Phia Group Media


Phia Group Media

Dialysis Carve-Outs and Network Contracts: Like Oil and Water

On September 30, 2021
It’s renewal season once again, and you know what that means: time for health plans to make decisions about vendors, pay ment models, and other things that help contain costs while maintaining robust benefits! One important choice that plans need to make is about dialysis. Specifically, when the plan uses a PPO network to price and pay claims, what does that mean for dialysis claims, which are of course some of the most expensive and marked-up claims of them all?

A Failure to Communicate

On August 13, 2021
What is insurance? Why are there problems with health insurance in the U.S.? Read about the healthcare system and insurance through the lense of COVID-19.

Canadian Drug Importation – Back on Track (but not for everyone)

On July 19, 2021
The Biden administration is likely to uphold a Trump administration executive order to approve certain legal foreign drug importation programs. Learn more.

MHPAEA Compliance: The Dreaded NQTL Analysis

On June 1, 2021
The MHPAEA now requires NQTL analyses: need help understanding the policy or analysis guidelines? Contact The Phia Group today.

I Hate Surprises!

On December 22, 2020
The "No Surprises Act" is a proposed law that relates to "surprise" balance health insurance bills. Click to learn all about what it is and what it isn't.

The U&C Gap Keeps Rearing Its Ugly Head

On December 8, 2020
What constitutes U&C? Find out more about U&C language gaps between a plan and a stop-loss carrier, with easy-to-follow examples. Learn more now!

Drug Pricing Still on the Ballot in 2020

On September 24, 2020
The cost of prescription drugs continues to be a source of financial pain for households, making drug pricing reform a critical election topic. Learn more.

New Rules on Prescription Drug Importation Are Released – Or Are They?

On August 11, 2020
On July 4, 2020, an "Executive Order on Increasing Drug Importation to Lower Prices for American Patients" was issued. Is this a real step forward? Read on.

Empowering Plans: P85 - Catching up with the Courts

On July 10, 2020
Check out Phia Group's latest discussion about recent high-profile court cases that could shape our industry: from requiring hospitals to post their negotiated rates with insurers online to the Trump administration's latest action in the Supreme Court case.

WC Recovery in a Post COVID World!

On May 6, 2020
It requires a little more nuanced thinking to find an answer to whether people can file workers' compensation claims if they fall ill during the pandemic. Learn more.

Bouncing Through Quarantine

On May 4, 2020
While most of the country is still maintaining social distancing order, it is very important to keep our personal well-being in mind. Learn more.

The Difference – Healthcare vs. Insurance; Never Clearer

On March 16, 2020
Health insurance isn't healthcare; it’s one way we pay for healthcare. Learn how the COVID-19 pandemic has made this distinction even clearer.

New Insight on Provider Surprise Billing

On February 17, 2020
Many states have enacted protections against balance billing and surprise billing, however, these state laws have limited applicability. Learn more.

A Simple Mistake with Big Consequences: Is Your HDHP Actually HSA-Qualified?

On February 5, 2020
An HDHP must meet certain criteria to allow individuals enrolled to contribute to Health Savings Accounts (HSA). Learn about the specific criteria.

I Got a Fever, and the Only Prescription is More Transparency

On January 23, 2020
A key part of the Administration's strategy to reduce health care costs involves increasing transparency in the healthcare industry. Learn More.