Health Insurance Industry Issues and Legislation

A five-day inpatient cardiac stay left both the group and stop-loss carrier facing more than $112,000 in PPO-priced liability — until H.H.C. Group stepped in. Through expert clinical review and fair, data-driven negotiation, H.H.C. Group secured a 47% reduction beyond PPO discounts, delivering more than $52,000 in combined savings. This case showcases how Real People deliver Real Savings for every stakeholder involved.

Results:

Billed Amount: $131,888.25
PPO Discounted Amount: $112,195.18
HHC Negotiated Payment: $59,349.71
Group Savings: $42,692.71
Stop-Loss Carrier Savings: $10,152.00
Total Savings: $52,845.47
Percent Saved vs PPO Allowed: 47.1%

Real People. Real Savings.

Trusted relationships and clinical expertise deliver measurable results. Contact H.H.C. Group today to see how our negotiators turn high-dollar claims into real savings.

December's claim surge creates short deadlines, inflated charges and limited access to provider decision makers — a combination that leads many payors to miss savings when they need them most.

H.H.C. Group's Real People deliver fast turnarounds, expert negotiation and clinically grounded review to capture discounts before the year closes.

When other vendors slow down, H.H.C. Group speeds up to protect your plan from costly year-end exposure.

In the latest episode of The Granite List.Live, H.H.C. Group's Bruce Roffé and Bob Serber break down the real strategies payors need to control escalating medical claim costs without compromising care.

They discuss attorney-led negotiations, defensible Independent Reviews and reference-based pricing — and how "real people" deliver deeper, more reliable savings than automation alone.

A must-listen for brokers, TPAs and employers navigating today's high-cost landscape.

A new bill, the ERISA Litigation Reform Act, aims to curb frivolous lawsuits and create clearer, more predictable legal standards for fiduciaries. With ERISA-related settlements topping $353 million in 2023, regulatory clarity is becoming essential — especially for employers, brokers and TPAs responsible for defending every plan decision.

As fiduciary scrutiny intensifies, H.H.C. Group helps protect payors with defensible clinical and financial reviews, precise negotiation strategies and documentation that stands up under audit and litigation pressure.

Protect your plan decisions with expert, defensible support. Contact H.H.C. Group today.