Phia Group

rss

Phia Group Media


Are Non-Competes Out the Window?

On February 2, 2023
Not just yet. Recently, the Federal Trade Commission (FTC) proposed a new rule that would ban post-employment non-competition agreements for all workers, including independent contractors, in nearly all workplaces. The proposed rule falls under Section 5 of the Federal Trade Commission Act, which bans unfair methods of competition. This proposed rule would greatly impact the entire healthcare industry.

No Matter the Remedy – No Language, No Luck!

On January 23, 2023
Recently, the 9th Circuit, a jurisdiction that has historically not been kind to benefit plans engaging in third party recovery activity, issued a decision that gives life to benefit plans whose participants shirk their obligations to reimburse their benefit plans from settlements they obtain in third-party liability cases.

Accommodating Pregnant Workers: Enhanced Protections Under New Legislation

On January 18, 2023
On December 29, 2022, President Biden signed the Consolidated Appropriations Act of 2023 (CAA 2023). Among many, many other things, the CAA included a key law expanding protections for pregnant workers. This law addresses significant limitations in the current regulatory framework for these workers, particularly under the Americans with Disabilities Act (ADA) which does not consider pregnancy a covered disability, and the Pregnancy Discrimination Act (PDA) which does not require accommodation (beyond those afforded to other similarly situated employees).

How the Adderall Shortage is Affecting Millions of Americans

On December 13, 2022
Across the country, Americans with attention-deficit hyperactivity disorder (ADHD) are struggling to find good alternatives to the highly popular stimulant Adderall, which has been in short supply in recent months and will likely not be sufficiently restocked until early 2023 due to skyrocketing demand and manufacturing delays. Because of the shortage, many patients and their families have been forced to try alternative treatments or to go without their medication altogether. This has led to frustration and concern among patients and advocates alike, who argue that the shortage is putting the health and well-being of those who rely on Adderall at risk.

NSA’s Model Notice: Doing Your Own Thing

On November 14, 2022
It’s November, and most TPAs are neck-deep in No Surprises Act compliance. This is a busy time of year as it is – but with new, daunting requirements piled onto a TPA’s usual renewal-time craziness, this is a special year. Some have opined that the last time they had a year like this was when the ACA was first passed, and that’s saying something!

The Fair Labor Standards Act (FLSA): Who Benefits and Who Doesn’t

On November 4, 2022
It’s hard to fathom today, but less than a century ago, America was a country in which elementary-school-aged children were accustomed to laboring in coalmines, glass factories, and shipyards; an untold number of employees earned less than $1 per day; a typical workweek consisted of six 12-hour shifts. Such was life for tens of millions of Americans barely scraping by during the depths of the Great Depression before FDR implemented his landmark New Deal, which, among other initiatives, provided workers greater protection with the passage of the Fair Labor Standards Act (FLSA).

Fourth Circuit Extends ADA Protection to Americans Suffering from Gender Dysphoria

On October 4, 2022
This August, the Fourth Circuit Court of Appeals in Williams v. Kincaid extended ADA protections to those suffering from gender dysphoria. The case related to the treatment of plaintiff Kesha Williams, a transgendered woman, while housed in a Virginia prison, but the holding has important implications in the workplace context.

More Twists to the IDR Process in the No Surprises Act?

On August 25, 2022
The latest final rule on the No Surprises Act has finally been released by the U.S. Departments of Health and Human Services, Labor, and Treasury. There are some important clarifications made in this latest rule, including confirmation that the Qualifying Payment Amount (QPA) is no longer the presumptive out-of-network rate.

Marietta Memorial Hospital Employee Health Benefit Plan v DaVita Inc. - Dialysis Carve-Out

On August 2, 2022
In one of last month’s momentous Supreme Court cases, Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., the justices confronted the legal question of whether the health plan covering employees of a small Ohio hospital contained a dialysis carve-out discriminating against participants with end-stage renal dialysis (ESRD). The Court, in a 7-2 decision, ruled that there was no such discrimination because the dialysis carve-out neutrally applied to all outpatient dialysis claims, not just those involving ESRD, and thus did not violate the Medicare Secondary Payer Act (MSP). While the Court’s ruling in favor of Marietta Memorial Hospital was surely a major victory for health plans implementing dialysis carve-outs, as well as plan sponsors, the contextual background to this case speaks to some critical underlying issues in the healthcare industry.

The Forum Redux

On July 21, 2022
After a three-year hiatus, The Phia Forum resumed on July 11th, exclusively geared toward Independent Consultation and Evaluation (“ICE”) clients, many of whom have been using Phia’s health care cost containment services for over two decades. During the two days of events, the first of which occurred at The Phia Group’s new office in Canton, Massachusetts, “ICE” clients enjoyed seminars highlighting enhancements to current services while learning how new developments in healthcare—and American legal landscape— will impact their businesses.

Transparency in Coverage Compliance? | The Phia Group

On June 16, 2022
It’s Almost July 1st – Are You Ready for Transparency in Coverage Compliance?

A Love Letter to Plaintiffs’ Attorneys Everywhere

On June 7, 2022
You know, in the modern information and technological age it is rather easy to forget that we are not in Kansas, anymore, i.e. the 1990s; anything you say or do on the internet can be accessed by the masses, can and will be used against you, and it will never go away. On the same token, it is important to understand the intended audience and perspective of the speaker and even perhaps get to know the person before you judge them based on what I, personally, would consider a (negligent, at worst) throw away phrase.

The Baby Formula Shortage and Preventive Care

On May 31, 2022
The baby formula shortage in the United States has been worsening for months. Our country’s supply was already squeezed by a perfect storm of pandemic-related supply chain issues and inflation costs. Then, with the detection of dangerous bacteria leading to the sickening and death of several infants, Abbott Nutrition shut down its Michigan plant in February – a plant that formerly supplied nearly one-fifth of all the baby formula in the country.

Limits of Arbitration Provisions on Participant ERISA Claims

On May 9, 2022
A recent sixth circuit decision shows limits of arbitration provisions on participant ERISA claims. Read our blog to find out the latest actions taken.

The Mess in the American Healthcare System | The Phia Group

On April 25, 2022
Do you have someone to relate to when it comes with the health care system? This blog discusses some of the hardships people go though with healthcare.