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Mental Health Parity and Addiction Equity Act Explained
Understanding Non-Quantitative Treatment Limitations (NQTLs)
The Insulin Cap Bill Offers Hope for Americans With Diabetes
In-Network vs Out-of-Network Claims
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The No Surprises Act Explained
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Phia Group
Phia Group Media
Tariff Talk - How Trump’s Pharmaceutical Tariffs Could Impact You (and How You Can Prepare)
On April 11, 2025
As the self-insurance industry braces for potential changes under President Trump’s administration, one issue looms large: impending tariffs on pharmaceutical drugs. These proposed tariffs, aimed at boosting domestic manufacturing, could ripple through the healthcare ecosystem, affecting employers sponsoring self-funded health plans, third-party administrators (TPAs), stop-loss carriers, brokers, and vendors. For an industry built on balancing cost control with quality care, understanding these impacts and preparing strategically is critical. More importantly, as we navigate these changes, we must remain steadfast in our commitment to ensuring that our members get access to quality, affordable prescription drugs.
Care Empowered Pricing as a Money Saver
On April 10, 2025
For over a quarter century, The Phia Group has championed a broad spectrum of cost containment initiatives to empower health plans and ultimately, their respective participants. The Phia Group believes that its latest endeavor—Care Empowered Pricing (CEP)—may be its most robust cost containment program yet. At its core, CEP is engineered to, quite simply, save plans money and as you can see below, there are a number of ways our revolutionary offering does so.
Journavx | A New Non-Opioid Solution for Pain Management
On February 11, 2025
Learn about Journavx, a groundbreaking non-opioid analgesic designed to treat acute pain, & its implications for patients seeking safer pain management options.
Health Disparities in Appalachia After Hurricane Helene
On December 2, 2024
Explore the widening health disparities in Appalachia following Hurricane Helene, highlighting the challenges faced by residents and healthcare facilities.
Having NSA Problems? Better Call The Phia Group
On October 31, 2024
The Independent Dispute Resolution (“IDR”) process was designed to be a cornerstone of the No Surprises Act (“NSA”), a means for resolving claims for payment for out-of-network items and services and a vital mechanism for buttressing the NSA’s protection for plan members against potentially devastating balance billing expenses. Unfortunately, since the NSA took effect on January 1, 2022, things have gone awry on many fronts.
2024 Benefest: Not Just Massachusetts in Focus
On June 14, 2024
Earlier this month, 2024 Benefest, hosted by the Massachusetts Chapter of the National Association of Benefits and Insurance Professionals (NABIP), took place at the DoubleTree by Hilton Hotel Boston-Westborough. While the conference largely focused on the Massachusetts healthcare ecosystem – panel discussions of which reached the general consensus that, from an affordability and access perspective, these are incredibly challenging times due to unprecedented staffing shortages reducing providers’ daily bandwidth – there was considerable time spent examining federal healthcare developments, including how November’s election will impact employer-sponsored benefit plans.
The Stewardship of Hospitals
On May 16, 2024
Hospitals, ambulatory surgery centers, long-term care facilities, primary care physician practices, nursing homes, hospice care. They are the most indispensable institutions of any functioning society, but unlike a Fortune 500 company or professional sports franchise, the identity of their respective owners often remains an afterthought. That is, unless you work for or are served by a financially distressed health care system, such as for example Steward Health Care, the massive private-for-profit healthcare conglomerate that recently filed for Chapter 11 bankruptcy protection.
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 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.
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.
Being Mindful of Telemedicine Access
On November 9, 2023
From a healthcare standpoint, two of the most significant byproducts of the COVID-19 pandemic have been the exploding popularity of Telemedicine, the practice of providing medical and mental health services remotely, and a heightened awareness of many Americans’ longstanding mental health issues. Due to a confluence of prolonged extenuating circumstances, it became readily apparent to healthcare providers, politicians, social workers, employers, teachers, and parents on both sides of the Mississippi that a.) the inimitable convenience of virtual healthcare does not compromise quality (at least for some patients and practitioners) and b.) many Americans experiencing emotional distress have long been suffering in silence.
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