The Phia Group's Podcast

The Phia Group's Podcast

By The Phia GroupNews
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The Phia Group's Podcast episodes

  • Episode 252: Empowering Plans: P213 – Error 304: Good Faith Negotiation Not Found

    Artificial intelligence may be changing the trajectory of the self-funded industry – but can it negotiate? In this episode of The Phia Group’s Empowering Plans podcast, attorneys Brian O’Hara and Jon Jablon break down real-life examples of AI-driven responses in the No Surprises Act’s Open Negotiations process that range from nonsensical to outright misleading, where negotiating with AI is like trying to haggle with a toaster. From missing claim numbers to automated counteroffers that make no sense, Brian and Jon discuss whether AI is making negotiations easier, or defeating the purpose of the statutory process to begin with. Tune in for an honest discussion of the pitfalls of AI in No Surprises Act negotiations.

    24 min
  • Episode 250: Empowering Plans: P211 – Network Adequacy Under MHPAEA

    Attorneys Kelly Dempsey and Bryan Dunton dive into the results of the 2024 MHPAEA Report to Congress. The EBSA and CMS have continued to improve their focus on network design and adequacy for group health plans. In this episode, Kelly and Bryan discuss how these parity problems manifest themselves in testing and what plans can do to resolve them. 

    20 min
  • Episode 249: Empowering Plans: P210 – Mental Health Parity: New Year, New Rules, New Lawsuits

    Attorneys Jen McCormick and Nick Bonds ring in the Lunar New Year by breaking down the ERIC v. HHS lawsuit in which an industry advocate challenged the federal regulators’ new Final Rules enforcing the MHPAEA and mental health parity rules. Could this case blaze a new path for challenging agency actions in a post-Chevron Doctrine world? Join us as we discuss the potential implications for group health plans.

    15 min
  • Episode 248: Empowering Plans: P209 – 2025 Healthcare Hot Takes

    It’s a new year, and a new type of Empowering Plans podcast! In a world full of talking heads and 2-minute news cycles, hot takes have become the norm. This is true from mainstream news media to sports talk radio. Ron Peck and Corey Crigger throw their hat in the hot take ring by speculating on what some of the biggest news stories could be in 2025. From AI to RFK Jr, join Ron and Corey as they gaze into the crystal ball and make their bold predictions of what we will be talking about all year.

    31 min
  • Episode 245: Empowering Plans: P206 – Non-Preferred Carrier Fees: Incentives or Control?

    In this episode of the Empowering Plans podcast, attorneys Jon Jablon and Brady Bizarro delve into the details of a recent lawsuit where BCBS of Michigan, in its capacity as a TPA, is alleged to have engaged in anticompetitive practices for charging a fee to a group that chose a stop-loss carrier other than BCBS. This case is in its infancy as of December 2024, but we expect it to have noticeable effects on the stop-loss marketplace regardless of outcome. In this episode, Jon and Brady discuss those potential effects and how a holding either way could impact self-funding as a whole.

    18 min

About The Phia Group's Podcast

From the publisher's feed

The Phia Group, LLC is an experienced provider of health care cost containment techniques offering comprehensive consulting services, legal expertise, plan document drafting, subrogation and…

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