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Phia Group Media


Montanile Changes Subrogation – How Will You Respond?

On January 27, 2016
On January 20, 2016, The Supreme Court of the United States decided in favor of the plan participant in the case of Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan

ERISA Plan Cannot Recover Settlement Funds That Have Been Spent

On January 25, 2016
The U.S. Supreme Court has narrowed, ever so slightly, the ever-changing definition of “appropriate equitable relief” under ERISA Section 502(a)(3).

How to Proactively Manage Self-Funded Employer Health Plans Recommendations by a Hospital Legal Advisor

On January 25, 2016
As more patients join self-funded plans, hospitals face new challenges regarding billing and collection. The increase in self-funded employer health plans has triggered an unintended consequence for hospitals with respect to payment for services.

Saving Stop-Loss - Protecting a Key Self-Funding Ingredient in a Hostile World

On January 19, 2016
Thank you for joining The Phia Group’s legal team on Tuesday, January 19, 2016, as they provided first-hand insight into the self-funded market’s reliance on stop-loss and threats to that industry, including what TPAs and brokers should look for – and look out for – when advising health plan sponsors regarding stop-loss options.

Secrets to Making Reference-based Pricing Work

On January 18, 2016
Employers, administrators, brokers and courts have begun to realize that determining the value of a health care service must involve something more than considering only a provider’s billed charges.

Anti-Assignment Clauses Bar Provider’s ERISA Claims

On January 7, 2016
An out-of-network health-care provider can’t continue with her claims under the Employee Retirement Income Security Act for unpaid benefits, fiduciary breach and failure to disclose documents against four health benefit plans, the U.S. Court of Appeals for the Eleventh Circuit ruled.