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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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New York Bill Could Remove References to CDC Guidelines

Existing laws and guidelines that refer to CDC guidelines would shift to “nationally recognized clinical practice guidelines.”
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November 17, 2025

Texas Issues Data Call

The call focuses on annual experience and workers’ comp deductible plans for the period of January 1, 2025, through December 31, 2025.
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November 17, 2025

Wisconsin Introduces Significant Reform Bill

Assembly Bill 651 could impact benefits levels, PTSD presumptions, penalties, and more
Read More →
November 17, 2025

New Mexico Revises Rules for Fee Schedule Changes

Effective January 1st, CARC and RARC codes will be permitted for use in EOBs, leveraging nationally recognized standards.
Read More →
November 17, 2025

Massachusetts Advisory Council Discusses Medical Fee Schedule

The fee schedule has not been updated since 2009, resulting in low reimbursement rates, which has impacted access to care.
Read More →
November 17, 2025

CMS Finalizes 2026 Medicare Physician Fee Schedule

States that base their workers’ comp fee schedules on the CMS Fee Schedule may adopt these adjustments, which go into effect January 1st.
Read More →
November 17, 2025

White House Announces Deal to Expand Access to GLP-1 Medications

Qualifying CMS patients could face a co-pay of $50 a month for these highly popular drugs for obesity and diabetes.
Read More →
November 10, 2025

NCCI Reports on Medical Inflation Insights

Headline inflation rose 3% year over year in September, still above the Federal Reserve’s 2% target but well below 2022 levels.
Read More →
November 10, 2025

NCCI Reports on the Latest Trends in Medical Equipment Cost Share

Average medical equipment costs increased 87% from 2012-2024, with medical equipment representing 8.3% of total workers’ comp medical spend.
Read More →
November 10, 2025
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 Further resources you may be interested in

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

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

California Updates Pharmacy Fee Schedule

Among many changes, the state is replacing AWP with a new pricing model.
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Missouri Proposes Bill for Psilocybin Therapy

Medical use would be legalized, with legal protections for patients and physicians.
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New York Enacts Mental Injury Presumption for All Workers

All workers will now have the right to file a claim for mental injuries, based upon extraordinary work-related stress incurred on the job.
Read More

Texas Considers Making Infertility an Occupational Illness for First Responders

A proposed bill would apply to male and female reproductive systems for firefighters and EMTs.
Read More
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