The Phia Group Blog

Welcome to The Phia Group Blog, your source for cutting-edge insights into health plans, cost containment, and industry regulations updates. We break down top stories and trends, share actionable strategies, and provide expert perspectives to help you stay ahead.

By: Chris Aguiar, Esq. Subrogation added another case to the win column last week when the 5th Circuit ruled in favor of a benefit plan’s reimbursement rights even though the Plan only had an SPD, and that SPD referenced another,…

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By: Kelly Dempsey, Esq. It’s clear the rules of the Health Care Reform game we’ve been playing for the last seven years are going to be changing.  If you’ve been living under a rock and haven’t heard about the ongoing…

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Bite the Hand

May 30, 2017

By: Ron Peck, Esq. In case you missed it, there is a movement afoot.  It’s found some real purchase in California, but you hear rumblings everywhere.  A call for a single payer system.  Medicare for all.  I’m going to avoid…

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It’s Never Too Soon

May 22, 2017

By: Jen McCormick, Esq. Although the regulations may change, it’s important to begin thinking about plan changes for the upcoming plan year.  The specifics for compliance requirements may still be unclear, employers should already be in process of contemplating cost…

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By: Jon Jablon, Esq. Author’s Note: Written in ballad meter, this can be sung to the tune of “Gilligan’s Island.” You carriers are sometimes great, all flexible and fair;     But sometimes you issue denials That make me lose my…

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…is what a nice lady asked me when we were discussing the charges her office submitted for drug addiction treatments. You see, this office billed $3,800.00 per day for inpatient detox, and separately, under a different corporate name (but same…

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