renewals, another challenge looms large in 2023 – the first annual gag clause attestation. As a reminder, the Consolidated Appropriations Act, 2021 (CAA) prohibits plans from entering into any contracts with providers and certain other entities that contain “gag clauses” – and requires them to attest annually that their contracts are free of them. The first attestation is due at the end of 2023, and it will cover the period of December 27, 2021 through December 31, 2023. The goal of the legislation is transparency, but it has glaring holes – contracts can’t prohibit plans from sharing certain information with other entities, but nothing requires them to be granted access to this information in the first place.

Sickle Cell Disease Treatments | Cost of Casgevy & Lyfgenia

On December 21, 2023
Learn about the groundbreaking treatments for sickle cell disease, including Casgevy and Lyfgenia, and the financial implications for patients and health plans.

Empowering Plans: P178 – Back to December (Phia’s Version)

On December 21, 2023
It is the last podcast of the year, and you know All Too Well that it is Phia’s 2023 year-in-review! Sparks Fly as Kendall Jackson and Corey Crigger talk about how Everything in PGC and Provider Relations Has Changed in 2023. If you need to catch up on anything from the No Surprises Act to Gag Clause Attestations, You Need To Calm Down and Stay Stay Stay tuned into this podcast episode. In addition to the big changes in 2023, we look forward to 2024 and ask, are you … Ready For It?

The Stacks – 1st Quarter 2024 Newsletter

On December 14, 2023
This is "The Stacks" from The Phia Group's 1st Quarter 2024 Newsletter

AI in Healthcare | Revolutionizing Patient Care and Access

On December 12, 2023
Learn about the potential of AI to transform healthcare delivery, enhance patient outcomes, & streamline administrative tasks, along with the associated risks.

July 2012 Newsletter

On December 11, 2023
What a month it has been. Typical, not much happens in our industry in July but not this year! Less than two weeks after the historic decision, we here at The Phia Group did a webinar on the Supreme Court case with the largest audience we have ever had. Its great to know we are trusted for our efforts on behalf of all of you.

Empowering Plans: P177 – Entering the Danger Zone: Cross-Plan Offsetting

On December 8, 2023
Attorneys Jon Jablon and Cindy Merrell discuss the practice of cross-plan offsetting and the recent settlement between the Department of Labor and EmblemHealth Inc. Who wins and who loses when a TPA decides to use cross-plan offset?

MAHP 2023 Annual Health Care Conference: Health Care Affordability, Quality and Equity in a Post Pandemic World

On November 28, 2023
Last November, the Massachusetts Association of Health Plans (MAHP) Annual Conference focused on healthcare challenges and opportunities – both from a regional and national perspective -- amidst a receding pandemic. The 2022 conference, headlined by then-Governor Charlie Baker, homed in on two topics: a.) healthcare equity and b.) regulation of provider prices. Twelve months later, on November 17, 2023, the MAHP 2023 Annual Conference, held once again at the Seaport Hotel in downtown Boston, had an eerily familiar theme: “Health Care Affordability, Quality and Equity in a Post Pandemic World.”

Minor Members and Third-Party Settlements | Key Insights

On November 27, 2023
Explore the rights of self-funded ERISA plans regarding third-party settlements for minors, including subrogation and reimbursement considerations.