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The Phia Group's Podcast
The Phia Group
100 episodes
2 days ago
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. 
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All content for The Phia Group's Podcast is the property of The Phia Group and is served directly from their servers with no modification, redirects, or rehosting. The podcast is not affiliated with or endorsed by Podjoint in any way.
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. 
Show more...
News
Episodes (20/100)
The Phia Group's Podcast
Episode 269: Empowering Plans: P230 – What Happens When Subrogation and the NSA Collide?
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.
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2 days ago
16 minutes

The Phia Group's Podcast
Episode 268: Empowering Plans: P229 – From Free to Fee: The New Rules for COVID Vaccines and Testing"
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.
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1 month ago
20 minutes

The Phia Group's Podcast
Episode 267: Empowering Plans: P228 – Prior Authorization – The Promise and the Peril
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.
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1 month ago
29 minutes

The Phia Group's Podcast
Episode 266: Empowering Plans: P227 – Method to the Badness
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!
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1 month ago
23 minutes

The Phia Group's Podcast
Episode 265: Empowering Plans: P226 – RBP Meets NSA: Clearing Up the Confusion
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.
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2 months ago
23 minutes

The Phia Group's Podcast
Episode 264: Empowering Plans: P225 – Adverse Claims & Prior Authorizations: Big Changes Ahead
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.
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2 months ago
16 minutes

The Phia Group's Podcast
Episode 263: Empowering Plans: P224 – CMS Spotlight: Cleaning Up Provider Data and Fixing IDR Errors
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?
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3 months ago
21 minutes

The Phia Group's Podcast
Episode 262: Empowering Plans: P223 – Telemedicine, DPCs, and the Future of HSA-Compatible Plans under The One, Big, Beautiful Bill
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.
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3 months ago
17 minutes

The Phia Group's Podcast
Episode 261: Empowering Plans: P222 – SCOTUS Shockwaves: Analysis of June Decisions for Self-Funded Plans
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.
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4 months ago
21 minutes

The Phia Group's Podcast
Episode 260: Empowering Plans: P221 – Saying What You’re Thinking
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.
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4 months ago
26 minutes

The Phia Group's Podcast
Episode 259: Empowering Plans: P220 – Algorithms and Adjudication: How AI Is Affecting the Self-Funded Industry
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!
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5 months ago
22 minutes

The Phia Group's Podcast
Episode 258: Empowering Plans: P219 – Executive Orders, Tariffs, and a Crystal Ball
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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5 months ago
24 minutes

The Phia Group's Podcast
Episode 257: Empowering Plans: P218 – Unreasonable Plan Fees on Trial: Cunningham v. Cornell University
In this episode, we unpack the Supreme Court’s unanimous decision in Cunningham v. Cornell University — a landmark ERISA case with major implications for retirement and health plan fiduciaries. We explain the facts behind the case, what “prohibited transactions” really mean, and why the Court's ruling on affirmative defenses matters. If your health plan pays fees to TPAs, PBMs, IDR vendors, or brokers, this episode is for you.
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6 months ago
15 minutes

The Phia Group's Podcast
Episode 256: Empowering Plans: P217 – The Most Exciting Two Minutes in Cost Containment
The Run for the Roses is here! Join two of Phia’s Louisville, Kentucky, employees, Corey Crigger and Cindy Merrell, as they discuss the event that takes over their city once a year! Coming on the heels of a historic weather event, Corey and Cindy discuss all things Derby. From Cindy’s experience at Dawn at the Downs to predictions for winners, this podcast has it all. Don’t be fooled, this podcast isn’t just about horse racing. Corey and Cindy also discuss pitfalls of AI use in the legal world. Can attorneys depend on AI for their legal research? Meanwhile, which horse has the best chance to win the Derby? Can Corey hit the trifecta for the second year in a row? Tune in to the Empowering Plans Podcast for these answers and many more!
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6 months ago
28 minutes

The Phia Group's Podcast
Episode 255: Empowering Plans: P216 – Why 2025 is the Year to Go Self-Funded
Our consulting team has received numerous questions in Q1 2025 about employers considering self-funding their health plans. Join Attorneys Jennifer McCormick and Kelly Dempsey as they go through what the driving factors are behind employers considering self-funding, the pros and cons of self-funding, and some of the major differences employers will encounter. If you’re considering taking the leap, take a listen first!
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6 months ago
18 minutes

The Phia Group's Podcast
Episode 254: Empowering Plans: P215 – Plan Sponsor Discretion Advised
ERISA gives plan sponsors great power and great responsibility. On this week’s podcast, attorneys Ron Peck and Nick Bonds get back to ERISA fundamentals to talk about how to really embrace fiduciary status and properly exercise discretionary authority.
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7 months ago
33 minutes

The Phia Group's Podcast
Episode 253: Empowering Plans: P214 – Unpacking Weight Loss Drugs
On this episode of the Empowering Plans podcast, attorneys Corey Crigger and Kendall Jackson discuss the hot button topic of weight loss drugs. Tune in to learn more about the latest advances in this space and the various coverage and exclusion options plans may pursue. 
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7 months ago
27 minutes

The Phia Group's Podcast
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.
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7 months ago
23 minutes

The Phia Group's Podcast
Episode 251: Empowering Plans: P212 – Lewandowski v. Johnson & Johnson – Big win or warning?
On this episode of the Empowering Plans Podcast, attorneys Brady Bizzaro and Cindy Merrell delve into the details of the Lewandowski v. Johnson & Johnson case. Is this case a big win for plan fiduciaries or a warning?
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8 months ago
15 minutes

The Phia Group's Podcast
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. 
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8 months ago
19 minutes

The Phia Group's Podcast
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.