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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 Recap

A weekly e-newsletter informed by the Advocacy & Compliance team to help keep our clients and industry contacts in the know on the latest legislation and policy updates impacting workers’ comp.
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Florida Proposes Prior Auth Requirements for Packs and Kits

Requiring prior authorization would likely reduce utilization, and by extension reduce spend.
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September 9, 2024

Ohio Issues Draft Rules for Outpatient Drug Payments

The AWP discount could go from a fixed 15% to a variable rate set by the BWC, with an annual review.
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September 9, 2024

California’s Indoor Heat Protections Go into Effect

When temperatures reach 87°F, employers must implement work-rest schedules and provide personal heat protective equipment, where feasible.
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July 29, 2024

WCRI Publishes Behavioral Health Report for New York State

About 3% of claims had services for behavioral health, representing 8% of total medical payments
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August 5, 2024

California WCRIB Releases State of the System Report

Pharmaceutical costs decreased 88% since 2012, but medical costs are increasing due to longer claim durations and inflationary updates to fee schedules.
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August 5, 2024

California Supreme Court Rules Rideshare Drivers are Contractors

Proposition 22's exemption for rideshare drivers was upheld after four years of litigation.
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August 5, 2024

WCRI Webinar on Interstate Variation in Drug Trends

Healthe attended the August 1st webinar to capture key findings.
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August 12, 2024

Massachusetts Considers Psychedelics Initiatives

A Voter Initiative may allow for therapeutic use, while a new bill could allow for a working group would explore treatment for veterans.
Read More →
August 12, 2024

WCRI Reports on Factors Associated with High-Cost Claims

High-cost claims are defined as the top 5% of medical payments within 36 months of injury.
Read More →
August 19, 2024

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 Further resources you may be interested in

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