The Phia Group Blog

By: David Ostrowsky 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…

By: Ron Peck, Esq. I recently drafted an article regarding legislative proposals to “cap” patient out of pocket costs for insulin.  In it, I explained that – while the individual patient’s out of pocket cost may be reduced at the…

By: David Ostrowsky January 1, 2021. 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…

  Patients frequently hear the terms “In-Network” and “Out-of-Network” with respect to their healthcare providers and treatment options, but what do these terms actually mean, and what are the key differences between the two?   Generally speaking, healthcare providers –…

By: Jen McCormick, Esq. Crucial healthcare and employee benefits issues were addressed during President Biden’s recent State of the Union, including a commitment to expanding paid family and medical leave. Thirty years ago, the Family and Medical Leave Act (FMLA)…

By: Jon Jablon, Esq. 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…