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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 overpayment recovery, claim negotiation, and plan defense designed to control costs and protect plan assets.
275 Episodes
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On this episode of the Empowering Plans podcast, attorney Ron Peck engages in a one-on-one discussion with YOU, regarding two of the “hottest” topics being discussed on the road. Don’t be left out; tune in now!
On today’s episode of the Empowering Plans podcast, attorneys Jon Jablon and Kendall Jackson discuss the current state of the No Surprises Act (NSA) and the Independent Dispute Resolution (IDR) process. From difficulties managing dispute volume to current litigation and legislative proposals, this episode provides key insight into changes to and challenges with the IDR process.
In this installment of The Phia Group’s “Empowering Plans” podcast, attorneys Bryan Dunton and Cindy Merrell discuss what happens when laws evolve faster than contracts, and how many compliance failures live in old documents. This episode breaks down how legacy contract language creates modern risk under HIPAA Part 2 and emerging PBM transparency reforms, particularly where downstream data sharing and compensation disclosures are involved. Brokers, TPAs, and plan fiduciaries will want to tune in and find out how these changes will impact their groups.
In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Brian O’Hara share the latest information TPAs and employer plan sponsors need to know about the No Surprises Act. The discussion focuses on recent federal guidance, updated arbitration data, key court decisions affecting NSA enforcement, and practical takeaways for managing provider billing disputes and controlling plan exposure in 2026.
Tobacco surcharges have long been a common cost containment wellness tool for self-funded plans, but recent lawsuits are putting them under the microscope. In this episode, attorneys Kelly Dempsey and Naga Vivekanandan break down how tobacco surcharges work, why they are treated differently under federal law, and what recent court decisions mean for employers navigating wellness program risk.
In this episode, Phia Group legends – CLO Ron Peck and EVP Jen McCormick – dive deep into waters rarely discussed. They contemplate how the rising costs of healthcare impact employers and their employees in areas outside of healthcare – from hiring to counting steps. Join them as they share insight into this, and how to get employees and their families to embrace healthcare literacy, and positively impact aspects of their lives beyond “just healthcare.”
This week on the Empowering Plans podcast, attorneys Corey Crigger and Nick Bonds dig into the growing movement to use psychedelics in treating mental health and substance use disorders. As states ramp up research and regulation, they unpack what’s driving this shift — and what health plans should watch for in a changing compliance landscape.
In the latest installment of The Phia Group’s “Empowering Plans” podcast, attorneys Kendall Jackson and Jon Jablon explore Essential Health Benefits – an important facet of self-funded health plans that seems straightforward, but has garnered a great deal of confusion and misconception through the years. This episode touches on the significance of state benchmark plans, the difference between EHBs and state-mandated benefits, application of EHBs to the maximum out-of-pocket limit, and more.
Join attorneys Bryan Dunton and Cindy Merrell as they discuss what happens when the No Surprises Act collides with subrogation. They explore the practical implications of the legislation, including how it intersects with common recovery models like “pay and chase” and “pend and pay.” This conversation offers valuable insights into how the Act may affect your approach to healthcare claims and reimbursement strategies.
The rules around COVID coverage are entering a new phase. attorneys Kelly Dempsey and Naga Vivekanandan as they explore how recent ACIP guidance narrows preventive coverage for COVID vaccines and what it means for both PPO and HDHP plans. They also dig into the gray areas employers face when updating plan documents and how participants may see their costs shift.
Attorneys Jon Jablon and Nick Bonds break down some of the issues around administering prior authorization requirements, including their use as a cost-containment tool, the procedural aspects, perceptions, and the impact that can have on plan participants. They also discuss some of the regulatory guardrails being put around prior authorizations at the state and federal levels, and some of the key questions for plan sponsors to consider when designing and implementing prior authorization requirements.
Join the dynamic duo of Ron Peck and Corey Crigger as they discuss the surge of equity investment into “sin” services – such as gambling and adult entertainment – and how this is likely only one part of a bigger strategy… A strategy that ties into the same investors’ recent backing of health care providers treating conditions caused, triggered, or exacerbated by the same behaviors. Conspiracy theory or incredible insight? You decide!
In the latest episode of the Empowering Plans podcast, attorneys Jon Jablon and Kendall Jackson discuss common misconceptions surrounding RBP plans and the NSA. From protections against balance billing to the Independent Dispute Resolution process, we are covering all of the areas of the NSA that you need to consider for an RBP plan.
On the latest and greatest episode of the Empowering Plans podcast series, attorneys Bryan Dunton and Cindy Merrell discuss news that matters to you: how recent headlines signal sweeping changes to adverse claims determinations and prior authorization practices.
In this episode, we take a closer look at two key developments out of CMS that could reshape how provider data and dispute resolution work in practice. First, we explore the agency’s proposed National Provider Directory — an ambitious effort to clean up fragmented provider data and reduce ghost networks. Then, we break down insights from the July 2025 CMS Technical Assistance Seminar, which tackled the growing problem of errors in the Federal Independent Dispute Resolution (IDR) process — from procedural missteps to jurisdictional mistakes and default determinations on ineligible claims. What’s CMS doing to fix the system — and what gaps are still leaving plans vulnerable?
Today, attorneys Kelly Dempsey and Naga Vivekanandan dive into the latest landmark healthcare-related legislation, nicknamed “The One, Big, Beautiful Bill," and how it will reshape High-Deductible Health Plans (HDHPs), telemedicine, and Direct Primary Care (DPC) arrangements. They explore the IRS rules, what's changed, and what it means for employers, employees, and plan administrators.
In this episode of Phia’s Empowering Plans Podcast, attorneys Nicholas Bonds, Esq. and Bryan M. Dunton, Esq., break down the key Supreme Court rulings issued in June 2025 that have direct implications for self-funded group health plans and their fiduciaries. From decisions impacting coverage mandates, nationwide injunctions, and gender-affirming care, Nick and Bryan explore how these opinions reshape the regulatory landscape and discuss practical takeaways for plan administrators and TPAs. Whether you’re updating plan language or keeping an eye out for compliance risks, this is an episode you can’t afford to skip.
Join The Phia Group’s Corey Crigger and Ron Peck as they discuss some of the things many in our industry seem to be thinking, but are often afraid to say aloud. Does being a good fiduciary mean being a bad guy? Tune in and find out.
On the latest installment of the Empowering Plans podcast series, join attorneys Jon Jablon and Kendall Jackson as they discuss the integration of AI into the self-funded industry. From HIPAA considerations to current case law, this episode explores the impact of AI on health plans and TPAs thus far. It is an episode you can’t afford to miss!
Join attorneys Bryan Dunton and Cindy Merrell as they explore President Trump’s latest moves to address the rising cost of prescription drugs. Cindy and Bryan discuss potential impacts of recent Executive Orders and proposed tariffs.
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