Month: October 2025

Are PPO’s the Problem? Here’s What They Don’t Want You to Know. (Ep. 32)

Are PPO’s the Problem? Here’s What They Don’t Want You to Know. (Ep. 32)

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In this episode, Ralph Weber is joined once again by compliance strategist Ann Lewandowski to dive deep into the unseen world of healthcare data, who owns it, who profits from it, and what most employer contracts don’t actually protect.

They break down the illusion of “transparency” in benefit plans, the legal blind spots of HIPAA, and the skyrocketing value of employee data in today’s AI-driven ecosystem. Ann shares how contracts that don’t explicitly restrict de-identified data sales could cost employers millions, and why plan sponsors must learn to read between the lines.

You’ll also hear how new privacy laws (like the California Consumer Privacy Act) could impact your plan, whether you realize it or not. If you’re an HR leader, CFO, or benefits broker still trusting your vendors without verifying what’s under the hood… this episode is your wake-up call.

00:00 Data-Driven Decision Making in Healthcare
04:03 Understanding Healthcare Data Management
04:47 The Role of AI in Healthcare
06:21 Navigating Healthcare Regulations and Privacy
07:13 Contracting with Third-Party Vendors
08:14 The Value of Data in Healthcare
11:02 The Limitations of HIPAA
12:49 Contract Clauses and Data Protection
15:47 The Importance of Data Breach Language
18:16 The Need for Independent Healthcare Consulting
19:50 Understanding Pharmacy Benefit Managers (PBMs) and Rebates
23:08 Transparency in Healthcare Contracts

Host:
Ralph Weber
📧 ralph@thebenefitwhisperer.com
📞 (832) 924-3330
🔗 fixmybenefitsnow.com

Guest:
Ann Lewandowski
Founder, Healthcare Rebel Alliance
📧 ann@hcrebelalliance.com
🔗 hcrebelalliance.com
🔗 linkedin.com/in/annlewandowski

 

Trust, But Verify: Why Your TPA May Be Selling Your Employees’ Data (Ep. 31)

Trust, But Verify: Why Your TPA May Be Selling Your Employees’ Data (Ep. 31)

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Ralph Weber welcomes back Ann Lewandowski to unpack one of the most overlooked threats in benefits: your data. This episode exposes how TPAs and PBMs can legally profit from “de-identified” plan data, why HIPAA offers false comfort, and what transparency should mean in 2025. If you’re a plan sponsor, this is essential listening.

00:00 The Importance of Trust in Benefits

02:35 Understanding Healthcare Operations and Compliance

05:12 Evaluating Individual vs. Group Health Plans

08:10 The Role of Fiduciaries in Employee Benefits

10:45 Identifying Misaligned Incentives

13:18 Trust but Verify: The Need for Transparency

16:08 Employee Trust and Data Privacy

18:56 Wellness Programs and Legal Risks

21:32 The Future of Wellness Litigation

24:16 Data-Driven Decision Making in Healthcare

Guest: Ann Lewandowski

Website: hcrebelalliance.com

Email: ann@hcrebelalliance.com

LinkedIn: linkedin.com/in/annlewandowski

 

Host: Ralph Weber

Website: FixMyBenefitsNow.com

Free Consultation: bit.ly/3WiO5zY

Email: Ralph@thebenefitwhisperer.com

LinkedIn: https://www.linkedin.com/in/ralphweber/

 

The PBM Princess: From Rebate Myths to Deception, How PBMs Hide True Rx Costs (Ep. 30)

The PBM Princess: From Rebate Myths to Deception, How PBMs Hide True Rx Costs (Ep. 30)

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On this episode of The Benefit Whisperer, Ralph Weber interviews Rachel Strauss, the “PBM Princess,” to expose how pharmacy benefit managers manipulate contracts, rebates, and definitions to extract margin from employers. They break down contract landmines, phony transparency language, weak audit clauses, and the real story behind “100% pass-through.”

If you’re an employer, broker, or benefits leader struggling to contain pharmacy costs, this episode is your roadmap to fighting back.

00:00 Understanding Pharmacy Benefits and PBMs

01:17 Contract Landmines and Definitions

03:58 Rebates and Their Implications

06:24 Guarantees and Risk in PBM Contracts

09:56 Audit Rights and Transparency

15:37 The Illusion of Pass-Through Pricing

18:39 Prior Authorization and Cost Management

23:06 Navigating High Deductible Health Plans

26:46 The Need for Transparency in Healthcare Pricing

Guest:
Rachel Strauss • rachelmstrauss.com
LinkedIn: linkedin.com/in/rachelmstrauss
Email: rachel@rachelmstrauss.com

Host:
Ralph Weber • ralph@thebenefitwhisperer.com
Phone: (832) 924-3330
Website: fixmybenefitsnow.com

Schedule a FREE consultation with Ralph: https://calendly.com/ralph-weber-routethree?utm_source=blubrry&utm_medium=emails&utm_campaign=ep30&utm_id=podcast
What If You Could Pay the Hospital with a QR Code? (Ep. 29)

What If You Could Pay the Hospital with a QR Code? (Ep. 29)

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A trillion dollars.

That’s how much the U.S. loses every single year, not on doctors or medicine, but on the billing chaos of healthcare.

In this episode, Ralph Weber unveils something quietly revolutionary: Noverasys. It’s not just a payment system, it’s a reset button for healthcare costs. One where hospitals get paid instantly, patients stop drowning in surprise bills, and employers finally get transparency and control.

You’ll hear how a $240 prescription became $46 in seconds…why hospitals secretly love cash… and what happens when the patient, not the insurer, becomes the payer. This isn’t theory. It’s happening. And it could change everything.

What you’ll discover in this episode:

  • Why traditional insurance payment rails waste billions, and how Noverasys eliminates that inefficiency
  • Real-world examples of instant-pay models saving employers and employees thousands of dollars
  • How QR-code payment systems make healthcare transactions faster, cheaper, and cyber-secure
  • The hidden opportunity for employers to give employees lower costs and more choice while protecting their bottom line
  • And more!

Resources:

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