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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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Alaska Considers Reimbursement Changes for Home Health, DME, And Ambulance Services

The proposed changes will be discussed further in the next meeting on July 18th.
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July 14, 2025

Wisconsin WCAC Meeting Shares Key Regulatory Updates

Among other updates, Wisconsin will implement a hospital fee schedule by July 1, 2027.
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July 14, 2025

California P&T Committee Reviews Drug List Changes

The July 16th meeting will review upcoming MTUS changes, which go into effect August 6th.
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July 14, 2025

California Reports on Independent Medical Reviews (IMRs)

The report reviews 1.57 million IMR decision letters from 2015 through March 2025.
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July 14, 2025

California Proposes Multiple New Presumptions for Hospital Workers

Senate Bill 632 would grant these workers presumptions for musculoskeletal injuries, COVID-19, respiratory disease, cancer, and PTSD.
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July 14, 2025

Maine Indefinitely Extends PTSD Presumption for First Responders

Set to expire on October 30th, the state’s PTSD presumption no longer faces an expiration date.
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July 14, 2025

New Jersey May Require Counseling for First Responders After Traumatic Incidents

Up to 12 hours of counseling must be provided by workers’ comp – with up to 24 hours more if a mental health professional finds it necessary.
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July 14, 2025

WCRI Publishes Report on Post-Inflation Trends in Medical Payments

From 2021 to 2024, medical payments per claim increased by about 5% per year in most states, rebounding from earlier pandemic-related declines.
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July 14, 2025

WCRI Reports on High-Cost Claims with Rotator Cuff Disorders

In rotator cuff claims exceeding $65,000 in costs within 36 months of injury, surgery was present 85% of the time.
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July 14, 2025
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 Further resources you may be interested in

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

State of the Nation

A roundup of regulatory activity around the country
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Congress Urges USPS to Adopt Department of Labor’s Proposed Heat Protections

The push comes after a letter carrier died after working without air conditioning in 95° weather.
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FDA Rejects MDMA for PTSD – Clinical Research to Continue for Psychedelics

The FDA requested additional trial data, with researchers eager to continue psychedelic trials.
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In Person, In Print, and On Stage: Connect with Healthe at National Comp 2024!

Stop by our educational session or visit our booth for the latest issue of RxInformer magazine.
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Worker Heat Protections Continue to Make Waves

The U.S. Department of Labor proposed new rules, while other states introduce legislation.
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WCRI Reports on Drug Payment Trends

Dermatologicals made up the largest share of drug payments, with NSAIDs coming in second.
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