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A significant part of the Healthesystems vision is to create a more integrated experience for our customers

Advocacy & Compliance

Healthesystems’ Advocacy & Compliance experts are essential in the management of pharmacy and ancillary benefits for our clients. By tracking and influencing regulatory activity, our team stays  ahead of evolving trends and identifies opportunities to advocate on behalf of our clients, their injured workers, and the broader industry.

The Advocacy & 
Compliance Team

Monitors and reports on proposed and pending regulatory changes that impact workers' comp, helping shape effective program strategies

Advocates for fair and balanced public policy through proactive engagement with regulators, customers, and other stakeholders throughout the rulemaking lifecycle

Supports operational compliance by providing guidance to internal stakeholders and external partners during the implementation of new regulatory changes

Regulatory Tracking

To track relevant regulatory trends across the nation, access our interactive map.
Go to Map

Regulatory Recap

A weekly e-newsletter informed by our Advocacy & Compliance team to help keep our clients and industry contacts in the know on the latest legislation and policy updates impacting workers' comp. Explore our complete article repository below.

California P&T Committee to Meet on April 16th

The hybrid meeting will cover the pharmacy fee schedule, biosimilars, cannabis coverage, and payments for topical drugs.
Read More →
April 14, 2025

California Releases Report on Independent Medical Reviews

A total of 199,651 IMR applications were received in 2024, with pharmaceuticals making up 32.7%.
Read More →
April 14, 2025

Louisiana Proposes a Workers’ Comp Fee Schedule

The bill could require biennial updates, utilizing RVUs form the resource-based relative value scale (RBRVS).
Read More →
April 14, 2025

Nevada Now Considering Evidence-Based Formulary After Bill Hearing

Senate Bill 317 originally focused on provider panels, but a recent hearing amended the bill to include a workers’ comp formulary.
Read More →
April 14, 2025

Ohio Withdraws Outpatient Medication Reimbursement Rules

Filed in October 2024, the amendments aimed to adjust AWP discount rates and standardize dispensing fees.
Read More →
April 14, 2025

Wisconsin May Expand PTSD Presumption to Emergency Medical Workers and Others

The existing presumption only applies to firefighters and law enforcement officers, while this new bill would apply to other first responders.
Read More →
April 14, 2025

WCRI Publishes Study on Degenerative and Comorbid Conditions

Approximately 38.8% of claims had one or more comorbidities, based on an analysis of 930,000 claims with at least 7 days lost time across 32 states.
Read More →
April 7, 2025

California Considers Updates to Billing Disputes Over Contracted Discounts

These disputes would qualify for independent bill review, and contracts must be presented when justifying payments below fee schedule.
Read More →
April 7, 2025

Connecticut Proposes Expansion to PTSD Presumption

A new qualifying event would include witnessing a serious physical injury that does not result in death or permanent disfigurement.
Read More →
April 7, 2025
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 Further resources you may be interested in

Additional articles and updates from Healthesystems related to policy shaping workers’ comp.

PTSD Presumptions Continue to See Activity

New York backpedaled on a PTSD presumption for all workers, while California considers a PTSD presumption for healthcare workers.
Read More

Psilocybin and Ketamine Therapy Bills Introduced Across the Country

So far, seven psilocybin therapy bills have been introduced in 2025, with three ketamine therapy bills.
Read More

Digital Therapeutics: The Promise of Better Health Outcomes for Injured Workers

Digital therapeutics products aim to improve patient health outcomes. What are their applications in workers’ comp?
Read More

A Hot Topic: The Latest News on Workers and Extreme Heat

Extreme heat continues to be a serious risk for workers. What are the latest heat-related developments in workers’ comp?
Read More

2025 Workers’ Comp Industry Insights Survey Report

The seventh annual survey report highlights the top challenges and priorities for 515 industry stakeholders.
Read More

Flurry of States Eye Updates for Cancer and PTSD Presumptions

Various states are proposing modifications to existing presumptions to expand coverage for first responders.
Read More
1 2 3 … 41

 Interactive Map

To interact with this map, use the drop-downs to select a topic and type, then click the Display button. You can then roll over and click on individual states for more detailed information. This map represents legislation proposed during the most recent legislative cycle, typically spanning two years in most states. All current regulations are displayed up to present.
The content above is representative of topics Healthesystems proactively monitors and reports on. While not all topics are directly applicable to workers' compensation claims, some may have potential to impact workers' compensation in the future.
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