Phia Group

Price Transparency: A Chief Concern at SIIA’s Recent Kanas City Forum

On March 9, 2023
KANSAS CITY, MISSOURI – In the opening presentation of the SIIA Price Transparency Forum held at the Kanas City Marriott Downtown last month, SIIA’s Senior Vice President of Government Relations, Ryan Work, made a bold prediction: if healthcare costs remain on this decades-long rising trajectory it could lead to the demise of employer-based healthcare as we know it.

Hospital Prices: Fully Transparent or Still Somewhat Opaque?

On February 23, 2023
In the throes of the first pandemic winter, still months before coronavirus vaccines would roll out in earnest, the Hospital Price Transparency Rule went into effect. It was a promising development in the world of healthcare cost containment—hospitals were now obligated to provide a single, machine-readable digital file containing standard charges for all services and items provided by the facility.

SPD Payment Limitations Under the No Surprises Act

On February 9, 2023
Ah, the Plan Document! It’s the “supreme law of the land” governing the health plan’s benefits. Would that make ERISA the Declaration of Independence of self-funding, maybe? Freedom from the tyranny of state or federal laws that attempt to make their own rules for the plan rather than letting the plan govern itself?

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!

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 NBA Health Care Scandal

On October 28, 2021
Learn more about health care fraud in sports leagues, the recent NBA health care scandal and what health care plans can do to prevent fraudulent behavior.

No Surprises Act & “Plan Websites”

On March 19, 2021
We received a great question about whether plans must host the provider list and directory on their website or can simply link to it. Read to 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.

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.

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.

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.

Patients are Increasingly Being Sent to Collections and Finding Themselves In Court – Sued by the Providers That Swore to Protect Them

On September 20, 2019
Court clerks in various geographic regions witnessed an undeniable uptick in the number of lawsuits being filed by hospitals and providers against patients.

Everything I Ever Needed to Learn, I learned in Pre-School!

On June 26, 2019
As the saying goes, many of the basic skills we need to be effective in life are taught to us early. “Use your words” – a common instruction given to young children who are struggling to express themselves or communicate effectively, is an instruction I still use daily – albeit with a slight adjustment. Especially with matters relating to plan administration, words alone aren’t enough! it’s important to use the correct words to avoid any confusion and ensure that everyone reading the plan understands exactly what you mean!

No No-fault – Michigan Revamps its Auto Insurance Rules

On June 19, 2019
Michigan's Senate passed sweeping legislation to get the state's auto insurance rates under control. Learn more about this new law and how it can impact you.