Keep Hands, Arms, Legs, and Feet Inside the Ride at All Times and Remain Seated Until the Ride Comes to a Complete Stop

By: Kelly Dempsey, Esq. The last 7 years have been a wild ride and it’s not quite over yet.  As noted in many other posts and articles, the rules will be changing under the new administration and in recent weeks we’ve seen a clearer picture of how the rules will be changing, but there
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Health Insurance is NOT Health Care

By: Ron E Peck, Esq. The Congressional Budget Office (CBO) has provided its assessment of the American Health Care Act, and already Congressional would-be supporters of the law are jumping ship. The CBO’s analysis resulted in what is being called a “devastating blow” to the proposed l
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If I Can Change, So Can The Average American

By: Garrick Hunt I recently celebrated my two year anniversary at The Phia Group; an organization that two years ago I didn’t know existed. In my time here, I have learned a great deal about an industry, which should matter to every American, but often is filed away the likes of cell
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ACA to AHCA… A Look Back on the Past 7 Years

By: Jen McCormick, Esq. Last Monday, the House Republicans finally had their chance to offer their version of a health care bill.  The American Health Care Act, or AHCA, noted as the repeal and replace measure of the current version of the Affordable Care Act, or ACA, actually seems t
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The Cost-Containment Carve-Out Compliance Conundrum

By: Jon Jablon, Esq. There is an interesting phenomenon happening in the self-funded industry today. Because medical costs are so exorbitant and arbitrary, many health plans have elected to use “carve-outs,” which are provisions in a plan document or an amendment which specify that a
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Employer-sponsored Plans Should Prepare to be Taxed

By: Brady Bizarro, Esq. The latest news in the repeal and replace saga is that congressional Republicans are pushing to get a bill to the Senate by the end of this month. The ambitious timeline means that lawmakers and independent analysts will have very little time to review the comp
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It will be my pleasure to balance bill the patient $1.3 Million…

By: Jason Davis …Is what a Hospital VP of Accounts Receivable said to me when I called to discuss a reference-based pricing (RBP) claim that was referred to The Phia Group for handling.  Upon review, the health plan had issued a reasonable percentage above Medicare on a large claim, a
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