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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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NCCI Economic Outlook for Q4 2025

This new report focuses on the economic impacts of the recent 43-day government shutdown.
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December 15, 2025

NCCI Reports on Interstate Regional Cost Differences

The report provides a collection of actuarial metrics across three of the NCCI’s largest jurisdictions by population – Florida, Illinois, and Texas.
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December 15, 2025

Indiana and Washington Introduce Provider Choice Bills

If enacted, Indiana House Bill 1069 would go into effect July 1, 2026, while Washington Senate Bill 5847 would go into effect June 30, 2027.
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December 15, 2025

New York Pharmacy Network Bill Vetoed by Governor

The bill would have duplicated existing protections for filling certain prescription out-of-network.
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December 8, 2025

Expanding Access to Care Across the Country

Delaware reported success with a recent bill, while Washington State is undergoing rulemaking and the U.S. Senate introduced a new bill.
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December 8, 2025

Pennsylvania Supreme Court Reviews Drug Pricing Case

The case will examine the Bureau of Workers’ Compensation’s use of RED BOOK for calculating AWP.
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December 8, 2025

CMS Publishes 2026 Q1 NCCI Edits

Changes will impact DME supplier services, facility outpatient hospital services, and practitioner services.
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December 8, 2025

Delaware and Pennsylvania Expand Medical Data Call Reporting

Insurers with 0.25% of market share must begin sharing data by July 1, 2026, while those with lower market share must begin by January 1, 2027.
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December 8, 2025

Nevada Schedules Workshop to Review Reform Rule Changes

This workshop will cover rules around panel provider lists, delegating follow-up care to physician assistants, and other clerical matters.
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December 8, 2025
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 Further resources you may be interested in

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

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.
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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

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

Recent data insights, state proposals, and updates on federal rulemaking procedures.
Read More

FDA Issues Draft Guidance for the Use of AI in the Creation of Drugs and Medical Devices

The guidelines provide recommendations on using AI to demonstrate drug safety and effectiveness, and recommendations for AI-enabled medical devices.
Read More
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