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.

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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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Claim Costs Industry Data

NCCI Reports on Medical Inflation Highlights

While overall medical inflation remains low, certain tariffs are still pending, which could impact long-term costs.

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August 4, 2025

California Publishes 2025 State of the System Report

Medical costs went up 8% in 2024, driven by increased utilization, fee schedule inflation, and growth in medical-legal services.

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August 4, 2025

Advocacy Opportunity Cost Containment

California Sees Delay to Utilization Review Regulations

The Office of Administrative Law informed the DWC that seven areas of the proposed update required additional clarification or public notice.

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August 4, 2025

Industry Data

NCCI Publishes Labor Market Insights

147,000 new jobs were reported in June, though half were driven by likely-seasonal education jobs.

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July 28, 2025

Industry Data

NCCI Publishes Industry Trends Report

While claim severity decreased across all industries, construction saw the steepest decline since 2015.

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July 28, 2025

Access to Care Claim Costs Industry Data

WCRI Reports on Advanced Practitioners and Workers’ Comp Outcomes

Initial treatment from nurse practitioners saw a 2.3% shorter time from injury to the first non-emergency service.

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July 28, 2025

Claim Costs Industry Data

Minnesota Publishes Workers’ Comp System Trends Report

The report covers trends from 2003 to 2023, looking at claim frequency and costs, vocational rehab, dispute resolutions, and more.

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July 28, 2025

Claim Costs

California Increases Advisory Pure Premium Rate

An 8.7% increase will take effect on September 1, 2025, slightly below the WCIRB’s suggested 11.2% increase.

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July 28, 2025

Advocacy Opportunity Cost Containment

CMS Proposes Update to Physician Fee Schedule

The proposed changes would impact reimbursement rates, telehealth services, and much more.

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July 21, 2025

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Further resources you may be interested in

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

Expert Q&A: Cybersecurity Tactics in Workers’ Compensation

RxInformer editors sat down with Healthesystems’ AVP of Information Security and resident cybersecurity expert, Tony Brown, to discuss how cyber threats affect workers’ comp organizations.

Drug Pricing Legislation and Its Impact on Workers' Comp

Lawmakers look to regulate the U.S. drug supply chain in ways that could impact workers’ comp pharmacy management.

High Prices, High Impact: Meet the Drugs Driving Up Claim Costs in Workers’ Comp

High-impact drugs, including topicals and compounds, represent proportionately low utilization compared to opioids or NSAIDs, but they can increase pharmacy spend exponentially on impacted claims.