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Empowering Plans: P42 - Eliminating the Noise

On May 29, 2018
In this episode, Adam, Ron, and Brady interview David Contorno, President of Lake Normal Benefits. They discuss emerging trends in the industry; from reference-based pricing to direct primary care. They also address the incentive problem and how HSAs are harming the health insurance industry.

Empowering Plans: P41 - The Case for Collusion (Continued)

On May 24, 2018
Join The Phia Group’s Sr. VP, Ron E. Peck, and healthcare attorney Brady C. Bizarro as they answer the questions that you asked during our webinar on PBMs, specialty drug prices, and lawsuits alleging fraud.

How About Some Evidence? - Montanile v Board of Trustees

On May 23, 2018
You may be curious about the decisions made in the Montanile v Board of Trustees Supreme Court case. Read more about the new approach to third-party liability.

Empowering Plans: P40 - Reference Based Pricing - Yeah, You Know Me

On May 17, 2018
In this episode, The Phia Group chats once again with one of their Partners in Empowerment, Gregory S. Everett, President and CEO of Payer Compass. Greg addresses all of our hosts’ questions regarding reference based pricing, balance billing, the value of physician networks, and the future of RBP.

MHP – Are You Still Paying Attention?

On May 16, 2018
Lawsuits and Department of Labor audits related to Mental Health Parity violations are still arising. Read more about the recent Munnelly v Fordham case!

The Case for Collusion: How the Power Players May Have Defrauded Us All

On May 15, 2018
At long last, after a lengthy investigation, we are ready to present the allegations of collusion. It is alleged that powerful forces have been working together in a complex scheme to mislead us. To be clear, we are talking about Big Pharma and certain PBMs. A new class action lawsuit has been filed against CVS Health alleging that it knowingly colluded with PBMs to raise generic drug prices. The claim is that health plans and consumers alike have been overpaying for drugs. We have seen this playbook before. This time, however, there is potential for TPAs and their groups to join the lawsuit to recoup funds allegedly overpaid to CVS. Join The Phia Group’s Special Counsels for an hour as they share reports on this alleged fraudulent scheme and discuss the ways in which our industry can fight back and tackle the underlying problem of specialty drug prices.

One Shot at This

On May 14, 2018
When writing plan documents, make sure to get it right the first time before handing to clients. Click here for everything I have learned & my story.

The Gap Doesn't Stop At the Document

On May 9, 2018
There are many types of gaps within coverage including plan documents & network agreements. Click here to learn about all the gaps you should be aware of.

Empowering Plans: P39 - Everything's Bigger In Texas!

On May 7, 2018
In this episode, our hosts interview Third Party Administrator, visionary, and industry expert – Caprock Healthplans’ own Executive Vice President, John Farnsley – as we review some of his recent talking points, cover where he thinks the industry is headed, and dissect the biggest issues he thinks will impact everyone involved.

The Complications Surrounding Intermittent FMLA Leave

On May 7, 2018
There are many complications dealing with Intermittent FMLA Leave. Click here to learn everything you need to ensure to administer this properly.

North Cypress Medical Center: What Does it Mean for RBP?

On May 2, 2018
Reference-based pricing has a lot of hurdles for businesses and legality. Read here about the recent court case regarding patient pricing.